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Shi R, Feldman R, Liu J, Clark PI. Correcting misperceptions about very low nicotine cigarettes for cigarette-only smokers, dual/poly smokers, other tobacco users, and non-tobacco users. Prev Med Rep 2024; 46:102856. [PMID: 39253723 PMCID: PMC11381749 DOI: 10.1016/j.pmedr.2024.102856] [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: 05/14/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 09/11/2024] Open
Abstract
Background The U.S. Food and Drug Administration authorized the sale and marketing of two very low nicotine cigarettes (VLNC) as modified risk tobacco products. The misperception that VLNC are healthier than regular cigarettes is common. This study explores effective message strategies to inform the public about health risks associated with VLNC use, encourage cigarette smokers to try VLNC, and prevent other tobacco users and non-users from product initiation. Methods Following the Reasoned Action approach, a VLNC educational message was developed based on the salient beliefs associated with behavioral intention. The message was tested in an online survey conducted in 2018, where 410 participants were randomly assigned to one of the two message conditions (no-message, VLNC message). Message effects were assessed across four tobacco-use groups (non-tobacco users, cigarette-only smokers, cigarette dual/poly smokers, other tobacco users). Results Compared to the no-message control, the VLNC message condition showed lower nicotine risk perception for all participants, lower misbelief in VLNC safety for non-users and cigarette-only smokers, higher belief in VLNC carcinogenicity for other tobacco users, stronger belief in second-hand smoke harm for cigarette dual/poly smokers and other tobacco users, and higher VLNC intention for cigarette-only smokers. Conclusions Different messages are needed for different types of tobacco users. Both cigarette smokers and other tobacco users could benefit from messages that acknowledge the non-addictiveness but emphasize the health risks of VLNC. Regulators could consider making physical harm statements a requirement for VLNC packaging and marketing. New strategies need to be explored to inform cigarette dual/poly smokers.
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Affiliation(s)
- Rui Shi
- Department of Communication Studies, Ric Edelman College of Communication & Creative Arts, Rowan University, Glassboro, NJ, USA
| | - Robert Feldman
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Jiaying Liu
- Department of Communication, UC Santa Barbara, Santa Barbara, CA, USA
| | - Pamela I Clark
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
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2
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Sharma E, Zebrak K, Lauten K, Gravely S, Cooper M, Gardner LD, Zaganjor I, Edwards KC, Kasza K, Marshall D, Kimmel HL, Stanton C, Hyland A, Fong G. Cigarette and ENDS dual use longitudinal transitions among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 4-5 (2016-2019). Addict Behav Rep 2024; 19:100528. [PMID: 38384864 PMCID: PMC10879705 DOI: 10.1016/j.abrep.2024.100528] [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: 06/20/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The study assessed longitudinal transitions among adult (18 and older) past 30-day daily and non-daily dual users of cigarettes and electronic nicotine delivery systems (ENDS). Methods Using data from Wave 4 (W4; 2016/17) and Wave 5 (W5; 2018/19) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of US adults, multivariable regressions were conducted among W4 dual users of cigarettes and ENDS to examine past 30-day cigarette smoking at W5. The study also analyzed changes in frequency of past 30-day smoking and cigarettes smoked per day between W4 and W5, stratified by W4/W5 daily/non-daily ENDS use among W4 daily and non-daily cigarette smokers. Results Among W4 dual users, those smoking daily and using ENDS non-daily had higher odds of daily cigarette smoking at W5 than daily users of both products (AOR: 2.32, 95 % CI: 1.38-3.90). W4 daily smokers who used ENDS daily at Wave 5 smoked cigarettes on fewer days at Wave 5 than W4 daily smokers who were either daily ENDS users at Wave 4 (B = -4.59; SE = 1.43, p < 0.01) or non-daily ENDS users at Wave 4 (B = -4.55; SE = 1.24, p < 0.001). Among W4 non-daily cigarette smokers, W4 non-daily ENDS users who used daily at W5 smoked cigarettes on fewer days (B = -4.04, SE = 1.82) at W5 than those who were non-daily ENDS users at W4 and W5. Conclusions Findings highlight the importance of frequency of ENDS use in reducing cigarette smoking and could inform smoking cessation interventions among daily cigarette smokers.
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Affiliation(s)
| | | | | | | | - Maria Cooper
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lisa D. Gardner
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Ibrahim Zaganjor
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | | | - Karin Kasza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Axle Informatics, Rockville, MD, USA
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Geoff Fong
- University of Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Bejarano G, Bluestein MA, Tackett AP, Duano J, Rawls S, Ahluwalia JS, Vandewater EA, Hébert ET. Factors Associated With Successful E-Cigarette Cessation Among a Convenience Sample of Adult Users. Subst Use Misuse 2024; 59:1126-1132. [PMID: 38503709 PMCID: PMC11017730 DOI: 10.1080/10826084.2024.2320395] [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] [Indexed: 03/21/2024]
Abstract
Background: A growing body of literature suggests that many people who use e-cigarettes become dependent and have difficulty quitting. Most people who use e-cigarettes have interest in quitting, yet there is currently a lack of evidence to inform interventions for e-cigarette cessation. Objective: The purpose of this study was to identify factors associated with successful e-cigarette quit attempts among a large sample of people who use e-cigarettes. Methods: Participants (n=586) were people who use e-cigarettes who reported at least one lifetime attempt to quit their e-cigarette use. Adjusted logistic regression models were performed to examine differences in e-cigarette use characteristics and quit methods between people who currently use e-cigarettes and who quit e-cigarettes. Results: Most participants were people who currently use e-cigarettes and only 27.5% reported successfully quitting. Most participants (90.6%) used e-cigarettes that contained nicotine, and over half (54.0%) used closed-system e-cigarette devices with replaceable pre-filled pods or cartridges. The quit method most commonly used overall (63.1%) and for people who quit e-cigarettes (70.8%) was cold turkey. Past 30-day cigarette use and past 30-day other tobacco use was significantly associated with reduced odds of quitting, and there were no e-cigarette characteristics significantly associated with successful cessation. Nicotine replacement therapy was the only e-cigarette cessation method that was significantly associated with increased odds of quitting after adjusting for past 30-day cigarette and other tobacco use. Conclusions: These results suggests that cigarette use, other tobacco use, and quit method used may significantly influence the likelihood of e-cigarette cessation. Future research is needed to determine the effectiveness of interventions for e-cigarette cessation using nicotine replacement therapy.
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Affiliation(s)
- Geronimo Bejarano
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Alayna P. Tackett
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Jaimie Duano
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Shelby Rawls
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Legorreta Cancer Center at Brown University, Providence, Rhode Island
| | | | - Emily T. Hébert
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
- Department of Health Promotion and Behavioral Sciences, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX
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4
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Reed BW, Doran N, Courtney KE. Associations between nicotine product use and craving among stable daily and non-daily users. Addict Behav 2023; 146:107803. [PMID: 37423069 PMCID: PMC10827279 DOI: 10.1016/j.addbeh.2023.107803] [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: 04/10/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Nicotine craving typically develops shortly after last use and is conceptualized as essential to the development, maintenance, and treatment of nicotine dependence. Previous research has primarily examined the relationship between craving and use among individuals trying to quit smoking, and less is known about this relationship among active users, particularly e-cigarette users. The current study evaluated the association between craving and use by assessing both constructs twice daily over 7 days in a sample of daily (n = 80) and non-daily (n = 34) users of combustible tobacco and e-cigarette products. We used negative binomial regression modeling to analyze the relationship between nicotine craving and use in two ways. First, we evaluated a lagged model in which craving at the time of assessment predicted use during the next time period. Next, we evaluated a model in which maximum craving since the last assessment predicted use during the same time period. Maximum craving was significantly and positively associated with nicotine product use (p <.05) while craving at the time of assessment was not. These associations did not differ depending on use frequency or on specific products used. Findings provide evidence that self-report ratings of craving are associated with greater nicotine and tobacco product use for both frequent and intermittent users. Furthermore, these results may be useful in developing or modifying interventions for a wide variety of nicotine users, including those who are not yet intending to make a change to their nicotine use.
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Affiliation(s)
- Brandon W Reed
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA 920093, USA.
| | - Neal Doran
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA 920093, USA.
| | - Kelly E Courtney
- Department of Psychiatry, University of California San Diego, La Jolla, CA 920093, USA.
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5
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Park M, Song H. Examining Factors Associated with E-Cigarette Use among Current Smokers. Healthcare (Basel) 2023; 11:2526. [PMID: 37761722 PMCID: PMC10530552 DOI: 10.3390/healthcare11182526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/04/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
We present a secondary data analysis of the raw data from the eighth Korea National Health and Nutrition Examination Survey (KNHANES). A total of 827 current smokers who responded that they had smoked >5 packs (100 cigarettes) of cigarettes in their lifetime and were currently smoking traditional cigarettes were selected. This study was conducted to identify sociodemographic, smoking-related, and health-related characteristics that influence the use of e-cigarettes in adult smokers. To examine these factors, general characteristics such as age, marital status, education level, and occupation were included in Model 1, while health-related characteristics such as the level of smoking and depression were included in Model 2. In Model 1, age, a high level of education, and working in an office were found to be significantly correlated with e-cigarette use among smokers, while age and working in the office were found to be significantly correlated with e-cigarette use in Model 2. Therefore, e-cigarette use was high among adult smokers of young ages who were office workers. Although evidence is lacking regarding its safety and use as smoking cessation aids, many smokers have been reported to use e-cigarettes as smoking cessation aids, making it necessary to provide accurate information on e-cigarettes.
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Affiliation(s)
- MinHee Park
- Department of Nursing, Wonkwang University, 460 Iksanda-ro, Iksan-si 54538, Jeollabuk-do, Republic of Korea;
| | - HyeYoung Song
- Department of Nursing, Woosuk University, Samrye-eup, Wanju-gun 55338, Jeonbuk, Republic of Korea
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6
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Augustini ALRM, Borg C, Sielemann S, Telgheder U. Making Every Single Puff Count-Simple and Sensitive E-Cigarette Aerosol Sampling for GCxIMS and GC-MS Analysis. Molecules 2023; 28:6574. [PMID: 37764350 PMCID: PMC10536117 DOI: 10.3390/molecules28186574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The analysis of the aerosol from tobaccoless electronic cigarettes (e-cigarettes) is an important part of understanding their impact on human health, yet sampling aerosol from e-cigarettes is still considered a challenge. It lacks a standard method for research and quality control and there are a variety of methods. However, few are simple and inexpensive, and none have been suggested for the use with gas chromatography coupled ion mobility spectrometry (GCxIMS). This work presents and evaluates such a setup made from standard lab equipment to quickly collect a quantitative sample from the aerosol of a single puff (5 s totaling 125 mL). The aerosol condensates directly in the cooled headspace (HS) vial, which is analyzed in the HS-GCxIMS or mass spectrometer (HS-GC-MS). The combined use of GC-MS and GCxIMS allows the simple and sensitive identification of unknown substances in complex mixtures and the identification of degradation products in the aerosols. A calibration of 26 flavor compounds (0.2-20 µg/g) was created using single puffs of a spiked, flavorless commercial refill solution and 2-alkanones as internal standards. This sensitive but easily reproducible setup enables a wide range of further investigations, even for labs that were previously unable to afford it.
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Affiliation(s)
- Alexander L. R. M. Augustini
- Department Hamm 2, Hamm-Lippstadt University of Applied Sciences, Marker Allee 76-78, 59063 Hamm, Germany; (A.L.R.M.A.)
- Faculty of Chemistry, Instrumental Analytical Chemistry, University of Duisburg-Essen, Universitätsstraße 5, 45141 Essen, Germany
| | - Christopher Borg
- Department Hamm 2, Hamm-Lippstadt University of Applied Sciences, Marker Allee 76-78, 59063 Hamm, Germany; (A.L.R.M.A.)
| | - Stefanie Sielemann
- Department Hamm 2, Hamm-Lippstadt University of Applied Sciences, Marker Allee 76-78, 59063 Hamm, Germany; (A.L.R.M.A.)
| | - Ursula Telgheder
- Faculty of Chemistry, Instrumental Analytical Chemistry, University of Duisburg-Essen, Universitätsstraße 5, 45141 Essen, Germany
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7
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Marusich JA, Palmatier MI. Development of a nicotine aerosol self-administration model in rats and the effects of e-liquid flavors. Behav Pharmacol 2023; 34:141-153. [PMID: 36752651 PMCID: PMC10006336 DOI: 10.1097/fbp.0000000000000717] [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] [Indexed: 02/09/2023]
Abstract
Electronic nicotine delivery system (ENDS) use is maintained by the positive reinforcement associated with preferred flavors. These flavors become conditioned reinforcers through pairings with primary reinforcers. This study sought to extend prior research with intravenous nicotine self-administration and develop a more ecologically valid preclinical model of aerosol self-administration in rats that incorporated flavors paired with sucrose. Rats were first trained to respond for oral sucrose with or without raspberry flavor to establish the flavor as a conditioned reinforcer for some groups. Rats were then exposed to aerosol self-administration. All groups responded for raspberry-flavored aerosol with or without nicotine. Rats responded more for raspberry flavored sucrose than unflavored sucrose. Despite raspberry increasing responding for sucrose, the flavor did not function as a conditioned reinforcer during aerosol self-administration and did not increase responding for nicotine. Throughout the aerosol self-administration phase, most groups responded more on the active than inactive lever, and some groups increased their response when the fixed ratio value was increased. At the end of the study, rats in nicotine groups earned similar or fewer aerosol deliveries than rats in vehicle groups. Aerosolized nicotine did not function as a reinforcer in this study, whereas aerosolized raspberry flavor may have maintained self-administration. Further preclinical investigation is needed to articulate the impact of flavors on ENDS use and whether they offset some aversive effects of nicotine or maintain responding on their own. If flavors reduce some aversive effects of self-administered nicotine, then policies to regulate flavors in e-liquids are prudent.
