Nicotine & Tobacco Research最新文献

Introduction: To document the development and implementation of a WHO Framework Convention on Tobacco Control (FCTC)-guided law in Ethiopia.

Methods: We analyzed 15 publicly available documents including news articles and government documents. We triangulated findings by interviewing three tobacco control advocates, two academic researchers, and four government officials. We used a thematic framework analysis to analyze the data and documented this through a retrospective policy analysis.

Results: Local and international health advocacy groups supported regulation development through capacity building workshops. The National Tobacco Enterprise/Japan Tobacco International used standard industry arguments to weaken draft regulations but government officials, supported by health advocacy messages promoting Ethiopia's WHO FCTC obligations, rejected these arguments. Key barriers to implementation included industry interference, lack of funding and resources, monitoring and evaluation system issues, government system coordination issues, and a lack in organizational knowledge. Key facilitators included financial mechanisms and health advocacy support and government and inter-governmental support which contributed to increased monitoring, education efforts, and technical support.

Conclusion: The tobacco industry remains the biggest barrier to FCTC implementation continuing to advertise at the point-of-sale, fuel illicit tobacco trade, and push the sale of single cigarette sticks near schools. Other barriers include a shortage of funding/resources, a lack of strict enforcement, and an absence of local regulations. Financial and technical support and leveraging the FCTC as a legal instrument can help uphold strong regulations. More efforts are needed to educate government authorities and establish local regulations to protect policy implementation.

Introduction: The Program for LUng cancer screening and TObacco cessation (PLUTO) trial was a sequential, multiple assignment, randomized trial to optimize the delivery of tobacco longitudinal care (TLC), a one-year telephone coaching and combination nicotine replacement therapy program. Our analyses tested the effects of the randomized response assessment timepoint.

Methods: Participants who smoked daily and were eligible for lung cancer screening (N=636) were randomized to have their response to treatment assessed after 4 or 8 weeks of TLC. Participants' responses determined whether they could be randomized to more (TLC with prescription medication therapy management, MTM) or less (TLC delivered quarterly) intensive treatment for the remainder of the trial. We used chi-squares and generalized linear models to test whether assessment timing affected 7-day point prevalence abstinence at weeks 12, 26, 52, and 78.

Results: Participants who were assessed at week 4, rather than 8, were more likely to report abstinence at weeks 12 and 26 (ORs>1.48, p's<0.034). Among participants who were smoking at week 4, early assessment was associated with higher abstinence at weeks 12-52 (ORs>1.31, p's<0.019), and there was some evidence at weeks 12 and 52 that it was better to offer MTM earlier rather than later (ORs>1.27, p's<0.057).

Conclusions: Earlier treatment response assessment may be beneficial, especially for those who are not responsive to initial treatment, but more research is needed to understand the mechanisms, generalizability, and robustness of the effect.

Implications: The timing of response assessment in adaptive interventions may be an important, but often overlooked, factor for optimizing clinical treatment programs. In the context of tobacco longitudinal care delivered to participants who are eligible for lung cancer screening, there may be a benefit to assessing participant responses to tobacco cessation treatment earlier (after 4 weeks) rather than later (after 8 weeks), although the reasons for the benefit remain unclear.

Introduction: This review summarizes research on the public health impacts of flavored cigar bans, which are policies that restrict the sale of cigars containing characterizing flavors.

Methods: A systematic literature search was conducted using PubMed, Scopus, PsycInfo, CINAHL, and Applied Social Sciences Index and Abstracts. Studies were included if they evaluated the impact of a real-world or hypothesized flavored cigar ban. The primary outcome was tobacco use behavior. Secondary outcomes included retailer compliance, sales, and the tobacco industry response to flavored cigar bans. Two reviewers independently screened articles for inclusion, extracted data, and assessed study quality. We also conducted a meta-analysis using random effects models to pool estimates on tobacco use behavior after a flavored cigar ban. This review was registered with PROSPERO (CRD42023481603).

