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Verma M, Sangeeta K, Verma BK, Dubey DK, Mondal M, Mazumder MN, Khan HT, Verma V. The association between anti-smoking legislation and prevalence of acute respiratory illnesses in Indian children. PUBLIC HEALTH IN PRACTICE 2024; 7:100481. [PMID: 38419738 PMCID: PMC10901132 DOI: 10.1016/j.puhip.2024.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Exposure to tobacco smoke causes numerous health problems in children, and create burden on the population in terms of economy, morbidity and mortality. In order to protect the child from exposure to tobacco smoke in the outdoor environment, sufficient legislative enactments are available in Indian legislation. The objective of the present study is to investigate the fact that in absence of any specific laws stating about protection of children from exposure to tobacco smoke in indoor environment, whether outdoor related legislations are sufficient to protect children from exposureand to explore the scope for enforcement of both state and central laws in improving health of children in India. Study design The study considered cross-sectional survey data of Demographic and Health Survey Data on India, National Family and Health Survey fourth round (NFHS-4) for the year 2015-16 on Indian children (below age of four). Methods Both bivariate and multivariate logistic regression models were used to assess the impact of anti-smoking laws on the prevalence of acute respiratory infection (ARI) based on the place of residence, indoor tobacco smoke exposure and age of the child. Results The results have shown an inclination of ARI among children in association with states having single law, rural area resident, exposure to indoor tobacco smoke and age of the child, both as independent or in combination are quite conspicuous, and are found to be underestimated. The logistic regression also revealed the influence of these factors both as independent and even in interaction with other. Conclusions Legislative intervention through both at central (or national)and state levels through anti-smoking laws will decrease the indoor tobacco smoke exposure as a result ARI prevalence will also decrease among children in India.
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Affiliation(s)
- Mamta Verma
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - K. Sangeeta
- HRC HOSPITAL, Hyderabad, 500016, Telangana, India
| | | | - Dharmendra Kumar Dubey
- Department of Biostatistics, School of Allied Health Sciences (SAHS), Sharda Hospital, Sharda University, Uttar Pradesh, 201310, India
| | - Mukul Mondal
- Department of Law, Kazi Nazrul University, West Bengal, 713340, India
| | - Mousumi Nath Mazumder
- Indian Council of Social Science Research (ICSSR), JNU Institutional Area, Aruna Asaf Ali Marg, New Delhi, 110067, India
| | - Hafiz T.A. Khan
- Health Promotion and Public Health, College of Nursing, Midwifery and Healthcare, University of West London, Paragon House, Boston Manor Road, Brentford, TW8 9GB, United Kingdom
| | - Vivek Verma
- Department of Statistics, Assam University, Silchar, Assam, 788011, India
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Venrick SJ, Margolis KA, Bernat JK, Donaldson E, Pepper JK, Eggers ME, Nonnemaker JM. Believability of messaging concerning a hypothetical product standard to lower a constituent in cigarettes or smokeless tobacco among U.S. Adults who use tobacco. Prev Med Rep 2024; 37:102544. [PMID: 38169982 PMCID: PMC10758972 DOI: 10.1016/j.pmedr.2023.102544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
The U.S. Food and Drug Administration (FDA) has regulatory authority to implement tobacco product standards to reduce harmful and potentially harmful constituents (HPHCs). This study examines people who use tobacco products' awareness of FDA's tobacco regulatory authority, knowledge of HPHCs, and belief in hypothetical tobacco product standard statements. We recruited adults who reported currently using tobacco (N = 1,592) from the National Panel of Tobacco Consumer Studies and randomized them to one of four conditions. Participants viewed a stimulus which consisted of a statement about a hypothetical product standard that would reduce the level of a chemical in cigarettes or smokeless tobacco (ST) and reduce cases of cancer or heart attack and stroke. A small majority of participants correctly believed that FDA regulates tobacco; however, the percentage of participants who recognized HPHCs varied widely depending upon the chemical. People who currently use ST found chemical and health statements more believable than people who did not currently use ST. Participants found it more believable that cigarettes, not ST, could be made with fewer harm-causing chemicals, and their belief in the chemical and health statements did not differ based on the health outcome specified in the hypothetical product standard statement.
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Affiliation(s)
- Samantha J. Venrick
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
| | - Katherine A. Margolis
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
| | - Jennifer K. Bernat
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
| | - Elisabeth Donaldson
- Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
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Ganz O, Wackowski OA, Strasser AA, Jeong M, Villanti AC, Miller Lo E, Talbot EM, Delnevo CD. Emergence and growth of 'natural' cigars in the USA. Tob Control 2023; 33:137-140. [PMID: 36282630 PMCID: PMC9718888 DOI: 10.1136/tobaccocontrol-2022-057396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Andrew A Strasser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle Jeong
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Andrea C Villanti
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Erin Miller Lo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Eugene M Talbot
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
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Kheirkhah Rahimabad P, Jones AD, Zhang H, Chen S, Jiang Y, Ewart S, Holloway JW, Arshad H, Eslamimehr S, Bruce R, Karmaus W. Polymorphisms in Glutathione S-Transferase ( GST) Genes Modify the Effect of Exposure to Maternal Smoking Metabolites in Pregnancy and Offspring DNA Methylation. Genes (Basel) 2023; 14:1644. [PMID: 37628696 PMCID: PMC10454475 DOI: 10.3390/genes14081644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Maternal smoking in pregnancy (MSP) affects the offspring's DNA methylation (DNAm). There is a lack of knowledge regarding individual differences in susceptibility to exposure to MSP. Glutathione S-transferase (GST) genes are involved in protection against harmful oxidants such as those found in cigarette smoke. This study aimed to test whether polymorphisms in GST genes influence the effect of MSP on offspring DNAm. Using data from the Isle of Wight birth cohort, we assessed the association of MSP and offspring DNAm in 493 mother-child dyads (251 male, 242 female) with the effect-modifying role of GST gene polymorphism (at rs506008, rs574344, rs12736389, rs3768490, rs1537234, and rs1695). MSP was assessed by levels of nicotine and its downstream metabolites (cotinine, norcotinine, and hydroxycotinine) in maternal sera. In males, associations of hydroxycotinine with DNAm at cg18473733, cg25949550, cg11647108, and cg01952185 and norcotinine with DNAm at cg09935388 were modified by GST gene polymorphisms (p-values < 0.05). In females, associations of hydroxycotinine with DNAm at cg12160087 and norcotinine with DNAm at cg18473733 were modified by GST gene polymorphisms (p-values < 0.05). Our study emphasizes the role of genetic polymorphism in GST genes in DNAm's susceptibility to MSP.
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Affiliation(s)
- Parnian Kheirkhah Rahimabad
- Division of Epidemiology, Biostatistics, and Environmental Health Sciences, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (P.K.R.); (H.Z.); (Y.J.); (S.E.)
| | - A. Daniel Jones
- Department of Biochemistry & Molecular Biology, Michigan State University, East Lansing, MI 48824, USA;
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health Sciences, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (P.K.R.); (H.Z.); (Y.J.); (S.E.)
| | - Su Chen
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Yu Jiang
- Division of Epidemiology, Biostatistics, and Environmental Health Sciences, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (P.K.R.); (H.Z.); (Y.J.); (S.E.)
| | - Susan Ewart
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824, USA
| | - John W. Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
| | - Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, Newport PO30 5TG, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Hampshire, Southampton SO16 6YD, UK
| | - Shakiba Eslamimehr
- Division of Epidemiology, Biostatistics, and Environmental Health Sciences, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (P.K.R.); (H.Z.); (Y.J.); (S.E.)
| | - Robert Bruce
- Department of Anesthesiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health Sciences, School of Public Health, University of Memphis, Memphis, TN 38111, USA; (P.K.R.); (H.Z.); (Y.J.); (S.E.)
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Wells AC, Lotfipour S. Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11628. [PMID: 38389806 PMCID: PMC10880762 DOI: 10.3389/adar.2023.11628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/28/2023] [Indexed: 02/24/2024]
Abstract
Maternal tobacco use and nicotine exposure during pregnancy have been associated with adverse birth outcomes in infants and can lead to preventable pregnancy complications. Exposure to nicotine and other compounds in tobacco and electronic cigarettes (e-cigarettes) has been shown to increases the risk of miscarriage, prematurity, stillbirth, low birth weight, perinatal morbidity, and sudden infant death syndrome (SIDS). Additionally, recent data provided by clinical and pre-clinical research demonstrates that nicotine exposure during pregnancy may heighten the risk for adverse neurodevelopmental disorders such as Attention-Deficit Hyperactivity (ADHD), anxiety, and depression along with altering the infants underlying brain circuitry, response to neurotransmitters, and brain volume. In the United States, one in 14 women (7.2%) reported to have smoked cigarettes during their pregnancy with the global prevalence of smoking during pregnancy estimated to be 1.7%. Approximately 1.1% of women in the United States also reported to have used e-cigarettes during the last 3 months of pregnancy. Due to the large percentage of women utilizing nicotine products during pregnancy in the United States and globally, this review seeks to centralize pre-clinical and clinical studies focused on the neurobehavioral and neurodevelopmental complications associated with prenatal nicotine exposure (PNE) such as alterations to the hypothalamic-pituitary-adrenal (HPA) axis and brain regions such as the prefrontal cortex (PFC), ventral tegmental area (VTA), nucleus accumbens (NA), hippocampus, and caudate as well as changes to nAChR and cholinergic receptor signaling, long-term drug seeking behavior following PNE, and other related developmental disorders. Current literature analyzing the association between PNE and the risk for offspring developing schizophrenia, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), anxiety, and obesity will also be discussed.
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Affiliation(s)
- Alicia C Wells
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Shahrdad Lotfipour
- School of Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Emergency Medicine, Pharmaceutical Sciences, Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, United States
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Cha SR, Jang J, Park SM, Ryu SM, Cho SJ, Yang SR. Cigarette Smoke-Induced Respiratory Response: Insights into Cellular Processes and Biomarkers. Antioxidants (Basel) 2023; 12:1210. [PMID: 37371940 DOI: 10.3390/antiox12061210] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Cigarette smoke (CS) poses a significant risk factor for respiratory, vascular, and organ diseases owing to its high content of harmful chemicals and reactive oxygen species (ROS). These substances are known to induce oxidative stress, inflammation, apoptosis, and senescence due to their exposure to environmental pollutants and the presence of oxidative enzymes. The lung is particularly susceptible to oxidative stress. Persistent oxidative stress caused by chronic exposure to CS can lead to respiratory diseases such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF), and lung cancer. Avoiding exposure to environmental pollutants, like cigarette smoke and air pollution, can help mitigate oxidative stress. A comprehensive understanding of oxidative stress and its impact on the lungs requires future research. This includes identifying strategies for preventing and treating lung diseases as well as investigating the underlying mechanisms behind oxidative stress. Thus, this review aims to investigate the cellular processes induced by CS, specifically inflammation, apoptosis, senescence, and their associated biomarkers. Furthermore, this review will delve into the alveolar response provoked by CS, emphasizing the roles of potential therapeutic target markers and strategies in inflammation and oxidative stress.
