Tobacco Use Insights最新文献

Introduction: India is one of the few countries to have banned production, manufacture, import, export, transport, sale, distribution, storage and advertisement of electronic cigarettes (e-cigarettes). With the advent of technology, these product are being marketed extensively on internet despite the ban. Objective: To assess promotion and sales of e-cigarettes on the internet, and social networking sites (SNS); and to assess the levels of awareness regarding e-cigarettes among youth participants and the source of receiving information on e-cigarettes. Methodology: In 2022, a survey was conducted with youth (18-24 years), along with a desk review to identify influencers promoting, and e-stores selling e-cigarettes in India. Further, a content analysis was conducted on the identified influencers and online stores. Results: 370 youth with a mean age of 21.1 ± 1.7 years participated in the survey. 66.6% of participants reported being aware of e-cigarettes through social media. Instagram (46%) was identified as the most popular social networking platform for promoting e-cigarettes. 189 influencers promoting e-cigarettes on Instagram were identified and their posts positively portrayed e-cigarettes (trendy/cool, flavours, hedonic value, features cessation aid and cost-effective). Additionally, 83 e-stores (49 Indian and 34 international) were identified as selling e-cigarettes in India. Findings from content analysis of both influencers and e-stores highlighted issue of international cross-border marketing. Conclusion: To safeguard youth and achieve a path to Tobacco-free generation; there is a dire need for strengthening the monitoring and enforcement of PECA 2019, especially to address international cross-border advertisements and sales of e-cigarettes. Additionally establishing strong reporting violation mechanisms is also needed. Furthermore, educating youth, retailers, policy makers and community via sensitization programs on detrimental effects of e-cigarette use and existing policies related to e-cigarettes in India is crucial.

Background: Marketing of flavored tobacco products has drawn concern because they are used disproportionately by young people. Online retailers have marketed e-cigarette liquids and devices to minors despite knowing it is illegal. The onset of the COVID-19 pandemic resulted in substantial increases in online purchasing, however, there has been limited study of possible shifts in online tobacco product marketing associated with this change.

Objectives: We sought to identify types of tobacco regulatory violations in 2021-2022, marketing claims made by retailers, the extent to which retailers had processes in place to deter minors from browsing websites, and the types of flavors promoted.

Design and methods: Our observational study was based on an initial sample of 100 tobacco retailers that had received FDA Warning Letters in 2020-2021. Using methods validated in previous research, we coded the letters for retailer information, violation type, and for retailers with an online presence, the types of products sold, and their marketing claims.

Results: Most retailers with violations were in the US South (48%), 65% had an online presence at the time of analysis, and 53% had a website that offered online product sales. The most common type of violation was the sale of new tobacco products without required marketing authorization (83%). For the retailers in the sample with active websites, 42% were still selling a product that the FDA had indicated was marketed unlawfully. Among these retailers with active websites, 32% did not have processes in place to deter access by minors. Advertised flavors focused on food (eg, mango, honey) and concepts (eg, "love", "classic").

Conclusions: Online retailers appeared less likely to remediate tobacco product violations identified by the FDA after the onset of the COVID-19 pandemic than before it, and few websites had strong processes in place that would deter youth browsing.

Objective: This study aimed to assess tobacco and vaping habits among university students, exploring awareness of university policies, attitudes, and behaviors related to smoking and vaping.

Methods: An online questionnaire was distributed among students from various universities, including institutions in Pakistan, covering demographics, smoking and vaping behaviors, awareness of policies, and beliefs. Data was analyzed using descriptive statistics, Binomial tests, Chi-square tests, and logistic regression.

Results: Out of the total 683 respondents, 65.02% were female, and 34.98% were male. Most participants were undergraduate students (71.31%), with Dentistry being the most represented field (50.36%). Most students perceived smoking or vaping as socially acceptable (58.3%) and were aware of university policies (59.3%). However, 46.6% were aware of cessation programs. Most of the students expressed concern about long-term vaping health risks (74.5%). Logistic regression identified gender (Male) and field of study (Dentistry) as significant predictors of policy awareness.

Conclusion: University students exhibit varied perceptions and behaviors related to smoking and vaping. The study highlights the importance of implementing effective policies and interventions to address tobacco and vaping use among them.