Results: Of 2399 articles identified in the preliminary search, 55 were included in the review. Many real-world studies found declines in cigar use post-ban, specifically among youth. However, other studies found no significant changes in cigar use. Among studies examining sales, there were declines in flavored cigar sales but increases in sales of non-flavored cigars and other tobacco products. Among studies assessing hypothesized tobacco use behavior, pooled results indicate that 8% (95% CI: 2%, 27%) of flavored cigar users intend to quit tobacco altogether, 45% (95% CI: 39%, 50%) would switch to non-flavored cigars or cigarettes, and 41% (95% CI: 32%, 51%) would switch to other tobacco products.

Conclusion: Flavored cigar bans may reduce cigar use and improve public health when policies are comprehensive and well-enforced.

Introduction: The popularity of e-cigarettes is increasing globally. Validated instruments in local languages are needed to measure e-cigarette dependence for surveillance, diagnosis, and treatment of e-cigarette dependence. We assessed the psychometric properties of the Malay language version of the 8-item E-cigarette Dependence Scale, EDS-8(Malay), among exclusive e-cigarette users.

Methods: The original English version of the eight-item E-cigarette Dependence Scale (EDS-8) was translated into Malay to suit the local context by standard forward and backward translation methods. Two professional native Malay-speaking translators and two professional native English-speaking translators carried out the forward and backward translation process, respectively. The reliability and validity of the EDS-8(Malay) were determined using a group of 251 adult Malaysians who were exclusive e-cigarette users. They were recruited from social media platforms.

Results: Their mean age was 37.9 (SD=10.3) years, and 73.2% were males, Malay race (41.3%), attained secondary education (51.8%), were employed(88.4%), and 61.7% were frequent vapers. Cronbach's alpha of EDS-8(Malay) was 0.894. Corrected item-total correlations were >0.4. The EDS-8(Malay) displayed a good composite reliability of 0.896. A confirmatory factor analysis revealed that the one-factor model exhibited good fit indices, including RMSEA (0.056), GFI (0.967), AGFI (0.935), CFI (0.984), and NNFI (0.975). EDS-8 (Malay) was able to detect the between-group mean differences as shown by higher scores among e-cigarette users who were Indians, had lower income, received secondary education, and vaped regularly.

Conclusions: The instrument EDS-8 (Malay) displayed acceptable reliability, content, and construct validity. The convergent validity of EDS-8 (Malay) should be tested when comparable tools become available in the Malay language.

Implications: To date, there are no validated translated versions of e-cigarette dependence tools originally developed in the English language. Our Malay language version of the eight-item e-cigarette dependence scale provides locally validated e-cigarette dependence for potential use in Malaysian clinical settings and for research on e-cigarette addiction. The other tools available for the assessment of e-cigarettes need to be translated and validated to assess the convergent validity of the eight-item e-cigarette dependence scale in the Malay language.

Introduction: Couple-based smoking cessation interventions can be more effective than individual ones in initiating and maintaining cessation behaviors, but they often require costly in-person visits. More affordable and accessible options are needed. The aim of this study was to develop a couple-based, web-app, WeQuit, for smoking couples and to pilot-test its feasibility, acceptability, and preliminary effects.

Methods: Using Family Systems theory, WeQuit was developed focusing on three relational constructs: communal coping, smoking-system fit, and ironic processes. Feasibility was evaluated by completion rates and time spent on the app. Acceptability was determined by using standardized measures of perceived usability and satisfaction with WeQuit. Preliminary effects were determined by changes in smoking-related and relational couple dynamic variables.

Results: Forty couples were invited and completed WeQuit. Nearly half of the primary smoking participants were female (n = 20, 50.0%) and Black (n = 18, 45.0%). About 77.5% (n = 31/40) and 45.0% (n = 18/ 40) completed more than half and 100% of the program, respectively. WeQuit was perceived as "very useful" (80.0 %) and "very easy to use (87.0 %). Respondents felt 'very confident developing quit plans' (80.0 %) and 'very satisfied" (87.0 %). WeQuit significantly improved positive partner support (p<.001). Participants who quit showed significant improvements in positive partner support (p<.001) and dyadic efficacy (p=.006).

