Tobacco Prevention & Cessation最新文献

Introduction: Although varenicline tartrate is the most effective monotherapy for smoking cessation, the standard-dose (1 mg twice daily) is associated with adverse events: gastrointestinal, sleep-related, and mood-related. Lower doses have demonstrated similar efficacy with lower adverse event incidence. The purpose of this study was to determine whether patients who previously discontinued standard-dose varenicline due to adverse events could tolerate and benefit from low-dose varenicline.

Methods: We conducted a prospective longitudinal pilot study of 22 adult daily smokers in Durham NC, USA, in 2022. All participants previously discontinued standard-dose varenicline due to adverse events. These patients were prescribed either 0.5 mg twice daily for varenicline-related nausea or 1 mg in the morning for sleep problems. The primary outcome was change in self-reported adverse event severity (scale: 0-7). Secondary outcomes were smoking abstinence at 6-week follow-up and tolerance of the lower dose.

Results: Patients with intolerable nausea reported significant severity reduction (6.00 to 0.00; p<0.001) as did patients with intolerable vivid dreams (3.27 to 0.27; p=0.001). Smoking abstinence rates were 28.6% for 0.5 mg twice daily and 26.7% for 1 mg once daily. Low-dose varenicline tolerance was 81.8%.

Conclusions: Patients who experience significant nausea with standard-dose varenicline may successfully make transition to a 0.5 mg low dose twice daily and those who experience vivid dreams to 1 mg varenicline in the morning. Treatment efficacy rates remained relatively high. This suggests a need for a future randomized controlled trial to establish low-dose varenicline as an approach for patients who do not tolerate the standard-dose varenicline.

Introduction: Previous studies investigating socioeconomic status and tobacco consumption during the COVID-19 pandemic were survey-based. To extend knowledge beyond prevalence rates and trends of tobacco consumption, qualitative research is needed to identify individual's experiences. There is a critical gap within this context, particularly in low-middle income countries. The aim of the study was to perform a qualitative analysis on consumption patterns of tobacco users from a low-middle income country during the COVID-19 pandemic, and to identify factors influencing motivation to quit tobacco products during the pandemic and the perceptions of self-risk for complications of tobacco consumption and COVID-19.

Methods: A qualitative study was conducted in São Paulo, Brazil in September 2020. We used a focus group with semi-structured interviews. Participants were invited to answer questions about behavioral and consumption patterns of tobacco products during early stages of COVID-19 pandemic. Two investigators independently performed triangulation of content of the transcripts. Data were analyzed using inductive content analysis.

Results: Eighteen participants were evaluated (66.7% males) with mean age 34.1 ± 14.9 years. Many participants presented high levels (33.3%) of nicotine dependence. Thematic analysis of participants' narratives resulted in two themes: Theme 1: Behavioral and psychological factors impacting consumption; and Theme 2: Consumption patterns, dependence, and information. Open-coding process resulted on four codes: 1) Behavioral and lifestyle changes; 2) Psychological and motivational factors; 3) Consumption patterns and dependence; and 4) Information exposure and awareness. Nine categories were generated from the codes.

Conclusions: Behavioral and consumption patterns varied significantly in tobacco users in Brazil during the early stages of the COVID-19 pandemic, ranging from increases to no changes. Individuals consuming tobacco products showed awareness about the harmful effects of smoking and COVID-19 complications.

Introduction: Heated tobacco products (HTPs) are readily available at diverse points of sale (POS) in Egypt. This study aims to assess these advertisements and promotions to provide evidence for policymakers on the need for tobacco control law amendments and enforcement in Egypt.

Methods: A cross-sectional descriptive study was conducted in Cairo and Giza governorates in 2022 through a convenience sample to collect data from 150 POS. The study's data collection tools assessed the availability, display, advertisement, and promotion of HTP at each site.

Results: Price promotions were available at 18% of the visited sites, ranging between bundles and promo code discounts; 75% of the points of sale had some type of advertisement, either inside (67.3%) or outside (36%), stating that HTP are less harmful than traditional cigarettes because they do not burn. HTP display was commonly around the cashier area (87.3%), followed by candy and gum (80.7%) or soda, ice cream, or coffee machines (66%).

Conclusions: The reported advertisement and promotion of HTP at POS and their sale to minors violate the National Tobacco Control Law 52/1981. These violations risk the health of the youth. We call on policymakers to explicitly ban all sorts of advertisement and promotion of tobacco products at POS, and enforce the ban of sale to minors (under 18 years).

