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Noguchi S, Ishimaru T, Fujino Y, Yatera K, Tabuchi T. Association of cigarette smoking with increased use of heated tobacco products in middle-aged and older adults with self-reported chronic obstructive pulmonary disease, asthma, and asthma-COPD overlap in Japan, 2022: the JASTIS study. BMC Pulm Med 2023; 23:365. [PMID: 37777737 PMCID: PMC10542693 DOI: 10.1186/s12890-023-02668-1] [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] [Received: 02/11/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Smoking cessation is the most important intervention in chronic obstructive pulmonary disease (COPD), asthma, and asthma-COPD overlap (ACO); however, high rates of current cigarette smoking are observed in adults with these respiratory diseases. Meanwhile, rapidly increasing use of heated tobacco products (HTPs) is observed in Japan; however, the status of HTPs use has not been fully understood in adults with COPD, asthma, and ACO. This study aimed to reveal the association between COPD, asthma, and ACO and HTPs use in adults. METHODS Data on Japanese individuals ≥ 40 years old obtained from the Japan Society and New Tobacco Internet Survey were analyzed. The prevalence of HTPs use in adults with COPD, asthma, and ACO, among individuals categorized into three groups according to cigarette smoking (never, former, and current), was calculated and the relationship between each disease and HTPs use were evaluated. The clinical diagnosis of these diseases was based on the self-reported diagnosis, as obtained from questionnaires. RESULTS A total of 19,308 individuals were included. The proportions of never, past, and current cigarettes smokers were 10,900 (56.5%), 4,903 (25.4%), and 3,505 (18.2%), respectively, and that of HTPs use was 1,813 (9.4%). In current cigarettes smokers, the adjusted odds ratios (ORs) of HTPs use was 2.88 (95% CI [confidence interval], 1.86-4.47), 1.23 (95% CI, 0.99-1.52), and 5.81 (95% CI, 3.12-10.82) in adults with COPD, asthma, and ACO compared to those without these respiratory diseases, respectively. Meanwhile, in past cigarettes smokers, the adjusted ORs of HTPs use was 0.51 (95% CI, 0.24-1.08), 0.69 (95% CI, 0.53-0.88), and 0.25 (95% CI, 0.06-1.07) in adults with COPD, asthma, and ACO, respectively. CONCLUSIONS HTPs use is more prevalent among current cigarettes smokers with COPD, asthma, and ACO compared to those without these respiratory diseases. Complete cessation of smoking both cigarettes and HTPs is the only way to achieve complete smoking cessation, therefore, adults with COPD, asthma, and ACO need to make greater efforts to quit smoking.
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Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine, Tobata General Hospital, 1-3-33, Fukuryugi, Tobata-Ku, Kitakyushu-City, Fukuoka, 804-0025, Japan.
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu-City, Fukuoka, 807-8555, Japan.
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu-City, Fukuoka, 807-8555, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu-City, Fukuoka, 807-8555, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu-City, Fukuoka, 807-8555, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan
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McDermott S, Reichmann K, Mason E, Fearon IM, O'Connell G, Nahde T. An assessment of nicotine pharmacokinetics and subjective effects of the pulze heated tobacco system compared with cigarettes. Sci Rep 2023; 13:9037. [PMID: 37270650 DOI: 10.1038/s41598-023-36259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/31/2023] [Indexed: 06/05/2023] Open
Abstract
Nicotine delivery and subjective effects are determinants of the ability of potentially less harmful tobacco products such as heated tobacco products (HTPs) to support adult smokers in switching away from cigarettes, and therefore to support tobacco harm reduction. This open-label, randomised, crossover, clinical study in 24 healthy adult smokers study assessed nicotine pharmacokinetics and subjective effects of the Pulze Heated Tobacco System (HTS; Pulze HTP device and three iD stick variants-Intense American Blend, Regular American Blend and Regular Menthol) compared with subjects' usual brand cigarettes (UBC). Cmax and AUCt were highest for UBC and significantly lower for each Pulze HTS variant. Cmax and AUCt were significantly higher for Intense American Blend compared with Regular American Blend, while AUCt was significantly higher for Intense American Blend compared with Regular Menthol. Median Tmax was lowest (i.e., nicotine delivery was fastest) for subjects' usual brand cigarettes and similar across the iD stick variants, although no between-product differences were statistically significant. All study products reduced urges to smoke; this effect was greatest for cigarettes although this was not statistically significant. Product evaluation scores for each Pulze HTS variant in the domains of 'satisfaction', 'psychological reward' and 'relief' were similar, and lower than those for UBC. These data demonstrate that the Pulze HTS effectively delivers nicotine and generates positive subjective effects, including satisfaction and reduced urge to smoke. This supports the conclusion that the Pulze HTS may be an acceptable alternative to cigarettes for adult smokers while having a lower abuse liability than cigarettes.