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Affiliation(s)
- Julie A Marusich
- Center for Drug Discovery, RTI International, Research Triangle Park, NC
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8
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Mayer M, Shin YE, Baker L, Cordova J, Mayne RG, Reyes-Guzman CM, Pfeiffer RM, Choi K. A Longitudinal Analysis of Respiratory Illness and Tobacco Use Transitions. Am J Prev Med 2023; 64:175-183. [PMID: 36220674 PMCID: PMC9852011 DOI: 10.1016/j.amepre.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Among individuals with chronic respiratory conditions, transitions between patterns of tobacco product use are not well understood. This study examines how transitions, including quitting altogether, differ over time between those who do and do not have chronic respiratory conditions. METHODS Data from youth and adult participants of the longitudinal Population Assessment of Tobacco and Health Study (2013-2018) were analyzed. Youth aged 12-17 years were included if they had aged into the adult sample by Wave 4. Stratified polytomous regression models built under a first-order Markov assumption modeled the probability of transitioning between different states/patterns of tobacco product use (exclusive current E-cigarette use, exclusive current combustible tobacco product use, current dual use of combustible products and E-cigarettes, and no current tobacco product use) at each wave. Marginal transition probabilities were computed as a function of ever or past-year diagnosis of a respiratory condition (separately for asthma and a composite variable representing chronic bronchitis, emphysema, and/or chronic obstructive pulmonary disease). Analyses were conducted in 2020-2021. RESULTS Most individuals, regardless of respiratory condition, maintained the same pattern of tobacco use between waves. Exclusive combustible tobacco product users, including those with or without a respiratory condition, were not likely to become exclusive E-cigarette users or to quit using tobacco entirely. CONCLUSIONS Although combustible tobacco use negatively impacts the management and prognosis of respiratory illnesses, combustible tobacco users who were recently diagnosed with a chronic respiratory condition were not likely to quit using tobacco. Efforts to encourage and support cessation in this medically vulnerable population should be increased.
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Affiliation(s)
- Margaret Mayer
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, Maryland.
| | - Yei Eun Shin
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland; Department of Statistics, Seoul National University, Seoul, South Korea; College of Liberal Studies, Seoul National University, Seoul, South Korea
| | - Laura Baker
- The Bizzell Group, LLC, New Carrollton, Maryland
| | - Jamie Cordova
- Noninfectious Disease Programs, National Foundation for the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rachel Grana Mayne
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, Maryland
| | - Carolyn M Reyes-Guzman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, Maryland
| | - Ruth M Pfeiffer
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland
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Monshi SS, Arbaein TJ, Alzhrani AA, Alzahrani AM, Alharbi KK, Alfahmi A, Alqahatani M, Alzahrani AH, Yaqoob A, Almazroua A, Alanazi AMM. Factors associated with the desire to quit tobacco smoking in Saudi Arabia: Evidence from the 2019 Global Adult Tobacco Survey. Tob Induc Dis 2023; 21:33. [PMID: 36875735 PMCID: PMC9983308 DOI: 10.18332/tid/159735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Saudi Arabia is expected to witness a slight reduction in tobacco use. The Saudi government offers free-of-charge smoking cessation services. Yet, factors influencing the desire to quit smoking are not comprehensively investigated in Saudi Arabia. This study examines the factors influencing the desire to quit among smoking adults in Saudi Arabia and investigates whether using alternative tobacco products, such as e-cigarettes, is associated with the desire to quit smoking. METHODS Data from the 2019 nationally representative Global Adults Tobacco Survey (GATS) was used. GATS utilized a face-to-face household cross-sectional survey that collected data from adults aged ≥15 years. Several factors including, sociodemographic characteristics, use of alternative tobacco products, attitude toward tobacco control, and awareness of smoking cessation clinics (SCCs), were examined to predict the desire to quit. Logistic regression analysis was conducted. RESULTS A total of 11381 individuals completed the survey. Of the total sample, 1667 participants were tobacco smokers. The majority of the tobacco smokers were interested in quitting smoking (82.4%); 58% of cigarette smokers and 17.1% of waterpipe smokers were interested in quitting smoking. The desire to quit smoking was positively associated with the awareness of SCCs (AOR=3; 95% CI: 1.8-5), attitude toward raising tobacco taxes (AOR=2.3; 95% CI: 1.4-3.8), and a strict rule of smoking inside the home (AOR=2; 95% CI: 1.1-3.9). No statistical association was found between the desire to quit smoking and the use of e-cigarettes. CONCLUSIONS The desire to quit tobacco smoking among Saudi smokers increased with awareness of SCCs, favoring taxes on tobacco products, and implementing strict rules of smoking inside the home. The study reveals valuable insights into the main factors that could inform the development of more effective policy interventions targeting smokers in Saudi Arabia.
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Affiliation(s)
- Sarah S Monshi
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Turky J Arbaein
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulrhman A Alzhrani
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ali M Alzahrani
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Khulud K Alharbi
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Afrah Alfahmi
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ali H Alzahrani
- Tobacco Control Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmad Yaqoob
- Tobacco Control Program, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Abdullah M M Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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10
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Huh J, Yu S, Galimov A, Meza L, Galstyan E, Medel D, Unger JB, Baezconde-Garbanati L, Sussman S. Hypothetical flavour ban and intention to vape among vape shop customers: the role of flavour preference and e-cigarette dependence. Tob Control 2023; 32:110-113. [PMID: 34112647 PMCID: PMC8660941 DOI: 10.1136/tobaccocontrol-2020-056321] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/18/2021] [Accepted: 03/31/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION E-cigarette users typically initiate vaping with flavoured e-liquids. People who vape flavours tend to underestimate the harm of vaping. We examined the inter-relationship between flavour preference, vaping for cessation purposes, e-cigarette dependence, e-cigarette harm perception and purchase/use intention, given a hypothetical flavour ban. We hypothesised that non-tobacco flavour preference and vaping for cessation would be negatively associated with harm perception of e-cigarettes and intention to continue vaping if a flavour ban occurred and that these effects would be mediated by e-cigarette dependence. METHODS From July 2019 to March 2020, we conducted intercept interviews with 276 customers at 44 vape shops in California. The predictor variables were flavour preference and vaping for cessation. The outcome variables were harm perception of e-cigarettes and intention to purchase/use, given a hypothetical flavour ban. Multilevel structural equation modelling tested whether e-cigarette dependence mediates the effects of flavour preference on hypothetical continued vaping and purchase. RESULTS Those who preferred flavours showed significantly lower intention to purchase e-liquids (β=-0.28, p<0.001) and to continue vaping (β=-0.17, p=0.001), given a hypothetical flavour ban. Those who vaped for smoking cessation indicated greater intention to purchase e-liquid (β=0.10, p=0.016) and to continue vaping (β=0.17, p=0.001), given a hypothetical flavour ban. E-cigarette dependence significantly mediated these effects (ps<0.04). DISCUSSION Flavour preference was negatively related to intention to continue to vape within a hypothetical flavour ban. Our results also highlight the importance of e-cigarette dependence and use of e-cigarettes as smoking cessation methods. Implications for future flavour bans are discussed.
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Affiliation(s)
- Jimi Huh
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Sheila Yu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Artur Galimov
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Leah Meza
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Ellen Galstyan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Donna Medel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | | | - Steve Sussman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California,Department of Psychology, University of Southern California,School of Social Work, University of Southern California
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11
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Coleman SRM, Piper ME, Byron MJ, Bold KW. Dual Use of Combustible Cigarettes and E-cigarettes: a Narrative Review of Current Evidence. CURRENT ADDICTION REPORTS 2022; 9:353-362. [PMID: 36467719 PMCID: PMC9718538 DOI: 10.1007/s40429-022-00448-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review E-cigarette use (vaping) among adults has increased, and various patterns of concurrent smoking and vaping (i.e., "dual use") have emerged. Understanding dual use is important for mitigating tobacco-related harm. This narrative review summarizes recent research on dual use, including prevalence and types of dual use, sociodemographic and psychiatric characteristics, nicotine dependence, reasons for dual use, harm perceptions, toxicant exposure, trajectories of dual use, and emerging treatments for dual use. Recent Findings Nearly half of e-cigarette users concurrently use cigarettes, and many smoke more frequently than they use e-cigarettes. This is concerning because dual users are exposed to both cigarette and potential e-cigarette toxicants and the data are mixed regarding the ability of e-cigarettes to promote smoking cessation. Summary Further work is needed to identify ways to increase complete smoking abstinence and optimize harm reduction among dual users, including strategies to encourage e-cigarette cessation after stopping smoking.
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Affiliation(s)
- Sulamunn R. M. Coleman
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401-1419, USA
| | - Megan E. Piper
- Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - M. Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Krysten W. Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Robertson L, Sanford KR, Waa A, Hoek J. A Qualitative Analysis of the Experiences of People Who Resumed Smoking Following Exclusive Electronic Nicotine Delivery Systems Use. Nicotine Tob Res 2022; 25:470-477. [PMID: 36448851 PMCID: PMC9910152 DOI: 10.1093/ntr/ntac157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION For electronic nicotine delivery systems (ENDS) to reduce harms caused by smoking, people who smoke must be able to switch to exclusive ENDS use without subsequently returning to smoking. Identifying factors prompting a return to smoking among former exclusive ENDS users is crucial, yet few qualitative studies have probed experiences of this process. AIMS AND METHODS We conducted in-depth, semi-structured interviews with 20 people (seven indigenous Māori and 13 non-Māori) who smoked tobacco at least weekly, had smoked at least 100 cigarettes in their lifetime, and reported using ENDS to stop smoking cigarettes for at least 30 days (ideally, within the preceding 6 months). We explored their experiences of ENDS use, probed critical return-to-smoking settings and triggers, and analyzed strategies that could promote sustained smoking abstinence. We managed data using NVivo12 and used a reflexive thematic analysis approach to interpret the transcripts. RESULTS We identified three themes that explained participants' experiences. ENDS performed a functional role by mimicking some aspects of smoking. Yet participants experienced ENDS as inauthentic and unsatisfying across physical, social, and affectual domains, including in the most common return-to-smoking situations. Furthermore, fewer constraints on ENDS usage led participants to feel they could perpetuate addiction and risk of harm. CONCLUSIONS Return to smoking reflected two factors: ENDS' failure to replicate core smoking attributes that remained appealing, and the burden of self-regulation required when using ENDS. Understanding and informing people about the challenges involved in transitioning to ENDS, beyond obtaining sufficient nicotine, could help support informed ENDS use and may potentially prevent people returning to smoking. IMPLICATIONS Our study extends our understanding of the satisfaction people seek when attempting to transition from smoking to exclusive ENDS use, and how ENDS' failure to replicate that satisfaction, in addition to uncertainty about ENDS-related risks, contributes to smoking resumption. Satisfaction went beyond nicotine delivery, and included affective experiences, maintenance of rituals, rewards, and social connections. Conceptualizing satisfaction more broadly could support a richer understanding of factors that prompt return to smoking. People might manage challenges more effectively if they understood these before attempting to switch from smoking to ENDS, and if they are advised to monitor and regulate their ENDS use. Educational resources and behavioral support could provide more guidance on these points.
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Affiliation(s)
- Lindsay Robertson
- Corresponding Author: Lindsay Robertson, PhD, Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand. Telephone: 0064 3 479 7202; Fax: 0064 3 479 7298; E-mail:
| | - Kealey-Rei Sanford
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Anaru Waa
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
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Tehrani H, Rajabi A, Ghelichi- Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80:240. [PMID: 36415010 PMCID: PMC9682677 DOI: 10.1186/s13690-022-00998-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping. METHOD The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author. RESULTS In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively. CONCLUSIONS Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.
