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Kowitt SD, Clark SA, Glaser O, Jetsupphasuk M, Jarman KL, Goldstein AO, Thrasher JF, Ranney LM, Cornacchione Ross J. Examining the influence of cigar and cannabis co-marketing on packaging perceptions: An experiment with a sample of US youth. Addict Behav 2024; 158:108126. [PMID: 39121827 DOI: 10.1016/j.addbeh.2024.108126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/13/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024]
Abstract
SIGNIFICANCE Cigars are sometimes marketed with cannabis references because they are often used for smoking blunts (i.e., cannabis rolled in cigar paper with or without tobacco). However, little research exists on the impact of cannabis co-marketing on cigar perceptions. METHODS Participants included 506 US youth (ages 15-20) recruited April-June 2023 through Qualtrics who reported ever using little cigars or cigarillos (LCCs), past 30-day use of LCCs, or susceptibility to using LCCs. We then conducted a between-subjects experiment, randomizing youth to view one of two cigarillo packages: 1) a package with cannabis co-marketing (i.e., the package included a cannabis-related flavor descriptor and the word "blunt" appeared in the brand name and product label) or 2) a package with no cannabis co-marketing. We assessed the effects of the packaging on perceptions of product ingredients, addictiveness and harm perceptions, product appeal, susceptibility to using the product shown, and purchase intentions. RESULTS Packages with cannabis co-marketing were perceived as more likely to contain cannabis (OR: 5.56, 95 % CI: 3.73, 8.27) and less likely to contain tobacco (OR: 0.42, 95 % CI: 0.25, 0.70) or nicotine (OR: 0.57, 95 % CI: 0.40, 0.82). Cannabis co-marketing also led to higher susceptibility to using the product shown (B: 0.21, p = 0.02). We did not find evidence that cannabis co-marketing changed harm perceptions or purchase intentions. CONCLUSIONS Among a sample of US youth, cannabis co-marketing on cigar packages may change perceptions of product ingredients and increase susceptibility to using such products, which could lead to the initiation of cigars and cannabis.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
| | - Sonia A Clark
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Olivia Glaser
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Michael Jetsupphasuk
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Kristen L Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Adam O Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States
| | - Leah M Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, United States
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Yang Q, Clendennen SL, Marti CN, Loukas A. Associations between social media engagement and young adults' subsequent onset of ENDS dependence symptoms one year later. Addict Behav 2024; 157:108096. [PMID: 38908051 PMCID: PMC11283342 DOI: 10.1016/j.addbeh.2024.108096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/16/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Young adults are more vulnerable than older adults to engagement with online tobacco marketing and to the use of electronic nicotine delivery systems (ENDS) products. Our study examined the longitudinal associations between engagement with pro- and anti-tobacco information on social media (SM) and young adults' subsequent onset of symptoms of dependence on ENDS products one year later, which remain unclear. METHODS Participants were college students in the Marketing and Promotions Across Colleges in Texas study. We analyzed data collected in spring 2018 (wave 8, baseline) and spring 2019 (wave 9), which involves 1,764 college students (Mean age = 24.48, 34.8% White) who reported having ever used any ENDS products but no ENDS dependence symptoms at baseline. Logistic regression analyses were conducted to examine the associations between pro- and anti-engagement with tobacco information at baseline and onset of ENDS dependence symptoms at one-year follow-up, controlling for baseline sociodemographic characteristics and tobacco smoking status. We also examined participant sex and depressive symptoms as moderators of the aforementioned associations. RESULTS Engagement with both pro- (Odds Ratio = 1.73, p < 0.05) and anti- (Odds Ratio = 1.36, p < 0.05) tobacco information at baseline predicted the subsequent onset of symptoms of dependence on ENDS products one year later. The association between pro-engagement and subsequent onset of ENDS dependence symptoms was stronger among females than males (Exp(β) = 3.21, p < 0.05). Depressive symptomology did not moderate any of the associations. CONCLUSIONS Findings suggest that engaging with tobacco information on SM, regardless of its valence, serves as a risk factor for the development of subsequent dependence symptoms among young adult ever ENDS users. Considering the uncertainty of ENDS products' health effects, regulation of SM is encouraged to reduce young adults' (re)posting thoughts or comments about the advantages of ENDS products.
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Affiliation(s)
- Qinghua Yang
- Bob Schieffer College of Commuication, Texas Christian University, Fort Worth, TX, United States.
| | | | - C Nathan Marti
- College of Education, The University of Texas at Austin, Austin, TX, United States
| | - Alexandra Loukas
- College of Education, The University of Texas at Austin, Austin, TX, United States
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Li C, Kuang J, Wang X, Zhang G, Hong M, Cheng G, Zhao T. Exosomal Hsp27 protein are associated with heart failure in STZ-induced type 1 diabetic rats. Int J Biol Macromol 2024; 277:133772. [PMID: 38992522 DOI: 10.1016/j.ijbiomac.2024.133772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/02/2024] [Accepted: 07/07/2024] [Indexed: 07/13/2024]
Abstract
The researchers evaluated cardiac function by measuring the left ventricular ejection fraction and fractional shortening. Plasma samples were collected to measure the levels of EVs and Hsp27. The presence and levels of Hsp27 within the EVs were analyzed. The researchers observed the protective effect of Hsp27-overexpressed BMSC exosomes on heart failure in the rats. The levels of plasma EVs were lower in these rats compared to the control rats. Additionally, the EVs derived from the plasma of the rats with STZ-induced type 1 diabetes contained lower levels of Hsp27. The overexpression of Hsp27 in BMSCs effectively improved heart failure induced by STZ in the rats. The results of this study suggest that EVs and their cargo, specifically Hsp27, play a role in the development of heart failure in individuals with type 1 diabetes.
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Affiliation(s)
- Chunyan Li
- Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
| | - Jiangying Kuang
- Central Research Laboratory, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Xin Wang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Guanghao Zhang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Ming Hong
- Department of Cardiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Guanghui Cheng
- Central Research Laboratory, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Tong Zhao
- Department of Cardiology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China.
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Liu J, Roberts J, Hanby E, Louaddi O, Winickoff JP, Reynolds MJ, Gundersen DA, Gottlieb MA, Emmons KM, Tan ASL. Impacts of the Massachusetts 2019 An Act Modernizing Tobacco Control on tobacco retailer settings: A multi-methods study. Addict Behav 2024; 157:108089. [PMID: 38908050 PMCID: PMC11283354 DOI: 10.1016/j.addbeh.2024.108089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/16/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND In November 2019, the Massachusetts legislature passed An Act Modernizing Tobacco Control and became the first state to restrict retail sales of all flavored (including menthol) cigarettes, e-cigarettes, and other tobacco products. Our study aims to provide the retailer experience of the new law from the perspectives of multiple stakeholders, including tobacco retailers themselves, public health officials, and Massachusetts residents. METHODS We conducted in-depth interviews with seven tobacco retailers and ten public health officials from March 2021 to April 2022. Monthly repeated cross-sectional surveys were administered through the online survey panel Prodege from April 2021 to August 2022 (adult sample: N = 765; adolescent sample: N = 900). Themes from interviews were identified by drawing on deductive codes informed by the interview guide, followed by inductive coding of data. Survey data were descriptively analyzed in R. RESULTS Key themes included retailer frustration over loss of sales to neighboring states, factors associated with retailer compliance, and the need for increased education regarding the law. Survey results showed that a minority of adolescents (13.3%) and adults (26.1%) who vaped in the past 30-days were traveling to border states to purchase vape products. Less than one-quarter of adolescent participants and less than half of adult participants could correctly identify which products Massachusetts did not sell. CONCLUSIONS Evidence from the retailer, public health, and end-user perspectives support mutual benefits of adjacent states enacting flavored tobacco sales restrictions, improved policy education for retailers and the public, and improved retailer enforcement.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States.
| | - Jane Roberts
- Dana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, United States
| | - Elaine Hanby
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States
| | - Oulaya Louaddi
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States
| | - Jonathan P Winickoff
- MassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, United States; MGH Tobacco Research and Treatment Center, Boston, MA, United States; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, United States
| | | | - Daniel A Gundersen
- Dana-Farber Cancer Institute, Survey and Qualitative Methods Core, Boston, MA, United States; Harvard University, TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, United States
| | - Mark A Gottlieb
- Public Health Advocacy Institute, Northeastern University, Boston, MA, United States
| | - Karen M Emmons
- Harvard University, TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, United States
| | - Andy S L Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, United States; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, United States
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Chen-Sankey J, La Capria K, Glasser A, Padon AA, Moran MB, Wagoner KG, Jackson KM, Berg CJ. Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among U.S. adults, 2021. Addict Behav 2024; 157:108090. [PMID: 38880059 DOI: 10.1016/j.addbeh.2024.108090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
INTRODUCTION Little is known about the influence of e-cigarette marketing on cannabis vaping behaviors. This study examined the associations between e-cigarette marketing exposure and nicotine and cannabis vaping among adults. METHODS This cross-sectional study included a U.S. nationally representative sample of adults from the Wave 6 survey of the Population Assessment of Tobacco and Health Study. We used multinomial logistic regressions to examine the associations between past 30-day e-cigarette marketing exposure and past 30-day vaping behavior (sole- and dual-vaping of nicotine and cannabis) overall and stratified by age. RESULTS Overall, 52.0 % of respondents reported e-cigarette marketing exposure, and 89.8 %, 5.6 %, 3.2 %, and 1.4 % reported no vaping, sole-nicotine vaping, sole-cannabis vaping, and dual-vaping, respectively. E-cigarette marketing exposure was associated with increased odds of reporting sole-cannabis vaping versus no vaping (adjusted risk ratio [aRR], 1.31; 95 % confidence interval [CI], 1.09-1.57) and dual-vaping versus no vaping (aRR, 1.26; 95 % CI, 1.01-1.57). This association was found among those aged 18-24 and 25-34 years. It was also associated with increased odds of reporting sole-cannabis vaping versus sole-nicotine vaping (aRR, 1.28; 95 % CI, 1.04-1.58). This association was found among those aged 18-24 years. DISCUSSION E-cigarette marketing exposure was associated with sole-cannabis vaping and dual-vaping, not sole-nicotine vaping among U.S. adults. Such associations were mainly driven by young adults aged 18-24 and 25-34 years. Greater restrictions on tobacco marketing may have reduced the influence of e-cigarette marketing on nicotine vaping, while gaps in marketing restrictions for cannabis may contribute to e-cigarette marketing influence on cannabis vaping.
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Affiliation(s)
- Julia Chen-Sankey
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, United States; Rutgers School of Public Health, Piscataway, NJ, United States.
| | - Kathryn La Capria
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, United States
| | - Allison Glasser
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, United States
| | | | - Meghan B Moran
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kimberly G Wagoner
- Wake Forest University, School of Medicine, Winston-Salem, NC, United States
| | - Kristina M Jackson
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States; Rutgers Addiction Research Center, Piscataway, NJ, United States
| | - Carla J Berg
- George Washington University, Milken Institute School of Public Health, Washington, DC, United States
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Aston ER, Merrill JE, Boyle HK, Berey BL, López G. Utility of a brief measure of cannabis demand: Day-level associations with cannabis use. Drug Alcohol Depend 2024; 262:111396. [PMID: 39094382 PMCID: PMC11338517 DOI: 10.1016/j.drugalcdep.2024.111396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 06/02/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Cannabis demand (i.e., relative value) is usually assessed as a trait-level risk-factor for cannabis use and consequences. This study examined within-person variability in day-level intensity (i.e., amount consumed at zero cost) and Omax (i.e., maximum cannabis expenditure) and tested hypotheses that demand would be positively associated with day-level cannabis use. METHODS Young adults (n=85) reporting past-month simultaneous alcohol and cannabis use completed two daily surveys for 30 days. Morning surveys assessed prior-day cannabis use and evening surveys assessed day-level demand (i.e., intensity, Omax). Multilevel models tested day-level effects of intensity and Omax on any cannabis use and flower use frequency and quantity (i.e., grams). RESULTS Approximately 52 % and 46 % of variability in intensity and Omax, respectively, was due to within-person change. At the day-level, higher intensity and Omax were associated with higher likelihood of any cannabis use, regardless of formulation; Omax was associated with use of flower in particular; and intensity was associated with the highest quantity of use. At the person-level, only Omax was associated with flower use likelihood, and only intensity was associated with flower quantity across days. CONCLUSIONS Cannabis demand demonstrated day-to-day variability, conceivably in response to various internal states and external factors. Intensity and Omax were related to elevated likelihood of using any cannabis, particularly flower, at the day-level. Overall, these data illustrate the validity and utility of brief cannabis demand measures, which might be used to further understand cannabis' reinforcing value at a fine-grained level.
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Affiliation(s)
- Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA.
