Tobacco Prevention & Cessation最新文献

Introduction: College students are a priority population for substance use prevention, and other studies have reported associations between mental health and e-cigarette use. This study described the association of mental health to e-cigarette and other substance use (ECIG+ use) among US college students.

Methods: We used Fall 2018 and Spring 2019 National College Health Assessment data among undergraduate students aged 18-24 years (n=55654) at 138 institutions. We characterized substance use patterns and used multinomial regression to model adjusted odds of past 30-day ECIG use type [no substance use (reference); sole e-cigarette use; e-cigarette use and other substance use (ECIG+ use); no e-cigarette use but other substance use] by mental health characteristics, past 12-month diagnosis/treatment and psychological distress, individual characteristics, and college characteristics.

Results: Alcohol was the most prevalent substance (58%) used, followed by cannabis (23%) and e-cigarettes (15%). Nearly all (95%) students who used e-cigarettes reported using another substance. Adjusted odds of ECIG+ use (vs no substance use) were higher among students with past 12-month mental health diagnosis/treatment (AOR=1.5; 95% CI: 1.4-1.6) and higher psychological distress (AOR=1.1; 95% CI: 1.1-1.2). Other characteristics significantly associated with ECIG+ use included gender identity, sexual orientation, race and ethnicity, self-rated health, year in school, cumulative grade average, fraternity/sorority membership, and current residence.

Conclusions: Most students who used e-cigarettes also reported other substance use, and this pattern of use was associated with poorer mental health outcomes than no substance use. Clarifying the relationship between mental health and ECIG+ use may enhance health interventions for college students.

Introduction: Cytisine is a smoking cessation drug now used worldwide. Most of the data available in the literature predict a 25-day treatment, accepted on the basis of previous clinical experience in Eastern Europe. There are few studies on dosing, and only recently some researchers have tried a longer treatment period.

Methods: This real-world retrospective cross-sectional study analyzed data collected consecutively from 2015 to 2021, in seven smoking cessation centers in north-central Italy. The aim of this study is to evaluate the effectiveness and tolerability of a 40-day cytisine treatment with an induction phase and a slower reduction schedule. Data were collected from a group of 871 patients treated with cysteine, varenicline, and nicotine replacement therapy (NRT). The sample was not randomized. Behavioral support (4-6 sessions, each lasting 20-30 min, plus the evaluation session) was delivered to all patients.

Results: Subgroups taking cytisine (n=543 for 40 days), varenicline (n=281 for 12 weeks), and NRT (n=47 for eight weeks) showed biochemically confirmed smoking abstinence at 6 months of 50.5%, 55.9%, and 51.0%, respectively, with a statistically significant difference between cytisine versus varenicline (p<0.01) but not between cytisine versus NRT (p=0.5597). Adverse events were 4.4% with cytisine and 33.3% with varenicline. Behavioral support was an important factor in effectiveness.

Conclusions: This study produced preliminary evidence that the 40-day regimen of cytisine, appears to have less effectiveness in comparison to varenicline but the magnitude of the effect is comparable. The results and tolerability seem to be better than in most other studies.

Introduction: Heated tobacco products (HTPs) have emerged as a prominent category in the tobacco market, particularly within European countries such as Poland. The introduction of HTPs has been met with increasing public interest, reflected in online search behavior. However, the public health implications of this new form of tobacco consumption remain a concern due to the lack of comprehensive research on its long-term effects. This study aimed to track the trends in online searches related to HTPs in Poland between 2016 and 2022, and to assess the impact of significant events on these trends in order to provide insights into public awareness of HTPs.

Methods: Utilizing Google Trends, a free source tool, this study analyzed relative search volume (RSV) for HTP-related keywords in Poland. Key events were identified and mapped against the fluctuations in RSV to understand their impact on search behavior. The analysis was confined to specific HTP-related keywords, excluding broader tobacco-related terms.

Results: A notable increase in HTP-related search queries was observed, particularly around the time of product launches and legislative changes. The largest increases occurred during the introduction of HTPs to the Polish market and during major events such as the COVID-19 pandemic.

