Tobacco Use Insights最新文献

Introduction: Tobacco quitlines play a crucial role in cessation efforts; however, the proportion of quitline use among those who smoke remains low with less than 1% of U.S. adults utilizing quitline services in 2022. In 2020, the Illinois Department of Public Health and Illinois' Tobacco Quitline (ITQL) provider, the American Lung Association, developed a mass media campaign to drive call volume to the state's quitline (ITQL). Based on available data on quitline use and formative research learnings, campaign messages promoting urgency were tailored to the lived experiences of Illinois adults who smoke, with a focus on priority populations (i.e., males, individuals of lower socio-economic position, those with a history of a mental health diagnosis).

Methods: This study assessed whether self-reported ITQL media campaign awareness and online engagement are associated with commitment to quitting, intention to quit in the next 12 months, and intention to use ITQL. Three cross-sectional online surveys (n = 1122) were conducted during campaign media implementation with current Illinois residents aged 18-65 who self-reported smoking in the past 30 days and/or had at least one quit attempt in the past 12 months. A series of logistic and linear regression models were used to evaluate the relationships between campaign awareness/engagement and outcomes.

Results: The overall rate of campaign awareness and online engagement (55%) exceeded those reported by similar campaigns. In adjusted regression analyses, campaign awareness/engagement had a significant, positive influence on commitment to quitting (ß = 0.27), intentions to quit (OR = 1.51; 95% CI: 1.064,2.134), and intentions to use ITQL (ß = 0.99) among adults in Illinois who smoke, including priority audiences.

Conclusion: While more research is needed on tailored mass media campaigns that promote the use of quitlines, this study provides evidence that tailored mass media campaigns are effective in changing quitting behavior and can be utilized in reaching priority populations.

Background: Existent research examining perceptions of nicotine addiction use largely surface level items that fail to address the complexity of nicotine addiction. Additional investigation is needed to better understand people's perceptions of nicotine addiction and whether these align with measures of nicotine dependence. Understanding these perceptions about nicotine addiction may help provide insight into vaping intentions and behavior. This study examines the validity of the Nicotine Addiction Perceptions (NAP) scale, a novel measure designed to assess perceptions of addictive vaping behavior that aligns with the clinical dimensions of tobacco use disorder.

Methods: Data were collected from U.S. adults via Prolific (n = 549). As part of scale development and validation a confirmatory factor analysis and psychometric evaluation was conducted. The NAP's reliability, convergent, discriminant, and criterion validity were established.

Results: A five-factor solution returned acceptable fit on all model indices (RMSEA = 0.050; CFI = 0.994; TLI = 0.993). The NAP was significantly related to assessments of perceived risk, 6 month quit intentions, the number of quit intentions over the past year, and past 30-day e-cigarette use (P's < .05). Findings also indicate support for discriminant validity.

Conclusions: Findings suggest that for most, perceptions of nicotine addiction may not fully align with the clinical criteria of addiction, which may be due to the lack of education surrounding the clinical definition. Future research examining perceptions of nicotine addiction can utilize the NAP scale to better understand people's understanding of addiction and its relationship to vaping-related behavior.

Introduction: Smoking remains a significant public health issue, leading to severe non-communicable diseases (NCDs) and a considerable economic burden, particularly in low- and middle-income countries. In Iran, smoking-attributable diseases account for substantial healthcare costs. This study aims to estimate the direct medical costs of smoking-attributable NCDs in hospitals affiliated with Mashhad University of Medical Sciences from 2015 to 2023. Methods: A descriptive-analytical study was conducted using a cross-sectional design, analyzing hospital records from 2015 to 2023. The study population included all patients aged 35 and older with smoking-attributable NCDs hospitalized during this period. The smoking-attributable fraction (SAF) was calculated using prevalence data for current and former smokers and relative risk estimates for various NCDs. Direct medical costs were extracted from the hospital information system and analyzed using Microsoft Excel 2019 and STATA 14 software. Results: The total direct medical costs of smoking-related NCDs averaged $10.5 million annually, with male patients accounting for 93.4% of these costs. Cardiovascular diseases were the largest cost driver, comprising 74.1% of the total expenses, followed by respiratory diseases (15.2%) and cancers (10.7%). The attributable risk for smoking-related diseases was consistently higher in men, particularly for lung cancer (76.9%) and chronic obstructive pulmonary disease (68.3%). Conclusion: Smoking imposes a significant financial burden on the healthcare system, particularly for male patients. Targeted tobacco control interventions, such as increased taxation and public awareness campaigns, are urgently needed to reduce smoking prevalence and mitigate its economic impact on healthcare systems. Comprehensive policies could alleviate the strain on Iran's healthcare system and improve public health outcomes.

