Nicotine & Tobacco Research最新文献

Introduction: This single-arm pilot study aimed to assess the feasibility, acceptability, and preliminary impact of TRANSformá tu salud, a culturally adapted smoking cessation intervention for transgender and gender diverse (TGD) individuals living in Argentina.

Methods: Forty TGD individuals who smoked received TRANSformá tu Salud, which consisted of two components: 1) a 3-month instant messaging intervention delivered via WhatsApp that allowed longitudinal and bidirectional text, image, video, and voice messages; and 2) the provision of nicotine patches at no cost. Feasibility was measured by the enrollment and follow-up rates. Acceptability was measured by satisfaction with the intervention and whether they would recommend the intervention to other TGD individuals. Preliminary impact was measured by self-reported and biochemically verified abstinence rates, nicotine patch use, and changes in self-efficacy for smoking abstinence between baseline and follow-up assessments.

Results: Forty TGD individuals were enrolled and 37 (92.5%) completed the follow-up assessment at Month 3. Eleven participants (27.5%, 11/40) self-reported 7-day smoking abstinence. Five participants (12.5%, 5/40) were biochemically verified abstinent. Almost all participants (94.6%, 35/37) reported using the nicotine patches for at least one day. Mean self-efficacy scores significantly increased from 16.76 (SD 7.12) at baseline to 25.38 (SD 8.75) at Month 3 (p<0.001). Most participants (77.7%, 28/36) were satisfied/extremely satisfied with the intervention. Almost all participants (94.4%, 34/36) reported that they would recommend the intervention to other TGD individuals.

Conclusions: It is feasible to recruit and retain TGD individuals. TRANSformá tu salud is acceptable and holds promising preliminary impact. Additional testing in a randomized clinical trial is warranted to assess the efficacy of the intervention.

Introduction: Tobacco control policies aim to limit access, reduce initiation, and mitigate tobacco-related harms, particularly among youth. However, the effectiveness of these policies relies on consistent enforcement to ensure widespread compliance and achieve their intended public health impacts. Socioeconomic vulnerability and neighborhood characteristics have been shown to influence retailer compliance, although existing studies often primarily focus on compliance violations instead of inspections. This study uses Los Angeles (LA) County, California to explore the associations between compliance inspections, violations, and neighborhood social vulnerability.

Methods: We identified inspection and violation data from the FDA Tobacco Compliance Check Outcomes database for Los Angeles County, CA (January 1, 2021, to December 31, 2023) and linked these data to census tract level data from the 2022 CDC Social Vulnerability Index (SVI). All analyses were conducted at the census-tract level, with separate multivariable models adjusted for tobacco retailer density, and used to examine the relationship between inspections, violations, and neighborhood social vulnerability.

Findings: Neighborhood-level social vulnerability significantly predicted the likelihood of tobacco retailer inspections, but not violations. Census tracts with greater socioeconomic vulnerability and housing vulnerability had higher odds of inspections, while census tracts with higher proportions of racial/ethnic minority residents were less likely to undergo compliance inspections.

Conclusion: The uneven distribution of FDA compliance inspection efforts in socially vulnerable neighborhoods highlights systemic inequities. The results underscore the importance of utilizing equitable enforcement frameworks that leverage tools like SVI to pinpoint high-need areas, optimize resource allocation, and support comprehensive tobacco policy implementation.

Implications: This study reveals disparities in FDA compliance inspections with a concentration of inspections identified in socioeconomically vulnerable areas and gaps in predominantly racial/ethnic minority communities. No direct link was found between social vulnerability and violations, suggesting heightened retailer compliance may stem from successful outreach, past regulatory scrutiny, or other factors. Leveraging the CDC's Social Vulnerability Index can strengthen tobacco control enforcement in high-need areas, ensuring inspections are more equitable and targeted where enforcement gaps and tobacco access remain most pronounced.

Introduction: This study aimed to evaluate whether in-utero and early-life tobacco exposure and genetic factors jointly contribute to incident chronic obstructive pulmonary disease (COPD).

Methods: A total of 412 050 participants without COPD at baseline were included. We assessed the associations of in-utero tobacco exposure, age of smoking initiation, and their interactions with joint COPD polygenic risk scores (PRS) with COPD risk using Poisson regression models.

Results: Participants with in-utero tobacco exposure exhibited a higher risk of COPD (adjusted relative risk [aRR], 1.29; 95% confidence intervals [CIs], 1.25-1.33) compared to participants without in-utero tobacco exposure. Compared with nonsmokers, the aRRs (95% CIs) of COPD risk for smoking initiation during adulthood, adolescence, and childhood were 4.23 (4.05-4.42), 5.17 (4.95-5.38), and 7.01 (6.68-7.36), respectively (Ptrend < 0.001). Significant interactions were observed between in-utero tobacco exposure, age of smoking initiation and the genetic risk. Participants with both in-utero tobacco exposure and smoking initiation during childhood had the highest risk of COPD (aRR, 9.04, 95% CI: 8.44-9.69; Pmult = 0.006, Padd < 0.001) compared to nonsmokers without in-utero tobacco exposure. Furthermore, compared to nonsmokers with low genetic risk, individuals with high genetic risk and childhood smoking initiation exhibited the greatest risk of COPD (aRR, 8.29, 95% CI, 7.65-8.99; Padd < 0.001).

