Tobacco Prevention & Cessation最新文献

Nicotine pouches are a fast-growing class of tobacco-free nicotine products, marketed for oral absorption and often promoted as cleaner alternatives to traditional tobacco. Regulatory efforts to ban flavors such as menthol have been inconsistent, with the US withdrawal of a proposed menthol ban in 2025 intensifying policy instability and raising concerns over youth use. The aim of this monitoring letter is to examine the development of nicotine pouch markets, regulatory responses, and the need for independent research to guide future policy. Sales of nicotine pouches increased dramatically from their US introduction in 2016, with youth uptake rising alongside aggressive marketing and flavored product availability. ZYN commands nearly 68.7% of the youth market, supported by social media campaigns and influencer endorsement. Despite the FDA's 2025 authorization of select ZYN products, most brands remain unregulated. Research primarily sponsored by industry suggests harm reduction, yet independent studies have found carcinogens and toxic metals in some products, and evidence gaps persist regarding health risks and long-term outcomes. International regulation varies, with France instituting a nationwide ban in 2025, contrasting sharply with the US approach. Nicotine pouches continue to expand in both market reach and youth appeal, driven by flavor options and harm-reduction narratives. Regulatory and scientific oversight remain fragmented, echoing previous challenges faced with e-cigarettes. Coordinated policy action and independent research are urgently needed to prevent a repeat of prior youth and public health concerns.

Introduction: This study explores patterns and determinants of attempted quitting of smokeless tobacco (AQSLT) in India and Bangladesh, using data from two waves of the Global Adult Tobacco Survey (GATS).

Methods: A secondary analysis was conducted using nationally representative data from GATS Wave 1 (2009-2010) and Wave 2 (2016-2017) in India and Bangladesh. Adults who reported using SLT currently or within 12 months at the time of each wave were included. Changes in AQSLT prevalence, associated factors, and contribution of independent variables were assessed using descriptive statistics, logistic regression, and multivariate decomposition analysis.

Results: While smokeless tobacco (SLT) use declined from Wave 1 to Wave 2 in both countries, changes in AQSLT prevalence were not statistically significant. In India, multivariate decomposition revealed that increases in the proportion of individuals who received quitting advice from a doctor or healthcare professional, noticed health warnings on SLT products, saw SLT warnings in print media, and were exposed to pro-SLT advertisements, had positive endowment effects on AQSLT. Behavioral changes among those exposed to SLT product warnings had the strongest negative composition effect. In Bangladesh, increased exposure to warnings in print media had positive, while decreased exposure to pro-SLT advertisements had a negative endowment effect on AQSLT. No significant composition effects were observed in Bangladesh.

Conclusions: Interventions such as providing advice and health warnings show inconsistent effects on quit behavior. Findings warrant further evaluation of effectiveness of interventions and exploring tested culturally sensitive cessation strategies, that effectively motivate quit attempts among SLT users.

Introduction: Non-formal education students are a vulnerable group due to social influences and varying health literacy. However, evidence on their intention to use e-cigarettes and influencing factors is limited. This study aimed to investigate these intentions and associated factors among students in Bangkok, Thailand.

Methods: A cross-sectional survey was conducted among non-formal education students in Bangkok, Central Thailand, aged 13-24 years, who had never used e-cigarettes. A total of 116 participants were included in the study. Data were collected between 1 and 15 August 2025 using a self-administered structured questionnaire designed to assess knowledge, attitudes, subjective norms, perceived behavioral control, and intention to use e-cigarettes, based on the Theory of Planned Behavior. Descriptive statistics and multiple linear regression were applied to identify factors associated with the intention to use e-cigarettes.