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Affiliation(s)
- Simon McDermott
- ICON PLC, South County Business Park, Leopardstown, Dublin 18, Ireland
| | | | - Elizabeth Mason
- Imperial Brands PLC, 121 Winterstoke Road, Bristol, BS3 2LL, UK
| | - Ian M Fearon
- whatIF? Consulting Ltd, The Crispin, Burr Street, Harwell, OX11 0DT, UK
| | - Grant O'Connell
- Imperial Brands PLC, 121 Winterstoke Road, Bristol, BS3 2LL, UK
| | - Thomas Nahde
- Reemtsma Cigarettenfabriken GmbH, Max-Born-Straße 4, 22761, Hamburg, Germany.
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Yuki D, Kikuchi A, Suzuki T, Sakaguchi C, Huangfu D, Nagata Y, Kakehi A. Assessment of the exposure to selected smoke constituents in adult smokers using in-market heated tobacco products: a randomized, controlled study. Sci Rep 2022; 12:18167. [PMID: 36307514 PMCID: PMC9616951 DOI: 10.1038/s41598-022-22997-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/21/2022] [Indexed: 12/31/2022] Open
Abstract
The objectives of this clinical study were to demonstrate a reduction in exposure to selected harmful and potentially harmful constituents (HPHCs) in Japanese healthy adult smokers who switched to four in-market heated tobacco products. Eighty-nine smokers were randomly assigned for five days to one of six study groups: four groups who switched to one of the commercially available heated tobacco products; a group who continued to smoke their own brand of combustible cigarettes (CC); or a group who stopped smoking (SS). Fifteen biomarkers of exposure (BoE) to 14 HPHCs and pyrene were measured at baseline, Day 3 and Day 5 in 24 h urine and breath, under clinical confinement. Product consumption, nicotine uptake and subjective effects were also measured before and after product switching. On Day 5, significant reductions in most BoE relative to the CC group were observed after switching to heated tobacco products. No changes in BoE were observed between baseline and Day 5 in the CC group. Significantly, the magnitude of the reduction in exposure to most of the selected HPHCs observed in the heated tobacco product groups was close to that observed in the SS group.
