Tobacco Prevention & Cessation最新文献

Introduction: Continued smoking increases the risk of all-cause and cancer-specific mortality and adversely affects treatment outcomes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effectiveness of smoking cessation interventions in individuals diagnosed with cancer.

Methods: We conducted a systematic review across several databases, including PsychINFO, EMBASE (through OVID), PubMed (also through OVID), and CINAHL, of RCTs evaluating smoking intervention trials of adult cancer survivors regardless of cancer type, stage, or treatment received. The Cochrane Risk of Bias Tool 2 (ROB-2) evaluated the risk of bias. A meta-analysis was performed using fixed-effect models in R. The last database search was conducted in March 2025.

Results: The search yielded 984 publications. Twenty-three studies met the inclusion criteria. Smoking cessation interventions significantly enhanced cessation rates compared to control (risk ratio, RR=1.36; 95% CI: 1.22-1.51). Results did not show a difference between behavioral interventions alone versus control in the random-effects model (OR=1.08; 95% CI: 0.74-1.60). For studies using biochemical verification, the RR was stronger (RR=1.57; 95% CI: 1.32-1.87) than studies using self-report (RR=1.25; 95% CI: 1.09-1.42). In studies reporting higher success rates in the intervention group, there was a high number of contacts and follow-ups, averaging at least five times.

Conclusions: The present systematic review and meta-analysis provide robust evidence supporting the effectiveness of smoking cessation interventions in cancer patients, particularly when combining pharmacological and behavioral approaches. Cancer patients are capable of successfully quitting tobacco and should be encouraged by healthcare providers to initiate a smoking cessation effort that combines both approaches.

Introduction: People with HIV (PWH) are disproportionately affected by cigarette use, with a 40-60% prevalence rate. They achieve relatively low cessation rates following traditional interventions and often confront compounded challenges related to social factors. HIV care services have integrated Peer Navigators (PNs) into clinical care for many years, but not in the context of smoking cessation. The purpose of this study was to describe the experiences of PWH on a novel smoking cessation intervention that integrated PNs as part of a pilot randomized controlled trial.

Methods: This qualitative examination was conducted among PWH who smoke cigarettes and who participated in a randomized controlled trial between June 2020 and 2021 in Providence, Rhode Island, USA. A PN, defined as a PWH who smoked daily and successfully quit, was trained to provide cessation resources, encourage readiness to quit, and provide social support for quitting. Participants were randomized to either PN or usual care. Twenty-three participants assigned to a PN completed a semi-structured, in-depth qualitative interview. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

Results: Analysis revealed that participants valued the interaction with the PN and described feeling increased social support for quitting. They expressed that the use of storytelling by the PN was linked to a sense of success, and that certain traits of the PN were perceived as salient. Interacting with a PN enforced a sense of accountability, and lead to feelings of enhanced self-efficacy.

Conclusions: Integrating PNs to increase support for quitting seems to be highly acceptable among PWH who smoke. The findings underscore the significance of the lived experience of the peer navigator and the provision of social support.

Introduction: Electronic cigarettes (ECs) and heated tobacco products (HTPs) have gained popularity worldwide, despite concerns about their safety. In Italy, updated national data on these devices remain scarce. The aim of this study is to estimate prevalence, patterns, determinants and trends of EC and HTP use among Italian adults in 2024.

Methods: A face-to-face cross-sectional survey was conducted in 2024 on a representative sample of 3125 Italian individuals aged ≥15 years. Data were collected through interviewer-administered questionnaires and included self-reported information on conventional cigarette (CC), EC, and HTP use. We used multivariable logistic regression models to assess adjusted odds ratios (AOR) for EC and HTP use, including sex, age, education level, and smoking status as covariates. Trends (2022-2024) were assessed using analogous surveys.

Results: In 2024, 2.3% (95% CI: 1.7-2.8) of Italian adults used EC, and 4.5% (95% CI: 3.7-5.2) HTP. Use of both products declined with age (p for trend <0.001). Dual use with CCs was prevalent among EC (87.8%; 95% CI: 80.1-95.4) and HTP (92.5%; 95% CI: 88.1-96.8) users. Compared with current CC smokers, odds of EC and HTP use were lower in never (EC: AOR=0.04; 95% CI: 0.02-0.09; HTP: AOR=0.01, 95% CI: 0.00-0.03) and former smokers (EC: AOR=0.14; 95% CI: 0.04-0.48; HTP: AOR=0.18; 95% CI: 0.08-0.41). Use of HTP increased by 40% over two years (p for trend = 0.085). Use of EC did not substantially change.

Conclusions: The widespread dual use and the increasing prevalence of HTP use in Italy highlight growing public health concerns. Instead of serving as cessation aids for smokers, these devices are frequently used by youth and alongside CCs.

[This corrects the article DOI: 10.18332/tpc/208691.].

[This corrects the article DOI: 10.18332/tpc/208884.].

