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Welding K, Marynak KL, Trigger S, Kelley D, Jewler L, Kennedy RD. ENDS advertising expenditures in English language media in the USA, 2015-2020. Tob Control 2023; 33:122-125. [PMID: 35973789 PMCID: PMC10514744 DOI: 10.1136/tc-2022-057279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/19/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Electronic nicotine delivery system (ENDS) advertising is associated with ENDS purchase and use. This study assessed trends in ENDS advertisement (ad) expenditures in the USA from 2015 to 2020 overall, by media channel and by advertiser. METHODS Data came from Numerator, which conducts surveillance of ads and estimates expenditures. The estimates are dollars spent (adjusted to 2020) by the advertiser for each ad occurrence for print, radio, television and digital (online, mobile) media channels. ENDS ad expenditures were assessed by quarter, media channel and the top five advertisers based on ad occurrences. RESULTS Overall ENDS ad expenditures increased from $38 million in 2015 to $217 million in 2019 before decreasing to a low of $22 million in 2020. By media channel, print expenditures led the channels with more than twice as much spent as television, four times more than radio and 10 times more than digital. By advertiser, JUUL led in ENDS ad expenditures from 2015 to 2020 with almost $189 million spent, followed by British American Tobacco (BAT, $105 million) and Imperial Tobacco ($62 million). CONCLUSIONS Overall ad expenditures were relatively stable from 2015 to mid-2018 when large expenditures by JUUL and subsequent expenditures by BAT and Imperial Tobacco led to expenditure highs in 2019. E-cigarette and vaping-associated lung injury (EVALI), the JUUL self-imposed ad suspension and COVID-19 likely all played a role in advertising lows in 2020. The absence of popular Puff Bar brand ads from the traditional media channels studied highlights the importance of monitoring direct and indirect advertising on newer media channels like social media.
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Affiliation(s)
- Kevin Welding
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristy L Marynak
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Office on Smoking and Health, CDC, Atlanta, Georgia, USA
| | - Sarah Trigger
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dannielle Kelley
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lena Jewler
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan David Kennedy
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Kramer RD, Park-Lee E, Marynak KL, Jones JT, Sawdey MD, Cullen KA. Nicotine Pouch Awareness and Use Among Youth, National Youth Tobacco Survey, 2021. Nicotine Tob Res 2023; 25:1610-1613. [PMID: 37279928 PMCID: PMC10961705 DOI: 10.1093/ntr/ntad080] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION This manuscript examines prevalence of awareness and use of nicotine pouches among U.S. middle and high school students by sociodemographic characteristics and other tobacco product use and characterizes nicotine pouch and other tobacco product use behaviors among current nicotine pouch users. AIMS AND METHODS Data are from the 2021 National Tobacco Youth Survey, a cross-sectional, school-based survey of middle and high school students (N = 20 413; overall response rate: 44.6%), which included questions on nicotine pouches in 2021 for the first time. Prevalence estimates, 95% confidence intervals, and estimated population counts were assessed for nicotine pouch awareness, ever use, and current (past 30 days) use, and for use behaviors related to nicotine pouches (frequency of use, flavor(s) used) and other tobacco products (ever, current, frequency of use) among current nicotine pouch users. RESULTS Over one-third of students (35.5%) had ever heard of nicotine pouches. An estimated 1.9% (490 000) reported ever using them, while 0.8% (200 000) reported current use. Among current nicotine pouch users, 61.6% reported flavored nicotine pouch use, 64.2% reported current e-cigarette use, and 52.6% used multiple (≥2) tobacco products. Current use of nicotine pouches was common among current smokeless tobacco users (41.3%). CONCLUSIONS Overall, in 2021, while relatively few students had ever tried nicotine pouches or currently used them, more than one-third had heard of them. Current nicotine pouch users tended to use other tobacco products, particularly e-cigarettes and smokeless tobacco. Given previous rapid increases in youth uptake of e-cigarettes, it is important to continue monitoring nicotine pouch use among young people. IMPLICATIONS This study's findings provide an important baseline for future monitoring of nicotine pouch awareness and use among middle and high school students. Emerging tobacco products, particularly those that are flavored, widely available, discreet, and inexpensive have the potential to attract youth. Given the potential of these products to appeal to young people, ongoing monitoring of nicotine pouch use behaviors is important to inform public health and regulatory efforts.
