Tobacco Prevention & Cessation最新文献

Introduction: It is unclear how young adults who do not use tobacco perceive FDA-authorized e-cigarettes for market entry. This study explored the perceptions and use interests of FDA-authorized e-cigarettes among this population to inform policy decision-making.

Methods: We conducted in-depth interviews with young adults in the US, aged 18-29 years, who do not use tobacco (n=25). Participants viewed images of FDA-authorized e-cigarettes and discussed their perceptions and interest in using these products. We used reflexive thematic analysis to analyze interview data.

Results: Many participants stated that they were not interested in using FDA-authorized e-cigarettes because they had little interest in using e-cigarettes in general. Additionally, almost all participants found the tobacco flavor and product design of these products unappealing, which further added to their disinterest. Most reported high trust in the FDA and its authorization process for e-cigarette market entry and considered FDA-authorized e-cigarettes safe to use. Most considered FDA-authorized products less harmful than other (unauthorized) e-cigarettes they saw in daily life but were not more interested in using the authorized products. When given the hypothetical scenario where FDA-authorized products come with a variety of fruit and candy flavors, most participants still expressed little interest in using them, mainly due to the high perceived harm from using any e-cigarette products.

Conclusions: Although non-tobacco-using young adults in our study reported low interest in using FDA-authorized e-cigarettes for market entry and e-cigarettes in general, the FDA is recommended to continue to evaluate the impact of flavorings and packages on e-cigarette product appeal to reduce e-cigarette use among young people. The FDA should also examine strategies to effectively communicate the purpose of FDA authorization to the public and emphasize that it does not mean these products are 'approved' or safer than unauthorized products.

Introduction: Financial incentives to stop smoking (FISS) programs have been implemented internationally to encourage people who smoke to quit smoking. However, such programs require that the financial reward structure and its resulting effects on smoking quit rates are considered. We analyzed a number of scenarios for FISS reward schedules for current smoking individuals in Ireland, with a view to identify the potential implications in terms of financial consequences and expected effects.

Methods: Using national QuitManager services data 2021-2023, we defined smoking quit rates for smokers currently using the national Health Services Executive stop smoking services in Ireland. Smoking quit rates at 4, 12 and 52 weeks were defined, and additionally defined by sex, age and education level. Using scenarios assuming different FISS reward sizes, structures and targeted population sub-groups, we estimated the number of additional quitters, budget impact, and incremental cost-effectiveness ratio.

Results: A FISS program, if implemented for a cohort of 3500 smokers can result in a budget impact ranging €250000 - €870000. The cost-effectiveness trade-off between different payment schedules and the expected effect size suggested that FISS are cost-effective even at a moderate effect size. A FISS program implemented to approximately 20000 smokers nationally would cost between €2.0 million and €4.8 million, subject to the chosen reward schedule. Across social groups, FISS is more cost-effective for females, individuals in the youngest age group, and individuals with a medium level of education.

Conclusions: This analysis highlights the importance of considering different FISS schedules and potential quit effects, when designing such programs. We highlight that FISS programs should be targeted at certain social groups to achieve highest long-term smoking cessation rates. We also identified important challenges that decision-makers face when designing the reward structure of FISS programs. The acceptability or otherwise of the FISS structures may differ among stakeholders and should be explored.

Introduction: Recently, a concerning pattern has emerged in clinical settings, drawing attention to the potential health risks associated with the accidental ingestion, mostly by children, of a new Heated Tobacco Product (HTP) stick, which contains a sharp metal blade inside.

Methods: Following a webinar of the Joint Action on Tobacco Control 2 project, where data on adverse health incidents related to novel tobacco and nicotine products from EU Member States were presented, the Milan Poison Control Center (PCC) conducted a case series study on the accidental ingestion of blade-containing HTP sticks in Italy, between July 2023 and February 2024. The data in the medical records were analyzed to identify the age distribution, clinical presentation symptoms, performed diagnostic procedures, and medical management.

Results: Overall, 40 cases of accidental ingestion of HTP sticks were identified and are described. A total of 33 (82.5%) children (infants and toddlers, mean age 12.3 ± 3.3 months) were hospitalized. Of these, 29 underwent abdominal X-rays, two children underwent esophagogastroduodenoscopy, and one child suffered from cut injuries to the tonsillar pillar and genian mucosa, requiring anesthesia for fibroscopy. The observed clinical cases associated with new HTP sticks containing a metal blade occurred over just eight months. This issue required the immediate implementation of corrective measures to mitigate health risks. The Ministry of Health issued an alert regarding the dangers related to the accidental ingestion of the stick and imposed more visible warnings on the package.

Conclusions: It is of the utmost importance to raise awareness among both the general public and medical practitioners to prevent further cases of accidental ingestion of HTP sticks by infants and toddlers, and ensure a prompt and informed response in emergency situations.

This review aims to discuss the complex relationship between smoking and interstitial lung diseases (ILDs), emphasizing the significant morbidity and mortality associated with these conditions. While the etiology of ILDs remains multifactorial, cigarette smoking emerges as a prominent modifiable risk factor implicated in their pathogenesis and progression. This narrative review will provide insight into smoking-associated interstitial lung diseases and personalised approaches to smoking cessation. Epidemiological studies consistently link smoking to ILDs such as idiopathic pulmonary fibrosis (IPF), respiratory bronchiolitis-associated ILD (RB-ILD), and desquamative interstitial pneumonia (DIP), highlighting the urgent need for comprehensive tobacco cessation strategies. Despite the established benefits of smoking cessation, adherence to cessation programs remains challenging due to nicotine addiction, psychological factors, and social influences. The modest success rates of smoking cessation in ILD patients, emphasises the importance of tailored interventions and ongoing support is needed to overcome barriers and to improve outcomes of quitting smoking in this category of vulnerable patients.

