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Kierstead EC, Smiley SL, Kucherlapaty P, Kingsley M, Rogers T, Schillo B, Rose SW. Recommendations for Centering Equity to Advance Federal and Local US Policies Regulating the Availability and Sale of Flavored Tobacco Products. Nicotine Tob Res 2024:ntae078. [PMID: 38652492 DOI: 10.1093/ntr/ntae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/01/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Affiliation(s)
| | - Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | | | | | - Todd Rogers
- Public Health Division, RTI International, Research Triangle Park, NC, USA
| | | | - Shyanika W Rose
- Center for Health Equity Transformation and Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
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Erinoso O, Brown JL, Glasser AM, Gravely S, Fong GT, Chung-Hall J, Kyriakos CN, Liber AC, Craig LV, White AM, Rose SW, Smiley SL, Zeller M, Leischow S, Ayo-Yusuf O, Cohen JE, Ashley D. Evidence-based post-ban research to inform effective menthol cigarette bans in the United States and other jurisdictions. Nicotine Tob Res 2024:ntae082. [PMID: 38613422 DOI: 10.1093/ntr/ntae082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Indexed: 04/15/2024]
Affiliation(s)
| | - Jennifer L Brown
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, US
| | - Allison M Glasser
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers University, US
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Canada
- Ontario Institute for Cancer Research, Canada
| | | | - Christina N Kyriakos
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Alex C Liber
- Policy and Regulatory Science Program, RTI International, US
| | | | - Augustus M White
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia
| | - Shyanika W Rose
- Department of Behavioral Science and Center for Health Equity Transformation, College of Medicine, University of Kentucky, US
| | | | - Mitch Zeller
- Retired Director, Food and Drug Administration, Center for Tobacco Products
| | - Scott Leischow
- College of Health Solutions, Arizona State University, US
| | - Olalekan Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research, School of Health Systems and Public Health, University of Pretoria, South Africa
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, US
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Smiley SL, Shin H. Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions. Subst Use Misuse 2024; 59:727-731. [PMID: 38226661 DOI: 10.1080/10826084.2023.2294984] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.
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Affiliation(s)
- Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Heesung Shin
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
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Smiley SL, Shin H, Brown N, Geraci AA, Sussman S. Hypothetical e-liquid flavor ban and opinions among vape shop retailers in the Greater Los Angeles Area. Tob Induc Dis 2023; 21:133. [PMID: 37842544 PMCID: PMC10571508 DOI: 10.18332/tid/172078] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Evaluating anticipated responses to flavor bans in the context of vape shops is needed to inform legislation and enforcement. This cross-sectional study examined vape shop retailers' opinions about the potential impacts of an e-liquid flavor ban on shop sales and customer behavior-change intentions. METHODS From December 2019 to October 2020 we conducted structured interviews over the phone with 46 brick-and-mortar vape shop retailers in the Greater Los Angeles Area. RESULTS Most participants were managers (43.5%), followed by owners (26.1%) and clerks (26.1%). More than half (52.2%) reported that sales would drop a lot if flavored e-liquids were banned in all vape shops. Controlling for store position, multivariable linear regression showed that opposition to a hypothetical ban on non-tobacco flavored e-liquids was associated with participants' opinions that customers would likely not purchase tobacco flavored e-liquids (b= -0.44, p<0.01), and would likely use combustible tobacco products (b=0.47, p<0.05). CONCLUSIONS In this cross-sectional study, vape shop retailers in the Greater Los Angeles Area reported that if a ban on non-tobacco e-liquid flavors occurred, they would oppose strongly, and that a ban would have a negative impact on their shop (e.g. loss in sales) and customer behavior (e.g. would replace vaping with smoking combustible tobacco products). Implications for research and practice are discussed.
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Affiliation(s)
- Sabrina L. Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
| | - Heesung Shin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Nichelle Brown
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
| | - Angela A. Geraci
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
| | - Steve Sussman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, United States
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Kidd JD, Smiley SL, Coffin PO, Carmody TJ, Levin FR, Nunes EV, Shoptaw SJ, Trivedi MH. Sexual orientation differences among men in a randomized clinical trial of extended-release naltrexone and bupropion for methamphetamine use disorder. Drug Alcohol Depend 2023; 250:110899. [PMID: 37478502 PMCID: PMC10530262 DOI: 10.1016/j.drugalcdep.2023.110899] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Methamphetamine use disorder (MethUD) disproportionately affects men who have sex exclusively with men or with men and women (collectively MSM/W), compared to men who have sex with women (MSW). This study is the first MethUD medication trial to compare treatment effect for these groups, hypothesizing that extended-release injectable naltrexone 380mg every 3 weeks plus oral extended-release bupropion 450mg daily would be less effective for MSM/W than MSW. METHODS Data come from men (N = 246) in a multi-site, double-blind, randomized, placebo-controlled trial with sequential parallel comparison design. In Stage 1 (6-weeks), participants were randomized to active treatment or placebo. In Stage 2 (6-weeks), Stage 1 placebo non-responders were rerandomized. Treatment response was ≥3 methamphetamine-negative urine samples, out of four obtained at the end of Stages 1 and 2. Treatment effect was the active-versus-placebo between-group difference in the weighted average Stages 1 and 2 responses. RESULTS MSM/W (n = 151) were more likely than MSW (n = 95) to be Hispanic, college-educated, and living with HIV. Adjusting for demographics, among MSM/W, response rates were 13.95 % (active treatment) and 2.78 % (placebo) in Stage 1; 23.26 % (active treatment) and 4.26 % (placebo) in Stage 2. Among MSW, response rates were 7.69 % (active treatment) and 5.80 % (placebo) in Stage 1; 3.57 % (active treatment) and 0 % (placebo) in Stage 2. Treatment effect was significantly larger for MSM/W (h = 0.1479) than MSW (h = 0.0227) (p = 0.04). CONCLUSIONS Findings suggest efficacy of extended-release naltrexone plus bupropion for MSM/W, a population heavily burdened by MethUD. While a secondary outcome, this intriguing finding merits testing in prospective trials.
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Affiliation(s)
- Jeremy D Kidd
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY10032, USA.
| | - Sabrina L Smiley
- San Diego State University School of Public Health, 5500 Campanile Drive, San Diego, CA92182, USA.
| | - Phillip O Coffin
- Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA94143, USA; San Francisco Department of Health, 101 Grove Street, San Francisco, CA94102, USA.
| | - Thomas J Carmody
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX75390, USA.
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY10032, USA.
| | - Edward V Nunes
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY10032, USA.
| | - Steven J Shoptaw
- Department of Family Medicine, University of California Los Angeles, 10880 Wilshire Boulevard, Los Angeles, CA90024, USA.
| | - Madhukar H Trivedi
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX75390, USA.
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Ozga JE, Smiley SL, Hart JL, Popova L, Stanton CA. Premium Cigar Festivals: A Potential Target for Marketing Restrictions. Nicotine Tob Res 2023; 25:S81-S83. [PMID: 37506236 PMCID: PMC10380184 DOI: 10.1093/ntr/ntac286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/16/2022] [Accepted: 12/13/2022] [Indexed: 07/30/2023]
Affiliation(s)
- Jenny E Ozga
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Joy L Hart
- Department of Communication and Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, USA
| | - Lucy Popova
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Heley K, Popova L, Moran MB, Ben Taleb Z, Hart JL, Wackowski OA, Westling E, Smiley SL, Stanton CA. Targeted tobacco marketing in 2020: the case of #BlackLivesMatter. Tob Control 2023; 32:530-533. [PMID: 34907090 PMCID: PMC9295306 DOI: 10.1136/tobaccocontrol-2021-056838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, Kentucky, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Sabrina L Smiley
- Tobacco Center of Regulatory Science, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Cassandra A Stanton
- Behavioral Health & Health Policy, Westat, Rockville, Maryland, USA
- Georgetown University Medical Center, Washington, District of Columbia, USA
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Smiley SL, Brown N. Assessing access to smoking cessation services in Southern California HIV safety nets: A secret shopper study. Drug Alcohol Depend Rep 2023; 7:100169. [PMID: 37305014 PMCID: PMC10248787 DOI: 10.1016/j.dadr.2023.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/13/2023]
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Taggart T, Smiley SL, Ritchwood TD. Advancing Public Health and Social Equity Through Research, Training, and Action. Am J Public Health 2023; 113:S98-S101. [PMID: 37339414 PMCID: PMC10282846 DOI: 10.2105/ajph.2023.307340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Tamara Taggart
- Tamara Taggart is with the Department of Prevention and Community Health, George Washington University, Washington, DC. Sabrina L. Smiley is with the Division of Health Promotion and Behavioral Science, San Diego State University School of Public Health, San Diego, CA. Tiarney D. Ritchwood is with the Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC. All authors are also guest editors of this special issue
| | - Sabrina L Smiley
- Tamara Taggart is with the Department of Prevention and Community Health, George Washington University, Washington, DC. Sabrina L. Smiley is with the Division of Health Promotion and Behavioral Science, San Diego State University School of Public Health, San Diego, CA. Tiarney D. Ritchwood is with the Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC. All authors are also guest editors of this special issue
| | - Tiarney D Ritchwood
- Tamara Taggart is with the Department of Prevention and Community Health, George Washington University, Washington, DC. Sabrina L. Smiley is with the Division of Health Promotion and Behavioral Science, San Diego State University School of Public Health, San Diego, CA. Tiarney D. Ritchwood is with the Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC. All authors are also guest editors of this special issue
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Cwalina SN, Ihenacho U, Barker J, Smiley SL, Pentz MA, Wipfli H. Advancing racial equity and social justice for Black communities in US tobacco control policy. Tob Control 2023; 32:381-384. [PMID: 34526408 PMCID: PMC8920941 DOI: 10.1136/tobaccocontrol-2021-056704] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/07/2021] [Accepted: 09/02/2021] [Indexed: 11/03/2022]
Abstract
The US Food and Drug Administration (FDA) applies the Population Health Standard in tobacco product review processes by weighing anticipated health benefits against risks associated with a given commercial tobacco product at the population level. However, systemic racism (ie, discriminatory policies and practices) contributes to an inequitable distribution of tobacco-related health benefits and risks between white and Black/African Americans at the population level. Therefore, Black-centered, antiracist data standards for tobacco product review processes are needed to achieve racial equity and social justice in US tobacco control policy. Regardless of whether FDA implements such data standards, non-industry tobacco scientists should prioritise producing and disseminating Black-centred data relevant to FDA's regulatory authority. We describe how systemic racism contributes to disparities in tobacco-related outcomes and why these disparities are relevant for population-level risk assessments, then discuss four possible options for Black-centred data standards relevant to tobacco product review processes.