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Affiliation(s)
- Renee D. Kramer
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Eunice Park-Lee
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Kristy L. Marynak
- Office on Smoking and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jamal T. Jones
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Michael D. Sawdey
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Karen A. Cullen
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Marynak KL, Robichaud MO, Puryear T, Kennedy RD, Moran MB. #Nicotineaddiction on TikTok: A quantitative content analysis of top-viewed posts. Tob Induc Dis 2022; 20:69. [PMID: 35979474 PMCID: PMC9353672 DOI: 10.18332/tid/151868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/15/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION TikTok, the video-sharing app popular among youth, is a source of user-generated content about nicotine addiction with the potential to endorse or deter nicotine use among young viewers. We systematically analyzed content and themes of TikTok posts tagged #nicotineaddiction. METHODS We conducted a quantitative content analysis of the visual and textual content of the 149 top-viewed English-language TikTok posts tagged #nicotineaddiction as of 1 March 2021. Posts were double-coded using a shared codebook, noting content creator characteristics, nicotine products featured, references to quitting, and overall themes of #nicotineaddiction expressed. We assessed the prevalence of post characteristics and themes overall and by apparent age of content creators (aged ≥21 years versus <21 years). RESULTS The 149 posts analyzed received a mean and median of 62433 and 15800 likes, respectively. E-cigarettes were referenced or featured in 75% of posts; 58% featured a specific nicotine product brand, most commonly Puff Bar (23% of total) and JUUL (19%). Overall, 22% of posts mentioned quitting nicotine. The top themes of #nicotineaddiction expressed were physical or psychological consequences (e.g. withdrawal symptoms, 46%), physical or psychological benefits (e.g. tasting good, feeling ‘buzzed’, 28%), and social benefits (e.g. bonding with fellow users, 28%). Compared to those aged ≥21 years, posts by content creators likely <21 years (26%) less commonly mentioned quitting (p<0.01), had fewer followers (p<0.01), were more commonly from Canada (p<0.01) and less commonly from the US (p<0.01), and more commonly featured JUUL (p<0.05). CONCLUSIONS While reaching a large and engaged audience, TikTok content creators suggest a range of benefits and consequences of nicotine addiction. Future research is warranted to examine this content’s potential to influence young people’s intentions to use or quit nicotine products.
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Affiliation(s)
- Kristy L. Marynak
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Meagan O. Robichaud
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Tyler Puryear
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Ryan D. Kennedy
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Meghan B. Moran
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
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Abstract
This study uses retail scanner data to assess nicotine pouch sales in the US between 2016 and 2020.
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Affiliation(s)
- Kristy L. Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xu Wang
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Michael A. Tynan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Brian A. King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ali FRM, Marynak KL, Kim Y, Binns S, Emery SL, Gomez Y, King BA. E-cigarette advertising expenditures in the USA, 2014-2018. Tob Control 2020; 29:e124-e126. [PMID: 32108086 DOI: 10.1136/tobaccocontrol-2019-055424] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/23/2019] [Accepted: 01/06/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco product advertising has been shown to reach youth and promote initiation. This study assessed trends in e-cigarette advertising expenditures in the USA during 2014-2018, overall and by manufacturer and media type. METHODS Data came from Kantar Media, which provides information on US advertising expenditures, including for e-cigarettes. Advertising expenditures were estimated as the dollar amount spent by e-cigarette companies to purchase advertising space in print, television, Internet, radio and outdoors. Dollar amounts were adjusted to 2017 dollars. Trends in e-cigarette advertising expenditures during 2014-2018 were analysed using Joinpoint regression overall, by media type, and by manufacturers based on 2017-2018 national sales. RESULTS Total e-cigarette advertising expenditures in print, radio, television, Internet and outdoors decreased substantially from US$133 million in 2014 to US$48 million in 2017, followed by an increase to US$110 million in 2018. By media type, expenditures were highest for print advertising, irrespective of year. By manufacturer, Altria had the highest e-cigarette advertising expenditures, totalling over US$134 million during 2014-2018. Imperial Tobacco had the second highest, totalling over US$85 million during 2014-2018, while JUUL Labs had the highest single-year expenditures, spending over US$73 million in 2018 alone. CONCLUSIONS E-cigarette advertising expenditures have been volatile in the USA, with declines in traditional advertising venues during 2014-2017 that may reflect a shift towards social media. However, an increase occurred in 2018 that is likely reflective of advertising by newer manufacturers. Continued monitoring of e-cigarette advertising is important to inform tobacco control strategies.