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Affiliation(s)
- Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Environmental Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Temourian AA, Song AV, Halliday DM, Gonzalez M, Epperson AE. Why do smokers use e-cigarettes? A study on reasons among dual users. Prev Med Rep 2022; 29:101924. [PMID: 35911573 PMCID: PMC9334340 DOI: 10.1016/j.pmedr.2022.101924] [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: 01/10/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022] Open
Abstract
Objective There is minimal research that has measured motivations behind e-cigarette use and the relationship to cigarette and e-cigarette use. The aim of this study was to (1) examine extent to which motivations to use e-cigarettes varies among dual users and (2) examine whether e-cigarette motivations are related to e-cigarette and cigarette consumption among dual users. Methods Adults residing in California were recruited through social media (n = 1762, 68.9 % males, 62.9 % White) to complete an online survey. Participants self-identified as using combustible cigarettes and e-cigarettes (dual users) and reported their motivations for using an e-cigarette device, nicotine consumption, and nicotine dependence with both combustible cigarettes and e-cigarettes. Results A greater proportion of people reported using e-cigarettes for enjoyment purposes than other motivations (34.2 %). Motivations to use e-cigarettes to quit were positively related to monthly cigarette consumption (IRR = 1.17, 95 % CI [1.08, 1.26]). Motivations to use e-cigarettes to quit smoking were also related to smoking the first cigarette within 30 min (IRR = 1.46, 95 % CI [1.05, 2.02]) and first e-cigarette within 30 min (b = 0.28, 95 % CI [0.19, 0.37]). Conclusions Compared to those who use e-cigarettes for enjoyment, smokers who are motivated to use e-cigarettes for cessation purposes are more likely to have greater nicotine dependence, cigarette consumption, and e-cigarette consumption. Future research needs to acknowledge that not all e-cigarette users are the same; motivations and use differ and are related to both consumption and dependence.
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Affiliation(s)
- Allison A Temourian
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, USA
| | - Anna V Song
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, USA.,Nicotine and Cannabis Policy Center, University of California, Merced, USA
| | - Deanna M Halliday
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, USA.,Nicotine and Cannabis Policy Center, University of California, Merced, USA
| | - Mariaelena Gonzalez
- Nicotine and Cannabis Policy Center, University of California, Merced, USA.,Department of Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, USA
| | - Anna E Epperson
- Department of Psychological Sciences, School of Social Sciences, Humanities, & Arts, University of California, Merced, USA.,Nicotine and Cannabis Policy Center, University of California, Merced, USA
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15
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Harlow AF, Cho J, Tackett AP, McConnell RS, Leventhal AM, Stokes AC, Barrington-Trimis JL. Motivations for E-cigarette use and associations with vaping frequency and smoking abstinence among adults who smoke cigarettes in the United States. Drug Alcohol Depend 2022; 238:109583. [PMID: 35907310 PMCID: PMC9994580 DOI: 10.1016/j.drugalcdep.2022.109583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION In observational studies, vaping daily is positively associated with cigarette smoking abstinence, while non-daily vaping is associated with less smoking abstinence (versus no e-cigarette use). It remains unknown whether cigarette smokers who vape daily have different motivations for using e-cigarettes than those who vape non-daily. METHODS Using latent class analysis and 10 self-reported reasons for vaping, we identified sub-groups of participants based on vaping motivations among 1544 adult (≥18 y) dual users of e-cigarettes and cigarettes at wave 4 of the Population Assessment of Tobacco and Health (2016-2018). We examined the association of motivation sub-groups with vaping frequency at wave 4, and subsequent cigarette smoking abstinence at wave 5 (2018-2019). Additional analyses examined the association of vaping frequency with smoking abstinence before and after adjustment for motivation sub-groups. RESULTS Four distinct sub-groups of e-cigarette users emerged, including 54 % of participants who were "Vaping Enthusiasts", 20 % who vaped for "Convenience and Social Acceptability", 10 % classified as "Experimenters", and 16 % who vaped for "Quitting Smoking and Harm Reduction." The Convenience and Social Acceptability sub-group were less likely than "Vaping Enthusiasts" (AOR=0.29, 95 %CI[0.20-0.42]) and "Quitting Smoking and Harm Reduction" (AOR=0.41, 95 %CI[0.24-0.71]) classes to vape daily (versus non-daily). Sub-groups were not associated with smoking abstinence after one year. Adjustment for motivation sub-groups did not attenuate a positive association of daily vaping with smoking abstinence. CONCLUSIONS Cigarette smokers who vaped for convenience and social acceptability were less frequent e-cigarette users than those with other vaping motivations. Vaping motivations were not associated with subsequent smoking abstinence.
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Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Rob S McConnell
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
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16
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Harlow AF, Fetterman JL, Ross CS, Robertson RM, Bhatnagar A, Benjamin EJ, Stokes AC. Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA. Tob Control 2022; 31:e10-e17. [PMID: 33479031 PMCID: PMC8292448 DOI: 10.1136/tobaccocontrol-2020-055999] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/23/2020] [Accepted: 12/11/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Few studies assess whether electronic cigarette (e-cigarette) device characteristics or flavours impact longitudinal patterns of cigarette and e-cigarette use. DESIGN We examined data from waves 2-4 of the Population Assessment of Tobacco and Health Study (2014-2018). Among adult (≥18 years) current e-cigarette users at wave 2 who were current smokers (dual users; n=1759) and former smokers (exclusive e-cigarette users; n=470), we classified participants into four use patterns at wave 3 (~12 months later) and wave 4 (~24 months later): (1) dual use of e-cigarettes and cigarettes; (2) exclusive cigarette smoking; (3) exclusive e-cigarette use; (4) non-use of both products. We used multinomial logistic regression to assess correlates of changing use patterns at 24 months, relative to no change, adjusting for sociodemographic factors. RESULTS At 24 months, 26.5% of baseline exclusive e-cigarette users, and 9% of baseline dual users, abstained from both vaping and smoking. Participants who vaped non-tobacco flavours (vs tobacco flavours), and used refillable tank or modifiable devices (vs disposable, cartridges and other devices) were less likely to transition to non-use of both products and to exclusive cigarette smoking. Baseline daily vaping (vs non-daily) was positively associated with exclusive e-cigarette use at 24 months for baseline daily cigarette smokers, but negatively associated with exclusive e-cigarette use and non-use of both products at 24 months for baseline non-daily smokers. CONCLUSIONS Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.
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Affiliation(s)
- Alyssa F Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jessica L Fetterman
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Craig S Ross
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Rose Marie Robertson
- Tobacco Regulation and Addiction Center, American Heart Association, Dallas, Texas, USA
| | - Aruni Bhatnagar
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Emelia J Benjamin
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Alqahtani MM, Pavela G, Lein DH, Vilcassim R, Hendricks PS. The Influence of Mental Health and Respiratory Symptoms on the Association Between Chronic Lung Disease and E-Cigarette Use in Adults in the United States. Respir Care 2022; 67:814-822. [PMID: 35440495 PMCID: PMC9994082 DOI: 10.4187/respcare.09579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adults with chronic lung disease use electronic cigarettes (e-cigarette) at higher rates than those without chronic lung disease. Because e-cigarettes have now been shown to cause adverse pulmonary effects and impair immune responses, it is particularly important to identify the factors that contribute to e-cigarette use in individuals with chronic lung disease. We tested whether mental health explains the association between chronic lung disease and e-cigarette use, and whether the association between chronic lung disease and e-cigarette use is conditional on the presence of respiratory symptoms. METHODS Data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Logistic regression was used to test the association between chronic lung disease status and e-cigarette use when controlling for demographic variables and comorbidities. Structural equation modeling was then used to evaluate (a) whether the number of bad mental health days in the past 30 days explained the association between chronic lung disease and e-cigarette use, and (b) if respiratory symptoms moderated the association between chronic lung disease and e-cigarette use. RESULTS The prevalence of lifetime and current e-cigarette use was significantly higher in those with than in those without chronic lung disease, as was the number of bad mental health days in the past 30 days. Mediation analysis indicated a statistically significant indirect effect of chronic lung disease on the likelihood of e-cigarette use (lifetime and current) through mental health. However, our analyses did not indicate a statistically significant interaction between chronic lung disease and respiratory symptoms in the likelihood of e-cigarette use. CONCLUSIONS The association between chronic lung disease and e-cigarette use may be due, in part, to poorer mental health among individuals with chronic lung disease. These findings provide preliminary evidence that improving the mental health of individuals with chronic lung disease could reduce e-cigarette use in this vulnerable population.
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Affiliation(s)
- Mohammed M Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; and Department of Physical and Occupational Therapy, School of Health Profession, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Gregory Pavela
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Donald H Lein
- Department of Physical Therapy, School of Health Profession, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Ruzmyn Vilcassim
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
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Perceptions and Use of Electronic Cigarettes Among Young Adults in Vietnam 2020. J Community Health 2022; 47:822-827. [PMID: 35764721 DOI: 10.1007/s10900-022-01113-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 10/17/2022]
Abstract
Electronic cigarette use among adolescents has increased in the past decade. Little is known about the perception and use of e-cigarettes in Vietnam, especially among young people. This study examines the perceptions and use of electronic cigarettes among young adults in Vietnam. The study uses data from a survey of adult tobacco consumption among adults at the provincial level in 2020, which was funded and managed by the Vietnam Tobacco Control Fund-Ministry of Health. Data were collected from 34 provinces and cities throughout Vietnam and managed using REDCap software. The survey engaged 80,166 participants, of which 9478 were young adults aged 15-24 were selected and reported in this paper. The results show that, at the time of the survey, 2.4% of young Vietnamese adults were smoking e-cigarettes. Many survey participants cited more than one reason for smoking e-cigarettes. These reasons included preferring the taste of e-cigarettes (64.0%), disliking the odour of other cigarettes (46.2%), following the example of family members (44.9%), and believing e-cigarettes threatened fewer health risks (39.1%). Almost half of the e-cigarette users wanted to quit (48%). E-cigarette use was associated with males living in urban areas who are aware of the Law on Prevention and Control of Tobacco Harms. The findings of this study provide evidential data that support public health policies aimed at reducing and ceasing e-cigarette use among young people.
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Hussain S, Sreeramareddy CT. Smoking cessation behaviors and reasons for use of electronic cigarettes and heated tobacco products among Romanian adults. Sci Rep 2022; 12:5446. [PMID: 35361852 PMCID: PMC8968304 DOI: 10.1038/s41598-022-09456-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/23/2022] [Indexed: 11/09/2022] Open
Abstract
We report cessation behaviors, reasons for use of electronic cigarettes (EC) and heated tobacco products (HTP) and association of their use with quit attempts and smoking intensity using Romania Global Adult Tobacco Survey 2018. Weighted estimates of EC and HTP by cigarette smoking (CS) status were assessed. Quit attempts, intention to quit, reasons for lack of intention to quit among current CS, and reasons for current use of EC and HTP were estimated. The association of 'ever use' of EC and HTP with cigarette smoking intensity and quit attempts was explored using binary logistic regression. Of the total 4571 surveyed, 1243 (27.3%) were current CS, 300 (24.4%) made quit attempts in the past 12 months. Only 38 (12.5%) and 26 (8.6%) had used EC and HTP as an aid to quit. Among current CS, 512 (41.2%) had no intention to quit. Reasons for this were, 'enjoy smoking' (86.1%), 'reduce stress' (65.9%), and 'staying alert' (46.3%). Awareness and use of EC and HTP were significantly higher among current CS. 'Dual use' of EC and HTP with CS was manifolds higher than stand-alone use. Reasons for current use of EC and HTP were 'enjoyment', and 'use in places where smoking was prohibited'.
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Affiliation(s)
- Sumaira Hussain
- Division of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
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20
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Enyioha C, Boynton MH, Ranney LM, Byron MJ, Goldstein AO, Kistler CE. Preferences for different features of ENDS products by tobacco product use: a latent class analysis. Subst Abuse Treat Prev Policy 2022; 17:18. [PMID: 35260177 PMCID: PMC8906001 DOI: 10.1186/s13011-022-00448-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND From a public health perspective, electronic nicotine delivery devices (ENDS) use may be beneficial for some populations (e.g., smokers who fully switch to ENDS) but detrimental for others (e.g., nonsmokers). Understanding the importance placed on different ENDS product features by user groups can guide interventions and regulations. METHODS Participants were US adults who had used ENDS at least once and from a convenience sample drawn from a market research software in 2016. Participants chose between 9 different ENDS product features (harms of use, general effects of use, use as a cessation aid, initial purchase price, monthly cost, nicotine content, flavor availability, device design, and modifiability). A latent class analysis (LCA) identified subgroups of feature preferences and examined differences between groups by socio-demographics and tobacco product use. RESULTS Of the 636 participants, 81% were White, the median age was 42, and 65% were current cigarette smokers. The LCA identified a 4-class solution as the most appropriate model: (1) people with high nicotine dependence who preferred ENDS similar to combustible cigarettes, (2) people with moderate tobacco use who were interested in low nicotine ENDS (3) people who use ENDS and combustible tobacco who preferred lower price and flavored ENDS products, and (4) people who used ENDS predominantly, without a strong preference for any of the features presented. CONCLUSIONS Tobacco use classes were associated with differences in preferences for ENDS features. These findings can inform regulations to reduce ENDS use among specific groups of people who use ENDS products.
