Nicotine & Tobacco Research最新文献

Introduction: Lung cancer screening (LCS) trials, targeting people with a smoking history, have demonstrated reduced mortality. How to optimally embed evidence-based smoking cessation support in LCS, including in Australia, needs to be better understood. We sought experts' perspectives to identify potential barriers and effective implementation strategies.

Aims and methods: Perceptions of providing smoking cessation support in LCS were elicited in 24 focus groups and three individual interviews with clinicians, cancer screening program managers/policymakers, and researchers during 2021. We conducted framework analysis and mapped key topics to the updated Consolidated Framework for Implementation Research (CFIR).

Results: Experts (N = 84 participants) strongly supported capitalizing on an "opportune time" for smoking cessation and new LCS participant contact opportunities throughout the screening and assessment pathway. Many advocated for adapting existing cessation resources to the LCS setting and providing support without participant costs. Experts generally considered referral alone to established programs (eg, telephone Quitline) as insufficient, but likely helpful in follow-up, and dedicated cessation specialist roles as essential. Broader cessation messaging (via mass media/community channels) was also suggested to reinforce individualized support. Experts described inherent alignment, and an ethical responsibility, to deliver smoking cessation as a core LCS component. It was suggested that LCS-eligible participants' varied experiences of stigma, health literacy, and motivation, be considered in cessation support. Primary care support and individualized interventions were suggested to facilitate implementation.

Conclusions: Experts considered smoking cessation support essential in LCS. The expert-identified and multi-level implementation strategies described here can directly inform smoking cessation-specific planning for Australia's forthcoming National LCS Program.

Implications: The international literature includes few examples considering how best to provide smoking cessation support within a LCS program in advance of program commencement. Our analysis, using the updated CFIR, is one of the first to explore experts' perspectives within this context. Experts identified multiple implementation barriers to providing smoking cessation support within and outside of an Australian LCS program, including key work infrastructure barriers, and advocated for providing tailored interventions within this program. Our foundational work in a new targeted screening program's preimplementation phase will allow international comparisons to be made.

Introduction: Smoking is one of the most important predisposing factors of intestinal inflammatory diseases. Heated tobacco product (HTP) is a novel tobacco category that is claimed to deliver reduced chemicals to humans those reported in combustible cigarette smoke (CS). However, the effect of HTP on the intestine is still unknown.

Aims and methods: Our study aims to explore the potential effects of HTP on intestine. In the framework of Organization for Economic Co-operation and Development guidelines 413 guidelines, Sprague-Dawley rats were exposed to HTP aerosol and CS for 13 weeks. The atmosphere was characterized and oxidative stress and inflammation of the intestine were investigated after exposure. Furthermore, the feces we performed with 16S sequencing and metabolomics analysis.

Results: HTP aerosol and CS led to obvious intestinal damage evidenced by increased intestinal proinflammatory cytokines and oxidative stress in male and female rats After HTP and CS exposure, the abundance that obviously changed were Lactobacillus and Turiciacter in male rats and Lactobacillus and Prevotella in female rats. HTP mainly induces the metabolism of amino acids and fatty acyls such as short-chain fatty acids and tryptophan, while CS is involved in the main metabolism of bile acids, especially indole and derivatives. Although different metabolic pathways in the gut are mediated by HTP and CS, both inflammation and oxidative stress were ultimately induced.

Conclusions: HTP aerosol and CS-induced intestinal damage are mediated by different gut microbiota and metabolites, while both lead to inflammation and oxidative stress.

Implications: The concentration of various harmful components in heated tobacco product aerosol is reported lower than that of traditional cigarette smoke, however, its health risk impact on consumers remains to be studied. Our research findings indicate that heated tobacco products and cigarette smoke inhalation induced intestinal damage through different metabolic pathways mediated by the gut microbiome, indicating the health risk of heated tobacco products in the intestine.

Introduction: Aboriginal and Torres Strait Islander people want to quit smoking. There is global evidence of combination nicotine replacement therapy (c-NRT) alongside behavioral support as a best practice approach to smoking cessation care. However, there is limited adherence and acceptability research regarding NRT and behavioral supports for Aboriginal and Torres Strait Islander people. Similarly, there is limited research on what is considered culturally appropriate and safe support for Aboriginal and Torres Strait Islander people to quit smoking.

Aims and methods: This Aboriginal-led qualitative study explored the acceptability of the Koori Quit Pack. Aboriginal and Torres Strait Islander participants shared their experiences of quitting with the mailout c-NRT program and behavioral cessation support through Yarning. Collaborative Yarning and reflexive thematic analysis was used to develop themes.