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Affiliation(s)
- Dai Yuki
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Akira Kikuchi
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Takuya Suzuki
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Chikako Sakaguchi
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Danting Huangfu
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Yasufumi Nagata
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
| | - Aoi Kakehi
- grid.417743.20000 0004 0493 3502Scientific and Regulatory Affairs, Japan Tobacco Inc., 4-1-1 Toranomon Minato-ku, Tokyo, 105-6927 Japan
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Hardie G, Gale N, McEwan M, Oscar SM, Ziviani L, Proctor CJ, Murphy J. An abuse liability assessment of the glo tobacco heating product in comparison to combustible cigarettes and nicotine replacement therapy. Sci Rep 2022; 12:14701. [PMID: 36038580 PMCID: PMC9424205 DOI: 10.1038/s41598-022-19167-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/25/2022] [Indexed: 11/26/2022] Open
Abstract
Tobacco heating products (THPs) have reduced emissions of toxicants compared with cigarette smoke, and as they expose user to lower levels than smoking, have for a role to play in tobacco harm reduction. One key concern of Public Health is that new tobacco and nicotine products should not be more addictive than cigarettes. To assess their abuse liability, we determined nicotine pharmacokinetics and subjective effects of two THPs compared with conventional cigarettes and a nicotine replacement therapy (Nicotine inhaler). In a randomised, controlled, open-label, crossover study healthy adult smokers used a different study product in a 5 min ad libitum use session in each of four study periods. Product liking, overall intent to use again, urge for product and urge to smoke questionnaires were utilised to assess subjective effects. Nicotine uptake was greater for the cigarette (Cmax = 22.7 ng/mL) than for either THP (8.6 and 10.5 ng/mL) and the NRT (2.3 ng/mL). Median Tmax was significantly longer for the NRT (15.03 min) than for the tobacco products (4.05–6.03 min). Product liking and overall intent to use again was highest for the cigarette, and higher for the THPs than the NRT. Urge to smoke was reduced more by the cigarette than by the other three products. Urge to use the THPs was greater than the NRT. These findings suggest that the abuse liability of the THPs lies between that of subjects usual brand cigarettes and the NRT.
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Affiliation(s)
- George Hardie
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK.
| | - Nathan Gale
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Michael McEwan
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Stefano Milleri Oscar
- Centro Ricerche Cliniche di Verona, Policlinico G. B. Rossi, P.Le L. A. Scuro 10, 37134, Verona, Italy
| | - Luigi Ziviani
- Centro Ricerche Cliniche di Verona, Policlinico G. B. Rossi, P.Le L. A. Scuro 10, 37134, Verona, Italy
| | | | - James Murphy
- R. J. Reynolds Tobacco Company, 401 N Main Street, Winston Salem, NC, 27101, USA
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Goodall S, Gale N, Thorne D, Hadley S, Prasad K, Gilmour I, Miazzi F, Proctor C. Evaluation of behavioural, chemical, toxicological and clinical studies of a tobacco heated product glo™ and the potential for bridging from a foundational dataset to new product iterations. Toxicol Rep 2022; 9:1426-1442. [PMID: 36561950 PMCID: PMC9764197 DOI: 10.1016/j.toxrep.2022.06.014] [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: 12/21/2021] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/25/2022] Open
Abstract
Background Tobacco Heating Products (THPs) are tobacco products that heat rather than burn tobacco with temperatures less than 350 °C. Because of this operating principle, they produce substantially fewer and lower levels of tobacco smoke toxicants than combustible cigarette smoke produced when tobacco is burnt, which occurs at much higher temperatures of around 900 °C. This paper analyses data on a THP, glo™, and assesses whether its use would result in reduced health risks compared to the health risks of smoking cigarettes. It also looks at the possibility of bridging datasets across the different variants of the glo™ product. Methods The approach is to consider whether datasets from behavioural, chemical, toxicological and clinical studies provide consistent findings of reductions in toxicant exposure with glo™ use by subjects who switch completely from smoking cigarettes to using glo™ and whether these reductions are similar to those who stop smoking cigarettes without switching to glo™ or any other tobacco or nicotine product. We also examine the similarities and differences of different versions of the glo™ product and benchmark it against a THP from another manufacturer. Results The studies indicate that the use of the glo™ results in substantial and prolonged reductions in toxicant exposure for smokers who switch to glo™ completely. A long-term clinical study shows substantial reductions in toxicant exposure over a period of time, similar to reduction of some biomarkers of exposure found following smoking cessation without switching to glo™ or any other tobacco product, and biomarkers of potential harm trending in a favourable manner for both groups that switch to glo™ and that quit all tobacco and nicotine use. Data suggests that all iterations of glo™ result in substantial reductions in toxicant exposure compared to smoking cigarettes and that bridging across datasets is feasible. Conclusions Given the accumulated scientific data summarised in this paper, and particularly the findings from a long-term clinical study, the data demonstrate that glo™ is a reduced exposure product compared to combustible cigarettes and is reasonably deemed to reduce the risk of smoking-related diseases and supports the conclusion that smokers who would have otherwise continued to smoke and instead switch entirely to THP glo™ use, will reduce their relative risk of developing smoking-related diseases as compared to continued smoking. The extent of reduction in risk compared to continuing to smoke is likely to vary by smoking-related disease and by an individuals' smoking history, other risk factors and an individual's susceptibility to disease. Use of the THP will present some level of increased health risk as compared to cessation of tobacco and nicotine products and will cause dependence. As long as the principles of heat-not-burn are maintained, THP use will result in substantially reduced exposure to smoke toxicants as compared to continued conventional cigarette smoking. It is possible to use bridging or read across to apply these conclusions to new iterations of the glo™ product, extending the utility and validity of the evidence generated through study of prior iterations.