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Affiliation(s)
- Chineme Enyioha
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Marcella H Boynton
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leah M Ranney
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Justin Byron
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Adam O Goldstein
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine E Kistler
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Okuyemi KS, Ojo-Fati O, Aremu TO, Friedrichsen SC, Grude L, Oyenuga M, Shyne M, Murphy SE, Hatsukami D, Joseph AM. A Randomized Trial of Nicotine versus No-nicotine E-cigarettes Among African American Smokers: Changes in Smoking and Tobacco Biomarkers. Nicotine Tob Res 2022; 24:555-563. [PMID: 34669956 DOI: 10.1093/ntr/ntab212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The objective of this clinical trial was to compare the effects of e-cigarettes with and without nicotine on patterns of combustible cigarette use and biomarkers of exposure to tobacco toxicants among African American smokers. METHODS African American smokers (n = 234) were enrolled in a 12-week, single blind, randomized controlled trial and assigned to ad lib use of nicotine e-cigarettes with or without menthol (2.4% nicotine [equivalent to combustible cigarettes], n = 118), or no-nicotine e-cigarettes (n = 116) for 6 weeks. Surveys were administered at baseline, 2, 6, and 12 weeks, and urinary biomarkers 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and total nicotine equivalents (TNE) were assessed at baseline and 6 weeks. RESULTS Participants smoked an average of 11.4 cigarettes per day (CPD) and 88% used menthol cigarettes at baseline. At Week 6, the nicotine group reported using e-cigarettes 9.1 times per day compared to 11.4 times in the no-nicotine group (p = 0.42). Combustible cigarette smoking decreased 3.0 CPD in the nicotine group compared to 2.7 CPD in the no-nicotine group (p = 0.74). Neither TNE nor NNAL changed significantly between baseline and Week 6. There were no differences in nicotine withdrawal symptoms between treatment groups. Smoking reduction persisted in both groups at Week 12. CONCLUSIONS Contrary to our hypotheses, nicotine e-cigarettes did not significantly reduce the use of combustible cigarettes compared to no-nicotine e-cigarettes in this cohort of African American smokers. Findings suggest e-cigarettes are modestly associated with the decreased use of combustible cigarettes among non-treatment seeking smokers, regardless of nicotine content, but without a reduction in tobacco toxicants. IMPLICATIONS Although e-cigarettes have the potential to reduce harm if substituted for combusted cigarettes (or if they promoted cessation) because of lower levels of tobacco toxicants, this study suggests ad lib use of e-cigarettes among African American smokers, with or without nicotine, results in modest smoking reduction but does not change toxicant exposure in a cohort where smoking cessation or reduction is not the goal. These data suggest that testing future harm reduction interventions using e-cigarettes should include more specific behavioral change coaching, including substituting for or completely stopping combusted cigarettes. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov - NCT03084315.
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Affiliation(s)
- Kolawole S Okuyemi
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Olamide Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Taiwo O Aremu
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Samantha C Friedrichsen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Lindsay Grude
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mosunmoluwa Oyenuga
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael Shyne
- Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MN, USA
| | - Sharon E Murphy
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, USA
| | - Dorothy Hatsukami
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Anne M Joseph
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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22
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Brooks JM, Mermelstein RJ. Negative Affect and Cigarette Cessation in Dual Users of Cigarettes and Electronic Nicotine Delivery Systems. Subst Use Misuse 2022; 57:1294-1302. [PMID: 35611915 PMCID: PMC10108370 DOI: 10.1080/10826084.2022.2079135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives: Dual use of cigarettes and electronic nicotine delivery systems (ENDS) is increasingly common in adult smokers, who often report using ENDS to quit smoking. Elevated negative affect is an established predictor of increased difficulty quitting smoking combustible cigarettes but has not yet been examined in the context of cigarette cessation for dual users. Method: This study examined whether mood-related factors predict cigarette smoking cessation among dual users (N = 364) over 12-months. Self-reported cigarette smoking at 12 months, with abstinence defined as no smoking for the past 7 days, was the primary outcome variable. Logistic regression included baseline levels of depression symptoms (CES-D), anxiety symptoms (MASQ), and negative affect expectancies for smoking, with baseline nicotine dependence for cigarettes (NDSS), motivation to quit, age, race/ethnicity, rate of cigarette smoking at baseline, and ENDS usage at baseline and 12 months as covariates. Interactions between CES-D, MASQ, and negative affect expectancies were examined. We predicted that negative affect, especially for smokers who had high negative affect expectancies for smoking, would be negatively associated with quitting. Results: Contrary to expectations, negative affect constructs did not predict quitting. Baseline nicotine dependence for cigarettes, gender, and race/ethnicity significantly predicted the likelihood of cigarette cessation. Higher rates of ENDS use, higher motivation, and lower negative affect smoking expectancies were significantly correlated with quitting cigarettes. Conclusion: In this non-treatment seeking sample of dual users, negative affect did not predict cigarette cessation over and above nicotine dependence for cigarettes, gender, and race/ethnicity.
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Affiliation(s)
- Julia M Brooks
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Robin J Mermelstein
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.,Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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23
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Jackson SE, Beard E, Brown J. Smokers' Use of E-Cigarettes in Situations Where Smoking Is not Permitted in England: Quarterly Trends 2011-2020 and Associations With Sociodemographic and Smoking Characteristics. Nicotine Tob Res 2021; 23:1831-1838. [PMID: 34089607 PMCID: PMC8496468 DOI: 10.1093/ntr/ntab119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION This study aimed to examine how the proportion of dual users of cigarettes and e-cigarettes who use e-cigarettes in situations where smoking is not permitted has changed since e-cigarettes became popular in England, and to characterize those who do so. METHODS Data were from 5081 adults in England who reported current smoking and current use of e-cigarettes ('dual users') participating in a nationally-representative monthly survey between April 2011 and February 2020. We modeled quarterly changes in prevalence of e-cigarette use in situations where smoking is not permitted and assessed multivariable associations with sociodemographic and smoking characteristics. RESULTS Between 2011 and 2020, prevalence of e-cigarette use in situations where smoking is not permitted followed a positive cubic trend, with a decelerating increase from an estimated 52.5% of dual users in Q2-2011 to 72.7% in Q3-2014, followed by a small decline to 67.5% in 2018, and subsequent increase to 74.0% in 2020. Odds were higher among those who were from more disadvantaged social grades, reported stronger smoking urges, or had made a past-year quit attempt, and lower among those who were aged at least 65 years (vs. 16-24 years), from the south (vs. north) of England, reported currently cutting down on their cigarette consumption or currently using nicotine replacement therapy. CONCLUSIONS In England, use of e-cigarettes in situations where smoking is not permitted is common among dual cigarette and e-cigarette users, has increased nonlinearly since 2011, and is particularly prevalent among those who are younger, disadvantaged, more addicted, have recently failed to quit, and are not attempting to cut down. IMPLICATIONS The ability to use nicotine in smoke-free settings appears to be an important part of the appeal of e-cigarettes. It is possible that if e-cigarette use was prohibited in public places, smokers may be deterred from using e-cigarettes alongside combustible tobacco, which could undermine quitting. Our results suggest disadvantaged and more addicted smokers would be disproportionately affected, suggesting such restrictions may contribute to inequalities in smoking and associated health outcomes.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
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24
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Beard E, Brown J, Jackson SE, Tattan‐Birch H, Shahab L. Differences between ethnic groups in self-reported use of e-cigarettes and nicotine replacement therapy for cutting down and temporary abstinence: a cross-sectional population-level survey in England. Addiction 2021; 116:2476-2485. [PMID: 33738884 PMCID: PMC8438700 DOI: 10.1111/add.15431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/13/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS The National Institute for Health and Care Excellence (NICE) has called for research into tobacco harm reduction across ethnicities, genders and socio-economic status. Although there is increasing research focused on the latter two, relatively few studies have considered ethnic variations. Therefore this study aimed to assess (i) the association between ethnicity and use of e-cigarettes and nicotine replacement therapy (NRT) for temporary abstinence and cutting down, and (ii) trends in prevalence of these over time. DESIGN Repeated cross-sectional household survey. SETTING England. PARTICIPANTS Between April 2013 and September 2019, data were collected on 24 114 smokers, 16+ of age, taking part in the Smoking Toolkit Study (STS). MEASUREMENTS Ethnicity coding included: White, mixed/multiple ethnic group, Asian, Black and Arab/other ethnic group. Smokers reported whether they were currently using e-cigarettes and/or NRT for cutting down or during periods of temporary abstinence. FINDINGS Odds of e-cigarette use for cutting down and temporary abstinence were significantly lower among those of Asian ethnicity (OR = 0.79, 95% CI = 0.66-0.93) and Arab/other ethnicity (OR = 0.58, 95% CI = 0.40-0.83) compared with White ethnicity. Those of mixed/multiple ethnicity had higher odds for NRT us (OR = 1.42, 95% CI = 1.04-1.94) compared with those of White ethnicity. Trend analysis indicated that for White ethnicity, e-cigarette use by smokers for cutting down and temporary abstinence followed an 'inverse S' shaped cubic curve indicating an overall rise, whereas NRT use followed an 'S' shaped cubic curve, indicating an overall decline. For mixed/multiple ethnicity a similar trend was found for NRT use only, with other ethnicities showing no statistically significant trends (suggesting relative stability over time). CONCLUSIONS In England, e-cigarette use by smokers for cutting down and temporary abstinence is less common among Asian and Arab/other ethnicity smokers compared with White smokers. Smokers of mixed/multiple ethnicity are the most likely to be using NRT compared with other ethnic groups for cutting down and temporary abstinence. E-cigarette use by smokers for cutting down and temporary abstinence has increased over time among White smokers, whereas prevalence in other ethnic groups has remained stable.
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Affiliation(s)
- Emma Beard
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Harry Tattan‐Birch
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Lion Shahab
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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25
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Pénzes M, Bakacs M, Brys Z, Vitrai J, Tóth G, Berezvai Z, Urbán R. Vaping-Related Adverse Events and Perceived Health Improvements: A Cross-Sectional Survey among Daily E-Cigarette Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168301. [PMID: 34444050 PMCID: PMC8394644 DOI: 10.3390/ijerph18168301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 11/20/2022]
Abstract
Web-based samples of e-cigarette users commonly report significant vaping-related health improvements (HIs) and mild adverse events (AEs). This cross-sectional study with in-person interviewing data collection examined self-reported AEs and perceived HIs among Hungarian adult current daily exclusive e-cigarette (n = 65) and dual users (n = 127), and former daily e-cigarette users (n = 91) in 2018. Logistic regression was used to evaluate associations between reporting any AEs/HIs, vaping status, and covariates. More former users (52.7%) reported AEs than current users (39.6%; p = 0.038). Exclusive and dual daily users reported similar rates of AEs (44.6% and 37.0%, respectively; p = 0.308). More current users (46.9%) experienced HIs than former users (35.2%; p = 0.064). Exclusive daily users were more likely to report HIs than dual users (63.1% versus 38.6%; p = 0.001). Former user status and smoking cessation/reduction reasons increased the odds of reporting AEs, whereas nicotine-containing e-liquid use and older age decreased the odds of reporting AEs. Exclusive vaper status, using advanced generation devices, and smoking cessation/reduction reasons increased the odds of experiencing HIs. This study, which used a traditional data collection methodology, found a higher rate of AEs and a lower rate of HIs compared to web-based surveys. Our results highlight that experiencing AEs and HIs is affected by users’ characteristics, in addition to the device and e-liquid type.