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Holly K Boyle
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Benjamin L Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA; Providence VA Medical Center, Providence, RI 02908, USA
| | - Gabriela López
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
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Ruleman AM, Clendennen SL, Chen B, Harrell MB. Reasons for multiple tobacco product and cannabis co-use among Texas young adults. Addict Behav 2024; 156:108063. [PMID: 38824720 DOI: 10.1016/j.addbeh.2024.108063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE This study examines differences in reasons for e-cigarette, cigarette, and cannabis use across exclusive, dual, co-, and poly co-users. METHODS Participants were 645 young adults who reported past 30-day (P30D) use of e-cigarettes, cigarettes, or cannabis at wave 14 (Fall, 2021) of the Texas Adolescent Tobacco Marketing and Surveillance System (TATAMS). Exclusive users reported P30D use of one product, dual users reported P30D use of e-cigarettes and cigarettes, co-users reported use of cannabis and one tobacco product, and poly co-users reported P30D use of all three products. Participants were asked if they agreed with a series of reasons for using their respective products. Multinomial logistic regression analyses were conducted to examine associations between reasons for use and pattern of use, controlling for sex, race/ethnicity, and lifetime product use. RESULTS 26.36 % of P30D users reported cannabis and tobacco use. Poly co-users were more likely to report using e-cigarettes because their friends do than e-cigarette co-users (aRRR = 2.64; 95 %CI = 1.19-5.83) and dual tobacco users (aRRR = 5.11; 95 %CI = 1.73-15.12). Poly co-users were more likely to smoke cigarettes while drinking alcohol (aRRR = 4.68; 95 %CI = 1.06-20.72) or to experience a pleasurable buzz (aRRR = 5.48; 95 %CI = 1.62-18.57) than exclusive cigarette users. Poly co-users more often reported using cannabis for taste (aRRR = 3.13; 95 %CI = 1.51-6.51), because their friends use it (aRRR = 2.19; 95 %CI = 1.08-4.42), and while drinking alcohol (aRRR = 2.13; 95 %CI = 1.03-4.41) than exclusive cannabis users. CONCLUSIONS Given that reasons for use differ significantly among types of multiple product users and exclusive users, interventions should be tailored to address the specific tobacco and cannabis use practices of young adults.
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Affiliation(s)
- Ashlynn M Ruleman
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA.
| | - Stephanie L Clendennen
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
| | - Baojiang Chen
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
| | - Melissa B Harrell
- University of Texas Health Science Center, School of Public Health, 1836 San Jacinto Blvd, Austin, TX 78701, USA
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Wang Y, Romm KF, Edberg MC, Bingenheimer JB, LoParco CR, Cui Y, Berg CJ. Two-part models identifying predictors of cigarette, e-cigarette, and cannabis use and change in use over time among young adults in the US. Am J Addict 2024; 33:559-568. [PMID: 38685757 DOI: 10.1111/ajad.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 04/01/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Limited longitudinal research has examined differential interpersonal and intrapersonal correlates of young adult use and use frequency of cigarettes, e-cigarettes, and cannabis. This study aimed to address these limitations. METHODS We analyzed five waves of longitudinal data (2018-2020) among 3006 US young adults (Mage = 24.55, 44% male, 32% sexual minority, ~30% racial/ethnic minority). Two-part latent growth models examined likelihood of past-month cigarette, e-cigarette, and cannabis use (binary part) and days used (continuous part) and identified predictors (depressive symptoms, personality traits, adverse childhood experiences [ACEs], parental use) of baseline use and changes over time. RESULTS Regarding baseline past-month use (27% cigarettes, 38% e-cigarettes, 39% cannabis), depressive symptoms, ACEs, and parental substance use predicted use outcomes (i.e., likelihood, frequency) for each product; extraversion predicted cigarette and e-cigarette use outcomes; openness predicted e-cigarette and cannabis use outcomes; conscientiousness negatively predicted cigarette and cannabis use outcomes; and agreeableness negatively predicted cannabis use frequency. Regarding longitudinal changes, conscientiousness predicted accelerated increase of cigarette use frequency at later timepoints; depressive symptoms predicted increases in likelihood of e-cigarette use but the association weakened over time; and parental cannabis use predicted decreased cannabis use frequency but the association weakened over time. DISCUSSION AND CONCLUSIONS Young adult substance use interventions should target high-risk subgroups and focus on distinct factors impacting use, including chronic, escalating, and decreasing use. SCIENTIFIC SIGNIFICANCE This study advances the literature regarding distinct predictors of different substance use outcomes and provides unique data to inform interventions targeting young adult cigarette, e-cigarette, and cannabis use.
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Affiliation(s)
- Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Mark C Edberg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
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Izquierdo-Condoy JS, Ortiz-Prado E. Urgent action needed: addressing the regulatory gap in e-cigarette trade and usage. J Public Health Policy 2024; 45:582-587. [PMID: 38969788 PMCID: PMC11315660 DOI: 10.1057/s41271-024-00505-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
Tobacco use is associated with serious health problems. Global efforts, such as the World Health Organization's Framework for Tobacco Control, have reduced tobacco use, but challenges remain. Initially perceived as aids for smoking cessation, e-cigarettes have gained popularity among young people and non-smokers. Government approaches to regulating e-cigarettes range from treating them like tobacco, requiring a prescription for their use to outright bans. Although touted as a valuable alternative, evidence suggests that increased e-cigarette use carries potential direct and indirect health risks, necessitating urgent regulatory measures on a global scale. Lack of defined and uniform regulations poses substantial public health risks, compounded by marketing targeting vulnerable groups. Immediate interventions, public awareness, and research are essential to effectively control the current e-cigarette epidemic.
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Affiliation(s)
- Juan S Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Calle de los Colimes y Avenida de los Granados, Universidad de Las Américas, 170137, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Calle de los Colimes y Avenida de los Granados, Universidad de Las Américas, 170137, Quito, Ecuador.
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Kim K, Niederdeppe J, Kalaji M, Scolere L, Porticella N, Mathios A, Avery R, Dorf M, Greiner Safi A, Byrne S. Contingent Effects of E-Cigarette Warning Label Messages on Cognitive Elaboration and Fear Among U.S. Youth Ages 14-17 by Vaping Experience and Peer Vaping Behavior. HEALTH COMMUNICATION 2024:1-13. [PMID: 39192551 DOI: 10.1080/10410236.2024.2394260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
The U.S. Food and Drug Administration (FDA) currently requires a warning about the addictive nature of nicotine to be placed on electronic cigarette advertisements and packaging. To consider the value of additional warning messages on public health outcomes, this study examines the additive effect of new warnings that are based on recent claims from U.S. federal authorities. We conducted a secondary analysis of recent data from 1,202 U.S. youth ages 14-17 to test the impact of exposure to additional warnings placed on advertisements for vaping products on cognitive elaboration, fear, and willingness to vape and smoke. This investigation also looked closely at effects on youth who may have increased risk of future vaping due to prior vaping experiences or having friends who vape. Exposure to the alternative warnings did not amplify cognitive elaboration compared to the current FDA warning alone, but it did increase fear. Youth elaboration on both the benefits and risks of vaping was associated with willingness to both vape and smoke, but fear was not associated with either outcome. The effects of warning label exposure and cognitive elaboration varied by prior vaping experience and having at least one friend who vapes. We conclude by discussing the implications of this contingent pattern of effect and association.
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Affiliation(s)
- Kwanho Kim
- Department of Communication, Cornell University
| | - Jeff Niederdeppe
- Department of Communication, Cornell University
- Cornell Jeb E. Brooks School of Public Policy, Cornell University
| | - Motasem Kalaji
- Department of Communication Studies, California State Northridge
| | - Leah Scolere
- Department of Design and Merchandising, Colorado State University
| | | | - Alan Mathios
- Cornell Jeb E. Brooks School of Public Policy, Cornell University
- Department of Economics, Cornell University
| | - Rosemary Avery
- Cornell Jeb E. Brooks School of Public Policy, Cornell University
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Wu J, Fetterman JL, Cornacchione Ross J, Hong T. Quitting on TikTok: Effects of Message Themes, Frames, and Sources on Engagement with Vaping Cessation Videos. JOURNAL OF HEALTH COMMUNICATION 2024:1-12. [PMID: 39186489 DOI: 10.1080/10810730.2024.2394774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
This study examined how message themes, frames, and sources in vaping cessation videos on TikTok influenced positive (i.e. likes, shares, positive comments regarding quitting vaping) and negative video engagement (i.e. negative comments regarding quitting vaping). TikTok videos (N = 412) with the hashtags #quitvaping and #quittingvaping were analyzed. Aspect-based sentiment analysis was conducted to evaluate the sentiment of quitting vaping in comments. Negative binomial regression models predicted video engagement from six message themes, ratios of gain and loss frames, and message sources. Themes related to nicotine addiction and physical health effectively drove positive engagement, such as likes and shares. The theme of harmful chemicals elicited mixed responses, generating both positive and negative comments regarding quitting vaping. Videos with a higher ratio of gain frames led to more positive engagement, including likes, shares, and positive comments regarding quitting vaping. Sources with informal expertise (e.g. those who have successfully quit vaping) and current e-cigarette users were more effective in engaging the TikTok audience than non-expert and non-user sources. These findings provide insights into messaging strategies that can effectively engage TikTok audiences and encourage vaping cessation.
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Affiliation(s)
- Jiaxi Wu
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Traci Hong
- College of Communication, Boston University, Boston, MA, USA
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12
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Lillie HM, Ratcliff CL, King AJ, Pokharel M, Jensen JD. Using narratives to correct politically charged health misinformation and address affective belief echoes. J Public Health (Oxf) 2024; 46:430-436. [PMID: 38632889 DOI: 10.1093/pubmed/fdae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/15/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In May 2020, news outlets reported misinformation about the Centers for Disease Control (CDC) related to COVID-19. Correcting misinformation about outbreaks and politics is particularly challenging. Affective belief echoes continue to influence audiences even after successful correction. Narrative and emotional flow scholarship suggest that a narrative corrective with a positive ending could reduce belief echoes. Therefore, this study investigated the efficacy of a narrative corrective with a relief ending for correcting misinformation about the CDC. METHODS Between 29 May and 4 June 2020, we tested the effectiveness of a narrative to correct this misinformation. Participants in the United States (N = 469) were enrolled via Qualtrics panels in an online message experiment and randomized to receive a narrative corrective, a didactic corrective or no corrective. RESULTS The narrative corrective resulted in lower endorsement of the misinformation compared with the control and the didactic corrective. The narrative corrective had a positive indirect effect on perceived CDC competence and mask wearing intentions for politically moderate and conservative participants via relief. CONCLUSIONS Public health institutions, such as the CDC, should consider utilizing narrative messaging with positive emotion endings to correct misinformation. Narratives better address affective belief echoes, particularly for counter-attitudinal audiences.
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Affiliation(s)
- Helen M Lillie
- Department of Communication Studies, University of Iowa, Iowa City 52242, USA
| | - Chelsea L Ratcliff
- Department of Communication Studies, University of Georgia, Athens 30602, USA
| | - Andy J King
- Department of Communication, University of Utah, Salt Lake City 84112, USA
| | - Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos 78666, USA
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City 84112, USA
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13
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Klemperer EM, Kock L, Feinstein MJP, Coleman SRM, Gaalema DE, Higgins ST. Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study. Prev Med 2024:108112. [PMID: 39181738 DOI: 10.1016/j.ypmed.2024.108112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
SIGNIFICANCE A growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. METHODS Data came from Waves 4-6 (12/2016-11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. RESULTS Among US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9-16.4) of females and 23.4% (20.0-26.9) of males were young adults (aged 18-24), 11.7% (9.2-14.2) of females and 14.4% (11.6-17.2) of males had CONCLUSION US females who dually use e-cigarettes and cigarettes were more likely to attempt to quit smoking, but not more likely to succeed at quitting, than males.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America.
| | - Loren Kock
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Marc Jerome P Feinstein
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Sulamunn R M Coleman
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Diann E Gaalema
- Division of Cardiovascular Medicine, University of Texas Medical Branch, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
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14
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Chen W, Chen G, Qi S, Han J. Trends of electronic cigarette use among adolescents: A bibliometric analysis. Tob Induc Dis 2024; 22:TID-22-146. [PMID: 39175625 PMCID: PMC11339947 DOI: 10.18332/tid/191761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/29/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION The use rate of electronic cigarettes (e-cigarettes) among adolescents is continuously rising globally, posing new challenges to public health and negatively impacting adolescent health. This study employs bibliometric methods to systematically present the current state and evolving trends in global research on adolescent e-cigarette use. METHODS This study uses CiteSpace to conduct a bibliometric analysis of articles related to adolescent e-cigarette use from the Web of Science (WoS) Core Collection database. Firstly, performance analysis and collaboration network analysis were utilized to clarify the basic publication status, main knowledge producers, and knowledge collaboration networks in adolescent e-cigarette use research. Secondly, a co-citation network analysis was performed to visually analyze the disciplinary characteristics and 'hot topics' in this field. Finally, keyword burst detection and clustering techniques were employed to further explain the development trends and frontiers of research on adolescent e-cigarette use. RESULTS A total of 2063 research articles and review articles were included in this study. Research on adolescent e-cigarette use has significantly increased from 2002 to 2024. The United States, the United Kingdom and Canada are the main contributors, with their institutions and researchers playing key roles in the international collaborative network. Current research increasingly adopts interdisciplinary approaches. Keyword co-occurrence and burst identified current research 'hotspots' including vaping, substance use, public policy, prevention, advertising, and cessation. Co-citation cluster analysis revealed promising research areas such as attractiveness, environment and health, accessibility and smoking behavior, and mental health. CONCLUSIONS Through data mining and visualization techniques, this study provides a comprehensive bibliometric analysis of published work on e-cigarettes and adolescence. The results of this work offer references for researchers in future investigations.