Introduction: Flavored e-cigarette use among US youth remains prevalent, prompting regulatory action by the Food and Drug Administration (FDA). On 2 January 2020, the FDA announced a federal ban on flavored e-cigarettes, which may be circumvented through unregulated do-it-yourself (DIY) methods shared in online communities. Understanding discourse within these communities is essential to understanding unintended policy effects. This study's primary aim was to describe discourse in a DIY e-cigarette subreddit, with a secondary aim of examining how discussions shifted following the 2020 flavor ban.

Methods: We conducted a mixed-methods study of posts from the subreddit r/DIY_eJuice, an online community focused on DIY e-liquid mixing. A total of 5110 posts were extracted between January 2019 and January 2021, with posts before 2 January 2020 defined as the pre-ban period and those after as the post-ban period. From this dataset, we randomly selected 800 posts (17% of the total; 400 pre-ban and 400 post-ban), which were coded by three trained human coders using a systematically developed codebook with 12 thematic categories. Chi-squared tests were applied to compare thematic distributions between periods.

Results: DIY mixing methods (76%, n=605) and discussions about flavors (49%, n=390) were the most frequent topics across both periods, despite the flavor ban. Policy-related discussions significantly increased from 3.5% (n=14) pre-ban to 8.3% (n=33) post-ban (p=0.004). Posts related to safety concerns remained infrequent in both pre- and post-ban period. The proportion of beginner users was constant at 22% across both periods (n=90 at pre-ban, and n=88 at post-ban), while discussions by experienced users increased from 35.3% (n=141) to 41.5% (n=166).

Conclusions: Regulatory action on flavored e-cigarettes influenced community discourse, increasing conversations about policy and DIY mixing techniques, but not significantly affecting discussions of safety. Continued surveillance of DIY communities is necessary to inform future public health strategies.

Introduction: Tobacco use imposes substantial global economic costs - estimated at $1803 to $1899 billion annually (1.76-1.85% of global gross domestic product) - through healthcare expenditures and productivity losses. In 2019, it contributed to approximately 8.70 million deaths and 229.77 million disability-adjusted life years (DALYs); secondhand smoke exposure added 1.31 million deaths and 37.01 million DALYs. While tobacco control efforts continue, evidence on the economic impacts of interventions remains limited. This study systematically reviews the cost-effectiveness of smoke-free interventions to inform policy.

Methods: A systematic literature review was conducted following PRISMA guidelines and registered with PROSPERO (CRD42024521198). Searches conducted in January 2024 in PubMed, Web of Science, and Cochrane databases identified English-language economic evaluations of smoke-free interventions. Data were extracted using pre-defined checklists, and results were summarized using narrative synthesis. Studies were further assessed using the Consensus Health Economic Criteria (CHEC) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) tools. Studies scoring <60% on CHEERS were excluded.

Results: Of 639 articles, 9 met the inclusion criteria. Most used healthcare or government perspectives (56%), 33% adopting a societal perspective. Interventions included public (44%), workplace, and school-based smoking bans. Studies were conducted in Vietnam, the US, Indonesia, Tanzania, Estonia, Denmark, India, and EU countries, employing economic models such as Markov models (44%). Time horizons ranged from one year to lifetime. Incremental cost-effectiveness ratios (ICERs) ranged from $7 per DALY averted to $17056 per life year gained. Most interventions were found to be cost-effective or dominant.

Conclusions: Public smoking bans consistently saved healthcare costs; workplace and school-based bans were also cost-effective, though context-dependent. This review suggests that smoking bans, particularly comprehensive smoke-free policies, should be prioritized by decision-makers as they demonstrate both health and economic benefits, proving to be cost-effective or even cost-saving public health interventions.

Introduction: We hypothesize that the predictors of smoking cessation in the medium-term are not the same as in the long-term of follow-up. The aim of this study was to identify predictors for smoking cessation (continuous abstinence) and determine if these are maintained over time.

Methods: This is an observational longitudinal (prospective cohort) multicenter study conducted in daily clinical practice in Spain. Patients were consecutively enrolled as they attended consultations, and all patients followed for 12 months. To identify predictors of smoking cessation (at 24 and 52 weeks post-cessation) we have collected sociodemographic and clinical data, smoking consumption characteristics, and psychological and physical dependence variables. Multivariate logistic regression models were fitted. The analysis was by intention to treat.

Results: A total of 337 participants were considered for the study. Predictors of smoking cessation at 24 weeks were baseline weight (AOR=1.02; 95% CI: 1-1.03), not having made a previous quit attempt (AOR=2.72; 95% CI: 1.44-5.15), lower sedation levels on the psychological dependence test (AOR=1.78; 95% CI: 1.06-2.97), and adherence to treatment (AOR=8.03; 95% CI: 3.85-16.73). At 52 weeks, predictors of smoking cessation were being male (AOR=2.38; 95% CI: 1.35-4.18), low self-efficacy (AOR=2.60; 95% CI: 1.36-5.00), not having made a previous quit attempt (AOR=5.06; 95% CI: 2.20-11.66), lower sedation levels on the psychological dependence test (AOR=1.96; 95% CI: 1.13-3.40), and adherence to treatment (AOR=12.03; 95% CI: 4.14-34.94). These last three predictors were those that were maintained between 24 and 52 weeks of follow-up.