Introduction: Communities with low socioeconomic status have disproportionately high rates of tobacco use, and community health workers (CHWs) have an increasing role in delivering tobacco cessation interventions. However, existing tobacco cessation trainings are not appropriate for the CHW model of care. The aim of this study was to identify training needs of CHWs to develop a tailored tobacco cessation curriculum to help them effectively serve their high-risk patients. Incorporating results of a previously conducted needs assessment survey, we developed a preliminary outline of a tobacco cessation training curriculum that was specific to the CHW experience.

Methods: Participants (N = 14) discussed their impressions of (a) the training content, (b) the unique needs of patients seen by CHWs, and (c) tailoring to the CHW care model. We conducted virtual qualitative interviews and focus groups with stakeholders (i.e., managers/directors of CHW programs) and CHWs, respectively, to obtain feedback on training, as well as a sample 2-hour training schedule and curriculum. Two independent coders analyzed the data using the Framework method.

Results: Two overarching themes emerged: the need for strategies to (a) personalize treatment to each high-risk patient and (b) increase and maintain patient motivation. CHWs also reported the need for specific language to engage patients who were not ready to quit.

Conclusion: A tailored training might focus on motivational interviewing, including how to personalize treatment to the patient's experiences, and role-playing scenarios with scenes on how to flexibly support patients who are overburdened and unmotivated.

Introduction: Tobacco use is not only a major risk factor for morbidity and mortality but also associated with alcohol misuse. While personality traits may be driving this association, the psychoactive component of tobacco, nicotine, may also be a major risk factor. The aim with this study was to further assess the prospective association between tobacco use and alcohol consumption, with special emphasis on the role of the tobacco product used (cigarettes and Swedish snus), frequency of use, and gender. Methods: Data was extracted from the prospective cohort Longitudinal Research on Development In Adolescence (LoRDIA), following Swedish adolescents over four waves (∼13 to 17 years of age). Tobacco use was reported with respect to product used and frequency of use, while alcohol use was assessed using AUDIT-C, as well as frequency of use within the last year. Results: Use of tobacco, independent of product used and gender, was associated with increased alcohol consumption. High frequency of use and dual use strengthened to association. Individuals initiating tobacco use during the study period progressively increased their frequency of alcohol consumption compared to non-users during consecutive waves. Furthermore, tobacco use was associated with at-risk consumption of alcohol at follow up, even when adjusting for previous alcohol inebriation, socioeconomical factors, gender and novelty seeking. Conclusions: The data presented here suggests that nicotine use during adolescence, and especially dual use, is a major risk factor for future hazardous alcohol intake. This finding is especially important considering the escalated use of nicotine pouches, which in many ways resembles Swedish snus. From a public health perspective, preventive measures and policies designed to counteract all forms of nicotine use among youths is warranted.

Introduction: E-cigarettes have been shown to be effective for tobacco smoking cessation. Predicting those who are most likely to achieve smoking abstinence after receiving an e-cigarette based smoking cessation intervention could help to target interventions more efficiently.

Methods: A secondary analysis of baseline characteristics of 505 people who received an emergency department based smoking cessation intervention incorporating brief advice, provision of an e-cigarette starter kit and referral to stop smoking services. Gender, ethnicity, age, employment status, deprivation, partner smoking status, cigarettes per day, motivation to quit, cigarette dependence and previous e-cigarette use were assessed as predictors of abstinence. Self-reported smoking status was collected 6 months after intervention delivery.

Results: At 6 months 169/505 (33%) of those who received the intervention self-reported abstinence. The groups that were more likely to report having quit were females (37.4% of females vs 31.0% of males), older people (41.1% of over 50s vs 33.3% of under 35s), lighter smokers (36.4% of those who smoked less than 10 cigarettes per day vs 30.7% for those who smoked over 20) and more motivated quitters (35.6% for those with high motivation vs 29.2% for those with low motivation). However, in multiple logistic regression, when adjusting for the other factors, no factors significantly predicted smoking abstinence. Degree of nicotine dependence was very similar between those who quit and those who did not.

Conclusion: The study found no baseline factors that could predict successful smoking cessation with e-cigarettes. Consequently, this study does not support the use of a targeted e-cigarette-based smoking cessation intervention, suggesting the adoption of a more universal approach.

Background: Smoking cessation is linked to improved mental health that encompasses the overall well-being and psychological functioning of an individual.

Objective: Examine relationships between smoking, mental health, and social connectedness among adults in Maryland, US in 2020.