Results: Aboriginal and Torres Strait Islander people are motivated to quit smoking and have accessed cessation supports from health professionals. However, the support(s) received are not always appropriate or culturally safe. The Koori Quit Pack was deemed acceptable and useful for smoking cessation. Having access to smoking cessation care and knowledge of c-NRT helped people quit smoking and support others to quit too.

Conclusions: A combination of NRT products alongside culturally responsive behavioral support(s), delivered through a mailout package was a beneficial strategy to help Aboriginal and Torres Strait Islander people quit smoking. National implementation of such a package could assist to accelerate reductions in tobacco use, helping meet national smoking reduction targets and improve health outcomes.

Implications: Cessation supports offered to Aboriginal and Torres Strait Islander people are not always culturally safe or effectively delivered. The Koori Quit Pack provided Aboriginal and Torres Strait Islander people with culturally safe smoking cessation support delivered for and by Aboriginal and Torres Strait Islander people, demonstrating mailout smoking cessation supports as acceptable and highly valued. Mailout support eliminates accessibility barriers to cessation care while providing tools and knowledge to quit can lead to smoke-free behaviors among individuals and communities. Country-wide availability of this program can accelerate reductions in tobacco use, helping meet national targets and improve health outcomes consistent with the National Tobacco Strategy and the WHO Framework Convention on Tobacco Control.

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

Aims and methods: Male C57BL6/J mice received subcutaneous nicotine doses (0.5, 1, or 2 mg/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 2 mg/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 4 mg/kg.

Conclusions: Nicotine-induced weight reduction is frequency-dependent, with 2 mg/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 2 mg/kg leads to optimal weight reduction. Nicotine induces browning in white adipose tissue, increases BAT quantity and UCP1 expression, and affects energy expenditure. The findings underscore nicotine's nuanced effects across different adipose tissue types and lay the groundwork for further exploration of its mechanisms and therapeutic potential in weight management.

Introduction: Cigarillos are the second most used tobacco product among younger populations. The highest prevalence of the use of cigars is among sexual and gender minority (SGM) women. Policy interventions like flavor bans and the availability of alternative tobacco products may have a disparate effect.

Aims and methods: The current study utilized an online store analog, The experimental tobacco marketplace, to investigate the effects of cigarillo and electronic nicotine delivery devices (ENDS) flavor bans on tobacco product purchasing. SGM (n = 72) and cisgender heterosexual (CisHet; n = 46) women viewed conditions in which cigarillo flavors were available or unavailable and ENDS flavors available or unavailable and the interaction between the two. Mixed models were conducted on each dependent variable with condition, price, and SGM identity as predictors and nicotine dependence, annual income, and race/ethnicity as covariates. Simple linear regressions were performed to determine the substitution profile for each tobacco product. Condition showed no effect.

Results: We found a main effect of price on cigarillo purchasing and a main effect of SGM identity in which SGM women purchased more ENDS than CisHet women. A complementary association between cigarillos and ENDS in which ENDS purchasing decreased as cigarillo purchasing decreased was found. This association was irrespective of flavor ban conditions and among SGM women only.

Conclusions: These results suggest that flavor availability of cigarillos and ENDS may not influence women who use cigarillos to move to another tobacco product and that women SGM cigarillo users are not likely to substitute their cigarillo smoking behavior with ENDS.

Implications: The results of this study suggest that SGM women are not likely to quit using cigarillos if flavors are removed from the market and instead will use unflavored products. Substituting their cigarillo use with ENDS does not appear likely given the complementary relation found between cigarillos and ENDS. The substitution patterns found for cigarettes and ENDS are not found for cigarillos and ENDS among young adult women who use cigarillos, further demonstrating the need for research on the conditions in which people who use cigarillos will decrease consumption or switch to a potentially less harmful product.

Introduction: The emergence of heated tobacco products (HTPs) has made it important to monitor HTP-generated aerosols in addition to combustible cigarette (CC) smoke as a source of secondhand tobacco (SHT) exposure. We investigated the trend of SHT exposure in school-aged children and assessed whether SHT exposure depended on household tobacco use status.

Aims and methods: This repeated cross-sectional study from 2011 to 2021 (15 927 participants) was based on data from an annual survey of fourth-grade students (aged 10 years) in Kumagaya City, Japan. In addition to a questionnaire which includes questions about household tobacco use status, we measured the urinary cotinine levels of each participant by their first-morning urine sample to objectively assess SHT exposure. We defined the participants with urinary cotinine levels ≥5.0 ng/mL as being exposed to SHT.