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Affiliation(s)
- Wenqi Chen
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Gaoran Chen
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Shaojie Qi
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Jinzheng Han
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
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15
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Dyer ML, Suddell SF, Khouja JN, Havill MA, Blackwell AKM, Maynard OM, Munafò MR, Attwood AS. Do Flavor Descriptions Influence Subjective Ratings of Flavored and Unflavored E-liquids Among Nonsmoking and Non-vaping UK Adolescents? Nicotine Tob Res 2024; 26:1141-1149. [PMID: 38468465 PMCID: PMC11339169 DOI: 10.1093/ntr/ntae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Youth use of electronic cigarettes (e-cigarettes) is rising globally and is associated with health harms. Flavor descriptions on e-liquid packaging may contribute to the appeal of e-cigarettes among youth. This study compared subjective ratings of e-liquid packaging flavor descriptions among nonsmoking and non-vaping UK adolescents. AIMS AND METHODS This was an online observational study in a UK sample of nonsmoking and non-vaping adolescents aged 11-17 years. The primary analyses compared flavored versus unflavored descriptions and the secondary analyses compared sweet flavor versus fruit flavor descriptions. Outcomes were packaging appraisal, packaging receptivity, perceived harm, and perceived audience. RESULTS The survey was completed by 120 participants (74% female). Packaging appraisal ratings were higher for e-liquids with flavored descriptions than unflavored descriptions (mean difference 5.9, 95% CI: 4.2 to 7.6, p < .001). Similarly, packaging receptivity ratings were higher for e-liquids with flavored descriptions than unflavored descriptions (mean difference 4.2, 95% CI: 2.8 to 5.6, p < .001). Participants also perceived e-liquids with flavored (vs. unflavored) descriptions as less "grown-up" (mean difference -5.2, 95% CI: -7.3 to -3.1, p < .001). However, ratings of perceived harm were similar for flavored and unflavored descriptions (mean difference -1.0, 95% CI: -2.6 to .5, p = .189). CONCLUSIONS Although this study found differences in subjective ratings of e-liquids with flavored and unflavored descriptions, nonsmoking and non-vaping UK adolescents generally had low appraisal and receptivity for e-liquids and they perceived them as being "grown-up" and harmful. IMPLICATIONS Youth use of electronic cigarettes (e-cigarettes) is increasing globally, leading to concerns about health harms. This study compared adolescents' ratings of e-liquids with flavored versus unflavored descriptions and e-liquids with sweet flavor versus fruit flavor descriptions. This study adds to previous studies that have compared adolescents' ratings of e-liquids with tobacco flavor versus non-tobacco flavor descriptions. Although packaging appraisal and receptivity ratings were higher (more positive) for e-liquids with flavored versus unflavored descriptions, overall, adolescents who do not smoke or vape had low appraisal and receptivity for e-liquids, and they perceived them as being "grown-up" and harmful.
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Affiliation(s)
- Maddy L Dyer
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Steph F Suddell
- Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
| | - Jasmine N Khouja
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Michelle A Havill
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, UK
| | | | - Olivia M Maynard
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Angela S Attwood
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
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16
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Dolan S, McDonald J, Claus E, Gahl RF, Sun Y, Farrar J, Meredith S. A Method for Amending Loose Smokeless Tobacco With Menthol for Administration in Clinical Studies. Nicotine Tob Res 2024; 26:1244-1247. [PMID: 38513001 DOI: 10.1093/ntr/ntae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Menthol has long been incorporated as a flavor additive in tobacco products and can impact use behaviors. Despite its inclusion in some of the most popular flavored smokeless tobacco (ST) products (eg, "mint" flavored products), few studies have systematically investigated the impact of menthol on ST use behaviors in prospective empirical studies. Rigorous investigation of ST menthol content on behavioral and physiological outcomes requires ST products with stable and precise levels of menthol; however, commercial product composition variability prevents product comparisons when evaluating the effects of systematic changes in menthol content on clinical outcomes. AIMS AND METHODS We developed amended loose moist snuff ST products by treating commercially available, unflavored loose ST with an ethanol-based menthol spiking solution or a nonmentholated ethanol control solution to develop test products with different levels of menthol: 0, 1, 3, and 5 mg menthol/g tobacco. We evaluated the stability of menthol content in these products over 24 months and evaluated menthol exposure associated with the products through pharmacokinetic analysis of plasma menthol-glucuronide in human participants (n = 22). RESULTS Menthol content of the amended products was on target, homogenous, and stable for up to 24 months. Menthol exposure (menthol-glucuronide Cmax and AUC) significantly differed between each test product. CONCLUSIONS These data suggest that stable products with nonoverlapping menthol content can be developed using a menthol spiking solution and can be subsequently administered for clinical assessments of mentholated loose ST. IMPLICATIONS The results from this study suggest that a menthol spiking solution can be used to mentholate unflavored, loose ST to a target menthol content. With this method, the ST menthol content was stable for at least 24 months, and the products exposed users to menthol in a dose-dependent manner. This method yielded loose ST products with precise, stable levels of menthol to allow systematic evaluation of ST menthol content on clinical outcomes. The method may have applications for systematically evaluating changes in other tobacco product ingredients.
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Affiliation(s)
- Sean Dolan
- Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, USA
| | - Jacob McDonald
- Lovelace Biomedical Research Institute, Albuquerque, NM, USA
| | - Eric Claus
- Lovelace Biomedical Research Institute, Albuquerque, NM, USA
- The Mind Research Network, Albuquerque, New Mexico, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Robert F Gahl
- Division of Extramural Activities, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yan Sun
- Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, USA
| | - Jabari Farrar
- Lovelace Biomedical Research Institute, Albuquerque, NM, USA
| | - Steven Meredith
- Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, USA
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17
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Silver NA, Kucherlapaty P, Bertrand A, Falk RN, Rath JM. Improving Enforcement Measures and Establishing Clear Criteria: A Content Analysis of Tobacco-Brand-Owned Instagram Accounts. Nicotine Tob Res 2024; 26:1175-1182. [PMID: 38470229 DOI: 10.1093/ntr/ntae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION This study examines limitations of the current regulatory framework for tobacco advertising on Instagram. We first investigate compliance with Food and Drug Administration (FDA) warning label requirements for posts by tobacco-owned accounts. Next, we examine the prevalence of content that has been restricted in broadcast or print for its youth appeal, followed by content meeting more expansive criteria for youth appeal set forth in the FDA's guidance document. AIMS AND METHODS Posts by tobacco-brand-owned accounts between January 1, 2021, and February 14, 2022, were sampled from Mintel's Comperemedia Omni database. Instagram posts from 15 accounts were examined for violations of FDA warning label requirements and content that has been restricted on other mediums, including cartoons, sports branding, unauthorized claims, and young models (N = 1243). Finally, a subsample of n = 453 unambiguously branded posts was coded for themes that met the FDA's criteria of resonating with younger audiences, particularly that "adolescents rely on external information as they seek to shape their own identities." RESULTS Only 12.8% of posts had fully compliant warning labels. Content that has been in some way regulated on other mediums, such as cartoons (1.6%), unauthorized health claims (<1%), sports branding (<1%), and young models (4.4%) were infrequent. However, a conservative analysis focusing only on branded posts found that posts frequently highlighted tech elements (45%), device customizability (24.5%), vaper identity (17.7%), stylized product photography (33.6%), social media engagement (32.2%), and memes (5.7%). CONCLUSIONS Enforcement of existing regulations on Instagram is minimal. Explicit content restrictions applying evidence-based guidance on youth-appealing advertising are needed. IMPLICATIONS This research has important implications for enforcing and expanding advertising regulations on social media. First, Instagram's self-imposed regulations are ineffective, permitting tobacco companies to post ads from brand-owned accounts despite claiming to restrict tobacco promotion on the platform. Second, policymakers should seek to apply FDA guidance on youth-appealing advertising informed by decades of research to create explicit enforceable content restrictions that extend beyond cartoons, sports figures, and young models to include content likely to situate tobacco use within the developing self-concept of vulnerable youth such as presenting e-cigarettes as hi-tech devices, highlighting vaper identity, or infiltrating online social media culture. Finally, greater resources for enforcement are needed given the only applicable regulation, warning labels, remains largely ignored.
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Affiliation(s)
| | | | | | - Robert N Falk
- Truth Initiative Schroeder Institute®, Washington, DC, USA
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18
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Gomes MN, Reid JL, Rynard VL, East KA, Goniewicz ML, Piper ME, Hammond D. Comparison of Indicators of Dependence for Vaping and Smoking: Trends Between 2017 and 2022 Among Youth in Canada, England, and the United States. Nicotine Tob Res 2024; 26:1192-1200. [PMID: 38531767 PMCID: PMC11339172 DOI: 10.1093/ntr/ntae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market. AIMS AND METHODS Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16-19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use. RESULTS All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking. CONCLUSIONS From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking. IMPLICATIONS Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products.
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Affiliation(s)
- Makenna N Gomes
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Vicki L Rynard
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Katherine A East
- Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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19
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Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021. Tob Control 2024:tc-2023-058453. [PMID: 39174323 DOI: 10.1136/tc-2023-058453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 08/03/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the lung injuries outbreak, flavour bans, Tobacco 21 and the COVID-19 pandemic. METHODS Using the Population Assessment of Tobacco and Health Study, we applied a multistate transition model to 28 061 adults in waves 4-5 (2017-2019) and 24 584 adults in waves 5-6 (2019-2021), estimating transition rates for initiation, cessation and switching products for each period overall and by age group. RESULTS Cigarette initiation among adults who never used either product decreased from 2017-2019 to 2019-2021, but ENDS initiation did not significantly change. The persistence of ENDS-only use remained high (75%-80% after 1 year). Cigarette-only use transitions remained similar (88% remaining, 7% to non-current use and 5% to dual or ENDS-only use). In contrast, dual use to ENDS-only transitions increased from 9.5% (95% CI 7.3% to 11.7%) to 20.0% (95% CI 17.4% to 22.6%) per year, decreasing the persistence of dual use. The dual to cigarette-only use transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use. CONCLUSIONS The persistence of ENDS use among adults remained high in 2019-2021, but a larger fraction of dual users transitioned to ENDS-only use compared with 2017-2019. Because the fraction of cigarette-only users switching to dual use remained low, especially among older adults, the public health implications of this change are minimal.
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Affiliation(s)
| | - Jihyoun Jeon
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stephanie R Land
- Tobacco Control Research Branch, National Cancer Institute Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
| | | | - Abigail S Friedman
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Jamie Tam
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Ritesh Mistry
- Health Behavior Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Rafael Meza
- Integrative Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
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20
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Pike Moore S, Osborn C, Suratkal J, Vasu P, Koopman Gonzalez S, Trapl E. What Is (Un)Flavored? A Scoping Review of the Conceptualization of Flavored Cigarillos. Nicotine Tob Res 2024; 26:1120-1131. [PMID: 38401171 PMCID: PMC11339174 DOI: 10.1093/ntr/ntae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION To identify how flavor is conceptualized with respect to cigarillos to illuminate areas of concordance and discordance and provide a pathway for the harmonization of tobacco flavor measurement. AIMS AND METHODS Three methods were used to identify research measuring flavors respective to cigarillo products including: (1) querying research databases using key words "cigarillo," "tobacco" and "flavor"/'flavour,' (2) sub-sampling of the eligible literature with backward and forward reference searching, and (3) a bibliographic search of key experts. Two reviewers independently screened titles, abstracts, and full texts. Inclusion criteria required manuscripts to be available in English, published prior to 3/1/2022, be original and peer-reviewed, and include a measure of flavor pertaining to cigarillo products. A total of 163 manuscripts met these criteria and were subsequently evaluated. RESULTS Cigarillo flavor determinations were made based on the presence of flavoring agents, sensory characteristics, marketing or package characteristics, pre-defined lists, the absence of any of these, and/or were undefined. Individual flavors and their related classifications were not altogether mutually exclusive due to differences in conceptualization which has evolved over time. CONCLUSIONS Flavor measures continue to evolve, likely in response to both tobacco control policies and industry shifts. There is a lack of standardization in flavor conceptualization that can be ameliorated through intentional integration of multiple forms of research such as identifying patterns of flavoring agents and/or marketing strategies that elicit a specific flavor profile. By doing this, we may more comprehensively evaluate the impact of flavors, their constituents, and related marketing strategies on broader population health. IMPLICATIONS There are discrepancies in the conceptualization of flavor in tobacco and nicotine products. The lack of standardized, definitive language limits our ability to comprehensively evaluate the population-level health impact of flavors in addition to our ability to effectively inform, implement, and enforce policies restricting flavors in tobacco and nicotine products.