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Affiliation(s)
- Sang-Ryul Cha
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Jimin Jang
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Sung-Min Park
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Se Min Ryu
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Seong-Joon Cho
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
| | - Se-Ran Yang
- Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kangwon National University, 1 Kangwondaehak-gil, Chuncheon 24341, Republic of Korea
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Venrick SJ, Margolis KA, Bernat JK, Pepper JK, Nonnemaker JM, Eggers ME. Youth and adult understanding of public displays of information about harmful constituents in cigarette smoke. Prev Med 2023; 169:107458. [PMID: 36813248 PMCID: PMC10023421 DOI: 10.1016/j.ypmed.2023.107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
The U.S. FDA is required by law to publicly display a list of harmful and potentially harmful constituents (HPHCs) "by brand and by quantity in each brand and subbrand" in a format that is "understandable and not misleading to a lay person." An online experiment examined youth and adult understanding of which HPHCs are present in cigarette smoke, understanding of health effects of smoking cigarettes, and endorsement of misleading information after viewing HPHC information displayed in one of six formats. We recruited youth (N = 1324) and adults (N = 2904) from an online panel and randomized them to one of six formats of presenting HPHC information. Participants responded to survey items before and after exposure to an HPHC format. Understanding of HPHCs in cigarette smoke and understanding of health effects of cigarette smoking significantly increased pre- to post-exposure for all formats. Respondents (20.6% to 73.5%) endorsed misleading beliefs after exposure to information about HPHCs. Endorsement of the one misleading belief that was measured pre- and post-exposure significantly increased for viewers of four formats. All formats increased understanding of HPHCs in cigarette smoke and the health effects of smoking cigarettes, but some participants endorsed each misleading belief after exposure to HPHC information.
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Affiliation(s)
- Samantha J Venrick
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA.
| | - Katherine A Margolis
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer K Bernat
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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eldesouky M, Abd-elazim A, Elhakim H, Fayed H. Impact of KIF6 Trp719Arg gene variant on Coronary Artery Disease Development.. [DOI: 10.21203/rs.3.rs-2705882/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Coronary artery disease (CAD) is a multifactorial disease resulting from the interaction of genetic varia-tion and environmental traditional risk factors (TRFs), including diabetes mellitus, smoking, dyslipidemia, and hypertension. KIF6 Trp719Arg (rs20455; A>G) is an interesting gene variant reported as one of the most important risk factors for CAD in different populations. The study enrolled 150 participants belong-ing to the National Heart Institute (NHI) catheterization unit in Egypt, who were grouped into three main study groups regarding the presence of different TRFs. Biochemical investigations and clinical data were assessed and recorded. Analysis for KIF6 Trp719Arg polymorphism (rs20455; A>G) was performed for all participants using the TaqMan genotyping real-time PCR assay (rs20455). The study demonstrated that diabetes mellitus, hypertension, dyslipidemia, and smoking were highly statistically significant among CAD with TRF and non-CAD with TRF patients with p-values of 0.009*, 0.003*, 0.046*, and 0.001**, re-spectively. The family history of premature CAD represents a high percentage of CAD without TRF pa-tients compared to the other groups with a statistical difference of p-value= 0.004*. A high prevalence of AG+GG genotypes among the different groups was obtained, representing 66.0% of CAD with TRF, 76.0% of CAD without TRF, and 60% of non-CAD with TRF patients. The present study elucidated the impact of KIF6 Trp719Arg as a dependent risk factor for CAD, as it could have a significant role in CAD develop-ment when it interacts with one or more of the other traditional risk factors.
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Li C, Tian S, You J, Liu J, Li E, Wang C, Wang Q, Zhu Z, Fan D, Tian R. Qualitative determination of volatile substances in different flavored cigarette paper by using headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) combined with chemometrics. Heliyon 2022; 9:e12146. [PMID: 36685456 PMCID: PMC9850002 DOI: 10.1016/j.heliyon.2022.e12146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/08/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
In order to investigate the difference of volatile substances among flavored cigarette paper, which are supplied by several manufacturers with different batches, the stability of the complex system of scented cigarette paper was analyzed and evaluated. In this study, Headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) was used to detect the aroma compounds of 23 flavored cigarette paper samples. Based on fingerprint analysis, the differences and changes of aroma compounds of different samples were studied in the form of data visualization. Principal component analysis, partial least squares regression analysis, cluster heatmap analysis and artificial neural network analysis were used to evaluate the stability of different cigarette paper. The results show that: A total of 29 volatile substances were identified from different scented cigarette paper. Fingerprint analysis revealed that the volatile substances of different cigarette paper samples were roughly the same, but not the content. The results of chemometrics analysis showed that there were significant differences in the characteristic aroma compounds of cigarette paper from different manufacturers. HS-GC-IMS technology combined with chemometrics method could be applied to determine the difference of volatile substances among different flavored cigarette paper, which theoretically and technically supported the quality stability maintenance and identification of flavored cigarette paper processed in different places.
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Affiliation(s)
- Chao Li
- School of Environmental Science and Engineering, Kunming University of Science and Technology, No. 727 Jingming South Road, Chenggong District, Kunming 650500, China,Cigarette Product Quality Test Center, Technology Center of China Tobacco Yunnan Industrial Co., Ltd., Kunming 650023, China
| | - Senlin Tian
- School of Environmental Science and Engineering, Kunming University of Science and Technology, No. 727 Jingming South Road, Chenggong District, Kunming 650500, China
| | - Junheng You
- Cigarette Product Quality Test Center, Technology Center of China Tobacco Yunnan Industrial Co., Ltd., Kunming 650023, China
| | - Jinyun Liu
- Ministry of Technology, Yunnan Industrial Tobacco Hi-tech Material Co., Ltd., Kunming 650106, China
| | - E’xian Li
- Institute of Biotechnology and Genetic Resources, Yunnan Academy of Agricultural Sciences, Kunming 650223, China
| | - Chunqiong Wang
- Yunnan Tobacco Quality Supervision and Test Station, Kunming 650106, China
| | - Qinghua Wang
- Cigarette Product Quality Test Center, Technology Center of China Tobacco Yunnan Industrial Co., Ltd., Kunming 650023, China
| | - Zijian Zhu
- Chemmind Technologies Ltd., Beijing, 100022, China
| | - Duoqing Fan
- Cigarette Product Quality Test Center, Technology Center of China Tobacco Yunnan Industrial Co., Ltd., Kunming 650023, China,Corresponding author.
| | - Runtao Tian
- Chemmind Technologies Ltd., Beijing, 100022, China,Corresponding author.
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Byron MJ, Lazard AJ, Brewer NT. Is a cigarette brand with fewer chemicals safer? Public perceptions in two national US experiments. J Behav Med 2022; 45:812-817. [PMID: 35688959 PMCID: PMC10990283 DOI: 10.1007/s10865-022-00329-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 05/02/2022] [Indexed: 11/29/2022]
Abstract
By law, the US government must publicly display the quantities of harmful chemicals in cigarettes by brand, but doing so could mislead people to incorrectly think that some cigarettes are safer than others. We evaluated formats for presenting chemical quantities side-by-side to see if any were misleading. We recruited US convenience (n = 604) and probability (n = 1440) samples. We randomized participants to 1 of 5 formats: checklist, point estimates, ranges, a visual risk indicator, or no-quantity control. Participants were far more likely to incorrectly endorse one cigarette brand as riskier than the other in the checklist (65% made error), point estimate (67-70%), range (64-67%), or risk indicator (68-75%) conditions as compared to the no-quantity control (1%, all p < .001). Among smokers, erroneous risk perceptions mediated the impact of quantity format on interest in switching brands. People viewing chemical quantities for cigarette brands side-by-side misperceived differences in risk, suggesting limited public health value of this information.
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Affiliation(s)
- M Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, 590 Manning Dr, CB 7595, Chapel Hill, NC, 27599, USA.
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Current Knowledge and Novel Therapeutic Approaches Based on Pharmacokinetics and Pharmacodynamics in Stress-Induced Pathology. Medicina (B Aires) 2022; 58:medicina58070839. [PMID: 35888559 PMCID: PMC9318175 DOI: 10.3390/medicina58070839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
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Dalisay F, Pokhrel P, Buente W, Kawabata Y. Exposure to tobacco and betel nut content on social media, risk perceptions, and susceptibility to peer influence among early adolescents in Guam. Addict Behav Rep 2022; 15:100405. [PMID: 35434250 PMCID: PMC9006756 DOI: 10.1016/j.abrep.2021.100405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction This study aimed to examine the associations between exposure to tobacco and betel nut-related content on social media, perceived risks of tobacco and betel nut use, and susceptibility to peer influence for tobacco and betel nut use among adolescents living in Guam, a United States-Affiliated Pacific Island in the Western Pacific. Methods A representative survey of adolescents (N = 670) attending public middle schools on Guam was conducted. The survey measured exposure to tobacco and betel nut content on the following social media platforms: (a) Facebook, (b) Twitter, (c) Instagram, (d) Snapchat, and (e) WhatsApp. The survey also measured perceived risks of tobacco and betel nut use and susceptibility to peer influence for tobacco and betel nut use. Results Guam adolescents' exposure to tobacco-related content on social media was found to be associated with lower perceived risks toward the use of tobacco (β = -0.18, p < 0.001) and betel nut (β = -0.16, p < 0.001). Also, exposure to tobacco-related content on social media was found to be associated with higher levels of susceptibility to peer influence for uses of both tobacco (β = 0.10, p < 0.05) and betel nut (β = 0.15, p < 0.001). Similarly, exposure to betel nut-related content on social media was associated with lower perceived risks of using betel nut (β = -0.20, p < 0.001) and tobacco (β = -0.24, p < 0.001). Also, exposure to betel nut-related content on social media was associated with increased susceptibility to peer influence for use of both betel nut (β = 0.35, p < 0.001) and tobacco (β = 0.29, p < 0.001). Conclusions Adolescents' exposure to tobacco- and betel nut-related content on social media may influence attitudinal risk factors associated with tobacco and betel nut use.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam 96923, United States
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawaiʻi Cancer Center, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Wayne Buente
- School of Communications, University of Hawai’i at Manoa, 2550 Campus Road #304, Honolulu, HI 96822, United States
| | - Yoshito Kawabata
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam 96923, United States
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13
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Moodie C, O'Donnell R. 'I'm killing myself, but I'm saving the planet': rolling tobacco smokers' perceptions of rolling papers. Tob Control 2022; 31:479-482. [PMID: 33229464 DOI: 10.1136/tobaccocontrol-2020-056103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/28/2020] [Accepted: 10/12/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Despite the global growth of rolling tobacco, we are unaware of any research that has explored smokers' perceptions of the types of rolling papers available, or plain rolling papers, which are now required in Canada and Israel. METHODS Eight focus groups were conducted with rolling tobacco smokers (n=50) in Greater Glasgow (Scotland) between February and March 2020. Participants were shown a number of packs of promotional rolling papers (natural, transparent, prerolled cones, flavoured) and plain rolling papers. RESULTS Rolling papers were often viewed as functional, a necessity for making roll-ups. The appeal of papers was based on the packaging, with a booklet-style pack of natural papers viewed very positively, as well as novelty, usability and taste/smell. Participants often associated papers with particular users, with prerolled cones and some flavoured papers thought to be used by cannabis smokers or younger people and those just starting to smoke. In terms of harm perceptions, natural papers were viewed as a healthier choice than standard papers and more environmentally friendly, whereas transparent papers raised concerns about safety to both the user and the environment. Participants were generally ambivalent towards plain papers, which they did not feel would alter their purchasing or smoking behaviour, although some felt they may be less appealing to youth as the branding would be diminished. CONCLUSIONS The panoply of rolling papers available offers consumers considerable choice. As some promotional papers can increase appeal or create misperceptions of harm then standardising papers would help to counter this.