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Cruz-Jiménez L, Barrientos-Gutiérrez I, Zavala-Arciniega L, Arillo-Santillán E, Gallegos-Carrillo K, Rodríguez-Bolaños R, Gravely S, Thrasher JF. Heated tobacco product use, its correlates, and reasons for use among Mexican smokers. Drug Alcohol Depend 2022; 232:109283. [PMID: 35134734 PMCID: PMC9390091 DOI: 10.1016/j.drugalcdep.2022.109283] [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: 06/18/2021] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the use of novel heated tobacco products (HTPs) in low- and middle-income countries. We examined among smokers in Mexico the prevalence and correlates of HTP use, as well as reasons for using HTPs. METHODS We analyzed data from five surveys (November 2019-March 2021) of an open cohort of adult smokers (n = 6500), including an oversample of those who also use e-cigarettes. Mixed-effects multinomial logistic models were used to estimate associations between study variables and current HTP use or prior HTP trial relative to never trying HTPs. RESULTS The weighted prevalence of current HTP use was 1.1%. Independent correlates of current HTP use included smoking frequency, intention to quit, e-cigarette use, having partners/family-members who use e-cigarettes, friends who use HTPs, and exposure to HTP information inside/outside tobacco shops. Having partners/family members who smoke and not knowing about the harm of HTPs relative to cigarettes were associated with lower likelihood of current HTP use. Having tried HTPs was more likely among light daily smokers, those with family who use HTPs and exposure to HTP information outside shops and on newspapers/magazines. Among current users, the top reasons for using HTPs were greater social acceptability (50.6%) and lower perceived harm (34.9%) relative to cigarettes. CONCLUSIONS Uptake of HTPs appears relatively low among Mexican smokers, and correlates of use are similar to those for e-cigarette use. Further research is needed to determine if HTPs use promotes or impedes smoking cessation, given current HTP users are also likely to use various nicotine products.
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Affiliation(s)
- Lizeth Cruz-Jiménez
- Evaluation and Survey Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Inti Barrientos-Gutiérrez
- Evaluation and Survey Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Katia Gallegos-Carrillo
- Evaluation and Survey Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico; Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Morelos, Mexico
| | | | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico; Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.