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Affiliation(s)
- Sam N Cwalina
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Ugonna Ihenacho
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Joshua Barker
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Sabrina L Smiley
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Heather Wipfli
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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Sidhu NK, Lechner WV, Cwalina SN, Whitted L, Smiley SL, Barrington-Trimis JL, Cho J, Wagener TL, Leventhal AM, Tackett AP. Adolescent and Young Adult Response to Hypothetical E-Liquid Flavor Restrictions. J Stud Alcohol Drugs 2023; 84:303-308. [PMID: 36971721 PMCID: PMC10171255 DOI: 10.15288/jsad.21-00466] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/20/2021] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Rates of e-cigarette use among adolescents and young adults (AYAs) remain high despite several federal policy changes intended to limit their availability and appeal. The current study examined how restricting flavors would affect current AYA users' intentions to discontinue vaping, as a function of their current flavor preference. METHOD In a national cross-sectional survey, AYA e-cigarette users (N = 1,414) completed measures of e-cigarette use, device type, e-liquid flavor (tobacco, menthol, cool mint, fruit ice, fruit/sweet), and intent to discontinue e-cigarette use in response to hypothetical federal product standards (i.e., tobacco and menthol or tobacco-only e-liquid). Logistic regression was used to model the association of preferred flavor with odds of discontinuing e-cigarette use (vs. continuing), for menthol and tobacco hypothetical product standards. RESULTS Overall, 38.8% of the sample reported intent to discontinue using their e-cigarette if tobacco and menthol-flavored e-liquid were the only options available, whereas 70.8% would discontinue under a tobacco-only product standard. AYAs preferring fruit/sweet flavor were most sensitive to either restricted scenario, with odds of discontinuing use ranging from adjusted odds ratio (aOR) = 2.22 to aOR = 2.38 under a tobacco and menthol product standard and aOR = 1.33 to aOR = 2.59 under a tobacco-only product standard, compared with other flavor preferences. In addition, AYAs using cooling flavors (e.g., fruit ice) reported higher odds of discontinuing use under a tobacco-only product standard, compared with menthol flavor users, indicating an important distinction between these groups. CONCLUSIONS Results indicate potential for flavor restrictions to reduce use of e-cigarettes among AYAs and suggest that a tobacco flavor product standard may result in the greatest discontinuation of use.
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Affiliation(s)
- Natasha K. Sidhu
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | | | - Sam N. Cwalina
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lauren Whitted
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sabrina L. Smiley
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California
| | | | - Junhan Cho
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Theodore L. Wagener
- Division of Medical Oncology, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Adam M. Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Alayna P. Tackett
- Institute for Addiction Science, University of Southern California, Los Angeles, California
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Brown N, Shin H, Whooley S, Tefilin N, Les O, Smiley SL. A content analysis of website marketing for cooling flavored
e-liquids in a sample of brick-and-mortar vape shops in the
Greater Los Angeles area. Tob Prev Cessat 2022; 8:29. [PMID: 35949949 PMCID: PMC9310102 DOI: 10.18332/tpc/150771] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Menthol is a characterizing flavor in combustible cigarettes and electronic nicotine delivery systems (ENDS). E-liquids are recognized as an important reason for ENDS use. Yet, compared to menthol cigarettes, menthol flavored e-liquids and other cooling flavors, including mint and ‘ice’ for ENDS, are an understudied area of investigation. The present study examined cooling flavored e-liquid website marketing among brick-and-mortar vape shops in Greater Los Angeles Area. METHODS A total of 104 brick-and-mortar vape shops were identified, and 38 had active websites. Over a 30-day period (28 September – 28 October 2020), we collected marketing for all flavored refillable e-liquids (photos/images) from each website. Data were collected for 1330 products. Only refillable e-liquid bottles were selected for this study, excluding prefilled pod vapes and disposable vapes. Each e-liquid per website was coded (e.g. menthol or not) and grouped into categories (e.g. type of menthol). The three flavor descriptor categories that the e-liquids were grouped into were menthol, mint, or ice. An ‘other’ category was also created for identified e-liquids with flavor descriptors that did not mention menthol, mint, or ice. RESULTS A total of 1330 e-liquid flavors were identified from 38 active websites. Among them, 219 were coded as menthol/mint/ice flavor e-liquids. Frequencies included ice/iced/icy (n=123; 56%), menthol (n=32; 15%), mint (n=23; 11%), and other (n=41; 19%). Of the 123 ice-flavor e-liquids, 70.3% (n=83) were in combination with fruit (e.g. ‘Apple Ice’, ‘Grape Iced’, ‘Icy Mango’). Of the 32 menthol-flavored e-liquids, 63.3% (n=19) were in combination with fruit (e.g. ‘Dragon Fruit Menthol’, ‘Blue Raspberry Menthol’, ‘Fresh Peach Menthol’). Flavors in the other category were ice-related flavor descriptors (e.g. ‘Arctic Air’, ‘Brain Freeze’, ‘Frozen Hulk Tears’). CONCLUSIONS Brick-and-mortar vape shops in the Greater Los Angeles Area market a variety of cooling flavor e-liquids on their websites. Such marketing focused largely on ice fruit flavor combinations. Future research is needed to understand how exposure to and appeal of cooling flavored e-liquid marketing differs among diverse consumer groups, including adult menthol cigarette smokers and non-smoking youth.
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Affiliation(s)
- Nichelle Brown
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
| | - Heesung Shin
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
| | - Simone Whooley
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Nathan Tefilin
- College of Letters and Science, University of California, Los Angeles, United States
| | - Olena Les
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Sabrina L. Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
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Pavy M, Shin H, Malik N, Whooley S, Tefilin N, Smiley SL. Marketing claims on websites of brick-and-mortar vape
shops in the Greater Los Angeles area. Tob Prev Cessat 2022; 8:25. [PMID: 35855291 PMCID: PMC9241445 DOI: 10.18332/tpc/150585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Megan Pavy
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Heesung Shin
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Nicole Malik
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Simone Whooley
- Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Nathan Tefilin
- College of Letters and Science, University of California, Los Angeles, United States
| | - Sabrina L. Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, United States
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Kechter A, Simpson KA, Ceasar RC, Schiff SJ, Yamaguchi N, Bluthenthal RN, Smiley SL, Barrington-Trimis JL. Trajectories of Nicotine Use Leading to Dual and Cyclical Tobacco Product Use in Young Adults. Nicotine Tob Res 2022; 24:986-993. [PMID: 34850184 PMCID: PMC9199940 DOI: 10.1093/ntr/ntab249] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/30/2021] [Revised: 11/10/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Young adult never-smokers who vape are at elevated risk of initiating cigarettes, while young adults who smoke often begin vaping to substitute or reduce cigarette use. Reasons underlying different use patterns of tobacco products are not well-understood. AIMS AND METHODS We conducted 1-on-1 qualitative interviews with young adults (N = 62) who vape in Los Angeles, California from June 2018 to June 2019. Participants were 18-25 years old (79% male; racially/ethnically diverse) and self-reported vaping ≥1x/week. We used a semi-structured interview guide and applied thematic analysis method to analyze data. RESULTS Young adults initiated vaping due to peer socialization and e-liquid flavor novelty. They often reported vaping (after first smoking) due to a belief that e-cigarettes are healthier, social pressure to quit smoking, and convenience of use. Participants reported smoking (after first vaping) when traveling outside of the United States where vaping products were less accessible, and cigarettes were normative. Many of the personal narratives described patterns of dual and cyclical use, which was often attributed to nicotine dependence and cost, or described as dependent upon the current environment (eg, at a party). CONCLUSIONS The current study characterizes nicotine use trajectories and reasons why young adults vape, and smoke cigarettes. Dual and cyclical use of both e-cigarettes and cigarettes was common; this pattern of use should be considered in policy and prevention work to address nicotine dependence among young people. IMPLICATIONS We display findings from the current study in a model depicting common trajectories of nicotine use, along with reasons for initiation, transitions between products, and dual/cyclical e-cigarette and combustible cigarette use.