Introduction: Certified peer support specialists, recovery coaches and community health workers uniquely connect to individuals who smoke through shared experiences. This study examines peers' perceptions of tobacco cessation supports to enhance policy and intervention opportunities in rural and non-rural communities.

Methods: Peers (n=172) responded to a needs assessment available from 30 November 2023 to 1 February 2024. Peers were asked questions about their perceptions of currently available and additional support for tobacco cessation. We report overall ratings of these services, as well as ratings stratified by rurality.

Results: Over half of peers perceived widely available tobacco cessation services (Quitline, counseling, NRT, medications, peer-to-peer support) as somewhat effective. Peers tended to favor financial accessibility, holistic health approaches, flexible approaches focused on harm reduction, and increased tobacco cessation services awareness, as well as peer support as additional services. When stratified by rurality, more rural-residing peers reported current tobacco cessation services as at least somewhat effective, but called for greater access to these services and/or the need for novel approaches specifically for individuals in rural communities. Rural peers emphasized the importance of more holistic support, cessation services awareness, virtual opportunities, peer-led services, and healthcare provider education for stigma prevention than their urban counterparts.

Conclusions: Most peers view existing supports as somewhat effective, with peer-to-peer support rated highest. Rural-residing peers favored holistic and virtual supports and urban-residing peers emphasized harm reduction and healthcare coverage, suggesting future cessation efforts within the peer workforce should address rural-specific barriers and leverage community-centered, flexible approaches.

Introduction: Implementation of a 100% tobacco-free policy at universities can assist in limiting the potential negative health impacts of tobacco use, such as susceptibility to lung and heart disease, cancer, addiction, and life-long use. This study's goal was to gain the perspective of students and non-students across a large Midwestern university campus on implementation of a 100% tobacco-free policy.

Methods: Students, faculty, and staff of a Midwestern university were recruited to complete a 19-question cross-sectional online survey on tobacco use on campus, awareness of the current tobacco-free policy, and their interest in supporting a 100% smoke-free policy on campus. The survey included open- and close-ended questions, and responses were analyzed qualitatively and quantitatively.

Results: A total of 2389 respondents completed the survey, and 291 (12.2%) reported current tobacco use from April to July 2024. Participants with a higher probability of current tobacco use were associated with having a higher degree of exposure to secondhand aerosols (AOR=1.34; 95% CI: 1.10-1.62), more awareness of the current tobacco policy (AOR=1.19; 95% CI: 1.06-1.32), and disagreed with the petition statement in support of a 100% tobacco-free campus policy (AOR=2.47; 95% CI: 1.48-4.12). Participants that reported a higher degree of exposure to secondhand aerosols (AOR=2.18; 95% CI: 1.19-3.99) and agreed with the statement that a 100% smoke-free campus policy would promote a healthier college campus (AOR=2.18; 95% CI: 1.20-3.96) were significantly associated with supporting the petition for a 100% smoke-free policy on this university campus.

Conclusions: Supporting a 100% tobacco-free policy for a healthier and safer university campus was demonstrated to be associated with secondhand aerosol exposure among survey respondents.

Introduction: Tobacco waste is a costly, widespread blight and environmental toxicant that is not distributed equally across geographical areas. This investigation reports on the prevalence of noticing tobacco litter and potential inequities in tobacco litter exposure among adolescents in California, USA.

Methods: Data from the 2023 Teens, Nicotine, and Tobacco (TNT) Online Survey (N=4910), a statewide, online cross-sectional survey of California adolescents aged 12-17 years, were analyzed for the self-reported frequency of noticing tobacco product litter. All participants were asked to report how often they notice tobacco product litter (closed-ended response options: almost always, sometimes, once in a while, never). Survey-weighted multivariable regression models were fitted to quantify the odds of noticing tobacco litter 'almost always' according to participant characteristics (age, sex, gender/sexual identity, race/ethnicity, location, family finances, and own and household tobacco use). Data were weighted for geographical and demographic representativeness and response quality.

