Tobacco Use Insights最新文献

Background: E-cigarette use among young people has increased significantly in recent years, and their health impact is a concern. Countries are challenged to define an effective regulatory and public health response. In Ireland, information is limited in terms of access, knowledge, and the context in which e-cigarettes are used. The study aims to provide an in-depth understanding of these factors to help develop policies and interventions to combat e-cigarette use among young people.

Method: Focus groups of children aged 15-16 years (n = 76) were conducted in three schools. A topic guide was utilised to facilitate discussion. Topics were introduced using a third person technique, asking participants to discuss them in terms of schoolchildren in general. Focus groups were recorded, transcribed, and thematically analysed.

Results: E-cigarettes are popular, with the emergence of a sub-culture of young users. Risk awareness of nicotine, or the health effects of e-cigarettes was unclear. Few had seen e-cigarette warning labels. There was a lack of school education about e-cigarettes. E-cigarettes were used in locations where they can be concealed. There was an awareness of the e-cigarette flavours, with sweet and fruity flavours being popular. E-cigarettes were easy to access, particularly by using social media, with online buying and selling online between schoolchildren. Pop up adverts with discount codes were common plus social media was used to view videos of 'vape tricks'. Smoking, alcohol consumption, and use of e-cigarettes were interlinked; participants felt that those who smoked or vaped also consumed alcohol, which would often be consumed at the same time. Alcohol may influence the decision to experiment with e-cigarettes and other substances.

Conclusions: The study highlights the urgent need for further policy action, including better education for children and parents, regulating social venues and advertising, and restricting flavours and product placement of e-cigarettes.

Background: Globally, workplaces have introduced non-smokers-only hiring policies to avoid hiring people who smoke since they cost thousands of dollars more annually to employ compared to non-smokers. Tobacco industry efforts gave rise to state smoker protection laws in the United States (U.S.), which protect people who smoke from employment discrimination.

Objectives: This study examined the association between living in a state with a smoker protection law and smoking status among U.S. adults and employment status and attempting to quit smoking in the past 12 months among those who currently smoke.

Design and methods: Cross-sectional, nationally representative data from the 2015 - 2018 Behavioral Risk Factor Surveillance System were analyzed. Participants were U.S. adults who reported being unemployed or employed for wages. Unadjusted and adjusted logistic regression models controlling for race/ethnicity, income, education, health insurance, state, and sex assessed associations between living in a state with a smoker protection law and smoking status (n = 678,203) and employment status and attempting to quit smoking in the past 12 months among people who currently smoke (n = 110,630). Interactions for income were assessed.

Results: Smoker protection laws were not associated with smoking status in the overall sample (OR_adj = 0.99, 95% CI: 0.89, 1.11) or employment among those who smoke (OR_adj = 1.23, 95% CI: 0.92, 1.65). They were associated with a significantly higher odds of being employed (OR_adj = 1.30, 95% CI: 1.06, 1.60) among those who smoke earning <$35,000. They were associated with a significantly lower odds of attempting to quit smoking among people who smoke (OR_adj = 0.80, 95% CI: 0.66, 0.97), especially those earning <$35,000 (OR_adj = 0.71, 95% CI: 0.53, 0.96) and $35,000-<$50,000 (OR_adj. = 0.52, 95% CI: 0.32, 0.84).

Conclusions: While smoker protection laws may promote employment among low-income individuals who smoke, they may reduce quit attempts. Policies should promote evidence-based smoking cessation treatments to support quit attempts among people who smoke.

Background: Nicotine pouches (NPs) are smokeless, tobacco-free products gaining global popularity, particularly among youth, for perceived harm reduction. However, many concerns remain regarding their side effects, addictive potential and cardiovascular risks as they avoid the inhalation of smoke but still pose toxicity. Research on NP use patterns in regions such as Saudi Arabia is lacking.

Methods: A cross-sectional survey was conducted online from March to August 2025 targeting NP users aged 18 years or older in Saudi Arabia. The employed questionnaire evaluated demographics, usage habits, health impacts, dependency levels and risk perception. Descriptive statistics and Chi-square tests (P < .05) were used to analyze the collected data.