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Affiliation(s)
- Afton Kechter
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kelsey A Simpson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rachel Carmen Ceasar
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sara J Schiff
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Naosuke Yamaguchi
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ricky N Bluthenthal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sabrina L Smiley
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Pearson JL, Smiley SL. E-Cigarettes, Harm Reduction, and Smoking Cessation: Where Are We Now? Nicotine Tob Res 2022; 24:943-944. [PMID: 35427419 DOI: 10.1093/ntr/ntac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jennifer L Pearson
- Division of Social and Behavioral Health/Health Administration and Policy, School of Public Health, University of Nevada, Reno, NV, USA
| | - Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA, USA
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16
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Pearson JL, Zhou Y, Smiley SL, Rubin LF, Harvey E, Koch B, Niaura R, Abrams DB. Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking. Nicotine Tob Res 2021; 23:527-534. [PMID: 32421191 PMCID: PMC7885790 DOI: 10.1093/ntr/ntaa086] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/12/2019] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION This study examined the association between the introduction of an e-cigarette and subsequent change in cigarette smoking among smokers who were not immediately interested in quitting. AIMS AND METHODS The Moment Study was a 21-day intensive longitudinal study with an online follow-up survey at 30 days. After observing baseline cigarette smoking for 1 week, participants received 10 cigalike e-cigarettes on study days 6 and 13. Participants reported cigarettes per day, e-cigarette puffs per day, and e-cigarette satisfaction using text-message-based surveys. RESULTS The sample of 96 daily smokers was majority female (53.1%), African American (67.7%), and non-Hispanic (95.8%). When e-cigarettes were provided (day 6), average cigarettes per day dropped by 1.82 cigarettes (p < .0001). The within-person e-cigarette puff effect on daily cigarette smoking was significantly negative (β = -0.023; p = .005); a participant who consumed 100 more e-cigarette puffs in a day than usual for that person was expected to smoke 2.3 fewer cigarettes that day, but this was only true for non-menthol smokers (p = .006). Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps < .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up. CONCLUSIONS Giving e-cigarettes to smokers who did not intend to quit reduced their cigarette smoking on days when they used e-cigarette more frequently, but this relationship did not hold for menthol smokers. Satisfaction with e-cigarette use was predictive of continued use 30 days later. IMPLICATIONS A greater amount of cigalike e-cigarette use resulted in less smoking among adult daily smokers without immediate plans to quit, but a lack of nicotine delivery and satisfaction for these devices may have limited their utility as a replacement for cigarette smoking, especially among menthol smokers. The global concept of "satisfaction" may be an important driver of e-cigarette use among adult smokers.
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Affiliation(s)
- Jennifer L Pearson
- Division of Social and Behavioral Health/Health Administration and Policy, University of Nevada, Reno, NV
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yitong Zhou
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Sabrina L Smiley
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Leslie F Rubin
- Counseling and Psychological Services, Northwestern University, Evanston, IL
| | - Emily Harvey
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Contractor—Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Brandon Koch
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Nevada, Reno, NV
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY
| | - David B Abrams
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY
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17
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Smiley SL, Cho J, Blackman KCA, Cruz TB, Pentz MA, Samet JM, Baezconde-Garbanati L. Retail Marketing of Menthol Cigarettes in Los Angeles, California: a Challenge to Health Equity. Prev Chronic Dis 2021; 18:E11. [PMID: 33571082 PMCID: PMC7879965 DOI: 10.5888/pcd18.200144] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction Sales of menthol cigarettes continue to increase, accounting for a third of the US cigarette market. Retail marketing of menthol cigarettes is a contributing factor to tobacco-related health disparities. To inform regulation to address associated disparities, we examined retail marketing strategies for menthol cigarettes and their features and characteristics in relation to neighborhood racial/ethnic composition. Methods We used multilevel regression models to examine associations of neighborhood racial/ethnic composition and store type with menthol cigarette sales outcomes, including availability, exterior advertising, price promotions, and price in a sample of tobacco retailers (N = 673) in Los Angeles County neighborhoods with a median or below-median household income. We also recorded the prices of Newport cigarettes (the highest selling menthol cigarette brand in the United States) and blu disposable menthol e-cigarettes. Results Overall, 94.5% of retailers sold menthol cigarettes, 31.2% displayed menthol cigarette price promotions, and 30.2% displayed at least one menthol cigarette advertisement on their exterior. Adjusting for racial/ethnic zip code cluster and store type, stores located in predominantly African American neighborhoods showed significantly higher odds in the availability of Newport cigarettes than stores in Hispanic neighborhoods (OR = 0.21; 95% CI, 0.09–0.53; P = .001) or non-Hispanic White (OR = 0.12; 95% CI, 0.05–0.31; P < .001) neighborhoods. Stores located in predominantly African American neighborhoods displayed significantly higher odds of having price promotions for menthol cigarettes and storefront advertisements than those in Hispanic neighborhoods (OR = 0.51; 95% CI, 0.30–0.88; P = .02 and OR = 0.25; 95% CI, 0.13–0.48; P < .001, respectively). Conclusion In 2016 and 2017, menthol cigarettes were widely available in Los Angeles County across racial/ethnic neighborhoods. We found a disproportionate number of storefront advertisements and price promotions for menthol cigarettes in stores located in predominantly African American neighborhoods along with the lowest advertised pack price. This evidence supports tobacco control policies that restrict menthol cigarette sales in the retail environment.
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Affiliation(s)
- Sabrina L Smiley
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Soto Street Building, 2001 N Soto St, 2nd Flr, 214, Los Angeles, CA 90032-3628.
| | - Junhan Cho
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kacie C A Blackman
- Department of Health Sciences, Health Equity Research and Education Center, California State University, Northridge, California
| | - Tess Boley Cruz
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mary Ann Pentz
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | | | - Lourdes Baezconde-Garbanati
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
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Kim S, Mourali A, Allem JP, Unger JB, Boley Cruz T, Smiley SL. Instagram Posts Related to Backwoods Cigarillo Blunts: Content Analysis. JMIR Public Health Surveill 2021; 7:e22946. [PMID: 33560242 PMCID: PMC7902186 DOI: 10.2196/22946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/27/2020] [Accepted: 01/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background Instagram, one of the most popular social media platforms among youth, offers a unique opportunity to examine blunts—partially or fully hollowed-out large cigars, little cigars, and cigarillos that are filled with marijuana. Cigarillo brands like Backwoods (Imperial Tobacco Group Brands LLC) have product features that facilitate blunt making, including a variety of brand-specific flavors that enhance the smoking experience (eg, honey, dark stout). Backwoods has an active online presence with a user-friendly website. Objective This study examined the extent to which Backwoods cigarillo–related posts on Instagram showed blunt making. Instagram offers a unique opportunity to examine blunt making as Instagram accounts will contain images reflective of behavior occurring without the prime of a researcher. Methods Data consisted of publicly available Instagram posts with the hashtag #backwoods collected from August 30 to September 12, 2018. Inclusion criteria for this study included an Instagram post with the hashtag “#backwoods”. Rules were established to content analyze posts. Categories included Type of post (ie, photo, video, or both); Blunt-related hashtags (ie, the corresponding post caption contained one or more hashtags like #blunts, #cannabis, and #weed that were identified in previous social media research); Rolling blunts (ie, the post contained an image of one or more individuals rolling a Backwoods cigarillo visibly containing marijuana); and Smoking blunts (ie, the post contained an image of one or more individuals blowing smoke or holding a lit blunt). We coded images for Product flavor reference, where a code of 1 showed a Backwoods cigarillo pack with a brand-specific flavor (eg, honey, dark stout, Russian crème) visible in the blunt-related image, and a code of 0 indicated that it was not visible anywhere in the image. Results Among all posts (N=1206), 871 (72.2%) were coded as Blunt-related hashtags. A total of 125 (10.4%) images were coded as Smoking blunts, and 25 (2.1%) were coded as Rolling blunts (ie, Backwoods cigarillo explicitly used to roll blunts). Among blunt images, 434 of 836 (51.9%) were coded as Product flavor (ie, a Backwoods pack with a brand-specific flavor was visible). Conclusions Most Backwoods cigarillo–related Instagram images were blunt-related, and these blunt-related images showed Backwoods packages indicating flavor preference. Continued monitoring and surveillance of blunt-related posts on Instagram is needed to inform policies and interventions that reduce the risk that youth may experiment with blunts. Specific policies could include restrictions on product features (eg, flavors, perforated lines, attractive resealable foil pouches, sale as singles) that facilitate blunt making.