In June of 2024, I was asked by the Environmental Health Officer of Galway, Ireland, to recount my endeavors in support of the 2002 push to ban smoking in Irish workplaces, led by The Office of Tobacco Control (OTC) for The Republic of Ireland. At that time, OTC's smoke-free campaign was being vigorously opposed by publicans as well as the Irish tobacco industry. Their opposition had downplayed any effects of secondhand smoke on pub workers' health. As a researcher, I had published 46 peer-reviewed papers on the hazard, exposure, dose, risk, and control of secondhand smoke since 1980. In 1998, I had become a secondhand smoke consultant, assisting entities in the U.S. and abroad who were attempting to enact workplace smoking bans. In 2002, OTC's then Director, Tom Power, had contacted me to request my technical assistance to the Irish government in their campaign to enact a workplace smoking ban in Irish pubs. Accordingly, I asked for any local data that might aid me in my effort. He provided me with measurements of carbon monoxide from secondhand smoke in 14 Galway Pubs, performed by the Irish researcher Maurice Mulcahy in support of his Master's Thesis. Using a pharmacokinetic model that enabled mapping secondhand smoke carbon monoxide to its equivalent nicotine metabolite body fluid cotinine, I estimated that based on the Galway pub data, secondhand smoke exposures of nonsmoking Irish pub workers were at the upper extreme for nonsmokers when compared to a study of cotinine in London pub staff relative to the general population. Further, using a dose-response relationship, I was able to estimate that the working-lifetime risk of mortality from workplace secondhand smoke exposure would produce an estimated 150 deaths per year among the ∼28,000 full-time Irish pub workers. I presented this information to the Health Minister and Members of Parliament at the Dail, and in numerous multi-media interviews. These estimates rebutted bogus tobacco industry assertions that ventilation could control secondhand smoke, fired up the effort championed by Health Minister Micheál Martin to ban smoking in pubs, and helped to protect pub workers from being forced to trade their health for a pay cheque.

E-cigarettes (ECs) are a well-established consumer product. To study their respiratory health effects, there is the issue of heterogenous patterns of use: concurrently with cigarette smoking (dual use), exclusive use after smoking cessation (exclusive use), or use initiated without any prior or current use of cigarettes (naïve use). Our primary goal was to synthesize the evidence on the respiratory effects of ECs use in adults, categorized by their pattern of use. Additionally, we identified the highest quality systematic reviews and critically evaluated the current literature on this topic. The review was developed with published umbrella review guidelines. The database searches were Medline, Scopus, Cochrane, Epistemonikos, LILACS, and grey literature databases. The criterion for inclusion of systematic reviews was analyses of respiratory tests from randomized controlled trials or cohort studies. Quality assessments were performed with AMSTAR2 and a checklist of reporting biases. A narrative analysis was synthesized by test method: spirometry, impulse oscillometry, breath gasses, biomarkers, and clinical serious adverse events. Twelve systematic reviews were included. The findings on respiratory functioning were statistically non-significant across all patterns of use. Reporting bias was frequently observed. Based on the current research, there is no evidence of significant change in the short or medium term in respiratory function with any pattern of ECs use. We attribute the null findings to the weaknesses of acute studies, the participants' smoking history masking testing, and the inclusion of participants with a low frequency of use.

Objectives: The novelty of e-cigarette regulatory policy poses difficulties for evidence-informed decision making because there is little evaluative evidence on the effects of specific policies. One way to provide evidence to inform Canadian policy in this situation is to learn from users how they would behave under different policy scenarios without actually implementing those policies in real-world settings. Discrete Choice Experiments provide an opportunity to undertake this research. Methods: We recruited an online sample of 600 e-cigarette current and past users aged 16-25, using an existing panel of recently recruited e-cigarette users, to participate in a discrete choice experiment. Participants chose their preferred option from a choice of 2 e-cigarette products described by 4 attributes: flavour availability, location availability, nicotine concentration, and price. Results: Our findings provide an overview of how important each attribute (price, nicotine concentration, availability, and flavour) is to young e-cigarette users. Across all features, as price increases, respondents were less willing to purchase. The study provides evidence that while all 4 attributes have strong effects, nicotine concentration and flavour most significantly influenced preferences for e-cigarettes. Conclusion: This could provide points of comparison and a better understanding of how hypothetical regulatory restrictions could prevent youth uptake of e-cigarettes, encourage current youth vapers to quit vaping, and make e-cigarettes available and useful for smokers interested in vaping to help them completely quit combustible cigarette smoking.

Objective: To explore the association of hookah use on the age of asthma onset among adults who were asthma/COPD free and who did not use cigarettes, cigars, electronic cigarettes or smokeless tobacco prior to asthma onset.