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Affiliation(s)
- Crawford Moodie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O'Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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14
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Archie SR, Sharma S, Burks E, Abbruscato T. Biological determinants impact the neurovascular toxicity of nicotine and tobacco smoke: A pharmacokinetic and pharmacodynamics perspective. Neurotoxicology 2022; 89:140-160. [PMID: 35150755 PMCID: PMC8958572 DOI: 10.1016/j.neuro.2022.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/30/2022] [Accepted: 02/05/2022] [Indexed: 01/01/2023]
Abstract
Accumulating evidence suggests that the detrimental effect of nicotine and tobacco smoke on the central nervous system (CNS) is caused by the neurotoxic role of nicotine on blood-brain barrier (BBB) permeability, nicotinic acetylcholine receptor expression, and the dopaminergic system. The ultimate consequence of these nicotine associated neurotoxicities can lead to cerebrovascular dysfunction, altered behavioral outcomes (hyperactivity and cognitive dysfunction) as well as future drug abuse and addiction. The severity of these detrimental effects can be associated with several biological determinants. Sex and age are two important biological determinants which can affect the pharmacokinetics and pharmacodynamics of several systemically available substances, including nicotine. With regard to sex, the availability of gonadal hormone is impacted by the pregnancy status and menstrual cycle resulting in altered metabolism rate of nicotine. Additionally, the observed lower smoking cessation rate in females compared to males is a consequence of differential effects of sex on pharmacokinetics and pharmacodynamics of nicotine. Similarly, age-dependent alterations in the pharmacokinetics and pharmacodynamics of nicotine have also been observed. One such example is related to severe vulnerability of adolescence towards addiction and long-term behavioral changes which may continue through adulthood. Considering the possible neurotoxic effects of nicotine on the central nervous system and the deterministic role of sex as well as age on these neurotoxic effects of smoking, it has become important to consider sex and age to study nicotine induced neurotoxicity and development of treatment strategies for combating possible harmful effects of nicotine. In the future, understanding the role of sex and age on the neurotoxic actions of nicotine can facilitate the individualization and optimization of treatment(s) to mitigate nicotine induced neurotoxicity as well as smoking cessation therapy. Unfortunately, however, no such comprehensive study is available which has considered both the sex- and age-dependent neurotoxicity of nicotine, as of today. Hence, the overreaching goal of this review article is to analyze and summarize the impact of sex and age on pharmacokinetics and pharmacodynamics of nicotine and possible neurotoxic consequences associated with nicotine in order to emphasize the importance of including these biological factors for such studies.
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Affiliation(s)
- Sabrina Rahman Archie
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Sejal Sharma
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Elizabeth Burks
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA
| | - Thomas Abbruscato
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center (TTUHSC), Amarillo, TX, USA.
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15
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Assessment Tear Film Parameters in Smokers and Subjects with a High Body Mass Index. Optom Vis Sci 2022; 99:358-362. [DOI: 10.1097/opx.0000000000001891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Tobacco Smoking and Liver Cancer Risk: Potential Avenues for Carcinogenesis. JOURNAL OF ONCOLOGY 2021; 2021:5905357. [PMID: 34925509 PMCID: PMC8683172 DOI: 10.1155/2021/5905357] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/27/2021] [Indexed: 12/20/2022]
Abstract
Smoking a cigarette generates over 4000 chemicals that have a deleterious impact on each part of the human body. It produces three main severe effects on the liver organ: oncogenic, immunological, and indirect or direct toxic effects. It results in the production of cytotoxic substances, which raises fibrosis and necro-inflammation. Additionally, it also directs the production of pro-inflammatory cytokines tumour necrosis factor alfa (TNF-α) and interleukins (IL-1β, IL-6) that will be responsible for the chronic liver injury. Furthermore, it gives rise to secondary polycythemia and successively raises the turnover and mass of red cells, which might be a common factor responsible for the development of oxidative stress in the liver due to iron overload. It also produces chemicals that are having oncogenic properties and raises the risk of liver cancer especially in sufferers of chronic hepatitis C. Smoking modulates both humoral and cell-mediated responses by restricting the proliferation of lymphocytes and inducing their apoptosis and ultimately decreasing the surveillance of cancer cells. Moreover, it has been determined that heavy smoking impacts the response of hepatitis C patients to interferon (IFN) therapy through different mechanisms, which can be improved by phlebotomy. Efforts are being made in different nations in decreasing the prevalence of smoking to improve premature death and ill effects of their nation's individuals.
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17
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Jin SW, Im JS, Park JH, Kim HG, Lee GH, Kim SJ, Kwack SJ, Kim KB, Chung KH, Lee BM, Kacew S, Jeong HG, Kim HS. Effects of tobacco compound 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) on the expression of epigenetically regulated genes in lung carcinogenesis. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2021; 84:1004-1019. [PMID: 34459362 DOI: 10.1080/15287394.2021.1965059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cigarette smoking is a major cause of lung cancer. Although tobacco smoking-induced genotoxicity has been well established, there is apparent lack of abundance functional epigenetic effects reported On cigarette smoke-induced lung carcinogenesis. The aim of this study was to determine effects of intratracheal administration of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) utilizing target gene expression DNA methylation patterns in lung tissues of mice following twice weekly for 8 weeks treatment. An unbiased approach where genomic regions was undertaken to assess early methylation changes within mouse pulmonary tissues. A methylated-CpG island recovery assay (MIRA) was performed to map the DNA methylome in lung tissues, with the position of methylated DNA determined using a Genome Analyzer (MIRA-SEQ). Alterations in epigenetic-regulated target genes were confirmed with quantitative reverse transcription-PCR, which revealed 35 differentially hypermethylated genes including Cdkn1C, Hsf4, Hnf1a, Cdx1, and Hoxa5 and 30 differentially hypomethylated genes including Ddx4, Piwi1, Mdm2, and Pce1 in NNK-exposed lung tissue compared with controls. The main pathway of these genes for mediating biological information was analyzed using the Kyoto Encyclopedia of Genes and Genomes database. Among them, Rssf1 and Mdm2 were closely associated with NNK-induced lung carcinogenesis. Taken together, our data provide valuable resources for detecting cigarette smoke-induced lung carcinogenesis.
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Affiliation(s)
- Sun Woo Jin
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Jong Seung Im
- School Of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jae Hyeon Park
- School Of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Hyung Gyun Kim
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Gi Ho Lee
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Se Jong Kim
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Seung Jun Kwack
- Department Of Biochemistry And Health Science, Changwon National University, Gyeongnam Republic of Korea
| | - Kyu-Bong Kim
- College Of Pharmacy, Dankook University, Chungnam, Republic of Korea
| | - Kyu Hyuck Chung
- School Of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Byung Mu Lee
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Sam Kacew
- McLaughlin Centre for Population Health Risk Assessment, University Of Ottawa, Ottawa, ON, Canada
| | - Hye Gwang Jeong
- College Of Pharmacy, Chungnam National University, Daejeon, Republic of Korea
| | - Hyung Sik Kim
- School Of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
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18
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Ahuja N, Kedia SK, Dillon PJ, Jiang Y, Yu X. Perception and intention of using less harmful and less addictive hypothetical modified risk tobacco products among never tobacco users in the united states. Addict Behav 2021; 122:107016. [PMID: 34147711 DOI: 10.1016/j.addbeh.2021.107016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 01/03/2023]
Abstract
AIMS There is limited research focusing on how never tobacco users respond to claims associated with modified risk tobacco products (MRTPs). The purpose of the present study is twofold: (1) to identify how never tobacco users perceive hypothetical modified risk tobacco product (MRTP) claims; and (2) to assess whether these perceptions impact their intentions of using MRTPs described as "less harmful" and "less addictive." METHOD The present study draws upon a nationally representative dataset of US adults aged ≥ 18 years (n = 850) from a cross-sectional survey (HINTS-FDA, Cycle 2, 2017). Weighted unadjusted and adjusted logistic regression analyses were performed to analyze the data. RESULTS Participants who perceived tobacco products labeled as having "no additives" to be less harmful were close to three times more likely to report intentions of using "less harmful" (Adjusted OR = 2.93 [95% CI: 1.12-7.65]) and "less addictive" (Adjusted OR = 2.72 [95% CI: 1.03-7.21]) tobacco products than those who perceived them to be more/equally harmful. Participants who believed that tobacco products could be manufactured without some chemicals were over five and six times more likely to report intentions of using "less harmful" (Adjusted OR = 5.53 [95% CI: 1.59-19.25]) and "less addictive" (Adjusted OR = 6.60 [95% CI: 2.65-16.46]) tobacco products than those who were unlikely to believe it. CONCLUSIONS Our findings have implications for FDA's regulation of MRTPs and provides insights regarding how the marketing of authorized MRTPs could impact population health in the future.
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Affiliation(s)
- Nikhil Ahuja
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA.
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, TN, USA.
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, TN, USA.
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19
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Moodie C, Best C, Critchlow N, Hitchman S, Stead M, McNeill A. The impacts of including information about the number of carcinogens in smoke on standardized cigarette packs in the UK. Eur J Public Health 2021; 31:1031-1037. [PMID: 34519345 PMCID: PMC8546877 DOI: 10.1093/eurpub/ckab101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Since May 2017, standardized packaging has been mandatory in the UK, with packs required to display an 'information message' explaining that there are more than 70 carcinogens in tobacco smoke. METHODS Three waves of a longitudinal online survey in the UK with smokers pre-standardized packaging (Wave 1: April-May 2016) and followed up post-standardized packaging (Wave 2: September-November 2017, Wave 3: May-July 2019). Of the 6233 smokers at Wave 1, 4293 responded at Wave 2 and 3175 at Wave 3. We explored knowledge of the number of carcinogens in smoke, and whether knowing that smoke contains more than 70 carcinogens mediated change in the belief that the dangers of smoking are exaggerated (risk perception), stubbing out cigarettes, quit intentions and quitting. As the information message is larger on roll-your-own packs than on cigarette packs, as the packs are larger, we also explored whether there was any difference in knowing that smoke contains more than 70 carcinogens between exclusive cigarette smokers and exclusive roll-your-own smokers. RESULTS Knowledge that there are over 70 carcinogens in smoke increased among smokers across waves, with the increase from Waves 1 to 3 greater for exclusive roll-your-own smokers than exclusive cigarette smokers (adjusted odds ratio=1.44; 95% CI 1.03-2.03). Knowledge that there are over 70 carcinogens in smoke mediated higher risk perception but not stubbing cigarettes out, quit intentions or quitting. CONCLUSIONS The information message improved knowledge of how many carcinogens are in smoke, particularly among exclusive roll-your-own smokers, and this was linked to higher risk perception.