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Affiliation(s)
- Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Catherine Osborn
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Suratkal
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Pranav Vasu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Sarah Koopman Gonzalez
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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21
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Omaiye E, Luo W, McWhirter KJ, Talbot P. Ultrasonic Cigarettes: Chemicals and Cytotoxicity are Similar to Heated-Coil Pod-Style Electronic Cigarettes. Chem Res Toxicol 2024; 37:1329-1343. [PMID: 39051826 PMCID: PMC11337213 DOI: 10.1021/acs.chemrestox.4c00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
Our purpose was to test the hypothesis that ultrasonic cigarettes (u-cigarettes), which operate at relatively low temperatures, produce aerosols that are less harmful than heated-coil pod-style electronic cigarettes (e-cigarettes). The major chemicals in SURGE u-cigarette fluids and aerosols were quantified, their cytotoxicity and cellular effects were assessed, and a Margin of Exposure risk assessment was performed on chemicals in SURGE fluids. Four SURGE u-cigarette flavor variants ("Blueberry Ice," "Watermelon Ice," "Green Mint," and "Polar Mint") were evaluated. Flavor chemicals were quantified in fluids and aerosols using gas chromatography/mass spectrometry. Cytotoxicity and cell dynamics were assessed using the MTT assay, live-cell imaging, and fluorescence microscopy. WS-23 (a coolant) and total flavor chemical concentrations in SURGE were similar to e-cigarettes, while SURGE nicotine concentrations (13-19 mg/mL) were lower than many fourth generation e-cigarettes. Transfer efficiencies of dominant chemicals to aerosols in SURGE ranged from 44-100%. SURGE fluids and aerosols had four dominant flavor chemicals (>1 mg/mL). Toxic aldehydes were usually higher in SURGE aerosols than in SURGE fluids. SURGE fluids and aerosols had aldehyde concentrations significantly higher than pod-style e-cigarettes. Chemical constituents, solvent ratios, and aldehydes varied among SURGE flavor variants. SURGE fluids and aerosols inhibited cell growth and mitochondrial reductases, produced attenuated and round cells, and depolymerized actin filaments, effects that depended on pod flavor, chemical constituents, and concentration. The MOEs for nicotine, WS-23, and propylene glycol were <100 based on consumption of 1-2 SURGE u-cigarettes/day. Replacing the heating coil with a sonicator did not eliminate chemicals, including aldehydes, in aerosols or diminish toxicity in comparisons between SURGE and other e-cigarette pod products. The high concentrations of nicotine, WS-23, flavor chemicals, and aldehydes and the cytotoxicity of SURGE aerosols do not support the hypothesis that aerosols from u-cigarettes are less harmful than those from e-cigarettes.
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Affiliation(s)
- Esther
E. Omaiye
- Department
of Molecular, Cell, and Systems Biology. University of California, Riverside, California 92521, United States
| | - Wentai Luo
- Department
of Civil and Environmental Engineering, Portland State University, Portland, Oregon 97207, United States
| | - Kevin J. McWhirter
- Department
of Civil and Environmental Engineering, Portland State University, Portland, Oregon 97207, United States
| | - Prue Talbot
- Department
of Molecular, Cell, and Systems Biology. University of California, Riverside, California 92521, United States
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22
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Harris T. Physical and Chemical Characterization of Aerosols Produced from Experimentally Designed Nicotine Salt-Based E-Liquids. Chem Res Toxicol 2024; 37:1315-1328. [PMID: 39078024 PMCID: PMC11337207 DOI: 10.1021/acs.chemrestox.4c00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024]
Abstract
Nicotine salt-based e-liquids deliver nicotine more rapidly and efficiently to electronic nicotine delivery system (ENDS) users than freebase nicotine formulations. Nicotine salt-based products represent a substantial majority of the United States ENDS market. Despite the popularity of nicotine salt formulations, the chemical and physical characteristics of aerosols produced by nicotine salt e-liquids are still not well understood. To address this, this study reports the harmful and potentially harmful constituents (HPHCs) and particle sizes of aerosols produced by laboratory-made freebase nicotine and nicotine salt e-liquids. The nicotine salt e-liquids were formulated with benzoic acid, citric acid, lactic acid, malic acid, or oxalic acid. The nicotine salt aerosols had different HPHC profiles than the freebase nicotine aerosols, indicating that the carboxylic acids were not innocent bystanders. The polycarboxylic acid e-liquids containing citric acid, malic acid, or oxalic acid produced higher acrolein yields than the monocarboxylic acid e-liquids containing benzoic acid or lactic acid. Across most PG:VG ratios, nicotine benzoate or nicotine lactate aerosols contained the highest nicotine quantities (in %) and the highest nicotine yields (per milligram of aerosol). Additionally, the nicotine benzoate and nicotine lactate e-liquids produced the highest carboxylic acid yields under all tested conditions. The lower acid yields of the citric, malic, and oxalic acid formulations are potentially due to a combination of factors such as lower transfer efficiencies, lower thermostabilities, and greater susceptibility to side reactions because of their additional carboxyl groups serving as new sites for reactivity. For all nicotine formulations, the particle size characteristics were primarily controlled by the e-liquid solvent ratios, and there were no clear trends between nicotine salt and freebase nicotine aerosols that indicated nicotine protonation affected particle size. The carboxylic acids impacted aerosol output, nicotine delivery, and HPHC yields in distinct ways such that interchanging them in ENDS can potentially cause downstream effects.
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Affiliation(s)
- Trevor Harris
- Office of Science, Center
for Tobacco Products, U.S. Food and Drug
Administration, Silver
Spring, Maryland 20993, United States
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23
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Zvolensky MJ, Shepherd JM, Clausen BK, Redmond BY, De Dios M, Cano MÁ. Combustible cigarette smokers versus dual combustible and electronic users: Evaluation of differences in anxiety, depression, and transdiagnostic constructs among Latinx adults. J Ethn Subst Abuse 2024:1-18. [PMID: 39145994 DOI: 10.1080/15332640.2024.2391309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Research on dual combustible and electronic nicotine use among Latinx persons is needed to better understand patterns of use because this group is an established tobacco disparities population. Negative emotional symptoms and related processes (e.g., reactive transdiagnostic vulnerabilities) have been among the most prominent factors linked to the onset, maintenance, and relapse of smoking. As such, the current study sought to compare levels of mental health symptoms among combustible users compared to dual combustible and electronic users among Latinx persons who smoke. The current sample consisted of 297 adult Latinx daily cigarette smokers (Mage = 35.90 years; SD = 8.87; age range 18-61; 36.4% female), of which 92 reported current dual use of an e-cigarette (Mage = 33.34 years; SD = 7.75; age range 19-60; 28.3% female). Differences in anxiety, depression, anxiety sensitivity, emotion dysregulation, and distress tolerance were examined, and we hypothesized that dual users would showcase higher mental health problems. Results indicated that adult Latinx dual users evidenced greater levels of anxiety, depression, emotional dysregulation, anxiety sensitivity, and lower levels of distress tolerance compared to combustible users. The current study sheds light on the clinical importance of affective differences among dual versus combustible Latinx smokers.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Justin M Shepherd
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Brooke Y Redmond
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Marcel De Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Houston, Texas, USA
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24
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Lowe AT, Maki A, Figueroa C, Venugopal PD. Place-based estimates of cigarette butt litter raise environmental justice concerns in the United States. PLoS One 2024; 19:e0308930. [PMID: 39146265 PMCID: PMC11326580 DOI: 10.1371/journal.pone.0308930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 08/02/2024] [Indexed: 08/17/2024] Open
Abstract
Littering of cigarette butts is a major environmental challenge. In 2022, ~124 billion cigarette butts were littered in the United States. This litter may pose an environmental justice concern by disproportionately affecting human and environmental health in communities of color or communities of low socioeconomic status. However, the lack of data on the distribution and magnitude of cigarette butt littering prevents an environmental justice analysis and limits the ability to tackle this environmental challenge. We conducted an environmental justice assessment of tobacco product waste, specifically cigarette butts, through spatially-explicit, place-based estimates across the contiguous U.S. We built a bottom-up model by synthesizing census tract-level population and smoking prevalence, state-level cigarette consumption, and published littering data to assess the spatial pattern of cigarette consumption and littering, and its implications for environmental injustice in >71,600 U.S. census tracts. Further, we compared the model output to urbanicity (rural-urban commuting area) and Social-Environmental Risk (SER; CDC Environmental Justice Index). Cigarette butt density was not uniformly distributed across the U.S. and ranged from 0-45.5 butts/m2, with an area-weighted average of 0.019 ± 0.0005 butts/m2. Cigarette butt density was 96 times higher in metropolitan vs. rural areas. Cigarette butt density increased significantly with SER, with 5.6 times more littered cigarette butts, and a steeper response to population density, in census tracts with the highest SER vs. the lowest SER. These results demonstrate the relative influences of location, smoking prevalence, and population density, and show that cigarette butt littering is a potential environmental justice concern in the U.S. This study provides information that may help devise targeted strategies to reduce cigarette butt pollution and prevent disproportionate impacts. The spatial data layer with place-based cigarette consumption and butt density is a tool that can support municipal, state, and federal level policy work and future studies on associations among cigarette butt pollution and environmental health outcomes.
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Affiliation(s)
- Alexander T Lowe
- Division of Nonclinical Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States of America
| | - Alexander Maki
- Division of Population Health Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States of America
| | - Carla Figueroa
- Division of Nonclinical Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States of America
| | - P Dilip Venugopal
- Division of Nonclinical Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States of America
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25
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Heywood J, Abele G, Langenbach B, Litvin S, Smallets S, Paustenbach D. Composition of e-cigarette aerosols: A review and risk assessment of selected compounds. J Appl Toxicol 2024. [PMID: 39147402 DOI: 10.1002/jat.4683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/17/2024]
Abstract
The potential harms and benefits of e-cigarettes, or electronic nicotine delivery systems (ENDS), have received significant attention from public health and regulatory communities. Such products may provide a reduced risk means of nicotine delivery for combustible cigarette smokers while being inappropriately appealing to nicotine naive youth. Numerous authors have examined the chemical complexity of aerosols from various open- and closed-system ENDS. This body of literature is reviewed here, with the risks of ENDS aerosol exposure among users evaluated with a margin of exposure (MoE) approach for two non-carcinogens (methylglyoxal, butyraldehyde) and a cancer risk analysis for the carcinogen N-nitrosonornicotine (NNN). We identified 96 relevant papers, including 17, 13, and 5 reporting data for methylglyoxal, butyraldehyde, and NNN, respectively. Using low-end (minimum aerosol concentration, low ENDS use) and high-end (maximum aerosol concentration, high ENDS use) assumptions, estimated doses for methylglyoxal (1.78 × 10-3-135 μg/kg-bw/day) and butyraldehyde (1.9 × 10-4-66.54 μg/kg-bw/day) corresponded to MoEs of 227-17,200,000 and 271-280,000,000, respectively, using identified points of departure (PoDs). Doses of 9.90 × 10-6-1.99 × 10-4 μg/kg-bw/day NNN corresponded to 1.4-28 surplus cancers per 100,000 ENDS users, relative to a NNN-attributable surplus of 7440 per 100,000 cigarette smokers. It was concluded that methylglyoxal and butyraldehyde in ENDS aerosols, while not innocuous, did not present a significant risk of irritant effects among ENDS users. The carcinogenic risks of NNN in ENDS aerosols were reduced, but not eliminated, relative to concentrations reported in combustible cigarette smoke.
