M. Wang, W. Li, Y. Cheung, Oi Bun Christina Lam, Y. Wu, A. Kwong, V. Lai, S. Chan, T. Lam
Aims To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking. Methods Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment. Results By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months. Conclusions Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence. Implications This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.
目的比较由训练有素的志愿者在不使用药物治疗的情况下，向有意戒烟的香港内地吸烟者提供“减少戒烟”简短建议和“立即戒烟”简短建议的效果。方法将参加2014年戒烟与胜利竞赛并打算戒烟或减少吸烟的吸烟者(N = 1077)随机分为CDTQ组(N = 559)和QI组(N = 518)。CDTQ组的受试者收到了简短的建议和一张关于减少吸烟的卡片。QI组的受试者收到了关于戒烟的简短建议和传单。每隔1周、1个月或2个月，所有人都收到戒烟小册子和相应的CDTQ或QI简短电话咨询。主要结果是在3个月和6个月的随访中自我报告的7天点流行戒断(PPA)。次要结局包括经生化试验验证的戒断率、吸烟减少(较基线减少≥50%)和戒烟尝试(QA)。结果评估者在分组分配方面采用盲法。结果在治疗意向方面，QI组和CDTQ组在(i)自我报告PPA (10.6% [95% CI 8.1%-13.6%]对9.1% [95% CI 6.9%-11.8%])， (ii) 6个月有效戒断率(5.6%[3.8%-7.9%]对5.4%[3.6%-7.6%])和(iii) QA率(59.2%[53.5%-64.8%]对54.1%[48.7%-59.3%])方面显示相似的结果。然而，CDTQ组的降低率明显高于QI组(20.9% [CI 17.6%-24.5%] vs. 14.5% [CI 11.6%-17.8%])。总体干预依从性是次优的(45.4%)，特别是在CDTQ组(42.3%)。6个月时，两组在戒烟方面的自我效能感相似。结论简要建议CDTQ与QI具有相似的短期ppa。需要长期随访来了解减少吸烟对戒烟的潜在影响。这是第一个在华裔吸烟者中进行的随机对照试验，以评估关于戒烟的(a) CDTQ和(b) QI的简短建议的相对疗效。两种干预措施在PPA方面显示出相似的效果。研究结果表明，在社区环境中招募的吸烟者中，对CDTQ的简短建议可能与对QI的简短建议一样有效。
{"title":"Brief Advice on Smoking Reduction Versus Abrupt Quitting for Smoking Cessation in Chinese Smokers: A Cluster Randomized Controlled Trial","authors":"M. Wang, W. Li, Y. Cheung, Oi Bun Christina Lam, Y. Wu, A. Kwong, V. Lai, S. Chan, T. Lam","doi":"10.1093/ntr/ntx026","DOIUrl":"https://doi.org/10.1093/ntr/ntx026","url":null,"abstract":"Aims\u0000To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking.\u0000\u0000\u0000Methods\u0000Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment.\u0000\u0000\u0000Results\u0000By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months.\u0000\u0000\u0000Conclusions\u0000Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence.\u0000\u0000\u0000Implications\u0000This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"42 1","pages":"67–72"},"PeriodicalIF":0.0,"publicationDate":"2017-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85369990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Bold, Grace Kong, D. Cavallo, D. Camenga, S. Krishnan-Sarin
Introduction Identifying youth at risk for future e-cigarette use is critical for informing prevention efforts. Prior research established measures of susceptibility to conventional cigarettes, and this study aimed to examine whether items adapted for e-cigarette susceptibility predicted subsequent e-cigarette use among never e-cigarette users. Methods Longitudinal school-wide survey data were collected from middle and high school students in Fall 2013 (wave 1) and Spring 2014 (wave 2). Among never e-cigarette users at wave 1 (n = 1720), e-cigarette susceptibility was measured by two items assessing anticipation of experimenting with e-cigarettes in the future and willingness to use an e-cigarette if offered by a best friend. Logistic regression models examined susceptibility as a predictor of e-cigarette initiation and past 30-day use 6 months later at wave 2. Models were clustered by school and controlled for sex, age, race, SES, and other substance use (alcohol, marijuana, and other tobacco). Results In total, 8.9% (n = 153) of youth initiated e-cigarettes and 3.7% (n = 63) reported past 30-day use at wave 2. E-cigarette susceptibility was a significant independent predictor of subsequent initiation (OR = 4.27, 95% CI = 3.12-5.85) and past 30-day e-cigarette use (OR = 5.10, 95%CI = 3.38-7.68) 6 months later. Susceptible youth were more likely to be male, older, and have used alcohol, marijuana, or other tobacco products. Conclusions These findings provide initial support for adapting two susceptibility items to identify adolescents at risk for future e-cigarette use. Identifying strategies that are effective for targeting susceptible youth and preventing future e-cigarette use will be critical areas for future research. Implications More than a quarter of the sample who reported both a willingness to try e-cigarettes if offered by a best friend and anticipation of experimenting with e-cigarettes in the future went on to try e-cigarettes within the academic year, suggesting that targeting this group will be critical for preventing youth e-cigarette initiation. There were notable demographic differences between susceptible and non-susceptible youth, suggesting targeting e-cigarette prevention efforts to male students who have used other substances may be especially important for preventing future e-cigarette use. Research is needed to determine the most effective prevention strategies to reach susceptible youth.