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Affiliation(s)
- Fatma Romeh M Ali
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Faculty of Economics and Political Science, Department of Economics, Cairo University, Giza, Egypt
| | - Kristy L Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yoonsang Kim
- Public Health, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Steven Binns
- Public Health, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Sherry L Emery
- Public Health, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Yessica Gomez
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Marynak KL, Ali FRM, Schauer GL, Tynan MA, King BA. Use and reasons for use of electronic vapour products shaped like USB flash drives among a national sample of adults. Tob Control 2019; 28:685-688. [PMID: 31023856 PMCID: PMC11017232 DOI: 10.1136/tobaccocontrol-2019-054932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Assess use and reasons for use of electronic vapour products (EVPs) shaped like universal serial bus (USB) flash drives among adults in the USA. METHODS Data came from SummerStyles, an internet survey of US adults aged ≥18 (N=4088) fielded in June to July 2018. Respondents were shown product images and asked about ever use, current (past 30 days) use and reasons for use. Weighted point estimates and adjusted ORs were assessed. RESULTS In 2018, 7.9% of participants had ever used flash drive-shaped EVPs, including 25.7% of current cigarette smokers and 45.9% of current EVP users. Moreover, 2.0% reported current use, including 6.8% of cigarette smokers and 34.3% of EVP users. Leading reasons for ever use were 'to deliver nicotine' (30.7%) and 'friend or family member used them' (30.2%). CONCLUSIONS About one in 13 US adults have ever used flash drive-shaped EVPs, with use being highest among current EVP users. Nicotine content and friend/family use are drivers of ever use. PUBLIC HEALTH IMPLICATIONS Understanding use of emerging EVP types can inform strategies to maximise any potential benefits for adult cessation and minimise risks of youth initiation.
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Affiliation(s)
- Kristy L Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fatma Romeh M Ali
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gillian L Schauer
- Carter Consulting, Inc, Contractor to Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Michael A Tynan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Trivers KF, Gentzke AS, Phillips E, Tynan M, Marynak KL, Schauer GL. Substances used in electronic vapor products among adults in the United States, 2017. Addict Behav Rep 2019; 10:100222. [PMID: 31828201 PMCID: PMC6888746 DOI: 10.1016/j.abrep.2019.100222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 12/31/2022] Open
Abstract
Electronic vapor products are used by adults for a variety of substances. Nicotine was the most commonly reported substance used in electronic vapor products. Many adults also use these devices for flavors and marijuana. Adults younger than 30 years and females were more likely to report flavor use.
Introduction Electronic vapor products (EVPs), including e-cigarettes, can be used to aerosolize many substances. Examination of substances used in EVPs by US adults has been limited; we assessed past-year use of EVPs to deliver various substances. Methods Data came from the 2017 SummerStyles Survey, a web-based survey of US adults (N = 4107). Ever EVP users were asked if they had used nicotine, marijuana, flavors or “something else” in an EVP during the past year. Weighted estimates for any, exclusive, and combined EVP substance use were calculated among ever (n = 586) and current (past 30-day; n = 121) EVP users. Results Past-year use of nicotine, flavors, and marijuana in EVPs was 30.7%, 23.6%, and 12.5% among ever EVP users, respectively; and 72.3%, 54.6%, and 17.8% among current EVP users. Among ever EVP users, the most commonly used substances were nicotine only (29.6%), nicotine plus flavors (27.2%), flavors only (16.4%), and marijuana only (14.9%). Among current EVP users, the most common substances used were nicotine plus flavors (39.1%), nicotine only (29.6%), and flavors only (11.2%). Among ever users, males and 18–29 year olds were more likely to report use of flavors than females and respondents ≥30 years. Conclusions Approximately 7 in 10 current EVP users reported nicotine use, about 1 in 2 used flavors, and nearly 1 in 6 used marijuana. These findings suggest that EVPs are used to consume a variety of substances and could guide efforts to address tobacco and non-tobacco substance use.
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Affiliation(s)
- Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Elyse Phillips
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Michael Tynan
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Gillian L Schauer
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States.,McKing Consulting, Atlanta, GA, United States
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Schier JG, Meiman JG, Layden J, Mikosz CA, VanFrank B, King BA, Salvatore PP, Weissman DN, Thomas J, Melstrom PC, Baldwin GT, Parker EM, Courtney-Long EA, Krishnasamy VP, Pickens CM, Evans ME, Tsay SV, Powell KM, Kiernan EA, Marynak KL, Adjemian J, Holton K, Armour BS, England LJ, Briss PA, Houry D, Hacker KA, Reagan-Steiner S, Zaki S, Meaney-Delman D. Severe Pulmonary Disease Associated with Electronic-Cigarette-Product Use - Interim Guidance. MMWR Morb Mortal Wkly Rep 2019; 68:787-790. [PMID: 31513561 PMCID: PMC6755818 DOI: 10.15585/mmwr.mm6836e2] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On September 6, 2019, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). As of August 27, 2019, 215 possible cases of severe pulmonary disease associated with the use of electronic cigarette (e-cigarette) products (e.g., devices, liquids, refill pods, and cartridges) had been reported to CDC by 25 state health departments. E-cigarettes are devices that produce an aerosol by heating a liquid containing various chemicals, including nicotine, flavorings, and other additives (e.g., propellants, solvents, and oils). Users inhale the aerosol, including any additives, into their lungs. Aerosols produced by e-cigarettes can contain harmful or potentially harmful substances, including heavy metals such as lead, volatile organic compounds, ultrafine particles, cancer-causing chemicals, or other agents such as chemicals used for cleaning the device (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis, or other drugs; for example, "dabbing" involves superheating substances that contain high concentrations of THC and other plant compounds (e.g., cannabidiol) with the intent of inhaling the aerosol. E-cigarette users could potentially add other substances to the devices. This report summarizes available information and provides interim case definitions and guidance for reporting possible cases of severe pulmonary disease. The guidance in this report reflects data available as of September 6, 2019; guidance will be updated as additional information becomes available.
