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Salari N, Rahimi S, Darvishi N, Abdolmaleki A, Mohammadi M. The global prevalence of E-cigarettes in youth: A comprehensive systematic review and meta-analysis. PUBLIC HEALTH IN PRACTICE 2024; 7:100506. [PMID: 38817636 PMCID: PMC11137589 DOI: 10.1016/j.puhip.2024.100506] [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: 11/28/2023] [Revised: 03/22/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
Objectives Smoking, especially cigarettes, is known as one of the most common social and health problems among people. E-cigarettes are another form of tobacco that has been an ordinary daily occurrence.Study Design: systematic review and meta-analysis. Methods Systematic searching of databases was performed in Scopus, Web of Science, PubMed, Science Direct, MagIran, IranDoc, SID and Google search engine based on the PRISMA 2020 guideline. This search was conducted by the end of May 2021. Following full-text assessments, the related data were extracted from the papers. Newcastle-Ottawa scale was also used to evaluate the quality of methodology of the articles. Finally, study analysis was performed using Comprehensive Meta-Analysis software (version 2) based on the random effect model. Results Global prevalence of E-cigarette in younger individuals was 16.8 (95 % CI: 10.6-25.6) and 4.8 (95 % CI: 3-7.6) in the Ever and Current modes of E-cigarette, respectively. We also found that E-cigarettes were used more common in young boys than young girls in both Ever and Current modes. In young boys, the prevalence of E-cigarette were 18.8 (95 % CI: 8.4-36.8) and 4.9 (95 % CI: 3-8) in both modes of Ever and Current, respectively. In young girls, these factors were 9.9 (95 % CI: 5-18.6) and 1.6 (95 % CI: 1-3.1) in both modes of Ever and Current, respectively. Conclusions The global prevalence of e-cigarettes among young people, especially young boys, is increasing. Based on this, the prevention and management of the damage of this social phenomenon requires comprehensive global study, planning and policy.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahel Rahimi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Darvishi
- Department of Psychiatric Nursing, Faculty of Nursing School, Tehran Medical Sciences, Islamic Azad University Science and Research Branch, Tehran, Iran
| | - Amir Abdolmaleki
- Department of Operating Room, Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Mohammadi
- Research Center for NonCommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
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Cuomo RE, Purushothaman VL, Mackey TK, Yang JW. Rates of adverse events and related risk factors following e-cigarette use. J Public Health (Oxf) 2024; 46:e230-e239. [PMID: 38282109 DOI: 10.1093/pubmed/fdad281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND E-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample. METHODS A cross-sectional survey was conducted with a sample of 4695 current and former e-cigarette users with a median age of 34 years. The survey collected data on e-cigarette use, adverse events experienced, product characteristics, related behaviors, sociodemographic factors and presence of medical comorbidities. Statistical analyses were conducted using Pearson's chi-squared tests and logistic regression. RESULTS A total of 78.9% of respondents reported experiencing an adverse event within 6 h of using a vaping device, with the most common events being headache, anxiety and coughing. Product characteristics and related behaviors significantly influenced the risk of adverse events. There were also sociodemographic disparities, with Hispanic respondents and those with at least college-level education reporting higher rates of adverse events. CONCLUSIONS Our study found a high rate of adverse events among e-cigarette users. We identified that certain e-cigarette product characteristics, behaviors and medical comorbidities significantly increased the risk of these events.
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Affiliation(s)
- Raphael E Cuomo
- School of Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | | | - Tim K Mackey
- San Diego Supercomputer Center, San Diego, CA 92093, USA
| | - Joshua W Yang
- Department of Public Health, California State University, Fullerton, CA 92831, USA
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Roh T, Fields S, Sahu R, Trisha NF, Carrillo G. Vaping Behavior and Intention to Quit among Undergraduate Students in a Hispanic-Serving University. J Community Health 2024:10.1007/s10900-024-01364-3. [PMID: 38762685 DOI: 10.1007/s10900-024-01364-3] [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: 05/04/2024] [Indexed: 05/20/2024]
Abstract
The surge in electronic nicotine delivery systems (ENDS) usage, particularly among young adults, poses significant public health concerns. This study aimed to identify predictors of e-cigarette use, quit attempts, and frequency among undergraduate students in a Hispanic-serving university in Texas. A cross-sectional study was conducted between August 1 and October 26, 2023, recruiting undergraduate students through the Sona system, an online experiment management platform. Participants completed an online survey that covered demographics, educational status, vaping status, initiation age, reasons for first and current e-cigarette use, frequency of past usage, intentions to quit, and quit attempt frequency. Statistical analysis included descriptive statistics, multinomial logistic regression, and multivariable linear regression. Among 316 participants, 33.9% reported current e-cigarette use. Junior and senior students, as well as prior tobacco users, were more likely to be current vapers. Prior vaping experience was more prevalent among Hispanic individuals and those with a history of tobacco use. Notably, 74.3% of current users attempted to quit in the past year, with a higher frequency of quit attempts among females, Hispanic students, and those with vaping acquaintances. However, the vaping behavior and quit attempt patterns were similar across other categories. This study highlights how various factors influence e-cigarette use among college students. It suggests that prevention and quitting programs should consider the specific needs of different groups. Future studies will continue to look at different student groups to find the most effective ways to help them quit vaping.
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Affiliation(s)
- Taehyun Roh
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA.
| | - Sherecce Fields
- Department of Psychological and Brain Sciences, College of Arts and Science, Texas A&M University, College Station, TX, 77843, USA
| | - Ruchi Sahu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
| | - Nusrat Fahmida Trisha
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
| | - Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
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Li W, Osibogun O. Time-Varying Determinants of Changes in E-Cigarette Relative Harm Perception Among US Young Adults. Int J Behav Med 2024; 31:276-283. [PMID: 37184820 DOI: 10.1007/s12529-023-10181-2] [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] [Accepted: 04/27/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Current e-cigarette use has increased among young adults in the USA despite a consistent decrease in perceiving e-cigarettes as less harmful than cigarettes over time. This study examined time-varying predictors associated with the changes in e-cigarette relative harm perception over time among US young adults. METHODS Data were from the 2013-2018 Population Assessment of Tobacco and Health (PATH) Study for young adults (18-24 years). A time-varying effect model (TVEM) was applied to examine the association between the relative harm perception change and the associated time-varying predictors. RESULTS Of the 8427 young adults, the prevalence of those who perceived e-cigarettes as less harmful than cigarettes decreased from 50.3% in Wave 1 (2013-2014) to 27.7% in Wave 4 (2016-2018). Young adults who were male were more likely to perceive e-cigarettes as less harmful than cigarettes over time (OR = 1.58; 95%CI, 1.53-1.64). In addition, the changes in e-cigarette relative harm perception were less noticeable among those with advanced degrees, who had non-combustible smoke-free home rules, who held negative tobacco-related attitudes, and those who were current e-cigarette users or ever used alcohol (all p values < 0.05). CONCLUSIONS A decline was observed in US young adults who perceived e-cigarettes as less harmful than cigarettes from the PATH Study across four waves (2013-2018). The study findings underscore the importance of risk communication that focuses on harm perception profiles and the need for appropriate interventions to balance the considerations of e-cigarette use among young adults.
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Affiliation(s)
- Wei Li
- Department of Psychiatry, Yale School of Medicine, Yale University, S-206, 34 Park St, New Haven, CT, 06519, USA.
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
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Dyson J, Skinner J, Crick J, Crooks MG. Designing an intervention to help the quitters quit: A qualitative, intervention co-design study. PEC INNOVATION 2023; 2:100141. [PMID: 37214522 PMCID: PMC10194124 DOI: 10.1016/j.pecinn.2023.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 05/24/2023]
Abstract
Objective E-cigarettes are increasingly being provided by publicly funded stop smoking services. Our objectives were to understand the challenges and establish the means by which services could best support the use and subsequent discontinuation of e-cigarettes for this purpose. Methods Semi-structured interviews and co-design workshops with service users and providers of a stop smoking service. Results Thematic analysis was conducted. Interviews identified: 1. a reluctance to use e-cigarettes for cessation, 2. struggle to quit e-cigarettes (dependency, fear of relapse, compensatory "puffing") and 3. service development needs (consistency of approach). Co-design workshops suggested: 1. facilitation of e-cigarette use through understanding previous failed attempts, 2. offering a longer, two-staged approach to tobacco then e-cigarette cessation, careful timing of behavioural strategies and 3. enhanced communication between providers. Conclusions Our study suggests additional modifications to smoking cessation support measures when e-cigarettes are used for smoking cessation to address the challenges posed by public health guidance: "smokers should switch to vaping and vapers should stop smoking completely". Innovation Our study is the first to consider experiences of service users and providers about the challenges of using e-cigarettes for cessation; our co-design group of providers informed nine strategies needed to support this approach in practice.
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Affiliation(s)
- Judith Dyson
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - James Skinner
- Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - James Crick
- Hull Clinical Commissioning Group/Hull City Council, Hull, UK
| | - Michael G. Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical School, Hull, UK
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Silva-Gallardo CP, Maggs JL. Pubertal development at age 14 is associated with male adolescents' combustible cigarette smoking and dual use, but not with e-cigarette use - Findings from the UK Millennium Cohort Study. Drug Alcohol Depend 2023; 253:111031. [PMID: 37995392 DOI: 10.1016/j.drugalcdep.2023.111031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/30/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Adolescent nicotine exposure via electronic cigarettes (e-cigarettes) is a global health concern. Pubertal development earlier than peers increases the risk of tobacco smoking compared to peers experiencing on-time or late maturation, yet relationships of pubertal timing with e-cigarettes are unknown. We examine whether early pubertal timing is associated with risk for e-cigarette use, tobacco cigarettes, or both by age 14. METHODS The Millennium Cohort Study follows a representative cohort of 18,552 9-month-old children born 2000-2002 in the United Kingdom. Our sample includes 11,445 adolescents (5697 boys, 5748 girls) classified at age 14 as early, on-time, or late in pubertal development timing (PDT) relative to same-age, same-sex peers using the Pubertal Development Scale. Outcomes were use of e-cigarettes, tobacco cigarettes, or both by age 14. We included childhood liability confounders and demographics measured from age 7-11. RESULTS For girls, no PDT differences in age 14 e-cigarette or tobacco cigarette use were observed. All relative to on-time PDT boys, early maturing boys' odds of tobacco cigarette use were 59% higher (OR=1.59, 95% confidence interval (CI)=1.08,2.35), and odds of dual-use were 49% higher (OR=1.49, CI=1.11,1.99), both compared to odds of never use. Among late PDT boys, dual-use odds were lower than never use by 35% (OR=0.65, CI=0.47,0.91) and lower than e-cigarette use only by 36% (OR=0.64, CI=0.42,0.97). CONCLUSIONS At age 14, PDT was not associated with e-cigarette use for either sex, yet it was linked with tobacco use and dual use among boys.