{"title":"E-Cigarette Susceptibility as a Predictor of Youth Initiation of E-Cigarettes","authors":"K. Bold, Grace Kong, D. Cavallo, D. Camenga, S. Krishnan-Sarin","doi":"10.1093/ntr/ntw393","DOIUrl":"https://doi.org/10.1093/ntr/ntw393","url":null,"abstract":"Introduction\u0000Identifying youth at risk for future e-cigarette use is critical for informing prevention efforts. Prior research established measures of susceptibility to conventional cigarettes, and this study aimed to examine whether items adapted for e-cigarette susceptibility predicted subsequent e-cigarette use among never e-cigarette users.\u0000\u0000\u0000Methods\u0000Longitudinal school-wide survey data were collected from middle and high school students in Fall 2013 (wave 1) and Spring 2014 (wave 2). Among never e-cigarette users at wave 1 (n = 1720), e-cigarette susceptibility was measured by two items assessing anticipation of experimenting with e-cigarettes in the future and willingness to use an e-cigarette if offered by a best friend. Logistic regression models examined susceptibility as a predictor of e-cigarette initiation and past 30-day use 6 months later at wave 2. Models were clustered by school and controlled for sex, age, race, SES, and other substance use (alcohol, marijuana, and other tobacco).\u0000\u0000\u0000Results\u0000In total, 8.9% (n = 153) of youth initiated e-cigarettes and 3.7% (n = 63) reported past 30-day use at wave 2. E-cigarette susceptibility was a significant independent predictor of subsequent initiation (OR = 4.27, 95% CI = 3.12-5.85) and past 30-day e-cigarette use (OR = 5.10, 95%CI = 3.38-7.68) 6 months later. Susceptible youth were more likely to be male, older, and have used alcohol, marijuana, or other tobacco products.\u0000\u0000\u0000Conclusions\u0000These findings provide initial support for adapting two susceptibility items to identify adolescents at risk for future e-cigarette use. Identifying strategies that are effective for targeting susceptible youth and preventing future e-cigarette use will be critical areas for future research.\u0000\u0000\u0000Implications\u0000More than a quarter of the sample who reported both a willingness to try e-cigarettes if offered by a best friend and anticipation of experimenting with e-cigarettes in the future went on to try e-cigarettes within the academic year, suggesting that targeting this group will be critical for preventing youth e-cigarette initiation. There were notable demographic differences between susceptible and non-susceptible youth, suggesting targeting e-cigarette prevention efforts to male students who have used other substances may be especially important for preventing future e-cigarette use. Research is needed to determine the most effective prevention strategies to reach susceptible youth.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"30 1","pages":"140–144"},"PeriodicalIF":0.0,"publicationDate":"2016-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88004388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellen Meier, Jessica L. Burris, A. Wahlquist, E. Garrett-Mayer, K. Gray, A. Alberg, K. Cummings, M. Carpenter
Introduction Snus uptake is nominal among US smokers. This longitudinal study examines (1) perceptions of snus among US smokers given free snus for 6 weeks and (2) a method for assessment of an alternative tobacco product at the population level. Methods Adult smokers (n = 543; 69.2% female; Mage = 49.3 years), uninterested in quitting, received free snus for ad libitum use. Based on their snus use during a 6-week sampling period, participants included: (1) never users (18.4%, n = 100); (2) experimenters; that is, used ≥ once, but not during the last week of sampling (33.1%; n = 180); and (3) persistent users; that is, used ≥ once during the final week, and ≥ once during any other week of the sampling period. (48.4%; n = 263). Results Following the sampling period, those who became persistent users were more likely than experimenters to report that switching to alternative tobacco products would lower their risk for health problems (66.5% vs. 50.0%; p = .006). Persistent users also reported greater negative affect relief and craving reduction (ps < .001) than experimenters. Finally, persistent users were more likely than experimenters to describe snus in favorable terms with respect to ease of use, satisfaction, and liking (ps < .05). Conclusions Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes. This study design (randomized, yet naturalistic) could be extended to other novel tobacco products, including e-cigarettes, to help understand the role new products may have in the tobacco landscape. Implications This is the first large scale, US-based naturalistic assessment of smokers' reactions to snus during an extended sampling period. This study is directly in line with FDA goals to better understand predictors of initiation, uptake, and use of other tobacco products such as snus, and serves as model for assessment methods of alternative tobacco products at the population level. Most smokers tried the provided sample of snus (approximately 82%). Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes.