Conclusions: The study demonstrates a market interest in HTPs among Polish internet users, with search trends influenced by product launches and policy changes. The findings highlight the importance of monitoring online behaviors to inform public health efforts, despite limitations such as the lack of demographic data. Further research is needed to deepen the understanding of how these online trends correlate with actual consumer behavior and product sales.

Introduction: Little is known about media exposures to heated tobacco products (HTPs). In this study, we examined sources of HTP exposure, including from paid and unpaid media and social connections, in relation to HTP use and use intentions.

Methods: In the fall of 2021, we conducted a cross-sectional survey among adult online panelists (aged 18-45 years) in the US and Israel, oversampling tobacco users. The current study analyzed data from participants who responded to the question about HTP awareness or use (n=2061). Multivariable linear and logistic regression analyses examined the relationship between sources of HTP exposure, HTP use, and use intentions.

Results: Among those aware of HTPs, both Israelis and Americans reported past-month HTP media exposure via advertisements (58.2% vs 48.0%), non-advertisement sources (49.7% vs 30.7%), and social connections (51.5% vs 33.6%), respectively. Factors associated with HTP awareness (n=677/2061; 32.9%) included media use frequency (AOR=1.13; 95% CI: 1.01-1.28) and social connections using HTPs (AOR=2.45; 95% CI: 1.92-3.15). Among those aware of HTPs, past-month HTP exposure via digital media advertisements (AOR=2.06; 95% CI: 1.09-3.91) and non-advertising promotion via radio, podcast, movie, television or theatre (AOR=2.30; 95% CI: 1.19-4.44) and websites (AOR=2.36; 95% CI: 1.32-4.21) were associated with current HTP use. Exposure to digital media advertisements (β=0.35; 95% CI: 0.07-0.62) and non-advertising promotion via social media (β=0.62; 95% CI: 0.34-0.91) were correlated with higher use intentions. Having social connections using HTPs was correlated with higher use (AOR=2.21; 95% CI: 1.19-4.11) and intentions (β=0.66; 95% CI: 0.42-0.91). No significant differences were found across countries.

Conclusions: Digital media (e.g. online, social media) were particularly salient correlates of HTP intentions and use. Future studies are needed that further examine media exposures to these products, as well as that examine possible regulations to limit HTP promotion via these channels.

Introduction: Patient-provider communication quality is instrumental for healthy outcomes in patients. The objective of this study is to examine the relationships between patient-provider communication quality and participant characteristics, perception of e-cigarette harmfulness, and smoking outcomes.

Methods: A pooled cross-sectional design was used on secondary data obtained from the Health Information National Trends Survey (HINTS) 5 from Cycle 1 through Cycle 4, from 2017-2022. Our final sample contained 3511 observations. Our outcome variable was the perception of electronic cigarette smoking status. The independent variable was patient-provider communication quality (PPCQ), measured from a series of questions with responses on a 4-item Likert scale (always, usually, sometimes, never). Demographic variables such as marital status, health insurance status, occupation status, and health-related variables were used as participant characteristics. Ordinal logistic regression models were used to examine the above relationships.

Results: Compared to males, females had lower odds of being in a higher category of perception of e-cigarette harmfulness compared to other categories of e-cigarette harmfulness (AOR=0.66; 95% CI: 0.57-0.76). Respondents who were non-Hispanic Black or Hispanic had lower odds of being in a higher category of perception of e-cigarettes compared to Whites (AOR=0.52; 95% CI: 0.49-0.78, and AOR=0.51; 95% CI: 0.41-0.65, respectively). Respondents who had higher education level compared to those with less than high school had lower odds (AOR=0.30; 95% CI: 0.17-0.51), and Hispanics compared to Whites had higher odds (AOR=1.59; 95% CI: 1.05-2.40), of being former smokers rather than current smokers.

Conclusions: Providers should invest in staff training and development to target the populations that need conversations regarding e-cigarette usage.

Introduction: Research in low- and middle-income countries (LMICs), where the majority of global tobacco users reside, is critical to addressing the global tobacco epidemic. This analysis describes the global tobacco control research portfolio funded by the National Cancer Institute from fiscal years 2000 to 2019.