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Affiliation(s)
- Constanza P Silva-Gallardo
- Prevention Research Center, Pennsylvania State University, University Park, PA, USA; Society and Health Research Center and Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile.
| | - Jennifer L Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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Mzhavanadze G. Perceived relative harm of e-cigarettes among Ukrainian adults. Cent Eur J Public Health 2023; 31:271-278. [PMID: 38309705 DOI: 10.21101/cejph.a7963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/15/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Emerging evidence suggests that the use of safer nicotine products (SNPs), such as e-cigarettes and heated tobacco products (HTPs) poses significantly lower health risks than continued smoking, particularly over the short and medium term. However, it remains uncertain whether the public has been adequately informed about these relative risks. This study assesses the perceived relative harm of e-cigarettes compared to conventional cigarettes in Ukraine. METHODS Two nationally representative surveys were conducted in February 2021 and December 2022. Participants, irrespective of their smoking status, were asked whether they agreed with the statement that "using e-cigarettes is more harmful than smoking conventional cigarettes". The surveys also included questions about tobacco product usage, the most dangerous substances in cigarettes, and smoking cessation methods. The data were statistically analysed by deriving design-based weighted point estimates and 95% confidence intervals for the proportions within each response category. RESULTS In 2022, 38.1% (95% CI: 35.3-40.9) of adults believed that e-cigarettes were more harmful than cigarettes and the perception of relative harm remained relatively unchanged between the two surveys. Furthermore, 56.2% (95% CI: 50.0-62.2) of current cigarette smokers agreed with this statement, while only a small percentage of vapers (e-cigarette users) 7.4% (95% CI: 1.5-30.0) perceived e-cigarettes as more harmful than conventional cigarettes. Among non-smokers and dual users the share was 33.4% (95% CI: 30.0-36.9) and 32.7% (95% CI: 25.1-41.5), respectively. CONCLUSION Our findings indicate that in Ukraine the perception that e-cigarettes are more harmful than cigarettes, or the lack of knowledge regarding relative risks, prevails. This highlights the importance of accurate risk communication to promote a harm reduction approach to tobacco use.
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Khanal G, Karna A, Kandel S, Sharma HK. Prevalence, Correlates, and Perception of E-cigarettes among Undergraduate Students of Kathmandu Metropolitan City, Nepal: A Cross-Sectional Study. J Smok Cessat 2023; 2023:1330946. [PMID: 38029059 PMCID: PMC10673664 DOI: 10.1155/2023/1330946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/14/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The use of e-cigarettes has been increasing globally especially among the youth population due to rigorous advertisement, marketing, and promotion which has become a significant public health concern. Hence, this study is aimed at identifying the prevalence, correlates, and perception of e-cigarettes among undergraduate students of Kathmandu city. Methods A cross-sectional study was conducted among 405 undergraduates of capital city of Nepal from April 2022 to December 2022. A two-stage systematic random sampling was used to select the respondents. An anonymous, semistructured, self-administered questionnaire was used for data collection. A descriptive, bivariable, and multivariable analysis was done using SPSS version 20. Results The prevalence of ever use and current use of e-cigarettes was 21.2% and 5.9%, respectively. Number of close friends (AOR = 5.23, CI: 1.26, 16.39), number of friends using e-cigarettes (AOR = 7.23, CI: 0.93, 22.82), male sex (AOR = 2.88, CI: 2.15, 10.35), and age (COR = 5.07, CI: 0.93, 8.19) were the major predictors of current e-cigarette usage. Similarly, number of friends using e-cigarettes (AOR = 5.90, CI: 2.15, 10.35), male sex (AOR = 3.53, CI: 2.15, 10.35), age (COR = 4.56, CI: 0.98, 6.24), and place of residence (COR: 5.19, CI: 0.83, 8.02) were the major predictors of ever e-cigarette usage. The prevalence of e-cigarette consumption was higher in males than females (5.4% vs. 0.5%). Approximately, 34.8% respondents had perceived e-cigarettes as a means to help in smoking cessation. 56.5% adults knew that e-cigarettes promoted conventional smoking. Majority (64.7%) of the undergraduate students had presumed e-cigarettes as less harmful to conventional smoking. Conclusion Ever use, current use, and misconception on e-cigarettes were widespread among the undergraduate students. Age, male sex, number of close friends, number of peers using e-cigarette, and place of residence were the major predictors for e-cigarette usage. To deal with the increased e-cigarette consumption state, awareness on the harmful addictive properties of e-cigarettes along with its adverse health consequences must be propagated and an appropriate intervention must be implemented.
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Affiliation(s)
- Gayatri Khanal
- Department of School of Public Health and Community Medicine, Chitwan Medical College Teaching Hospital (CMC), Bharatpur-13, Chitwan, Nepal
| | - Abhishek Karna
- Centre for Research on Educational, Health and Social Science (CREHSS), Bafal, Kathmandu, Nepal
| | - Suresh Kandel
- College of Medical Science and Teaching Hospital (COMS), Bharatpur-10, Chitwan, Nepal
| | - Hari Krishna Sharma
- National Health Education Information and Communication Centre (NHEICC), Teku, Kathmandu, Nepal
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Le D, Ciceron AC, Romm KF, Clausen ME, Abroms LC, Evans WD, Graham AL, Berg CJ. E-cigarette cessation interest and quit attempts among young adults reporting exclusive e-cigarette use or dual use with other tobacco products: How can we reach them? Tob Prev Cessat 2023; 9:33. [PMID: 38026820 PMCID: PMC10652571 DOI: 10.18332/tpc/172416] [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: 02/13/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION There is limited evidence to inform e-cigarette quitting interventions. This mixed-methods study examined: 1) e-cigarette and other tobacco product perceptions and cessation-related factors; and 2) potential behavioral intervention strategies among young adults reporting exclusive e-cigarette use or dual use with other tobacco products. METHODS We analyzed Fall 2020 survey data from 726 participants reporting past 6-month e-cigarette use (mean age=24.15 years, 51.1% female, 38.5% racial/ethnic minority) from 6 US metropolitan areas and Spring 2021 qualitative interview data from a subset (n=40), comparing tobacco-related perceptions and cessation-related factors among those reporting exclusive use versus dual use. RESULTS Among survey participants (35.5% exclusive e-cigarette use, 64.5% dual use), those reporting dual use indicated greater importance of quitting all tobacco or nicotine products (mean=5.28, SD=3.44 vs mean=4.65, SD=3.75, p=0.033), whereas those reporting exclusive use expressed greater confidence in quitting e-cigarettes (mean=7.59, SD=3.06 vs mean=7.08, SD=3.01, p=0.029) and all tobacco and nicotine products (mean=7.00, SD=3.16 vs mean=6.31, SD=3.13, p=0.008), as well as less favorable perceptions (i.e. more harmful to health and addictive, less socially acceptable) of cigarettes, cigars, and smokeless tobacco (p<0.05). Interview participants (50.0% exclusive e-cigarette use; 50.0% dual use) attributed previous failed e-cigarette quit attempts to their inability to cope with social influences, stress, and withdrawal symptoms. Although most expressed disinterest in quitting due to belief of eventually outgrowing e-cigarettes (among those reporting exclusive use) or unreadiness to abstain from nicotine (among those reporting dual use), many acknowledged the need for quitting interventions. CONCLUSIONS Young adult e-cigarette cessation interventions should target risk perceptions, cessation barriers, and social influences/support.
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Affiliation(s)
- Daisy Le
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - Annie C. Ciceron
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
| | - Katelyn F. Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, OK, United States
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, OK, United States
| | - Michelle E. Clausen
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington DC, United States
| | - Lorien C. Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - W. Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
| | - Amanda L. Graham
- Innovations Center, Truth Initiative, Washington DC, United States
- Department of Medicine, College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington DC, United States
- George Washington Cancer Center, George Washington University, Washington DC, United States
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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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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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Hester JW, Wiggins AT, Ickes MJ. Examining intention to quit using Juul among emerging adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1547-1556. [PMID: 34292854 DOI: 10.1080/07448481.2021.1942885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 04/28/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES (1) Describe intention to quit, (2) identify relationships between various factors and intention to quit, (3) explore if Theory of Planned Behavior-informed constructs are associated with intention to quit, and (4) discover if descriptive norms strengthen association with intention to quit among emerging adults currently using Juul. Participants: First-year students currently using Juul at a large public university (N = 182). Methods: A November 2018 online survey assessed sociodemographic characteristics, social influences, patterns of use, quit intention, and attitudes, norms, and perceived behavioral control toward Juul. Results: A quarter of participants reported current use, with nearly half intending to quit within six months. Recent quit attempts was the only factor related to intention. Two models were created that showed association with intention to quit, but only perceived behavioral control was individually significant. Conclusions: Cessation-focused campaigns and interventions are needed on college campuses and could be less tailored than prevention.
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Affiliation(s)
- Jakob W Hester
- Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Amanda T Wiggins
- Data Management & Outcomes, BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Melinda J Ickes
- Health Promotion, University of Kentucky, Lexington, Kentucky, USA
- Kinesiology and Health Promotion, Tobacco Policy, BREATHE, University of Kentucky, Lexington, Kentucky, USA
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Al-Hamdani M, Davidson M, Bird D, Hopkins DB, Smith S. Learning from their experiences: Strategies used by youth and young adult ex-vapers. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 149:209038. [PMID: 37061190 DOI: 10.1016/j.josat.2023.209038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/07/2022] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION The prevalence of vaping among youth and young adults (YYAs; 16-18 and 19-24 years old, respectively) is moderate worldwide. Existing vaping cessation evidence lacks input from ex-vapers with a history of regular use and substantial maintenance periods. This study noted cessation strategies, relapse triggers, and recommendations for quitting identified by ex-vapers and assessed differences in outcomes across age and gender groups. METHODS We recruited ex-vapers (N = 290; mean use = 6.5 days/week, SD = 1.05) with a minimum maintenance period of 30 days and a history of three months of consecutive use of nicotine-based devices from Nova Scotia, Canada. The ex-vapers responded to open-ended questions regarding vaping cessation strategies, triggers, and recommendations for quit strategies in an online survey. We coded responses to each topic (e.g., triggers) and grouped them into categories (e.g., social influences). We used chi-square tests and Bonferroni correction tests to determine group differences by topic and within each category. RESULTS YYA ex-vapers identified cold turkey (28.9 %), self-restriction (27.5 %), and alternative coping mechanisms (19.0 %) as the most common cessation strategies; social influences (35.5 %,), mental state (18.3 %), and substance use (15.7 %) as the top triggers; and support systems (29.5 %), apps (17.3 %), and education (11.8 %) as the most useful recommendations for others. A higher proportion of female youth (51.3 %) identified social influences as a relapse trigger than male YAs (21.2 %) and female YAs (30.3 %). Further, male YAs (36.5 %) reported higher proportions of substance use as a relapse trigger than male youth (3.0 %) and female youth (2.6 %). Female youth (23.7 %) and YAs (22.6 %) recommended apps as a useful cessation strategy more often than male YAs (3.8 %). CONCLUSIONS Input from ex-vapers can help to inform cessation practices, and gender and age differences shed light onto the need to tailor treatments, such as using social-centric behavioral therapy, for female youth and adopting a polysubstance substance use treatment approach for YAs.