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Gammon DG, Rogers T, Coats EM, Nonnemaker JM, Marynak KL, Kuiper NM, King BA. National and state patterns of concept-flavoured cigar sales, USA, 2012-2016. Tob Control 2019; 28:394-400. [PMID: 30068564 PMCID: PMC10938265 DOI: 10.1136/tobaccocontrol-2018-054348] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/14/2018] [Accepted: 06/27/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Cigar sales have increased in the USA in recent years. A growing proportion of cigar sales are of flavoured varieties, many bearing ambiguous or 'concept' flavour descriptions (eg, Jazz). This study assessed US cigar sales by flavour category (ie, concept flavoured, characterising flavoured and tobacco), at national, regional and state levels. METHODS Sales of cigarillos, large cigars and little cigars from chain, franchise and convenience stores, mass merchandisers, supermarkets, drug, dollar and club stores, and military commissaries during 2012-2016 were acquired from the Nielsen Company. US national-level and state-level sales, including District of Columbia, were analysed by flavour category. Flavour descriptors were classified as 'tobacco', 'characterising' or 'concept', based on Universal Product Code (UPC)-linked characteristics and brand website and consumer review descriptions. RESULTS Cigar sales increased by 29% during 2012-2016, driven by a 78% increase in cigarillo sales. The proportion of concept-flavoured sales increased from 9% to 15%, while the proportion of sales decreased for tobacco (50% to 49%) and characterising flavours (eg, cherry) (41% to 36%). Cigarillos had the greatest increase in unique concept flavour descriptions (17 to 46 unique UPCs), with most sales occurring among Sweet, Jazz and Green Sweets concept flavours. By US region, total and concept-flavoured cigarillo sales were highest in the South. CONCLUSIONS Flavoured cigars are increasingly labelled with concept flavours, including in areas with flavoured tobacco sales restrictions. Cigarillos are driving recent increases in US cigar and concept-flavoured cigar sales. It is important to consider concept flavours when addressing flavoured tobacco product sales and use.
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Affiliation(s)
- Doris G Gammon
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina, USA
| | - Todd Rogers
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina, USA
| | - Ellen M Coats
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina, USA
| | - James M Nonnemaker
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina, USA
| | - Kristy L Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia, USA
| | - Nicole M Kuiper
- Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia, USA
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Gentzke AS, Wang TW, Marynak KL, Trivers KF, King BA. Exposure to Secondhand Smoke and Secondhand E-Cigarette Aerosol Among Middle and High School Students. Prev Chronic Dis 2019; 16:E42. [PMID: 30950787 PMCID: PMC6464049 DOI: 10.5888/pcd16.180531] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Youth exposure to secondhand smoke (SHS) and secondhand aerosol from e-cigarettes (SHA) may contribute to the renormalization of tobacco product use behaviors. Our study assessed self-reported SHS or SHA exposures in indoor or outdoor public places among US students. Methods Data came from the 2015 and 2017 National Youth Tobacco Survey, a school-based survey of US students in grades 6 through 12. Past 30-day exposure to SHS and SHA in indoor and outdoor public places was assessed. The prevalence of exposure was assessed overall and by covariates for each year. We used adjusted prevalence ratios (aPRs) to assess determinants of exposure. Results We observed no significant change from 2015 through 2017 in exposure to SHS (52.6% to 50.5%), SHA (25.2% to 25.6%), or either SHS or SHA (56.7% to 55.1%). Following multivariable adjustment, in 2017, exposure to either SHS or SHA in public was higher among female students versus male students (aPR = 1.29), high school students versus middle school students (aPR = 1.15), current e-cigarette users versus nonusers (aPR = 2.89), and current users of other tobacco product versus nonusers (aPR = 1.21). Exposure was higher for students who reported that a household member used tobacco products. Conclusion In 2017, more than half (55.1%, 14.3 million) of US middle and high school students reported exposure to secondhand tobacco product emissions in indoor or outdoor public places. E-cigarette use may complicate the enforcement of existing smoke-free policies and contribute to the renormalization of tobacco use behaviors. Continued efforts are warranted to reduce the social acceptability of tobacco product use and protect bystanders from all tobacco product emissions.