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Affiliation(s)
- Stephanie Kim
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Alia Mourali
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jon-Patrick Allem
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jennifer B Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Sabrina L Smiley
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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19
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Chen-Sankey JC, Broun A, Duarte DA, Ajith A, Jewett B, Smiley SL, Mead-Morse EL, Guy MC, Choi K. Exploring changes in cigar smoking patterns and motivations to quit cigars among black young adults in the time of COVID-19. Addict Behav Rep 2020; 12:100317. [PMID: 33364325 PMCID: PMC7752713 DOI: 10.1016/j.abrep.2020.100317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has disproportionately impacted the Black/African American communities in the U.S. The objective of this study is to understand the change in cigar smoking patterns and motivations to quit cigars during the COVID-19 pandemic among Black young adult cigar smokers. METHODS During May-June 2020, in-depth telephone interviews were conducted to investigate cigar (i.e., large cigars, cigarillos, filtered cigars, and blunts) smoking behaviors during the pandemic among self-identified, non-Hispanic Black/African American young adult cigar smokers (n = 40; ages 21-29). Interviews were audio-recorded, transcribed verbatim, and coded separately by three coders. Thematic analysis was used to assess thematic patterns arising from the interviews. RESULTS Most participants reported smoking cigarillos and blunts in higher frequency and quantity to cope with COVID-19-induced stress, anxiety, loneliness, and boredom due to economic losses and physical isolation. Some also reported contextual changes in cigarillo and blunt smoking, including smoking around the clock, smoking immediately after waking up, and smoking an entire cigarillo or blunt in one setting. Very few participants reported motivations to quit cigars during the pandemic. Perceiving higher risks of progressed COVID-19 outcomes did not prompt participants' increased motivations for quitting cigars. CONCLUSIONS Black young adults in this study increasingly smoked cigarillos and blunts during the COVID-19 pandemic, mainly attributed to daily life stressors. Participants did not have increased motivations for quitting cigars to reduce COVID-19-related risks. Promoting contextually appropriate healthy coping and cigar smoking cessation may minimize COVID-19-related health consequences of cigar smoking and reduce health disparities among Black young adults.
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Affiliation(s)
- Julia C. Chen-Sankey
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
| | - Aaron Broun
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
| | - Danielle A. Duarte
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
| | - Aniruddh Ajith
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
| | - Bambi Jewett
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
| | - Sabrina L. Smiley
- University of Southern California, Keck School of Medicine, Department of Preventive Medicine, United States
| | | | - Mignonne C. Guy
- Virginia Commonwealth University, College of Humanities & Sciences, Department of African American Studies, United States
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, United States
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20
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Smiley SL, Milburn NG, Nyhan K, Taggart T. A Systematic Review of Recent Methodological Approaches for Using Ecological Momentary Assessment to Examine Outcomes in U.S. Based HIV Research. Curr HIV/AIDS Rep 2020; 17:333-342. [PMID: 32594365 DOI: 10.1007/s11904-020-00507-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW In recent years, researchers have been adopting and using ecological momentary assessment (EMA) methods via technology devices for real-time measurement of exposures and outcomes in HIV research. To assess and critically evaluate how EMA methods are currently being used in HIV research, we systematically reviewed recent published literature (October 2017-October 2019) and searched select conference databases for 2018 and 2019. RECENT FINDINGS Our searches identified 8 published articles that used EMA via smartphone app, a handheld Personal Digital Assistant, and web-based survey programs for real-time measurement of HIV-related exposures and outcomes in behavioral research. Overall trends include use of EMA and technology devices to address substance use, HIV primary prevention (e.g., condom use and preexposure prophylaxis), and HIV treatment (medication adherence). This review supports the use of EMA methods in HIV research and recommends that researchers use EMA methods to measure psychosocial factors and social contexts and with Black and Latinx samples of gay and bisexual men, transgender women, and cisgendered women to reflect current HIV disparities in the U.S.A.
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Affiliation(s)
- Sabrina L Smiley
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavior Health, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kate Nyhan
- Yale School of Public Health, New Haven, CT, USA
| | - Tamara Taggart
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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21
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Smiley SL, Shin H, Rose SW, Rodriguez YL, Barahona R, Baezconde-Garbanati L. Perceptions of E-cigarettes and Flavor Restrictions among Tobacco Retailers in Los Angeles. Am J Health Behav 2020; 44:893-901. [PMID: 33081884 DOI: 10.5993/ajhb.44.6.12] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this study, we examined tobacco retailers' perceptions of e-cigarettes and associations with in-store availability of e-cigarettes. Methods: Retailers (N = 700) in multiple, racial/ethnic neighborhoods (black/African-American, N = 200); Hispanic/Latino, N = 200; white American, N = 200; Korean American, N = 100) in Los Angeles County participated in on-site interviews and store observations. Results: Controlling for individual and racial/ethnic neighborhood factors, retailers in majority-white neighborhoods had significantly higher odds of selling e-cigarettes and flavored e-cigarettes than retailers located in Hispanic/Latino (p < .001, OR = 0.14, 95% CI = 0.08-0.25; p < .001, OR = 0.19, 95% CI = 0.11-0.33) and Korean American (p < .05, OR = 0.21, 95% CI = 0.12-0.37; p < .05, OR = 0.21, 95% CI = 0.12-0.39) neighborhoods. Perceptions of e-cigarettes as being completely safe/safer than cigarettes were significantly associated with availability of flavored e-cigarettes (p < .05, OR = 2.03, 95% CI = 1.04-3.97); and opposition to flavored e-cigarette restrictions was marginally significantly associated with availability of flavored e-cigarettes (p < .10, OR = 1.56, 95% CI = 0.96-2.51). Adjusting for store type, perceptions of e-cigarettes as being completely safe/safer than cigarettes were marginally significantly associated with availability of flavored e-cigarettes (p < .10, OR = 1.78, 95% CI = 0.85-3.73). Conclusions: Targeted efforts are warranted for educating retailers and employees in these neighborhoods on the appeal and nicotine dependence potential of e-cigarette use for youth.
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Affiliation(s)
- Sabrina L. Smiley
- Sabrina L. Smiley, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, United States;,
| | - Heesung Shin
- Heesung Shin, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, United States
| | - Shyanika W. Rose
- Shyanika W. Rose, University of Kentucky, College of Medicine, Department of Behavioral Science, Lexington, KY, United States
| | - Yaneth L. Rodriguez
- Yaneth L. Rodriguez, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, United States
| | - Rosa Barahona
- Rosa Barahona, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, United States
| | - Lourdes Baezconde-Garbanati
- Lourdes Baezconde-Garbanati, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, United States
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22
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Smiley SL, Kim S, Mourali A, Allem JP, Unger JB, Boley Cruz T. Characterizing #Backwoods on Instagram: "The Number One Selling All Natural Cigar". Int J Environ Res Public Health 2020; 17:ijerph17124584. [PMID: 32630567 PMCID: PMC7345638 DOI: 10.3390/ijerph17124584] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/29/2020] [Accepted: 06/06/2020] [Indexed: 11/30/2022]
Abstract
We sought to assess the proportion of Backwoods (Imperial Tobacco Group Brands LLC) cigar-related posts to Instagram that may contain misleading claims, nature-evoking imagery, and appealing flavors. Inclusion criteria for this study included an Instagram post with the hashtag “#backwoods” from 30 August to 12 September 2018. Rules were established to content analyze (n = 1206) posts. Categories included misleading packaging (i.e., the post contained an image of a Backwoods product with the descriptor “natural” on the packaging), misleading promo (i.e., the corresponding caption to the post contained hashtag(s) like “#natural”, “#authentic”, “#alwaystrue”), nature-evoking imagery (i.e., the post contained images of grass, water, and pastural views along with a Backwoods product), flavors (i.e., the post contained a Backwoods product with brand-specific flavors on the packaging), flavor promo (i.e., the corresponding caption to the post contained hashtag(s) of Backwoods’ brand-specific flavors), marijuana-related (i.e., the post contained an image of marijuana next to a Backwoods pack, rolled cigars visibly contained marijuana, or hollowed-out cigars next to marijuana), smoking (the post contained an image of smoke or a lit cigar), brand-specific promo (i.e., the post contained an image of a Backwoods t-shirt, sweatshirt, hat, etc.), and perceived gender. Among the posts analyzed, 645 (53.5%) were marijuana-related, 564 (46.8%) were flavors, 463 (38.4%) were misleading packaging, 335 (27.8%) were flavor promo, 309 (25.6%) were misleading promo, 188 (15.6%) were nature-evoking imagery, 165 (13.7%) were smoking, 157 (13.0%) were brand-specific promo, and 239 (19.8%) were perceived male gender. Backwoods cigar-related posts to Instagram often contained misleading images and promotions of a “natural” tobacco product, images of marijuana use (in the form of blunt-making), brand-specific flavors, smoking, and promotional merchandise. Misleading images and the depictions of marijuana use in addition to the variety of flavor options may increase product appeal to consumers. These results underscore the need for comprehensive regulation of cigar products similar to cigarettes.