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Affiliation(s)
- Jonathan Heywood
- Paustenbach and Associates, Denver, Colorado, USA
- Insight Exposure & Risk Sciences Group, Boulder, Colorado, USA
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26
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Poudel R, Li S, Hong H, Zhao J, Srivastava S, Robertson RM, Hall JL, Srivastava S, Hamburg NM, Bhatnagar A, Keith RJ. Catecholamine levels with use of electronic and combustible cigarettes. Tob Induc Dis 2024; 22:TID-22-144. [PMID: 39144677 PMCID: PMC11320712 DOI: 10.18332/tid/190687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION Smoking elevates catecholamines that increase the risk for cardiovascular disease. Sparse evidence exists about the effects of e-cigarettes and catecholamines. Higher levels of catecholamines could trigger the increased heart rate, blood pressure, and decreased vascular function reported with the use of e-cigarettes. We investigated the difference in urinary catecholamines and their metabolites before and after the use of an e-cigarette containing nicotine or cigarettes compared to no tobacco use. METHODS In our observational cohort exposure study, healthy adults aged 21-45 years who were currently using e-cigarettes, cigarettes, or had never used tobacco, participated in an acute exposure visit using their most common tobacco product. Urine was collected before, 1, and 2 hours after a 3-second puff every 30 seconds for 10 minutes on an e-cigarette or straw or use of 1 cigarette. Urinary catecholamines and their metabolites were measured by ultra-high-performance liquid chromatography. Participants (n=323) were grouped by the product used at the visit. We compared levels of creatinine normalized log-transformed urinary catecholamines and their metabolites across groups using Dunn's test following a Kruskal-Wallis test in unadjusted and demographically adjusted models. RESULTS Prior to use, individuals who used cigarettes (n=70) had lower urinary metabolites from epinephrine, serotonin, and norepinephrine. No differences were seen in those who used e-cigarettes (n=171) and those who did not use tobacco (n=82). In fully adjusted models, 1 h after the use of a combustible or e-cigarette, log-transformed urinary metabolites from norepinephrine (β=1.22; 95% CI: 0.39-2.05, p=0.004 and β=1.06; 95% CI: 0.39-1.74, p=0.002), dopamine (β=0.37; 95% CI: 0.24-0.5, p<0.001 and β=0.15; 95% CI: 0.05-0.26, p<0.001), and epinephrine (β=1.89; 95% CI: 0.51-3.27, p=0.008 and β=1.49; 95% CI: 0.38-2.61, p=0.009) were elevated. In fully adjusted models, combustible cigarette use was associated with elevated urinary norepinephrine (β=0.46; 95% CI: 0.13-0.81, p=0.007) and dopamine (β=0.19; 95% CI: 0.06-0.31, p=0.003) 1 h after use. CONCLUSIONS We found that the use of both e-cigarettes and cigarettes was associated with elevated urinary catecholamines or their metabolites. Catecholamines could be useful as a biomarker of harm for tobacco use and considered by tobacco regulatory scientists in future research.
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Affiliation(s)
- Remy Poudel
- American Heart Association, Dallas, United States
| | - Shen Li
- American Heart Association, Dallas, United States
| | - Haoyun Hong
- American Heart Association, Dallas, United States
| | - Juan Zhao
- American Heart Association, Dallas, United States
| | - Shweta Srivastava
- Department of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | | | | | - Sanjay Srivastava
- Department of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Naomi M. Hamburg
- Whitaker Cardiovascular Institute, Chobanian & Avedisian School of Medicine, Boston University, Boston, United States
| | - Aruni Bhatnagar
- Department of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Rachel J. Keith
- Department of Medicine, Envirome Institute, University of Louisville, Louisville, United States
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27
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Morgil GK, Çok İ. Evaluation and comparison of DNA alkylation and oxidative damage in e-cigarette and heated tobacco users. Toxicol Mech Methods 2024:1-11. [PMID: 39138671 DOI: 10.1080/15376516.2024.2390028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/02/2024] [Accepted: 08/03/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES This study, aimed to determine and compare DNA damage in e-cigarette and HTP (IQOS) users by assessing DNA-adducts, which are biomarkers of various DNA alkylation and oxidation. METHODS For the evaluation of DNA alkylation, N3-Ethyladenine (N3-EtA) and N3-Methyladenine (N3-MeA) adducts were used. DNA oxidation was assessed using, 8-hydroxy-2'-deoxyguanosine(8-OHdG). The urinary cotinine, N3-MeA, N3-EtA, and 8-OHdG concentrations of the cigarette smokers (n:39), e-cigarette users (n:28), IQOS users (n:20), passive smokers (n:32), and nonsmokers(n:41) who lived Ankara, Turkiye were determined using, liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS In light of the detected 8-OHdG levels, e-cigarette (3.19 ng/g creatinine) and IQOS (4.38 ng/g creatinine) users had higher oxidative DNA damage than healthy nonsmokers (2.51 ng/g creatinine). Alkylated DNA-adducts were identified in the urine of e-cigarette (N3-MeA: 3.92 ng/g creatinine; N3-EtA: 0.23 ng/g creatinine) and IQOS (N3-MeA: 7.54 ng/g creatinine; N3-EtA: 0.29 ng/g creatinine) users. In the generation of N3-MeA adducts, a significant difference was found between IQOS users and e-cigarette users (p < 0.05). Also, DNA alkylation in flavored e-cigarette users (N3-MeA: 4.51 ng/g creatinine; N3-EtA: 0.27 ng/g creatinine) was higher than in non-flavored e-cigarette users (N3-MeA: 2.27 ng/g creatinine; N3-EtA: 0.06 ng/g creatinine). The highest cotinine levels were found in cigarette smokers (16.1316 ng/g creatinine). No significant difference was found when e-cigarette (1163.02 ng/g creatinine) and IQOS smokers were compared (1088.3 ng/g creatinine). CONCLUSION People who use e-cigarettes and IQOS may be at higher risk of genotoxicity than those who do not use and are not exposed to any tobacco products. Furthermore, the usage of flavoring additives in e-cigarettes contributed to additional genotoxic damage risks.
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Affiliation(s)
- Göksel Koç Morgil
- Minister of Health, General Directorate of Public Health, Department of Consumer Safety and Public Health Laboratories, Toxicology Laboratory, Sıhhıye, Ankara, Türkiye
| | - İsmet Çok
- Faculty of Pharmacy, Department of Toxicology, Gazi University, Ankara, Turkiye
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28
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Bremmer MP, Paladino MB, Campbell AM, Xia K, Tarran R, Hendershot CS, Girdler SS. Acute analgesic effect of nicotine vaping using three experimental pain induction tasks: a randomized, placebo-controlled laboratory study. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06669-8. [PMID: 39120697 DOI: 10.1007/s00213-024-06669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
RATIONALE Pain and nicotine use are co-occurring conditions with a significant impact on health. Experimental evidence supports an acute analgesic effect of nicotine which may reinforce nicotine use among those with chronic pain. Evidence for nicotine analgesia have primarily been gathered in combustible cigarette users and have not been extended to electronic nicotine delivery systems (ENDS or vaping). Furthermore, the mechanisms of nicotine analgesia in humans are not well understood. OBJECTIVES Assess the effect of acute vaped nicotine on subjective and behavioral indices of pain sensitivity using three tasks designed to probe distinct mechanisms of analgesia. METHODS This study recruited ENDS users (N = 86) to undergo a paced vaping protocol followed by pain tasks in counterbalanced order. Across four sessions, participants vaped e-liquid containing nicotine or placebo, and flavor or no-flavor in a 2 × 2 within-subject design. Assessments included cold pressor, submaximal effort tourniquet to induce ischemic pain, and temporal summation of heat pain, an index of central sensitization. RESULTS Compared to placebo, nicotine increased cold pressor pain tolerance (ηp2 = 0.031), ischemic pain threshold (ηp2 = 0.073) and tolerance (ηp2 = 0.056) but had no effect on temporal summation of pain. Flavor did not affect pain sensitivity. Females reported greater ischemic pain sensitivity (ηp2 = 0.027) and greater reductions in craving (ηp2 = 0.086). CONCLUSIONS Consistent with research from tobacco smoking, analgesia may be reinforcing and contribute to nicotine dependence among ENDS users. More research on sex differences is warranted.
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Affiliation(s)
- Michael P Bremmer
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Michael B Paladino
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alana M Campbell
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kai Xia
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Tarran
- Division of Genetic, Environmental and Inhalational Disease, Department of Internal Medicine, Kansas University Medical Center, Kansas City, KS, USA
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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29
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Mills A, Nassabeh S, Hurley A, Shouldis L, Chantler PD, Dakhlallah D, Olfert IM. Influence of gestational window on offspring vascular health in rodents with in utero exposure to electronic cigarettes. J Physiol 2024. [PMID: 39106241 DOI: 10.1113/jp286493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/04/2024] [Indexed: 08/09/2024] Open
Abstract
Studies have shown cerebrovascular dysfunction in offspring with full-gestational electronic cigarette (Ecig) exposure, but little is known about how individual trimester exposure impacts offspring health. This study aimed to determine if there is a critical window during gestation that contributes to vascular and anxiety-like behavioural changes seen with full-term exposure. To test this, rats were time-mated, and the pregnant dams were randomly assigned to Ecig exposure during first trimester (gestational day, GD2-7), second trimester (GD8-14), third trimester (GD15-21) or full-term gestation (GD2-21). We also assessed the effect of maternal preconception exposure. Both male and female offspring from all maternal exposure conditions were compared to offspring from dams under ambient air (control) conditions. Ecig exposure consisted of 60-puffs/day (5 days/week) using either 5 or 30 watts for each respective exposure group. We found that maternal exposure to Ecig in the second and third trimesters resulted in a decrease (23-38%) in vascular reactivity of the middle cerebral artery (MCA) reactivity in 3- and 6-month-old offspring compared to Air offspring. Further, the severity of impairment was comparable to the full-term exposure (31-46%). Offspring also displayed changes in body composition, body mass, anxiety-like behaviour and locomotor activity, indicating that Ecigs influence neurodevelopment and metabolism. Maternal preconception exposure showed no impact on offspring body mass, anxiety-like behaviour, or vascular function. Thus, the critical exposure window where Ecig affects vascular development in offspring occurs during mid- to late-gestation in pregnancy, and both 5 W and 30 W exposure produce significant vascular dysfunction compared to Air. KEY POINTS: Exposure to electronic cigarettes (Ecigs) is known to increase risk factors for cardiovascular disease in both animals and humans. Maternal Ecig use during pregnancy in rodents is found to impair the vascular health of adolescent and adult offspring, but the critical gestation window for Ecig-induced vascular impairment is not known. This study demonstrates Ecig exposure during mid- and late-gestation (i.e. second or third trimester) results in impaired endothelial cell-mediated dilatation (i.e. middle cerebral artery reactivity) and alters anxiety-like behaviour in offspring. Maternal exposure prior to conception did not impact offspring's vascular or anxiety-like behavioural outcomes. Rodent models have been a reliable and useful predictor of inhalation-induced harm to humans. These data indicate maternal use of Ecigs during pregnancy should not be considered safe, and begin to inform clinicians and women about potential long-term harm to their offspring.
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Affiliation(s)
- Amber Mills
- Department of Physiology, Pharmacology & Toxicology, West Virginia University School of Medicine, Morgantown, WV, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Sydney Nassabeh
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Audra Hurley
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Lainey Shouldis
- Department of Immunology and Microbial Pathogenesis, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Paul D Chantler
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV, USA
- Department of Neuroscience, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Duaa Dakhlallah
- Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - I Mark Olfert
- Department of Physiology, Pharmacology & Toxicology, West Virginia University School of Medicine, Morgantown, WV, USA
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV, USA
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV, USA
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30
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Saenz-de-Miera B, Welding K, Tseng TY, Grilo G, Cohen JE. Tobacco industry pricing strategies during recent tax adjustments in Mexico: evidence from sales data. Tob Control 2024:tc-2024-058711. [PMID: 39107105 DOI: 10.1136/tc-2024-058711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Previous studies have identified pricing strategies that the tobacco industry employs to try to minimise the impact of tobacco taxation, but these studies are mostly about high-income countries. This research examines industry price responses to a recent cigarette tax increase in Mexico, including in the capsule cigarette segment that has expanded rapidly in Latin America. METHODS Data of cigarette prices and sales in Mexico between October 2018 and September 2021 licensed from NielsenIQ were used following a quasi-experimental design to analyse price changes after excise tax increases with fixed effect models by product. To explore heterogeneous responses, estimates were disaggregated by cigarette attributes such as presence of capsules and market segment. Differential shifting was also assessed. RESULTS Increasing the tobacco tax from 2011MX$0.35(≈US$0.02) to 2020 MX$0.4944(≈US$0.0283) in January 2020 was associated with an overall 8% cigarette price increase in real terms. However, some cigarette types, including premium to discount segments, exhibited price increases larger than the tax increase, which reduced the relative price of ultra-low-priced cigarettes. Instead of a single hike, prices were gradually raised throughout the first months of 2020 for all cigarette types. A combination of both pricing strategies was employed for capsule cigarettes. The 2021 smaller tax adjustment for annual inflation was fully passed onto consumer, maintaining real prices constant. CONCLUSIONS The industry's ability to raise prices more than the tax increase and manage these price increases smoothly suggests that there was room for larger tobacco tax increases in Mexico. Future developments on tobacco taxes could consider a fully specific tax structure or minimum taxes to mitigate the adverse effects of market segmentation and differential shifting.