Results: Most participants were male (92.17%), aged 18-24 (46.18%), and Saudi (97.85%), with 88.45% reporting no chronic disease. Nearly half were former smokers (49.51%), 29.35% current, and 21.14% never smokers. The most used NP strength was 10 mg (59.16%), with 61.45% using 1-5 pouches/day; 72.41% reported adequate craving control. Main perceived benefits included being smoke-free (61.45%), odor-free (61.25%), and aiding cessation (58.12%). Common symptoms were nausea (47.55%) and dizziness (32.68%). Craving control was associated with dosage (P = .018), dependence with perceived advantages (P < .001), and quitting intentions with smoking status (P < .001).

Conclusion: Nicotine pouch consumption in Saudi Arabia is prevalent among young current and former smokers, valued for perceived safety, affordability, and cessation support. Stronger strengths and frequent use correlated with greater dependency and motivation to quit. While effective for craving control, reported side effects highlight the need to raise awareness of potential health risks from long-term use.

Background: This study examines the geographic representativeness of people who smoke, among newly registered users of a free digital tobacco cessation program ('EX').

Methods: User-provided ZIP codes from EX® Program registrants were mapped to Rural Urban Continuum Codes (RUCC). Reach Ratios (ReRas) and 95% confidence intervals were used to determine the extent to which geographic representation in EX was proportionate to their representation in the national population of individuals who smoke, as obtained from the United States National Survey of Drug Use and Health (2018-2020). Under- and overrepresentation was demonstrated by ReRas <1 or >1, respectively. Joinpoint regression analyses were used to determine significant changes in trend for ReRas from 2013 to 2020.

Results: Individuals who reported smoking residing in nonmetro rural areas were significantly overrepresented in 2018 [ReRa = 1.18 (95% CI: 1.15, 1.23)], 2019 [ReRa = 1.10 (95% CI: 1.07, 1.13)], and 2020 [ReRa = 1.10 (95% CI: 1.06, 1.13)]. Individuals who reported smoking from small metro areas were also overrepresented from 2018 to 2020 [ReRas = 1.09 (95% CI: 1.06, 1.11); 1.06 (95% CI: 1.04, 1.08), and 1.05 (95% CI: 1.03, 1.08), respectively] and individuals who reported smoking from large metro areas were underrepresented during the same time frame [ReRas = 0.87 (95% CI: 0.85, 0.89); 0.92 (95% CI: 0.91, 0.94), and 0.93 (95% CI: 0.91, 0.94), respectively]. ReRas for large metro areas decreased from 2013 to 2018 (annual percentage change, APC = -3.26; 95% CI: -6.69, -1.91). ReRas for non-metro areas increased from 2013 to 2017 (APC = 7.35; 95% CI: 4.10, 17.63).

Conclusions: Results suggest that individuals that smoke residing in nonmetro rural areas and small metro areas are proportionally reached by a digital tobacco cessation program. However, there continues to be an underrepresentation of individuals who smoke from large metro areas, which warrants further study.

Background: The tobacco industry has argued for decades that standardised packaging would lead to an increase in illicit tobacco use, but this is not supported by current evidence.

Objective: To explore longer-term associations between standardised packaging and illicit tobacco use.

Design: The Adult Tobacco Policy Survey is a longitudinal online survey with people who smoke or who previously smoked aged 16 and older in the United Kingdom (UK), with one wave pre-standardised packaging (2016) and three waves post-standardised packaging (2017, 2019, 2022).

Methods: Participants who smoke and who bought cigarettes or roll-your-own (RYO) tobacco were asked where they last bought, and usually buy, cigarettes or RYO tobacco to identify illicit purchasing channels. They were also asked whether they purchased potentially illicit cigarettes or RYO (with no or incorrect Warnings, Smuggled, or Fake (WSF) in the last three months and, if so, how often, why, and price paid.

Results: People who smoke were less likely to report buying illicit (WSF) cigarettes or RYO in 2019 (11.2%) and 2022 (11.4%) relative to 2016 (13.2%), although this only remained significant in adjusted models in 2022. For participants that purchased or received any illicit (WSF) tobacco product, low cost, high availability and opportunism were the key reasons for doing so. In comparison, relatively few people who smoke reported 'packs looking nice' as a reason for purchasing illicit tobacco pre- and post-standardised packaging.