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Affiliation(s)
- Melinda Pénzes
- Department of Public Health, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary
- Correspondence: ; Tel.: +36-70-380-7655
| | - Márta Bakacs
- National Institute of Pharmacy and Nutrition, H-1051 Budapest, Hungary;
| | - Zoltán Brys
- Department of Telecommunications and Media Informatics, Faculty of Electrical Engineering and Informatics, Budapest University of Technology and Economics, H-1117 Budapest, Hungary;
| | - József Vitrai
- Pharmaproject-Statisztika Ltd., H-2081 Piliscsaba, Hungary;
| | - Gergely Tóth
- Institute of Sociology, Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Eötvös Loránd Research Network, H-1097 Budapest, Hungary;
- Faculty of Humanities and Social Sciences, Károli Gáspár University of the Reformed Church in Hungary, H-1091 Budapest, Hungary
| | - Zombor Berezvai
- Institute of Marketing, Corvinus University of Budapest, H-1093 Budapest, Hungary;
| | - Róbert Urbán
- Institute of Psychology, Eötvös Loránd University, H-1064 Budapest, Hungary;
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26
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Kirkpatrick MG, Dormanesh A, Rivera V, Majmundar A, Soto DW, Chen-Sankey JC, Cruz TB, Unger JB, Allem JP. #FlavorsSaveLives: An Analysis of Twitter Posts Opposing Flavored E-cigarette Bans. Nicotine Tob Res 2021; 23:1431-1435. [PMID: 33394024 DOI: 10.1093/ntr/ntaa276] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Starting in 2019 policies restricting the availability of flavored e-cigarette products were proposed or implemented in the United States to curb vaping by youth. People took to Twitter to voice their opposition, referencing the phrase "Flavors Save Lives." This study documented the emerging themes pertaining to "Flavors Saves Lives" over a 12-month period. METHODS The study period was from May 1, 2019, to May 1, 2020. A stratified sampling procedure supplied 2500 tweets for analysis. Posts were classified by one or more of the following themes: (1) Political Referendum; (2) Institutional Distrust; (3) Individual Rights; (4) Misinformation; (5) THC Vaping is the Real Problem; (6) Smoking Cessation; (7) Adult Use; and (8) Not a Bot. The temporal pattern of tweets over the year was examined. RESULTS Political Referendum (76.5%) and Institutional Distrust (31.3%) were the most prominent themes, followed by Not a Bot (11.0%), Individual Rights (10.4%), Adult Use (8.0%), Smoking Cessation (6.6%), Misinformation (5.9%), and THC Vaping is the Real Problem (3.5%). Total tweet frequencies increased in September 2019 and peaked in November 2019 before returning to relatively low numbers. Political Referendum and Institutional Distrust were consistently the most prevalent themes over time. CONCLUSION Twitter posts with the phrase "Flavors Save Lives" commonly discussed voting against political incumbents and mentioned distrust of government representatives. Findings demonstrated the possibility of near real-time Twitter monitoring of public opposition to flavor bans. These data may be valuable for designing tobacco control information campaigns in the future. IMPLICATIONS (a) Starting in 2019 policies restricting the availability of flavored e-cigarette products were proposed or implemented in the United States to curb vaping by youth. (b) This study content analyzed Twitter posts with the phrase "Flavors Save Lives" from a 12-month period to understand opposition to flavor restrictions. (c) Twitter posts commonly discussed voting against political incumbents and mentioned distrust of government representatives. (d) Findings demonstrated the possibility of near real-time Twitter monitoring of public opposition to flavor bans, and contribute to a more comprehensive assessment of different sub-population's responses to current and proposed tobacco control information policies.
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Affiliation(s)
- Matthew G Kirkpatrick
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Allison Dormanesh
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Vanessa Rivera
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Anuja Majmundar
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Daniel W Soto
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Julia Cen Chen-Sankey
- Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Tess Boley Cruz
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Jon-Patrick Allem
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
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27
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Oloyede EO, Ola O, Kolade VO, Tevie J. Looking Back and Going Forward: Roles of Varenicline and Electronic Cigarettes in Smoking Cessation. Cureus 2021; 13:e16824. [PMID: 34522481 PMCID: PMC8425133 DOI: 10.7759/cureus.16824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/03/2022] Open
Abstract
Tobacco use is the single largest preventable cause of death in the United States (US). The national goal of reducing the prevalence of adult cigarette smoking to 12% was retained for 20 years due to non-attainment. Meanwhile, varenicline and electronic cigarettes (ECs) became available in the US in 2006 and 2007, respectively, and have been used by many smokers wanting to quit. The purpose of this review is to compare varenicline and ECs in terms of efficacy for smoking cessation after over a decade of widespread use in the US. Data collection for systematic review and qualitative synthesis by a PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelinesand the Oxford Quality Scale, respectively, was performed in June 2018 and updated in June 2020. Articles were eligible if published in English as original research in the form of a randomized clinical trial (RCT), a systematic review and meta-analysis, a systematic review, or a cross-sectional study. Eighteen studies were included: nine RCTs, four cross-sectional studies, two meta-analyses, one systematic review, one systematic review and meta-analysis, and one cohort study. No head-to-head RCT compared varenicline to ECs. In four RCTs, varenicline was more effective than placebo for smoking cessation. In two RCTs, ECs were more effective than placebo but a meta-analysis of 20 studies reported a statistically significant decrease in the odds of quitting smoking using ECs as compared to placebo. To conclude, varenicline and ECs have data suggesting efficacy for smoking cessation; however, unlike varenicline, ECs were not effective in all studies.
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Affiliation(s)
| | - Olatunde Ola
- Hospital Medicine, Mayo Clinic Health System, La Crosse, USA
- Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, USA
| | | | - Justin Tevie
- Health Economics, Missouri Department of Mental Health, Jefferson City, USA
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28
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Sharma E, Yang DH, Stroud LR. Variations in Electronic Nicotine Delivery System (ENDS) device types and association with cigarette quit attempts. Prev Med 2021; 148:106588. [PMID: 33930433 PMCID: PMC8497016 DOI: 10.1016/j.ypmed.2021.106588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 11/16/2022]
Abstract
This study examined electronic nicotine delivery systems (ENDS) devices classified as disposable, non-refillable cartridge, refillable cartridge, refillable tank, and refillable mod systems and examined if cigarette quit attempts varied by device type among daily and non-daily ENDS users. Data from Wave 3 (2015-16) of the Population Assessment of Tobacco and Health Study, a nationally representative study in the U.S. was used to explore ENDS device types among past 12 month adult cigarette and ENDS users (n = 4952). Multivariate models were fitted to predict cigarette quit attempts among daily (n = 474) and nondaily (n = 1074) ENDS users by ENDS device types. Analyses were conducted in April 2020. Refillable tank system (38.5%) was the most prevalent and refillable cartridge was the least prevalent (3.3%) device type among past 12 month cigarette and ENDS users. Adults who used disposable ENDS were least likely to use ENDS as "an alternative to quitting all tobacco" (p < 0.001) or "as a way of cutting down on smoking" (p < 0.001). The odds of attempting to quit smoking were higher among daily ENDS users who used non-refillable cartridge (AOR = 7.3, 95% CI: 1.5-34.9), refillable tank (AOR = 5.3, 95% CI: 1.5-19.3) or refillable mod systems (AOR = 5.9, 95% CI: 1.2-30.1) compared to those who used disposables adjusting for age group, gender, race, ethnicity, and nicotine dependence. The likelihood of quit attempt among non-daily ENDS users did not differ by device type. Better understanding of ENDS device types and their use in smoking cessation is needed to inform health interventions.
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Affiliation(s)
- Eva Sharma
- Behavioral Health and Health Policy, Westat, Rockville, MD, United States.
| | - Duck-Hye Yang
- Behavioral Health and Health Policy, Westat, Rockville, MD, United States
| | - Laura R Stroud
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, United States
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29
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Alqahtani MM, Alanazi AM, Pavela G, Dransfield MT, Wells JM, Lein DH, Hendricks PS. Binge Drinking Moderates the Association Between Chronic Lung Disease and E-Cigarette Use. Respir Care 2021; 66:936-942. [PMID: 33688091 DOI: 10.4187/respcare.08559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is a paucity of research on e-cigarette use among adults with chronic lung disease. Accordingly, little is known about the factors that may contribute to e-cigarette use in this population. The purpose of this study was to evaluate the relationship between chronic lung disease and e-cigarette use and to determine whether binge drinking moderates this relationship. METHODS Data were derived from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). Logistic regression was used to test the association between chronic lung disease status and e-cigarette use, controlling for demographic variables and chronic health conditions. We conducted moderation analyses to test the hypothesis that the association between chronic lung disease and lifetime e-cigarette use would be modified by binge drinking. RESULTS The prevalence of lifetime e-cigarette use was higher among adults with chronic lung disease than among those without, and more frequent binge drinking was associated with an increased likelihood of lifetime e-cigarette use independent of chronic lung disease status. Binge drinking moderated the relationship between chronic lung disease and lifetime use of e-cigarettes such that the association between chronic lung disease and e-cigarette use was weaker among those who engaged in more episodes of binge drinking in the past 30 d. Among those without chronic lung disease, binge drinking was associated with an increased likelihood of e-cigarette use. CONCLUSIONS E-cigarette use appears to be more common among adults with chronic lung disease. Although binge drinking was positively associated with e-cigarette use, more frequent binge drinking weakened the relationship between chronic lung disease and e-cigarette use. Though future studies are needed to determine precisely how binge drinking affects this association, it is possible that individuals with chronic lung disease who binge drink more frequently use e-cigarettes less frequently, despite an increased likelihood of having ever used an e-cigarette. (ClinicalTrials.gov registration NCT04135404.).
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Affiliation(s)
- Mohammed M Alqahtani
- Respiratory Care Department, King Saud Abdul-Aziz University for Health Science, Riyadh, Saudi Arabia.
- University of Ala bama at Birmingham, Birmingham, Ala bama
| | - Abdullah M Alanazi
- Respiratory Care Department, King Saud Abdul-Aziz University for Health Science, Riyadh, Saudi Arabia
- University of Ala bama at Birmingham, Birmingham, Ala bama
| | - Gregory Pavela
- Department of Health Behavior, University of Ala bama at Birmingham, Birmingham, Alabama
| | | | - J Michael Wells
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Donald H Lein
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama
| | - Peter S Hendricks
- Department of Health Behavior, University of Ala bama at Birmingham, Birmingham, Alabama
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30
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Gold AK, Otto MW, Hoyt DL, Garey L, Smit T, Zvolensky M. Do Pain-Related Anxiety and Difficulties With Emotion Regulation Impact Abstinence Expectancies or Motivation to Quit E-Cigarette Use? J Stud Alcohol Drugs 2021; 82:414-421. [PMID: 34100710 PMCID: PMC8328231 DOI: 10.15288/jsad.2021.82.414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/15/2020] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarette users. We evaluated whether pain-related anxiety and difficulties with emotion regulation independently and in interaction predict e-cigarette users' expectancies surrounding abstinence and their motivation to stop using e-cigarettes. METHOD Daily e-cigarette users (n = 290, mean age= 35.5, SD = 10.9, 56.6% male) completed an online survey about e-cigarette use. We conducted hierarchical multiple regression analyses to evaluate the main and interactive influence of pain-related anxiety and difficulties with emotion regulation on our outcomes. RESULTS Increased pain-related anxiety independently predicted negative abstinence expectancies and increased motivation to quit e-cigarette use (ps < .001). Increased difficulties with emotion regulation predicted only negative abstinence expectancies (ps < .01) when pain-related anxiety was included in the model. The interaction between pain-related anxiety and difficulties with emotion regulation was not significant. CONCLUSIONS As hypothesized, increased pain-related anxiety was associated with both negative expectancies of abstinence and increased motivation to quit e-cigarette use, but contrary to our hypothesis, difficulties with emotion regulation were not significantly associated with increased motivation to quit e-cigarette use when evaluated with pain-related anxiety in the model. These findings may elucidate processes influencing abstinence expectancies and motivation to quit in a sample of e-cigarette users, although replication in a larger, more diverse sample is warranted.
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Affiliation(s)
- Alexandra K. Gold
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- University of Texas MD Anderson Cancer Center, Houston, Texas
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Suryadinata RV, Wirjatmadi B, Lorensia A. The time pattern of selenomethionine administration in preventing free radicals due to exposure to electric cigarette smoke. J Public Health Res 2021; 10. [PMID: 33855416 PMCID: PMC8129744 DOI: 10.4081/jphr.2021.2232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Most people believe that electric cigarettes have no negative effect on health, which causes them to use it more. However, exposure to the smoke from these cigarettes is bad for the health and causes cell damage. Antioxidants play an important role in preventing cell damage, and they can be obtained through the oral administration of selenomethionine. DESIGN AND METHODS This study used an experimental method and a post-test control group design. Male Wistar rats, which were exposed to cigarette smoke were given selenomethionine orally and then tested for the presence of free radicals. The measurement of lung tissue damage was conducted by assessing the level of malondialdehyde in the blood and immunohistochemistry (IHC) of the lung tissue. RESULT The study showed that differences in the time of administration of selenomethionine affect the levels of malondialdehyde in the blood and expression of malondialdehyde in the lung tissue (p<0.05). Consequently, the two groups showed a strong (r=0.861) and significant (p=0.000) relationship with each other. CONCLUSION The early application of selenomethionine can prevent increased levels of malondialdehyde in the blood and lung tissue due to exposure to e-cigarette smoke.
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Affiliation(s)
| | | | - Amelia Lorensia
- Faculty of Pharmacy, Universitas Surabaya (UBAYA), Surabaya.