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Affiliation(s)
- Belen Saenz-de-Miera
- Department of Economics, Autonomous University of Baja California Sur, La Paz, Baja California Sur, Mexico
| | - Kevin Welding
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tuo-Yen Tseng
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Graziele Grilo
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Williams R, Romm KF, LoParco CR, Berg CJ. Experiences of Microaggressions, Attributions, and Impact Among US Young Adults: An Intersectional Perspective Regarding Sexual/Gender and Racial/Ethnic Minorities. J Racial Ethn Health Disparities 2024; 11:2444-2458. [PMID: 37531018 DOI: 10.1007/s40615-023-01710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Understanding discrimination (e.g., microaggressions) toward sexual/gender minorities (SGM) and racial/ethnic minorities (REM) from an intersectional perspective is critical in informing interventions to reduce such experiences and their impacts. PURPOSE This study examined US young adults identifying as SGM, REM, both, or neither in relation to microaggression experiences, and these factors in relation to mental health. METHODS Using 2022 data from 932 US adults (Mage = 27.61) in an online survey study, we compared subgroups (SGM-only, REM-only, both, neither) in relation to microaggression experiences and mental health symptoms, stratified by sex (male, female). Multivariable linear regression examined: 1) sex and intersectional subgroup in relation to number of microaggressions experienced; and 2) sex, subgroup, and number of microaggression experiences in relation to mental health symptoms. RESULTS Among females (n = 612), 42.0% were SGM-only, 17.3% REM-only, 15.2% both, and 25.5% neither. Among males (n = 320), 25.0% were SGM-only, 25.0% REM-only, 8.4% both, and 41.6% neither. Females (vs. males) reported more microaggressions (M = 5.67, SD = 3.00 vs. M = 3.95, SD = 3.46, p < .001). Those with intersecting minority identities experienced the most microagressions (females: M = 6.98, SD = 2.64; males: M = 6.44, SD = 2.95, respectively). In multivariable analyses, females and those in any of the 3 minority-identifying subgroups experienced more microaggressions; those with intersecting minority identities experienced more microaggressions than SGM-only and REM-only. Identifying as SGM-only or both SGM and REM, as well as experiencing more microaggressions, was associated with greater mental health symptoms. CONCLUSIONS Intersecting minority identities increase risk for microaggressions and mental health consequences. Multilevel interventions must reduce minority subgroups' experiences of microaggressions and their impacts.
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Affiliation(s)
- River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
- George Washington Cancer Center, George Washington University, Washington, DC, USA.
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Hendricks JW, Peres SC. An Experimental Investigation of Hazard Statement Compliance in Procedures Using Eye Tracking Technology: Should Task be Included in the C-HIP Model? HUMAN FACTORS 2024; 66:1981-1994. [PMID: 37978866 DOI: 10.1177/00187208231212259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Using eye tracking technology, this study sought to determine if differences in hazard statement (HS) compliance based on design elements are attributable to attention maintenance (AM). BACKGROUND Recent empirical work has demonstrated counter-intuitive findings for HS designs embedded in procedures. Specifically, prevalent HS designs in procedures were associated with lower compliance. METHOD The current study utilized eye tracking technology to determine whether participants are attending to HSs differently based on the inclusion or absence of visually distinct HS design elements typically used for consumer products. We used two different designs that previously yielded the largest gap in HS compliance. In a fully-crossed design, 33 participants completed four rounds of tasks using four procedures with embedded HSs. To assess AM, eye tracking was used to measure gaze and fixation duration. RESULTS The results indicated there are differences in AM between the two designs. The HSs that included elements traditionally considered effective in the consumer products literature elicited lower fixation duration times, and were associated with lower compliance. However, AM did not mediate the design effect on compliance. CONCLUSIONS The study results suggest the design of HSs are impacting individuals as early as the AM stage of the C-HIP model. The absence of HS design-AM-compliance mediation suggests other C-HIP elements more directly explain the HS design-compliance effects. APPLICATION These results provide more evidence that the communication of Health, Environment, and Safety information in procedures may need to be different from those on consumer products, suggesting design efficacy may be task dependent.
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Klemperer EM, Kock L, Feinstein MJP, Coleman SRM, Gaalema DE, Higgins ST. Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study. Prev Med 2024; 185:108024. [PMID: 38849056 PMCID: PMC11269003 DOI: 10.1016/j.ypmed.2024.108024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
SIGNIFICANCE A growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. METHODS Data came from Waves 4-6 (12/2016-11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. RESULTS Among US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9-16.4) of females and 23.4% (20.0-26.9) of males were young adults (aged 18-24), 11.7% (9.2-14.2) of females and 14.4% (11.6-17.2) of males had CONCLUSION US females who dual use e-cigarettes and cigarettes were more likely to attempt to quit smoking, but not more likely to succeed at quitting, than males.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America.
| | - Loren Kock
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Marc Jerome P Feinstein
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Sulamunn R M Coleman
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Diann E Gaalema
- Division of Cardiovascular Medicine, University of Texas Medical Branch, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
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Buszkiewicz JH, Mok Y, Mukerjee R, Fleischer NL, Meza R, Jeon J. Cross-sectional patterns and longitudinal transitions of unflavored and flavored cigar use without and with cigarettes among United States adults. Prev Med 2024; 185:108027. [PMID: 38844050 DOI: 10.1016/j.ypmed.2024.108027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Over half of US adults who smoke cigars use flavored cigars, illustrating their broad appeal; however, their long-term impact on cigar and cigarette use is unknown. METHODS Using restricted data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, we investigated cross-sectional patterns and longitudinal transition rates of unflavored and flavored cigar use with and without cigarettes among a nationally representative sample of US adults. RESULTS Proportionally, more adults who used flavored cigars without or with cigarettes were younger and female. More adults with exclusive cigar use were non-Hispanic Black. More adults with dual use had lower educational attainment. The median number of cigars smoked daily and tobacco dependence was highest among adults who used flavored cigars with cigarettes. Only 14.6% of adults with exclusive flavored cigar use at Wave 1 continued their use to Wave 5, with most transitioning to non-current (46.4%) or exclusive cigarette use (22.9%). Likewise, 13.8% of adults with dual flavored cigar and cigarette use at Wave 1 continued their use to Wave 5, with 57.6% transitioning to exclusive cigarette use and 19.7% transitioning to non-current use. Comparatively, 72.9% of adults with exclusive cigarette use continued their use to Wave 5, while 23.6% transitioned to non-current use. CONCLUSION Adult cigar use was less stable than cigarette use, particularly among those who use flavored cigars. Future research should investigate whether these transition patterns between flavored and unflavored cigar and cigarette use vary across sociodemographic groups and their potential long-term health implications.
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Affiliation(s)
- James H Buszkiewicz
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Yoonseo Mok
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | - Richa Mukerjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Jeong M, Weiger C, Uriarte C, Wackowski OA, Delnevo CD. Youth attention, perceptions, and appeal in response to e-cigarette advertising features: A focus group study. Prev Med Rep 2024; 44:102789. [PMID: 38979482 PMCID: PMC11228789 DOI: 10.1016/j.pmedr.2024.102789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Abstract
Background E-cigarette marketing exposure may influence vaping-related outcomes among youth, but less is known on which specific advertising features impact youth attention, perceptions, and appeal. This study qualitatively examines responses to different e-cigarette advertising features among e-cigarette-naïve youth. Methods We conducted four online focus groups in 2021 with a national U.S. sample of 13-17 year olds (n = 25) who had never used e-cigarettes. Participants viewed and discussed their reactions to different e-cigarette advertisements varying in the inclusion of ad features, including color, models in imagery, text claims targeting smokers, and the nicotine warning label. Results Participants were attracted to ads with bright colors, particularly when contrasted against a dark background. Ads featuring models attracted attention and reduced perceptions that the product is harmful. Comments indicated mixed reactions to smoker-targeted text claims. On one hand, participants perceived ads with text that specified "for smokers" as targeting older adults. On the other hand, text referring to "switching" from cigarettes to e-cigarettes led to some perceptions that the product is healthy, and certain text that implicitly referred to smoking (e.g., "no odor") had the potential to appeal to youth who wanted to use e-cigarettes discreetly. The level of attention paid to warnings depended on warning size and the color contrast between the warning and the rest of the ad. Conclusions Findings suggest specific e-cigarette ad features play an important role in attracting youth attention and influencing perceptions. More research is needed on the potential public health benefits versus unintended consequences of smoker-targeted text claims.
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Affiliation(s)
- Michelle Jeong
- Rutgers Institute for Nicotine & Tobacco Studies, 303 George Street Suite 500, New Brunswick, NJ, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ, USA
| | - Caitlin Weiger
- Rutgers Institute for Nicotine & Tobacco Studies, 303 George Street Suite 500, New Brunswick, NJ, USA
| | - Caitlin Uriarte
- Rutgers Institute for Nicotine & Tobacco Studies, 303 George Street Suite 500, New Brunswick, NJ, USA
| | - Olivia A. Wackowski
- Rutgers Institute for Nicotine & Tobacco Studies, 303 George Street Suite 500, New Brunswick, NJ, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ, USA
| | - Cristine D. Delnevo
- Rutgers Institute for Nicotine & Tobacco Studies, 303 George Street Suite 500, New Brunswick, NJ, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ, USA
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Kasza KA, Rivard C, Goniewicz ML, Fong GT, Hammond D, Cummings KM, Hyland A. E-Cigarette Characteristics and Cigarette Cessation Among Adults Who Use E-Cigarettes. JAMA Netw Open 2024; 7:e2423960. [PMID: 39088219 PMCID: PMC11294961 DOI: 10.1001/jamanetworkopen.2024.23960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/28/2024] [Indexed: 08/02/2024] Open
Abstract
Importance Population-level health outcomes associated with e-cigarettes depend in part on the association between e-cigarettes and combustible cigarette cessation. The US Food and Drug Administration has authority to regulate e-cigarette characteristics, including flavor and device type. Objective To investigate whether e-cigarette characteristics are associated with cigarette cessation behaviors among adults in the US population who use e-cigarettes. Design, Setting, and Participants This cohort study was conducted using longitudinal data collected in 2014 to 2021 by the Population Assessment of Tobacco and Health Study, a population-based, US nationally representative study. Participants were sampled from the civilian noninstitutionalized population using a 4-staged, stratified sampling design. Data were weighted and analyzed from 1985 adults ages 21 or older who smoked cigarettes daily and had used e-cigarettes in the past 30 days. Data were analyzed in May 2021 to May 2024. Exposures The following e-cigarette characteristics were assessed: use frequency (daily and nondaily), flavor type (tobacco, menthol or mint, sweet, and combination), device type (disposable, cartridge, and tank), and year of data collection as a proxy for the evolving e-cigarette marketplace. Main Outcomes and Measures The following cigarette cessation behaviors were assessed: making a cigarette quit attempt, cigarette cessation among individuals who made a quit attempt, and overall cigarette discontinuation regardless of quit attempts. Associations were evaluated between e-cigarette characteristics (assessed at baseline in 1 approach and assessed at follow-up in another approach) and cigarette cessation outcomes, controlling for demographic, cigarette smoking, and other e-cigarette use characteristics. Results The study sample consisted of 1985 participants representing adults in the population (mean age, 40.0 years [95% CI, 39.2-40.9 years]; 49.4% [95% CI, 46.3%-52.6%] male; 11.4% [95% CI, 9.6%-13.4%] Black, 80.7% [95% CI, 77.8%-83.3%] White, and 8.0% [95% CI, 6.3%-10.0%] other race; 9.2% [95% CI, 7.5%-11.2%] Hispanic). Daily vs nondaily e-cigarette use was associated with greater overall cigarette discontinuation rates (12.8% [95% CI, 9.1%-17.7%] vs 6.1% [95% CI, 4.8%-7.7%]; adjusted odds ratio [aOR], 2.26 [95% CI, 1.34-3.81]), and use of e-cigarettes in 2019 to 2021 vs 2014-2015 to 2015-2016 was also associated with greater overall cigarette discontinuation rates (12.0% [95% CI, 8.8%-16.0%] vs 5.3% [95% CI, 2.9%-9.3%]; aOR, 2.75 [95% CI, 1.13-6.67]). Use of menthol or mint vs tobacco flavor e-cigarettes was associated with greater overall cigarette discontinuation rates (9.2% [95% CI, 6.6%-12.8%] vs 4.7% [95% CI, 3.0%-7.1%]; aOR, 2.63 [95% CI, 1.32-5.27]) only when assessing e-cigarette use at baseline. E-cigarette device type was not associated with cigarette discontinuation rates in adjusted analyses. Conclusions and Relevance In this study, daily e-cigarette use and use of e-cigarettes in 2019 to 2021 were consistently associated with greater cigarette discontinuation rates. These findings suggest that research focused on e-cigarettes marketed in recent years is needed to inform product regulation and public health policy decisions.