Conclusion: Evidence from four waves of longitudinal data suggests that there was no increase in illicit tobacco use in the UK following the introduction of standardised packaging.

Objective: To assess the feasibility, acceptability, and treatment outcomes of a proactive motivational texting program with phone-based care coordination among people with chronic obstructive pulmonary disease who smoke (PCWS).

Design: Randomized, unblinded pilot among PCWS, regardless of intention to quit smoking.

Methods: Consenting participants were randomized 2:1 to the intervention vs a mailed offer of cessation services. Intervention consisted of a 12-week tapering-frequency motivational texting protocol, adapted from an existing clinically available protocol. Tailoring included COPD-specific messages and the option for phone-based care coordination, connecting participants to their choice of tobacco treatments. Primary outcomes were feasibility and treatment participation through 6 months. Results were analyzed using logistic regression, adjusted for imbalanced baseline characteristics deemed a priori likely to impact cessation behaviors.

Results: Of 697 invited, 125 enrolled and were randomized (83 intervention and 42 control) and 148 were ineligible, for an enrollment rate of 22.8% among eligible individuals. Primary reasons for ineligibility were: already quit or engaged in cessation efforts (n = 79), no text-capable phone (n = 50). Participants were older (mean age 68.4 years), predominantly male (82.3%) and white (78.2%). Most participants in the intervention arm completed the texting protocol (71/83, 85.5%) and responded to it at least once (63/83, 75.9%). Cessation outcomes were not statistically significant but favored the intervention. More participants in the intervention arm utilized any treatment (34.9% vs 21.9%, OR 2.37, 95%CI 0.94-6.40); 11 (13.2%) vs 1 (2.4%) (P = 0.053) completed a care coordination call. Acceptability of the texting protocol was high with 80.6% of participants finding the content relevant and 69.4% indicating they would recommend it. There were no identified harms. Study has completed all study procedures.

Conclusion: In this randomized pilot of a proactive, motivational texting program for PCWS, we found evidence of feasibility, acceptability, and possible benefits for cessation outcomes. Such a program is low burden and may be suitable for both future research and broad use.

Introduction: The life expectancy of a cigarette smoker is reduced by an average of 10 years as a result of smoking, although this effect may be mitigated by timely cessation. It has been proven that smoking cessation is beneficial to health regardless of comorbidities and age. The objective of this study was to analyse and assess the motivation and readiness to quit or reduce smoking among conventional cigarette smokers in Poland.

Method: A representative cross-sectional study was conducted using a structured telephone survey method CATI where interviewers followed a customized script provided by a software application. The survey involved a representative sample of 5000 inhabitants of Poland aged 18 years and older. The primary data was collected between March and May 2022 by the research company in cooperation with the Medical University of Warsaw. Respondents were classified into groups based on their answers to questions regarding their age, gender, and geographical location.

Results: Almost a quarter of conventional cigarette smokers who have ever tried to cease smoking reported to have made such an attempt in the past 12 months. The proportion of individuals who attempted to quit smoking decreased with age. The most significant challenges to quitting smoking among respondents surveyed, irrespective of age group, included being around smokers at work or home, fear of not being able to cope with a stressful situation, discouragement after previous unsuccessful attempts or fear of weight gain. Concern for personal health was the predominant factor motivating individuals with a history of daily smoking to successfully discontinue conventional cigarettes. For those who had smoked conventional cigarettes daily for less than 1 year, the odds of reducing or quitting was significantly higher than among those who had smoked for 10 years or longer.

Conclusions: The formulation of effective anti-nicotine policies must consider the realities and challenges encountered by individuals addicted to nicotine. It is therefore important to understand the nature of addiction, the characteristics of smokers and ex-smokers, and to search for effective methods of treating nicotine addiction. In addition to education and health promotion, Poland's tobacco control policy should include multi-sectoral interventions aimed at those who are already addicted.

Background: Large health warning labels (HWLs) with pictures on tobacco packaging are an effective policy to communicate the harms of tobacco use and discourage consumption. The tobacco industry also uses packaging as a key communication tool, altering its design to appeal and attract specific groups. Few studies have assessed compliance of HWLs noting ways that the tobacco industry exploits packaging and labeling regulation loopholes. This study assessed compliance with HWL requirements on cigarette packs from Mexico.