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Affiliation(s)
- Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS S107-7, Atlanta, GA, 30341. E-mail:
| | - Teresa W Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Research shows that there is no risk-free level of exposure to secondhand smoke (SHS) and that eliminating smoking indoors fully protects nonsmokers from indoor SHS exposure. Casinos often allow smoking indoors and can be a source of involuntary SHS exposure for employees and visitors. We examined attitudes toward smoke-free casino policies among US adults. During June and July 2017, we used a web-based survey to ask a nationally representative sample of 4107 adults aged ≥18 about their attitudes toward smoke-free casinos. Among 4048 respondents aged ≥18, a weighted 75.0% favored smoke-free casino policies, including respondents who visited casinos about once per year (74.1%), several times per year (75.3%), and at least once per month (74.2%). Although the sociodemographic characteristics of respondents who favored smoke-free casino policies varied, the majority in each group, except current smokers (45.4%), supported smoke-free policies. Allowing smoking inside casinos involuntarily exposes casino employees and visitors to SHS, a known and preventable health risk. Further assessment of public knowledge and attitudes toward smoke-free casinos at state and local levels may help inform tobacco control policy, planning, and practice.
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Affiliation(s)
- Michael A Tynan
- 1 Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Teresa W Wang
- 1 Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Kristy L Marynak
- 1 Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Pamela Lemos
- 1 Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Stephen D Babb
- 1 Office on Smoking and Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
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Mitchko J, Lewis S, Marynak KL, Shannon C, Burnette D, King BA. E-Cigarettes and Young People: Communicating an Emerging Public Health Risk. Am J Health Promot 2019; 33:955-957. [PMID: 30871329 DOI: 10.1177/0890117119835519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
E-cigarettes are the most commonly used tobacco product among US youth. Most e-cigarettes contain nicotine, which can cause addiction and can harm the developing adolescent brain. In coordination with the release of a Surgeon General's Report on e-cigarette use among young people, the Centers for Disease Control and Prevention collaborated with the Office of the Surgeon General to launch a campaign to educate parents, youth influencers, and young people about the risks of e-cigarettes. This article describes the development of communication products, including innovative media, about this public health risk, and shares lessons learned to inform public health practice.
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Affiliation(s)
- Jane Mitchko
- 1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, USA
| | - Sarah Lewis
- 1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, USA
| | - Kristy L Marynak
- 1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, USA
| | - Curt Shannon
- 1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, USA
| | | | - Brian A King
- 1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, USA
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Sharapova S, Reyes-Guzman C, Singh T, Phillips E, Marynak KL, Agaku I. Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014-2016. Tob Control 2018; 29:49-54. [PMID: 30498008 DOI: 10.1136/tobaccocontrol-2018-054593] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/03/2018] [Accepted: 10/10/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Tobacco use mostly begins in adolescence and young adulthood. Earlier age of initiation of cigarette smoking is associated with greater nicotine dependence and sustained tobacco use. However, data are limited on the age of initiation of non-cigarette tobacco products, and the association between using these products and nicotine dependence and progression to established use. METHODS Combined 2014-2016 National Youth Tobacco Survey data, a nationally representative cross-sectional survey of US students in grades 6-12 yielded 19 580 respondents who reported ever using any of five tobacco products: electronic cigarettes, cigarettes, cigars, smokeless tobacco and hookah. Analyses assessed age of reported first use of each product among ever-users, overall and by sex and race/ethnicity. Current daily use, past 30-day use, feelings of craving tobacco and time to first tobacco use after waking were assessed by age of first use. RESULTS Among ever-users, weighted median age for first use was 12.6 years for cigarettes, 13.8 years for cigars, 13.4 years for smokeless tobacco, 14.1 years for hookah and 14.1 years for e-cigarettes. First trying these tobacco products at age ≤13 years was associated with greater current use of the respective product and nicotine dependence compared with initiating use at age >13 years. CONCLUSIONS First tobacco use at age ≤13 years is associated with current daily and past 30-day use of non-cigarette tobacco products, and with the development of nicotine dependence among youth ever-users. Proven tobacco prevention interventions that reach early adolescents are important to reduce overall youth tobacco use.
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Affiliation(s)
- Saida Sharapova
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolyn Reyes-Guzman
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Tushar Singh
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elyse Phillips
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Israel Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
This study uses e-cigarette retail sales data to estimate estimate e-cigarette sales and market share of e-cigarette sales by manufacturer in the United States during 2013-2017.