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Affiliation(s)
- Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Cheryl Rivard
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Kishinchand R, Boyce M, Vyas H, Sewell L, Mohi A, Brengartner L, Miller R, Gorr MW, Wold LE, Cray J. In Utero Exposure to Maternal Electronic Nicotine Delivery System use Demonstrate Alterations to Craniofacial Development. Cleft Palate Craniofac J 2024; 61:1389-1397. [PMID: 36916055 DOI: 10.1177/10556656231163400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE Develop a model for the study of Electronic Nicotine Device (ENDS) exposure on craniofacial development. DESIGN Experimental preclinical design followed as pregnant murine dams were randomized and exposed to filtered air exposure, carrier exposure consisting of 50% volume of propylene glycol and vegetable glycine (ENDS Carrier) respectively, or carrier exposure with 20 mg/ml of nicotine added to the liquid vaporizer (ENDS carrier with nicotine). SETTING Preclinical murine model exposure using the SciReq exposure system. PARTICIPANTS C57BL6 adult 8 week old female pregnant mice and exposed in utero litters. INTERVENTIONS Exposure to control filtered air, ENDS carrier or ENDS carrier with nicotine added throughout gestation at 1 puff/minute, 4 h/day, five days a week. MAIN OUTCOME MEASURES Cephalometric measures of post-natal day 15 pups born as exposed litters. RESULTS Data suggests alterations to several facial morphology parameters in the developing offspring, suggesting electronic nicotine device systems may alter facial growth if used during pregnancy. CONCLUSIONS Future research should concentrate on varied formulations and exposure regimens of ENDS to determine timing windows of exposures and ENDS formulations that may be harmful to craniofacial development.
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Affiliation(s)
- Rajiv Kishinchand
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Mark Boyce
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Heema Vyas
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Leslie Sewell
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Amr Mohi
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Lexie Brengartner
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Roy Miller
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
| | - Matthew W Gorr
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Loren E Wold
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - James Cray
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
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Kikut-Stein A, Givan K, Branson P, Fishman J, Bailey K, Paolicelli M, Crockett T, Morris T, Adesipo A, Allen D, Blanco-Liz A, Bonds LF, Brooks N, Carriker M, Francis K, Jean Pierre M, Konner H, Myers R, Newkirk N, Poole M, Riina N, Robinson M, Rubens V, Savage A, Savage M, Sy D, Zhou X, Tan A. Youth Participatory Action Communication Research: A Model for Developing Youth-Driven Health Campaigns. HEALTH COMMUNICATION 2024:1-16. [PMID: 39081194 DOI: 10.1080/10410236.2024.2386713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Youth offer valuable insight on health communication needs and solutions in their communities. We propose youth participatory action communication research (YPACR) as a model for health campaign development that engages youth perspectives in applying systematic theory-informed communication research to addressing youth-identified health priorities. YPACR informed a series of paid high school internship programs in West Philadelphia, in which youth interns identified mental health help-seeking communication as a need among peers. In Phase 1, guided by the reasoned action approach and Hornik & Woolf method, youth interns conducted a survey measuring behavioral beliefs, normative beliefs, and control beliefs associated with mental health help-seeking, as well as trusted sources of mental health information, among local high school students. Survey results suggested control (self-efficacy) was an important message target and peers were trusted mental health information sources. In Phase 2, youth interns developed TikTok-style messages focused on strengthening control beliefs and promoting a youth-selected mental health support resource. Youth interns distributed an online survey experiment to test whether youth-created messages shown alongside resource information increased help-seeking self-efficacy compared to an information-only control. The YPACR framework contributed to youth-relevant campaign goals, study measurements, recruitment approaches, data interpretation, and message design. We discuss the benefits and challenges of this youth-driven health campaign development model and recommendations for future research.
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Affiliation(s)
- Ava Kikut-Stein
- Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute
| | | | - Paulette Branson
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Jeffrey Fishman
- Annenberg School for Communication, University of Pennsylvania
| | - Kavon Bailey
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | - Toni Crockett
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Tamera Morris
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Ajibola Adesipo
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Dayana Allen
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | | | - Ny'zera Brooks
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Malaysia Carriker
- Netter Center for Community Partnerships, University of Pennsylvania
| | | | - Micah Jean Pierre
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Holly Konner
- Annenberg School for Communication, University of Pennsylvania
| | - Ryen Myers
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Naiim Newkirk
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Milan Poole
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Nolan Riina
- Annenberg School for Communication, University of Pennsylvania
| | | | - Valerie Rubens
- Annenberg School for Communication, University of Pennsylvania
| | - Abdullah Savage
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Maryam Savage
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Dahirou Sy
- Netter Center for Community Partnerships, University of Pennsylvania
| | - Xuefei Zhou
- Annenberg School for Communication, University of Pennsylvania
| | - Andy Tan
- Annenberg School for Communication, University of Pennsylvania
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Izquierdo-Condoy JS, Naranjo-Lara P, Morales-Lapo E, Hidalgo MR, Tello-De-la-Torre A, Vásconez-Gonzáles E, Salazar-Santoliva C, Loaiza-Guevara V, Rincón Hernández W, Becerra DA, González MBD, López-Cortés A, Ortiz-Prado E. Direct health implications of e-cigarette use: a systematic scoping review with evidence assessment. Front Public Health 2024; 12:1427752. [PMID: 39135931 PMCID: PMC11317248 DOI: 10.3389/fpubh.2024.1427752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/15/2024] [Indexed: 08/15/2024] Open
Abstract
Background E-cigarettes are often marketed as a less harmful alternative to traditional tobacco cigarettes. Despite their popularity, the evidence regarding their effects on human health remains unclear and is filled with complexities. Objectives This systematic review aims to elucidate the direct effects of electronic cigarette use on human health, carefully distinguishing between the specific characteristics of the populations studied. Methodology Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed/Medline, Web of Science, Scopus, and Google Scholar databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of primary studies to understand the direct effect of electronic cigarettes on human health. Results A total of 33 studies were included that evaluated cardiovascular, pulmonary, renal, weight and fertility effects. Only five studies analyzed e-cigarettes in healthy populations and seven studies compared healthy individuals against smokers. The effects evaluated on smokers or former tobacco smokers were apparently positive, however, among healthy individuals, increased heart rate, mean arterial pressure, oxidative stress, alteration of respiratory epithelial cells and increased airflow resistance were found. Conclusion Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking. However, in healthy individuals who have never smoked traditional cigarettes, the use of e-cigarettes introduces several cardiovascular and respiratory adverse effects. These findings suggest that while e-cigarettes can be a strategic harm reduction tool for smokers, they are not a safe option for non-smokers.
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Affiliation(s)
| | - Patricio Naranjo-Lara
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | - Estefanía Morales-Lapo
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | - Marlon R. Hidalgo
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | | | | | | | | | | | | | | | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Jin L, Richardson A, Lynch J, Lorkiewicz P, Srivastava S, Fryar L, Miller A, Theis W, Shirk G, Bhatnagar A, Srivastava S, Riggs DW, Conklin DJ. Formaldehyde and the Transient Receptor Potential Ankyrin-1 Contribute to Electronic Cigarette Aerosol-induced Endothelial Dysfunction in Mice. Toxicol Sci 2024:kfae096. [PMID: 39067042 DOI: 10.1093/toxsci/kfae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Electronic Nicotine Delivery Systems (ENDS) aerosol exposures can induce endothelial dysfunction (ED) in healthy young humans and animals. Thermal degradation of ENDS solvents, propylene glycol and vegetable glycerin (PG: VG), generates abundant formaldehyde (FA) and other carbonyls. Because FA can activate the transient receptor potential ankyrin-1 (TRPA1) sensor, we hypothesized that FA in ENDS aerosols provokes TRPA1-mediated changes that include ED and 'respiratory braking' - biomarkers of harm. To test this, wild-type (WT) and TRPA1-null mice were exposed by inhalation to either filtered air, PG: VG-derived aerosol, or formaldehyde (FA, 5 ppm). Short-term exposures to PG: VG and FA induced ED in female WT but not in female TRPA1-null mice. Moreover, acute exposures to PG: VG and FA stimulated respiratory braking in WT but not in TRPA1-null female mice. Urinary metabolites of FA (ie, N -1,3-thiazolidine-4-carboxylic acid, TCA; N -1,3-thiazolidine-4-carbonyl glycine, TCG) and monoamines were measured by LC-MS/MS. PG: VG and FA exposures significantly increased urinary excretion of both TCA and TCG in both WT and TRPA1-null mice. To confirm that inhaled FA directly contributed to urinary TCA, mice were exposed to isotopic 13C-FA gas (1 ppm, 6 h).13C-FA exposure significantly increased the urine level of 13C-TCA in the early collection (0-3 h) supporting a direct relationship between inhaled FA and TCA. Collectively, these data suggest that ENDS use may increase CVD risk dependent on FA, TRPA1, and catecholamines, yet independently of either nicotine or flavorants. This study supports that levels of FA in ENDS-derived aerosols should be lowered to mitigate CVD risk in people who use ENDS.
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Affiliation(s)
- Lexiao Jin
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Andre Richardson
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Jordan Lynch
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Pawel Lorkiewicz
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
- Division of Environmental Medicine, Department of Medicine, University of Louisville
- Superfund Research Center, University of Louisville
| | - Shweta Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville
- Superfund Research Center, University of Louisville
| | - Laura Fryar
- School of Medicine, University of Louisville, Louisville, KY, 40202, USA
| | - Alexis Miller
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Whitney Theis
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Gregg Shirk
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
| | - Aruni Bhatnagar
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
- Division of Environmental Medicine, Department of Medicine, University of Louisville
- Superfund Research Center, University of Louisville
| | - Sanjay Srivastava
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
- Division of Environmental Medicine, Department of Medicine, University of Louisville
- Superfund Research Center, University of Louisville
| | - Daniel W Riggs
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
- Division of Environmental Medicine, Department of Medicine, University of Louisville
- Superfund Research Center, University of Louisville
| | - Daniel J Conklin
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville
- Christina Lee Brown Envirome Institute, University of Louisville
- Division of Environmental Medicine, Department of Medicine, University of Louisville
- Superfund Research Center, University of Louisville
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Koh YC, Pan MH. Food-Borne Polycyclic Aromatic Hydrocarbons and Circadian Disruption. ACS OMEGA 2024; 9:31298-31312. [PMID: 39072055 PMCID: PMC11270680 DOI: 10.1021/acsomega.4c04120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/30/2024]
Abstract
Circadian disruption has been found to increase the risk of metabolic diseases, brain disorders, and cancer. The aryl hydrocarbon receptor (AhR), responsible for xenobiotic metabolism, is known to be activated by certain environmental stimuli, including polycyclic aromatic hydrocarbons (PAHs). Exposure to these stimuli may lead to diseases related to circadian disruption, with AhR activation suggested as a leading cause. Both the aryl hydrocarbon receptor nuclear translocator (ARNT) and aryl hydrocarbon receptor nuclear translocator-like (BMAL1) are class II basic helix-loop-helix/Per-ARNT-SIM (bHLH-PAS) proteins. These proteins form heterodimers with stimulated class I bHLH-PAS proteins, including circadian locomotor output cycles kaput (CLOCK) and AhR. Due to their sequential similarity, the overactivation of AhR by toxicants, such as PAHs, may lead to the formation of heterodimers with BMAL1, potentially causing circadian disruption. Dysregulation of BMAL1 can affect a wide range of metabolic genes, emphasizing its crucial roles. However, this issue has not been adequately addressed. Previous studies have reported that the inhibitory effects of phytochemicals on AhR activation can ameliorate diseases induced by environmental toxicants. Additionally, some phytochemicals have shown preventive effects on circadian misalignment. Therefore, this Review aims to explore potential strategies to prevent circadian disruption induced by food-borne toxicants, such as benzo[a]pyrene; to generate new ideas for future studies; and to highlight the importance of investigating these preventive strategies.
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Affiliation(s)
- Yen-Chun Koh
- Institute
of Food Science and Technology, National
Taiwan University, Taipei 106017, Taiwan
| | - Min-Hsiung Pan
- Institute
of Food Science and Technology, National
Taiwan University, Taipei 106017, Taiwan
- Department
of Medical Research, China Medical University Hospital, China Medical University, Taichung City 404327, Taiwan
- Department
of Health and Nutrition Biotechnology, Asia
University, Taichung City 413305, Taiwan
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Cheng KW, Liber AC, Levy DT. Cross-State Border Nicotine Vaping Products Purchase-Early Evidence From State Emergency Sales Restrictions in 2019. Nicotine Tob Res 2024; 26:1007-1013. [PMID: 38297975 DOI: 10.1093/ntr/ntae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/07/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION While retail sales and retailer inspection studies generally indicate high compliance with state sales restrictions on Nicotine Vaping Products (NVPs) within the restricted area, studies using survey data generally indicate that most users could readily continue gaining access to restricted NVPs. Our study bridges a gap in the current literature and investigates the potential role of cross-state border purchases to evade state emergency NVP sales restrictions in 2019. AIMS AND METHODS The study sample was restricted to NVP sales from the states neighboring Massachusetts, Rhode Island, and Washington, three states that implemented all NVP or flavored NVP sales restrictions in 2019. Among these neighboring states, the 2019 weekly county-level NVP sales by flavors (tobacco, mint/menthol, and other flavors) were compiled using Nielsen Scanner data. A quasi-experimental, comparison group pre-post study design was used to study the impacts of NVP sales restrictions on cross-state border NVP purchases. RESULTS Weekly NVP sales for border counties significantly increased in response to the MA, RI, and WA bans for tobacco flavored (56%, 45%, 14%, respectively), menthol/mint flavored (51%, 2%, 41%, respectively), and other flavored (79%, 3%, 4%, respectively) products, compared to sales for non-border counties (all p-values < .01). CONCLUSIONS Our study identified significant cross-state border NVP purchases in all studied states to circumvent NVP emergency sales restrictions in response to the EVALI outbreak. Policymakers should factor in these purchasing behaviors to evade sales restrictions when evaluating any future potential policies at the state or local levels. IMPLICATIONS While retail sales data and retailer inspections indicate high compliance with Nicotine Vaping Product (NVP) flavor sales restrictions from major retail outlets, survey data obtain mixed findings on the effects of sales restrictions on vaping behaviors. Our study identified a significant increase in cross-state border NVP purchases to circumvent NVP sales restrictions in 2019, consistent across all three settings of Massachusetts, Rhode Island, and Washington. Policymakers should factor in these cross-state border NVP purchases in response to sales restrictions when evaluating any future potential NVP sales restrictions.