{"title":"Perceptions of Snus Among US Adult Smokers Given Free Product","authors":"Ellen Meier, Jessica L. Burris, A. Wahlquist, E. Garrett-Mayer, K. Gray, A. Alberg, K. Cummings, M. Carpenter","doi":"10.1093/ntr/ntw392","DOIUrl":"https://doi.org/10.1093/ntr/ntw392","url":null,"abstract":"Introduction\u0000Snus uptake is nominal among US smokers. This longitudinal study examines (1) perceptions of snus among US smokers given free snus for 6 weeks and (2) a method for assessment of an alternative tobacco product at the population level.\u0000\u0000\u0000Methods\u0000Adult smokers (n = 543; 69.2% female; Mage = 49.3 years), uninterested in quitting, received free snus for ad libitum use. Based on their snus use during a 6-week sampling period, participants included: (1) never users (18.4%, n = 100); (2) experimenters; that is, used ≥ once, but not during the last week of sampling (33.1%; n = 180); and (3) persistent users; that is, used ≥ once during the final week, and ≥ once during any other week of the sampling period. (48.4%; n = 263).\u0000\u0000\u0000Results\u0000Following the sampling period, those who became persistent users were more likely than experimenters to report that switching to alternative tobacco products would lower their risk for health problems (66.5% vs. 50.0%; p = .006). Persistent users also reported greater negative affect relief and craving reduction (ps < .001) than experimenters. Finally, persistent users were more likely than experimenters to describe snus in favorable terms with respect to ease of use, satisfaction, and liking (ps < .05).\u0000\u0000\u0000Conclusions\u0000Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes. This study design (randomized, yet naturalistic) could be extended to other novel tobacco products, including e-cigarettes, to help understand the role new products may have in the tobacco landscape.\u0000\u0000\u0000Implications\u0000This is the first large scale, US-based naturalistic assessment of smokers' reactions to snus during an extended sampling period. This study is directly in line with FDA goals to better understand predictors of initiation, uptake, and use of other tobacco products such as snus, and serves as model for assessment methods of alternative tobacco products at the population level. Most smokers tried the provided sample of snus (approximately 82%). Subjective experiences with snus, rather than nicotine dependence, explained experimentation versus persistent use. Even among smokers who became persistent snus users, snus was perceived as a poor substitute for cigarettes.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"58 1","pages":"22–29"},"PeriodicalIF":0.0,"publicationDate":"2016-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90189436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Adolescent electronic cigarette ("e-cigarette") use tripled in recent years, yet little is known about the school-level correlates of teenage e-cigarette use, harm and risk perceptions, or pre-use intentions to use. Methods Multilevel regression and 2014 National Youth Tobacco Survey data were used to assess school-level e-cigarette prevalence and person-level e-cigarette use as well as age at initiation and frequency of use (among initiates), expectations for future use (among abstainers), and perceived e-cigarette addictivity and harm. Results Lifetime use was higher among students in medium- (odds ratio [OR] = 2.30, 95% confidence interval [CI] = 1.82, 2.89) and high- (OR = 4.66, 95% CI = 3.67, 5.90) versus low-use schools. Past 30-day use followed a similar pattern. Multilevel ordinal logistic models revealed that initiates from high-use schools reported more days of use in the past month (OR = 2.25, 95% CI = 1.52, 3.33) and higher age-at-first-use (OR = 1.45, 95% CI = 1.08, 2.00) than students at low-use schools. Expectations for future use were higher among abstainers from medium- and high- versus low-use schools, and among all students, perceived addictivity and harm caused by e-cigarettes were lower in medium- and high- versus low-use schools. Conclusion School context is associated with multiple dimensions of e-cigarette use, pre-use intentions, and perceptions of e-cigarette health risks. Implications The current study demonstrates a link between school prevalence of e-cigarette use and student-level use, as well as perceived risks of e-cigarette use, age of initiation and frequency of use among users, and intentions to use among abstainers. Health communication and prevention initiatives should target school social environments to promote nicotine abstinence and a culture of health.
近年来，青少年电子烟(“电子烟”)的使用量增加了两倍，但对青少年电子烟使用、危害和风险认知或使用前使用意图在学校层面的相关性知之甚少。方法采用多水平回归和2014年全国青少年烟草调查数据来评估学校层面的电子烟流行情况和个人层面的电子烟使用情况，以及开始使用电子烟的年龄和频率，对未来使用电子烟的预期(戒烟者)，以及对电子烟成瘾和危害的感知。结果中效学校(比值比[OR] = 2.30, 95%可信区间[CI] = 1.82, 2.89)和高效学校(OR = 4.66, 95% CI = 3.67, 5.90)学生的生活时间使用高于低效学校。过去30天的使用情况与此类似。多层有序逻辑模型显示，与低使用率学校的学生相比，高使用率学校的新生报告在过去一个月里使用手机的天数更多(OR = 2.25, 95% CI = 1.52, 3.33)，第一次使用手机的年龄更高(OR = 1.45, 95% CI = 1.08, 2.00)。与低使用学校相比，中、高使用学校的戒毒者对未来使用电子烟的期望更高，在所有学生中，中、高使用学校的戒毒者对电子烟的成瘾程度和危害程度低于低使用学校。结论:学校环境与电子烟使用、使用前意图和对电子烟健康风险的认知的多个维度有关。目前的研究表明，学校电子烟使用的流行程度与学生水平的使用之间存在联系，以及使用电子烟的感知风险、用户开始使用的年龄和使用频率以及戒烟者的使用意图之间存在联系。健康沟通和预防举措应针对学校和社会环境，以促进尼古丁戒断和健康文化。