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Srikanth N, Xie L, Morales-Marroquin E, Ofori A, de la Cruz-Muñoz N, Messiah SE. Intersection of smoking, e-cigarette use, obesity, and metabolic and bariatric surgery: a systematic review of the current state of evidence. J Addict Dis 2021; 39:331-346. [PMID: 33543677 DOI: 10.1080/10550887.2021.1874817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Millions of Americans qualify for metabolic and bariatric surgery (MBS) based on the proportion of the population with severe obesity. Simultaneously, the use of electronic nicotine/non-nicotine delivery systems (ENDS) has become epidemic. OBJECTIVE We conducted a timely systematic review to examine the impact of tobacco and ENDS use on post-operative health outcomes among MBS patients. METHODS PRISMA guidelines were used as the search framework. Keyword combinations of either "smoking," "tobacco," "e-cigarette," "vaping," or "ENDS" and "bariatric surgery," "RYGB," or "sleeve gastrectomy" were used as search terms in PUBMED, Science Direct, and EMBASE. Studies published in English between January 1990 and June 2020 were screened. RESULTS From the 3251 articles found, a total of 48 articles were included in the review. No articles described a relationship between ENDS and post-operative health outcomes in MBS patients. Seven studies reported smokers had greater post-MBS weight loss, six studies suggested no relationship between smoking and post-MBS weight loss, and one study reported smoking cessation pre-MBS was related to post-MBS weight gain. Perioperative use of tobacco is positively associated with several post-surgery complications and mortality in MBS patients. CONCLUSIONS Combustible tobacco use among MBS patients is significantly related to higher mortality risk and complication rates, but not weight loss. No data currently is available on the impact of ENDS use in these patients. With ENDS use at epidemic levels, it is imperative to determine any potential health effects among patients with severe obesity, and who complete MBS.
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Affiliation(s)
- Nimisha Srikanth
- School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA.,School of Public Health, Texas A&M University, College Station, TX, USA
| | - Luyu Xie
- School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | - Elisa Morales-Marroquin
- School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | - Ashley Ofori
- School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
| | | | - Sarah E Messiah
- School of Public Health, Dallas Regional Campus, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
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Kos K. Cardiometabolic Morbidity and Mortality with Smoking Cessation, Review of Recommendations for People with Diabetes and Obesity. Curr Diab Rep 2020; 20:82. [PMID: 33289870 PMCID: PMC7722253 DOI: 10.1007/s11892-020-01352-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Obesity is closely linked with the pathogenesis of type 2 diabetes (T2DM) and cardiovascular disease (CVD), and whilst smoking cessation is associated with weight gain, there are concerns that this weight gain may offset the benefit of CVD risk reduction especially in those with considerable post-cessation weight gain. The aim of this narrative review is to evaluate recent evidence on smoking cessation and cardiometabolic outcomes and discuss limitations of current knowledge and studies. RECENT FINDINGS Nicotine is a key player in modulating energy balance by influencing lipid storage in adipose tissue by affecting lipolysis, energy input by modulating appetite and energy output by increasing sympathetic drive and thermogenesis. It also increases insulin resistance and promotes abdominal obesity. The CVD risk and mortality associated with cigarette smoking potentiate the CVD risks in patients with diabetes. Evidence supports the benefit of quitting cigarette smoking regardless of any subsequent weight gain. Data suggests that the cardiometabolic risk is limited to the first few years and that cardiovascular health and mortality benefit of smoking cessation outweighs the harm related to weight gain. This weight gain can be limited by nicotine replacement of which e-cigarettes (vaping) are increasingly popular if it is not an alternative to cigarette smoking. However, long-term health data on e-cigarettes is needed prior to formal recommendation for its use in smoking cessation. The recommendation for cessation of cigarette smoking is justified for those at high risk of weight gain and diabetes. However, for most benefit, consideration should be given for personalized weight management to limit weight gain. Awareness of a 'lean paradox' by which lower weight is associated with increased CVD risk may help to improve motivation and insight into the bias of smoking, health and body composition otherwise known to epidemiologists as the 'obesity paradox'.
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Affiliation(s)
- Katarina Kos
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
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Owusu D, Massey Z, Popova L. An experimental study of messages communicating potential harms of electronic cigarettes. PLoS One 2020; 15:e0240611. [PMID: 33085686 PMCID: PMC7577451 DOI: 10.1371/journal.pone.0240611] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
There has been an upsurge of e-cigarette use in the United States in recent years. While e-cigarettes may contain lower levels of toxic chemicals than combusted cigarettes, they still pose serious health hazards, including increased risk for heart and respiratory disease. Despite these risks, public awareness of the health harms of e-cigarettes remains low. Thus, it is important to educate the public about the potential harms of e-cigarettes. This study took themes commonly found in antismoking messages and used them to develop messages about harms of e-cigarettes. A national sample of 2801 current smokers and nonsmokers (aged 18+ years) were randomized to view one of four e-cigarette messages (harmful effect of chemicals, uncertainty about ingredients, distrust of big tobacco, or cost of vaping) or a control message (bottled water ad). Participants' reactions to the messages and behavioral intentions were assessed immediately following the exposure. MANOVA examined effects of the messages on blocks of the outcome variables and univariate analyses estimated adjusted means for each experimental condition for each outcome. The message about harmful chemicals was perceived as the most informative and effective and elicited the highest levels of negative emotions (Ps<0.05). However, on measures of actual effectiveness, the other messages performed equally well. Specifically, messages with different themes (harmful chemicals, uncertainty about ingredients, anti-industry, or financial cost) increased perceived risk of e-cigarettes, support for e-cigarette control, and lowered self-exempting beliefs and intentions to use e-cigarettes (Ps<0.05). Themes commonly used in anti-smoking messages may be effective in educating the public about the potential harm of e-cigarettes. The observed differential effects of the messages suggest the need to use multiple themes in a public education campaign about e-cigarettes.
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Affiliation(s)
- Daniel Owusu
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Zachary Massey
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
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Patel M, Cuccia AF, Zhou Y, Kierstead EC, Briggs J, Schillo BA. Smoking cessation among US adults: use of e-cigarettes, including JUUL, and NRT use. Tob Control 2020; 30:693-695. [PMID: 32958602 DOI: 10.1136/tobaccocontrol-2020-056013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) are a common tobacco product in the US. Despite lacking Food and Drug Administration (FDA) approval for cessation, e-cigarettes, including JUUL, a popular device, have been viewed by some as a potential tool for tobacco users seeking to quit combustible tobacco use. It is unknown how current and former smokers report using these products for cigarette smoking cessation. METHODS Online surveys were collected from a probability-based panel of US adults aged 18-64, with an oversample of past 12-month JUUL users (n=3415). Weighted past 12-month and past 30-day use of popular e-cigarette brands were measured. Former smokers with a quit attempt in the past 4 years and current smokers with a quit attempt in the past 12 months were asked about methods for smoking cessation, including e-cigarettes and nicotine replacement therapies (NRTs) use. RESULTS Among former smokers (n=157), 21.2% used e-cigarettes and/or NRTs to help them quit. Specifically, 2.2% used JUUL only, compared with 10.3% who used NRTs only, and 6.9% used other e-cigarettes only to quit. Among current smokers with a quit attempt (n=308), 24.0% used any product (NRT or e-cigarettes) to quit, and only 1.1% used JUUL only. Current smokers reported relatively low use of NRTs only (10.1%), other e-cigarettes only (5.6%) and other e-cigarettes and NRTs (5.1%). CONCLUSIONS Data suggest that few smokers in the US use e-cigarettes, and JUUL specifically, for cessation, and NRTs use is relatively low. All e-cigarettes should undergo FDA review to minimise recreational use and understand their cessation efficacy.
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Affiliation(s)
- Minal Patel
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Yitong Zhou
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | | | - Jodie Briggs
- Schroeder Institute, Truth Initiative, Washington, DC, USA
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Malt L, Verron T, Cahours X, Guo M, Weaver S, Walele T, O’Connell G. Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population Assessment of Tobacco and Health (PATH) study data. Harm Reduct J 2020; 17:65. [PMID: 32948187 PMCID: PMC7501702 DOI: 10.1186/s12954-020-00410-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have been characterised as significantly less harmful than cigarettes by many health agencies and regulators globally. In this study, we examined to what extent perceived relative harms of e-cigarettes compared to cigarettes have changed in the USA. METHODS We analysed the data from the longitudinal and nationally representative, Population Assessment of Tobacco and Health Study to assess the relative perceived harm of e-cigarettes amongst US adults between 2013 and 2016. RESULTS The proportion of US adults who correctly perceived e-cigarettes as less harmful than cigarettes decreased each year from 41.1% (CI 40.1-42.1%) in 2013-2014, 31.5% (CI 30.8-32.2%) in 2014-2015 and 25.3% (CI 24.6-26.0%) in 2015-2016. Concurrently, the proportion of US adults who perceived e-cigarettes as equally, or more, harmful than cigarettes increased from 53.7% (CI 52.3-55.1%), 64.9% (CI 63.6-66.2%) to 72.7% (CI 71.5-73.9%) respectively. The proportion of US adults who held negative relative harm perceptions of e-cigarettes increased regardless of current smoking or vaping status by 24.6% and 29.6% respectively within 3 years. In Wave 3, the proportion of current smokers who perceived the relative harm of e-cigarettes as less harmful was lower at 29.3% (CI 28.2-30.4%) compared to current e-cigarette users at 43.5% (CI 40.3-46.7%). Former smokers who used e-cigarettes and believed that they were equally, or more, harmful than cigarettes in 2014-2015 had significantly higher rates of smoking relapse in the following year, 29% and 37% (p < 2.2e-16), respectively, compared to those with positive relative harm perceptions who reported relapse rates of 19%. CONCLUSIONS In this study, the proportion of US adults who incorrectly perceived e-cigarettes as equal to, or more, harmful than cigarettes increased steadily regardless of smoking or vaping status. Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products. The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms. Further research is required to elucidate why the relative harm of e-cigarettes is misunderstood and continues to deteriorate.
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Affiliation(s)
- Layla Malt
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Thomas Verron
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Xavier Cahours
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Mengran Guo
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Sarah Weaver
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Tanvir Walele
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Grant O’Connell
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
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Szafran BN, Pinkston R, Perveen Z, Ross MK, Morgan T, Paulsen DB, Penn AL, Kaplan BLF, Noël A. Electronic-Cigarette Vehicles and Flavoring Affect Lung Function and Immune Responses in a Murine Model. Int J Mol Sci 2020; 21:E6022. [PMID: 32825651 PMCID: PMC7504509 DOI: 10.3390/ijms21176022] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/15/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022] Open
Abstract
The use of electronic nicotine delivery systems (ENDS), also known as electronic-cigarettes (e-cigs), has raised serious public health concerns, especially in light of the 2019 outbreak of e-cig or vaping product use-associated acute lung injury (EVALI). While these cases have mostly been linked to ENDS that contain vitamin E acetate, there is limited research that has focused on the chronic pulmonary effects of the delivery vehicles (i.e., without nicotine and flavoring). Thus, we investigated lung function and immune responses in a mouse model following exposure to the nearly ubiquitous e-cig delivery vehicles, vegetable glycerin (VG) and propylene glycol (PG), used with a specific 70%/30% ratio, with or without vanilla flavoring. We hypothesized that mice exposed sub-acutely to these e-cig aerosols would exhibit lung inflammation and altered lung function. Adult female C57BL/6 mice (n = 11-12 per group) were exposed to filtered air, 70%/30% VG/PG, or 70%/30% VG/PG with a French vanilla flavoring for 2 h a day for 6 weeks. Prior to sacrifice, lung function was assessed. At sacrifice, broncho-alveolar lavage fluid and lung tissue were collected for lipid mediator analysis, flow cytometry, histopathology, and gene expression analyses. Exposures to VG/PG + vanilla e-cig aerosol increased lung tidal and minute volumes and tissue damping. Immunophenotyping of lung immune cells revealed an increased number of dendritic cells, CD4+ T cells, and CD19+ B cells in the VG/PG-exposed group compared to air, irrespective of the presence of vanilla flavoring. Quantification of bioactive lung lipids demonstrated a >3-fold increase of 2-arachidonoylglycerol (2-AG), an anti-inflammatory mediator, and a 2-fold increase of 12-hydroxyeicosatetraenoic acid (12-HETE), another inflammatory mediator, following VG/PG exposure, with or without vanilla flavoring. This suggests that e-cig aerosol vehicles may affect immunoregulatory molecules. We also found that the two e-cig aerosols dysregulated the expression of lung genes. Ingenuity Pathway Analysis revealed that the gene networks that are dysregulated by the VG/PG e-cig aerosol are associated with metabolism of cellular proteins and lipids. Overall, our findings demonstrate that VG and PG, the main constituents of e-liquid formulations, when aerosolized through an e-cig device, are not harmless to the lungs, since they disrupt immune homeostasis.
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Affiliation(s)
- Brittany N. Szafran
- Center for Environmental Health Sciences, Department of Basic Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS 39762, USA; (B.N.S.); (M.K.R.); (B.L.F.K.)
| | - Rakeysha Pinkston
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA; (R.P.); (Z.P.); (A.L.P.)