Results: Only 2.6% of participants reported an intention to use e-cigarettes, 6.90% indicated that they might use them in the future, while 90.52% reported no intention to use e-cigarettes. Most participants demonstrated high knowledge of e-cigarettes (62.07%) and negative attitudes toward use (63.79%). Subjective norms were rated high (59.48%), and perceived behavioral control was very high (48.28%). Multiple linear regression analysis showed that attitudes (β=0.223; 95% CI: 0.03-0.41, p=0.025) and subjective norms (β=0.211; 95% CI: 0.02-0.39, p=0.032) had significant positive effects on the intention to use e-cigarettes. Overall, the model explained 15.0% of the variance (R²=0.150, adjusted R²=0.119; F=4.90, p=0.001).

Conclusions: The findings highlight the importance of fostering negative attitudes toward e-cigarette use and reducing the influence of subjective norms among students. However, as this study employed a cross-sectional design, further longitudinal and interventional studies are needed to confirm these relationships and provide stronger evidence for the prevention of e-cigarette use among non-formal education students.

Introduction: In the Philippines, smoking prevalence among adult smokers is slowly decreasing from 23.8% in 2015 to 19.5% in 2021. Despite this decline, evidence shows that while two-thirds of smokers consider quitting, only half receive quit advice from healthcare providers. This study aims to assess the readiness and capacity of health facilities to deliver smoking cessation services in alignment with Administrative Order (AO) 2021-0031 of the Department of Health (DOH).

Methods: This study followed a cross-sectional design. From August to September 2023, we administered an online questionnaire to health facilities nationwide (n=618) in the Philippines to assess the current status of smoking cessation services across all levels of care regarding physical capacity, technical capacity, and availability of resources.

Results: In this descriptive study of 618 surveyed facilities, only 346 (55.99%) provide smoking cessation services. Among these (n=346), 52.02% (n=180) have certified basic tobacco intervention (BTI) providers, 21.97% (n=75) have certified intensive counseling providers, 88.73% (n=307) screen for tobacco use, 39.60% (n=137) assess for nicotine dependence, 53.18% (n=184) provide intensive counseling, 14.45% (n=50) prescribe pharmacotherapy, 66.47% (n=230) do not have directories or established referral networks, 54.34% (n=188) are aware of the DOH Quitline, and 7.51% (n=26) are aware of mobile-based cessation (mCessation) programs.

Conclusions: This study highlights the limited capacity of health facilities in the Philippines to deliver smoking cessation services. Our findings suggest several areas for strengthening, including developing cessation infrastructure, expanding designated cessation clinics, targeting awareness campaigns to promote existing services, and expanding access to comprehensive cessation services training programs. Further research can explore and evaluate the effectiveness of these measures to create a stronger basis for resource allocation and policy implementation.

Introduction: This study examined the association between smoking cessation and different usage combinations of three tobacco products (combustible cigarette [CC], electronic cigarette [EC], heated tobacco product [HTP]) in Korean adults.

Methods: We analyzed repeated data from the Korea Health Panel Survey (KHPS), which consisted of nationally representative samples. A total of 1380 Korean adults participated in the study. The outcome of interest was whether the participant succeeded in quitting smoking all types of tobacco products. Participants were classified according to whether they smoked any of the three tobacco products (CCs and/or ECs and/or HTPs) based on their self-reported responses.

Results: A total of 211 participants had quit smoking during the follow-up period. After adjusting for potential confounding factors, the adjusted odds ratio (AOR) for smoking cessation was 3.15 (95% CI: 1.66-5.95), and 1.81 (95% CI: 0.63-5.21) for participants who currently smoke only HTPs (HTP-only user) and participants who currently vape only ECs (EC-only user), respectively, compared with participants who currently smoke only CCs (CC-only user). There was no significant association between dual or triple smoking and smoking cessation.

Conclusions: HTP-only users had a statistically significant association with smoking cessation, with higher odds of quitting smoking within two years compared to CC-only users. Further studies with a large sample are required to validate our results considering a small number of participants in the comparison groups in this study.

Introduction: This rise in vaping has become a significant public health concern. This mixed-methods study aims to assess the impact of vaping cessation infographics on different cessation motivation and gather feedback regarding how the infographic could be further improved.