Introduction: Prior research has linked media tobacco promotion to increased tobacco use and favorable perceptions of tobacco products. Switzerland's tobacco lobby employs advertisements to sway policy decisions in its favor, yet no recent research has assessed this in detail. Our study aims to provide detailed estimates of tobacco industry (TI) advertisement costs, focusing on Philip Morris International (PMI) in Switzerland, and examine potential chronological links between TI advertisement campaigns and parliamentary discussions on tobacco bills. By spreading knowledge on this issue, we aim to support the development of future tobacco advertisement regulations.

Methods: We conducted an expenditure analysis of tobacco-related press advertisements in Swiss print media published between August 2020 and August 2021, accessed through the media intelligence firm Argus Data Insights. Advertisement costs were estimated using publicly available data. We plotted expenditure sums of PMI against key parliamentary session dates featuring discussions on proposed tobacco control measures, such as tighter restrictions on advertising.

Results: Over 12 months, 501 advertisements with tobacco-specific headlines were published in Swiss press media. Of these, 437 advertisements (87.22%) were linked to PMI. PMI accounted for 88.21% (CHF 6486969) of total advertisement expenditure. Notably, PMI advertisements coincided with key political sessions discussing tobacco legislation in parliament, with a limited presence outside these periods.

Conclusions: PMI advertisements were published parallel to key moments of parliamentary discussions, suggesting an attempt by TI to potentially influence discussions. Applying such an advertisement monitoring methodology helps understand the contextual conditions of public health in Switzerland. By analyzing TI advertisements in print media, we sought to highlight regulatory gaps and support the creation of stricter advertising regulations. We recommend continuing such research to strengthen tobacco control policymaking. Key public health efforts should include raising awareness of TI tactics, implementing a comprehensive ban on tobacco advertising, and strategically engaging with the media in tobacco control campaigns.

Introduction: Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic.

Methods: We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically.

Results: The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking.

Conclusions: Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19.

Introduction: Motivations for using electronic nicotine delivery systems (ENDS) include quitting or reducing cigarette smoking, flavor, and addiction. This study examines whether the primary reason for continued ENDS usage changes over time, and its association with device and liquid characteristics.

Methods: Data are from a longitudinal cohort study and include 526 US adults (≥21 years) using ENDS frequently (≥5 days/week) as self-reported, and uploaded photos of their most used ENDS devices and liquids and self-reported primary reason for continued ENDS usage in wave 2 (December 2020-April 2021) and wave 5 (February-April 2023). Device-liquid grouping was defined by device (disposable/disposable pod/refillable pod/tank, adjustable/no adjustable settings) and liquid (salt/freebase) characteristics. A device was classified as having adjustable settings if it allowed users to modify the power, coil, or airflow. Data were analyzed using multivariable logistic regressions and McNemar tests.

Results: From wave 2 to 5, the primary reason for continued ENDS usage significantly changed, with more participants reporting addiction (29.2% vs 34.6%, p<0.001); and significantly more participants used disposable devices (salt, no adjustable settings) (7.9% vs 25.2%, p<0.001). Compared to those using tanks (freebase, adjustable settings), participants using devices with nicotine salt liquids were more likely to report addiction (AOR>2; 95% CI: 1.12-8.19); and participants using disposable devices (salt, no adjustable settings) were less likely to report quitting/reducing smoking as the primary ENDS use reason after controlling for smoking status and sociodemographic characteristics (AOR<0.6; 95% CI: 0.14-0.995).

Conclusions: Over a 2.5-year period, the proportion of participants continuing to use ENDS at least 5 days/week because of addiction grew, and participants' motivations varied by device-liquid grouping. Restrictions on nicotine salts may disproportionately impact those using ENDS because of addiction; and regulations targeting tanks with freebase liquids may disproportionately impact those using ENDS for smoking cessation/reduction.

Introduction: Individuals with behavioral health conditions smoke at significantly higher rates and have been resistant to existing smoking cessation efforts. A clearer understanding of associations between vaping and daily cigarette consumption in this vulnerable population is warranted.

Methods: We analyzed data from the 2014-2018 National Health Interview Survey (NHIS) to examine whether vaping was associated with differences in number of cigarettes smoked per day (CPD) among adults who smoke daily and have varying levels of psychological distress.

Results: After adjustment for sociodemographic covariates, individuals who vaped every day smoked on average 1.48 fewer cigarettes per day than individuals who never vaped (p<0.01), while individuals who vaped some days and individuals who ever but no longer vaped smoked 0.77 and 1.48 more CPD, respectively, than individuals who never vaped. Differences between those who vaped every day and those who never vaped were even greater among those with moderate psychological distress (-2.21 CPD, p<0.01).

Conclusions: Our findings suggest that use of vaping devices may be associated with lower daily cigarette use among individuals with psychological distress, potentially supporting smoking harm reduction efforts.