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Affiliation(s)
- Brian A. King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Doris G. Gammon
- Centers for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina
| | - Kristy L. Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Todd Rogers
- Centers for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina
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Marynak KL, Wang TW, King BA, Agaku IT, Reimels EA, Graffunder CM. Awareness and Ever Use of "Heat-Not-Burn" Tobacco Products Among U.S. Adults, 2017. Am J Prev Med 2018; 55:551-554. [PMID: 30033025 DOI: 10.1016/j.amepre.2018.04.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/04/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Heated tobacco products, sometimes marketed as "heat-not-burn" technology, represent a diverse class of products that heat leaf tobacco to produce an inhaled aerosol. Global sales of heated tobacco products are increasing; however, the extent of current heated tobacco product awareness and use in the U.S. is unknown. This study assessed awareness and ever use of heated tobacco products among U.S. adults. METHODS Data were obtained from the 2017 SummerStyles, an Internet survey of U.S. adults aged ≥18 years (N=4,107). Respondents were given a description of heated tobacco products, then asked about awareness and ever use. In 2017, descriptive statistics were calculated overall and by sex, age, race/ethnicity, and cigarette smoking status. Logistic regression was used to calculate AORs. RESULTS In 2017, a total of 5.2% of U.S. adults were aware of heated tobacco products, including 9.9% of current cigarette smokers. Overall, 0.7% of U.S. adults, including 2.7% of current smokers, reported ever use of heated tobacco products. Odds of ever use were higher among current smokers (AOR=6.18) than never smokers, and higher among adults aged <30 years (AOR=3.35) than those aged ≥30 years. CONCLUSIONS As of July 2017, few U.S. adults had ever used heated tobacco products; however, about one in 20 were aware of the products, including one in ten cigarette smokers. The uncertain impact of heated tobacco products on individual- and population-level health warrants timely and accurate public health surveillance. These first estimates among U.S. adults can serve as a key baseline measure.
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Affiliation(s)
- Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Teresa W Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A Reimels
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Corinne M Graffunder
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Marynak KL, Gammon DG, King BA, Loomis BR, Fulmer EB, Wang TW, Rogers T. National and State Trends in Sales of Cigarettes and E-Cigarettes, U.S., 2011-2015. Am J Prev Med 2017; 53:96-101. [PMID: 28285828 PMCID: PMC5559880 DOI: 10.1016/j.amepre.2017.01.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/30/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION In recent years, self-reported cigarette smoking has declined among youth and adults, while electronic cigarette (e-cigarette) use has increased. However, sales trends for these products are less certain. This study assessed national and state patterns of U.S. cigarette and e-cigarette unit sales. METHODS Trends in cigarette and e-cigarette unit sales were analyzed using retail scanner data from September 25, 2011 through January 9, 2016 for: (1) convenience stores; and (2) all other outlets combined, including supermarkets, mass merchandisers, drug, dollar, and club stores, and military commissaries (online, tobacco-only, and "vape" shops were not available). Data by store type were available for the total contiguous U.S. and 29 states; combined data were available for the remaining states, except Alaska, Hawaii, and DC. RESULTS During 2011-2015, cigarette sales exhibited a small, significant decrease; however, positive year-over-year growth occurred in convenience stores throughout most of 2015. E-cigarette unit sales significantly increased during 2011-2015, but year-over-year growth slowed and was occasionally negative. Cigarette unit sales exceeded e-cigarettes by 64:1 during the last 4-week period. During 2014-2015, cigarette sales increases occurred in 15 of 48 assessed states; e-cigarette sales increased in 18 states. CONCLUSIONS Despite overall declines during 2011-2015, cigarette sales in 2015 grew for the first time in a decade. E-cigarette sales growth was positive, but slowed over the study period in assessed stores. Cigarette sales continued to exceed e-cigarette sales, reinforcing the importance of efforts to reduce the appeal and accessibility of cigarettes and other combusted tobacco products.