Methods: Current e-cigarette users completed an online cross-sectional survey in January 2022 through Prolific^®. Participants evaluated a vaping cessation infographic. Eligible participants were adults aged 19-64 years, US residents, fluent in English, and current e-cigarette users. Participants completed a questionnaire with questions regarding demographics, e-cigarette use, and assessment of the liking of infographics. Poisson regressions were conducted to assess the associations between infographic liking and perceived vaping cessation importance, readiness, and commitment. The open-ended feedback provided in the online survey on the infographic was assessed using content analysis.

Results: Among 361 participants who were presented with the cessation infographic, 85.9% of them rated the infographic favorably. The liking of the cessation infographic (e.g. excellent vs fair/poor) was associated with greater perceived quit importance (incidence rate ratio, IRR=2.0, p<0001, quit commitment (IRR=1.6, p=0.005), and readiness to quit (IRR=1.9, p=0.001). The analysis of open-ended feedback resulted in several themes. Participants appreciated the detailed coping strategies, ease of understanding and accessibility, timelines and expectations, support and encouragement, comprehensive information, youth-focused content, and visual and structural appeals. Areas identified for improvement included health information and risks, design and presentation, target audience and content, support and resources, and user engagement.

Conclusions: This study highlights the need for tailored vaping cessation interventions. The infographic presented in this study resonated more with African American and Hispanic participants, who reported higher favorability than White participants.

Introduction: Although significant efforts have been made to promote smoking cessation, people with mental health conditions continue to be more likely to smoke and to consume more tobacco than those without mental illness. This survey aimed to describe the provision of tobacco dependence support offered during admission and following discharge from NHS acute adult mental health wards across England.

Methods: A cross-sectional online descriptive questionnaire survey was conducted between August and September 2024 in National Health Service (NHS) Mental Health Trusts in England. Questions included identifying the Trust and role of the person responding, and characteristics of tobacco dependence support offered to patients when admitted to acute mental health wards and at discharge.

Results: Of the 50 Trusts approached, a response rate of 44% (n=22) was achieved. Almost all of the respondent Trusts reported offering behavioral support (n=22; 100%), nicotine replacement therapy (n=21; 95.45%), and e-cigarettes (n=21; 95.45%) during participants' time in hospital. Tobacco dependence support offered post-discharge was reported to be in place less frequently (n=13; 59.09%); variations in the duration of support were reported. Tobacco dependence support was delivered by healthcare professionals who had completed National Centre for Smoking Cessation and Training (NCSCT) Practitioner training in all Trusts, with most Trusts also offering the NCSCT specialist Mental Health module training and/or in-house training.

Conclusions: Inpatient tobacco dependence support within NHS mental health settings in England is relatively consistent; however, post-discharge care varies, presenting an opportunity to enhance smoking cessation outcomes.

Introduction: Smoking impairs the outcome of surgery for many reasons. This study aimed to determine the effect of smoking, smoking cessation intervention, and other factors on the incidence of postoperative complications after elective orthopedic and hand surgery directed at bone or cartilage attached at the bone.

Methods: Altogether 451 patients, aged 18 years, participated in this single-center interventional study in Finland between 2015 and 2019. Their smoking status was confirmed by laboratory tests. The study's outcome was the occurrence, number, and severity of complications. A complication was defined as a prolonged hospital stay or any additional treatment or visit to a healthcare unit within 12 months, and its severity was determined by a modified Clavien-Dindo-Sink (CDS) index.