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23
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Smiley SL. Abstract A022: “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-a022] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: In the U.S., lesbian, gay, bisexual, and transgender individuals (LGBT) are medically underserved, understudied, and are often difficult for researchers to access due in part to risks to participation (i.e., discrimination and stigma). While evidence regarding combustible tobacco use among LGBT adults is relatively underdeveloped, significant health disparities exist in this population. LGBT young adults in particular are nearly twice as likely to use tobacco compared to their heterosexual and cisgender counterparts, indicating that LGBT smokers have higher rates of tobacco-related cancers, including lung cancer. Informed by the Theory of Planned Behavior, this qualitative pilot study explored in depth attitudes, subjective norms, and perceived behavioral control toward combustible tobacco product use and cessation behaviors among a sample of young adult LGB smokers residing in Washington, D.C. Methods: Semistructured face-to-face interviews were conducted with self-identified lesbian (n=1), gay (n=5), and bisexual (n=2) young adult smokers. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis methodology. Digital audio recordings of the interviews were transcribed verbatim and edited to remove identifiers. Results: Participants ranged in age from 18 to 25 (M = 23.25, SD = 2.05). Five participants identified as African American and four identified as male. Three participants reported part-time employment and four reported that they “don’t meet basic expenses”. The mean age for cigarette smoking onset was 15.6. All participants reported menthol cigarette preference, four reported daily menthol cigarette use, and five reported past 30-day little cigar/cigarillo use. Attitudes, subjective norms, and perceived behavioral control toward combustible tobacco use and cessation behaviors fell under the broad themes of individual-level factors (self-image), psychosocial factors (stress and anxiety), socio-cultural factors (pro-smoking social norms), and stage of readiness. Intention to quit smoking in the next six months was low and influenced by pro-smoking attitudes and behaviors in the social environment surrounding LGBT young adults. Conclusions: Study findings contribute to a limited body of research investigating theoretically grounded variables related to combustible tobacco use among sexual minority young adult smokers. Multilevel cessation interventions are needed to address the psychosocial, socioeconomic, and cultural underpinnings of combustible tobacco use by distinct sexual identity. Additionally, study findings suggest opportunities to inform prevention campaigns like “This Free Life,” the Food and Drug Administration’s public education campaign designed to prevent and reduce tobacco use among LGBT young adults.
Citation Format: Sabrina L Smiley. “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C. [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A022.
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Begay C, Soto C, Baezconde-Garbanati L, Barahona R, Rodriguez YL, Unger JB, Smiley SL. Cigarette and E-Cigarette Retail Marketing on and Near California Tribal Lands. Health Promot Pract 2020; 21:18S-26S. [PMID: 31908191 DOI: 10.1177/1524839919883254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/15/2022]
Abstract
Introduction. Retail settings are major channels for the tobacco industry to market commercial tobacco products. However, few studies have examined marketing strategies on Tribal lands. The resulting evidence is important, especially given that American Indian/Alaska Native (AI/AN) youth and adults have the highest smoking prevalence of any racial/ethnic group in the United States. In this study, we examined cigarette, e-cigarette, and vape/vaporizer availability, advertising, and price-reducing promotions in retail settings on and within a 1-mile radius of Tribal lands in California. Method. Trained AI/AN community health representatives (n = 8) conducted store observations (n = 96) using a checklist adapted from the Standardized Tobacco Assessment for Retail Settings observation tool. Chi-square analyses were performed to look for potential differences in availability, exterior advertising, and price promotions for cigarettes, e-cigarettes, and vapes between stores. Results. All stores sold cigarettes and over 95% sold menthol cigarettes. Nearly 25% of stores on Tribal lands were located inside a casino, and 40.4% of stores on Tribal lands offered a Tribal member discount. Stores within a 1-mile radius of Tribal lands sold significantly (p < .01) more e-cigarettes (69.8%), including flavored e-cigarettes (53.4%), compared to stores on Tribal lands (37.7% and 28.3%, respectively). Price promotions for cigarettes were significantly (p < .01) more common in stores located within a 1-mile radius of Tribal lands (46.5%) than stores on Tribal lands (22.6%). Discussion. To our knowledge, this study is the first to use store observations to examine cigarette and e-cigarette availability, advertising, and price promotions in retail settings on and near California Tribal lands. We recommend future studies build on our initial efforts to take an AI/AN Tribal community-engaged approach in assessing and documenting tobacco marketing practices on and near Tribal lands. Tribal governments can consider tobacco policies to help reduce smoking disparities and advance health equity for their communities.
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Affiliation(s)
- Cynthia Begay
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Rosa Barahona
- University of Southern California, Los Angeles, CA, USA
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Smiley SL, Soto C, Cruz TB, Kintz N, Rodriguez YL, Sussman S, Baezconde-Garbanati L. Point-of-sale marketing of little cigars and cigarillos on and near California Tribal lands. Tob Control 2020; 29:122-124. [PMID: 30385648 PMCID: PMC6690808 DOI: 10.1136/tobaccocontrol-2018-054558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/11/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION American Indians have the highest cigarette smoking prevalence of any racial/ethnic group in the USA. Tobacco marketing at point-of-sale is associated with smoking, possibly due to easy access to cheap tobacco products. The sale of novel tobacco products like little cigars/cigarillos (LCCs) has increased in recent years which may further increase combustible tobacco use among American Indians. METHODS Between October 2015 and February 2017, trained community health workers collected LCC product and price information by conducting audits of tobacco retailers on Tribal lands (n=53) and retailers within a 1-mile radius of Tribal lands (n=43) in California. Χ2 analyses were performed to examine associations among the availability and advertising of LCCs, including indoor price promotions and store location. RESULTS Overall, 85.4% of stores sold LCCs, 76.0% sold flavoured LCCs and 51.0% sold LCCs for less than $1. Indoor price promotions were displayed at 45 (46.9%) stores. Stores within a 1-mile radius of Tribal lands sold significantly more LCC (p<0.01) and flavoured LCCs (p=0.01) than stores on Tribal lands. Stores within a 1-mile radius of Tribal lands also displayed significantly more LCCs priced at less than $1 (p<0.01) than stores on Tribal lands. CONCLUSIONS LCCs are widely available in stores on and near California Tribal lands. Stores located a short distance away from Tribal lands were more likely to sell LCCs, including flavoured versions, more likely to sell LCCs priced below $1, and more likely to advertise little LCC price promotions than stores on Tribal lands. Policy-makers and Tribal leaders should consider regulations that would limit access to LCCs at point of sale to help prevent youth initiation and reduce smoking-related morbidity and mortality among American Indians.
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Affiliation(s)
- Sabrina L Smiley
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Claradina Soto
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Tess Boley Cruz
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Natalie Kintz
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Yaneth L Rodriguez
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Steve Sussman
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lourdes Baezconde-Garbanati
- Tobacco Center of Regulatory Science for Vulnerable Populations, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Smiley SL, Kierstead EC, Harvey E, Abudayyeh H, Pearson JL. An exploratory analysis of adult daily smokers' experiences using e-cigarettes in smoke-free places. Tob Induc Dis 2019; 16:54. [PMID: 31516451 PMCID: PMC6659561 DOI: 10.18332/tid/98958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/27/2018] [Revised: 10/07/2018] [Accepted: 10/14/2018] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Evidence indicates that one reason cigarette smokers value e-cigarettes is the ability to use them in places where smoking is not permitted. We sought to: 1) explore adult daily smokers’ experiences using e-cigarettes in the context of smoke-free places; and 2) describe smokers’ perceptions of bystanders’ reactions. METHODS Twenty adult daily smokers in Washington, DC initiated e-cigarettes for three weeks and completed in semi-structured interviews at the end of each week. All interviews (n=60) were digitally-recorded, transcribed verbatim, imported into NVivo 10.0, and analyzed using thematic analysis methodology. RESULTS The sample had a mean age of 37.9 years and 18 participants reported having smoked their first cigarette by age 18. Common themes included descriptions of: 1) uncertainty about whether smoke-free policies included e-cigarettes; 2) using e-cigarettes in smoke-free places (e.g. restaurants, workplace, public transit-bus and rail); 3) approaches to e-cigarette use in smoke-free places as part of a complex decision-making process, ranging from testing and establishing the social and spatial boundaries of e-cigarette use, to confining e-cigarette use to inside their home; and 4) favorable, unfavorable, and impartial reactions from bystanders facilitated or impeded e-cigarette use, indicating social approval/social disapproval. CONCLUSIONS Results suggest a continuum of factors, including smoke-free policies and reactions from bystanders may facilitate or impede e-cigarette use among smokers in environments where a smoke-free imperative is well-established. As e-cigarette use evolves, study findings indicate the importance of the social environment and how it could affect those switching from cigarettes to e-cigarettes.
