Nicotine & Tobacco Research最新文献

Introduction: To determine whether e-cigarette brand use varies according to race/ethnicity among adolescent and young adult e-cigarette users.

Aims and methods: Data are from a cross-sectional online survey of respondents aged 15-24 years (January 2022-June 2023; 300 unique respondents/week). The analytic sample was restricted to current e-cigarette users (n = 6387). Respondents selected their usual brand and reported frequency of past 30-day e-cigarette use (in days). ANOVAs measured differences in frequency of use by usual brand, stratified by race/ethnicity. Linear regression identified changes in usual brand over time by race/ethnicity, controlling for age and use of other tobacco/nicotine products.

Results: One-quarter (25.6%) of Black and 22.2% of Hispanic e-cigarette users reported JUUL as their usual brand, compared to those who are White (15.7%) or another race (16.5%). Puff Bar was the second-most reported brand among Black (15.1%) or Hispanic (16.6%) e-cigarette users, to a greater extent than White (7.8%) e-cigarette users. Frequency of use varied significantly according to respondents' usual brand when stratified by race/ethnicity (p < .001).

Conclusions: Across all racial and ethnic categories, frequency of use was greater for brands marketed with more flavor options and containing nicotine (EB Design, SMOK, Hyde, and Vuse). Despite declines in popularity, Black or Hispanic respondents report using JUUL and Puff Bar to a greater extent than other respondents, and vape less frequently than White non-Hispanic respondents regardless of brand. As e-cigarette brands continue to proliferate, monitoring e-cigarette brand selection by race/ethnicity can inform studies of nicotine exposure, polyuse, and health disparities.

Implications: Our study demonstrates the importance of research methods to detect rapidly changing patterns of e-cigarette use by race/ethnicity and age. The inclusion of measures capturing brand use can detect evidence of product features and targeted marketing that may have consequences for patterns of tobacco use and nicotine exposure among these groups.

Introduction: Most adult smokers develop their addiction by trying smoking during adolescence. Elucidation of the psychosocial mechanisms underlying smoking initiation may be crucial for the prevention of adolescent tobacco use. The study aimed to identify key psychosocial factors in order to provide a scientific basis for preventing and reducing the occurrence of initial smoking behaviour among adolescents.

Methods: A total of 2671 students from rural middle schools in western China were surveyed three times as part of a two-year longitudinal study. The adolescent health questionnaire included the Global Youth Tobacco Survey, the Mental Health Inventory of Middle-School Students, the Social Support Rating Scale and the Adolescent Life Satisfaction Scale. Structural equation modelling was used to analyse the direct or indirect relationships between smoking initiation and psychosocial factors.

Results: The prevalence of trying smoking among adolescents was 28.3%, with boys (38.3%) having a higher rate than girls (19.7%) (P<0.05). Mental health problems were positively associated with trying smoking (β=0.112, P<0.05). Greater life satisfaction had a negative direct effect on trying smoking (β=-0.125, P<0.05) and also played a mediating role in the relationship between mental health problems and trying smoking (β=0.016, 95%CI: 0.008 to 0.025), accounting for 20.7% of the total effect. Social support had a full mediating effect on smoking initiation through both mental health problems and life satisfaction (β=-0.022, 95%CI: -0.028 to -0.016).

Conclusions: The behaviour of young people who try smoking is associated with complex psychosocial factors. Interventions aimed at preventing adolescent tobacco use should prioritize the provision of social support and the promotion of life satisfaction.

Implications: The study elucidated the direct and indirect relationships between psychosocial factors and trying smoking behaviour. In order to prevent adolescents from trying smoking, it is essential to intervene through external social support and internal development of mental health and well-being to improve adolescents' social support, increase their life satisfaction and maintain their mental health.

Introduction: This study investigates the effects of varying nicotine doses and administration frequencies on mouse body weight, adipose tissues, and liver.

Methods: Male C57BL6/J mice received subcutaneous nicotine doses (0.5mg/kg, 1mg/kg, or 2mg/kg) once daily (qd), twice daily (bid), or four times daily (qid) for 4 weeks. Body weight, inguinal white adipose tissue (iWAT), epididymal white adipose tissue (eWAT), brown adipose tissue (BAT) weight and size, and UCP1 expression were assessed, along with liver fat deposition and morphology.