- Department of Environmental Toxicology, Southern University, Baton Rouge, LA 70803, USA
| | - Zakia Perveen
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA; (R.P.); (Z.P.); (A.L.P.)
| | - Matthew K. Ross
- Center for Environmental Health Sciences, Department of Basic Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS 39762, USA; (B.N.S.); (M.K.R.); (B.L.F.K.)
| | - Timothy Morgan
- Department of Pathobiology and Population Medicine, Mississippi State University College of Veterinary Medicine, Mississippi State, MS 39762, USA;
| | - Daniel B. Paulsen
- Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Arthur L. Penn
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA; (R.P.); (Z.P.); (A.L.P.)
| | - Barbara L. F. Kaplan
- Center for Environmental Health Sciences, Department of Basic Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS 39762, USA; (B.N.S.); (M.K.R.); (B.L.F.K.)
| | - Alexandra Noël
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA; (R.P.); (Z.P.); (A.L.P.)
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Abdel-Qader DH, Al Meslamani AZ. Knowledge and Beliefs of Jordanian Community Toward E-cigarettes: A National Survey. J Community Health 2020; 46:577-586. [PMID: 32772206 DOI: 10.1007/s10900-020-00896-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Electronic nicotine delivery systems were promoted publically as a healthier replacement for conventional cigarettes. Knowledge and beliefs of the public can drive their behaviours to adapt or reject the new habit. No previous research was conducted in Jordan to assess electronic cigarettes (e-cigarettes) prevalence, and limited data are available on public opinions and orientation toward this new habit. To assess prevalence of, knowledge, attitude and beliefs about e-cigarettes, and examine factors associated with plans of quitting or initiating e-cigarettes among adults in Jordan. A large cross-sectional face-to-face survey on a random sample of adult population aged ≥ 18 years was conducted over two months to include 1820 adults in Jordan. A representative sample was collected using proportionate random sampling technique, which enabled us to geographically categorise the study population. Reliability and validity measures were taken to ensure a comprehensive and appropriate study tool. The Statistical Package for Social Science (SPSS®) version 24 was used to conduct descriptive analysis, logistic regression, and Rao-Scott chi-square. Findings were considered statistically significant at p value < 0.05 (with a confidence limit at 95%). Of 2164 adults approached, 1820 completed the questionnaire (84.1% response rate). The prevalence of current e-cigarette smokers and dual smokers were 11.7% and 4.0%, respectively. Quitting conventional smoking (38.8%) and enjoying the flavour (32.5%) were the most common reasons to start vaping. Friends were the major source of information about e-cigarettes. There was evidence that adults aged 45-59 years were less likely to be dual smokers (OR 0.51; 95%CI 0.29-0.66; p = 0.03). Poor knowledge about the content (23.7%) and types of e-cigarettes (14.5%) was reported. Plans to reduce or quit e-cigarettes were significantly associated with three factors: smokers' knowledge about its content, social impression, smokers' satisfaction with e-cigarettes. Social impression was also associated with plans of initiating e-cigarettes. Most participants thought vaping cannot be harmful to children and pregnant women (73.1%) and cannot be addictive (58.2%). Electronic cigarettes were considered helpful in smoking cessation by 69.1% of participants. The proportions of adults who were currently electronic cigarette and dual smokers were 11.7% and 4.0%, respectively. Our research may provide insight to product and individual factors that were associated with plans to sustain, quit or initiate electronic smoking.
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Abstract
Interest in electronic cigarette (EC) use, or vaping, to help control weight is increasing. Many American Indian (AI) populations have a high prevalence of smoking, obesity, and EC use, but their perceptions of EC use for weight control are unknown. In Oklahoma in 2016, 375 AI adults who smoke completed a survey including perceptions about smoking and EC effects on weight control. Only 24% believed that smoking helps control weight, and 8% believed that vaping helps control weight. Perceptions differed by EC use, with ever users more often than never users perceiving that smoking (30% vs 12%, respectively; p < .01) and vaping (10% vs 5%; p = .04) help to control weight. Sex, age group (18-44 years vs 45 + years), education (high school graduate/equivalent vs less than high school), smoking cessation attempt in past year, and likelihood to quit in 6 months were not associated with weight control perceptions for either smoking or vaping. Uncertainty regarding EC effects on weight control was less common among EC ever users compared to never users (41% vs 53%, respectively; p = .04). Most people who did not believe or were uncertain that smoking controls weight also did not believe or were uncertain that vaping controls weight. However, only a minority (29%) of people who believed smoking controls weight also believed that vaping controls weight. Among adult AI who smoke, both smoking and vaping were infrequently perceived as helping to control weight, but such perceptions were reported more frequently among those who ever used ECs.
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Her W. How Is Use of Electronic Cigarettes Related to Conventional Cigarette Use? A Qualitative Study among Korean American Young Adults. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:308-320. [PMID: 32631207 DOI: 10.1080/19371918.2020.1785982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Given the growing popularity of e-cigarettes in the United States, there is a need to understand the relationship between conventional and electronic cigarette use among Korean American young adults. Thus, this study aimed to explore Korean American young adults' experience of electronic cigarettes and its association with use of conventional cigarettes. This study employed an exploratory qualitative design. Individual interviews were conducted with 15 Korean American young adults aged between 18 and 25 years who reported having smoked at least one conventional cigarette per day for the past 6 months. Interview data were subjected to thematic analysis in order to gain an in-depth understanding of the interconnection between e-cigarette and conventional cigarette use. Data analysis revealed three themes involving reasons for buying, using, and stopping use of e-cigarettes, each of which had several sub-themes. Study results suggest that experience of e-cigarettes was related to conventional cigarette use. Thus, the experience of e-cigarettes as well as conventional cigarettes should be considered in designing smoking cessation interventions for Korean American young adults.
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Affiliation(s)
- Wonbin Her
- Public Policy Research Institute, Pukyong National University , Busan, Republic of Korea
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Dave D, Dench D, Kenkel D, Mathios A, Wang H. News that Takes Your Breath Away: Risk Perceptions During an Outbreak of Vaping-related Lung Injuries. JOURNAL OF RISK AND UNCERTAINTY 2020; 60:281-307. [PMID: 34504389 PMCID: PMC8425473 DOI: 10.1007/s11166-020-09329-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We study the impact of new information on people's perceptions of the risks of e-cigarettes. In September 2019 the U.S. experienced an outbreak of e-cigarette, or vaping, associated lung injuries (EVALI). The EVALI outbreak created an information shock, which was followed by additional new information in a later CDC recommendation. We use data on consumer risk perceptions from two sets of surveys conducted before (HINTS survey data) and during the EVALI outbreak (Google Survey data). The empirical model examines changes in risk perceptions during the early crisis period when the CDC was warning consumers that they should avoid all vaping products and during a later period when the message was refined and focused on a narrower set of illegal vaping products that contain THC (the main psychoactive compound in marijuana). Econometric results suggest that the immediate impact of the first information shock was to significantly increase the fraction of respondents who perceived e-cigarettes as more harmful than smoking. As the outbreak subsided and the CDC recommendation changed to emphasize the role of THC e-cigarette products, e-cigarette risk perceptions were only partially revised downwards. Individuals who had higher risk perceptions showed a weaker response to the first information shock but were more likely to later revise their risk perceptions downwards. We conclude the paper by discussing the public policy issues that stem from having risk perceptions of e-cigarette relative to combustible cigarettes remain at these elevated levels where a substantial portion of consumers believe that e-cigarettes are more harmful than cigarettes.
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Affiliation(s)
- Dhaval Dave
- Bentley University, National Bureau of Economic Research (NBER) & Institute of Labor Economics (IZA)
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Adamson J, Kanitscheider C, Prasad K, Camacho OM, Beyerlein E, Bhagavan YK, Proctor C, Murphy J. Results from a 2018 cross-sectional survey in Tokyo, Osaka and Sendai to assess tobacco and nicotine product usage after the introduction of heated tobacco products (HTPs) in Japan. Harm Reduct J 2020; 17:32. [PMID: 32450856 PMCID: PMC7249648 DOI: 10.1186/s12954-020-00374-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 04/28/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND For novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use. This pilot study was performed to examine the use of tobacco products in three Japanese urban regions. METHODS This study was a cross-sectional epidemiological survey administered in Sendai, Tokyo and Osaka, Japan, from May 19th to June 25th, 2018. Participants were selected with a three-stage probability random sampling process that first identified primary sampling units, then households and finally individuals. Eligible participants were aged at least 20 years who were willing to participate after information about the study was provided. People younger than 20 years and those living in institutions were excluded. Questionnaires were paper based and administered door to door. RESULTS Responses were obtained from 4154 participants. Sixty-five percent self-reported being never, 19% current and 16% former users of any tobacco product at the time of the survey. Combustible tobacco products (almost all being cigarette) were used most (16%) followed by HTPs (5%). In the categories of combustible tobacco users and HTP users, 70% and 16%, respectively, used these products exclusively. Dual use was reported by 11% of respondents. Compared with 12 months before the survey, 12% of sole combustible tobacco products users were using HTPs exclusively or as dual users and 6% had quit tobacco products completely; 94% of sole HTP users remained sole users and 4% had quit tobacco products completely; and amongst dual users 12% had reverted to exclusive use of combustible tobacco products, 14% had switched to sole use of HTPs and 4% had quit tobacco products completely. CONCLUSION HTPs seem to be accepted as an alternative tobacco product amongst combustible tobacco users. Given complex findings for dual use, improved understanding of the motivations underlying this behaviour would be of interest.
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Affiliation(s)
- Jason Adamson
- Research & Development, British American Tobacco, Southampton, SO15 8TL UK
| | | | - Krishna Prasad
- Research & Development, British American Tobacco, Southampton, SO15 8TL UK
| | - Oscar M. Camacho
- Research & Development, British American Tobacco, Southampton, SO15 8TL UK
| | | | | | | | - James Murphy
- Research & Development, British American Tobacco, Southampton, SO15 8TL UK
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Verplaetse TL, Moore KE, Pittman BP, Roberts W, Oberleitner LM, Peltier MKR, Hacker R, Cosgrove KP, McKee SA. Intersection of E-Cigarette Use and Gender on Transitions in Cigarette Smoking Status: Findings Across Waves 1 and 2 of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 21:1423-1428. [PMID: 30239953 DOI: 10.1093/ntr/nty187] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/05/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Cigarette smokers report using electronic cigarettes (e-cigarettes) to reduce or quit smoking, but findings are mixed regarding the benefit and risk of e-cigarettes in this population, and effects of gender are unknown. METHODS The Population Assessment of Tobacco and Health (PATH; waves 1 and 2; adult interviews) was used to evaluate relationships among wave 1 e-cigarette use (daily, nondaily, never) and gender and their association with transitions (quit vs. current; relapse vs. former) in cigarette smoking status across waves 1 and 2 of the PATH study. RESULTS Daily e-cigarette users had higher odds of quitting smoking (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.12 to 2.18) compared with never e-cigarette users. Conversely, daily and nondaily e-cigarette users were at greater risk of smoking relapse (OR = 1.84, 95% CI = 1.15 to 2.94 and OR = 1.85, 95% CI = 0.99 to 3.46, respectively) compared with never e-cigarette users. Women were less likely to quit smoking compared with men independent of e-cigarette use (OR = 0.76, 95% CI = 0.59 to 0.99). In stratified analyses, daily or nondaily e-cigarette use did not increase the likelihood of quitting or relapse in women. In men, daily and nondaily e-cigarette users were at greater risk of smoking relapse (OR = 2.96, 95% CI = 1.49 to 5.86 and OR = 3.05, 95% CI = 1.29 to 7.17, respectively) compared with men who were never e-cigarette users. CONCLUSIONS Findings identify e-cigarettes as a potential aid for smoking cessation but also as a potential risk for smoking relapse in men only. Overall, women were less likely to quit smoking, and e-cigarette use did not impact their ability to quit or to stay quit. IMPLICATIONS Cigarette smokers report using e-cigarettes to reduce or quit smoking, but findings are mixed regarding the benefit and risk of e-cigarettes in this population. Using data from the newly available PATH (waves 1 and 2; adult interviews), our findings identify e-cigarettes as a potential aid for smoking cessation but also identify e-cigarettes as a potential risk for smoking relapse in men only. These findings may have implications for the regulation of e-cigarettes by the Food and Drug Administration and the benefit-cost ratio of e-cigarette use in smokers.