Conclusions: This study reveals that the theory-guided couple-based web-app, WeQuit, holds promise for promoting smoking cessation among smoking couples. Future research will involve a large pilot trial to evaluate the effectiveness of WeQuit on smoking cessation outcomes.

Introduction: Sales of oral nicotine pouches (ONPs), including brands such as Zyn, on!, Velo, and Rogue, have risen precipitously in the United States. One potential driver of ONP use may be exposure to the products and their marketing in local tobacco retailers. This study examines the prevalence and correlates of ONP availability in a large, representative sample of tobacco retailers in three major US cities.

Aims and methods: In 2023, research staff visited a stratified, random sample of 20% of licensed tobacco retailers in San Francisco, New York City, and Philadelphia (n = 1402) and documented the availability of ONPs. Binomial generalized linear mixed models estimated adjusted odds of ONP availability by city, store type, and district sociodemographic characteristics.

Results: ONPs were available in 28.7% of retailers and were most prevalent in chain convenience stores (60.5%), followed by smoke/vape shops (53.3%, p < .0001). After adjusting for city and store type, the odds of a retailer carrying ONPs were higher in districts with a greater proportion of non-Hispanic White residents (adjusted odds ratio [aOR]: 2.33 [1.10, 4.94]), a higher median household income (aOR: 2.04 [1.23, 3.38]), and a lower proportion of youth residents (aOR: 0.25 [0.15, 0.43]).

Conclusions: ONP availability was greater in retailers located in predominantly White and higher-income neighborhoods and those with fewer youth. As researchers continue to evaluate the risks of ONPs as well as their potential as a tobacco harm reduction strategy, attention to variations in retail access and population patterns of use will be critical to determine impacts on health equity.

Implications: Sales of oral ONPs have increased precipitously in the United States, but little is known about patterns of retail access in neighborhoods, which may influence consumer use behaviors. This study found that over one in four tobacco retailers carried ONPs, but availability was greater in largely White and high-income neighborhoods and those with fewer youth. As researchers continue to evaluate ONP risks and potential benefits, this study provides insight into the role that retail access may play in shaping population patterns of use and subsequent impacts on health equity.

Introduction: Oral nicotine pouches (ONPs) are increasingly prevalent among young people and feature widely within social media content. This study systematically analyzes the most viewed videos on TikTok relating to ZYN (the most popular ONP, manufactured by a subsidiary of Philip Morris International) to understand their content sentiment and patterns, as well as the demographics and potential commercial biases of their creators.

Aims and methods: We used an Apify scraper in July 2024 to collect URLs and metadata for the top 100 most viewed videos on TikTok under the #ZYN hashtag. Profiles of content creators, plus their externally linked sites, were examined for commercial connections to ONP entities. We then undertook an inductive manifest content analysis.

Results: The top 100 TikTok videos identified garnered over 400 million views and over 3.8 million shares. A total of 10.3% (n = 9) of content creators had an external link to a website that sold ONPs. Videos predominantly indicated positive sentiment toward ZYN products or other ONPs (79%), and portrayed young men enthusing about the products, often employing humor. ZYN products are featured directly in 71% of videos. Few videos contained disclaimers or warnings about potential risks of ONPs and only 5% portrayed ZYN as a vaping or smoking cessation tool.

Discussion: Our findings suggest the most widely viewed content relating to ZYN on TikTok is overwhelmingly positive in sentiment, commonly featuring young men and often portraying ONP use in a humorous context, minimizing risks. Many content creators actively sell ONP products through TikTok, some overtly and some via external links.

Implications: ZYN oral nicotine pouches are presented positively and primarily for recreational purposes on TikTok. Few videos referenced ZYN for smoking cessation purposes or mentioned the risks of nicotine. 10.3% of the creators linked their profile to an external website selling oral nicotine pouches, which appears inconsistent with TikTok's policies. The use of humor and downplaying or omission of addiction and health risks across most of the sample echoes marketing efforts by the tobacco industry to present oral nicotine pouches as fun and safe.