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Affiliation(s)
- Sabrina L Smiley
- Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, United States
| | - Elexis C Kierstead
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, United States.,Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Emily Harvey
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, United States
| | - Haneen Abudayyeh
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, United States
| | - Jennifer L Pearson
- School of Community Health Sciences, University of Nevada, Reno, United States
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Smiley SL, DeAtley T, Rubin LF, Harvey E, Kierstead EC, Webb Hooper M, Niaura RS, Abrams DB, Pearson JL. Early Subjective Sensory Experiences with "Cigalike" E-cigarettes Among African American Menthol Smokers: A Qualitative Study. Nicotine Tob Res 2019; 20:1069-1075. [PMID: 28549156 DOI: 10.1093/ntr/ntx102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/09/2017] [Indexed: 12/20/2022]
Abstract
Introduction Despite smoker interest in e-cigarettes as a harm reduction or cessation aid, many smokers prematurely discontinue vaping after trying a product. This study explored the role of early subjective sensory experiences in vaping persistence and desistance. Methods African American menthol cigarette smokers aged ≥18 years (N = 15; M = 54.1 years; SD = 8.2), motivated to quit smoking, and interested in trying e-cigarettes were recruited in Washington, DC. Participants were followed for 3 weeks and provided menthol cigalike e-cigarettes after Week 1. Participants completed three interviews about their vaping experiences. Thematic analysis of responses was designed to understand the sensory aspects of vaping. Results During the first 2 weeks of vaping, four participants reported a positive vaping experience while 11 reported decreased satisfaction. Salient sensory attributes of dissatisfaction included poor taste, insufficient throat hit, difficulty pulling, and a lack of "whole body" satisfaction compared to their preferred cigarette brand. Conclusions The sensory experiences with a specific cigalike e-cigarette were related to vaping persistence and desistence. Although this was a small volunteer sample of African American menthol smokers motivated to quit smoking, 27% (N = 4) of participants with a positive vaping experience continued using the product, while 73% (N = 11) of participants' vaping experience was unsatisfactory across several experiential categories. In future research of e-cigarettes' efficacy as a smoking cessation or reduction aid, both device characteristics and smokers' expectations for these devices should be considered, so vapers do not expect the same taste sensations, throat sensations, and "whole body" satisfaction as they experienced with their menthol cigarettes. Implications The subjective sensory experiences associated with initial e-cigarette product use are associated with use patterns. Subjective sensory experiences may also help understand the differences in the appeal, satisfaction, and harm-reduction potential of the rapidly evolving diverse types of products emerging in the marketplace. How products meet the sensory needs of smokers wanting to switch or quit smoking may influence adherence and success rates.
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Affiliation(s)
- Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Teresa DeAtley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Leslie F Rubin
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Psychology, American University, Washington, DC
| | - Emily Harvey
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Elexis C Kierstead
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - David B Abrams
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Smiley SL, Kintz N, Baezconde-Garbanati L. Retail marketing for chewing tobacco in Los Angeles, California. Tob Prev Cessat 2019; 5:11. [PMID: 32411876 PMCID: PMC7205150 DOI: 10.18332/tpc/105109] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/20/2019] [Accepted: 02/28/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Retail marketing for chewing tobacco may be different across racial/ethnic neighborhoods, possibly leading to diverging patterns of use and disparate health risks relating to consumption. This study aimed to compare the frequencies of available chewing tobacco, available flavored chewing tobacco, price promotions, and exterior advertisements in tobacco retail stores in Los Angeles, California. METHODS In-person observational audits from tobacco retail stores (n=679) located in predominantly non-Hispanic White (n=196), non-Hispanic Black/African American (n=194), Hispanic/Latino (n=189), or Korean American (n=100) neighborhoods were conducted between January 2016 and April 2017. RESULTS There were statistically significant associations (p<0.001) between racial/ethnic neighborhood and chewing tobacco marketing, where retailers located in non-Hispanic White neighborhoods sold and advertised chewing tobacco and flavored chewing tobacco, used price promotions, and displayed exterior advertisements more frequently than retailers located in African American, Korean American, and Hispanic/Latino neighborhoods. CONCLUSIONS Stronger restrictions on chewing tobacco, price promotions and flavored versions could mitigate exposure and access to these products in the retail environment.
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Affiliation(s)
- Sabrina L. Smiley
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Natalie Kintz
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lourdes Baezconde-Garbanati
- Tobacco Center of Regulatory Science, Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Abstract
Objective E-cigarette use is increasing among adult cigarette smokers. With the availability and variety of appealing characteristics, including menthol flavor, e-cigarette use patterns may differ among menthol and non-menthol cigarette smokers. This study compared e-cigarette knowledge and use between current menthol and non-menthol smokers aged ≥18 years. Design Current adult cigarette smokers (N=223; M=42.1 years; SD=12.2; 68% menthol smokers) recruited in South Florida completed an interviewer-administered survey via telephone during June to November 2014. Main Outcome Measures E-cigarette use (ever-use, past 30-day use, past 30-day flavored e-cigarette use, and past 30-day mentholated e-cigarette use), consideration of e-cigarette use for quitting/reduction of cigarettes, and knowledge assessments. Bivariate and multivariate analyses tested associations with menthol smoking. Results Menthol smokers were more likely to be African American or Hispanic (P<.001) and report lower income (P=.02) and education (P<.001) than non-menthol smokers. Adjusted analyses found no association between menthol cigarette use and e-cigarette ever-use. However, menthol smokers demonstrated less e-cigarette knowledge (P<.01) and were more likely to consider using e-cigarettes to quit/reduce smoking (AOR=3.89, CI:1.55-9.78). Among ever-users, there was no association between menthol cigarette use and past 30-day e-cigarette use, yet menthol smokers were more likely to use menthol flavored e-cigarettes (AOR=6.65, CI: 1.94-12.78). Conclusions Our findings suggest that, compared with current non-menthol smokers, current menthol smokers are more likely to consider using e-cigarettes to help quit/reduce smoking, and are more likely to use menthol flavored e-cigarettes. Further research is needed to better examine low e-cigarette knowledge among menthol smokers, which may represent an important intervention target.
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Affiliation(s)
- Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Sabrina L Smiley
- Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Health Sciences Campus, Los Angeles, CA
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Sussman S, Cruz TB, Smiley SL, Chou CP, Unger JB, Kintz N, Rodriguez YL, Barahona R, Lienemann BA, Pentz MA, Samet J, Baezconde-Garbanati L. Tobacco regulatory compliance with STAKE Act age-of-sale signage among licensed tobacco retailers across diverse neighborhoods in Southern California. Tob Induc Dis 2018; 16. [PMID: 31321095 PMCID: PMC6637954 DOI: 10.18332/tid/91846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California. METHODS The sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law. RESULTS Overall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p<0.001). The difference in STAKE Act sign compliance between stores located in AA communities (16.9%) and stores located in NHW communities (41.5%) observed within the first three months after the change in law was statistically significant (χ2(1)=20.098, p<0.001). CONCLUSIONS Findings suggest the need for prompt, educational outreach to licensed tobacco retailers on age-of-sale signage changes, multiple compliance checks, and enforcement.
