Tobacco Use Insights最新文献

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.

[This corrects the article DOI: 10.1177/1179173X251389206.].

Introduction: Considering the scarcity of specialist cessation service providers in resource-constrained Low- & middle-income countries (LMICs), the dental healthcare system can be used as an alternate source of cessation support. This study assessed dental healthcare providers' current practices and perceptions about cessation support in teaching dental hospitals.

Methods: We assessed the cessation-related practices and perceptions of 348 dentists working in 10 teaching dental hospitals, using a cross-sectional design in the Khyber Pakhtunkhwa province of Pakistan. Participants were selected using simple random sampling technique and data were collected using a modified version of a previously used structured questionnaire, through face-to-face interviews by trained dentists. The Chi-squared test and logistic regression were used to determine associations between cessation support practices, cessation support perceptions, and their potential predictors.

Results: Overall, 13% of dentists provided cessation support, while 36% of participants practiced routine screening for tobacco use. 95% of dentists opined that cessation support should be provided in dental settings, with minimal counselling (5 As) being the preferred method. There was a strong association between dentists having formal training in cessation support and providing cessation support (aOR 6.58, 95% CI 1.95-22.11).

Conclusion: There is a lack of cessation training for DHCPs and a dearth of cessation services in the dental settings of Khyber Pakhtunkhwa, Pakistan. However, most DHCPs were willing to provide cessation services.

Implications: Cessation support falls behind compared to other MPOWER measures in Pakistan. As a resource-constrained LMIC, Pakistan can consider dental settings as a cost-efficient avenue for delivering cessation support-related services. Cessation services can be integrated into routine dental health care using a dental health workforce trained in cessation support. This untapped resource can help in curbing tobacco use in Pakistan and other similar contexts.

Tobacco use remains a critical public health challenge in Vietnam, contributing to significant health and economic burdens. Despite comprehensive tobacco control policies, cessation rates remain low. This study investigates how tobacco control awareness, media exposure, and health knowledge influence quit intentions among Vietnamese smokers. A cross-sectional analysis of 17 387 adult current smokers from the 2024 Provincial Global Adult Tobacco Survey (PGATS) was conducted. Structural equation modeling (SEM) tested direct and mediated pathways between tobacco control awareness, anti-/pro-tobacco media exposure, health knowledge, and quit intentions, adjusting for age and gender. Multiple imputation addressed missing data (3.7%), and model fit was assessed using AIC, BIC, and SRMR. Health knowledge and anti-tobacco media exposure were the strongest predictors of quit intentions (β = 0.107, P = 0.002; β = 0.250, P < 0.001, respectively). Pro-tobacco media exposure significantly strengthened quit intentions among smokers already planning to quit (interaction β = 0.445, P = 0.026). Multi-group analyses revealed health knowledge and media effects were significant only among male smokers. Educational stratification showed lower-educated smokers benefited more from health information, while higher-educated smokers responded better to anti-tobacco media campaigns. Individual-level health knowledge and anti-tobacco media campaigns drive quit intentions among Vietnamese smokers. The pro-tobacco media paradox, operating through psychological reactance among motivated quitters, highlights opportunities for targeted counter-advertising. Gender and educational disparities underscore the need for tailored interventions: clear health messaging and sophisticated media campaigns.

Introduction: Among dual-smoking couples, both partners have smoking-related motivations that may either facilitate or hinder cessation efforts. Existing research typically focuses on individual-level motivation, which may be inadequate for capturing aspects of concordance and discrepancy. This study characterized couples' motivational profiles and examined their associations with smoking cessation outcomes.

Methods: We conducted secondary analyses from a randomized controlled pilot study of 95 dual-smoking couples to examine how dyadic motivations to quit smoking predicted individual and joint point-prevalence abstinence at 3 months. Both partners reported their own motivation to quit (self-oriented) and their motivation for their partner to quit (partner-oriented). We examined dyadic motivation to quit smoking on abstinence across four goal characterizations: (1) Parallel Goals (partners' self-oriented motivations), (2) System-Oriented Goals (an individual's self- and partner-oriented motivation), (3) Shared Target Goals (both partners' motivation for one individual to quit), and (4) Parallel Partner-Oriented Goals (each partner's motivation for the other to quit). Using response surface analyses with logistic regression, we estimated the effects of alignment (a₁) and misalignment (a₂) in the couples'' motivation levels on individual and joint cessation outcomes.

Results: For individual cessation, quitting odds were higher when self-motivation or partner-oriented motivation aligned within the couple (Parallel goals: a₁ = 0.725; Shared Target goals: a₁ = 0.881; Parallel Partner-Oriented goals: a₁ = 0.729), when self-motivation exceeded partner's self-motivation (Parallel goals: a₃ = 0.453), or exceeded partner-oriented motivation (System-Oriented goals: a₃ = 1.094). Joint quitting was more likely when both partners had high self-motivation (Parallel goals: a₁ = 0.918), high self- and partner-oriented motivation (System-Oriented goals: a₁ = 0.310), high shared motivation for one partner to quit (Shared Target goals: a₁ = 0.673), or high partner-oriented motivation for each other (Parallel Partner-Oriented goals: a₁ = 0.965). All effects were statistically significant (P < .05).