Conclusions: Exposure to tobacco smoke in utero and during early life significantly increased the risk of COPD in adulthood, irrespective of genetic predisposition. Theses findings underscore the importance of early-life smoking prevention to mitigate the risk of developing COPD in adulthood.

Introduction: African Americans face significant disparities in tobacco-related diseases and access to smoking cessation resources. Digital health interventions using large language models (LLMs) show promise in increasing engagement and successful quit attempts. However, impressions regarding acceptability of LLM-based interventions among African Americans are unknown and evidence suggests such interventions require tailoring for underserved communities. Our goal was to evaluate perceptions of LLM-based interventions among African Americans to inform development of an LLM-based chatbot to support quit attempts.

Methods: We conducted remote focus groups with adult African Americans residing in Minnesota who smoke cigarettes to determine acceptability of LLM-based health interventions and inform the functionality of an LLM-based chatbot supporting quit attempts. Discussions followed a structured guide and were recorded to facilitate analysis. Transcripts were coded independently by two analysts with a shared codebook.

Results: 21 adults participated in focus group discussions. 57.1% of participants were female and the mean age was 45.6 (SD, 10.5). Three themes united participants' feedback: 1) participants limited familiarity with LLM and related AI technology; 2) willingness to use an LLM-based app to support quit attempts; 3) perceptions of features that impact the acceptability of an LLM-based chatbot to support quit attempts.

Conclusion: African Americans have complex perceptions and expectations regarding the use of LLMs to deliver health interventions. While many recognize the potential benefits, significant concerns and knowledge gaps remain. To build trust and acceptability, intervention developers should prioritize community engagement and ethical guidelines to ensure that LLM-driven solutions are inclusive and effective for multiple communities.

Introduction: Interventions for quitting smokeless tobacco are lacking in South Asia. In a pilot trial, we explored the feasibility of delivering and evaluating a culturally adapted behavioural intervention and/or nicotine replacement therapy in Bangladesh, India and Pakistan. This paper presents the process evaluation.

Methods: Mixed methods consisted of interviews with 46 participants and five cessation advisors, a questionnaire completed by 236 trial participants, fidelity assessment of intervention delivery for 38 participants and intervention logs. Data were triangulated across three process evaluation functions (implementation, mechanisms of impact, context) and self-reported abstinence outcomes.

Results: After everyone attending the pre-quit behavioural session, attendance dropped to 86.3% (quit session) and 65.9% (>1 post-quit sessions). Abstainers attended more sessions. Advisors were confident in delivering the intervention, favouring face-to-face over remote, yet fidelity scores showed room for improvement. Attendance and fidelity scores were consistently best in Bangladesh. There was high acceptability and perceived usefulness of the behavioural intervention with an important role for the advisor especially among abstainers. Two-thirds perceived nicotine replacement therapy as useful, higher among abstainers. Taste and side effects were barriers; adherence was highest in India. Perceived drivers to cessation were new knowledge leading to positive attitudes, beliefs in capability to quit, and family support. Perceived barriers were nicotine addiction, social pressure and easy access to smokeless tobacco.

Conclusions: This process evaluation affirms the feasibility and acceptability of implementing the BISCA and NRT interventions while identifying important areas for improvement prior to a full effectiveness trial.

Introduction: This study examined how message sidedness (one-sided vs. two-sided) and source (expert vs. peer) influence young adults' perceptions of e-cigarette heath messages, with attention to differences between those who currently vape, those who ever vaped and never vaped.

Methods: We conducted a 2 (sidedness) x 2 (source) online experiment with a sample of young adults (N=802, Mage=21.49). Participants were randomly assigned to view 18 messages about the health effects of vaping. After each message, they rated message and source perceptions. Following exposure to all messages, they completed measures assessing e-cigarette attitudes, risk beliefs, behavioral intentions, and demographics. Generalized linear models (GLMs) were used to examine the effects of message conditions and vaping status on outcomes, adjusting for demographics.

Results: Participants reported higher trust in experts than peers (p<0.001) and more positive message perceptions from expert-delivered messages (p=0.048). One-sided messages elicited greater perceived threat to freedom (p<0.001) and more positive e-cigarette attitudes than two-sided messages (p=0.037) among those who currently vape. Two-sided messages elicited greater anger than one-sided messages among those who ever vaped (p=0.041). Participants who never vaped, ever vaped, and currently vape reported the highest trust in the FDA (ps<0.001) and the lowest trust in influencers (ps<0.001).

Conclusions: Tailoring message design to audience's vaping status can strengthen e-cigarette health messages. Expert sources may be more effective in prevention campaigns, while two-sided messages may enhance cessation efforts. Results show that message source and sidedness interact with vaping status to meaningfully shape message perceptions.

Introduction: Tobacco use is a leading preventable cause of disability and death, with nicotine withdrawal-related affective and cognitive sequelae posing a key barrier to cessation. Understanding how the dynamics between salience (SN), default mode (DMN), and frontoparietal networks (FPN) support or lead to failures of adaptive attentional control - and how these network interactions may be altered by the cognitive and affective challenges of withdrawal - may help illuminate mechanisms that contribute to smoking relapse.

