Tobacco Use Insights最新文献

Introduction: Multiple tobacco product (MTP) use may intensify nicotine dependence and reduce the chances of quitting success. Characterizing MTP use in people with HIV (PWH) in low- and middle-income countries (LMICs) is needed to guide cessation approaches in this group. This study aimed to identify patterns and correlates of MTP use among PWH in a single clinic. Methods: This study was conducted among PWH at a clinic in Chennai, India. Participants completed an in-person survey providing information on tobacco use, demographics, and cessation-related factors. This analysis focused on PWH who reported current tobacco use. We used Fisher's exact test (categorical variables) and the Wilcoxon rank-sum test (continuous variables) to assess statistical differences in demographics and cessation-related factors between PWH who used single vs multiple tobacco products. Results: Of 154 PWH adults surveyed, 58 (37.7%) reported current tobacco use. Most PWH currently using tobacco were male (n = 49/58, 84%), with a median age of 21 years (IQR: 10). Forty-six percent (n = 27/58; 95% CI: 33% - 60%) reported MTP use, combining three products (IQR: 3) on average. Those who used multiple products were more likely to have a higher education level (n = 12/27, 44%; 95% CI: 25% - 65%) compared to those who used a single product (n = 2/16, 12%; 95% CI: 1% - 38%) (P-value = 0.03). A lower proportion of participants who reported MTP use were unemployed (n = 1/27, 97%; 95% CI: 0% - 19%) compared to those who used a single product (n = 5/16, 31%; 95% CI: 11% - 59%) (P-value = 0.04). All other factors, including gender, primary language, marital status, and cessation-related factors, were comparable between PWH who used a single tobacco product and those who used multiple products. Conclusion: Among PWH who currently smoke, almost half use tobacco combined multiple products. MTP use in PWH was linked to higher education levels and employment in this single clinical setting.

Introduction: Smoking causes disparate health outcomes among people living with HIV, who also experience higher rates of food insecurity compared to HIV-negative adults.

Objective: Aiming to characterize household food insecurity among HIV + smokers in Vietnam, we surveyed 182 smokers undergoing HIV-care at 5 clinics in Hanoi, Vietnam.

Methods: We estimated the proportion of food insecurity among our sample using the Household Food Insecurity Access Scale and analyzed covariates associated with food insecurity, like income, and moderators of smoking, like drug use.

Results: Food insecurity was reported by 13.3% of our sample. The mean (SD) of years living with HIV was 12.8 (6.45). Moderate-to-severe food insecurity was associated with tobacco dependence [RR = 1.68 (1.27, 2.22); P = .05] and readiness-to-quit smoking [RR = .45 (.24, .86); P = .002].

Conclusions: Our findings suggest people living with HIV who smoke are vulnerable to food insecurity and face very high or high tobacco addiction. We also find evidence that food insecurity is linked to several other conditions that alone or together are barriers to quitting. Considering these findings and the increasing interest in HIV and co-existing chronic conditions like smoking and food insecurity, further research is needed to understand how food insecurity and tobacco use intersect and impact people living with HIV who experience these concomitant conditions.

New nicotine products such as e-cigarettes, heated tobacco and smokeless tobacco/nicotine products, are popular among young people. Most regret having started using these products, but little is known about how to help adolescents and young adults to quit most effectively. This systematic review aimed to identify all existing studies on the efficacy of cessation interventions on the use of novel nicotine and tobacco products in adolescents and young adults. Original randomized controlled trials on cessation of use of e-cigarettes, heated tobacco and smokeless nicotine/tobacco products aimed at young people aged between 15 and 25 were included. The exclusion criteria were interventions on cessation of cigarette/conventional tobacco smoking and studies that focused on preventing initiation rather than cessation. Both researchers independently screened articles and extracted data. The risk of bias was assessed. A total of 345 papers were screened for eligibility, and 9 original studies were included. All studies were conducted in the United States. Populations ranged from 24 to 2588. Five studies reported significant effects of the study interventions, of which 4 were extensive multi-component smokeless tobacco cessation interventions in a high school or college setting. The fifth effective intervention was an SMS text-based e-cigarette cessation program. Low-grade evidence suggests that multi-component interventions that include counseling and an SMS text-based cessation program that is also based on behavioral support may be effective in the cessation of the use nicotine products in adolescents and young adults. Further research that includes cessation of the use of all new tobacco- and nicotine products is needed.

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.