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Affiliation(s)
- Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Doris G Gammon
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brett R Loomis
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina
| | - Erika B Fulmer
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Teresa W Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Todd Rogers
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, North Carolina
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Marynak KL, Xu X, Wang X, Holmes CB, Tynan MA, Pechacek T. Estimating the Impact of Raising Prices and Eliminating Discounts on Cigarette Smoking Prevalence in the United States. Public Health Rep 2017; 131:536-43. [PMID: 27453597 DOI: 10.1177/0033354916662211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The average retail price per pack of cigarettes is less than $6, which is substantially lower than the $10 per-pack target established in 2014 by the Surgeon General to reduce the smoking rate. We estimated the impact of three cigarette pricing scenarios on smoking prevalence among teens aged 12-17 years, young adults aged 18-25 years, and adults aged ≥26 years, by state: (1) $0.94 federal tax increase on cigarettes, as proposed in the fiscal year 2017 President's budget; (2) $10 per-pack retail price, allowing discounts; and (3) $10 per-pack retail price, eliminating discounts. We conducted Monte Carlo simulations to generate point estimates of reductions in cigarette smoking prevalence by state. We found that each price scenario would substantially reduce cigarette smoking prevalence. A $10 per-pack retail price eliminating discounts could result in 637,270 fewer smokers aged 12-17 years; 4,186,954 fewer smokers aged 18-25 years; and 7,722,460 fewer smokers aged ≥26 years. Raising cigarette prices and eliminating discounts could substantially reduce cigarette smoking prevalence as well as smoking-related death and disease.
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Affiliation(s)
- Kristy L Marynak
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA
| | - Xin Xu
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA
| | - Xu Wang
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA
| | - Carissa Baker Holmes
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA
| | - Michael A Tynan
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA; Oregon Health Authority, Public Health Division, Office of the State Public Health Director, Portland, OR
| | - Terry Pechacek
- Georgia State University, School of Public Health, Division of Health Management & Policy, Atlanta, GA
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Affiliation(s)
- Teresa W Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia2Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Marynak KL, Gammon DG, Rogers T, Coats EM, Singh T, King BA. Sales of Nicotine-Containing Electronic Cigarette Products: United States, 2015. Am J Public Health 2017; 107:702-705. [PMID: 28323467 DOI: 10.2105/ajph.2017.303660] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the proportion of electronic cigarette (e-cigarette) products sold in the United States that contain nicotine according to retail scanner data. METHODS We obtained unit sales data from January 11, 2015, to December 12, 2015, from The Nielsen Company for convenience stores; supermarkets; mass merchandisers; drug, club, and dollar stores; and Department of Defense commissaries. The data did not include purchases from tobacco specialty shops, "vape shops," or online sources. Nicotine content was assessed by product type (disposables, rechargeables, and refills), region, and flavor status based on nicotine strength listed in the Universal Product Codes. For the 36.7% of entries lacking nicotine content information, we conducted Internet searches by brand, product, and flavor. RESULTS In 2015, 99.0% of e-cigarette products sold contained nicotine, including 99.0% of disposables, 99.7% of rechargeables, and 98.8% of refills. Overall, 98.7% of flavored e-cigarette products and 99.4% of nonflavored e-cigarette products contained nicotine. CONCLUSIONS In 2015, almost all e-cigarette products sold in US convenience stores and other assessed channels contained nicotine. Public Health Implications. Findings reinforce the importance of warning labels for nicotine-containing products, ingredient reporting, and restrictions on sales to minors.
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Affiliation(s)
- Kristy L Marynak
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Doris G Gammon
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Todd Rogers
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Ellen M Coats
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Tushar Singh
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Brian A King
- Kristy L. Marynak, Tushar Singh, and Brian A. King are with the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Doris G. Gammon, Todd Rogers, and Ellen M. Coats are with the Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC. Tushar Singh is also with the Epidemic Intelligence Service, Centers for Disease Control and Prevention
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Nguyen KH, Tong VT, Marynak KL, King BA. US Adults' Perceptions of the Harmful Effects During Pregnancy of Using Electronic Vapor Products Versus Smoking Cigarettes, Styles Survey, 2015. Prev Chronic Dis 2016; 13:E175. [PMID: 28005528 PMCID: PMC5201153 DOI: 10.5888/pcd13.160349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Research suggests aerosol from electronic vapor products (EVPs) has fewer harmful constituents than conventional cigarette smoke. Even so, EVPs and other nicotine-containing products are not safe to use during pregnancy. We examined perceptions among US adults regarding harm in using EVPs rather than smoking cigarettes during pregnancy. METHODS Data came from the 2015 Styles Survey, an Internet panel survey of a sample of US adults aged 18 years or older (N = 4,127). Perceived harm was assessed by asking respondents whether using EVPs was less, equally, or more harmful for pregnant women than smoking cigarettes. Descriptive statistics were used to estimate perceived harm overall and by sociodemographic characteristics and tobacco-use status. Perceived harm was assessed among all adults, women of reproductive age (18-44 years, n = 820), and women of nonreproductive age (≥45 years, n = 1,398). RESULTS Among all adults, 11.1% believed using EVPs during pregnancy was less harmful than smoking conventional cigarettes, 51.0% believed it was equally harmful, 11.6% believed it was more harmful, and 26.2% did not know. Prevalence of perception of less harm, by demographic category, was greatest among adults aged 18 to 24 years, men, non-Hispanic whites, adults with less than a high school diploma, current EVP users, and current cigarette smokers (P < .05). Prevalence of perception of less harm was greater among women of reproductive age (9.6%) than among those of nonreproductive age (7.9%) (P < .05). CONCLUSION US adults have varying levels of perceptions about the harms of EVP use versus cigarette smoking during pregnancy. Efforts are warranted to prevent nicotine exposure during pregnancy and to educate adults on the dangers of using any form of tobacco during pregnancy, including EVPs.