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Affiliation(s)
- Steve Sussman
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Tess Boley Cruz
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Sabrina L Smiley
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Chih-Ping Chou
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Jennifer B Unger
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Natalie Kintz
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Yaneth L Rodriguez
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Rosa Barahona
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Brianna A Lienemann
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Mary Ann Pentz
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
| | - Jonathan Samet
- Colorado School of Public Health, University of Colorado, Aurora, United States
| | - Lourdes Baezconde-Garbanati
- USC Tobacco Center for Regulatory Sciences in Vulnerable Populations, Keck School of Medicine, University of Southern California, United States
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Smiley SL. Sociodemographic correlates of intention to quit smoking for good among U.S. adult menthol and non-menthol smokers: Evidence from the 2013-2014 National Adult Tobacco Survey. Tob Prev Cessat 2018; 4:22. [PMID: 32411848 PMCID: PMC7205077 DOI: 10.18332/tpc/90968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 03/12/2018] [Revised: 04/23/2018] [Accepted: 05/11/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In the U.S. significant progress has been made to reduce cigarette use, yet menthol cigarette use is a continuing public health problem, especially among young adults and Black/African Americans. Smoking cessation is warranted to reduce smoking-related diseases and premature death. Ample evidence has demonstrated that having an intention to quit smoking is strongly associated with attaining cessation. The objective of this study was to identify and compare the sociodemographic correlates of intention to quit smoking for good between menthol and non-menthol adult smokers in the U.S.. METHODS A cross-sectional secondary data analysis was conducted on the 2013– 2014 National Adult Tobacco Survey. Multivariable logistic regression was used to analyze individual factors and their relation to intention to quit smoking for good. The total sample was nationally representative of the U.S. population and included 10 121 adult smokers aged ≥18 years. RESULTS Among menthol smokers, non-Hispanic Blacks (adjusted odds ratio, AOR=1.31, 95% confidence interval, CI: 1.03–1.67) were significantly (p=0.03) more likely to have an intention to quit smoking for good compared to non-Hispanic Whites. Young adults aged 18–25 years (AOR=0.70, 95% CI: 0.58–0.85) were significantly (p=0.01) less likely to have an intention to quit compared to adults aged 50 years and older, and sexual minorities (i.e. lesbian, gay, bisexual) (AOR=0.69, 95% CI: 0.49–0.93) were significantly (p=0.03) less likely to have the intention to quit compared to heterosexuals. Among non-menthol smokers, adults aged 26–34 years (AOR=1.46, 95% CI: 1.13–1.88) and 35–49 years (AOR=1.71, 95% CI: 1.34–2.20) were significantly (p=0.01; p< 0.001, respectively) more likely to have an intention to quit smoking for good compared to those aged 50 years and older. CONCLUSIONS Study findings provide insight into the association of menthol cigarette consumption with intention to quit smoking for good, notably among Black Americans, young adults and sexual minorities. Smoking cessation efforts should consider demographics and menthol smoking status.
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Affiliation(s)
- Sabrina L Smiley
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Harvey EJ, Rubin LF, Smiley SL, Zhou Y, Elmasry H, Pearson JL. Metadata Correction: Mobile Phone Ownership Is Not a Serious Barrier to Participation in Studies: Descriptive Study. JMIR Mhealth Uhealth 2018; 6:e10403. [PMID: 29596049 PMCID: PMC5916556 DOI: 10.2196/10403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Emily J Harvey
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Leslie F Rubin
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Department of Psychology, American University, Washington, DC, United States
| | - Sabrina L Smiley
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Yitong Zhou
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Hoda Elmasry
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Jennifer L Pearson
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Harvey EJ, Rubin LF, Smiley SL, Zhou Y, Elmasry H, Pearson JL. Mobile Phone Ownership Is Not a Serious Barrier to Participation in Studies: Descriptive Study. JMIR Mhealth Uhealth 2018; 6:e21. [PMID: 29459355 PMCID: PMC5838361 DOI: 10.2196/mhealth.8123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/13/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rather than providing participants with study-specific data collection devices, their personal mobile phones are increasingly being used as a means for collecting geolocation and ecological momentary assessment (EMA) data in public health research. OBJECTIVE The purpose of this study was to (1) describe the sociodemographic characteristics of respondents to an online survey screener assessing eligibility to participate in a mixed methods study collecting geolocation and EMA data via the participants' personal mobile phones, and (2) examine how eligibility criteria requiring mobile phone ownership and an unlimited text messaging plan affected participant inclusion. METHODS Adult (≥18 years) daily smokers were recruited via public advertisements, free weekly newspapers, printed flyers, and word of mouth. An online survey screener was used as the initial method of determining eligibility for study participation. The survey screened for twenty-eight inclusion criteria grouped into three categories, which included (1) cell phone use, (2) tobacco use, and (3) additional criteria. RESULTS A total of 1003 individuals completed the online screener. Respondents were predominantly African American (605/1003, 60.3%) (60.4%), male (514/1003, 51.3%), and had a median age of 35 years (IQR 26-50). Nearly 50% (496/1003, 49.5%) were unemployed. Most smoked menthol cigarettes (699/1003, 69.7%), and had a median smoking history of 11 years (IQR 5-21). The majority owned a mobile phone (739/1003, 73.7%), could install apps (86.8%), used their mobile phone daily (89.5%), and had an unlimited text messaging plan (871/1003, 86.8%). Of those who completed the online screener, 302 were eligible to participate in the study; 163 were eligible after rescreening, and 117 were enrolled in the study. Compared to employed individuals, a significantly greater proportion of those who were unemployed were ineligible for the study based on mobile phone inclusion criteria (P<.001); yet, 46.4% (333/717) of the individuals who were unemployed met all mobile phone inclusion criteria. CONCLUSIONS Inclusion criteria requiring participants to use their personal mobile phones for data collection was not a major barrier to study participation for most respondents who completed the online screener, including those who were unemployed. TRIAL REGISTRATION ClinicalTrials.gov NCT02261363; https://clinicaltrials.gov/ct2/show/NCT02261363 (Archived by WebCite at http://www.webcitation.org/6wOmDluSt).
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Affiliation(s)
- Emily J Harvey
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Leslie F Rubin
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
- Department of Psychology, American University, Washington, DC, United States
| | - Sabrina L Smiley
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Yitong Zhou
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Hoda Elmasry
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Jennifer L Pearson
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Smiley SL, Collins L, Elmasry H, Moore RA, Hooper MW. The relationship between past-month marijuana, cigarette, and cigar use among older adults in the United States. Tob Prev Cessat 2018; 4:6. [PMID: 32411837 PMCID: PMC7205074 DOI: 10.18332/tpc/84867] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 01/21/2018] [Accepted: 01/28/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Previous research indicates that marijuana use may be interrelated with combustible tobacco use among U.S. adolescents and young adults. However, little is known about this relationship during older adulthood. The purpose of this study was: 1) examine the prevalence of past-month marijuana, cigarette and cigar use, and 2) assess the associations between demographic and tobacco-use variables with past-month marijuana use, among a nationally representative sample of U.S. adults 50 years and older. METHODS Data are from the public-use files of the 2013 National Survey on Drug Use and Health (NSDUH). The sample consisted of 6325 adults aged ≥50 years. RESULTS Overall, 2.98% (N=216) of the sample reported past-month marijuana use; higher prevalence was noted for those who were past-month users of cigarettes (15.62%, N=1162) and lower prevalence was noted for those who were past-month users of cigars (2.68%, N=176). After accounting for covariables, past-month cigarette use was the strongest predictor of past-month marijuana use (adjusted odds ratio [AOR]=5.19, 95% CI, 3.51-7.66). Additionally, past-month cigar use showed a positive association with past-month marijuana use (AOR=2.41, 95% CI, 1.23-4.72). CONCLUSIONS Tobacco prevention, cessation, and control efforts that target older adults should be tailored effectively to address the use of marijuana and other combustible tobacco products.
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Affiliation(s)
- Sabrina L Smiley
- Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, California, United States
| | - Lauren Collins
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Hoda Elmasry
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Rakiya A Moore
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center School of Medicine, Case Western Reserve University, Ohio, United States
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Pearson JL, Elmasry H, Das B, Smiley SL, Rubin LF, DeAtley T, Harvey E, Zhou Y, Niaura R, Abrams DB. Comparison of Ecological Momentary Assessment Versus Direct Measurement of E-Cigarette Use With a Bluetooth-Enabled E-Cigarette: A Pilot Study. JMIR Res Protoc 2017; 6:e84. [PMID: 28554877 PMCID: PMC5468540 DOI: 10.2196/resprot.6501] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/16/2016] [Accepted: 03/18/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Assessing the frequency and intensity of e-cigarette use presents special challenges beyond those posed by cigarette use. Accurate measurement of e-cigarette consumption, puff duration, and the stability of these measures over time will be informative for estimating the behavioral and health effects of e-cigarette use. OBJECTIVE The purpose of this pilot study was to compare the accuracy of self-reported e-cigarette puff counts collected via ecological momentary assessment (EMA) to objective puff count data collected by a Bluetooth-enabled e-cigarette device and to examine the feasibility and acceptability of using a second-generation e-cigarette among adult smokers. METHODS A total of 5 adult smokers were enrolled in a longitudinal parent study assessing how e-cigarette use affects cigarette use among e-cigarette-naïve smokers. Using a text message-based EMA system, participants reported e-cigarette puffs for 2 weeks. Participants were also given a Bluetooth-enabled e-cigarette (Smokio) that passively collected puff counts and puff duration. Comparisons between mean reports of Smokio (device-report) and EMA (self-report) use were evaluated using paired t tests. Correlation and agreement between device- and self-reports were evaluated using Pearson correlation and the concordance correlation coefficient (CCC), respectively. A linear mixed effect model was used to determine the fixed effect of timing and Smokio-reported daily puffs on report accuracy. We examined the relationship between time of day and reporting accuracy using Tukey's test for multiple pairwise comparisons. RESULTS A total of 5 African American participants, 4 men and 1 woman, who ranged in age from 24 to 59 years completed the study, resulting in 5180 observations (device-report) of e-cigarette use. At baseline, participants reported smoking for 5 to 25 years and consumed a mean of 7 to 13 cigarettes per day (CPD); 4 smoked within 30 minutes of waking. At the 30-day follow-up, CPD range decreased to 1 to 3 cigarettes; 4 participants reported past 7-day e-cigarette use, and 1 participant reported no cigarette smoking in the past 7 days. Over 2 weeks of e-cigarette use, participants took an average of 1074 e-cigarette (SD 779.0) puffs per person as captured by the device reports. Each participant took a mean of 75.0 (SD 58.8) puffs per day, with each puff lasting an average of 3.6 (SD 2.4) seconds. Device reports captured an average of 33.3 (SD 47.8) more puffs per person per day than the self-reported e-cigarette puffs. In 87% of days, participants underestimated the number of puffs they had taken on the Smokio. There was significant moderate correlation (r=.47, P<.001) but poor agreement (pc=0.31, 95% CI 0.15-0.46) between the device- and self-reported data. Reporting accuracy was affected by amount and timing of e-cigarette use. CONCLUSIONS Compared to self-reported e-cigarette use, the Bluetooth-enabled device captured significantly more e-cigarette use and allowed for examination of puff duration in addition to puff counts. A Bluetooth-enabled e-cigarette is a powerful and feasible tool for objective collection of e-cigarette use behavior in the real world.