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Affiliation(s)
- Mohammed Al-Hamdani
- Department of Public Health, College of Health Science, QU Health, Qatar University, Doha 2713, Qatar; Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada.
| | - Myles Davidson
- Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada
| | - Danielle Bird
- Department of Psychology, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - D Brett Hopkins
- Department of Community Health and Epidemiology, Halifax, NS B3H4H8, Canada
| | - Steven Smith
- Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada
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14
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Palmer AM, Carpenter MJ, Rojewski AM, Haire K, Baker NL, Toll BA. Nicotine replacement therapy for vaping cessation among mono and dual users: A mixed methods preliminary study. Addict Behav 2023; 139:107579. [PMID: 36549102 PMCID: PMC9872945 DOI: 10.1016/j.addbeh.2022.107579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Many adults express interest in e-cigarette cessation; however, there are few empirically tested interventions for quitting vaping. This study seeks to (1) evaluate reasons for quitting e-cigarettes in treatment-seeking adults, and (2) assess the feasibility and acceptability of nicotine replacement therapy (NRT) for e-cigarette cessation. Adult daily e-cigarette users completed qualitative interviews about quitting e-cigarettes, then were randomized to either 28-day supply of combination NRT (21 mg patches, 4 mg lozenges) + supportive booklet or Quitline referral. Primary aims were feasibility (number who enrolled) and acceptability (NRT use, adverse side effects). Exploratory aims evaluated abstinence (7-day point-prevalence) at end of treatment. Of the 30 participants who were enrolled, 50 % (n = 15) were dual users, and 50 % (n = 15) were mono-vapers, 26.6 % (n = 8) of whom were former smokers. Participants reported seeking treatment due to health concerns, dependence, stigma, and cost. Anticipated challenges of quitting vaping were withdrawal, negative mood, sensorimotor habits, and convenience. Most completed the end of treatment survey (n = 24; 80 %). Participants who received NRT reported using the patch M = 10.89 days and lozenges M = 6.39 days, with few days of adverse effects (M = 2.67). At end of treatment, 6/18 (33.3 %; 6 mono and 0 dual users) in the intervention group reported abstinence from vaping, compared to 0 in the control group (Fisher = 5.00, p =.057). In conclusion, adults are interested in quitting e-cigarettes due to negative consequences of use and are willing to use pharmacotherapy. Future research should confirm these results in a larger trial, address cigarette smoking in dual users, and aim to disseminate treatments.
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Affiliation(s)
- Amanda M Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Matthew J Carpenter
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Alana M Rojewski
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kayla Haire
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Benjamin A Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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15
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Obisesan OH, Uddin SMI, Boakye E, Osei AD, Mirbolouk M, Orimoloye OA, Dzaye O, El Shahawy O, Stokes A, DeFilippis AP, Benjamin EJ, Blaha MJ. Pod-based e-cigarette use among US college-aged adults: A survey on the perception of health effects, sociodemographic correlates, and interplay with other tobacco products. Tob Induc Dis 2023; 21:34. [PMID: 36875734 PMCID: PMC9983309 DOI: 10.18332/tid/159177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION E-cigarette use among youth and young adults remains of public health concern. Pod-based e-cigarettes, including JUUL, significantly changed the e-cigarette landscape in the US. Using an online survey, we explored the socio-behavioral correlates, predisposing factors, and addictive behaviors, among young adult pod-mod users within a University in Maryland, USA. METHODS In total, 112 eligible college students aged 18-24 years, recruited from a University in Maryland, who reported using pod-mods were included in this study. Participants were categorized into current/non-current users based on past-30-day use. Descriptive statistics were used to analyze participants' responses. RESULTS The mean age of the survey participants was 20.5 ± 1.2 years, 56.3% were female, 48.2% White, and 40.2% reported past-30-day (current) use of pod-mods. The mean age of first experimentation with pod-mods was 17.8 ± 1.4 years, while the mean age of regular use was 18.5 ± 1.4 years, with the majority (67.9%) citing social influence as the reason for initiation. Of the current users, 62.2% owned their own devices, and 82.2% predominantly used JUUL and menthol flavor (37.8%). A significant proportion of current users (73.3%) reported buying pods in person, 45.5% of whom were aged <21 years. Among all participants, 67% had had a past serious quit attempt. Among them, 89.3% neither used nicotine replacement therapy nor prescription medications. Finally, current use (adjusted odds ratio, AOR=4.52; 95% CI: 1.76-11.64), JUUL use (AOR=2.56; 95% CI: 1.08-6.03), and menthol flavor (AOR=6.52; 95% CI: 1.38-30.89) were associated with reduced nicotine autonomy, a measure of addiction. CONCLUSIONS Our findings provide specific data to inform the development of public health interventions targeted at college youth, including the need for more robust cessation support for pod-mod users.
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Affiliation(s)
- Olufunmilayo H. Obisesan
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, United States
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Medicine, Medstar Union Memorial Hospital, Baltimore, United States
| | - S. M. Iftekhar Uddin
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, United States
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
| | - Ellen Boakye
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, United States
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
| | - Albert D. Osei
- Department of Medicine, Medstar Union Memorial Hospital, Baltimore, United States
| | | | - Olusola A. Orimoloye
- Department of Medicine, Vanderbilt University Medical Center, Nashville, United States
| | - Omar Dzaye
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, United States
| | - Omar El Shahawy
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Population Health, New York University School of Medicine, New York, United States
| | - Andrew Stokes
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- School of Medicine, Boston University, Boston, United States
- School of Public Health, Boston University, Boston, United States
| | - Andrew P. DeFilippis
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- Department of Medicine, Vanderbilt University Medical Center, Nashville, United States
| | - Emelia J. Benjamin
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
- School of Medicine, Boston University, Boston, United States
- School of Public Health, Boston University, Boston, United States
| | - Michael J. Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, United States
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
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16
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Sun T, Lim CCW, Chung J, Cheng B, Davidson L, Tisdale C, Leung J, Gartner CE, Connor J, Hall WD, Chan GCK. Vaping on TikTok: a systematic thematic analysis. Tob Control 2023; 32:251-254. [PMID: 34312317 DOI: 10.1136/tobaccocontrol-2021-056619] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/21/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The rising popularity of TikTok among adolescents may influence their awareness and perceptions of e-cigarette use via user-generated content. This study aimed to examine how e-cigarette/vaping-related videos are portrayed on TikTok. METHODS The nine most viewed hashtag based keywords were used to identify popular e-cigarette/vaping-related videos on TikTok (n=1000) from its inception (earliest upload date: January 2019) to November 2020. Five researchers independently coded the number of views, likes, user category and theme. RESULTS A final sample of 808 e-cigarette/vaping-related videos that met study criteria were included. Collectively, these videos were viewed over 1.5 billion times, with a median view count of 1 000 000 (range 112 900-78 600 000) and a median 'likes' count of 143 000 (range 10 000-1 000 000). A majority of the videos portrayed e-cigarette use positively (63%; collectively viewed over 1.1 billion times). Neutral depictions of e-cigarette use were viewed a total of 290 million times (24%) and negative depictions of e-cigarettes were viewed a total of 193 million times (13%). The video themes included (not mutually exclusively): 'comedy and joke' (52%; total of 618 million views), 'lifestyle and acceptability' (35%; 459 million), 'marketing' (29%; 392 million), 'vaping tricks' (20%; 487 million), 'nicotine and addiction' (20%; 194 million), 'creativity' (16%; 322 million) and 'warning' (11%; 131 million). CONCLUSION Our findings illustrated that positively framed e-cigarette and vaping-related postings available without age restrictions on TikTok-a rising video-sharing platform that is popular among adolescents-have been viewed many times. Effective age restrictions are needed to reduce adolescents' potential exposure to videos that portray vaping positively.
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Affiliation(s)
- Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia .,School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia.,NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia.,NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Brandon Cheng
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Lily Davidson
- School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Calvert Tisdale
- School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia.,National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, NSW, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason Connor
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,Discipline of Psychiartry, The University of Queensland, Brisbane, Queensland, Australia
| | - Wayne D Hall
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia.,NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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17
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Chang JT, Mayer M, Jackson RA, Rostron BL, Coleman B, Lee T, Ambrose BK, Chang CM. Characteristics and Patterns of Cigarette Smoking and Vaping By Past-Year Smokers Who Reported Using Electronic Nicotine Delivery System to Help Quit Smoking in the Past Year: Findings From the 2018-2019 Tobacco Use Supplement to the Current Population Survey. Nicotine Tob Res 2023; 25:596-601. [PMID: 35973818 DOI: 10.1093/ntr/ntac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/09/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Cigarette smoking has declined, while electronic nicotine delivery system (ENDS) use has increased in the United States. Understanding the role of ENDS in adult smoking quit attempts and cessation is important for estimating their population health impact. AIMS AND METHODS We used data from 2018 to 2019 tobacco use supplement to the current population survey to examine demographic characteristics and ENDS use patterns among adult ENDS users who reported quitting smoking in the past year by trying to switch to ENDS ("switchers") and smokers who did or did not make a quit attempt in the past year. χ2 tests of proportions and t-tests were used to compare characteristics between groups. RESULTS In 2018-2019, about three-quarters of switchers reported daily use of ENDS compared to only one-third of dual users with a recent quit attempt by trying to switch to ENDS. Compared to dual users who made a quit attempt by trying to switch to ENDS, switchers were more likely to use menthol/mint-flavored ENDS exclusively (5.6% vs. 13.1%; p = .004) but less likely to use tobacco-flavored ENDS exclusively (21.2% vs. 13.7%; p = .01). CONCLUSIONS ENDS users who quit smoking in the past year and reported trying to quit by switching to ENDS were more likely to use menthol/mint flavors exclusively and use ENDS daily compared to dual users who made a quit attempt by trying to switch to ENDS. Longer-term prospective data may better clarify the role of ENDS in smoking quit attempts and cessation. IMPLICATIONS This study provides information on patterns of ENDS use in former smokers and current smokers who tried to quit smoking by switching to ENDS in a national sample of U.S. adults. These results can inform policy actions concerning ENDS products.