Methodology: This cross-sectional study used data from the Maryland 2020 Behavioral Risk Factor Surveillance System Survey of adults during the onset of COVID-19. Primary outcomes measured include demographics, depression, and number of not good mental health days among individuals with current and former smoking statuses compared to those who have never smoked.

Results: Compared to those who never smoked, individuals who currently smoked had an increased relative risk of reporting 14 or more days of not good mental health (RRR = 1.63, 95% CI: 1.35-1.97, P < .001) and a history of depression (RRR = 1.99, 95% CI: 1.69-2.35, P < .001). Individuals with former smoking status also showed elevated risk, with RRR = 1.24 (95% CI: 1.06-1.45, P = .006) for 14 or more days of not good mental health and RRR = 1.46 (95% CI: 1.28-1.66, P < .001) for a history of depression. Widowed, separated, or divorced; unemployed or unable to work; without a high school diploma; or recent physical exam were inclined to have a current or former smoking status.

Conclusion: We identify critical subpopulations vulnerable to life-long smoking behaviors amid the COVID-19 pandemic including adults under 35 years old, and those suffering from depression, a lack of social connectedness due to unemployment, changes in marital status, and outdated physical exams. The US Surgeon General's 2023 Advisory on the epidemic of loneliness and the 2021 Youth Mental Health Report emphasize the mental health crises among the young in which these findings serve as a compelling call to action for innovating targeted public health interventions.

Background: Smoking status is known to be an independent and significant predictor of health outcomes related to aging and plays a crucial role in overall mortality rates. This cohort study investigated the relationship between smoking status and survival outcomes over follow-up periods of 9 and 21 years. Methods: The sample consisted of 3526 participants with a mean age of 64 ± 12 years, 44.1% of whom were male. The median follow-up duration was 6315 days, with an interquartile range of 3441 to 7727 days. Smoking status [i.e., Brinkmann index (BI)] was calculated by multiplying the number of years smoked by the number of cigarettes smoked daily. Based on this, participants were categorized into non-smokers, former smokers, and current smokers. The data were analyzed using Cox regression, employing age as the time variable and accounting for various risk factors. Results: A total of 1111 participants (49.2%) were confirmed to have died. Among these, 564 were male (36.2% of all male participants), and 547 were female (27.8% of all female participants). The multivariate-adjusted odds ratio (95% confidence interval) for all-cause mortality compared with never-smokers was 1.51 (1.17-1.96) for former smokers with BI > 800, 1.61 (1.20-2.17) for current smokers with BI of 400-799 and 1.62 (95% CI, 1.24-2.10) with BI of ≥800 (P for trend <0.001). Participants who died within three years of follow-up were excluded to avoid the possibility of reverse causation, but the results were essentially unchanged. Conclusion: We found that the BI is a valid predictor of future mortality risk and that BI 800 for former smokers and BI 400 for current smokers were useful cutoff values. Efforts to control smoking should focus not only on current smokers but also on former smokers to reduce the risk of premature death associated with smoking.

Objectives: Extended-stay hotels (ESH) are a reliable and accessible housing option for low-income, minoritized renters, who are disproportionately exposed to secondhand and thirdhand cigarette smoke (SHS and THS). This study explores ESH residents' perceptions of their SHS and THS exposure, harms related to this exposure, their willingness to mitigate these harms, and the contextual factors associated with smoking in hotels.

Methods: Eighty ESH renters from the metropolitan Atlanta region were recruited to complete a survey about the perceived harm and persistence of tobacco smoke, exposure experiences, knowledge, attitudes, self-efficacy, and intentions to protect oneself. Eleven of these participants completed semi-structured interviews, during which they discussed their daily SHS and THS exposure at their ESHs in greater detail.

Results: Of the survey respondents, 62% reported being bothered by their level of smoke exposure, and 77% said they believed smoke particulates remained in their rooms even after housekeeping cleaned them. Approximately half of survey respondents had attempted to stop smoking in the 3 months prior to the study, and 29 of these individuals were still on their smoking cessation journeys. Most interview participants agreed that SHS and THS exposure exacerbated their existing chronic illnesses and could possibly result in death in the long term. Participants agreed with the benefits of smoke-free policies, but also acknowledged other priorities for ESH living-affordability, safety, and proximity to the workplace-that overshadowed their desires for such policies.

Conclusion: Overall, study findings suggest that ESH renters understand the dangers of smoking and SHS/THS and want to decrease their exposure, but the persistence of cultural and contextual factors prevents them from fully engaging with 100% smoke-free policies.