Tobacco Prevention & Cessation最新文献

Introduction: Electronic nicotine delivery systems (ENDS) have recently emerged as a public health threat globally. Despite the low proportion of e-cigarette users (1.22%) reported in the Global Adult Tobacco Survey-2, the Government of India enacted the Prohibition of E-cigarettes Act 2019 (PECA), prohibiting all forms of ENDS/ENNDS. The current analysis presents nationally representative findings on the level of awareness of e-cigarettes in India and its correlates and characteristics of those aware of e-cigarettes.

Methods: The current secondary analysis from GATS-2 among adults aged ≥15 years from all states and Union Territories of India used a standard protocol for data collection and management. A multi-stage cluster sampling design was used. The respondents who were aware of e-cigarettes were included (n=2524). Binomial logistic regression analysis was conducted, and adjusted odds ratios (AORs) with 95% CI, were calculated to measure the associations between independent and dependent variables.

Results: Only 3.4% of the respondents were aware (either heard or seen) of e-cigarettes and their awareness was found significantly higher among males (AOR=2.07; 95% CI: 1.90-2.24), urban population (AOR=2.83; 95% CI: 2.61-3.07), and higher education (AOR=0.41; 95% CI: 0.38-0.45).

Conclusions: Public awareness campaigns about the harms of e-cigarettes and the law (PECA) need to be rolled out in urban and rural areas. Capacity-building exercises of implementers and enforcers at the grassroots level could also support communicating the harms to hard-to-reach groups. Further, regular compliance monitoring of the legislation and prosecution of violators would facilitate its effective implementation at the national and sub-national levels.

Introduction: The purpose of this survey was to assess the prevalence of hookah smokers among children and adolescents aged 12-16 years in Belarus.

Methods: This survey involved 3485 people, including 1737 girls and 1726 boys, and included 6 questions from the main questionnaire of the GYTS aimed at hookah consumption. The statistical processing was performed using the SUDAAN software package; a 95% confidence interval was calculated to calculate weighted prevalence estimates and standard errors.

Results: According to the GYTS carried out in the Republic of Belarus in 2021, hookah smoking is becoming increasingly popular. The number of adolescents who have ever smoked a hookah is 9.3%. The prevalence of regular hookah smokers is quite low (0.9%). But there are justified fears that teens who have never smoked cigarettes but have tried hookah are more likely to start smoking cigarettes and become regular cigarette smokers two years later.The frequency of hookah use naturally increases with age. The number of adolescents who have ever smoked a hookah among those aged 14, 15 and 16 years (10.7%, 11.7% and 18.2%, respectively), was higher than among students aged 12 years (5.5%) or 13 years (5.6%) (p<0.001); hookah smoking was higher among students in the 9th and 10th grades (13.0% and 14.2%, respectively), then among students in the 7th grade (5.1%) (p<0.001).

Conclusions: This national survey provides the first data of prevalence of hookah smoking among children and adolescents in Belarus and allows us to conclude that the growing popularity of waterpipe tobacco smoking dictates the need for timely recommendations on waterpipe smoking policy.

Introduction: Increasing evidence suggests that a diagnosis of a respiratory health condition, such as COVID-19, can prompt a smoker to quit, providing an opportunity to promote and support smoking cessation. However, mandatory quarantine, because of a COVID-19 infection, may stimulate an increase in smoking, making such efforts seem inappropriate or ineffective. This study aimed to investigate the feasibility of a telephone-based smoking cessation intervention for smokers with COVID-19 in Malta.

Methods: An experimental design with a mixed-methods approach was adopted. Participants (n=80) were recruited from a COVID-19 testing center and equally randomized to the intervention (advised to quit and offered three or four telephone-based smoking cessation support sessions) and control (no intervention) groups. Both groups were asked about their smoking habits at baseline and at follow-up at 1 month and at 3 months. The participants in the intervention group were invited to provide feedback on the intervention using questionnaires and by holding interviews.

Results: Participants were recruited at a rate of 74.1% between March and April 2022. Most participants were female (58.8%), with a mean age of 41.6 years who smoked about 13 cigarettes per day. The majority (75%) accepted the offered smoking cessation support, receiving an average of two to three sessions. Findings indicate that the participants were satisfied with the support, finding it useful for attempting to quit. More participants in the intervention group reported a serious quitting attempt and a 7-day point prevalence abstinence at any point during the first month. However, 7-day point prevalence abstinence rates did not differ at the follow-up at 3 months.