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Affiliation(s)
- Joanne T Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Margaret Mayer
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca A Jackson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Brian L Rostron
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Blair Coleman
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Terrence Lee
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Bridget K Ambrose
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Cindy M Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
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18
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Silva CP, Maggs JL, Kelly BC, Vuolo M, Staff J. Associations Between E-cigarettes and Subsequent Cocaine Use in Adolescence: An Analysis of the UK Millennium Cohort Study. Nicotine Tob Res 2023; 25:514-523. [PMID: 36125041 DOI: 10.1093/ntr/ntac219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nicotine exposure via early combustible cigarette smoking can prime the adolescent brain for subsequent cocaine use. However, there is limited evidence whether e-cigarette use, a nicotine delivery system that is increasingly popular among youth, is associated with later cocaine use. We examine the association between e-cigarette use by the age of 14 years and cocaine use by the age of 17 years. AIMS AND METHODS The Millennium Cohort Study is a nationally representative sample of 18 552 9-month-old children born between September 2000 and January 2002 in the United Kingdom. Follow-up interviews and surveys were collected from children and their caregivers at modal ages 3, 5, 7, 9, 11, 14, and 17 years. Our analytic sample included 340 youth who had used e-cigarettes by age 14 years (exposure variable), matched using coarsened exact matching, to 4867 nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11. The outcome was cocaine use by the modal age of 17 years. RESULTS Of the 5207 successfully matched youth, 7.6% of adolescent e-cigarette users by age 14 years used cocaine by age 17 years versus 3.1% of non-e-cigarette users. Multivariable logistic regression in the matched sample indicated that e-cigarette use by age 14 years was associated with 2.7 times higher odds of cocaine use by age 17 years (95% CI, 1.75 to 4.28). CONCLUSIONS These findings in a UK sample showed that e-cigarette use in early adolescence is associated with higher odds of cocaine use later in adolescence, similar to risks posed by tobacco cigarette smoking. IMPLICATIONS In this large-scale prospective cohort study (n = 5207), youth who had used e-cigarettes by the age of 14 years were matched to nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11 years (e.g. school engagement, risk-taking propensity, delinquency, peer and parental smoking, parental educational attainment). After matching, 7.6% of age 14 years e-cigarette users had subsequently used cocaine by the age of 17 years versus 3.1% of non-e-cigarette users. Although e-cigarettes are promoted as a strategy for nicotine-dependent users to reduce the harms of combustible cigarettes, the evidence here suggests that for nicotine naïve youth, they may increase the risk of subsequent cocaine use.
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Affiliation(s)
- Constanza P Silva
- Criminal Justice Research Center, Pennsylvania State University, University Park, PA, USA.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Mike Vuolo
- Department of Sociology, Ohio State University, Columbus, OH, USA
| | - Jeremy Staff
- Criminal Justice Research Center, Pennsylvania State University, University Park, PA, USA.,Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA
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Hinds JT, Chow S, Loukas A, Perry CL. Exploring Transgender and Gender Diverse Young Adult Tobacco Use. JOURNAL OF HOMOSEXUALITY 2022; 69:2188-2208. [PMID: 34370630 DOI: 10.1080/00918369.2021.1935621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Aside from prevalence estimates and comparisons to heterosexual and presumed cisgender (i.e., not transgender) samples, little is known about transgender and gender diverse (TGD) young adult tobacco use. This study explored reasons and contexts TGD young adults used a variety of tobacco products through 25 one-on-one semi-structured qualitative interviews in 2018. Thematic analysis yielded four themes: (1) smoking in response to anxiety, depression, or stress, (2) social smoking, (3) accepting smoking-related norms, and (4) appealing aspects of tobacco. The first three themes contained elements specifically tied to TGD identity; the final theme related to perceptions of tobacco unrelated to identity. Findings suggest reasons for smoking that are unique to TGD young adults, who frequently reported smoking cigarettes as a coping response to an amalgam of stressors. Accounting for unique stressors related to TGD identity will assist in developing culturally relevant interventions to reduce the disproportionate tobacco burden in TGD communities.
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Affiliation(s)
- Josephine T Hinds
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
| | - Sherman Chow
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Cheryl L Perry
- The Michael & Susan Dell Center for Health Living, UTHealth School of Public Health, Austin Campus, Austin, Texas, USA
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20
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Palmer AM, Price SN, Foster MG, Sanford BT, Fucito LM, Toll BA. Urgent Need for Novel Investigations of Treatments to Quit E-cigarettes: Findings from a Systematic Review. Cancer Prev Res (Phila) 2022; 15:569-580. [PMID: 35816038 PMCID: PMC9444997 DOI: 10.1158/1940-6207.capr-22-0172] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022]
Abstract
E-cigarette use has been increasing globally over the past decade. Many use e-cigarettes as an alternative or method to quit cigarette smoking, whereas others use these products recreationally. As technology has advanced, many individuals have reported symptoms of dependence on these products and continue to use them beyond achieving abstinence from smoking. Despite individuals reporting interest in quitting, little is known about e-cigarette cessation. This systematic review sought to identify and evaluate all human subjects literature published on the outcome of e-cigarette cessation through September 2021. Of the 79 articles identified, 56 were cross-sectional, 6 were qualitative, 5 were cohort studies, 3 were experimental, 2 were mixed methods, and 7 reported intervention or case studies of e-cigarette cessation. Results showed youth generally had high intent to quit e-cigarettes, whereas results were mixed with adult samples. Youth were motivated to quit e-cigarettes by health concerns, whereas adults were motivated to quit e-cigarettes by cost, lack of satisfaction, and psychologic factors. Adults were more likely to report past e-cigarette quit attempts, most commonly "cold turkey." Few interventions tested strategies for e-cigarette cessation, with a majority targeted for youth. Given the lack of information on e-cigarette cessation, recommendations for future studies are outlined.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah N. Price
- Department of Psychology, University of Arizona, Tucson, AZ, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Madeline G. Foster
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon T. Sanford
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA,Yale Cancer Center, New Haven, CT USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
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21
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Torregrossa H, Dautzenberg B, Birkui P, Rieu N, Dautzenberg MD, Melchior M, Mary-Krause M. What differentiates youths who use e-cigarettes from those who smoke traditional tobacco products? BMC Public Health 2022; 22:1357. [PMID: 35841088 PMCID: PMC9288082 DOI: 10.1186/s12889-022-13673-0] [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: 11/08/2020] [Accepted: 06/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Electronic cigarette (e-cigarette) use has spread among adolescents in many countries, however users’ characteristics are not well known. We aimed to compare characteristics of exclusive e-cigarette users to those of exclusive tobacco users and dual users. Methods Data come from a representative sample of 11–19 years old students in Paris, surveyed each year between 2013 and 2017. Current e-cigarette and tobacco use were ascertained in the preceding 30 days. Data were analyzed using random intercept multinomial logistic regression models, exclusive tobacco smokers being the reference group. Results Among the 17,435 students included, 2.3% reported exclusive e-cigarette use, 7.9% exclusive tobacco use and 3.2% dual e-cigarette and tobacco use. Compared to exclusive tobacco smokers, e-cigarette users were: a) less likely to use cannabis (adjusted Odds-Ratio (aOR) = 0.15, 95% confidence interval (95% CI) = 0.09–0.25); b) more likely to initiate smoking with an e-cigarette or a hookah rather than traditional cigarettes (aOR = 2.91, 95% CI = 1.74–4.87 and aOR = 15.99, 95% CI = 8.62–29.67, respectively). Additionally, exclusive e-cigarette users are younger with an aOR = 0.29 (95% CI = 0.17–0.49) among 13–15 years and aOR = 0.11 (95% CI = 0.06–0.21) among > 17 years as compared to 11–13 years. The probability of being an exclusive e-cigarette user is lower among participants whose best friend smokes tobacco (aOR = 0.30, 95% CI = 0.20–0.44). Exclusive tobacco users and dual users have similar profiles. Conclusions Adolescents who only used e-cigarettes had intermediate levels of risk compared to nonusers and those who used tobacco and/or e-cigarettes, suggesting that e-cigarettes use extends to young people at low-risk of using tobacco products. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13673-0.
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Affiliation(s)
- Hugo Torregrossa
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France
| | - Bertrand Dautzenberg
- Service de Pharmacologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013, Paris, France.,Consultation de Tabacologie, Institut Arthur Vernes, 75006, Paris, France.,Paris Sans Tabac (PST), 75007, Paris, France
| | | | - Nicole Rieu
- Rectorat de L'Académie de Paris, 75019, Paris, France
| | | | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France.
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22
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Navas-Nacher EL, Estrella ML, Giachello AL, Payne TJ, Walker KL, Hart JL, Rodriguez CJ, Groom A, Landry RL, Kesh A, Vu THT, Sears CG, Tompkins LK, Robertson RM. Perceptions of electronic cigarettes among ethno-culturally diverse Latino adults in four US urban centers. ETHNICITY & HEALTH 2022; 27:1207-1221. [PMID: 33249917 PMCID: PMC8240696 DOI: 10.1080/13557858.2020.1844155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 10/13/2020] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aim of this study was to examine perceptions including knowledge, attitudes, and beliefs about e-cigarettes among ethno-culturally diverse Latino adults living in the US, a rapidly growing minority group for which we know little about their e-cigarette perceptions. DESIGN A total of 25 focus groups with Latinos (n = 180; ages 18-64 years) were conducted in 2014. E-cigarettes users and non-users were recruited via purposive sampling techniques. Participants completed brief questionnaires on sociodemographic factors and tobacco use. Focus group discussions were conducted in English and Spanish, audio-recorded, and transcribed. Data were analyzed using thematic analysis procedures. RESULTS Participants were of diverse Latino backgrounds. Over one-third (35%) reported current cigarette smoking and 8% reported current e-cigarette or hookah use. Nonsmokers reported experimenting with e-cigarettes and hookah during social occasions. Participants' perceptions towards e-cigarettes were generally formed in comparison to conventional cigarettes. Perceived benefits of using e-cigarettes included their utility as a smoking cessation aid, higher social acceptability, and lower harm compared to conventional cigarettes. Negative perceptions of e-cigarettes included lower overall satisfaction compared to conventional cigarettes and high content of toxins. Socio-cultural factors (e.g. gender roles, familismo, and simpatía) also influenced perceptions of e-cigarette of study participants. CONCLUSIONS Overall, Latino adults knew relatively little about the potential health risks associated with e-cigarette use. The limited knowledge about and misinformation of e-cigarettes among this rapidly growing minority group have important public health implications. Findings may inform culturally tailored health communication campaigns, which are much needed among underserved US Latino populations in light of low effectiveness of tobacco control and regulatory efforts.