Methods: Secondary data analyses were conducted of the waves 1-6 (2013-2021) of the US nationally representative Population Assessment of Tobacco and Health Study among adults (>18 years). The four hookahs use exposures evaluated were (1) past 30-day (P30D) hookah use at the first wave of participation, (2) total number of waves before asthma onset in which adults reported P30D hookah use, (3) total number of years since first hookah use, and (4) average length of hookah sessions. Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. Associations of the exposures on the age of asthma onset were estimated using weighted interval-censoring-Cox-regression.

Results: The total sample size for analysis was 5,768, representing 66.6 million adults. There was a lack of statistical power to detect differences in the age of asthma onset by (1) P30D hookah use (Adjusted Hazard Ratio (AHR) 3.77, 95CI%: .90-15.71). There was an association between (2) total number of waves of P30D hookah use (AHR 1.72, 95% CI 1.28-2.30), (3) total number of years since first hookah use (AHR 2.94, 95% CI 1.36-6.36), and (4) average length of hookah sessions (AHR 4.52, 95% CI 1.61-12.67) with the age of asthma onset. Females and Hispanics with over one year since first hookah use had higher risk of earlier age of asthma onset.

Conclusion: Prevention and cessation programs for adults who use hookah are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate hookah users to stop.

Background: Secondhand smoke (SHS) exposure remains a critical public health concern, especially for adolescents, who are more susceptible to its harmful effects and may initiate smoking as a result. SHS, comprising both mainstream and sidestream smoke, contains over 7000 chemicals, many of which are carcinogenic. Adolescents exposed to SHS are more likely to experiment with smoking due to environmental influences, peer pressure, and familial smoking behavior.

Objective: This study aims to examine the relationship between SHS exposure and smoking attitudes and behaviors among adolescents aged 13-15 in the Gaza Strip, where SHS exposure and tobacco use remain prevalent.

Methods: Data were obtained from the 2019 Global Youth Tobacco Survey (GYTS), a cross-sectional, school-based survey targeting students in Gaza. The study employed a two-stage cluster sampling design to ensure a representative sample. SHS exposure was assessed in multiple contexts, including home, public enclosed spaces, and outdoor areas. Smoking attitudes, initiation behaviors, and demographic variables were also analyzed using descriptive statistics, Chi-square tests, and multivariable logistic regression to identify predictors of smoking behaviors.

Results: Of the 1536 adolescents surveyed, 62.3% reported SHS exposure at home, and 53.9% reported exposure in enclosed public spaces. Adolescents exposed to SHS were significantly more likely to experiment with smoking, with curiosity (62.2%) and peer influence being key motivators. Additionally, SHS exposure in both indoor and outdoor environments was associated with a higher likelihood of shisha experimentation. Females reported higher SHS exposure rates than males across all environments (P < .001).

Conclusion: SHS exposure significantly increases the risk of smoking initiation among adolescents in the Gaza Strip. These findings emphasize the need for targeted public health interventions, including stricter smoke-free legislation, parental education, and awareness campaigns aimed at reducing SHS exposure and preventing smoking uptake in youth.

[This corrects the article DOI: 10.1177/1179173X241298524.].

Background: The availability of novel nicotine products like oral nicotine pouches (ONP) has been rising in South Asian countries, including Pakistan. We aimed to assess ONP marketing strategies at point-of-sale (POS) and understand the perceptions among consumers and sellers regarding its use in Karachi, Pakistan. Methods: We conducted a mixed-methods study in low, middle, and high socioeconomic neighborhoods of District East Karachi. For the quantitative component, we used a cross-sectional design, collecting data through observations and surveys. The observation checklist included items about advertising, product placement, display, and promotional aids. The survey questionnaire included questions on marketing tactics, product placement, and advertising strategies for ONP. For the qualitative component, we conducted in-depth interviews with ONP consumers and sellers to explore their perceptions and understand marketing strategies. Frequencies and percentages were used to report quantitative data, while thematic analysis was conducted for qualitative findings. Results: We observed 90 POS of ONP and found that 20% (n = 18) were located within 200 meters of schools. ONP advertisements were found in 67% (n = 60) of the surveyed shops, 59% (n = 53) displayed ONP next to candy, and 70% (n = 63) displayed at child's eye level. A higher proportion of consumers (n = 66, 73%) use ONP as a cessation aid for tobacco. Most sellers (n = 48, 53%) were approached by the companies to sell ONP, and 40% received a commission while achieving the targets on ONP sell. About one-fourth of sellers (n = 21, 23%) reported selling ONP to students less than 18 years. Our qualitative findings revealed marketing strategies, peer influence, ease of use in tobacco-restricted areas, and the perception of reduced harm compared to cigarettes as key drivers of ONP consumption. Conclusion: Our study highlights a critical public health concern and offers valuable insights that could inform the development of policies to regulate tobacco sales.