Results: The prevalence of noticing tobacco litter almost always was 44.6% overall and higher among participants who identified as Hispanic/Latino (50.9%) or LGBTQ+ (53.3%), lived in a small town (57.8%), or whose families were financially disadvantaged (52.7%). These inequities persisted in multivariable models, including adjustment for own and household tobacco use. For example, Hispanic/Latino participants had 1.66-times the adjusted odds of almost always noticing tobacco litter (95% CI: 1.32-2.07; reference: non-Hispanic White); the adjusted odds ratio for LGBTQ+ identity was 1.39 (95% CI: 1.04-1.87; reference: non-LGBTQ+).

Conclusions: The pervasive exposure to tobacco litter observed in this study suggests a need for stronger efforts to reduce tobacco waste, with an emphasis on advancing equity.

Geek Bar is an e-cigarette brand that has seen a substantial rise in sales in the past year. During this time, the brand has utilized an extensive experiential marketing campaign targeting music and arts festivals, especially electronic dance music (EDM) events. This campaign utilizes both festival attendance and social media to create associations between the brand and EDM culture. To analyze this campaign, we downloaded and coded 18 months of Instagram posts by Geek Bar for the festivals mentioned and relevant themes. During the last six months of data collection, 39% of all Instagram posts by Geek Bar were about festivals. The account regularly drew connections between the brand and EDM culture, showing artists/DJs performing alongside young, attractive e-cigarette users. Such attempts to create ties between the brand and EDM culture are concerning given the younger age of EDM fans. These techniques will likely continue due to the lack of regulations and enforcement on e-cigarettes and experiential marketing.

Introduction: People with psychiatric and substance use disorders are more likely to smoke and less likely to quit than smokers in the general population. We evaluated the efficacy of e-cigarettes for abstinence from tobacco smoking in people with psychiatric and substance use problems.

Methods: We analyzed data collected in the larger 'Efficacy, Safety, and Toxicology of ENDS as an Aid for Smoking Cessation' (ESTxENDS) trial (n=1246): the intervention group received e-cigarettes and e-liquids, plus standard-of-care smoking cessation counseling (SOC) for 6 months; the control group received SOC and a voucher. The primary outcome was biochemically validated continuous self-reported abstinence at 6 months; secondary outcomes included 6-month and 7-day self-reported abstinence. We calculated adjusted relative risks (ARR) for two subsamples meeting these conditions at the baseline visit: 1) psychotropic medication use; and 2) problematic substance or polysubstance use.

Results: Among the participants using psychotropic medications (n=239), the ARR for validated abstinence was 2.62 (95% CI: 1.40-4.90) in the intervention group versus the control group, 2.95 (95% CI: 1.72-5.07) for 6-month and 2.96 (95% CI: 1.92-4.55) for 7-day self-reported abstinence, while among participants with problematic substance or polysubstance use (n=818), the ARR was 1.57 (95% CI: 1.20-2.04), 1.42 (95% CI: 1.15-1.74), and 1.53 (95% CI: 1.31-1.79), respectively.

Conclusions: Adding e-cigarettes to standard-of-care counseling increased the likelihood that participants with psychiatric and substance use problems would abstain from smoking, but larger studies should test the efficacy and safety of smoking cessation interventions in this often-marginalized population.

Introduction: Rural regions generally report higher smoking rates than urban centers, which increases the risk of tobacco related harms and consequences, and makes promoting smoking cessation in these areas a priority. Mass distribution of nicotine replacement therapy (NRT) by postal mail has been found to increase the odds of successful cessation attempts. Understanding factors that contribute to the use of NRT could help maximize this intervention's effectiveness.

Methods: People who smoke cigarettes and live in rural areas of Canada were recruited from December 2020 to February 2022 using random digit telephone dialing. Participants were either randomized to be mailed a free, 5-week supply of NRT patches (experimental condition; n=252) or not (control condition; n=246). This secondary analysis used data from this randomized controlled trial to conduct an ordinal regression to determine if any variables measured at baseline predicted which participants in the experimental condition used none, some, or all of the NRT patches.

Results: Greater confidence in ability to quit (AOR=1.07; 95% CI: 1.00-1.15) independently predicted more patch use, while living in more remote places (AOR=0.25; 95% CI: 0.07-0.90) and past substance use (compared to having no history) (AOR=0.68; 95% CI: 0.45-1.04) independently predicted less use.

Conclusions: Understanding what contributes to NRT use in rural mass distribution programs could help maximize the odds of successful cessation attempts, personalize treatment recommendations, and target limited rural resources. Future research focused on rural NRT use and smoking cessation is merited.