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Ohmomo H, Harada S, Komaki S, Ono K, Sutoh Y, Otomo R, Umekage S, Hachiya T, Katanoda K, Takebayashi T, Shimizu A. DNA Methylation Abnormalities and Altered Whole Transcriptome Profiles after Switching from Combustible Tobacco Smoking to Heated Tobacco Products. Cancer Epidemiol Biomarkers Prev 2022; 31:269-279. [PMID: 34728466 PMCID: PMC9398167 DOI: 10.1158/1055-9965.epi-21-0444] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/29/2021] [Accepted: 10/18/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The use of heated tobacco products (HTP) has increased exponentially in Japan since 2016; however, their effects on health remain a major concern. METHODS Tsuruoka Metabolome Cohort Study participants (n = 11,002) were grouped on the basis of their smoking habits as never smokers (NS), past smokers (PS), combustible tobacco smokers (CS), and HTP users for <2 years. Peripheral blood mononuclear cells were collected from 52 participants per group matched to HTP users using propensity scores, and DNA and RNA were purified from the samples. DNA methylation (DNAm) analysis of the 17 smoking-associated DNAm biomarker genes (such as AHRR, F2RL3, LRRN3, and GPR15), as well as whole transcriptome analysis, was performed. RESULTS Ten of the 17 genes were significantly hypomethylated in CS and HTP users compared with NS, among which AHRR, F2RL3, and RARA showed intermediate characteristics between CS and NS; nonetheless, AHRR expression was significantly higher in CS than in the other three groups. Conversely, LRRN3 and GPR15 were more hypomethylated in HTP users than in NS, and GPR15 expression was markedly upregulated in all the groups when compared with that in NS. CONCLUSIONS HTP users (switched from CS <2 years) display abnormal DNAm and transcriptome profiles, albeit to a lesser extent than the CS. However, because the molecular genetic effects of long-term HTP use are still unknown, long-term molecular epidemiologic studies are needed. IMPACT This study provides new insights into the molecular genetic effects on DNAm and transcriptome profiles in HTP users who switched from CS.
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Affiliation(s)
- Hideki Ohmomo
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Sei Harada
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shohei Komaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Kanako Ono
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Yoichi Sutoh
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Ryo Otomo
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - So Umekage
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Tsuyoshi Hachiya
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan
| | - Kota Katanoda
- Division of Cancer Statistics Integration, National Cancer Center Research Institute, Chuo, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Atsushi Shimizu
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Shiwa, Iwate, Japan.,Corresponding Author: Atsushi Shimizu, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate 028-3694, Japan. Phone: 81-19-651-5110, ext. 5473; E-mail:
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Dalrymple A, McEwan M, Brandt M, Bielfeldt S, Bean E, Moga A, Coburn S, Hardie G. A novel clinical method to measure skin staining reveals activation of skin damage pathways by cigarette smoke. Skin Res Technol 2022; 28:162-170. [PMID: 34758171 PMCID: PMC9299119 DOI: 10.1111/srt.13108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long-term use of cigarettes can result in localised staining and aging of smokers' skin. The use of tobacco heating products (THPs) and electronic cigarettes (ECs) has grown on a global scale; however, the long-term effect of these products' aerosols on consumers' skin is unknown. This pilot clinical study aimed to determine whether THP or EC aerosol exposure results in skin staining or activation of biomarkers associated with oxidative stress. MATERIALS AND METHODS Eight areas were identified on the backs of 10 subjects. Two areas were used for air control, and two areas exposed to 32-puffs of cigarette smoke (CS), THP or EC aerosols, which were delivered to the skin using a 3-cm diameter exposure chamber and smoke engine. Skin colour was measured using a Chromameter. Squalene (SQ), SQ monohydroperoxide (SQOOH) and malondialdehyde (MDA) levels were measured in sebum samples by mass spectrometry and catalase colorimetry. RESULTS CS exposure significantly increased skin staining, SQOOH and MDA levels and SQOOH/SQ ratio. THP and EC values were significantly lower than CS; EC values being comparable to air control. THP values were comparable to EC and air control at all endpoints, apart from skin staining. SQ and catalase levels did not change with exposure. CONCLUSIONS CS stained skin and activated pathways known to be associated with skin damage. THPs and ECs produced significantly lower values, suggesting they could offer hygiene and cosmetic benefits for consumers who switch exclusively from smoking cigarettes. Further studies are required to assess longer-term effects of ECs and THPs on skin function.