Results: Nine out of 80 smokers stopped smoking with laboratory verification before surgery, and additionally, six smokers stopped smoking at or after surgery. In comparison to never smokers, continuing smokers had more often at least one complication (adjusted odds ratio, AOR=2.50; 95% confidence interval, CI: 1.23-5.09; p<0.05) and more complications (adjusted risk ratio, ARR=1.58; 95% CI: 1.08-2.30; p<0.05). Further, the odds of being in a higher CDS-index category compared to the lower category (AOR=2.19; 95% CI: 1.14-4.19; p<0.05) also increased. With decreasing age, the occurrence (AOR = 0.98; 95% CI: 0.96-1.00; p<0.05) and number of complications (ARR=0.98; 95% CI: 0.97-1.00; p<0.01) decreased. Additionally, the odds of being in a higher CDS-index category compared to a lower category increased (AOR=0.98; 95% CI: 0.96-1.00; p<0.05). In comparison to men, women were more likely to have at least one complication (AOR=1.68; 95% CI: 1.03-2.75; p<0.05). With increasing alcohol consumption, the occurrence of at least one complication increased (AOR=1.10; 95% CI: 1.02-1.19; p<0.05).

Conclusions: Continuing to smoke and decreasing age, the occurrence, number, and severity of complications increased. Alcohol consumption and female sex were linked to an elevated occurrence of complications. It is important to wean every smoking patient, especially young smokers, from smoking to reduce the occurrence and severity of complications.

Introduction: Implementing and maintaining smoking cessation requires high motivation. This study examines the role of Self-Determination Theory (SDT) in enhancing smoking cessation strategies by highlighting the significance of psychological needs for lasting behavioral change. We aimed to explore how participants perceive the importance of SDT's basic psychological needs - autonomy, competence, and relatedness - in the context of smoking cessation treatment and support (SCTS).

Methods: This qualitative study, employing SDT-driven content analysis, utilized a co-design workshop held in Finland in 2019, where 12 participants engaged in group dialogues. The workshop dialogues were examined to determine whether SDT influenced participants' responses regarding SCTS.

Results: The qualitative analysis emphasized the respondents' need for autonomous motivation. The study highlighted the importance of acknowledging individual differences and psychological needs for effective support in SCTS. We identified ten categories: Addiction, Aids and appliances, Characteristics, Collective quitting, Expert advice, Follow-up data, Personal experience, Rewards, Health political decision-making, Ways of quitting smoking. All were linked to basic psychological need. The desire for autonomy was the most common theme (41.2%) followed by competence (34.6%) and relatedness (24.2 %).

Conclusions: Health practitioners should recognize and address the basic psychological needs of autonomy, competence, and relatedness when assisting smokers in their cessation efforts. By offering meaningful choices to support autonomy and enhance competence, and by providing positive, informative feedback while empathizing with the smoker's situation, professionals can improve the effectiveness of SCTS interventions. To be truly effective, support must be tailored to individual differences and needs.

Introduction: Characterized by persistently high smoking prevalence, France nonetheless faces difficulties in implementing coherent and sustained tobacco control measures. To understand what sustains this situation, we explored how French parliamentarians perceive tobacco, tobacco control policies (with a focus on taxation), and the stakeholders they believe should inform policy decisions.

Methods: As all parliamentarians vote on tobacco control policies, between March and June 2022 we undertook 25 individual interviews with French senators and deputies representing diverse political affiliations and regions. Interviews were analyzed using reflexive thematic analysis, guided by Grounded Theory. The section on tax increases was analyzed deductively. We used NVivo 15 for data management.

Results: Among the 25 parliamentarians (17 senators, 8 deputies), they acknowledged the health and economic harms of tobacco, although some minimized its risks. They were more likely to consider media/educational campaigns and taxation as effective, and tobacco sales ban or plain packaging as not. Most accepted anti-tax arguments promoted by the tobacco industry (illicit trade, ineffectiveness, regressivity), and were more likely to engage with tobacconists than health stakeholders during consultations.

Conclusions: In line with streams identified in the Kingdon's Multiple Streams Framework (problem, policy, political), this study suggests that competing framings of tobacco, weak support for evidence-based measures and a political environment favorable to the tobacco industry, weakened prospects for sustained tobacco control. Our findings highlight the need for further research exploring narratives likely to influence policymakers' support for tobacco control measures.