{"title":"Association Between School-Level Prevalence of Electronic Cigarette Use and Student-Level Use Behaviors, Pre-Use Intentions, and Risk Perceptions: Evidence From the 2014 US National Youth Tobacco Survey","authors":"Adam M. Lippert","doi":"10.1093/ntr/ntw395","DOIUrl":"https://doi.org/10.1093/ntr/ntw395","url":null,"abstract":"Background\u0000Adolescent electronic cigarette (\"e-cigarette\") use tripled in recent years, yet little is known about the school-level correlates of teenage e-cigarette use, harm and risk perceptions, or pre-use intentions to use.\u0000\u0000\u0000Methods\u0000Multilevel regression and 2014 National Youth Tobacco Survey data were used to assess school-level e-cigarette prevalence and person-level e-cigarette use as well as age at initiation and frequency of use (among initiates), expectations for future use (among abstainers), and perceived e-cigarette addictivity and harm.\u0000\u0000\u0000Results\u0000Lifetime use was higher among students in medium- (odds ratio [OR] = 2.30, 95% confidence interval [CI] = 1.82, 2.89) and high- (OR = 4.66, 95% CI = 3.67, 5.90) versus low-use schools. Past 30-day use followed a similar pattern. Multilevel ordinal logistic models revealed that initiates from high-use schools reported more days of use in the past month (OR = 2.25, 95% CI = 1.52, 3.33) and higher age-at-first-use (OR = 1.45, 95% CI = 1.08, 2.00) than students at low-use schools. Expectations for future use were higher among abstainers from medium- and high- versus low-use schools, and among all students, perceived addictivity and harm caused by e-cigarettes were lower in medium- and high- versus low-use schools.\u0000\u0000\u0000Conclusion\u0000School context is associated with multiple dimensions of e-cigarette use, pre-use intentions, and perceptions of e-cigarette health risks.\u0000\u0000\u0000Implications\u0000The current study demonstrates a link between school prevalence of e-cigarette use and student-level use, as well as perceived risks of e-cigarette use, age of initiation and frequency of use among users, and intentions to use among abstainers. Health communication and prevention initiatives should target school social environments to promote nicotine abstinence and a culture of health.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"16 1","pages":"231–238"},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89197924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erika S. Trapl, Sarah Koopman Gonzalez, Leslie E. Cofie, Laura D Yoder, Jean L. Frank, K. Sterling
Introduction Prevalence of cigar use has been increasing among youth. Research indicates that youth are modifying cigar products either by "freaking" (ie, removing the filter paper) or "blunting" (removing the tobacco and supplementing or replacing with marijuana), yet little is known about youth who engage in this behavior. Thus, this study examines demographic and concurrent substance use behaviors of youth who modify cigars. Methods Data from the 2013 Cuyahoga County Youth Risk Behavior survey were examined (n = 16 855). The survey collected data on demographics, cigar product use, cigar modification behaviors, and current cigarette, hookah and marijuana use. Responses to cigar product use items were used to create a composite to classify youth in one of eight unique user categories. Univariate and bivariate statistics were calculated using SPSS complex samples procedures. Results Overall, 15.2% reported current cigar product use, 11.0% reported current freaking, and 18.5% reported current blunt use; taken together, 25.3% of respondents reported any current use of a cigar product. When examined by user category, of those who endorsed any cigar product use, cigars, cigarillos, and little cigars use only was most endorsed (26.3%), followed by Blunt only (25.2%) and all three (ie, cigars, cigarillos, and little cigars, freaking, and blunting; 17.4%). Conclusion A substantial proportion of high school youth who report using cigar products are modifying them in some way, with nearly half freaking and nearly two-thirds blunting. Given the FDA Center for Tobacco products recent extension of its regulatory authority to include cigar products, it is imperative to understand more about the prevalence of and reasons for cigar modification behaviors. Implications Although the FDA has recently enacted regulatory authority over cigar products, little is known about cigar product modification. This is the first study to concurrently examine two unique cigar modification behaviors, "freaking" (ie, removing the filter paper) and "blunting" (removing the tobacco and supplementing or replacing with marijuana). A significant proportion of high school youth are modifying cigar products to be used as a tobacco product and as a mechanism to smoke marijuana. More research is needed to understand these behaviors to prevent and reduce the use of cigar products among youth.