Results: Nicotine administration reduced body weight and decreased the weight and size of iWAT and eWAT compared to controls. The frequency of nicotine administration had a more significant impact on body weight and fat tissues than the dosage itself, with 2mg/kg bid being optimal for weight reduction. Nicotine increased BAT cell numbers and amplified UCP1 expression in iWAT and BAT. It had minor effects on eWAT UCP1 expression and no substantial impact on liver fat deposition or morphology, except for a reduction in liver weight with doses exceeding 4mg/kg.

Conclusions: Nicotine-induced weight reduction is frequency-dependent, with 2mg/kg bid being the optimal regimen. The mechanisms may include reductions in iWAT and eWAT weights and cell sizes, induction of browning in iWAT, increased BAT quantity and UCP1 expression, and heightened energy expenditure in iWAT and BAT. Nicotine's ability to induce eWAT browning is relatively weak, indicating diverse mechanisms of action across different adipose tissue types. These findings provide a foundation for further exploration of nicotine's multifaceted functions and underlying mechanisms.

Implications: This study examines how different nicotine doses and administration frequencies affect mouse body weight and adipose tissues. It finds that administering nicotine bid (twice daily) at 2mg/kg leads to optimal weight reduction. Nicotine induces browning in white adipose tissue, increases brown adipose tissue quantity and UCP1 expression, and affects energy expenditure. The findings underscore nicotine's nuanced effects across different adipose tissue types and lay groundwork for further exploration of its mechanisms and therapeutic potential in weight management.

Introduction: There is considerable interest in raising the age of sale of tobacco above the conventional age of 18. We systematically reviewed whether raising the minimum legal sales age of tobacco (MLSA) to 20 or above is associated with reduced prevalence of smoking compared to an MLSA set at 18 or below.

Methods: Following a pre-registered protocol on PROSPERO (ref: CRD42022347604), six databases of peer-reviewed journals were searched from January 2015 to April 2024. Backwards and forwards reference searching was conducted. Included studies assessed the association between MLSAs ≥20 with cigarette smoking or cigarette sales for those aged 11-20. Assessments on e-cigarettes were excluded. Pairs of reviewers independently extracted study data. We used ROBINS-I to assess risk of bias and GRADE to assess quality of evidence. Findings were also synthesised narratively.

Results: 23 studies were reviewed and 34 estimates of association were extracted. All extracted studies related to Tobacco 21 laws in the United States. Moderate quality evidence was found for reduced cigarette sales, moderate quality evidence was found for reduced current smoking for 18 - 20 year olds, and low quality evidence was found for reduced current smoking for 11 - 17 year olds. The positive association was stronger for those with lower education. Study bias was variable.

Conclusions: There is moderate quality evidence that Tobacco 21 can reduce overall cigarette sales and current cigarette smoking amongst those aged 18- 20. It has potential to reduce health inequalities. Research in settings other than the United States is required.

Implications: This systematic review on raising the minimum legal sale age of tobacco to 20 or above demonstrates there is moderate quality evidence that such laws reduce cigarette sales, and moderate quality evidence they reduce smoking prevalence amongst those aged 18-20 compared to a minimum legal sale age of 18 or below. The research highlights potential benefits in reducing health inequalities, especially individuals from lower educational backgrounds. Studies are limited to the United States, highlighting a need for more global research to assess the impact of these policies in other settings.

Introduction: The use of cigars for blunts (i.e., cannabis rolled in cigar paper) is well-documented; prevalence of cigar and blunt use and associated characteristics are less studied.

Methods: Pooled data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) were analyzed in 2023. Respondents aged 12+ who reported past 30-day cigar use were categorized into three mutually exclusive use categories: (1) exclusively cigars, (2) exclusively blunts, and (3) both cigars and blunts. We examined associations between cigar-blunt use categories and sociodemographic characteristics.

Results: Among respondents aged 12+ who reported past 30-day cigar use, 48.6% (95% CI=47.6-49.6) reported exclusive cigar use; 44.3% (95% CI=43.3-45.3) reported exclusive blunt use; and 7.2% (95% CI=6.8-7.6) reported cigars and blunts. The prevalence differed by age, with exclusive blunt use most prevalent among youth (72.5% [95% CI=70.7-74.3]) and young adults (62.4% [95% CI=61.4-63.5]), and exclusive cigar use most prevalent among adults 26+ (61.2% [95% CI=59.8-62.5]). Exclusive blunt users smoked more days in the past month (17.5; 95% CI=16.8-18.2), compared to 13.8 days (95% CI=13.2-14.4) for cigar and blunt users, and 7.7 days (95% CI=7.5-8.0) for exclusive cigar users. There were significant differences in sociodemographic characteristics, with female (41.6%; 95% CI=40.3-42.9) and Hispanic (18.2%; 95% CI=17.3-19.2) participants more likely to report exclusive blunt use.