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Affiliation(s)
- Crawford Moodie
- Faculty of Health Sciences and Sport, Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
| | - Catherine Best
- Faculty of Health Sciences and Sport, Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
| | - Nathan Critchlow
- Faculty of Health Sciences and Sport, Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
| | - Sara Hitchman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
| | - Martine Stead
- Faculty of Health Sciences and Sport, Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England
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20
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Baig SA. Bayesian inference: Parameter estimation for inference in small samples. Nicotine Tob Res 2021; 24:937-941. [PMID: 34679175 DOI: 10.1093/ntr/ntab221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/19/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Sabeeh A Baig
- Center for Tobacco Products, Food and Drug Administration, Document Control Center, Silver Spring, MD
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21
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Yang J, Hashemi S, Han W, Lee C, Song Y, Lim Y. Study on the daily Ad Libitum smoking habits of active Korean smokers and their effect on urinary smoking exposure and impact biomarkers. Biomarkers 2021; 26:691-702. [PMID: 34530669 DOI: 10.1080/1354750x.2021.1981448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Understanding interactions of smoking topography with biomarkers of exposure to tobacco is essential for accurate smoking risk assessments. METHODS In this study, the smoking topography and the levels of tobacco smoke exposure urinary biomarkers of a sample of active Korean smokers were quantified and measured. The results were used to investigate the effect of daily activities and smoking time on the smoking topography. Moreover, correlations between the smoking topography parameters and biomarkers were assessed. RESULTS No significant effect of either the daily activities or time on the smoking topography of the subjects were observed. Synchronic correlations of the cigarette consumption per day (CPD) and the average flow per puff with both urinary cotinine and trans-3'-hydroxycotinine were significant. For the urinary nicotine metabolites, the peak levels appeared when the CPD was over 19 cigarettes per day and the average puff velocity was between 35 and 45 ml/s. Nevertheless, when the average flow was over 60 ml/s, the levels of cotinine and trans-3'-hydroxycotinine significantly dropped. CONCLUSIONS The findings of this study may be beneficial for further smoking risk assessments with contributions of both the smoking topography and biomarkers to provide current smokers with applicable cession programs.Clinical significanceSmoking habits and levels of urinary biomarkers of Korean smokers are investigated.People with a higher dependency on nicotine smoke cigarettes with slower puffs.Effects of daily activities or time on smoking topography were not significant.Correlations between smoking topography and urinary biomarkers were significant.Peak biomarker levels were observed under certain smoking topography conditions.
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Affiliation(s)
- Jiyeon Yang
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shervin Hashemi
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Wonseok Han
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chaelin Lee
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Yoojin Song
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youngwook Lim
- Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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22
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SHAHI FATEMEH, POURRAZAVI SARA, KOUZEKANANI KAMIAR, JAFARABADI MOHAMMADASGHARI, ALLAHVERDIPOUR HAMID. Health warning messages on cigarette packs: how young smokers process it. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E742-E750. [PMID: 34909503 PMCID: PMC8639110 DOI: 10.15167/2421-4248/jpmh2021.62.3.2111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/14/2021] [Indexed: 12/01/2022]
Abstract
One of the major smoking prevention strategies has been to educate the public and increase people's awareness, using health-warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors based on the Elaboration Likelihood Model. This cross-sectional study was correlational in nature. The non-probability sample consisted of 387 tobacco smokers in the age range of 18 to 30 years old. The study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the investigation. It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health-warning message.
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Affiliation(s)
- FATEMEH SHAHI
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - SARA POURRAZAVI
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - KAMIAR KOUZEKANANI
- Department of Educational Leadership, College of Education & Human Development, TAMUCC, Corpus Christi, Texas, USA
| | | | - HAMID ALLAHVERDIPOUR
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence: Hamid Allahverdipour, Research Center of Psychiatry and Behavioral Sciences Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz 14711, Iran - E-mail:
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23
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King B, Borland R, Morphett K, Gartner C, Fielding K, O'Connor RJ, Romijnders K, Talhout R. 'It's all the other stuff!' How smokers understand (and misunderstand) chemicals in cigarettes and cigarette smoke. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2021; 30:777-796. [PMID: 33627027 DOI: 10.1177/0963662521991351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Many people understand chemicals as entities that do not occur naturally, and which are also invariably toxic. Tobacco control messages liberally use the term 'chemicals' to evoke these meanings and create concern among smokers. This may reinforce misunderstandings, potentially leading to smokers making harmful choices. To investigate smokers' understandings of chemicals, we conducted qualitative research using 18 individual interviews and three focus groups with Australian smokers and recently quit smokers. The research was guided by the 'mental models' framework and the recently developed Context, Executive, and Operational Systems theory. We discerned two clusters of mental models: the first cluster focused on combustion as the overarching cause of harm (and were largely consistent with the science) and the second cluster focused on additives as causes of harm. We found most participants displayed limited knowledge of the causes of harm from smoking and some held mutually incompatible beliefs. Most participants believed that cigarettes differ significantly in harmfulness according to whether or not they were believed to contain additives. Only a minority understood that the bulk of the toxicants to which smokers are exposed are combustion products. These findings are directly relevant to tobacco control but also have broader relevance to risk communications about toxic exposures.
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Affiliation(s)
| | | | | | | | | | | | | | - Reinskje Talhout
- Rijks Instituut voor Volksgezondheid en Milieu (RIVM) (National Institute for Public Health and Environment), The Netherlands
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24
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LORENSIA AMELIA, MUNTU CYNTHIAMARISCA, SURYADINATA RIVANVIRLANDO, SEPTIANI ROSLIN. Effect of lung function disorders and physical activity on smoking and non-smoking students. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E89-E96. [PMID: 34322622 PMCID: PMC8283647 DOI: 10.15167/2421-4248/jpmh2021.62.1.1763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
Background The number of young smokers is increasing, and hence their risk of respiratory problems. This risk is exacerbated by their low level of physical activity, which also reduces lung function. This study aimed to determine differences in lung function and levels of physical activity between smokers and non-smokers. Method This research was conducted from October 2019 to January 2020. The research design was cross-sectional, and a purposive sampling method was used. Pulmonary function was measured by means of spirometry, while physical activity was measured through a modified International Physical Activity Questionnaire (IPAQ). Results We enrolled 124 university students: 62 smokers and 62 non-smokers. A significant difference in lung function values (< 70 vs ≥ 70) was observed between smokers and non-smokers (p = 0.00). No difference (p = 0.907) in the level of physical activity was seen between smokers and non-smokers, with most subjects in both groups displaying moderate levels. Conclusions Students who smoked had more respiratory problems than those who did not. Although the level of physical activity did not correlate with respiratory problems, these problems were more common in the vigorous catgory.
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Affiliation(s)
- AMELIA LORENSIA
- Department of Clinical-Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
- Correspondence: Amelia Lorensia, Fakultas Farmasi Universitas Surabaya (UBAYA), Jl. Raya Kalirungkut Surabaya 60293, Indonesia - E-mail: -
| | - CYNTHIA MARISCA MUNTU
- Department of Pharmaceutical, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
| | | | - ROSLIN SEPTIANI
- Bachelor Student of Faculty of Pharmacy, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
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25
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Loken B, Borgida E, Wang T, Madzelan MK, Williams AL, Hatsukami D, Stepanov I. Can the Public Be Educated About Constituents in Smokeless Tobacco? A Three-Wave Randomized Controlled Trial. Nicotine Tob Res 2021; 23:161-170. [PMID: 32010948 PMCID: PMC7789948 DOI: 10.1093/ntr/ntz241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/19/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The U.S. Food and Drug Administration (FDA) is required by law to inform the public about levels of harmful and potentially harmful tobacco constituents in a format that is "understandable and not misleading to a lay person." Our study addresses a critical gap in research on communicating such information for smokeless tobacco (SLT) products. METHODS The design included random assignment to one of the experimental (online interactive) conditions differing in presentation format or a control condition (receiving no information). Experimental respondents viewed information on levels and health risks of 5 harmful constituents in up to 79 products. Outcome measures included knowledge of health risks of constituents, perception of constituent variability in SLT products, disease risk ratings, self-reported SLT use, and side-by-side product comparisons. The sample of 333 SLT users, 535 cigarette smokers, and 663 nontobacco users participated at baseline, time of intervention, and 6 weeks postintervention. RESULTS Presentation formats showed few systematic differences so were combined in analyses. Experimental condition respondents increased their knowledge about constituent health effects and their perceptions of constituent variability in SLT products, from baseline to postintervention, and relative to the control condition. Changes in respondents' ratings of disease risk and their estimates of constituent exposure from specific products were observed, but not in self-reported SLT use. CONCLUSIONS Interactive online graphic and numeric presentation formats can be efficient in increasing people's knowledge of health effects and perceived variation of constituents in SLT products. Further research on longer-term behavioral assessment, and usefulness of this approach for regulatory agencies, is needed. IMPLICATIONS Research on communicating the information about harmful constituents in SLT products to lay persons is critically lacking. This study proposes novel formats for effective communication about the levels and the health effects of SLT constituents to multiple user groups. The lack of misperceptions among study participants that some tobacco products are safe suggests that such formats can potentially be used for public display of SLT constituent data by the FDA and regulatory agencies in other countries.
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Affiliation(s)
- Barbara Loken
- Department of Marketing, Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Eugene Borgida
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Tzushuo Wang
- Department of Marketing, Carlson School of Management, University of Minnesota, Minneapolis, MN
| | - Molly K Madzelan
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Allison L Williams
- Department of Psychology, University of Minnesota, Minneapolis, MN
- Department of Psychology, Happify, New York, NY
| | - Dorothy Hatsukami
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
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A review of tobacco abuse and its epidemiological consequences. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:1485-1500. [PMID: 33425659 PMCID: PMC7786188 DOI: 10.1007/s10389-020-01443-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022]
Abstract
Aim The economic burden caused by death and disease in the world is credited mainly to tobacco use—currently linked to approximately 8,000,000 deaths per year with approximately 80% of these faralities reported in low and middle income economies. The World Health Organization (WHO) estimates that nearly 7,000,000 deaths are attributed to direct tobacco use, while approximately 1,200,000 non-smokers exposed to second hand cigarette smoke die every year. Accordingly, tobacco use is a major threat to the public health infrastructure; therefore, proper cessation interventions must be put in place to curb tobacco abuse and ease economic and social burdens caused by the tobacco epidemic. Methods A systematic review was conducted to investigate how scientific efforts have been advanced towards harm reduction among smokers and non-smokers. Relevant articles published during the period 2010–2020 in PubMed, Crossref, Google scholar, and Web of Science were used in this study. The articles were selected based on health impacts of cigarette smoking, tobacco cessation and emerging diseases, including Covid−19. Various cessation strategies have been identified although their efficiency is yet to match the desired results. Results A series of carcinogenic chemicals are generated during cigarette smoking resulting in serious health complications such as cancer and mutagenesis. The precursors for tobacco induced diseases are toxic and carcinogenic chemicals of the nitrosamine type, aldehydes, polonium-210 and benzo[a]pyrene, which bio-accumulate in the body system during cigarette smoking to cause disease. Rehabilitation facilities, use of drugs to diminish the desire to smoke, heavy taxation of tobacco products and warning labels on cigarettes are some of the cessation strategies employed towards curbing tobacco abuse. Conclusion The need for further research to develop better methods and research based policies for safe cigarette smoking and workable cessation strategies must be a priority in order to deal with the tobacco epidemic. Campaigns to promote tobacco cessation and abstinence are recommended in this review as a sure measure to mitigate against the deleterious impacts caused by cigarette smoking and tobacco abuse.
