Tobacco Use Insights最新文献

The World Health Organization estimates there are 1.1 billion cigarette smokers across the globe and that tobacco related deaths number 7 million per year. Electronic nicotine delivery systems (ENDS) are available to contribute options for smoking cessation and include e-cigarettes, e-hookahs, vape pens, mods, and vaping. The growing use of ENDS, or e-cigarettes, in the US and globally across populations is dramatic. Although users may think that e-cigarettes are less harmful than combustible tobacco products, the evidence shows that there are known risks and harms for users. E-cigarettes have varying amounts of toxicants, nicotine, and carcinogens and put the user at risk for lung diseases and COVID-19 similar to smokers. Currently, most governing bodies have not approved e-cigarettes as a smoking cessation tool but do state if a person has failed conventional smoking cessation treatments that e-cigarettes used alone for the short term may help those to quit combustible tobacco and nicotine. A shared decision-making approach should be used when discussing e-cigarettes as a harm reduction tool. More studies and long-term data are needed to assess potential benefits and harms. What is known is that prevention efforts and policy are needed to avoid adolescents and other vulnerable populations from initiating tobacco or e-cigarette use.

Background: Variation in alternative tobacco product (ATP) constituents, heating potential, and consumer behaviors have made it difficult to characterize their health risks. To date, most toxicity studies of ATPs have used established cigarette endpoints to inform study design. Furthermore, to assess where ATPs fall on the tobacco harm continuum, with cigarettes representing maximum potential risk, studies have tended to compare the relative biological responses to ATPs against those due to cigarettes.

Objectives: 1) To characterize the exhalation profiles of two popular ATPs: electronic cigarettes (e-cigarettes) and hookah waterpipes (hookah) and 2) to determine if ATP exhalation patterns were representative of cigarette exhalation patterns.

Methods: Exhalation patterns were recorded (mouth only, nose only, or both mouth and nose) among individuals observed in the New York City tri-state area using a recognizable tobacco product (cigarette, e-cigarette, or hookah). Cigarette smokers and e-cigarette vapers were observed on city streets; water-pipe smokers were observed inside Manhattan hookah bars.

Results: E-cigarette vapers practiced exclusive nasal exhalation at far higher rates than did cigarette smokers (19.5% vs 4.9%). Among vapers, e-cigarette device type was also significantly associated with exhalation profile. Overall, cigarette smokers exhaled from their nose approximately half to one-third as often as ATP users (hookah and e-cigarettes, respectively).

Conclusions: Nasal exhalation of tobacco emissions appears to be a shared characteristic across several types of ATPs. It is therefore plausible that ATP-specific consumer behaviors may foster unique upper respiratory health consequences that have not been observed in smokers. Thus, product-specific behaviors should inform the prioritization of biological endpoints used in studies evaluating ATP toxicity and health effects.

Background: Smoking behavior includes mechanisms taken on by persons to adjust for certain characteristic changes of cigarettes. However, as lung function declines due to lung-specific diseases, it is unclear how mechanical smoking behavior changes affect persons who smoke. We review two cases of patients who stopped smoking prior to and then subsequently resumed smoking after lung transplantation.

Methods: A retrospective review of two patients who were recipients of lung transplantation and sustained from cigarette usage prior to transplantation.

Results: Patient A was a 54-year-old woman who received a double lung transplant secondary to chronic obstructive pulmonary disease (COPD) in October 2017. She had stopped smoking cigarettes in July 2015 (FEV1 .56 L). Patient B was a 40-year-old man who received a double lung transplantation due to sarcoidosis in January 2015. He stopped smoking cigarettes in February 2012 (FEV1 1.15 L). Post-transplant, Patient A resumed smoking on March 2018 where her FEV1 was at 2.12 L (5 months post-transplantation), and Patient B resumed smoking in April 2017 where his FEV1 was 2.37 L (26 months post-transplantation).

Conclusion: We report on two patients who resumed smoking after lung transplantation. While variations of smoking mechanics have been identified as a function of nicotine yield and type of cigarette, it lung mechanics may play a role in active smoking as well. Therefore, proper screening for tobacco usage post-lung transplantation should be considered a priority in order to preserve transplanted lungs.

Introduction: Despite declines in cigarette smoking in the US, electronic cigarette (e-cigarette) use has increased among middle and high school students. In 2014, New York City (NYC) implemented Tobacco 21 (T21) to prohibit sales to anyone under age 21. Our study goal was to measure the effectiveness of T21 on e-cigarette use.