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Affiliation(s)
| | | | - Marianne Brandt
- proDERMInstitut für Angewandte Dermatologische ForschungHamburgGermany
| | - Stephan Bielfeldt
- proDERMInstitut für Angewandte Dermatologische ForschungHamburgGermany
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Camacho OM, Hill A, Fiebelkorn S, Williams A, Murphy J. Investigating the Health Effects of 3 Coexisting Tobacco-Related Products Using System Dynamics Population Modeling: An Italian Population Case Study. Front Public Health 2021; 9:700473. [PMID: 34869141 PMCID: PMC8634955 DOI: 10.3389/fpubh.2021.700473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
With the proliferation of tobacco products, there might be a need for more complex models than current two-product models. We have developed a three-product model able to represent interactions between three products in the marketplace. We also investigate if using several implementations of two-product models could provide sufficient information to assess 3 coexisting products. Italy is used as case-study with THPs and e-cigarettes as the products under investigation. We use transitions rates estimated for THPs in Japan and e-cigarettes in the USA to project what could happen if the Italian population were to behave as the Japanese for THP or USA for e-cigarettes. Results suggest that three-product models may be hindered by data availability while two product models could miss potential synergies between products. Both, THP and E-Cigarette scenarios, led to reduction in life-years lost although the Japanese THP scenario reductions were 3 times larger than the USA e-cigarette projections.
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Affiliation(s)
| | - Andrew Hill
- Ventana Systems UK Ltd., Salisbury, United Kingdom
| | | | - Aaron Williams
- British American Tobacco, R&D, Southampton, United Kingdom
| | - James Murphy
- British American Tobacco, R&D, Southampton, United Kingdom
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Myagmar-Ochir E, Kaneko M, Tomiyama K, Zaitsu M, Watanabe S, Nishino Y, Takahashi K, Haruyama Y, Kobashi G. Occupational difference in use of heated tobacco products: a cross-sectional analysis of retail workers in Japan. BMJ Open 2021; 11:e049395. [PMID: 34429314 PMCID: PMC8386230 DOI: 10.1136/bmjopen-2021-049395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Although heated tobacco products (HTPs) have become popular worldwide, research on occupational differences in smoking HTPs remains scarce. We aimed to examine the prevalence of smoking HTPs among a working population in Japan. SETTING, DESIGN AND PARTICIPANTS In 2018, we conducted a cross-sectional study comprised of 7714 retail business workers in the service industry in Japan. PRIMARY AND SECONDARY OUTCOME MEASURES For the definition of smoking HTPs, we identified current HTP smokers who only smoked HTPs, using five mutual categories of current smoking status (never, former, HTPs only, combustible cigarettes only and dual smokers who smoked both combustible cigarettes and HTPs). Occupational classes were classified into office workers (eg, upper non-manual workers) and other workers. ORs and 95% CIs of office workers were estimated for HTP usage, adjusted for age, sex, employment type and cigarette smoking-related health knowledge. RESULTS The overall prevalence of smoking HTPs was 3.0% (male 5.0%, female 2.2%). The prevalence of HTP smokers differed across occupational classes (5.6% in office workers vs 2.5% in others; p<0.05). Compared with other workers, the adjusted odds of office workers for smoking HTPs remained elevated (OR: 1.97, 95% CI: 1.40 to 2.77). Sensitivity analyses with workers of all smoking status showed the same pattern. When stratified by sex, the occupational difference only remained significant in male workers. CONCLUSIONS We found a positive occupational difference in smoking HTPs, particularly among male workers in the retail sector in Japan. National tobacco control should explicitly address this occupational gap and further encourage individuals to quit smoking.