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Affiliation(s)
- Kimberly H Nguyen
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79. Atlanta, Georgia GA 30341.
| | - Van T Tong
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Wang TW, Agaku IT, Marynak KL, King BA. Attitudes Toward Prohibiting Tobacco Sales in Pharmacy Stores Among U.S. Adults. Am J Prev Med 2016; 51:1038-1043. [PMID: 27593419 PMCID: PMC5118143 DOI: 10.1016/j.amepre.2016.06.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/25/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pharmacy stores are positioned to cultivate health and wellness among patrons. This study assessed attitudes toward prohibiting tobacco product sales in pharmacy stores among U.S. adults. METHODS Data from the 2014 Summer Styles, an Internet survey of U.S. adults aged ≥18 years (n=4,269), were analyzed in 2015. Respondents were asked: Do you favor or oppose banning the sale of all tobacco products in retail pharmacy stores? Responses were: strongly favor, somewhat favor, somewhat oppose, and strongly oppose. Prevalence ratios were calculated using multivariate Poisson regression to determine sociodemographic correlates of favorability (strongly or somewhat). RESULTS Among all adults, 66.1% "strongly" or "somewhat" favored prohibiting tobacco product sales in pharmacy stores. Favorability was 46.5% among current cigarette smokers, 66.3% among former smokers, and 71.8% among never smokers. Favorability was 47.8% among current non-cigarette tobacco users, 63.2% among former users, and 71.4% among never users. Following adjustment, favorability was more likely among women compared with men (p<0.05). Conversely, favorability was less likely among the following: adults aged 25-44 years and 45-64 years compared with those aged ≥65 years, those with annual household income of $15,000-$24,999 compared with ≥$60,000, current cigarette smokers compared with never smokers, and current and former non-cigarette tobacco users compared with never tobacco users (p<0.05). CONCLUSIONS Most U.S. adults favor prohibiting tobacco sales in retail pharmacy stores. Eliminating tobacco product sales in these settings may reinforce pharmacy stores' efforts to promote wellness, and further cultivate social climates that reduce the desirability, acceptability, and accessibility of tobacco.
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Affiliation(s)
- Teresa W Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia;; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Singh T, Agaku IT, Arrazola RA, Marynak KL, Neff LJ, Rolle IT, King BA. Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students. Pediatrics 2016; 137:peds.2015-4155. [PMID: 27244815 DOI: 10.1542/peds.2015-4155] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Electronic cigarette (e-cigarette) use among US students increased significantly during 2011 to 2014. We examined the association between e-cigarette advertisement exposure and current e-cigarette use among US middle school and high school students. METHODS Data came from the 2014 National Youth Tobacco Survey (n = 22 007), a survey of students in grades 6 through 12. The association between current e-cigarette use and exposure to e-cigarette advertisements via 4 sources (Internet, newspapers/magazines, retail stores, and TV/movies) was assessed. Three advertising exposure categories were assessed: never/rarely, sometimes, and most of the time/always. Separate logistic regression models were used to measure the association, adjusting for gender, race/ethnicity, grade, and other tobacco use. RESULTS Compared with students who reported exposure to e-cigarette advertisements never/rarely, the odds of current e-cigarette use were significantly (P < .05) greater among those reporting exposure sometimes and most of the time/always, respectively, as follows: Internet (adjusted odds ratio: middle school, 1.44 and 2.91; high school, 1.49, and 2.02); newspapers/magazines (middle school, 0.93 [not significant] and 1.87; high school, 1.26 and 1.71); retail stores (middle school, 1.78 and 2.34; high school, 1.37, and 1.91); and TV/movies (middle school, 1.25 [not significant] and 1.80; high school, 1.24 and 1.54). CONCLUSIONS E-cigarette advertisement exposure is associated with current e-cigarette use among students; greater exposure is associated with higher odds of use. Given that youth use of tobacco in any form is unsafe, comprehensive tobacco prevention and control strategies, including efforts to reduce youth exposure to advertising, are critical to prevent all forms of tobacco use among youth.
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Affiliation(s)
- Tushar Singh
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Israel T Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
| | - René A Arrazola
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
| | - Linda J Neff
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
| | - Italia T Rolle
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion; and
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