Conclusions: The study suggests that providing smoking cessation support to individuals with COVID-19 is feasible and well-received. However, the findings suggest that the intervention's impact may have been brief. Thus, further research is recommended before conducting a conclusive trial.

Introduction: Predicting the success of smoking cessation might be crucial to guide towards the treatment of smoking dependence in a clinical setting. We analyzed the potential determinants of successful smoking cessation with a specific focus on self-efficacy in predicting quitting smoking.

Methods: All consecutive smokers (n=478; 224 men and 254 women) attending the Careggi University Hospital Smoking Cessation Service in Florence (Italy) in 2018-2019 provided information on self-efficacy in predicting smoking cessation, using a 1-10 rating scale during their first visit. Patients were followed up for success in quitting smoking at 3, 6 and 12 months, validated through CO exhaled measurement. To evaluate the association between self-efficacy and the probability of success, we estimated multivariable relative risks (RRs) and corresponding 95% confidence intervals (CIs) through log-binomial models for longitudinal data.

Results: Overall, 47.9% of smokers succeeded in their attempt to quit at 3 months, 40.2% at 6 months, and 33.9% at 12 months. Compared to low self-efficacy (rating scale 1-5), the RR of success in quitting smoking was 1.40 (95% CI: 1.06-1.85) for intermediate self-efficacy (scale 6-7) and 1.64 (95% CI: 1.28-2.12) for high self-efficacy (scale 8-10).

Conclusions: Self-efficacy is an independent determinant of smoking cessation. We recommend to systematically collect self-efficacy, together with other relevant variables, to predict successful smoking cessation. Moreover, strategies to develop and maintain high levels of self-efficacy are essential to increase quit success and improve treatment.

Introduction: We describe the vaping and smoking habits of French adolescents aged 15-16 years in the Loire department with a view to assess the impact of e-cigarette experimentation and use on their smoking behavior.

Methods: This quantitative, cross-sectional, single-center and observational study conducted from January to July 2019 targeted 6622 students aged 15-16 years attending public high school in the Loire department, France.

Results: A total of 4937 (74.6%) adolescents were included. Of these, 73.2% were non-vapers and 72.2% non-smokers; 66.0% of adolescents were non-vapers and non-smokers. Slightly less than half of adolescents had experimented with e-cigarettes (44.6%), more than half of whom (26.8%) continued to use vaping products, with 6.02% vaping daily. Likewise, a little less than half of adolescents had experimented with smoked tobacco (42.4%), more than half of whom (27.8%) continued to use smoking products, with 10.3% smoking daily. Vapers and smokers (20.6%) tended to begin with the use of smoked tobacco and to progress to the dual use of vaping and smoked tobacco products. Vaping had a positive effect, as 71.8% of vapers who smoked tobacco before initiating vaping stopped or reduced smoking following their progression to this double use. More than half of tobacco users are daily users while this daily use affects only 1/3 boys and 1/6 girls for vape. Finally, nearly 80.7% of adolescents who had never smoked before vaping did not smoke at the time of the study.

Conclusions: Our data suggest that vaping has a rather marginal impact on smoking initiation among French adolescents aged 15-16 years in the Loire department. They therefore neither confirm nor completely disprove the gateway effect theory, relating to use of tobacco subsequent to vaping.

Introduction: The objective of this study was to investigate the differences in urine concentrations of heavy metals (uranium, cadmium, and lead) between exclusive menthol and non-menthol cigarette smokers across three racial/ethnic groups using data from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 Special Sample.

Methods: Data from NHANES 2015-2016 Special Sample were analyzed to assess the association between menthol smoking and heavy metal biomarkers in urine across three racial/ethnic groups (N=351), including Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic/Other (HISPO). Multivariable linear regression models were used to estimate adjusted geometric means (GMs) and ratio of GMs (menthol/non-menthol smokers) (RGMs) for urine biomarkers of heavy metals between menthol and non-menthol smokers by race/ethnicity.