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Affiliation(s)
- Elena L. Navas-Nacher
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Mayra L. Estrella
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Aida L. Giachello
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Thomas J. Payne
- Cancer Institute & Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, MS, USA
| | - Kandi La Walker
- Department of Communication, University of Louisville, Louisville, KY, USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY, USA
| | | | - Allison Groom
- American Heart Association, Tobacco Regulation and Addiction Center (A-TRAC), Dallas, TX, USA
| | - Robyn L. Landry
- American Heart Association, Tobacco Regulation and Addiction Center (A-TRAC), Dallas, TX, USA
| | - Anshula Kesh
- American Heart Association, Tobacco Regulation and Addiction Center (A-TRAC), Dallas, TX, USA
| | - Thanh-Huyen T. Vu
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Clara G. Sears
- Department of Communication, University of Louisville, Louisville, KY, USA
| | | | - Rose Marie Robertson
- American Heart Association, Tobacco Regulation and Addiction Center (A-TRAC), Dallas, TX, USA
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23
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Dyson J, Bhatnagar M, Skinner J, Crooks M. Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed. PATIENT EDUCATION AND COUNSELING 2022; 105:1402-1410. [PMID: 34579994 DOI: 10.1016/j.pec.2021.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the barriers and facilitators to and support needed for e-cigarette cessation. METHODS We systematically searched the subject-specific databases MEDLINE, CINAHL complete and psycINFO and the Cochrane database using synonyms relating to the terms e-cigarettes and cessation including English language, empirical, peer reviewed research papers, published from 2010 to 2021. We included papers that addressed the research question in its broadest sense, including papers reporting reasons for and interventions to support e-cigarette cessation. Data extraction was completed two authors independently using a bespoke spreadsheet. We conducted a narrative synthesis of all data and we were able to extract and combine descriptive quantitative data from included survey papers. RESULTS After reviewing 2593 titles 10 papers fit our criteria. Barriers to e-cigarette cessation were: a fear of returning to tobacco, dependency and stress reduction. Barriers or facilitators were: health and hazard beliefs, degree of enjoyment, social influences and environmental factors. A number of e-cigarette smoking support measures were suggested by participants. PRACTICE IMPLICATIONS E-cigarette cessation poses similar and additional challenges to that of tobacco cessation. E-cigarettes are not the final step on a journey to smoking cessation. Addressing barriers specific to e-cigarettes need to be considered in intervention design.
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Affiliation(s)
- Judith Dyson
- Social Care, Health and Related Research (C-SCHaRR) Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN, United Kingdom.
| | | | - James Skinner
- School of Sociology, Politics and International Studies (SPAIS), University of Bristol, Bristol, United Kingdom
| | - Michael Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical school, Hull HU16 5JQ, United Kingdom
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24
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Jiang N, Xu S, Li L, El-Shahawy O, Freudenberg N, Shearston JA, Sherman SE. The Mediating Effect of E-Cigarette Harm Perception in the Relationship between E-Cigarette Advertising Exposure and E-Cigarette Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6215. [PMID: 35627752 PMCID: PMC9142075 DOI: 10.3390/ijerph19106215] [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] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/04/2022] [Accepted: 05/18/2022] [Indexed: 12/04/2022]
Abstract
Exposure to e-cigarette advertising is associated with e-cigarette use among young people. This study examined the mediating effect of e-cigarette harm perception on the above relationship. Cross-sectional survey data were collected from 2112 college students in New York City in 2017-2018. The analytic sample comprised 2078 participants (58.6% females) who provided completed data. Structural equal modeling was performed to examine if e-cigarette harm perception mediated the relationship between e-cigarette advertising exposure (via TV, radio, large signs, print media, and online) and ever e-cigarette use and susceptibility to e-cigarette use. About 17.1% of participants reported ever e-cigarette use. Of never users, 17.5% were susceptible to e-cigarette use. E-cigarette advertising exposure was mainly through online sources (31.5%). Most participants (59.4%) perceived e-cigarettes as equally or more harmful than cigarettes. Advertising exposure showed different effects on e-cigarette harm perception depending on the source of the advertising exposure, but perceiving e-cigarettes as less harmful than cigarettes was consistently associated with e-cigarette use and susceptibility. Low harm perception mediated the association between advertising exposure (via online, TV, and radio) and ever e-cigarette use and between online advertising exposure and e-cigarette use susceptibility. Regulatory actions are needed to address e-cigarette marketing, particularly on the Internet.
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Affiliation(s)
- Nan Jiang
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA; (L.L.); (O.E.-S.); (S.E.S.)
| | - Shu Xu
- School of Global Public Health, New York University, New York, NY 10003, USA; (S.X.)
| | - Le Li
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA; (L.L.); (O.E.-S.); (S.E.S.)
| | - Omar El-Shahawy
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA; (L.L.); (O.E.-S.); (S.E.S.)
- School of Global Public Health, New York University, New York, NY 10003, USA; (S.X.)
| | | | - Jenni A. Shearston
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Scott E. Sherman
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA; (L.L.); (O.E.-S.); (S.E.S.)
- Department of Medicine, VA New York Harbor Healthcare System, New York, NY 10010, USA
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25
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Participant Experiences of a Quit Smoking Attempt Through Either Nicotine Replacement Therapy (NRT) Methods or the Use of an E-cigarette. J Addict Med 2022; 16:272-277. [PMID: 34128486 DOI: 10.1097/adm.0000000000000881] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES There is a lack of evidence exploring experiences of using e-cigarettes for smoking cessation. The study's main aim was to explore participant experiences of e-cigarettes compared to nicotine replacement therapy (NRT) delivered through stop smoking services. METHODS Semi-structured, face-to-face, and telephone interviews at 3-month post-quit follow-up in a randomized controlled trial comparing nicotine-containing e-cigarettes, nicotine-free e-cigarettes, and NRT for smoking cessation. N = 17 participants, 9 were male, mean age 44 years, 5 using nicotine-containing e-cigarettes, 7 nicotine-free e-cigarettes, and 5 NRT. Interviews were transcribed and analyzed using thematic analysis. RESULTS Two global themes and 5 organizing themes were identified. Global themes included: (1) experiences of e-cigarette and NRT quit aids (e-cigarette positive impact and dilemmas, NRT perceptions and experiences), and (2) key mechanisms to support quit attempt (physical aids, advice and support, feedback and structure). E-cigarettes were viewed with caution, however, generally evaluated positively alongside NRT methods, finding e-cigarettes useful during a quit attempt due to their versatility in application. Nicotinecontaining e-cigarettes were favored due to their support with nicotine cravings. Participants were, however, wary of replacing smoking addiction with vaping habit. CONCLUSIONS Participant e-cigarette experience were generally positive; however, concerns over long-term application were noted. There was a noticeable preference for nicotine-containing e-cigarettes, but further research is required to better understand how nicotine is used in conjunction with e-cigarettes long-term as a quit aid alongside other NRT.
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26
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Documento de posicionamiento de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ante las estrategias de reducción del daño del tabaco. OPEN RESPIRATORY ARCHIVES 2022. [PMID: 37497325 PMCID: PMC10369613 DOI: 10.1016/j.opresp.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the last decade, the appearance of electronic cigarettes and new tobacco products (heated tobacco or smokeless tobacco) has generated a growing interest in harm reduction methods that are defined as mechanisms that seek to reduce the harmful consequences of tobacco without give up the pleasant effects of it by replacing it with these new electronic devices. However, these products are addictive and not safe as they contain nicotine. Harm reduction is a false solution as it represents a commercial strategy of the tobacco industry to increase its sales, making it difficult to control smoking, since it keeps smokers from consuming tobacco and prevents them from making serious attempts to quit. In addition, these products are a gateway to adolescents in tobacco.
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27
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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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28
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Krishnan N, Abroms LC, Berg CJ. Electronic Nicotine Product Cessation and Cigarette Smoking: Analysis of Waves 3 and 4 From the PATH Study. Nicotine Tob Res 2022; 24:324-332. [PMID: 34313780 PMCID: PMC8842438 DOI: 10.1093/ntr/ntab155] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/26/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Identifying predictors of electronic nicotine product (ENP) cessation can inform ENP cessation interventions. High rates of cooccurring ENP and cigarette (dual) use and transitions between these products underscore the importance of considering cigarette smoking status when assessing and addressing ENP cessation. AIMS AND METHODS We analyzed waves 3 (W3) and 4 (W4) of the Population Assessment of Tobacco and Health (PATH) study to identify (1) W3 socio-demographics, tobacco and ENP use characteristics, and psychosocial correlates of W3 cigarette smoking status (non-smoker, former, and current) among W3 adult ENP users, and (2) W3 predictors of W4 combined ENP and cigarette smoking abstinence relative to use of one or both products. RESULTS At W3, 65.6% of ENP users concurrently smoked cigarettes. Adjusted multinomial regression results indicated that different W3 socio-demographics, tobacco and ENP use characteristics, and psychosocial correlates were significantly associated with distinct W3 cigarette use profiles. At W4, 9.9% of individuals were abstinent from both products. These individuals were less likely to: (1) be current smokers (vs. non-smokers) or be advised to quit using tobacco, compared with cigarette only or dual users, and (2) use ENPs daily or live in a household allowing ENP use, compared with ENP only or dual users (p < .05). CONCLUSIONS ENP cessation approaches need to be tailored to the distinct cigarette use profiles of ENP users. Dual users and daily ENP users may require more intensive interventions to achieve the cessation of both products. Supportive physical environments, such as home vape-free policies, may facilitate ENP cessation. IMPLICATIONS This analysis contributes to advancing the nascent literature on predictors of electronic nicotine product (ENP) cessation, which can guide the development of ENP cessation interventions by indicating which populations, psychosocial and environmental constructs, and cooccurring behaviors interventions should target. This research also highlights the importance of considering cigarette smoking status when designing ENP cessation interventions and defining intervention outcomes.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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29
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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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North C, Li X, Grossberg LA, Loukas A. A one year prospective examination of risk factors for pod-vape use among young adults. Drug Alcohol Depend 2021; 229:109141. [PMID: 34768141 PMCID: PMC8665107 DOI: 10.1016/j.drugalcdep.2021.109141] [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] [Received: 06/21/2021] [Revised: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Young adults have the highest prevalence of pod-vape use, compared to adolescents and older adults. Despite the increased use of pod-vapes among young adults, very few studies have explored the determinants associated with pod-vape use. PURPOSE The purpose of the current study was to examine the roles of social norms and risk perceptions in subsequent pod-vape use one year later among a cohort of 21-34-year-old young adults. METHOD Participants were 3543 young adults from the last two waves (spring 2018 and 2019) of the Marketing and Promotions across Colleges in Texas project (M-PACT). A multivariable logistic regression model was used to examine the role of social norms and risk perceptions on subsequent pod-vape use one year later. RESULTS The prevalence of current pod-vape use in the present sample increased by 139.3% between 2018 and 2019. The social norm variables of close friends' pod-vape use and inclination to date someone that uses pod-vapes, but not social acceptability of pod-vapes, predicted subsequent pod-vape use one year later. Neither of the risk perception variables predicted subsequent pod-vape use. CONCLUSION The current study highlights the importance of social norms as predictors of subsequent pod-vape use among older young adults (21-34 years old). The rise in pod-vape use indicates that preventative efforts that target young adults are warranted, especially those that consider the role of peers in pod-vape use.