Results: The prevalence of SHT exposure decreased over the 11-year period from 18.6% in 2011 to 5.3% in 2021. It was significantly higher in households with tobacco users than without tobacco users (t-test p< .001). Prevalence of SHT exposure was 1.4% among the 68.1% of households not using tobacco, 22.9% among the 16.5% using only CC, 3.1% among the 12.3% using only HTP, and 27.6% among the 3.9% of households using CC and HTP.

Conclusions: While the prevalence of SHT exposure showed a decreasing trend from 2011 to 2021, the prevalence of SHT exposure was higher in children with household members using tobacco products, regardless of the type of tobacco product, than in those without tobacco users.

Implications: This study observed that the prevalence of SHT exposure was higher among children in households with tobacco users than among those without tobacco users, regardless of the type of tobacco product. Our findings highlight the importance of advocating that HTPs do not reduce the likelihood of SHT exposure to bystanders.

Introduction: Mobile phone-based interventions show promise for smoking cessation but often face low engagement. This study assessed the feasibility and preliminary effectiveness of a 2-phase, multi-component mobile phone-based smoking-cessation intervention for patients with chronic diseases.

Aims and methods: This Sequential Multiple Assignment Randomized Trial recruited smokers with chronic diseases from hospitals in Zhuhai, China. Participants received brief cessation advice and were randomized to personalized chat support (PCS, n = 64) or group chat support (GCS, n = 64) for 1 month. At 1-month, PCS nonresponders (continuing smokers) were re-randomized to receive either multi-component optional support (MOS) or continued PCS for 2 months. GCS nonresponders were re-randomized to receive PCS or continued GCS. Responders continued with their initial intervention for 2 months. Feasibility outcomes included eligibility, participation, retention, intervention engagement, and satisfaction. Preliminary effectiveness was assessed by abstinence rates among nonresponders.

Results: Of 160 screened, 128 (all male, 46.1% aged ≤39 years) participated. At 1 month, 51 and 53 nonresponded to PCS and GCS, respectively. Of them, 26 were re-randomized to receive PCS-MOS and 26 to receive GCS-PCS. At 6 months, PCS-MOS showed a nonsignificant higher validated abstinence rate compared to PCS alone (11.5% vs. 4.2%, odds ratio [OR] 3.13, 95% CI: 0.30 to 32.31, p = .34), GCS-PCS showed a nonsignificant lower validated abstinence rate compared to GCS (0% vs. 11.1%, OR 0.50, 95% CI: 0.15 to 1.67, p = .26).

Conclusions: This trial showed the feasibility of leveraging hospital visits as teachable opportunities and integrating mobile phone-based smoking-cessation support into chronic disease management in China. Optional treatments alongside mobile support showed preliminary effectiveness.

Implications: (1) This study showed the feasibility and potential effectiveness of using a SMART design to personalize and adapt mobile phone-based smoking cessation interventions for patients with chronic diseases in China. (2) By leveraging teachable moments during hospital visits, the findings suggest that adaptive, personalized mHealth support can enhance smoking cessation outcomes, although not statistically significant. (3) The integration of mobile phone-based interventions into chronic disease management showed promise. (4) These findings support the need for broader implementation and optimization of mHealth interventions in clinical settings in China.

Trial registration: ClinicalTrials.gov, NCT06187142.

Introduction: The use of cigars for blunts (ie, cannabis rolled in cigar paper) is well documented; the 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 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% confidence interval [CI] = 47.6 to 49.6) reported exclusive cigar use; 44.3% (95% CI = 43.3 to 45.3) reported exclusive blunt use; and 7.2% (95% CI = 6.8 to 7.6) reported use of cigars and blunts. The prevalence differed by age, with exclusive blunt use most prevalent among youth (72.5% [95% CI = 70.7 to 74.3]) and young adults (62.4% [95% CI = 61.4 to 63.5]), and exclusive cigar use most prevalent among adults 26+ (61.2% [95% CI = 59.8 to 62.5]). Exclusive blunt users smoked more days in the past month (17.5; 95% CI = 16.8 to 18.2), compared to 13.8 days (95% CI = 13.2 to 14.4) for cigar and blunt users, and 7.7 days (95% CI = 7.5 to 8.0) for exclusive cigar users. There were significant differences in sociodemographic characteristics, with female (41.6%; 95% CI = 40.3 to 42.9) and Hispanic (18.2%; 95% CI = 17.3 to 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.