Methods: We used the New York State (NYS) Youth Tobacco Survey-a biennial, school-based, self-administered survey. We explored middle (N = 5249) and high (N = 7296) school NYC students' (male and female) current (past 30 days') e-cigarette use from 2014 (pre-T21) to 2018 (post-T21). Results were compared with students in the rest of NYS (ROS). Bivariate and multivariable logistic regression analyses assessed correlates of e-cigarette use, beliefs about harmfulness, addictiveness, and susceptibility.

Results: NYC high school students' current e-cigarette use increased from 2014 to 2018 (8.1% vs 23.5%, P < .001). Middle school students' use increased between 2014 (4.8%) and 2016 (9.0%) yet reversed by 2018 (5.7%) (2014 vs 2018, P = .576). ROS middle school (2.2% vs 7.4%, P < .001) and high school (12.0% vs 29.3%, (P < .001) use increased from 2014 to 2018. Willingness to try e-cigarettes among those who had never tried an e-cigarette was twice as high (AOR = 2.19, 95% CI = 1.15-3.17) among NYC high school students in 2018 compared with 2014.

Conclusions: E-cigarette use increased among NYC high school students despite T21. T21 may have reduced use among middle school students over time. Programs that denormalize e-cigarettes and policies that further restrict access are needed to decrease youth e-cigarette use.

Background: With the emergence of the WHO Framework Convention on Tobacco Control, globally the use of tobacco has decreased notably, although, it still requires efforts at individual, organizational, community level to decrease the rate further. Dental professionals are at an excellent position to provide tobacco cessation counselling and interventions, however, it is not practiced much due to lack of training and lack of knowledge. Therefore, this systematic review was conducted to assess the global status of knowledge, attitude and practice on tobacco cessation interventions among dental professionals.

Materials and method: A systematic search of 6 databases with no language restriction since 2000 was undertaken. Studies were included if they assessed knowledge, attitude and practice on tobacco cessation interventions among dental professionals using a validated or prevalidated tool. The data obtained for assessment of knowledge, attitude, practice, curriculum and barriers were represented through heatmaps. Quality assessment of the studies was done using Newcastle Ottawa scale.

Results: Fifty six studies were included in this systematic review. Majority of the studies were found to be of moderate quality. Knowledge regarding the tobacco cessation interventions was more theoretical than practical. All the studies showed a favorable attitude among dental professionals towards tobacco cessation intervention.

Conclusion: The included studies lack homogeneity in assessing knowledge, attitude and practice on tobacco cessation interventions. The development and validation of a standardized questionnaire to assess knowledge, attitude and practice on tobacco cessation interventions could be a potentially effective way to uniformly gather data on the subject.

Introduction: This study examined the impact of seeing and posting tobacco-related content on social media on tobacco use outcomes in youth.

Methods: Longitudinal secondary analyses of youth in the nationally representative 2014-2015 Population Assessment of Tobacco and Health (PATH) study were conducted to examine the association between the interaction of (i) seeing and (ii) posting tobacco-related social media content with previous ever use of each tobacco product, and 3 outcomes in 2015-2016: past 30-day e-cigarette use, past 30-day combustible product use, and past 30-day dual use of e-cigarettes and at least one combustible product. Six weighted multiple logistic regression models (2 interaction exposures*3 outcomes) were used to assess these associations, while adjusting for covariates.

Results: Among youth never users in 2014-2015, seeing tobacco-related social media content was significantly associated with past 30-day e-cigarette use (AOR 1.92; 95% CI= 1.36-2.71), and past 30-day dual use of e-cigarettes and at least one combustible product (AOR= 2.11; 95% CI= 1.08- 4.13) in 2015-2016. Among youth ever users in 2014-2015, posting tobacco-related content on social media was significantly associated with all 3 outcomes: past 30-day day e-cigarette use (AOR= 2.09;95%CI=1.23-3.55), past 30-day combustible product use (AOR=2.86; 95%CI=1.67-4.88), and past 30-day dual use of these products (AOR=3.02;95%CI=1.45-6.31), after adjusting for covariates.

Conclusions: Seeing and posting tobacco-related content on social media predicts tobacco use among youth, nationwide. Results suggest that interventions and policies prohibiting tobacco-related content on social media are needed to curb the impact of social media on youth tobacco-use.