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Affiliation(s)
- Enkhtuguldur Myagmar-Ochir
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Makiko Kaneko
- Division of Health Support, Department Store Health Insurance Association, Tokyo, Japan
| | - Kiyomi Tomiyama
- Division of Health Support, Department Store Health Insurance Association, Tokyo, Japan
| | - Masayoshi Zaitsu
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Shuichi Watanabe
- Division of Health Support, Department Store Health Insurance Association, Tokyo, Japan
| | - Yoshitaka Nishino
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Kyo Takahashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi, Japan
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Afolalu EF, Langer P, Fischer K, Roulet S, Magnani P. Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( IQOS®): a cross-sectional study. F1000Res 2021; 10:504. [PMID: 35528952 PMCID: PMC9069173 DOI: 10.12688/f1000research.52407.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/10/2023] Open
Abstract
Background: Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product IQOS® (Philip Morris International). Methods: We analyzed the first annual data (2016-2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult (≥20 years of age) population (N = 4,878) and a sample of adult IQOS users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, IQOS, e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the IQOS user sample. Results: The prevalence of current use across all TNP in the sampled general population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for IQOS use. Regarding the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7-22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.
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Affiliation(s)
| | - Peter Langer
- Philip Morris Products S.A., Lausanne, Switzerland
| | | | - Steve Roulet
- Philip Morris Products S.A., Lausanne, Switzerland
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Afolalu EF, Langer P, Fischer K, Roulet S, Magnani P. Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( IQOS®): a cross-sectional study. F1000Res 2021; 10:504. [PMID: 35528952 PMCID: PMC9069173 DOI: 10.12688/f1000research.52407.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 12/17/2023] Open
Abstract
Background: Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product IQOS® (Philip Morris International). Methods: We analyzed the first annual data (2016-2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult population (N = 4,878) and a sample of adult IQOS users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, IQOS, e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the IQOS user sample. Results: The prevalence of current use across all TNP in the general adult population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for IQOS use. With regard to the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7-22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.
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Affiliation(s)
| | - Peter Langer
- Philip Morris Products S.A., Lausanne, Switzerland
| | | | - Steve Roulet
- Philip Morris Products S.A., Lausanne, Switzerland
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Mendez D, Warner KE. A Magic Bullet? The Potential Impact of E-Cigarettes on the Toll of Cigarette Smoking. Nicotine Tob Res 2021; 23:654-661. [PMID: 32823272 PMCID: PMC7976928 DOI: 10.1093/ntr/ntaa160] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 08/17/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION We examine the proportion of US smoking-produced mortality that e-cigarettes might eliminate under assumptions regarding vaping's ability to increase smoking cessation, vaping's health risks, and the possibility that vaping will increase smoking among young people. METHODS We employ a dynamic population simulation model that tracks individuals from ages 0 to 110, differentiated by gender and smoking status. Using data from the US Census, the National Vital Statistics Reports, Cancer Prevention Study II, and the National Health Interview Survey, we estimate the number of smoking-related life-years lost (LYL) from 2018 to 2100 in a no-vaping scenario. We then compare results for model runs that assess the impact of vaping under a variety of assumptions. RESULTS The combination of assumptions produces 360 possible scenarios. 357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143 000 to 65 million. Most scenarios result in millions of individuals quitting smoking due to vaping. On average, vaping-induced quitters gain an extra 1.2-2.0 years of life compared to smokers who quit without vaping. The impact of vaping is greatest when it most helps smokers who otherwise have the greatest difficulty quitting smoking. While the numbers of LYS are generally large across all scenarios, they often represent a small fraction of the toll of smoking. CONCLUSIONS Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not "the" answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures. IMPLICATIONS E-cigarettes hold the potential to reduce cigarette smoking's enormous toll. By itself, however, tobacco harm reduction, as embodied in vaping, is no magic bullet. Going forward, tobacco control will require vigilant application of the evidence-based measures that have brought us so much success in combatting smoking. It will require, as well, the search for and adoption of novel means of attacking the remaining problem. Harm reduction can, and many would say should, be a part of the complex formula that will eventually bring about the demise of smoking.
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Affiliation(s)
- David Mendez
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI
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