Conclusions: Not having previous attempts to quit smoking, lower sedation levels in the psychological dependence test, and having greater adherence to treatment have been maintained as predictors of quitting over time.

Introduction: This study aimed to navigate the relationship between cigarette smoking, alcohol consumption, sleeping disorder, mental health and hearing loss in stroke patients.

Methods: This was a cross-sectional study that involved 1040 male and female patients aged 25-65 years. The research utilized physical examinations, radiological assessments, biochemical tests, and pure-tone audiometry (PTA) to evaluate hearing function.

Results: Among the 1040 stroke patients, 219 cigarette smokers (21.6%) were found to have hearing loss. Remarkable dissimilarities were observed in three categories: cigarette smokers with hearing loss, cigarette smokers without hearing loss, and non-smokers without hearing loss. These differences were noted in BMI (p<0.001), physical activity (p=0.002), hypertension (p<0.001), MP3 use (p<0.001), tinnitus (p<0.001), vertigo (p<0.001), dizziness (p<0.001), and headaches/migraines (p<0.001). Similarly, significant differences were identified among cigarette smokers with hearing loss, cigarette smokers without hearing loss, and non-smokers in relation to age (p<0.001), BMI (p<0.001), MP3 use (p=0.004), hypertension (p=0.028), ATP III metabolic syndrome (p<0.001), IDF metabolic syndrome (p<0.001), tinnitus (p<0.001), vertigo (p<0.001), dizziness (p=0.012), headaches/migraines (p<0.001), vitamin D (p<0.001), calcium (p<0.001), magnesium (p<0.001), potassium (p=0.019), fasting glucose (p<0.001), hemoglobin A1c (p<0.001), high blood pressure (p<0.001), microalbuminuria (p<0.001), and sleepiness (p=0.014). Multivariate stepwise regression analysis of cigarette smokers among stroke patients showed that vertigo (p<0.001), obesity (p<0.001), vitamin D deficiency (p<0.001), ATP III metabolic syndrome (p<0.001), IDF metabolic syndrome (p=0.004), calcium levels (p=0.008), headaches/migraines (p=0.039), and hypertension (p=0.025) could predict hearing loss.

Conclusions: This study puts forward that smoking cigarettes along with factors like hypertension, obesity, vitamin D deficiency, and sleepiness, serve as notable danger element for loosing hearing ability among stroke patients. There is increasing evidence linking cigarette tobacco smoking to lung cancer and various adverse health effects.

Introduction: Despite national and state policy interventions and public health efforts in tobacco control, tobacco use remains the leading cause of preventable death, disease, and disability in the United States. Point-of-sale marketing in the retail environment significantly contributes to tobacco initiation and use among youth and adults, particularly in communities with lower income. The aim of the study was to assess the retail landscape and marketing practices for tobacco products by location and retail store environment.

Methods: This cross-sectional study examined the retail landscape and marketing practices of tobacco products among a random sample of licensed retailers in the District of Columbia (DC) (n=264) from June 2024 to April 2025, including product availability, promotion, price, and placement. Predictors of marketing practices were evaluated by geographical location and store type for flavored and non-flavored products including cigarettes, cigarillos, cigars, chew/snuff/loose tobacco, e-cigarettes, and hookah. Data were collected using an adapted version of the Standardized Tobacco Assessment for Retail Settings (STARS) instrument.

Results: The most available products were cigarillos (80%, n=215), cigarettes (78%, n=206), and chew/snuff/loose tobacco (67%, n=176). Convenience stores were more likely to have price promotions [χ²(2, N=264)=13.4, p<0.01], tobacco products placed <12 inches of toys, candy, or gum [χ²(2, N=264)=16, p<0.001], and tobacco products advertised on the store exterior [χ²(2, N=264)=24.9, p<0.001] compared to all other store types. Lower income communities also had a higher frequency of price promotions [χ²(7, N=264)=34.99, p<0.001], products placed within 12 inches of toys, candy, or gum, [χ²(7, N=264)=41.28, p<0.001] and tobacco products advertised on the store exterior. We found significantly more types of marketing in lower income communities, particularly for cigarillos, which were disproportionately available, marketed, and lower priced.

Conclusions: There are differences in the way tobacco products are marketed and promoted across DC based on store type and location. Youth and adults in communities with lower income are at increased risk of being exposed to tobacco products and marketing. Additional studies examining restrictions on point-of-sale marketing practices, particularly price promotions, are important to complement regulatory interventions and policies.