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Jeong M, Noar SM, Zhang D, Mendel JR, Agans RP, Boynton MH, Byron MJ, Baig SA, Ranney LM, Ribisl KM, Brewer NT. Public Understanding of Cigarette Smoke Chemicals: Longitudinal Study of US Adults and Adolescents. Nicotine Tob Res 2020; 22:747-755. [PMID: 30852611 DOI: 10.1093/ntr/ntz035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 03/05/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The US Food and Drug Administration has increased communication efforts that aim to raise public awareness of the harmful constituents (ie, chemicals) in cigarette smoke. We sought to investigate whether the public's awareness of these chemicals has increased in light of such efforts. METHODS Participants were national probability samples of 11 322 US adults and adolescents recruited in 2014-2015 (wave 1) and 2016-2017 (wave 2). Cross-sectional telephone surveys assessed awareness of 24 cigarette smoke chemicals at both timepoints. RESULTS The proportion of US adults aware of cigarette smoke chemicals did not differ between waves 1 and 2 (25% and 26%, p = .19). In contrast, awareness of chemicals among adolescents fell from 28% to 22% (p < .001), mostly due to lower awareness of carbon monoxide, arsenic, benzene, and four other chemicals. Belief that most of the harmful chemicals in cigarette smoke come from burning the cigarette also fell from waves 1 to 2 (adults: 31% vs. 26%; adolescents: 47% vs. 41%, both ps < .05). Participants were more likely to be aware of cigarette smoke chemicals if they had been exposed to anti-smoking campaign advertisements (p < .05) or had previously sought chemical information (p < .05). Cigarette smoke chemical awareness did not differ between smokers and nonsmokers. CONCLUSION Awareness of cigarette smoke chemicals remains low and unchanged among adults and decreased somewhat among adolescents. The association of chemical awareness with information exposure via campaigns and information seeking behavior is promising. More concerted communication efforts may be needed to increase public awareness of cigarette smoke chemicals, which could potentially discourage smoking. IMPLICATIONS Awareness of the toxic chemicals in cigarette smoke may contribute to quitting. The US Food and Drug Administration is making efforts to increase public awareness of these chemicals. Two national surveys (2014-2017) found that chemical awareness was low among adults and adolescents. Although awareness did not change among adults, awareness among adolescents dropped over time. In addition, exposure to anti-smoking campaigns and chemical information seeking behavior were associated with higher awareness of chemicals in cigarette smoke. Campaigns and other efforts may be needed to increase awareness of cigarette smoke chemicals.
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Affiliation(s)
- Michelle Jeong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.,School of Media and Journalism, University of North Carolina, Chapel Hill, NC
| | - Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, DC
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Robert P Agans
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Carolina Survey Research Laboratory, University of North Carolina, Chapel Hill, NC
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - M Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Leah M Ranney
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Lazard AJ. Design cues for tobacco communication: Heuristic interpretations and usability of online health information about harmful chemicals. Int J Med Inform 2020; 141:104177. [PMID: 32521448 PMCID: PMC7606338 DOI: 10.1016/j.ijmedinf.2020.104177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Many people have a poor understanding of the numerous chemicals in tobacco products that cause severe health harms. The US government must display a list of these harmful chemicals for the public. Online disclosures are one promising solution, but evidence is needed for effective design strategies to encourage interpretation and use of information as intended. METHOD To examine the impact of website designs for the activation of heuristics and usability perceptions, a national probability sample of US adolescents and adults (n = 1441) was randomized in a 3 (chemical format) × 2 (webpage layout) between-subjects online experiment. Chemicals were displayed as names only, with a visual risk indicator, or with numerical ranges. Layouts displayed health harms at the top of the webpage separate from chemicals or the chemicals grouped by associated health harms. Participants viewed a webpage and reported activated heuristics, usability (perceived ease of use and usefulness), and intentions to use the website. RESULTS Displaying risk indicators increased website usability by encouraging users to rely on colors to interpret the risk of the chemicals (all p < .01). Website designs that grouped chemicals with harms allowed users to link the chemicals to harms they cause and increased perceived usability and intentions to use the website (all p < .001). CONCLUSION Assessing heuristics gives insights for how US adolescents and adults interpret chemical information and the impact of design strategies on usability. Public disclosures of chemicals in tobacco products could be optimized with color-coded risk indicators and layouts placing chemicals near the harms they cause.
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Affiliation(s)
- Allison J Lazard
- School of Media and Journalism, University of North Carolina at Chapel Hill, NC 27599-3365, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC 27599-3365, United States.
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Baig SA. Bayesian Inference: An Introduction to Hypothesis Testing Using Bayes Factors. Nicotine Tob Res 2020; 22:1244-1246. [PMID: 31693135 DOI: 10.1093/ntr/ntz207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/04/2019] [Indexed: 11/13/2022]
Affiliation(s)
- Sabeeh A Baig
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
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Domingo-Relloso A, Riffo-Campos AL, Haack K, Rentero-Garrido P, Ladd-Acosta C, Fallin DM, Tang WY, Herreros-Martinez M, Gonzalez JR, Bozack AK, Cole SA, Navas-Acien A, Tellez-Plaza M. Cadmium, Smoking, and Human Blood DNA Methylation Profiles in Adults from the Strong Heart Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67005. [PMID: 32484362 PMCID: PMC7265996 DOI: 10.1289/ehp6345] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 03/18/2020] [Accepted: 04/22/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND The epigenetic effects of individual environmental toxicants in tobacco remain largely unexplored. Cadmium (Cd) has been associated with smoking-related health effects, and its concentration in tobacco smoke is higher in comparison with other metals. OBJECTIVES We studied the association of Cd and smoking exposures with human blood DNA methylation (DNAm) profiles. We also evaluated the implication of findings to relevant methylation pathways and the potential contribution of Cd exposure from smoking to explain the association between smoking and site-specific DNAm. METHODS We conducted an epigenome-wide association study of urine Cd and self-reported smoking (current and former vs. never, and cumulative smoking dose) with blood DNAm in 790,026 CpGs (methylation sites) measured with the Illumina Infinium Human MethylationEPIC (Illumina Inc.) platform in 2,325 adults 45-74 years of age who participated in the Strong Heart Study in 1989-1991. In a mediation analysis, we estimated the amount of change in DNAm associated with smoking that can be independently attributed to increases in urine Cd concentrations from smoking. We also conducted enrichment analyses and in silico protein-protein interaction networks to explore the biological relevance of the findings. RESULTS At a false discovery rate (FDR)-corrected level of 0.05, we found 6 differentially methylated positions (DMPs) for Cd; 288 and 17, respectively, for current and former smoking status; and 77 for cigarette pack-years. Enrichment analyses of these DMPs displayed enrichment of 58 and 6 Gene Ontology and Kyoto Encyclopedia of Genes and Genomes gene sets, respectively, including biological pathways for cancer and cardiovascular disease. In in silico protein-to-protein networks, we observed key proteins in DNAm pathways directly and indirectly connected to Cd- and smoking-DMPs. Among DMPs that were significant for both Cd and current smoking (annotated to PRSS23, AHRR, F2RL3, RARA, and 2q37.1), we found statistically significant contributions of Cd to smoking-related DNAm. CONCLUSIONS Beyond replicating well-known smoking epigenetic signatures, we found novel DMPs related to smoking. Moreover, increases in smoking-related Cd exposure were associated with differential DNAm. Our integrative analysis supports a biological link for Cd and smoking-associated health effects, including the possibility that Cd is partly responsible for smoking toxicity through epigenetic changes. https://doi.org/10.1289/EHP6345.
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Affiliation(s)
- Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
- Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
- Department of Statistics and Operations Research, University of Valencia, Spain
| | | | - Karin Haack
- Population Health Program, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Pilar Rentero-Garrido
- Precision Medicine Unit, Institute for Biomedical Research INCLIVA, Valencia, Spain
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Daniele M Fallin
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wan Yee Tang
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Juan R Gonzalez
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Anne K Bozack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Shelley A Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Maria Tellez-Plaza
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Area of Cardiometabolic and Renal Risk, Institute for Biomedical Research INCLIVA, Valencia, Spain
- Department of Chronic Diseases Epidemiology, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
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Baig SA, Byron MJ, Lazard AJ, Brewer NT. "Organic," "Natural," and "Additive-Free" Cigarettes: Comparing the Effects of Advertising Claims and Disclaimers on Perceptions of Harm. Nicotine Tob Res 2020. [PMID: 29529277 DOI: 10.1093/ntr/nty036] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The US Tobacco Control Act restricts advertising or labeling that suggests one tobacco product is less harmful than another. We sought to examine how "organic," "natural," and "additive-free" advertising claims and corresponding disclaimers affect perceptions of cigarettes' harm. METHODS Participants were a national probability sample of adults in the United States (n = 1114, including 344 smokers). We conducted a 5 (claim) × 2 (disclaimer) between-subjects factorial experiment. Participants viewed a Natural American Spirit cigarettes ad claiming they were "organic," "natural," "additive-free," "light," or "regular;" and with or without a corresponding disclaimer. The outcome was perceived harm of the advertised cigarettes. Among smokers, we also assessed interest in switching within their current brand to cigarettes with this characteristic (eg, "additive-free"). RESULTS Claims in the ad had a large effect on perceived harm (Cohen's d = 0.87, 95% CI = 0.47 to 1.29). Claims of cigarettes being "organic," "natural," or "additive-free" reduced perceived harm from the advertised cigarettes, as compared with "regular" and "light" claims. Disclaimers had a small effect, increasing perceived harm (d = 0.25, 95% CI = 0.08 to 0.41). The problematic claims also increased smokers' interest in switching. Disclaimers had no effect on smokers' interest in switching. CONCLUSIONS "Organic," "natural," and "additive-free" claims may mislead people into thinking that the advertised cigarettes are less harmful than other cigarettes. Disclaimers did not offset misperceptions of harm created by false claims. The US Food and Drug Administration should restrict the use of these misleading claims in tobacco advertising. IMPLICATIONS "Organic," "natural," and "additive-free" cigarette advertising claims decrease perceptions of harm among the public and increase interest in switching to such cigarettes among smokers. Disclaimers do not counteract the reduced perceptions of harm or increased interest in switching to these cigarettes. The US Food and Drug Administration should restrict the use of "organic," "natural," and "additive-free" claims in tobacco marketing.