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Affiliation(s)
| | | | | | - Alexandra Loukas
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, USA.
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31
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Lee A, Park S, Kim J. Factors Associated with Former and Current E-Cigarette Use Among Lifetime Cigarette-Smoking College Students. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00691-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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32
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Bonner E, Chang Y, Christie E, Colvin V, Cunningham B, Elson D, Ghetu C, Huizenga J, Hutton SJ, Kolluri SK, Maggio S, Moran I, Parker B, Rericha Y, Rivera BN, Samon S, Schwichtenberg T, Shankar P, Simonich MT, Wilson LB, Tanguay RL. The chemistry and toxicology of vaping. Pharmacol Ther 2021; 225:107837. [PMID: 33753133 PMCID: PMC8263470 DOI: 10.1016/j.pharmthera.2021.107837] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/19/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
Vaping is the process of inhaling and exhaling an aerosol produced by an e-cigarette, vape pen, or personal aerosolizer. When the device contains nicotine, the Food and Drug Administration (FDA) lists the product as an electronic nicotine delivery system or ENDS device. Similar electronic devices can be used to vape cannabis extracts. Over the past decade, the vaping market has increased exponentially, raising health concerns over the number of people exposed and a nationwide outbreak of cases of severe, sometimes fatal, lung dysfunction that arose suddenly in otherwise healthy individuals. In this review, we discuss the various vaping technologies, which are remarkably diverse, and summarize the use prevalence in the U.S. over time by youths and adults. We examine the complex chemistry of vape carrier solvents, flavoring chemicals, and transformation products. We review the health effects from epidemiological and laboratory studies and, finally, discuss the proposed mechanisms underlying some of these health effects. We conclude that since much of the research in this area is recent and vaping technologies are dynamic, our understanding of the health effects is insufficient. With the rapid growth of ENDS use, consumers and regulatory bodies need a better understanding of constituent-dependent toxicity to guide product use and regulatory decisions.
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Affiliation(s)
- Emily Bonner
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Chang
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Emerson Christie
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Victoria Colvin
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brittany Cunningham
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Daniel Elson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Christine Ghetu
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Juliana Huizenga
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Sara J Hutton
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Siva K Kolluri
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Stephanie Maggio
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Ian Moran
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Bethany Parker
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Rericha
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brianna N Rivera
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Samantha Samon
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Trever Schwichtenberg
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Prarthana Shankar
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Michael T Simonich
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Lindsay B Wilson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Robyn L Tanguay
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA.
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Berg CJ, Krishnan N, Graham AL, Abroms LC. A synthesis of the literature to inform vaping cessation interventions for young adults. Addict Behav 2021; 119:106898. [PMID: 33894483 PMCID: PMC8113079 DOI: 10.1016/j.addbeh.2021.106898] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States.
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States
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Monzón J, Islam F, Mus S, Thrasher JF, Barnoya J. Effects of tobacco product type and characteristics on appeal and perceived harm: Results from a discrete choice experiment among Guatemalan adolescents. Prev Med 2021; 148:106590. [PMID: 33930431 PMCID: PMC8645268 DOI: 10.1016/j.ypmed.2021.106590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/16/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022]
Abstract
Guatemala is one of the few countries where both heated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) remain unregulated. We used a discrete choice experiment (DCE) administered to 2038 high school students to assess how tobacco product attributes influence their appeal among Guatemalan adolescents. Participants were randomly assigned to evaluate 4 of 32 contrasting sets, each containing 3 packs (1 of each product type). Experimental manipulations included: product type, brand, nicotine content and flavor. Participants then indicated which product they were most and least interested in trying and would be most and least harmful to their health. Conditional logistic regression models were used to assess the impact of product characteristics on choice. Product type accounted for almost 90% of variation in choices. Respondents were less interested in trying HTPs (B = -0.93; p < 0.001) and viewed them as more harmful (B = 2.77; p < 0.001) compared to cigarettes. They were more interested in trying e-cigarettes (B = 1.22; p < 0.001), which were also perceived as less harmful (B = -1.47; p < 0.001) compared to cigarettes. Products without nicotine were of more interest for trying (B = 0.14; p < 0.001) and perceived as more harmful (B = 0.20; p < 0.001) than those with. Students were more interested in trying a flavor compared to regular tobacco and among the flavors, berry was the highest rated one (B = 0.28; p < 0.001). Finally, in this country with weak tobacco control, e-cigarettes appear to be more appealing and perceived as less harmful than HTPs and cigarettes. Packaging and flavoring regulations are urgently needed on these products as they are a marketing strategy targeting adolescents.
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Affiliation(s)
- Jose Monzón
- Instituto de Investigación en Ciencias de la Salud (IECIS), Rafael Landívar University, Guatemala City, Guatemala
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sophia Mus
- Instituto de Investigación en Ciencias de la Salud (IECIS), Rafael Landívar University, Guatemala City, Guatemala
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Joaquin Barnoya
- Instituto de Investigación en Ciencias de la Salud (IECIS), Rafael Landívar University, Guatemala City, Guatemala; Unidad de Cirugía Cardiovascular de Guatemala (UNICAR), Guatemala City, Guatemala.
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E-Cigarette Use among Current Smokers Experiencing Homelessness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073691. [PMID: 33916203 PMCID: PMC8037859 DOI: 10.3390/ijerph18073691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
Two-thirds of cigarette smokers experiencing homelessness report using alternative tobacco products, including blunts, cigarillos (little cigars) or roll-your-own tobacco or electronic nicotine delivery systems such as e-cigarettes. We examined attitudes toward e-cigarette use and explored whether e-cigarette use patterns were associated with past-year cigarette quit attempts among current smokers experiencing homelessness. Among the 470 current cigarette smokers recruited from homeless service sites in San Francisco, 22.1% (n = 65) reported the use of e-cigarettes in the past 30 days ('dual users'). Compared to cigarette-only smokers, dual users considered e-cigarettes to be safer than cigarettes. Patterns of e-cigarette use, including the number of times used per day, duration of use during the day, manner of use and nicotine concentration were not associated with past-year cigarette quit attempts. Studies that examine the motivations for use of e-cigarettes, particularly for their use as smoking cessation aids, could inform interventions for tobacco use among people experiencing homelessness.
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Klemperer EM, Villanti AC. Why and how do dual users quit vaping? Survey findings from adults who use electronic and combustible cigarettes. Tob Induc Dis 2021; 19:12. [PMID: 33603595 PMCID: PMC7885258 DOI: 10.18332/tid/132547] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Most adults who use electronic cigarettes (ECs) also smoke combustible cigarettes (CCs). Quitting ECs appears common among dual users but little is known regarding adult dual users’ motivations and methods to quit ECs or how this relates to quitting CCs. METHODS We used Amazon Mechanical Turk, a web-based crowd-sourcing service, to survey 366 US adults with a history of regular EC and CC use. This analysis examined motivations and methods to quit both products among a subset of 204 (55.7%) respondents with dual use and a history of one or more attempts to quit ECs. RESULTS Most respondents (95%) were using ECs at the time of this survey and had a lifetime median of five EC quit attempts. The most common motivations to quit ECs were health (74%), money/cost (45%), and to reduce risk of COVID-19 (25%). The most common EC quit methods were cutting down (68%), getting advice from a doctor (28%), quitting 'cold turkey' (24%), nicotine replacement therapy (24%), and switching to ECs with less nicotine (24%). Most motivations and methods to quit ECs and CCs were moderately to highly correlated, suggesting similarity in dual users’ approach to quitting the two products. CONCLUSIONS Dual users had a range of motivations and methods to quit ECs, most of which were similar to their motivations and methods to quit CCs. These findings support the need to develop treatment for adults motivated to quit ECs and demonstrate that dual users may currently engage in similar strategies to quit both products.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
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Jayakumar N, O'Connor S, Diemert L, Schwartz R. Predictors of E-Cigarette Initiation: Findings From the Youth and Young Adult Panel Study. Tob Use Insights 2021; 13:1179173X20977486. [PMID: 33447117 PMCID: PMC7780163 DOI: 10.1177/1179173x20977486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/06/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives Although previous studies have identified reasons why youth try e-cigarettes, longitudinal research is needed to identify predictors of e-cigarette initiation. This study assesses predictors of e-cigarette initiation among youth and young adults in the 2018-2019 Youth and Young Adult Panel Study. Methods This study examined the proportion of Canadian participants aged 16 to 25 (n = 137) reporting never use of e-cigarettes at baseline in 2018. Individuals were categorized as not initiated and initiated at 12-month follow-up. We examined demographic characteristics, substance use, health status, social influences and perception by initiation category. Adjusted odds ratios (AORs) were calculated using logistic regression models and multivariable logistic regression model. Results Among the 137 never e-cigarette users at baseline, 59% remained never users while 41% initiated use of e-cigarettes during the 12-month follow-up. The results of multivariable logistic regression analysis showed that regularly seeing anyone use e-cigarettes (AOR: 4.11; 95% CI: 1.04, 16.31) and seeing anyone use e-cigarettes very often or always at baseline (AOR: 4.54; 95% CI: 1.21, 17.01) is associated with initiating e-cigarette use among youth and young adults. Conclusion The results revealed social influences to be the most important predictors of initiation among youth and young adults. Interventions to prevent youth and young adults from initiating e-cigarette use should expand from only focusing on peer use to reducing use in public space such as parks and recreational facilities.
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Affiliation(s)
- Navitha Jayakumar
- Dalla Lana School of Public Health, Ontario Tobacco Research Unit, University of Toronto, Toronto, ON, Canada
| | - Shawn O'Connor
- Dalla Lana School of Public Health, Ontario Tobacco Research Unit, University of Toronto, Toronto, ON, Canada
| | - Lori Diemert
- Dalla Lana School of Public Health, Ontario Tobacco Research Unit, University of Toronto, Toronto, ON, Canada
| | - Robert Schwartz
- Dalla Lana School of Public Health, Ontario Tobacco Research Unit, University of Toronto, Toronto, ON, Canada
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Garey L, Scott-Sheldon LAJ, Olofsson H, Nelson KM, Japuntich SJ. Electronic Cigarette Cessation among Adolescents and Young Adults. Subst Use Misuse 2021; 56:1900-1903. [PMID: 34348566 DOI: 10.1080/10826084.2021.1958850] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND E-cigarette use is common among adolescents and young adults, yet little is known about e-cigarette cessation among this group. The current study assessed e-cigarette cessation attempts, interest in e-cigarette cessation, and methods of e-cigarette cessation most favored by young e-cigarette users. METHODS A cross-sectional survey was administered via Facebook and Instagram between February and April 2019 to enroll current, regular e-cigarette using adolescents and young adults who reported non-regular use of other tobacco products. Participants included 212 (51.4% female) adolescents and young adults (14 to 21 years of age) who reported six or more days of e-cigarette use and less than four days of other tobacco product use in the last 30 days. RESULTS More than half (n = 110; 51.9%) of the participants reported at least one past serious e-cigarette quit attempt. Among those, the average number of past quit attempts was 2.9 (SD = 3.9). Of the 157 (74.1%) participants who indicated they were interested in quitting e-cigarettes, 78 (49.7%) endorsed health risks as their primary reason for wanting to quit e-cigarettes. The most frequently endorsed intervention methods to aid in e-cigarette cessation were those delivered via digital methods, such as smartphone apps. CONCLUSION The current study provides preliminary data to support continued development of e-cigarette cessation treatments for adolescents and young adults. Future research should evaluate the potential use of digital methods to aid in e-cigarette cessation.