{"title":"Cigar Product Modification Among High School Youth","authors":"Erika S. Trapl, Sarah Koopman Gonzalez, Leslie E. Cofie, Laura D Yoder, Jean L. Frank, K. Sterling","doi":"10.1093/ntr/ntw328","DOIUrl":"https://doi.org/10.1093/ntr/ntw328","url":null,"abstract":"Introduction\u0000Prevalence of cigar use has been increasing among youth. Research indicates that youth are modifying cigar products either by \"freaking\" (ie, removing the filter paper) or \"blunting\" (removing the tobacco and supplementing or replacing with marijuana), yet little is known about youth who engage in this behavior. Thus, this study examines demographic and concurrent substance use behaviors of youth who modify cigars.\u0000\u0000\u0000Methods\u0000Data from the 2013 Cuyahoga County Youth Risk Behavior survey were examined (n = 16 855). The survey collected data on demographics, cigar product use, cigar modification behaviors, and current cigarette, hookah and marijuana use. Responses to cigar product use items were used to create a composite to classify youth in one of eight unique user categories. Univariate and bivariate statistics were calculated using SPSS complex samples procedures.\u0000\u0000\u0000Results\u0000Overall, 15.2% reported current cigar product use, 11.0% reported current freaking, and 18.5% reported current blunt use; taken together, 25.3% of respondents reported any current use of a cigar product. When examined by user category, of those who endorsed any cigar product use, cigars, cigarillos, and little cigars use only was most endorsed (26.3%), followed by Blunt only (25.2%) and all three (ie, cigars, cigarillos, and little cigars, freaking, and blunting; 17.4%).\u0000\u0000\u0000Conclusion\u0000A substantial proportion of high school youth who report using cigar products are modifying them in some way, with nearly half freaking and nearly two-thirds blunting. Given the FDA Center for Tobacco products recent extension of its regulatory authority to include cigar products, it is imperative to understand more about the prevalence of and reasons for cigar modification behaviors.\u0000\u0000\u0000Implications\u0000Although the FDA has recently enacted regulatory authority over cigar products, little is known about cigar product modification. This is the first study to concurrently examine two unique cigar modification behaviors, \"freaking\" (ie, removing the filter paper) and \"blunting\" (removing the tobacco and supplementing or replacing with marijuana). A significant proportion of high school youth are modifying cigar products to be used as a tobacco product and as a mechanism to smoke marijuana. More research is needed to understand these behaviors to prevent and reduce the use of cigar products among youth.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"83 1","pages":"370–376"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76949939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Snus may present lower health risks than cigarettes, but its harm reduction potential may be undermined if used dually with cigarettes. The likelihood of exclusive snus use compared with dual use may depend in part on the capacity of snus to deliver nicotine in doses that are satisfactory to smokers. We examined characteristics of "American snus" products, including nicotine levels, and compared to snus products that are more typical of Sweden. Methods Tobacco industry reports for snus products submitted to the Massachusetts Department of Public Health for the year 2014 were used to assess moisture (%), pH, total nicotine, and unionized (free) nicotine (both mg/g and percent of total). A total of 14 ("American") snus products made by American manufacturers Philip Morris USA (n = 6), R.J. Reynolds Tobacco Company (n = 6), and US Smokeless Tobacco Company (n = 2), were compared with Swedish-style ("Swedish") snus products (n = 10) made by Swedish Match North America. Results Compared with Swedish snus, American snus brands contained significantly lower concentrations of unionized nicotine (median: 0.52 mg/g vs. 6.52 mg/g; p < .001) and proportion of unionized nicotine (median: 3.17% vs. 81.8%; p < .001). American snus brands also had significantly lower pH (median: 6.54 vs. 8.68; p < .001) and moisture (median: 30.3% vs. 53.4%; p < .001). Conclusions Swedish-made snus has higher unionized nicotine, measured by concentration and proportion of total nicotine, compared with snus products made by American manufacturers. These findings suggest that American snus products have lower addiction potential than Swedish snus, and may be more likely to be used dually with cigarettes than as a sole source of nicotine. Implications American snus products contain significantly lower unionized nicotine, lower pH, and lower moisture, compared with Swedish snus products. Snus addiction potential and patterns of usage, including co-use with cigarettes, may differ between American and Swedish snus products due to differences in snus product characteristics.
鼻烟的健康风险可能比香烟低，但如果与香烟同时使用，其减少危害的潜力可能会被削弱。与双重用途相比，单独使用鼻烟的可能性部分取决于鼻烟以吸烟者满意的剂量提供尼古丁的能力。我们研究了“美国鼻烟”产品的特征，包括尼古丁水平，并将其与更典型的瑞典鼻烟产品进行了比较。方法采用2014年烟草业向马萨诸塞州公共卫生部门提交的鼻烟产品报告，评估鼻烟产品的水分(%)、pH、总尼古丁和游离尼古丁(mg/g和占总尼古丁的百分比)。将美国制造商菲利普莫里斯美国公司(n = 6)、雷诺烟草公司(n = 6)和美国无烟烟草公司(n = 2)生产的14种(“美式”)鼻烟产品与瑞典火柴北美公司生产的瑞典风格(“Swedish”)鼻烟产品(n = 10)进行比较。结果与瑞典鼻烟相比，美国品牌鼻烟的游离尼古丁浓度显著低于瑞典品牌(中位数:0.52 mg/g vs. 6.52 mg/g;P < 0.001)和尼古丁结块比例(中位数:3.17% vs. 81.8%;P < 0.001)。美国鼻烟品牌的pH值也明显较低(中位数:6.54 vs. 8.68;P < 0.001)和湿度(中位数:30.3% vs. 53.4%;P < 0.001)。结论瑞典产鼻烟的总烟碱浓度和总烟碱比例高于美国产鼻烟。这些发现表明，美国鼻烟产品比瑞典鼻烟具有更低的成瘾潜力，并且可能更有可能与香烟双重使用，而不是作为尼古丁的唯一来源。与瑞典鼻烟产品相比，美国鼻烟产品含有明显较低的游离尼古丁，较低的pH值和较低的水分。由于鼻烟产品特性的差异，美国和瑞典的鼻烟产品可能会导致鼻烟成瘾的可能性和使用模式，包括与香烟共同使用。