Conclusions: Exclusive blunt use was the most prevalent pattern of past-30-day cigar use among youth and young adults. Those who use cigars as blunts smoked more cigars per month, suggesting this may be an important group for education and policy efforts.

Implications: Studies that aggregate cigars and blunts into one group may limit potentially meaningful subgroup risk profiles. Additionally, when assessing cigar use, particularly among youth and young adults, it is important to consider blunt use to avoid missing youth who exclusively use cigars for blunts and may not consider blunts as cigar products. Accurate measurement may better inform tobacco and cannabis regulatory actions. Finally, given the high prevalence of blunt use among youth and young adults identified in the present study, additional education efforts may be warranted for this population to reduce long-term risks.

Introduction: Australia's limited social housing has created geographically concentrated locales of poverty with high smoking rates. The impact of social housing on smoking initiation among adolescent residents is unknown, despite adolescence being a critical period for smoking prevention. We examine the relationship between social housing residency and smoking initiation amongst adolescents to quantify the likelihood of smoking uptake amongst social housing residents compared to a similar cohort in other tenures, accounting for socio-economic factors and household exposure to smoking.

Methods: We analysed data on 15-18-year-old adolescents (n=3,132) from the Household Income and Labour Dynamics in Australia survey (2001-2019). We applied inverse probability treatment weights to maximise exchangeability between social housing tenants and their counterparts in other tenures. We quantified the risk of smoking five years after exposure measurement among those in social housing on both an absolute and relative scale. Baseline covariates included household income, age at study entry, sex, family type, smoking at baseline, highest household education and, household exposure to smoking.

Results: Adolescent residents in social housing had a 17% greater risk of smoking five years after baseline measurement than their counterparts in all other tenures (ATE: 0.165, 95%CI: 0.02-0.31). On the relative scale those in social housing had 1.80 times (95% CI: 0.95-2.66) higher risk of being a smoker than those in other tenures.

Conclusions: Adolescents residing in social housing have a higher risk of becoming smokers as young adults than their counterparts in other tenures, irrespective of smoking exposure in their own homes.

Implications: This study investigates the impact of social housing on smoking initiation among adolescents, revealing that those residing in social housing have a higher risk of becoming smokers in young adulthood, independent of smoking exposure at home. The research highlights the contribution of social housing to ongoing disparities in smoking rates in Australia and emphasize the need to further understand and review social housing provision from the perspective of its consequences on health. Moreover, the results advocate for comprehensive policies that extend beyond individualized harm reduction strategies to promote social inclusion and address health inequalities associated with smoking in adolescents.

Introduction: E-cigarette industry's marketing and social media efforts have promoted adolescent vaping. We developed and pilot-tested an anti-vaping media literary program - MediaSense.

Methods: In addition to employing the Community-Based Participatory Research approach for program development, we applied a prospective, interventional, and single-arm design to assess the impact of MediaSense among students from five middle and high schools. Data were collected through REDCap surveys administered before and after the intervention. We performed generalized linear mixed models and median analysis to evaluate changes in vaping media literacy (i.e., Authors and Audiences [vAA], Messages and Meanings [vMM], and Representation and Reality [vRR]), knowledge, harm perception, and susceptibility to e-cigarette use before and after the intervention.

Results: A total of 384 students aged 11-18 years completed the pre-post survey assessment. After the intervention, students exhibited significantly improved vaping media literacy across all three domains (vAA,fold change [FC]=150%, p<0.0001; vMM, FC=143%, p<0.0001; vRR, FC=133%, p=0.0007). The intervention was associated with a reduction of vaping susceptibility (adjusted odds ratio [AOR]=0.7, p=0.04) and improvement in harm perception (AOR=1.6, p=0.009), knowledge of flavored e-cigarettes (AOR=4.4, p<0.0001) and Tobacco 21 policy (AOR=6.2, p<0.0001). Further mediation analysis unveiled the pathway of the intervention on reduction of vaping susceptibility through media literacy (βindirect=-0.03, p=0.003) and harm perception enhancement (βindirect=-0.02, p=0.03).