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Affiliation(s)
- Lorra Garey
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Psychology, University of Houston, Houston, Texas, USA
| | - Lori A J Scott-Sheldon
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Hannah Olofsson
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University, Boston, Massachusetts, USA
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Duan Z, Wang Y, Huang J, Redmon PB, Eriksen MP. Reasons why Chinese smokers prefer not to use electronic cigarettes. Tob Induc Dis 2020; 18:104. [PMID: 33328836 PMCID: PMC7735022 DOI: 10.18332/tid/130477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION China is the world’s largest e-cigarette manufacturer. It also has the world’s largest smoking population. Although smoking is strongly associated with e-cigarette use, the prevalence of e-cigarette use is low among Chinese smokers compared with smokers in countries such as the US and UK. This study aims to explore the reasons why Chinese smokers prefer not to use e-cigarettes. METHODS Cross-sectional data from the Tobacco Questions for Surveys (TQS) conducted in four large Chinese cities (Chengdu, Wuhan, Xiamen, and Xi’an) in 2017–2018 were analyzed. A multi-stage cluster sampling approach was applied to select a representative sample of adults for each city. Weighted percentages and 95% confidence intervals (CIs) were estimated for self-reported reasons why smokers in China had never tried e-cigarettes, in total and by demographic characteristics. Multivariate logistic regression models were used to examine the adjusted associations between the top reasons why smokers never tried e-cigarettes and demographic and socioeconomic characteristics. RESULTS The top three reasons that Chinese adult smokers reported for never having tried e-cigarettes were: ‘I do not want to quit smoking’ (35.35%), ‘I do not think they would help me quit or cut down’ (24.31%), and ‘I am not addicted to smoking and don't need help to quit’ (14.93%). Other prominent reasons included: ‘I am concerned they are not safe enough’, and ‘I do not want to substitute one addiction for another’. Generally, there were no statistically significant associations between reasons why smokers never tried e-cigarettes and demographic and socioeconomic characteristics. CONCLUSIONS Our results suggest that many Chinese smokers associate e-cigarette use with smoking cessation. Continued monitoring of smokers’ views, beliefs, and risk perceptions regarding e-cigarettes is warranted. Health education campaigns communicating the risks of e-cigarettes are also needed.
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Affiliation(s)
- Zongshuan Duan
- School of Public Health, Georgia State University, Atlanta, United States
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, United States
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, United States
| | - Pamela B Redmon
- Emory Global Health Institute, Emory University, Atlanta, United States
| | - Michael P Eriksen
- School of Public Health, Georgia State University, Atlanta, United States
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Evans AT, Henderson KC, Geier A, Weaver SR, Spears CA, Ashley DL, Fritz M, John L, Pechacek TF. What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238865. [PMID: 33260570 PMCID: PMC7729446 DOI: 10.3390/ijerph17238865] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/20/2022]
Abstract
Switching completely from cigarettes to electronic nicotine delivery systems (ENDS) may reduce health risks for addicted smokers. This paper provides information about perceptions and other factors that may influence smokers’ ENDS use and substitution for cigarettes. We conducted 12 online focus groups (N = 61) among smokers who had never tried using ENDS (Never Users, N = 11), currently used both cigarettes and ENDS (Dual Users, N = 21), used but discontinued ENDS (Rejectors, N = 14), and switched completely to ENDS use (Switchers, N = 15). Thematic analysis was used to interpret the transcripts. Participants described initial interest in trying ENDS in hopes of quitting smoking and because of convenience (i.e., due to rules, regulations, or social norms). Risk perceptions and higher prices relative to cigarettes were reported as disadvantages of ENDS that discouraged initiation. Dual Users and Rejectors reported product problems (e.g., products breaking) and dissatisfaction (i.e., inability to satisfy cravings for cigarettes) as factors that lowered their substitutability for cigarettes or led to discontinuing ENDS use. Switchers indicated that satisfaction, lack of product problems, and perceived safety facilitated successfully switching from cigarette smoking to exclusive ENDS use. However, Switchers reported trying many products before they found ones that satisfied their needs. We recommend that policymakers consider the potential impact of tobacco control policies on smokers’ motivation and ability to switch completely from cigarettes to ENDS.
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Affiliation(s)
- Abigail T. Evans
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
- Correspondence: (A.T.E.); (K.C.H.); Tel.: +1-319-621-7968 (A.T.E.); +1-678-827-3434 (K.C.H.)
| | - Katherine C. Henderson
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
- Correspondence: (A.T.E.); (K.C.H.); Tel.: +1-319-621-7968 (A.T.E.); +1-678-827-3434 (K.C.H.)
| | - Anna Geier
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - Claire Adams Spears
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - David L. Ashley
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - Meredith Fritz
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Lisa John
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Terry F. Pechacek
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
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McCausland K, Jancey J, Leaver T, Wolf K, Freeman B, Maycock B. Motivations for use, identity and the vaper subculture: a qualitative study of the experiences of Western Australian vapers. BMC Public Health 2020; 20:1552. [PMID: 33059652 PMCID: PMC7559168 DOI: 10.1186/s12889-020-09651-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaping is a relatively new practice, and therefore its symbolic meanings and social practices are yet to be fully understood, especially within Australia where the practice is strictly regulated. This study aimed to examine vapers motivations for use, reinforcing influences, and association with the vaper subculture. METHODS Working from a constructivist epistemology and a symbolic interaction framework, in-depth interviews were conducted with a purposive sample of 37 current (89%) and former (11%) adult vapers, 70% male, mean age of 32.5. Data was analysed via thematic analysis. RESULTS Vapers largely started vaping to quit smoking and underwent common experiences during their initiation phase. Subsequently, vapers tended to adopt one of two dominant identities, that of the 'cloud chaser' or the 'substitute', which some users moved between during different stages of their vaping career. The social and symbolic meaning of e-cigarettes and vaping varied and involved concepts of harm reduction, addiction, pleasure, stigma and community, and for some, connection to the vaper subculture. CONCLUSIONS Understanding the complexities of vaping, and the nuanced differences of 'cloud chasers' and 'substitute' vapers may have important implications for health communication, research and policy. E-cigarette users within this sample were not a homogeneous group and differed in their motivations for use, association with the vaper subculture and relationship with the vape community. These findings provide new insights into the socialisation process and subsequent identity adoption of vapers within the unique regulatory environment of Western Australia.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia, 6102, Australia.
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia, 6102, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Western Australia, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia, 6102, Australia.,Present affiliation: College of Medicine and Health, University of Exeter, Devon, South West England, UK
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Azagba S, Qeadan F, Shan L, Latham K, Wolfson M. E-Cigarette Use and Transition in Adult Smoking Frequency: A Longitudinal Study. Am J Prev Med 2020; 59:367-376. [PMID: 32684358 DOI: 10.1016/j.amepre.2020.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The relationship between e-cigarette use and cigarette smoking is the subject of ongoing debate. There is limited research on e-cigarette use and changes in the frequency of cigarette smoking. This study examines whether the frequency of e-cigarette use is associated with changes in cigarette smoking behavior among U.S. adults. METHODS The study used data (n=20,558) from Waves 1 (2013-2014) and 2 (2014-2015) of the Population Assessment of Tobacco and Health, analyzed in 2019. Multivariable multinomial logistic regression assessed the association between e-cigarette use at Wave 1 and change in cigarette smoking frequency between Waves 1 and 2. RESULTS Every day cigarette smokers who used e-cigarettes some days (OR=1.95, 95% CI=1.27, 2.98) and every day (OR=3.37, 95% CI=1.78, 6.36) in Wave 1 had significantly higher odds of switching to some days cigarette smoking in Wave 2. Every day smokers who used e-cigarettes every day in Wave 1 had higher odds of becoming former cigarette smokers in Wave 2. Likewise, e-cigarette use at baseline among former cigarette smokers was associated with higher odds of switching to some days cigarette smoking (experimental e-cigarette use: OR=5.43, 95% CI=2.13, 10.72; some days e-cigarette use: OR=4.78, 95% CI=2.13, 10.72). In addition, experimental smokers who were also some days e-cigarettes users in Wave 1 had significantly lower odds of switching to experimental former smokers. CONCLUSIONS Although e-cigarette use may reduce cigarette smoking frequency among continuing smokers, findings suggest that e-cigarette use may be associated with cigarette smoking relapse among former smokers.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Fares Qeadan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Keely Latham
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Mark Wolfson
- Department of Social Medicine, Population and Public Health, University of California, Riverside School of Medicine, Riverside, California
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Chang JT, Anic GM, Rostron BL, Tanwar M, Chang CM. Cigarette Smoking Reduction and Health Risks: A Systematic Review and Meta-analysis. Nicotine Tob Res 2020; 23:635-642. [DOI: 10.1093/ntr/ntaa156] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 08/11/2020] [Indexed: 12/17/2022]
Abstract
Abstract
Introduction
Studies have shown the health benefits of cigarette smoking cessation. However, the literature remains unclear about the relationship between smoking reduction and health risks. This comprehensive review and meta-analysis updates previous reviews with the newest estimates.
Aims and Methods
We conducted a systematic review and meta-analysis evaluating the association between smoking reduction and some health risks in observational studies. We defined the following smoking categories: heavy smokers smoked ≥15–20 cigarettes per day (CPD), moderate smokers smoked 10–19 CPD, and light smokers smoked <10 CPD. The relative risks (RRs) and 95% confidence intervals (CIs) were estimated using random-effect models.
Results
We identified 19 studies including four case–control and 15 cohort studies. Compared with continuing heavy smokers, we found decreased lung cancer risk for those who reduced CPD by more than 50% (RR = 0.72, 95% CI: 0.52, 0.91), from heavy to moderate (RR = 0.66, 95% CI: 0.46, 0.85), and from heavy to light (RR = 0.60, 95% CI: 0.49, 0.72). We also found lower risk of cardiovascular disease (CVD) for those who reduced from heavy to light smoking (RR = 0.78, 95% CI: 0.67, 0.89) but not those who reduced by more than 50% and reduced smoking from heavy to moderate. We did not find any significant difference in all-cause mortality, all-cancer risks, and smoking-/tobacco-related cancer risk among those who reduced.