{"title":"Characteristics of “American Snus” and Swedish Snus Products for Sale in Massachusetts, USA","authors":"A. Seidenberg, O. Ayo-Yusuf, V. Rees","doi":"10.1093/ntr/ntw334","DOIUrl":"https://doi.org/10.1093/ntr/ntw334","url":null,"abstract":"Introduction\u0000Snus may present lower health risks than cigarettes, but its harm reduction potential may be undermined if used dually with cigarettes. The likelihood of exclusive snus use compared with dual use may depend in part on the capacity of snus to deliver nicotine in doses that are satisfactory to smokers. We examined characteristics of \"American snus\" products, including nicotine levels, and compared to snus products that are more typical of Sweden.\u0000\u0000\u0000Methods\u0000Tobacco industry reports for snus products submitted to the Massachusetts Department of Public Health for the year 2014 were used to assess moisture (%), pH, total nicotine, and unionized (free) nicotine (both mg/g and percent of total). A total of 14 (\"American\") snus products made by American manufacturers Philip Morris USA (n = 6), R.J. Reynolds Tobacco Company (n = 6), and US Smokeless Tobacco Company (n = 2), were compared with Swedish-style (\"Swedish\") snus products (n = 10) made by Swedish Match North America.\u0000\u0000\u0000Results\u0000Compared with Swedish snus, American snus brands contained significantly lower concentrations of unionized nicotine (median: 0.52 mg/g vs. 6.52 mg/g; p < .001) and proportion of unionized nicotine (median: 3.17% vs. 81.8%; p < .001). American snus brands also had significantly lower pH (median: 6.54 vs. 8.68; p < .001) and moisture (median: 30.3% vs. 53.4%; p < .001).\u0000\u0000\u0000Conclusions\u0000Swedish-made snus has higher unionized nicotine, measured by concentration and proportion of total nicotine, compared with snus products made by American manufacturers. These findings suggest that American snus products have lower addiction potential than Swedish snus, and may be more likely to be used dually with cigarettes than as a sole source of nicotine.\u0000\u0000\u0000Implications\u0000American snus products contain significantly lower unionized nicotine, lower pH, and lower moisture, compared with Swedish snus products. Snus addiction potential and patterns of usage, including co-use with cigarettes, may differ between American and Swedish snus products due to differences in snus product characteristics.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"9 1","pages":"262–266"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81854377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kim Pulvers, Ashley S Emami, Nicole L. Nollen, Devan R Romero, D. Strong, N. Benowitz, J. Ahluwalia
Background There is considerable debate about the benefits and risks of electronic cigarettes (ECs). To better understand the risk-benefit ratio of ECs, more information is needed about net nicotine consumption and toxicant exposure of cigarette smokers switching to ECs. Methods Forty cigarette smokers (≥1 year of smoking) interested in switching to ECs but not necessarily quitting smoking were enrolled in a 4-week observational study and provided an e-Go C non-variable battery and refillable atomizers and choice of eight flavors in 12 or 24 mg nicotine dosage. Measurement of urinary cotinine (metabolite of nicotine), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; a pulmonary carcinogen), and eight volatile organic compounds (VOCs) that are toxic tobacco smoke constituents was conducted at baseline and week 4. Results All participants with follow-up data (92.5%) reported using the study EC. Of the 40 smokers, 16 reported no cigarettes at week 2 (40%) and six continued to report no cigarettes at week 4 (15%). Change in nicotine intake over the 4 weeks was non-significant (p = .90). Carbon monoxide (p < .001), NNAL (p < .01) and metabolites of benzene (p < .01) and acrylonitrile (p = .001) were significantly decreased in the study sample. Smokers switching exclusively to ECs for at least half of the study period demonstrated significant reductions in metabolites of ethylene oxide (p = .03) and acrylamide (p < .01). Conclusion Smokers using ECs over 4 weeks maintained cotinine levels and experienced significant reductions in carbon monoxide, NNAL, and two out of eight measured VOC metabolites. Those who switched exclusively to ECs for at least half of the study period significantly reduced two additional VOCs. Implications This study extends current literature by measuring change in smoking dependence and disease-associated biomarkers, NNAL and a panel of eight common VOCs that are toxic tobacco smoke constituents in smokers who switch to ECs. The findings support the idea of harm reduction, however some levels of toxicant exposure are still of clinical concern, particularly for dual users. Extrapolation of these results must be careful to separate the different toxic exposure results for exclusive switchers versus dual cigarette + EC users, and not to equate harm reduction with the idea that using ECs is harmless.