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Affiliation(s)
- Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - M Justin Byron
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Allison J Lazard
- School of Media and Journalism, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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32
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Gonzales D, Bjornson WG, Markin CJ, Coleman TM, Favela F, Clemons N, Koudelka C, Lapidus JA. Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages at a University Hospital Tobacco Cessation Service. Jt Comm J Qual Patient Saf 2020; 46:250-260. [PMID: 32362354 DOI: 10.1016/j.jcjq.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/02/2020] [Accepted: 02/11/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking-particularly carbon monoxide exposure-to hospital recovery would stimulate more patient interest in the hospital's cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. METHODS Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the SM (January-April; n = 323) or the TM (April-November; n =374) were analyzed. RESULTS Multivariate regression analysis showed that the TM was associated with significantly greater agreement for follow-up (odds ratio [OR] = 10.83, 95% confidence interval [CI] = 3.66-32.04, p < 0.0001) than the SM. Those patients who received the TM were more willing to try to remain abstinent postdischarge (willingness score = 10, p = 0.0052) and engaged in longer consults (consult time > 10 minutes, p = 0.0075) than SM patients. TM patients also self-reported a higher continuous abstinence rate (OR = 2.07, 95% CI = 1.17-3.66, p = 0.0130] at follow-up than SM. CONCLUSION Linking risks of continued smoking, particularly carbon monoxide exposure, to hospital patients' immediate recovery following discharge in a treatment protocol resulted in longer consult times and increased agreement to follow-up compared to the usual protocol message. The TM was integrated into the hospital tobacco cessation intervention as standard of care.
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Seidenberg AB, Jo CL, Ribisl KM. Knowledge and Awareness of Added Sugar in Cigarettes. Nicotine Tob Res 2019; 21:1689-1694. [PMID: 30329106 DOI: 10.1093/ntr/nty217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/11/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Sugars naturally occur in tobacco leaf but are also commonly added to cigarettes by tobacco companies. Added sugar increases levels of toxic chemicals in cigarette smoke. Little is known about smokers' knowledge of added sugar in cigarettes and awareness of its effects. METHODS Adult cigarette smokers were recruited through Amazon Mechanical Turk to participate in an online experiment on electronic cigarette advertising. After completing the experiment, participants (N = 4351) answered two items assessing knowledge and awareness of added sugar in cigarettes. Participants had the option of providing open-ended comments about the overall study, and two reviewers read and independently coded comments pertaining to the sugar items. RESULTS Only 5.5% of participants responded "yes" to the question: "Is sugar added to cigarettes?", and only 3.8% of participants indicated being aware that added sugar increases toxins in cigarette smoke. Forty-eight participants mentioned the sugar items when asked to comment about the overall questionnaire. Fifty-two percent of these comments expressed an interest in obtaining more information about added sugar, and 23% described the sugar items as interesting or informative. Three participants commented that learning about added sugar motivated them to quit or cut down on smoking. CONCLUSIONS Among a large sample of smokers, few reported knowledge of added sugar in cigarettes and awareness of its effects. Further, several smokers expressed an interest in learning more about added sugar. Messages about added sugar in cigarettes may be a promising new angle for campaigns to discourage smoking. IMPLICATIONS Few American smokers are aware that sugar is added to cigarettes, and some participants expressed a desire to learn more about this additive. Given such low awareness, the interest among smokers, and increased popular concerns about added sugar in foods and beverages, messaging about added sugar in cigarettes should be developed and tested for inclusion in public health media campaigns.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Catherine L Jo
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Ranney LM, Kowitt SD, Queen TL, Jarman KL, Goldstein AO. An Eye Tracking Study of Anti-Smoking Messages on Toxic Chemicals in Cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4435. [PMID: 31726727 PMCID: PMC6888389 DOI: 10.3390/ijerph16224435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/28/2019] [Accepted: 11/07/2019] [Indexed: 12/04/2022]
Abstract
The US Food and Drug Administration is tasked with communicating information to the public about the harmful chemicals in cigarette smoke. Our study used eye tracking method to test the effectiveness of messages about the harmful chemicals in cigarettes smoke among adult smokers. A sample size of 211 current cigarette smokers viewed four communication messages that included: Health effects of a chemical in cigarette smoke and an image depicting the health effect. The messages focused on arsenic, formaldehyde, uranium, and general health. Eye tracking recorded the length of time participants viewed the text and the image. After each message, the participants were asked about the messages' effectiveness in changing attitudes towards smoking. We analyzed the data using multilevel modeling, and of the 211 smokers, 59.7% were female, 36.5% were Black, and 21.3% had a high school degree or less. Compared to the general message, the messages about formaldehyde and uranium were more discouraging to smoking (p < 0.05). Messages about formaldehyde were more believable and made participants want to quit more than the general messages. Increasing message dose was significantly associated with discouraging participants from smoking and made participants want to quit (p < 0.05). Our findings suggest that anti-smoking messages, containing chemical information, can successfully increase negative attitudes toward smoking cigarettes and potentially encourage quitting.
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Affiliation(s)
- Leah M. Ranney
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
| | - Sarah D. Kowitt
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
| | - Tara L. Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
| | - Kristen L. Jarman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
| | - Adam O. Goldstein
- Department of Family Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599, USA; (S.D.K.); (A.O.G.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, CB# 7295, Chapel Hill, NC 27599, USA; (T.L.Q.); (K.L.J.)
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King B, Borland R, Yong HH, Gartner C, Hammond D, Lewandowsky S, O'Connor R. Understandings of the component causes of harm from cigarette smoking in Australia. Drug Alcohol Rev 2019; 38:807-817. [PMID: 31691407 DOI: 10.1111/dar.12995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/19/2019] [Accepted: 08/26/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS To investigate relationships between smoking-related behaviours and knowledge of the disease risks of smoking and the causes of smoking harms, using a four-way division of 'component causes': nicotine, other substances found in unburned tobacco, combustion products of tobacco and additives. DESIGN AND METHODS The data were collected using an on-line survey in Australia with 1047 participants in three groups; young non-smokers (18 to 25), young smokers (18 to 25) and older smokers (26 and above). RESULTS Most participants agreed that cancer and heart disease are major risks of smoking but only a quarter accurately quantified the mortality risk of lifetime daily smoking. Very few (two of 1047) correctly estimated the relative contributions of all four component causes. Post-hoc analyses reinterpreting responses as expressions of relative concern about combustion products and nicotine showed that 29% of participants rated combustion products above nicotine. We delineated six relative concern segments, most of which had distinctive patterns of beliefs and actions. However, higher levels of concern about combustion products were only weakly positively associated with harm reducing beliefs and actions. DISCUSSION AND CONCLUSIONS Most smokers do not appear to understand the risks of smoking and their causes well enough to be able to think systematically about the courses of action open to them to reduce their health risk. To facilitate informed decision-making, tobacco control communicators may need to better balance the dual aims of creating fear/negative affect about smoking and imparting knowledge about the health harms and their mechanisms.
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Affiliation(s)
- Bill King
- Cancer Council Victoria and School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ron Borland
- Cancer Council Victoria and School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Melbourne, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, Herston University of Queensland, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland and Queensland Alliance for Environmental Health Sciences, Brisbane, Australia
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Stephan Lewandowsky
- School of Psychology, University of Western Australia, Perth, Australia.,School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, USA
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36
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Lazard AJ, Kowitt SD, Huang LL, Noar SM, Jarman KL, Goldstein AO. Believability of Cigarette Warnings About Addiction: National Experiments of Adolescents and Adults. Nicotine Tob Res 2019; 20:867-875. [PMID: 29059352 DOI: 10.1093/ntr/ntx185] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/28/2017] [Indexed: 11/15/2022]
Abstract
Introduction We conducted two experiments to examine the believability of three addiction-focused cigarette warnings and the influence of message source on believability among adolescents and adults in the United States. Methods Experimental data were collected using national phone surveys of adolescents (age 13-17; n = 1125; response rate, 66%) and adults (age 18+; n = 5014; response rate, 42%). We assessed the believability of three cigarette warnings about addiction attributed to four message sources (Food and Drug Administration [FDA], Surgeon General, Centers for Disease Control and Prevention [CDC], no source). Results The majority of adolescents and adults reported the three cigarette warnings were very believable (49%-81% for adolescents; 47%-76% for adults). We found four to five times higher odds of adolescents believing a warning that cigarettes are addictive (warning 1) or that nicotine was an addictive chemical (warning 2) compared to a warning that differentiated the addictive risks of menthol versus traditional cigarettes (warning 3), warning 1 adjusted odds ratio (aOR): 4.53, 95% confidence interval (CI): 3.10, 6.63; warning 2 aOR: 3.87, 95% CI: 2.70, 5.50. Similarly, we found three to five times higher odds of adults (including current smokers) believing the same warnings, warning 1 aOR: 3.74, 95% CI: 2.82, 4.95; warning 2 aOR: 3.24, 95% CI: 2.45, 4.28. Message source had no overall impact on the believability of warnings for either population. Conclusions Our findings support the implementation of FDA's required warnings that cigarettes are addictive and that nicotine is an addictive chemical. These believable warnings may deter adolescents from initiating smoking and encourage adults to quit smoking. Implications This article describes, for the first time, the believability of different cigarette warnings about addiction. We now know that the majority of adolescents and adults believe cigarette warnings that highlight cigarettes as addictive and that nicotine is an addictive chemical in tobacco. However, a warning that highlighted the relative risk of addiction for menthol cigarettes compared to traditional cigarettes was not as believable among either population. Our findings support the implementation of FDA's required warnings that cigarettes are addictive and that nicotine is an addictive chemical that may deter adolescents from initiating smoking and encourage adults to quit smoking.
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Affiliation(s)
- Allison J Lazard
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sarah D Kowitt
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Li-Ling Huang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kristen L Jarman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam O Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Lazard AJ, Byron MJ, Peters E, Brewer NT. Communicating about chemicals in cigarette smoke: impact on knowledge and misunderstanding. Tob Control 2019; 29:556-563. [PMID: 31462579 DOI: 10.1136/tobaccocontrol-2018-054863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 05/16/2019] [Accepted: 06/05/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The USA must publicly share information about harmful and potentially harmful constituents (chemicals) in tobacco products. We sought to understand whether webpages with chemical information are "understandable and not misleading to a lay person." METHODS Participants were a national probability sample of US adults and adolescents (n=1441, 18% smokers). In an online experiment, we randomly assigned participants to view one of the developed webpages (chemical names only, names with quantity ranges, names with visual risk indicators) or no webpage in phase one (between subjects). Participants completed a survey assessing knowledge, misunderstanding, perceived likelihood, perceived severity of health effects from smoking and quit intentions (smokers only). In phase two (within subjects), participants viewed all three webpage formats and reported webpage perceptions (clarity, usability, usefulness) and perceived impact (affect, elaboration, perceived effectiveness). RESULTS In phase one, viewing any webpage led to more knowledge of chemicals (48%-54% vs 28% no webpage, ps<0.001) and health harms (77% vs 67% no webpage, ps<0.001). When exposed to any webpage, 5%-23% endorsed misunderstandings that some cigarettes are safer than others. Webpage format did not affect knowledge or reduce misunderstandings. Viewing any webpage led to higher perceived likelihood of experiencing health effects from smoking (p<0.001) and, among smokers, greater intentions to quit smoking (p=0.04). In phase two, where participants viewed all formats, a visual risk indicator led to the highest perceived impact. CONCLUSIONS Knowledge of chemicals and health effects can increase after viewing a website. Yet, websites may not correct the misunderstanding that some cigarettes are safer.