Conclusions
Substantial smoking reduction may decrease lung cancer risk but results on CVD (coronary heart disease and stroke combined) risk were mixed. The relationships between smoking reduction and other endpoints examined were not significant.
Implications
This meta-analysis helps clarify our understanding of various smoking reduction levels on some health risks. While smoking reduction may decrease risks of lung cancer, the relationships between smoking reduction and other endpoints, including all-cause mortality and cardiovascular disease, remain unclear. Although smoking reduction may decrease lung cancer risks, the magnitude of lung cancer risk remain high. Among smokers, complete cessation remains the most effective approach for cancer and CVD prevention.
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Affiliation(s)
- Joanne T Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD
| | - Gabriella M Anic
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD
| | - Brian L Rostron
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD
| | - Manju Tanwar
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD
| | - Cindy M Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD
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Farsalinos KE, Niaura R. E-cigarettes and Smoking Cessation in the United States According to Frequency of E-cigarette Use and Quitting Duration: Analysis of the 2016 and 2017 National Health Interview Surveys. Nicotine Tob Res 2020; 22:655-662. [PMID: 30768136 DOI: 10.1093/ntr/ntz025] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the association between electronic cigarette (e-cigarette) use and smoking cessation among US adults. Duration of smoking cessation was taken into consideration because e-cigarette awareness and use were low in the United States before 2010. METHODS A pooled analysis of the 2016 and 2017 National Health Interview Surveys on current (N = 9935) and former smokers (N = 14 754) was performed. Adjusted prevalence ratios (aPRs), for sociodemographic factors, were calculated. FINDINGS Current e-cigarette use was reported by 10.5% (95% CI = 9.8% to 11.3%) of current smokers and 4.5% (95% CI = 4.0% to 5.0%) of former smokers. Prevalence was high in former smokers of less than 1 year (16.8%, 95% CI = 13.9% to 20.2%), 1-3 years (15.0%, 95% CI = 13.0% to 17.3%), and 4-6 years (10.5%, 95% CI = 8.6% to 12.7%), and very low in former smokers of more than 6 years (0.7%, 95% CI = 0.5% to 0.9%). Similar patterns were observed for daily e-cigarette use. Current e-cigarette use was negatively associated with being a former smoker when quit duration was ignored (aPR = 0.64, 95% CI = 0.59 to 0.69) but was positively associated with being a former smoker of less than 1 year (aPR = 1.44, 95% CI = 1.12 to 1.84) and 1-3 years (aPR = 1.21, 95% CI = 1.03 to 1.42). Daily e-cigarette use was not associated with being a former smoker when quit duration was ignored but was positively associated with being a former smoker of less than 1 year (aPR = 3.44, 95% CI = 2.63 to 4.49), 1-3 years (aPR = 2.51, 95% CI = 2.13 to 2.95), and 4-6 years (aPR = 1.84, 95% CI = 1.49 to 2.26). CONCLUSIONS Daily e-cigarette use is strongly associated with recent smoking cessation (≤6 years) among US adults. Frequency of e-cigarette use and smoking cessation duration are important parameters when analyzing the effects of e-cigarettes in population surveys. IMPLICATIONS There is controversy on whether e-cigarettes promote or prevent smoking cessation. This study presents a detailed analysis of the association between e-cigarette use and smoking cessation in the United States considering frequency of e-cigarette use and duration of smoking cessation. The latter was considered appropriate because e-cigarette awareness and use were low in the United States before 2010. Daily e-cigarette use is strongly associated with recent (≤6 years) smoking cessation in the United States. Both frequency of e-cigarette use and duration of smoking cessation are important factors in determining the effects of e-cigarettes in population studies.
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Affiliation(s)
- Konstantinos E Farsalinos
- Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, Greece.,Department of Pharmacy, University of Patras, Patras, Greece.,Department of Public and Administrative Health, National School of Public Health, Athens, Greece
| | - Raymond Niaura
- Department of Social and Behavioral Science, College of Global Public Health, New York University, New York, NY.,Department of Epidemiology, College of Global Public Health, New York University, New York, NY
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Rocheleau GC, Vito AG, Intravia J. Peers, Perceptions, and E-Cigarettes: A Social Learning Approach to Explaining E-Cigarette Use Among Youth. JOURNAL OF DRUG ISSUES 2020. [DOI: 10.1177/0022042620921351] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study uses social learning theory to examine whether differential associations with e-cigarette-using peers is related to personal e-cigarette use among youth, and the extent to which this relationship is explained by personal risk perceptions of e-cigarettes. Moreover, this study tests whether the mediation process is moderated by type of e-cigarette user. This study uses a sample of high school seniors from the 2016 Monitoring the Future Study ( N = 2,100), and a subsample of e-cigarette users ( n = 523). Analyses are carried out using OLS and logistic regression. Findings demonstrate that higher levels of peer e-cigarette use are related to higher odds of personal e-cigarette use, but that risk perceptions of e-cigarettes only explain a modest portion of that relationship (about 10%). Furthermore, the mediation process does not appear to vary by type of e-cigarette user. Future directions and policy implications are discussed.
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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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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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Baig SA, Giovenco DP. Behavioral heterogeneity among cigarette and e-cigarette dual-users and associations with future tobacco use: Findings from the Population Assessment of Tobacco and Health Study. Addict Behav 2020; 104:106263. [PMID: 32028096 PMCID: PMC7092617 DOI: 10.1016/j.addbeh.2019.106263] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 11/27/2022]
Abstract
Dual-users of cigarettes and e-cigarettes are commonly treated as a single group. Our study applied a more nuanced classification of this complex behavior to examine its associations with future tobacco use behaviors using data from Waves 1 and 3 of the Population Assessment of Tobacco and Health. Dual-users at Wave 1 (n = 1,665) were categorized into 4 groups based on the frequency with which they used each product (i.e., some days, daily). Analyses identified sociodemographic correlates of group membership and the prevalence of (1) completely switching to e-cigarettes and (2) quitting both products by Wave 3. Dual-users who smoked cigarettes every day and used e-cigarettes some days (69.6%) were the majority and more likely to have lower education (p < .001). Although some day smoking and daily e-cigarette use was the least common category (5.9%), these individuals were most likely to have completely switched to e-cigarettes by Wave 3 (aOR = 6.19, 95% CI = 3.91, 9.79). Dual-users who smoked and used e-cigarettes some days were most likely to have completely quit tobacco by Wave 3 (aOR = 3.98, 95% CI = 2.93, 5.40). In general, dual-users who had higher education or income were more likely to have completely switched to e-cigarettes or quit tobacco use by Wave 3. Adults who concurrently use cigarettes and e-cigarettes exhibit considerable heterogeneity in their use of these tobacco products. Dual-users that are higher on the socioeconomic gradient are more likely to engage in plausibly less harmful dual-use behaviors, which are more strongly associated with harm reduction and cessation behaviors. Future research should consider this variation to more accurately characterize the public health impact of dual-use.
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Affiliation(s)
- Sabeeh A Baig
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Soule EK, Plunk AD, Harrell PT, Hayes RB, Edwards KC. Longitudinal Analysis of Associations Between Reasons for Electronic Cigarette Use and Change in Smoking Status Among Adults in the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 22:663-671. [PMID: 30698815 PMCID: PMC7171285 DOI: 10.1093/ntr/ntz005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Electronic cigarette (ECIG) use and changes in cigarette smoking status may be influenced by self-reported reasons for using ECIGs. METHODS We analyzed adult current and former cigarette smokers who were also current or former ECIG users at wave 1 (n = 3044) using wave 1 and wave 2 Population Assessment of Tobacco and Health Study data (2013-2015). Prevalence of reporting 13 reasons for ECIG use at wave 1 was examined and weighted logistic regressions were conducted predicting smoking status changes from wave 1 to wave 2. RESULTS Reasons for ECIG use ranged from 18.1% (people in the media or public figures use them) to 82.5% (they might be less harmful to people around me than cigarettes). From wave 1 to wave 2, 27.2% of former smokers (n = 249) became current smokers and 11.6% of current smokers (n = 246) became former smokers. Among wave 1 former smokers, using ECIGs because of the availability of flavors (AOR = 0.57, 95% CI = 0.39-0.85) or because they don't smell (AOR = 0.64, 95% CI = 0.42-0.97) was associated with lower odds of relapse to smoking, but using ECIGs because using them helps people quit smoking (AOR = 1.55, 95% CI = 1.01-2.38) was associated with greater odds of relapse. Among wave 1 current smokers, using ECIGs because they can be used where smoking is not allowed (AOR = 0.56, 95% CI = 0.38-0.85) was associated with reduced odds of quitting cigarettes. CONCLUSIONS Some reasons for ECIG use are associated with changes in self-reported smoking status. Researchers should examine ECIG user characteristics when assessing associations between ECIG use and smoking status transitions. IMPLICATIONS Given that certain reasons for ECIG use, such as using ECIGs in locations are where smoking is not allowed, may inhibit smoking reduction, policies may be developed to prevent ECIG use in locations where smoking is banned. In addition, because certain reasons for ECIG use may aid in relapse prevention, such as availability of desired flavors, efforts should be made to identify ECIG device characteristics that are appealing to smokers but not youth or nontobacco users. These results provide support for future research on reasons for ECIG use to inform regulatory policies.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC
| | - Andrew D Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
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Tucker JS, Shadel WG, Golinelli D, Seelam R, Siconolfi D. Motivation to quit cigarettes and alternative tobacco products: prevalence and correlates among youth experiencing homelessness. J Behav Med 2020; 43:318-328. [PMID: 31396821 PMCID: PMC7971096 DOI: 10.1007/s10865-019-00092-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product. Unaccompanied homeless youth were sampled from 25 street and service sites in Los Angeles County (N = 469). All participants were past month tobacco users who completed a survey on their tobacco-related behaviors and cognitions, including motivation to quit, as well as background characteristics. Among self-reported users of each product, motivation to quit in the next 30 days was highest for regular cigarettes (33%), followed by e-cigarettes/vaporizers (30%), little cigars/cigarillos (25%), cigars (20%), and natural cigarettes (20%). Between 33 and 49% of youth, depending on product, were not thinking about quitting at all. Correlates of lower motivation to quit differed somewhat by product type, with the most consistent being race, more frequent use, lower perceived riskiness of the product, and using the product because of its good taste or smell. Results from this study identify a set of psychosocial and behavioral factors, some that are common across tobacco products and others that are product-specific, that may be particularly important to address in efforts to reduce tobacco use among youth experiencing homelessness. Future regulations on the sale of flavored tobacco products may also serve to increase motivation to quit in this population.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
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