{"title":"Tobacco Consumption and Toxicant Exposure of Cigarette Smokers Using Electronic Cigarettes","authors":"Kim Pulvers, Ashley S Emami, Nicole L. Nollen, Devan R Romero, D. Strong, N. Benowitz, J. Ahluwalia","doi":"10.1093/ntr/ntw333","DOIUrl":"https://doi.org/10.1093/ntr/ntw333","url":null,"abstract":"Background\u0000There is considerable debate about the benefits and risks of electronic cigarettes (ECs). To better understand the risk-benefit ratio of ECs, more information is needed about net nicotine consumption and toxicant exposure of cigarette smokers switching to ECs.\u0000\u0000\u0000Methods\u0000Forty cigarette smokers (≥1 year of smoking) interested in switching to ECs but not necessarily quitting smoking were enrolled in a 4-week observational study and provided an e-Go C non-variable battery and refillable atomizers and choice of eight flavors in 12 or 24 mg nicotine dosage. Measurement of urinary cotinine (metabolite of nicotine), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; a pulmonary carcinogen), and eight volatile organic compounds (VOCs) that are toxic tobacco smoke constituents was conducted at baseline and week 4.\u0000\u0000\u0000Results\u0000All participants with follow-up data (92.5%) reported using the study EC. Of the 40 smokers, 16 reported no cigarettes at week 2 (40%) and six continued to report no cigarettes at week 4 (15%). Change in nicotine intake over the 4 weeks was non-significant (p = .90). Carbon monoxide (p < .001), NNAL (p < .01) and metabolites of benzene (p < .01) and acrylonitrile (p = .001) were significantly decreased in the study sample. Smokers switching exclusively to ECs for at least half of the study period demonstrated significant reductions in metabolites of ethylene oxide (p = .03) and acrylamide (p < .01).\u0000\u0000\u0000Conclusion\u0000Smokers using ECs over 4 weeks maintained cotinine levels and experienced significant reductions in carbon monoxide, NNAL, and two out of eight measured VOC metabolites. Those who switched exclusively to ECs for at least half of the study period significantly reduced two additional VOCs.\u0000\u0000\u0000Implications\u0000This study extends current literature by measuring change in smoking dependence and disease-associated biomarkers, NNAL and a panel of eight common VOCs that are toxic tobacco smoke constituents in smokers who switch to ECs. The findings support the idea of harm reduction, however some levels of toxicant exposure are still of clinical concern, particularly for dual users. Extrapolation of these results must be careful to separate the different toxic exposure results for exclusive switchers versus dual cigarette + EC users, and not to equate harm reduction with the idea that using ECs is harmless.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"29 1","pages":"206–214"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78148238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miranda R. Jones, C. Joshu, A. Navas-Acien, E. Platz
Introduction The burden of tobacco-related disease is not uniformly distributed across racial/ethnic groups. Differences in smoking duration by race/ethnicity may contribute to this disparity. Previous studies have examined racial/ethnic differences in smoking duration among ever smokers (former and current smokers combined). It is unknown if racial/ethnic differences in smoking duration are evident among quitters. This study examined racial/ethnic differences in duration of smoking among former smokers in the United States. Methods We studied 6030 white, black, and Mexican-American former smokers (3647 men and 2383 women) aged 20-79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2012. Mean differences in smoking duration by race/ethnicity were estimated using linear regression models. Results After adjustment for demographics, age at smoking initiation and smoking intensity, compared to white men, black men smoked for 2.3 (95% confidence interval [CI]: 1.3, 3.3) years longer before quitting and Mexican-American men for 0.2 (95% CI: -1.6, 1.2) years less before quitting. Compared to white women, black women smoked for 1.9 (95% CI: 0.7, 3.0) years longer before quitting and Mexican-American women for 0.9 (95% CI: -2.4, 0.5) years less before quitting. Conclusions In a representative sample of US adults, black former smokers continued smoking for longer periods before quitting compared to white former smokers. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors. The longer time to quit among black former smokers should be investigated as an explanation for racial/ethnic disparities in smoking-associated diseases. Implications In a representative sample of US adults that successfully quit smoking, the timing of smoking cessation differed by race/ethnicity with blacks smoking for longer periods before quitting compared to whites. Racial/ethnic differences in duration of smoking among former smokers differed by participant age and age at smoking initiation. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors.
{"title":"Racial/Ethnic Differences in Duration of Smoking Among Former Smokers in the National Health and Nutrition Examination Surveys","authors":"Miranda R. Jones, C. Joshu, A. Navas-Acien, E. Platz","doi":"10.1093/ntr/ntw326","DOIUrl":"https://doi.org/10.1093/ntr/ntw326","url":null,"abstract":"Introduction\u0000The burden of tobacco-related disease is not uniformly distributed across racial/ethnic groups. Differences in smoking duration by race/ethnicity may contribute to this disparity. Previous studies have examined racial/ethnic differences in smoking duration among ever smokers (former and current smokers combined). It is unknown if racial/ethnic differences in smoking duration are evident among quitters. This study examined racial/ethnic differences in duration of smoking among former smokers in the United States.\u0000\u0000\u0000Methods\u0000We studied 6030 white, black, and Mexican-American former smokers (3647 men and 2383 women) aged 20-79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2012. Mean differences in smoking duration by race/ethnicity were estimated using linear regression models.\u0000\u0000\u0000Results\u0000After adjustment for demographics, age at smoking initiation and smoking intensity, compared to white men, black men smoked for 2.3 (95% confidence interval [CI]: 1.3, 3.3) years longer before quitting and Mexican-American men for 0.2 (95% CI: -1.6, 1.2) years less before quitting. Compared to white women, black women smoked for 1.9 (95% CI: 0.7, 3.0) years longer before quitting and Mexican-American women for 0.9 (95% CI: -2.4, 0.5) years less before quitting.\u0000\u0000\u0000Conclusions\u0000In a representative sample of US adults, black former smokers continued smoking for longer periods before quitting compared to white former smokers. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors. The longer time to quit among black former smokers should be investigated as an explanation for racial/ethnic disparities in smoking-associated diseases.\u0000\u0000\u0000Implications\u0000In a representative sample of US adults that successfully quit smoking, the timing of smoking cessation differed by race/ethnicity with blacks smoking for longer periods before quitting compared to whites. Racial/ethnic differences in duration of smoking among former smokers differed by participant age and age at smoking initiation. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"38 1","pages":"303–311"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85815401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Jitnarin, W. Poston, C. Haddock, S. Jahnke, R. S. Day, H. Severson
Introduction Prevalence rates of smokeless tobacco (SLT) use and late initiation among firefighters (ie, starting use as an adult after joining the fire service) are remarkably high, 10.5% and 26.0%, respectively. The purpose of this study is to examine characteristics associated with late SLT initiation in a sample comprised of male career firefighters from two large cohort studies. Methods We examined correlates of late SLT initiation in a secondary analysis of data combining the baseline evaluations of two published firefighter health studies with 1474 male career firefighters in the United States. Results Fourteen percent of participants were current SLT users. Among this group, the unadjusted rate of firefighters who initiated SLT use after joining the fire service was 15.9%, while the age-standardized rate was 38.2%; this is substantially higher than the national adjusted late initiation rate among adult males (0.8%). In addition, firefighters demonstrated higher rates of late SLT initiation (15.9% unadjusted; 18.4% age-standardized) when compared to males in the military overall (13.8%). Conclusions The exceptionally high prevalence of SLT use overall and late initiation in the fire service suggest that joining the fire service in the United States is a risk factor for SLT use. There is a need to develop interventions aimed at reducing SLT use in the fire service that are specifically tailored for this occupational group. Implications The high prevalence of late SLT initiation (ie, starting use as an adult after joining the fire service) among firefighters should be addressed by both researchers and fire service organizations given the significant health risks associated with SLT and its impact on occupational readiness. There is a need for developing intervention programs aimed at reducing SLT use in the fire service. Interventions would need to be specifically tailored for this occupational group and their unique culture, given that joining the fire service appears to be a risk factor for SLT initiation among firefighters who did not use tobacco prior to joining the fire service.