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Affiliation(s)
- Allison J Lazard
- School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - M Justin Byron
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Health Behavior, Gillings School of Global Public, University of North Carolina, Chapel Hill, North Carolina, USA.,Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ellen Peters
- Psychology, Ohio State University, Columbus, Ohio, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA .,Department of Health Behavior, Gillings School of Global Public, University of North Carolina, Chapel Hill, North Carolina, USA
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Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101825. [PMID: 31126016 PMCID: PMC6572235 DOI: 10.3390/ijerph16101825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use recruited via Amazon Mechanical Turk (MTurk) completed an online survey in 2016 (analytic n = 706). Participants were randomly assigned to one of eight conditions differing in ECIG characteristics: nicotine content (no, low, high), flavor (menthol, tobacco, fruit), or modified risk message (reduced harm, reduced carcinogen exposure). Regressions assessed ECIG susceptibility, harm/addiction perceptions, and abuse liability indices (purchase task measures of breakpoint/intensity) within each regulatory domain (nicotine content, flavor, message) and their interactions with CTC/ECIG status. Differential effects on ECIG susceptibility, harm/addiction perceptions, and abuse liability indices were observed by regulatory domain with many effects moderated by CTC/ECIG status. ECIG nicotine content and flavor conditions were the most influential across outcomes. Greater nicotine content, tobacco-flavored and reduced carcinogen exposure ECIGs were more highly preferred by CTC smokers with some differing preferences for non-users. Findings reinforce consideration of discrete ECIG preferences across tobacco use status to improve regulatory efficacy.
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Baig SA, Byron MJ, Pepper JK, Brewer NT. Interest in "organic," "natural," and "additive-free" cigarettes after hearing about toxic chemicals in cigarette smoke. PLoS One 2019; 14:e0212480. [PMID: 30840639 PMCID: PMC6402619 DOI: 10.1371/journal.pone.0212480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 02/04/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The US Family Smoking Prevention and Tobacco Control Act requires the government to disseminate information about the toxic chemicals in cigarette smoke. We sought to understand how the descriptors "organic," "natural," or "additive-free" affect smokers' interest in cigarettes in the context of information about chemicals in cigarette smoke. METHODS Participants were a national probability sample of 1,101 US adult (ages ≥18) smokers recruited in 2014-2015. A between-subjects experiment randomized participants in a telephone survey to 1 of 4 cigarette descriptors: "organic," "natural," "additive-free," or "ultra-light" (control). The outcome was expected interest in cigarettes with the experimentally assigned descriptor, after learning that 2 chemicals (hydrogen cyanide and lead) are in cigarette smoke. Experimental data analysis was conducted in 2016-2017. RESULTS Smokers indicated greater expected interest in "organic," "natural," and "additive-free" cigarettes than "ultra-light" cigarettes (all p <.001) after learning that hydrogen cyanide and lead were in cigarette smoke. Smokers who intended to quit in the next 6 months expressed greater expected interest in the 4 types of cigarettes ("organic," "natural," "additive-free," and "ultra-light") compared to smokers not intending to quit (p <.001). CONCLUSIONS Smokers, especially those intending to quit, may be more inclined towards cigarettes described as "organic," "natural," and "additive-free" in the context of chemical information. An accumulating body of evidence shows that the US should fully restrict use of "organic" and "natural" descriptors for tobacco products as it has done for "additive-free" and "light" descriptors.
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Affiliation(s)
- Sabeeh A. Baig
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, United States of America
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - M. Justin Byron
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
- Department of Family Medicine, UNC School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Jessica K. Pepper
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Noel T. Brewer
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
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Gratale SK, Maloney EK, Cappella JN. Regulating language, not inference: an examination of the potential effectiveness of Natural American Spirit advertising restrictions. Tob Control 2019; 28:e43-e48. [DOI: 10.1136/tobaccocontrol-2018-054707] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 11/04/2022]
Abstract
ObjectiveIn 2017, the United States Food and Drug Administration (FDA) reached an agreement with Santa Fe Natural Tobacco Company (SFNTC) stipulating that SFNTC will remove ‘natural’ and ‘additive-free’ from Natural American Spirit (NAS) marketing to combat misperceptions that NAS is a healthier cigarette. The purpose of this study was to assess experimentally the potential effectiveness of the agreement in addressing NAS misperceptions.MethodsIn an online experiment, 820 current and former smokers were assigned randomly to advertising conditions with existing claims from NAS advertisements, modified claims or a no-exposure control. Advertising conditions included (1) ‘original’ NAS advertising text before the agreement; (2) ‘2017 agreement’ language permissible under the FDA–SFNTC agreement (removing ‘natural’, ‘additive-free’); (3) more restrictive (‘stricter’) language representing additional regulation (removing ‘natural’ from the brand name and the phrases ‘tobacco+water’, ‘no chemicals’). Participants completed outcome measures assessing misinformed beliefs and intentions towards NAS.ResultsOne-way ANOVA showed that relative to the ‘original’ language, the ‘2017 agreement’ language reduced misconceptions about NAS addictiveness, but not about health or constituent composition. Yet ‘stricter’ language significantly reduced all categories of misinformed beliefs, which in turn mediated effects on (lower) intentions to use NAS.ConclusionThe 2017 agreement helps dispel some misconceptions about NAS addictiveness, but does not sufficiently rectify misinformation about health or composition. Since ‘stricter’ language more effectively corrects misinformed beliefs, our results suggest the need for further regulations in addressing misinformation that drives intentions towards NAS.
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Kelley DE, Boynton MH, Noar SM, Morgan JC, Mendel JR, Ribisl KM, Stepanov I, Nylander-French LA, Brewer NT. Effective Message Elements for Disclosures About Chemicals in Cigarette Smoke. Nicotine Tob Res 2018; 20:1047-1054. [PMID: 28521063 PMCID: PMC6093311 DOI: 10.1093/ntr/ntx109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/12/2017] [Indexed: 11/13/2022]
Abstract
Introduction Cigarette smoke contains at least 93 chemicals or "constituents" that the Food and Drug Administration has identified as harmful and potentially harmful constituents to human health. Our study sought to identify which constituent disclosure message elements are most effective in discouraging people from smoking. Methods Three hundred eighty eight current smokers aged 18 and older completed an online survey in February 2015. We randomized participants to respond to one of two sets of 13 toxic products that contain cigarette constituents and 25 health effects associated with cigarette constituents. Results Products that elicited the most discouragement were those with lower chances of exposure (e.g., explosives), followed by products with possible exposure (e.g., rat poison), and products with a high likelihood of exposure (e.g., floor cleaner). Awareness of toxic products that constituents are found in (p < .001) and low exposure products (p < .001) were associated with higher discouragement. Health effects that people had heard are caused by cigarette smoke constituents elicited higher discouragement from smoking cigarettes (p < .001). Cancer was associated with higher discouragement relative to respiratory, cardiovascular, and reproductive health effects (all p < .001). Conclusions Cigarette smoke constituent messages may be more effective at discouraging smoking if they include information about carcinogenic health effects (e.g., mouth cancer and lung tumors) and low exposure toxic products (e.g., explosives and radioactive material) as message elements. Implications Our study identified health effects and toxic products, especially cancers and rarely encountered toxic products, that may discourage smoking when included in disclosure messages. By constructing messages that communicate the harms associated with tobacco use by contextualizing those harms in terms of specific constituents, tobacco education messaging efforts may be increasingly successful.
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Affiliation(s)
- Dannielle E Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Marcella H Boynton
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer C Morgan
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kurt M Ribisl
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Irina Stepanov
- Division of Environmental Health Sciences, Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Leena A Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Noel T Brewer
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Zettler PJ, Hemmerich N, Berman ML. Closing the Regulatory Gap for Synthetic Nicotine Products. BOSTON COLLEGE LAW REVIEW. BOSTON COLLEGE. LAW SCHOOL 2018; 59:1933-1982. [PMID: 30636822 PMCID: PMC6329380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In July 2017 the U.S. Food and Drug Administration (FDA) announced a new "comprehensive plan for tobacco and nicotine regulation." This plan is focused on making cigarettes less addictive while facilitating the development of alternative, and less-harmful, nicotine-containing products. This approach holds promise, and the public health stakes could not be higher-smoking is the leading cause of preventable death in the United States, resulting in roughly 480,000 deaths per year. But a new consumer product is emerging that could upset the FDA's plans for a well-balanced regulatory scheme: synthetic nicotine. These products currently fall into a regulatory gap because they fall outside the Federal Food, Drug, and Cosmetic Act's (FDCA) definition of a tobacco product. If this gap remains in place, it is likely that more companies will exploit it in order to evade regulation, undoing the potential benefits of the FDA's plan for tobacco and nicotine regulation. This Article argues that the FDA can, and should, address this problem by regulating synthetic nicotine products as drugs. After reviewing the science of nicotine addiction and the FDA's past and present regulatory schemes for nicotine, it explains how the FDA could establish that synthetic nicotine products satisfy the FDCA's definition of a drug. It concludes with a discussion of the policy benefits of categorizing synthetic nicotine products as drugs.
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Affiliation(s)
| | - Natalie Hemmerich
- Staff attorney with the Public Health Law Center at Mitchell Hamline School of Law
| | - Micah L Berman
- Associate professor Ohio State University's Moritz College of Law and College of Public Health
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Morgan JC, Moracco KE, Mendel JR, Kelley DE, Noar SM, Brewer NT. Increasing Effectiveness of Messages about Chemicals in Cigarette Smoke. TOB REGUL SCI 2018; 4:50-62. [PMID: 34141828 PMCID: PMC8208641 DOI: 10.18001/trs.4.4.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Federal law requires informing the public on toxic chemicals in cigarette smoke. We sought the public's advice about communicating information about these chemicals. METHODS Adolescents, young adults, and adults (N = 59), including smokers and non-smokers, participated in 9 focus groups that discussed inclusion of messages about toxic chemicals on cigarette packs, in media campaigns, and on a website. We transcribed, coded, and analyzed focus group audio-recordings. RESULTS Participants had 3 suggestions for message content to increase the impact of messages about cigarette smoke chemicals. First, they wanted to see messages rotated more frequently to increase message novelty. Second, they recommended using stories and pictures to help connect people to the abstract idea of chemicals in smoke. Third, they cautioned against making messages that might seem overblown and could appeal to the rebellious nature of adolescents. Some participants mentioned that chemical information on a website might discourage people from smoking; others mentioned that people might use it to choose which brand to smoke. CONCLUSIONS Legislation provides the impetus to design new chemical disclosure messages for cigarette packs and other media. Our findings can help increase the impact of these messages.