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Affiliation(s)
| | - Kelly E Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | | | - Robyn Hacker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Kelly P Cosgrove
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Zhao D, Zuo Y, Urmi DS, Liu Y, Zheng P, Fan W, Abdullah AS. Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2754. [PMID: 32316185 PMCID: PMC7216171 DOI: 10.3390/ijerph17082754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/29/2020] [Accepted: 04/02/2020] [Indexed: 11/21/2022]
Abstract
The use of electronic cigarettes (ECs) is increasing rapidly in China, but the perception of these products and their health impact among Chinese users have received little research attention. This study collected semi-structured in-depth interview data from experienced adult EC (including heated tobacco products also named ECs on the Chinese market) users in the Shanghai area. The subjects were recruited from those who participated in a previous online survey on EC use. A thematic narrative approach was used to analyze the data. Thirty current EC users were interviewed for evaluation of their perception of EC use in a variety of categories, including reasons for using, concerns, social acceptance, satisfaction, and health impacts. Participants' common reasons for using ECs were the ease of use and carrying, hygiene, no fire hazard, reduced smoke exposure, aiding quitting smoking, reduced health hazard, palatable flavor, being fashionable, and substituting cigarettes in non-smoking areas. Most (90%; 27/30) participants reduced (77%) or quit smoking (13%) after using ECs, and 80% were willing to recommend these products to others. Most (90%) of the participants reportedly noticed positive health changes after using ECs. Regulatory concerns were expressed by 33% participants. Participants predominately viewed ECs as a viable substitute for smoking, with substantial effects on tobacco harm reduction. These findings lend support to EC use as a promising opportunity for public health promotion in China through engaging smokers in smoking cessation attempts. However, overall public health benefits/risks of EC use, and its regulatory affairs need to be considered.
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Affiliation(s)
- Duan Zhao
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Yantao Zuo
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Dilshat S. Urmi
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Yangyujin Liu
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Pinpin Zheng
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 20032, China;
| | - Wang Fan
- Department of Politics, East China Normal University, Shanghai 200241, China;
| | - Abu S. Abdullah
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
- Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
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Comiford AL, Rhoades DA, Spicer P, Dvorak JD, Ding K, Wagener TL, Doescher MP. Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption. Tob Control 2020; 30:103-107. [PMID: 32054728 DOI: 10.1136/tobaccocontrol-2019-055338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Despite American Indian/Alaska Native (AI/AN) people having the highest prevalence of cigarette smoking nationwide, few studies have evaluated e-cigarette use among AI/AN adults who smoke. The primary objective of this observational pilot cohort study was to determine if e-cigarette use is associated with cigarette smoking cessation or reduction among adult AI individuals who smoke. METHODS In 2016, we collected baseline survey and biomarker data among AI adults who smoke. The survey included questions about cigarette consumption and use of e-cigarettes and biomarkers, such as salivary cotinine markers and exhaled carbon monoxide. After 18 months, we repeated data collection, and asked about changes in cigarette smoking status and cigarettes per day (CPD). Comparisons between groups were performed using the χ2 test, Fisher's exact test or Wilcoxon rank-sum test. RESULTS Of 375 baseline participants, 214 (57.07%) returned for follow-up and were included in analyses. Of these, 20 (9.3%) reported having stopped cigarette smoking and had biochemical verification of cigarette smoking abstinence. Among those who quit smoking, 15% were baseline e-cigarette users; while among those who continued to smoke at follow-up, about 11% were baseline e-cigarette users. This difference was not statistically significant (p=0.48). Among all those who continued to smoke at follow-up, there was no overall decrease in CPD, nor a significant difference in change in CPD between baseline e-cigarette users and non-users (p=0.98). CONCLUSIONS E-cigarette use at baseline was not associated with smoking cessation or a change in CPD in this cohort of AI adults who smoke after an 18-month follow-up period.
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Affiliation(s)
- Ashley L Comiford
- Community Health Promotions, Cherokee Nation, Tahlequah, Oklahoma, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul Spicer
- Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mark P Doescher
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Dunbar ZR, Giovino G, Wei B, O’Connor RJ, Goniewicz ML, Travers MJ. Use of Electronic Cigarettes in Smoke-Free Spaces by Smokers: Results from the 2014-2015 Population Assessment on Tobacco and Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E978. [PMID: 32033239 PMCID: PMC7038091 DOI: 10.3390/ijerph17030978] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 01/04/2023]
Abstract
Background: Smoke-free air policies exist to protect users and nonusers from exposure to tobacco smoke. Although electronic nicotine delivery systems (ENDS) may expose passerby to nicotine and particulate matter, few US states regulate indoor use of ENDS. The purpose of this study was to investigate reported rationales for ENDS use and reported ENDS use in public smoke-free places by dual cigarette/ENDS users. Methods: A population of ENDS/cigarette co-users (n = 2051) was drawn from Wave 2 of the Population Assessment of Tobacco and Health (PATH) dataset (2014-2015). Harm reduction beliefs and cessation behavior of co-users were investigated as predictors of ENDS use in public smoke-free places using logistic regression. Results: Fifty-eight percent of dual users reported past 30-day ENDS use in public smoke-free places. Reported use of ENDS to cut down on cigarette smoking (OR: 2.38, 95% CI: 1.86, 3.05), as an alternative to quitting tobacco (OR: 1.71, 95% CI: 1.37, 2.13), or because of belief that ENDS help people to quit cigarettes (OR: 1.52, 95% CI: 1.20, 1.92) were significantly associated with increased odds of ENDS use in smoke-free places. Conclusions: Beliefs that ENDS were useful as cessation tools or posed modified risk to users and nonusers were associated with elevated odds of use ENDS in locations where conventional tobacco is prohibited. Due to limitations in the survey instrument, in-home ENDS use could not be directly assessed in this analysis. However, these self-reported findings suggest that use of ENDS in public places where cigarette use is prohibited is prevalent enough to be of concern for future regulation and enforcement efforts.
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Affiliation(s)
- Zachary R. Dunbar
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Gary Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214-8028, USA;
| | - Binnian Wei
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Richard J. O’Connor
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Maciej L. Goniewicz
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Mark J. Travers
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
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47
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Jackson SE, Beard E, Michie S, West R, Brown J. Is the use of e-cigarettes for smoking cessation associated with alcohol consumption? A population-level survey of successful quitters in England. Addict Behav 2020; 101:106138. [PMID: 31645002 DOI: 10.1016/j.addbeh.2019.106138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine associations between the use of e-cigarettes for smoking cessation and levels of alcohol consumption, high-risk drinking, and attempts to cut down alcohol consumption compared with use of nicotine replacement therapy (NRT) or no aid. METHODS Cross-sectional survey of adults (≥16 years) in England. The sample included a total of 961 people who had quit smoking with the use of either e-cigarettes (n = 425), NRT (n = 116), or no aid (n = 421) within the past year and were still abstinent at the survey. Drinking behaviour was assessed with the AUDIT. RESULTS Mean (SD) alcohol consumption among those who quit smoking with e-cigarettes, NRT, and no aid was 7.78 (13.41), 7.12 (13.85), and 5.55 (8.70) units/week, respectively. The prevalence of high-risk drinking was 43.3% (n = 184), 32.2% (n = 37), and 36.8% (n = 155), respectively. Among high-risk drinkers, the prevalence of attempts to cut down alcohol consumption was 22.3% (n = 41), 18.9% (n = 7), and 27.7% (n = 43), respectively. After adjustment for covariates, those who quit with e-cigarettes had significantly higher alcohol consumption than those who quit unaided (B = 1.69, 95%CI 0.21-3.17), but there was no significant difference relative to those who quit with NRT. Differences in high-risk drinking and attempts to cut down were not significant, but Bayes factors indicated the data were insensitive (range: 0.47-0.95). CONCLUSIONS Recent ex-smokers who used e-cigarettes to help them quit consumed around two more units of alcohol each week than those who quit unaided, but their alcohol consumption was similar to those who quit with NRT. Data on differences in high-risk drinking and attempts to cut down alcohol consumption among high-risk drinkers were inconclusive.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK; Department of Clinical, Educational and Health Psychology, University College London, UK
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Lozano P, Arillo-Santillán E, Barrientos-Gutiérrez I, Zavala-Arciniega L, Reynales-Shigematsu LM, Thrasher JF. E-cigarette use and its association with smoking reduction and cessation intentions among Mexican smokers. SALUD PUBLICA DE MEXICO 2020; 61:276-285. [PMID: 31276343 DOI: 10.21149/9797] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/04/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Evaluate the patterns of e-cigarette use andtheir association with smoking behavior. MATERIALS AND METHODS We analyzed data from a population-based representative cohort of adult smokers who participated in the International Tobacco Control Policy Evaluation Surveys in Mexico. The analytic sample (n=760) was restricted to participants who were followed up from wave 6 (2012) to wave 7 (2014-2015). GEE models regressed e-cigarette use at follow-up and changes in cigarettes per day (CPD) between waves, on baseline sociodemographic variables, smoking status (daily, non-daily, quit), e-cigarette trial, and quit intentions. RESULTS Smokers who were younger, had a higher income, and had tried e-cigarettes at baseline were more likely to be current e-cigarette users at follow-up. Ecigarette use at follow-up was not associated with a change in CPD over time. CONCLUSIONS E-cigarette use does not appear to have promoted smoking cessation or reduction in this sample of Mexican smokers.
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Affiliation(s)
- Paula Lozano
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA
| | - Edna Arillo-Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Inti Barrientos-Gutiérrez
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Luis Zavala-Arciniega
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA.,Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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John WS, Grover K, Greenblatt LH, Schwartz RP, Wu LT. E-Cigarette Use Among Adult Primary Care Patients: Results from a Multisite Study. J Gen Intern Med 2020; 35:268-275. [PMID: 31705467 PMCID: PMC6957581 DOI: 10.1007/s11606-019-05488-4] [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: 03/01/2019] [Revised: 09/05/2019] [Accepted: 09/25/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Primary care settings provide opportunities to identify electronic-cigarette (e-cigarette) use and to implement strategies for changing tobacco use behavior. However, a better understanding of the extent and associated characteristics of e-cigarette use among primary care patients are needed to inform such efforts. OBJECTIVE To describe patient demographic and substance use characteristics by e-cigarette use status among a large sample of primary care patients. To examine the prevalence and correlates of e-cigarette use among tobacco users in the sample. DESIGN Cross-sectional analysis from a multisite validation study of a substance use screening instrument. PARTICIPANTS Adult primary care patients aged 18 and older (n = 2000) recruited across 5 primary care clinics in the Eastern USA from 2014 to 2015. MAIN MEASURES Patients reported past 3-month e-cigarette use, sociodemographics, tobacco use, and other substance use. Current nicotine dependence and DSM-5 criteria for past-year substance use disorders were also assessed. KEY RESULTS Among the total sample, 7.7% (n = 154) adults reported past 3-month e-cigarette use. Adults who reported e-cigarette use (vs. no use) were more likely to be younger, white, or have frequent tobacco use, nicotine dependence, or past-year illicit drug use/disorders. Among past 3-month tobacco users, 16.3% reported e-cigarette use. Adjusted logistic regression indicated that odds of e-cigarette use were greater among tobacco users who had some college education or more (vs. < high school) or were daily/almost daily tobacco users (vs. not); odds were lower among Blacks/African-Americans (vs. whites). E-cigarette use among tobacco users was associated with increased odds of current nicotine dependence or tobacco use disorder as well as more severe dependence/disorder. CONCLUSIONS Enhanced surveillance of e-cigarette use among adult tobacco users in primary care, particularly among those who use tobacco frequently, may have implications for helping patients with tobacco cessation using established approaches including behavioral support, pharmacotherapy, or referral to specialized care.
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Affiliation(s)
- William S John
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA.
| | - Kiran Grover
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA
| | - Lawrence H Greenblatt
- Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA
| | | | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
- Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USA
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Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014-2015. Addict Behav 2020; 100:106109. [PMID: 31522133 DOI: 10.1016/j.addbeh.2019.106109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Poly-use of tobacco, cannabis, and electronic cigarettes (e-cigarettes) is an emerging problem in the general population. The current study investigated poly-use of these products and receipt of smoking cessation counseling in a primary care setting. METHODS We conducted a cross-sectional secondary data analysis from a trial of a tablet intervention to increase provider delivery of the 5As (Ask, Advise, Assess, Assist, Arrange follow-up), a brief counseling intervention for smoking cessation, in 3 diverse primary care clinics in San Francisco, CA from 2014 to 2015. Participants were currently smoking cigarettes (N = 601; mean age = 50.8; 38.1% female) and reported information on past 30-day cigarette and e-cigarette use and past 3-month cannabis use. We classified participants into 4 groups: (1) cigarette-only, (2) dual-use of cigarettes and e-cigarettes, (3) dual-use of cigarettes and cannabis, (4) poly-use of cigarettes, e-cigarettes, and cannabis, and examined correlates of use. RESULTS Only cigarette smoking was reported by 48.6% of participants, 30.4% reported use of cigarettes and cannabis, 10.5% reported use of cigarettes and e-cigarettes, and 10.5% reported use of cigarettes, e-cigarettes, and cannabis. Cigarette-only smokers did not differ from other groups by cigarette smoking behavior and motivation to quit. Patients reporting dual-use of cigarettes and e-cigarettes had a higher likelihood of receiving the Arrange step and all 5As compared to cigarette-only smokers. CONCLUSIONS Providers should screen for co-use of cigarettes and other nicotine/cannabis products and consider co-use when delivering smoking cessation treatment and evaluating treatment outcomes. Development of guidelines to help facilitate provider training is needed.
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