Methods: The analysis included cigarette packs purchased in October and November 2021 using the Tobacco Pack Surveillance System (TPackSS) protocol in 12 low, middle, and high socioeconomic areas in each of five cities: Mexico City, Guadalajara, León, Durango, and Mérida. In total, 191 unique cigarette packs, with Mexican HWLs that were current at the time of data collection, were assessed for compliance based on HWL location, size, label elements (ie, text and background colors), and use of exact images as published by the government. Compliance with HWL size was examined by pack shape and type.

Results: All the cigarette packs that were assessed were compliant with HWL location and the majority (98%) complied with label elements; 85% complied with HWL size. Beveled edge packs were less likely to be compliant in terms of warning size than packs without them (P < 0.05). Only 27% of packs had the image appearing exactly as specified by the Mexican government, obscuring the intended visual composition and diverting attention away from the focal point-thus, diminishing the image's impact.

Conclusions: Countries, including Mexico, implementing new or revising current HWL policies should establish enforcement procedures to ensure correct implementation of HWLs and prevent loopholes that can be exploited by the tobacco industry. Part of this would be to consider standardized tobacco pack shape to allow for better HWL implementation and effectiveness.

Introduction: Dual use of tobacco products has gained increasing attention due to its potential implications for tobacco control efforts. This study utilized data from the 2022-2023 Vietnam Population-based Provincial Global Adult Tobacco Survey (PGATS) to examine the association between dual tobacco use (conventional cigarettes and e-cigarettes) and smoking cessation intention among Vietnamese adults aged 15 years and older.

Methods: This cross-sectional study included 9821 adults who were currently smokers from 30 provinces and cities in Vietnam. Data were collected using a standardized questionnaire adapted from previous rounds of PGATS and administered via the REDCap platform. Univariable and multivariable logistic regression models, including refined models, were employed to examine the association between dual tobacco use and smoking cessation intention.

Results: Among the 9821 smokers, 5.4% reported smoking cessation intention within the next month, 15.1% within the next 12 months, and the remaining participants had no quit plan. Dual users accounted for 1.8% of the sample. After adjusting for potential confounders, dual users were associated with higher odds of smoking cessation intention compared to single conventional cigarette use, with an adjusted odds ratio of 1.53 (95% CI: 1.09-2.16).

Conclusion: Although dual tobacco use was uncommon among Vietnamese adult smokers, it was associated with a higher likelihood of smoking cessation. These findings suggest the need for future research into usage patterns, user motivations, and contextual factors that influence cessation behavior and sustaining this behavior.

Objective: Transgender and gender diverse (TGD; e.g., non-binary) adults report higher cigarette smoking rates than cisgender adults. However, little is known about the prevalence and associations of current cigarette smoking among Latinx Transgender and Gender Diverse (LTGD) adults. This study examines the associations between current cigarette smoking and self-reported demographic and health characteristics (e.g., mental health diagnoses) among LTGD adults living in Puerto Rico (PR) and Florida (FL).

Methods: Using secondary data from a cross-sectional exploratory study (n = 133), binary logistic regression was conducted to evaluate associations with current cigarette smoking status (smoking vs non-smoking). The Benjamini-Hochberg procedure was applied to control the false discovery rate (FDR) using R.

Results: The mean age was 34.4 years (SD = 10.28). Almost half of participants self-identified as trans-women (45.8%), 33.6% as trans-men, and 21.1% as non-binary. More than half were born in Puerto Rico (53.5%), resided in Florida (53.5%), had an associate degree or higher (64.8%), and reported a monthly income of $0-$1000 (47.7%). Thirty-eight participants (28.6%) reported current smoking, with a median of 6 cigarettes daily (IQR: 2-10). Significant associations were observed between current smoking, country of birth, and lifetime diagnosis of depression (P < 0.05).

Conclusion: Findings highlight a high prevalence of cigarette smoking among LTGD adults and confirm associations with demographic factors and mental health. These results underscore the need to prioritize culturally adapted smoking cessation interventions for LTGD adults.