Current review: The goal of the current review is to synthesize existing literature on resting-state and task-based network connectivity studies of SN, DMN and FPN under nicotine withdrawal, while situating the interpretations of this literature in the broader cognitive neuroscientific understanding of the three-network dynamics. In particular, there is a need to clarify context-dependent network connectivity under nicotine withdrawal, particularly when cognitive and affective demands co-occur.

Empirical example: In addition to the review, we provide a proof-of-concept empirical example examining SN, DMN, and FPN dynamics in daily smokers following nicotine satiation and 12-hour abstinence when cognitive and affective demands were being manipulated. Although prior studies link nicotine withdrawal with increased salience signaling, our data provides initial evidence that SN's modulatory capacity may be reduced - impairing the SN's ability to toggle between the DMN and FPN under high demand.

Conclusion: Together, results from the literature and our empirical example underscore the importance of context-dependent connectivity analyses for understanding how affective and environmental demands shape attentional control and for informing precise risk prediction and intervention strategies.

Introduction: Secondhand smoke exposure remains a public health concern, particularly for vulnerable populations such as pregnant women. In the ultra-Orthodox community in Israel, cultural norms and religious practices shape health behaviors, including cigarette smoking and exposure. This study explores the perceptions of perinatal secondhand smoke exposure among ultra-Orthodox women in Israel and the influence of cultural and religious factors.

Methods: A qualitative phenomenological study was conducted with seventeen ultra-Orthodox pregnant and postpartum women exposed to smoking at home. Using a semi-structured interview guide, interviews were conducted by a culturally aligned nurse researcher.

Results: Two primary themes emerged from the narratives: "He smokes but not at such amounts that it bothers me" and Smoking is "antithetical to religion." Sixteen women had rules against cigarette smoking at home, although most permitted e-cigarettes in the house, perceiving them as "not as bad." Some of the women identified the risks of secondhand smoke exposure, although none were assessed for or received information about secondhand smoke from healthcare providers.

Conclusions: Secondhanded smoke exposure among ultra-Orthodox pregnant and postpartum women is influenced by socio-cultural and religious factors. Women understood that smoking was unhealthful and often tried to minimize their secondhand smoke exposure although some of the women accepted their husbands' smoking behavior as a norm in their community context. The women perceived smoking as contrary to religious values, despite its prevalence in the community. Healthcare providers must consider these factors, emphasizing culturally sensitive education and engagement with community leaders when developing and implementing interventions.

Implications: Healthcare providers should assess ultra-Orthodox pregnant and postpartum women about smoke exposure at home. It is critical to educate the women about the risks of secondhand smoke from combustible cigarettes and e-cigarettes, explaining that exposure occurs even in the absence of odor. To reduce exposure, advise families to implement rules against smoking in the home and in the proximity of pregnant women and children. Considering religious and cultural needs, coordinate discussions with rabbinic authorities and healthcare providers in their communities to develop culturally respectful recommendations and programs for mitigating secondhand smoke exposure, educating about the risks of smoke exposure framed in a religious context.

Introduction: Among nicotine-naïve youth, cognitive susceptibility (i.e., intentions/willingness to use) is a powerful predictor of initiating use of electronic nicotine delivery systems (ENDS). Our research objective is to examine the time-varying adolescent and family risk and protective factors that may be associated with youth susceptibility to ENDS initiation.

Methods: We used hybrid panel models on longitudinal data from parents and youth aged 12 to 17 in the Population Assessment of Tobacco and Health (PATH) study, followed over 7 survey waves between 2015 and 2023. Analyses included 16,142 nicotine-naïve youth whose ENDS susceptibility was assessed over 43,427 longitudinal observations.

Results: Youth were susceptible to ENDS initiation in 25.9% of longitudinal observations. Youth were more susceptible when they believed using ENDS was safer and less addictive than smoking, when they had high weekly earnings, and when they believed ENDS were easy to buy. Youth problem behaviors, and both parents' and friends' ENDS use, also predicted greater odds of ENDS susceptibility. The odds of susceptibility were lower when youth resided in homes with vaping bans, when they believed their parents would be upset if they started vaping nicotine, and when they were earning good grades. Girls were more susceptible to ENDS initiation than boys.

Conclusions: Parents may be interested in potentially malleable factors associated with greater susceptibility, including youth drinking alcohol, believing ENDS are safer and less addictive than smoking, and having friends who use ENDS. Conversely, maintaining household vaping bans and parental disapproval of ENDS were linked with lower susceptibility.

Implications: Research consistently identifies cognitive susceptibility-defined as intentions and willingness to use ENDS-as a powerful predictor of ENDS initiation in adolescence. Less is known about specific risk factors that heighten nicotine-naïve adolescents' willingness to vape nicotine or protective factors that may deter their intentions to initiate ENDS use. To address this gap, the present study leveraged longitudinal data to identify key adolescent and family risk factors that are associated with youth susceptibility to ENDS initiation.