{"title":"Prevalence and Correlates of Late Initiation of Smokeless Tobacco in US Firefighters","authors":"N. Jitnarin, W. Poston, C. Haddock, S. Jahnke, R. S. Day, H. Severson","doi":"10.1093/ntr/ntw321","DOIUrl":"https://doi.org/10.1093/ntr/ntw321","url":null,"abstract":"Introduction\u0000Prevalence rates of smokeless tobacco (SLT) use and late initiation among firefighters (ie, starting use as an adult after joining the fire service) are remarkably high, 10.5% and 26.0%, respectively. The purpose of this study is to examine characteristics associated with late SLT initiation in a sample comprised of male career firefighters from two large cohort studies.\u0000\u0000\u0000Methods\u0000We examined correlates of late SLT initiation in a secondary analysis of data combining the baseline evaluations of two published firefighter health studies with 1474 male career firefighters in the United States.\u0000\u0000\u0000Results\u0000Fourteen percent of participants were current SLT users. Among this group, the unadjusted rate of firefighters who initiated SLT use after joining the fire service was 15.9%, while the age-standardized rate was 38.2%; this is substantially higher than the national adjusted late initiation rate among adult males (0.8%). In addition, firefighters demonstrated higher rates of late SLT initiation (15.9% unadjusted; 18.4% age-standardized) when compared to males in the military overall (13.8%).\u0000\u0000\u0000Conclusions\u0000The exceptionally high prevalence of SLT use overall and late initiation in the fire service suggest that joining the fire service in the United States is a risk factor for SLT use. There is a need to develop interventions aimed at reducing SLT use in the fire service that are specifically tailored for this occupational group.\u0000\u0000\u0000Implications\u0000The high prevalence of late SLT initiation (ie, starting use as an adult after joining the fire service) among firefighters should be addressed by both researchers and fire service organizations given the significant health risks associated with SLT and its impact on occupational readiness. There is a need for developing intervention programs aimed at reducing SLT use in the fire service. Interventions would need to be specifically tailored for this occupational group and their unique culture, given that joining the fire service appears to be a risk factor for SLT initiation among firefighters who did not use tobacco prior to joining the fire service.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"34 1","pages":"130–134"},"PeriodicalIF":0.0,"publicationDate":"2016-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76127843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Khan, S. Khan, L. Christianson, S. Rehman, O. Ekwunife, Florence Samkange-Zeeb
Implications More than 250 million South and South East Asians use SLT in some form. As cigarettes prices climb up all over the world, more people could potentially take up SLT, particularly in the absence of epidemiological evidence regarding the harmful effects of these products, and SLT being advocated as a means of tobacco harm reduction. Our findings are thus relevant and timely in highlighting the harmful effects of SLT use, with a potential of influencing tobacco control policies in South Asia and beyond.
{"title":"Smokeless Tobacco and Oral Potentially Malignant Disorders in South Asia: A Systematic Review and Meta-analysis","authors":"Z. Khan, S. Khan, L. Christianson, S. Rehman, O. Ekwunife, Florence Samkange-Zeeb","doi":"10.1093/ntr/ntw310","DOIUrl":"https://doi.org/10.1093/ntr/ntw310","url":null,"abstract":"Implications\u0000More than 250 million South and South East Asians use SLT in some form. As cigarettes prices climb up all over the world, more people could potentially take up SLT, particularly in the absence of epidemiological evidence regarding the harmful effects of these products, and SLT being advocated as a means of tobacco harm reduction. Our findings are thus relevant and timely in highlighting the harmful effects of SLT use, with a potential of influencing tobacco control policies in South Asia and beyond.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"79 1","pages":"12–21"},"PeriodicalIF":0.0,"publicationDate":"2016-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85529097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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