Methods: We used the National Institutes of Health Query, View, Report database to identify extramural grants relevant to global tobacco control research. Abstracts were analyzed to describe grant characteristics, including topic areas, tobacco products, countries, and regions of focus. Bibliometric and co-authorship network analyses were performed for publications associated with relevant grants.

Results: Of the 93 relevant grants with foreign (non-US) involvement, the majority (83.9%) supported research in upper and lower middle-income countries. The majority of grants (86.0%) focused on cigarettes, with a small subset of grants addressing smokeless tobacco, waterpipe use, or other non-cigarette products. Most grants focused on at least one of the six tobacco control policy measures in the World Health Organization MPOWER package; almost half (48.4%) focused on monitoring tobacco use and around one-third (32.3%) focused on offering tobacco cessation treatment, while other MPOWER measures received less attention in the research portfolio. While most of these grants, and the funding initiatives that supported them, emphasized research in low- and middle-income countries (LMICs), only 3 of 93 grants were awarded directly to LMIC-based institutions.

Conclusions: There is a critical need for research to develop and test strategies to adapt, implement, and scale up evidence-based interventions across diverse LMIC settings. This study identified gaps in research activity that should be addressed to strengthen global tobacco control research capacity.

Introduction: Smoking cessation support (SCS) in the hospital is essential; patients often struggle to maintain quit attempts, which necessitates assistance from healthcare professionals (HCPs). However, unknown barriers can obstruct the implementation of SCS in hospitals. This study aims to uncover barriers to the implementation of SCS in psychiatric, somatic, inpatient, and outpatient hospital settings.

Methods: In the period from June to September 2021, HCPs in a large secondary care hospital in the Region of Southern Denmark completed an online, cross-sectional study, providing sociodemographic details and listing potential barriers to SCS. They also shared additional barriers in the form of free-text responses. Descriptive statistics and thematic analysis of free-text responses were performed.

Results: Of 1645 HCPs surveyed, 409 elaborated their response in the free-text field assessing unlisted barriers. Top listed barriers, reported by more than one-third of participants, included: 'lack of time' (45.1%), 'lack of patient motivation' (34.3%), and 'insufficient knowledge on how to support' (32.2%). Free-text responses revealed three barrier-related, which we grouped under the themes of: 'Concerned about the patient', 'Not part of my job', and 'Inappropriate setting'.

Conclusions: This quantitative and qualitative study identifies barriers to SCS on multiple levels in the hospital setting, i.e. on the patient, provider, and organizational levels. These results can inform healthcare organizations and professionals in the implementation of SCS in routine hospital care.

Introduction: The addition of cooling substances, such as menthol, might be attractive for youth to start smoking waterpipe by reducing the harshness of the smoke, thereby facilitating inhalation. These compounds simultaneously increase the addictiveness of tobacco and related products by stimulating nicotine uptake. Some menthol-like compounds also increase attractiveness by imparting a menthol/mint flavor. We provide an overview of the frequency and quantities of use of menthol-like substances in waterpipe tobacco, herbal molasses and steam stones.

Methods: The primary data source of this study was the European Common Entry Gate (EU-CEG). Product names and ingredients were obtained for 282 waterpipe tobacco products notified to The Netherlands in 2020. Subsequently, gas-chromatography-mass spectrometry (GC-MS) analysis was used to quantify seven menthol-like substances and nicotine in waterpipe tobacco (n=5), herbal molasses (n=1) and steam stones (n=12).

Results: Of the 282 EU-CEG-notified products, 39% have a menthol/mint declared flavor. GC-MS showed that 15 of the 18 investigated waterpipe products contained one or more menthol-like ingredients. GC-MS analysis showed that products termed 'freeze', 'ice' or 'mint' contained higher median menthol concentrations than products without these terms.

Conclusions: Nearly all investigated waterpipe products contained menthol-like compounds, irrespective of their flavor. Such compounds are known to provide flavoring or cooling effects, and some are known to be carcinogenic. Our results can support the regulation of these substances in waterpipe products. Regulators should screen all waterpipe products, not only those with menthol or a similar indicator in product names.