Results: Among the 351 eligible participants, 34.4% (n=121) were NHW, 33.6% (n=118) were NHB, and 32.0% (n=112) were HISPO exclusive cigarette smokers. The analysis revealed significantly higher concentrations of urine uranium in NHB menthol smokers compared to NHB non-menthol smokers (RGMs=1.3; 95% CI: 1.0-1.6; p=0.04). NHW menthol smokers appeared to have higher levels of urine uranium than non-menthol smokers, but the difference was not statistically significant (9.0 vs 6.3; RGMs=1.4; 95% CI: 1.0-2.2; p=0.08). There were no significant differences in urine metals (cadmium and lead) by menthol status among NHW, NHB, or HISPO cigarette smokers (p>0.05).

Conclusions: The research findings regarding the higher levels of urine uranium among Non-Hispanic Black (NHB) menthol cigarette smokers raise questions about the claims suggesting that additives in cigarettes do not contribute to increased toxicity.

Introduction: Smoking is one of the risk factors for noncommunicable diseases and is harmful to both active and passive smokers. This study aimed to identify the influence of socioeconomic and environmental issues on smoking in Thailand.

Methods: The study is a secondary dataset analysis of cross-sectional data using data from the 2017 Smoking and Drinking Behaviors Survey of the National Statistical Office of Thailand. The survey collected the data among 88689 participants using a structured questionnaire. The multi-level analysis was used to identify the association between socioeconomics, environmental factors, social marketing, and smoking while controlling for the effects of covariates and presenting the adjusted odds ratio (AOR) and its 95% confidence interval (CI).

Results: Among 88689 respondents, the prevalence of smoking was 18.2% (95% CI: 18.00-18.51). Factors that were associated with smoking were: exposure to secondhand smoke in residential settings (AOR=15.31; 95% CI: 14.47-16.20) and alcohol regular drinking (AOR=4.44; 95% CI: 4.14-4.76). In addition, social marketing factors include: disagreeing or being unsure of the opinions that cigarettes should be categorized as harmful goods (AOR=3.15; 95% CI: 2.94-3.37); not having been exposed to the disadvantages of smoking in social media (AOR=1.51; 95% CI: 1.43-1.61); not having been exposed to the disadvantages of smoking in newspapers, television, radio, advertisements, or other sources (AOR=1.46; 95% CI: 1.37-1.62); having never seen the warning cautions or having seen them but ignored the hazardous effect (AOR=4.81; 95% CI: 4.5-4.9); and having ever seen the warning cautions/ever seen but ignore the hazardous effect (AOR=4.81; 95% CI: 4.54-5.09), and ever seen advertisements or billboards which motivate smoking in various places (AOR=1.33; 95% CI: 1.24-1.42).

Conclusions: Smoking and secondhand smoke are crucial problems that affect health. In addition, related sectors should help to develop a policy recommendation to reduce the smoking rate through social marketing. Strict and comprehensive policies and laws on non-smoking in work places, public spaces, and homes, will help to reduce secondhand smoke exposure among non-smokers.

The Netherlands plans to ban tobacco sales in supermarkets in 2024. In a comprehensive policy evaluation, we aim to examine: 1) the impact of the policy on the number and types of tobacco outlets, 2) the impact on attitudes and behaviors of smoking adults and non-smoking youth, and 3) the influence of the tobacco industry on the policy process and the retail environment. In addition, our study focusses on differential effects in disadvantaged neighborhoods, where both smoking rates and tobacco outlet density are typically highest. This study brings together economic, psychological, and journalistic research methods. We investigate the impact of the new legislation on the number and type of tobacco outlets, and on the number of smokers by using routinely collected population monitoring data. We examine the impact of the legislation on smoking susceptibility of non-smoking youth and on impulse tobacco purchases by smoking adults with yearly quantitative surveys and with qualitative interviews and discussion sessions. We describe whether these impacts differ for disadvantaged versus non-disadvantaged neighborhoods. We investigate what strategies the tobacco industry uses to influence the new legislation, policy processes, and the tobacco retail environment by performing a journalistic investigation, by means of documents obtained by Freedom of Information Act (FOIA) requests, (possibly) leaked documents from insider meetings, and interviews with insiders. The methods of our evaluation can be used as a model for other comprehensive public policy evaluations.

Registration: Clinical Trials ID NCT05554120, Protocol ID KWF140282021-2.

Abbreviations: FOIA: Freedom of Information Act. SES-WOA: socioeconomic scores of private households. MCID: minimal clinically important difference.