Conclusion: The MediaSense program showed promise in vaping prevention among adolescents by reducing vaping susceptibility. Comprehensive vaping media literacy education, especially interventions aimed at decoding misleading marketing information and addressing emerging marketing themes, provides valuable evidence in curbing adolescent vaping.

Implications: MediaSense (Media Education for Sensible Evaluation and Nurturing Substance-free Experiences) represents a promising e-cigarette education program designed for adolescent vaping prevention. The findings of this study highlight the positive impact of the program on media literacy, harm perception, and knowledge of tobacco control policies.

Introduction: We conducted a pilot study to test the feasibility of a future randomized controlled trial comparing e-cigarettes to traditional pharmacotherapy among people who smoke daily, were motivated to quit, and failed to quit within the past 5 years using pharmacotherapy.

Methods: Eligible participants were assigned to either: 1) an e-cigarette (n=20) or 2) combination nicotine replacement therapy (patches and lozenges) (n=10). Participants received 5 weeks of product and selected a quit date 1 week later. Assessments were completed weekly, and electronic diaries were completed each day. As a pilot randomized controlled trial, outcomes focus on effects sizes and not statistical significance.

Results: Participants in the e-cigarette and NRT groups had a mean age of 51 (SD=13) and 50 (SD=10) years old, were 55% and 60% female, and were 15% and 0% non-white, respectively. At least 90% of participants completed each weekly assessment, and 77% of participants completed at least 80% of daily diaries. Mean cigarettes smoked per day reduced from 18 (SD=6.2) to 2.4 (SD=4.4) per day in the e-cigarette group and 16.5 (SD=8.5) to 4.9 (SD=5.9) per day in the NRT group. Rates of biochemically confirmed 7-day point prevalence abstinence at the end of treatment were numerically, but not statistically, higher in the e-cigarette group than the NRT group (35% vs. 10%, OR=4.8, 95% CI=0.5-46.5).

Conclusions: Among current daily cigarette smokers who have previously tried to quit and failed using standard pharmacotherapies, provision of an e-cigarette is a feasible intervention. A larger adequately powered trial is warranted.

Implications: This pilot study suggests that e-cigarettes may serve as an acceptable harm reduction intervention for people who smoke who cannot quit smoking with traditional pharmacotherapy, but adequately powered randomized controlled trials are needed.

Introduction: Little is known about how quitting and switching to other tobacco products affects cigarette smoking relapse. Additionally, there is no consensus on the best definition of relapse.

Aims and methods: Respondents who smoked cigarettes at baseline, had quit by the first follow-up, and completed the second follow-up survey in the Population Assessment of Tobacco and Health Study were included. We employed multivariable logistic regressions to assess the association between non-cigarette tobacco use at follow-up 1 and smoking relapse risk at follow-up 2, considering three definitions of relapse.

Results: 54.8% of the 1686 respondents who had recently quit smoking cigarettes relapsed according to Measure I (any smoking in the past 12 months), 40.3% using Measure II (any smoking in the past 30 days), and 30.1% using Measure III (smoked on ≥3 days in the past 30 days). Compared with no tobacco use at follow-up 1, any tobacco use was associated with increased relapse risk using Measure I (adjusted risk difference [aRD] = 7.14, CI [0.64 to 13.64]). The association was nonsignificant using Measures II (aRD = -0.53, CI [-6.62 to 5.56]) or III (aRD = -4.11, CI [-9.28 to 1.06]). Similarly, exclusive e-cigarette use was significantly associated with Measure I, but not with Measures II or III.

Conclusions: Compared with respondents who had recently quit and were tobacco-free at follow-up 1, those who switched to non-cigarette tobacco products may be more likely to slip but showed no difference in the likelihood of relapse when employing a relapse definition less strict than any smoking in the past 12 months.

Implications: The distinction between a slip and relapse needs to be considered more carefully, with researchers undertaking further studies that help us contemplate how we should define relapse. People who recently quit smoking cigarettes and switched to non-cigarette tobacco products (including e-cigarettes) may be more likely to slip compared to people who recently quit and were tobacco-free, but they are not clearly more likely to relapse.