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Affiliation(s)
- Jennifer L Pearson
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD, United States
| | - Hoda Elmasry
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Babita Das
- Tobacco Center of Regulatory Science, University of Maryland, School of Public Health, College Park, MD, United States
| | - Sabrina L Smiley
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Leslie F Rubin
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,American University, Department of Psychology, Washington, DC, United States
| | - Teresa DeAtley
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD, United States
| | - Emily Harvey
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,George Mason University, Department of Anthropology, Fairfax, VA, United States
| | - Yitong Zhou
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States
| | - Raymond Niaura
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD, United States
| | - David B Abrams
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.,Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD, United States.,Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Smiley SL, Elmasry H, Webb Hooper M, Niaura RS, Hamilton AB, Milburn NG. Feasibility of Ecological Momentary Assessment of Daily Sexting and Substance Use Among Young Adult African American Gay and Bisexual Men: A Pilot Study. JMIR Res Protoc 2017; 6:e9. [PMID: 28153816 PMCID: PMC5314099 DOI: 10.2196/resprot.6520] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/30/2016] [Accepted: 12/13/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent evidence suggests that sexualized text communication ("sexting") is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. OBJECTIVE The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. METHODS Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. RESULTS EMA feasibility was tested with 25 self-identified African American gay (n=16) and bisexual (n=9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses including yes/no and Likert scale options. There were 104 total days of EMA observation, and the retention rate was 72% (18 out of 25 participants). Participants responded to the random prompt surveys with a 57.3% compliance rate providing a total of 544 completed surveys out of 949 surveys. The overall mean response time to complete a survey was 6.1 minutes. There were significant positive associations between EMA texts sent and received questions (ρ 0.84, P<.001) as well as sexts sent and received queries (ρ 0.72, P<.001). CONCLUSIONS The use of an EMA protocol has the potential to be a very useful research tool for understanding episodic behaviors such as sexting and substance use in this relatively understudied and underserved population, and has implications for practice. Additional research is needed on how to maximize survey compliance.
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Affiliation(s)
- Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Hoda Elmasry
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, United States.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.,Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
| | - Alison B Hamilton
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Veterans Administration Greater Los Angeles Healthcare System, Veterans Administration Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States
| | - Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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Collins L, Smiley SL, Moore RA, Graham AL, Villanti AC. Physician tobacco screening and advice to quit among U.S. adolescents - National Survey on Drug Use and Health, 2013. Tob Induc Dis 2017; 15:2. [PMID: 28077940 PMCID: PMC5223531 DOI: 10.1186/s12971-016-0107-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 06/04/2016] [Accepted: 12/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking. Physician screening for tobacco use increases the odds of physicians intervening with patients who smoke; However, without appropriate follow-through by the physician, screening for tobacco use is not enough to significantly increase cessation rates. Given the critical phase of development adolescence poses in tobacco use and evidence that physician intervention improves adult cessation efforts, we sought to examine physician tobacco use screening and advice to quit among adolescents (12–17 years). Methods Using data from the 2013 National Survey on Drug Use and Health (NSDUH), we examined the prevalence and correlates of tobacco use screening in adolescent respondents who reported visiting their physician within the past year (N = 12,798). Multivariable logistic regression analyses explored the relationship between tobacco use screening and physician advice to quit in a sub-set of the sample who reported on physician advice to quit (n = 1,868), controlling for sociodemographics, cigarette use, and substance use and screening. Results Only 49% of adolescents who visited a physician within the past year reported being screened for tobacco use. Adolescents who were screened by their physician were predominantly female (56.6%), White (60.1%), in late adolescence (83.0%), and covered by private health insurance (63.8%). Screening for tobacco use was highly correlated with physician advice to quit smoking, controlling for sociodemographic characteristics and cigarette use; this relationship was attenuated, but remained significant, after screening for alcohol and marijuana were added to the model. Hispanic adolescents were significantly less likely to receive physician advice to quit in all multivariable models. Conclusions Our findings suggest missed opportunities for youth tobacco use prevention and cessation efforts in the clinical setting. Further research is needed to better facilitate an open dialogue on tobacco use between physicians and their adolescent patients.
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Affiliation(s)
- Lauren Collins
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC USA
| | - Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC USA
| | - Rakiya A Moore
- Evaluation Science and Research at Truth Initiative, Washington, DC USA
| | - Amanda L Graham
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC USA ; Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC USA
| | - Andrea C Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, Fourth Floor, Washington, DC USA ; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Pearson JL, Smiley SL, Rubin LF, Anesetti-Rothermel A, Elmasry H, Davis M, DeAtley T, Harvey E, Kirchner T, Abrams DB. The Moment Study: protocol for a mixed method observational cohort study of the Alternative Nicotine Delivery Systems (ANDS) initiation process among adult cigarette smokers. BMJ Open 2016; 6:e011717. [PMID: 27105716 PMCID: PMC4854005 DOI: 10.1136/bmjopen-2016-011717] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes are battery-powered devices that aerosolize nicotine and other substances to simulate smoking without using tobacco. Little is known about the ANDS initiation process among adult smokers. The aims of this research are threefold to: (1) examine how ANDS use affects cigarette use; (2) examine how the immediate environmental and psychosocial contexts of cigarette and ANDS use vary within-and between-participants in general and by menthol preference and race; and, (3) examine participants' 'lived experience' of the subjective perceptions, meaning, influences and utility of cigarette and ANDS use. METHODS AND ANALYSES This study's mixed method, 6-week longitudinal design will produce a detailed description of the ANDS initiation process among adult smokers (N=100). Qualitative and quantitative data collection will include 3 weeks of: (1) ecological momentary assessment of patterns of cigarette/ANDS use, satisfaction, mood and craving; (2) geospatial assessment of participants' environment, including indoor and outdoor cigarette/ANDS norms and rules; (3) in-depth interviews about the meaning and utility of cigarette smoking and ANDS use; and, (4) saliva cotinine and exhaled carbon monoxide (CO) biomarkers. A diverse sample will be recruited with an equal number of menthol and non-menthol cigarette smokers. As the primary independent variable, we will investigate how ANDS use affects cigarette consumption. We will also examine how smoking-related and ANDS-related rules and norms surrounding product use influence cigarette and ANDS product use, and how the subjective effects of ANDS use affect ANDS perceptions, beliefs and use. ETHICS AND DISSEMINATION This study was funded by the National Institute on Drug Abuse of the US National Institutes of Health (1R21DA036472), registered at ClinicalTrials.gov (NCT02261363), and approved by the Chesapeake IRB (Pro00008526). Findings will be disseminated to the scientific and lay community through presentations, reports and scientific publications. TRIAL REGISTRATION NUMBER NCT02261363; Pre-results.
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Affiliation(s)
- Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
| | - Leslie F Rubin
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- Department of Psychology, American University, Washington DC, USA
| | | | - Hoda Elmasry
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
| | - Megan Davis
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- George Washington University, Professional Psychology Program, Washington DC, USA
| | - Teresa DeAtley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Emily Harvey
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia, USA
| | - Thomas Kirchner
- New York University College of Global Public Health, New York, New York, USA
| | - David B Abrams
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington DC, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington DC, USA
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Benekli M, Smiley SL, Younis T, Czuczman MS, Hernandez-Ilizaliturri F, Bambach B, Battiwalla M, Padmanabhan S, McCarthy PL, Hahn T. Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma. Bone Marrow Transplant 2007; 41:613-9. [DOI: 10.1038/sj.bmt.1705951] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Reddy NM, Sullivan MA, Hahn TE, Battiwalla M, Smiley SL, McCarthy PL. Association of squamous cell carcinoma of the oral cavity in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2007; 40:907-9. [PMID: 17724441 DOI: 10.1038/sj.bmt.1705833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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