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Affiliation(s)
- Jennifer C Morgan
- Health Communication, Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
| | - Kathryn E Moracco
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, NC
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, North Carolina, NC
| | | | - Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, North Carolina, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, NC
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Philpott SE, Gehlert S, Waters EA. Smokers' unprompted comments on cigarette additives during conversations about the genetic basis for nicotine addiction: a focus group study. BMC Public Health 2018; 18:495. [PMID: 29653524 PMCID: PMC5899393 DOI: 10.1186/s12889-018-5395-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/03/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Research designed to elicit smokers' cognitive and affective reactions to information about chemicals that tobacco companies add to cigarettes ("additives") found that knowledge is limited. However, little is known about smokers' unprompted thoughts and feelings about additives. Such information could be used to shape future communication efforts. We explored the content and possible functions of spontaneous statements about cigarette additives made by smokers during a study examining reactions to learning about the genetic link to nicotine addiction. METHODS Adult smokers (N = 84) were recruited from a medium-sized Midwestern city. Focus groups (N = 13) were conducted between April-September 2012. Data were analyzed by 2 coders using thematic analysis. RESULTS Comments about cigarette additives arose without prompting by the focus group moderator. Three main themes were identified: (1) discussing additives helped participants navigate the conceptual link between smoking and genetics, (2) additives were discussed as an alternative mechanism for addiction to cigarettes, and (3) additives provided an alternative mechanism by which cigarette smoking exacerbates physical harm. Notably, discussion of additives contained a pervasive tone of mistrust illustrated by words like "they" and "them," by statements of uncertainty such as "you don't know what they're putting into cigarettes," and by negative affective verbalizations such as "nasty" and "disgusting". CONCLUSIONS Participants had distinct beliefs about cigarette additives, each of which seemed to serve a purpose. Although mistrust may complicate communication about the health risks of tobacco use, health communication experts could use smokers' existing beliefs and feelings to better design more effective anti-smoking messages.
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Affiliation(s)
- Sydney E. Philpott
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri USA
| | - Sarah Gehlert
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri USA
| | - Erika A. Waters
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri USA
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Brewer NT, Jeong M, Mendel JR, Hall MG, Zhang D, Parada H, Boynton MH, Noar SM, Baig SA, Morgan JC, Ribisl KM. Cigarette pack messages about toxic chemicals: a randomised clinical trial. Tob Control 2018; 28:74-80. [PMID: 29654122 PMCID: PMC6186198 DOI: 10.1136/tobaccocontrol-2017-054112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/22/2018] [Accepted: 02/20/2018] [Indexed: 11/07/2022]
Abstract
Background The USA can require tobacco companies to disclose information about harmful and potentially harmful chemicals in cigarette smoke, but the impact of these messages is uncertain. We sought to assess the effect of placing messages about toxic chemicals on smokers’ cigarette packs. Methods Participants were 719 adult cigarette smokers from California, USA, recruited from September 2016 through March 2017. We randomly assigned smokers to receive either factual messages about chemicals in cigarette smoke and their health harms (intervention) or messages about not littering cigarette butts (control) on the side of their cigarette packs for 3 weeks. The primary trial outcome was intention to quit smoking. Results In intent-to-treat analyses, smokers whose packs had chemical messages did not have higher intentions to quit smoking at the end of the trial than those whose packs had control messages (P=0.56). Compared with control messages, chemical messages led to higher awareness of the chemicals (28% vs 15%, P<0.001) and health harms (60% vs 52%, P=0.02) featured in the messages. In addition, chemical messages led to greater negative affect, thinking about the chemicals in cigarettes and the harms of smoking, conversations about the messages and forgoing a cigarette (all P<0.05). Discussion Chemical messages on cigarette packs did not lead to higher intentions to quit among smokers in our trial. However, chemical messages informed smokers of chemicals in cigarettes and harms of smoking, which directly supports their implementation and would be critical to defending the messages against cigarette company legal challenges. Trial registration number NCT02785484.
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Affiliation(s)
- Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michelle Jeong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer R Mendel
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Dongyu Zhang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.,School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Popova L, Thrul J, Glantz SA. Effects of Large Cigarette Warning Labels on Smokers' Expected Longevity. Am J Health Behav 2018; 42:85-92. [PMID: 29458517 DOI: 10.5993/ajhb.42.2.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Smokers underestimate the health risks of smoking and overestimate their expected longevity. Warning labels on cigarette packs might help correct these misperceptions. METHODS We carried out an online study with 1200 smokers (18-62 years old), randomized to 3 conditions: text warning labels, pictorial warning labels, and a control group (water bottle labels). Warning labels were based on those proposed by the US Food and Drug Administration in 2010. Participants in each condition saw 4 randomly selected labels and rated their expected longevity and chances of surviving to age 75 after exposure. Analyses of covariance controlled for cigarettes per day and self-rated health. RESULTS Compared to control, both text and pictorial warnings reduced participants' expected longevity (text: mean = 76.8 years, pictorial: 77.3, control 79.4) and their estimated chances of living to 75 (text: 62.0%, pictorial: 63.0%, control 66.5%). The contrast between text and pictorial labels combined and control showed significantly reduced expected longevity (p = .011) and chances of living to 75 (p = .004). Differences between text and pictorial conditions were not statistically significant. CONCLUSIONS Large text or pictorial warnings on cigarette packs might help smokers develop a more accurate understanding of the effects of smoking on their longevity.
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Affiliation(s)
- Lucy Popova
- Center for Tobacco Control Research and Education, University of California, San Fransisco CA
| | - Johannes Thrul
- Center for Tobacco Control Research and Education, University of California, San Fransisco CA
| | - Stanton A. Glantz
- Department of Medicine, Center for Tobacco Control Research and Education, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA
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Abstract
Objective The US government requires the public display of information about toxic chemicals in cigarettes and smoke by brand in a way that is understandable and not misleading. We sought to identify risk communication formats that meet these goals. Methods We conducted 3 online experiments with US adult convenience samples (total N = 1866). Participants viewed a webpage displaying information about chemicals in the smoke of a cigarette brand. Experiment 1 varied the chemicals listed and format for their health effects. Experiments 2 and 3 varied the format of chemical quantities and presence/absence of a visual risk indicator. Outcomes were understandable (increasing knowledge) and not misleading (not reinforcing misperceptions). Results Information about chemicals and health effects increased knowledge of these topics by ~30% (p < .001) compared to no information. Quantity format and use of a risk indicator generally did not affect knowledge. The proportion of participants misled ranged from 0% to 92%, depending on measure. Findings indicated 52% would use a website to search for safer cigarettes. Risk communication formats did little to reduce being misled. Conclusions Some risk communication formats successfully increased knowledge of chemicals and health effects. However, the formats did little to reduce the proportion of people misled.
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Drovandi A, Teague PA, Glass B, Malau-Aduli B. A systematic review of smoker and non-smoker perceptions of visually unappealing cigarette sticks. Tob Induc Dis 2018; 16:02. [PMID: 31516403 PMCID: PMC6659478 DOI: 10.18332/tid/82191] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 12/29/2017] [Accepted: 01/08/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Cigarette stick appearance can significantly contribute to perceptions of cigarette taste, harm, and appeal, and may be modified to reduce positive perceptions of cigarettes and other tobacco products. A systematic review was conducted to investigate how smokers and non-smokers identify cigarettes as being attractive or unattractive, and the resulting perceptions of cigarette appeal, perceived harm, and impact on quit intentions. METHODS Eligible articles were identified using database searches conducted with a date range of January 1990 to May 2017 in PubMed, CINAHL, PsycINFO, Google Scholar and Web of Science. Articles were included if they evaluated participant (any smoking status) perceptions of visual cigarette stick attributes. We identified studies describing visual attributes of cigarette sticks and the resulting perceptions of participants. Changes or differences in quitting intentions, cigarette appeal, perceptions of taste, and cigarette harm, and the likelihood of smoking uptake were recorded. Data were grouped into two main categories: those of physical cigarette design, and those including health messages on cigarette sticks. RESULTS Of the 950 identified non-duplicated records, 9 matched the eligibility criteria. These studies were all conducted in developed countries, and largely enrolled adolescent and young adult smokers and non-smokers. Slim, lighter coloured and branded cigarettes were favoured over longer, broader, or darker coloured cigarettes, and those without any branding or embellishments. Health warnings including ‘Minutes of life lost’, ‘Smoking kills’, and the names of carcinogenic constituents in cigarettes, reduced cigarette attractiveness and increased participant quit intentions. CONCLUSIONS Cigarette appeal and resulting smoking behaviours can be influenced by several visual attributes of individual cigarettes. Unappealing visual attributes of cigarette sticks, including modifications to the size and colour of cigarettes, and the inclusion of health warnings on cigarette sticks may serve as an effective tobacco control method, potentially leading to a reduction in tobacco use.
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Affiliation(s)
- Aaron Drovandi
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Peta-Ann Teague
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Beverley Glass
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Bunmi Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
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Brand switching and toxic chemicals in cigarette smoke: A national study. PLoS One 2018; 13:e0189928. [PMID: 29324749 PMCID: PMC5764241 DOI: 10.1371/journal.pone.0189928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/05/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction US law requires disclosure of quantities of toxic chemicals (constituents) in cigarette smoke by brand and sub-brand. This information may drive smokers to switch to cigarettes with lower chemical quantities, under the misperception that doing so can reduce health risk. We sought to understand past brand-switching behavior and whether learning about specific chemicals in cigarette smoke increases susceptibility to brand switching. Methods Participants were US adult smokers surveyed by phone (n = 1,151, probability sample) and online (n = 1,561, convenience sample). Surveys assessed whether smokers had ever switched cigarette brands or styles to reduce health risk and about likelihood of switching if the smoker learned their brand had more of a specific chemical than other cigarettes. Chemicals presented were nicotine, carbon monoxide, lead, formaldehyde, arsenic, and ammonia. Results Past brand switching to reduce health risk was common among smokers (43% in phone survey, 28% in online survey). Smokers who were female, over 25, and current “light” cigarette users were more likely to have switched brands to reduce health risks (all p < .05). Overall, 61–92% of smokers were susceptible to brand switching based on information about particular chemicals. In both samples, lead, formaldehyde, arsenic, and ammonia led to more susceptibility to switch than nicotine (all p < .05). Conclusions Many US smokers have switched brands or styles to reduce health risks. The majority said they might or would definitely switch brands if they learned their cigarettes had more of a toxic chemical than other brands. Brand switching is a probable unintended consequence of communications that show differences in smoke chemicals between brands.
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Noar SM, Kelley DE, Boynton MH, Morgan JC, Hall MG, Mendel JR, Ribisl KM, Brewer NT. Identifying principles for effective messages about chemicals in cigarette smoke. Prev Med 2018; 106:31-37. [PMID: 28890353 PMCID: PMC5764803 DOI: 10.1016/j.ypmed.2017.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/31/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
US law requires the Food and Drug Administration (FDA) to disclose information on harmful and potentially harmful chemicals in cigarette smoke (i.e., constituents) to the public. To inform this effort, we sought to identify principles for creating constituent messages that effectively discourage smoking. Participants were an online convenience sample of 1148 US smokers ages 18+. We developed a library of 76 messages about constituents only and constituents plus contextualizing information (i.e., toxic products that also contain the chemical, health effects, or both). We randomized smokers to receive 1 message from each of 7 message panels in a mixed between-/within-subjects experiment. Participants rated each message on perceived message effectiveness. Results indicated that smokers perceived messages about arsenic, formaldehyde, lead, uranium, and ammonia as more effective than messages about nitrosamines. Messages that contained information on toxic products, health effects, or both received higher effectiveness ratings than constituent-only messages. Among constituent-only messages, those that referenced multiple constituents received higher effectiveness ratings than those with fewer constituents. We conclude that chemical messages may have more impact if they pair known constituents with toxic product or health effect information. These message principles can be used to inform studies examining the impact of constituent messages on smoking beliefs and behavior.
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Affiliation(s)
- Seth M Noar
- School of Media and Journalism, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States.
| | - Dannielle E Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill, United States
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States
| | - Jennifer C Morgan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States
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