Conclusion: The findings highlight the role of dyadic motivations in predicting individual and dyadic abstinence among dual-smoking couples. Couple-based interventions that aim to increase and align partners' motivations to quit could improve cessation outcomes in this population.

Introduction: Numerous guidelines have been developed worldwide to support healthcare professionals in providing evidence-based interventions to help individuals quit smoking and other forms of tobacco use. The evaluation of the quality of the guidelines of tobacco cessation is however deficient and lacking.

Methodology: PubMed, Embase, Scopus and Cochrane Databases were electronically searched. Additional search was carried out in National Institute for Health Care Excellence, Guidelines International Network, Google Scholar and references of relevant articles to screen studies relevant to this review. Guidelines on both health and allied health professionals in English language were included. The assessment of the guidelines in this review was carried out using the AGREE II instrument by four appraisers.

Results: Twenty guidelines were included in this review. A comparative evaluation of all the guidelines revealed consistently higher scores in clarity of presentation domain (74.4 ± 20.9) followed by scope and purpose (65.23 ± 17.19), stakeholder involvement (63.84 ± 18.29) and rigour of development domain (61.76 ± 20.24). Lower scores were reported in Applicability (59.18 ± 18.02) and least in Editorial Independence domain (58.29 ± 19.36).

Conclusion: Further guidelines developed should address the gaps identified in this review and be both evidence-based and feasible to implement in diverse clinical contexts.

Background: California's Central Valley has high rates of tobacco product use and low rates of access to healthcare providers, making it difficult for residents to acquire effective tobacco cessation treatment. To address this disparity, California pharmacists can act as healthcare providers, with the ability to provide counseling and independently prescribe nicotine replacement therapy (NRT) medications through a process known as "furnishing".

Methods: All corporate and independent pharmacies in the Central Valley who serve the general community were contacted (n = 586) to ask whether pharmacists furnished NRT. The authors visited pharmacy locations (n = 23) that indicated they furnished NRT to request participation in a survey and interview. The authors analyzed if pharmacies furnished NRT, the characteristics of those that furnished, the creation of implementation of protocols, barriers, and facilitators, and how services were fostered.

Results: In interviews, pharmacists expressed generally positive attitudes toward furnishing, but were concerned about barriers, including concerns about feasibility and affordability, lack of administrative support, and perceived limited demand.

Conclusions: Despite the region's high tobacco usage rates, few pharmacies (n = 5; 0.88%) furnished NRT. To increase furnishing rates, corporate policy changes, recognition of pharmacists as providers by insurance companies, and support from the California Board of Pharmacy are likely needed. Increasing advertising, building rapport, and knowing patients' tobacco history may increase NRT utilization.

Background and objective: Electronic cigarettes use among pregnant individuals who currently or formerly smoked cigarettes was not previously examined in Romania. This study aimed at measuring the prevalence of ever using e-cigarette and its associated factors in a sample of pregnant individuals in Romania who currently or formerly smoked cigarettes. Design: Cross sectional study from formative and baseline phases of a randomized control trial. Methods: This study utilized data from a Randomized control trial (RCT) that was conducted between 2016 and 2019 in Romania. Data was collected via structured questionnaire at formative stage and was self-administered through the study website at baseline. The sample included 316 pregnant individuals (155 from formative phase, and 161 from baseline phase), of whom 75% were currently and 25% were formerly smoking cigarettes. Results: Ever using e-cigarette was reported by 122 (41.2%) of the 296 pregnant individuals who responded to this question, of whom 42 (34.4%) were currently using e-cigarettes. A total of 249 (84.4%) individuals attempted to quit smoking, of which 100 (40.2%) ever used e-cigarettes, and 35 (14.1%) used e-cigarettes at their last attempt to quit. Of the individuals who were currently using e-cigarettes, 4 (9.5%) were formerly smoking cigarettes (sole e-cigarette users) and 38 (90.5%) were currently smoking cigarettes (use both combustible and electronic cigarettes [dual users]). Low education was significantly associated with ever using e-cigarettes (OR = 5.94; 95% CI: 2.50-14.10; P = 0.001). Conclusions: High percentage of pregnant individuals used e-cigarettes and a notable percentage of them have reported current e-cigarette use. Half of the individuals who reported current e-cigarette use indicated they were using them with the intention of quitting cigarette smoking during pregnancy, though many continued to use both products (became dual users), highlighting a potential failure of cessation and ongoing nicotine exposure.