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Affiliation(s)
- Kai-Wen Cheng
- Department of Health Administration and Informatics, Governors State University, University Park, IL, USA
| | - Alex C Liber
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
- Policy and Regulatory Science Program, RTI International, Research Triangle Park, NC, USA
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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Mead-Morse EL, Cassidy RN, Kpormegbey DE, Moore T, Oncken C, Tidey JW, Delnevo CD, Litt M. Examining Demand and Substitutability of Usual Brand Little Cigars/Cigarillos and Cigarettes in Young Adults Who Dual Use. Nicotine Tob Res 2024; 26:1057-1065. [PMID: 38365185 DOI: 10.1093/ntr/ntae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/09/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Cigarette and little cigar/cigarillo (LCC) dual use is popular among young people and poses a substantial health risk. What remains unclear is the abuse liability of LCCs vs. cigarettes, LCCs' substitutability for cigarettes, and the influence of flavors on the abuse liability and substitutability of LCCs. METHODS Sixty-five young adults (18-34 years) who dual use completed hypothetical purchase tasks to measure consumption of usual brand cigarettes and LCCs in 24 hours at increasing prices (demand), and LCC consumption at increasing cigarette prices (substitution). Three demand indices were calculated from raw data: breakpoint (price after which consumption reaches 0), Omax (maximum daily expenditure), and Pmax (price at maximum expenditure). Two indices were estimated using nonlinear mixed-effects modeling: intensity (consumption when free) and price-sensitivity (rate of decline in consumption as price increases). Substitution, and associations of flavored use with demand and substitution, were estimated using linear mixed models. RESULTS Results indicated similar abuse liability for LCCs and cigarettes. Intensity was greater for cigarettes, but price-sensitivity was similar. Flavored LCC use was associated with lower price-sensitivity and greater intensity than unflavored. LCCs were significant substitutes for cigarettes, but the effect was small. Flavored use was not associated with substitution. CONCLUSIONS Among young adults who dual use, LCCs and cigarettes had similar abuse liability, and those who used flavored had higher demand for their LCCs. A flavored cigar ban, as well as targeted prevention and cessation services for those who smoke flavored LCCs, may be important for reducing dual use in young adults. IMPLICATIONS Cigarette and LCC dual use remains high among young adults. Using hypothetical purchase tasks with young adults who dual use, LCCs had abuse liability similar to cigarettes, but were only modest substitutes for cigarettes. Participants who used flavored LCCs reported greater abuse liability than those who used unflavored, but not greater substitution for cigarettes. Prevention and cessation services are needed to target LCCs in young people, particularly those smoking flavored products. A flavored cigar ban may help to reduce their demand.
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Affiliation(s)
- Erin L Mead-Morse
- Department of Public Health Sciences, UConn Health, Farmington, CT, USA
- Department of Medicine, UConn Health, Farmington, CT, USA
| | - Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Daniel E Kpormegbey
- Department of Statistics, University of Connecticut, Storrs, CT, USA
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, USA
| | - Timothy Moore
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, USA
| | - Cheryl Oncken
- Department of Medicine, UConn Health, Farmington, CT, USA
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Cristine D Delnevo
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
| | - Mark Litt
- Division of Behavioral Sciences and Community Health, UConn Health, Farmington, CT, USA
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Xie C, Jeffers AM, Winickoff JP. Categorizing Vaping Intensity Among Youth. Nicotine Tob Res 2024; 26:984-990. [PMID: 38227762 DOI: 10.1093/ntr/ntae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/25/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Increasing electronic cigarette use among youth has led to a need for a novel intensity measure of e-cigarette use and its association with nicotine addiction variables. AIMS AND METHODS Using a cross-sectional study of the 2018-2019 PATH Wave 5 Youth survey, a new intensity metric of e-cigarette use, the average number of puffs per month as a function of frequency (days of use per month), number of uses per day and number of puffs per use, was developed for adolescent e-cigarette users. Using logistic regression, standard addiction measures were tested for association with higher quartile (Q) of e-cigarette intensity: Q1 (1-5 puffs), Q2 (6-50 puffs), Q3 (51-528 puffs), and Q4 (529 + puffs). RESULTS Among 1051 current youth e-cigarette users, cravings were associated with greater intensity of use (Q2: aOR = 1.90, 95% CI: 0.94-3.87; Q3: aOR = 6.91, 95% CI: 3.25-14.69; and Q4: aOR = 21.48, 95% CI: 10.03-45.97). Craving associations exceeded the corresponding aORs for the identical regression using the frequency of use. Higher intensity was significantly associated with being an older adolescent (aOR = 1.85), best friend use (aOR: 3.35), not thinking about quitting (aOR: 2.51), and lower perceived addiction (aOR: 1.95). CONCLUSIONS This study found that an intensity metric (puffs per month) was strongly associated with cravings, best friend use, harm perception, and lack of intention to quit. This metric provides a more accurate picture of the intensity of youth e-cigarette use than other commonly used measures and may be important for understanding the current and future impact of the youth e-cigarette epidemic. IMPLICATIONS Adolescent addiction to e-cigarettes affects learning, memory, and attention. However, it is unknown whether the intensity of use, puffs per month, differs from frequency, days of use per month, and in relation to addiction measures. This study provides evidence that high-intensity use characterized by puffs per month has a stronger association with cravings compared to frequency, which suggests puffs per month may be a better measure of nicotine exposure. This new intensity metric may give insights into youth e-cigarette use patterns, addiction, and appropriate treatment of intense but intermittent users.
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Affiliation(s)
- Catherine Xie
- Department of Biology, University of Rochester, Rochester, NY, USA
| | - Abra M Jeffers
- Division of General Academic Pediatrics, Massachusetts General for Children, Boston, MA, USA
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan P Winickoff
- Division of General Academic Pediatrics, Massachusetts General for Children, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Tobacco Consortium, American Academy of Pediatrics, Itasca, IL, USA
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Zhao X, Malterud A, Curry L, Malo V, MacMonegle A, Nonnemaker J, Allen J. Promising Themes for Electronic Cigarette Prevention Campaigns for Youth and Young Adults. Nicotine Tob Res 2024; 26:999-1006. [PMID: 38302084 DOI: 10.1093/ntr/ntae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/10/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are the most widely used tobacco product by youth and young adults in the United States. Effective prevention campaigns require the identification of appropriate content focus for message construction. AIMS AND METHODS A sample of 2622 youth and young adults ages 15-24 were recruited through social media advertisements and completed an online survey. Respondents reported current e-cigarette use or intention to use if not currently using. They also indicated agreement or disagreement with 75 e-cigarette-related beliefs representing 16 themes. The relative promise of each theme/belief for campaign messaging was investigated by examining its association with the behavior/intention outcomes and the opportunity for positive change in its distribution (room to move). RESULTS All themes showed significant associations with the behavior (ORs = 2.49-19.04) and intention (ORs = 2.21-6.11) outcomes. Room to move for themes ranged from 32.9% to 96.3% in behavior analysis and 15.6-93.9% in intention analysis. A normed relative promise index (M = 50, SD = 17) showed flavors (72), comparison to cigarettes (69), and relaxation and mental health (68) as the top ranked themes. Subgroup analyses by demographics revealed few differences. Results on the belief level were largely consistent with those on the theme level. CONCLUSIONS Data from this study provide timely evidence for the relative value of various themes/beliefs as potential targets for message development in e-cigarette prevention campaigns. The final selection of target themes/beliefs requires consideration of openness to persuasion, which may be informed by additional testing. IMPLICATIONS Electronic cigarettes (e-cigarettes) are the most widely used tobacco products among youth and young adults in the United States. This study adds new evidence on the relative promise of a wide range of e-cigarette beliefs and belief clusters (themes) as potential targets for message development in educational campaigns. This evidence is important to consider in future campaign efforts directed at the youth and young adult populations in the United States.
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Affiliation(s)
- Xiaoquan Zhao
- Center for Tobacco Products, Food & Drug Administration, Silver Spring, MD, USA
- Department of Communication, George Mason University, Fairfax, VA, USA
| | - Andie Malterud
- Center for Tobacco Products, Food & Drug Administration, Silver Spring, MD, USA
| | - Laurel Curry
- RTI International, Research Triangle Park, NC, USA
| | | | | | | | - Jane Allen
- RTI International, Research Triangle Park, NC, USA
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Kong AY, Lee JGL, Halvorson-Fried SM, Sewell KB, Golden SD, Henriksen L, Herbert L, Ribisl KM. Neighbourhood inequities in the availability of retailers selling tobacco products: a systematic review. Tob Control 2024:tc-2024-058718. [PMID: 38937098 DOI: 10.1136/tc-2024-058718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To examine inequities in tobacco retailer availability by neighbourhood-level socioeconomic, racial/ethnic and same-sex couple composition. DATA SOURCES We conducted a 10 November 2022 search of PubMed, PsycINFO, Global Health, LILACS, Embase, ABI/Inform, CINAHL, Business Source Complete, Web of Science and Scopus. STUDY SELECTION We included records from Organisation for Economic Co-operation and Development member countries that tested associations of area-level measures of tobacco retailer availability and neighbourhood-level sociodemographic characteristics. Two coders reviewed the full text of eligible records (n=58), including 41 records and 205 effect sizes for synthesis. DATA EXTRACTION We used dual independent screening of titles, abstracts and full texts. One author abstracted and a second author confirmed the study design, location, unit of analysis, sample size, retailer data source, availability measure, statistical approach, sociodemographic characteristic and unadjusted effect sizes. DATA SYNTHESIS Of the 124 effect sizes related to socioeconomic inequities (60.5% of all effect sizes), 101 (81.5%) indicated evidence of inequities. Of 205 effect sizes, 69 (33.7%) tested associations between retailer availability and neighbourhood composition of racially and ethnically minoritised people, and 57/69 (82.6%) documented inequities. Tobacco availability was greater in neighbourhoods with more Black, Hispanic/Latine and Asian residents (82.8%, 90.3% and 40.0% of effect sizes, respectively). Two effect sizes found greater availability with more same-sex households. CONCLUSIONS There are stark inequities in tobacco retailer availability. Moving beyond documenting inequities to partnering with communities to design, implement, and evaluate interventions that reduce and eliminate inequities in retail availability is needed to promote an equitable retail environment. PROSPERO REGISTRATION NUMBER CRD42019124984.
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Affiliation(s)
- Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Sarah M Halvorson-Fried
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Kerry B Sewell
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Shelley Diane Golden
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, Stanford, California, USA
| | - Lily Herbert
- Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kurt M Ribisl
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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Lewis K, Cunningham D, Valera P. Marketing Strategies Used by Tobacco Companies Targeting the Queer Community. Tob Use Insights 2024; 17:1179173X241265743. [PMID: 39050706 PMCID: PMC11268003 DOI: 10.1177/1179173x241265743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
Background: This study described the marketing strategies tobacco companies use to advertise tobacco products to the Queer community. Methods: In this secondary qualitative analysis, 15 Queer participants were interviewed to explore their life experiences with tobacco product advertisements during the early days of the COVID-19 pandemic. Results: Participants self-reported as male (n = 5), followed by female (n = 4), gender non-binary (n = 4) and, transgender (n = 2). In addition, most participants identified as Black/African American (n = 7) or White (n = 7). Many participants identified as Bisexual (n = 5) or Queer (n = 4). Using narrative analysis, the themes for this study were: (1) tobacco and vaping companies target minoritized and Queer people; (2) tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons; and (3) the use of social media influencers represents a new social marketing technique. As a result, Queer participants were more likely to encounter many different types of advertisements from tobacco companies and, most recently, social media influencers. Conclusion: Social media influencers are a new factor that needs further study to understand the new tobacco advertising landscape.
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Affiliation(s)
- Kendra Lewis
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, USA
- Community Health Justice Lab (www.chjl.org)
| | - Diamond Cunningham
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, USA
- Community Health Justice Lab (www.chjl.org)
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, USA
- Community Health Justice Lab (www.chjl.org)
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McArthur J, Stewart S, Al-Hamdani M. Vaping Frequency in Young Users: The Role of Gender and Age Among Regular Users. Subst Use Misuse 2024:1-7. [PMID: 39028136 DOI: 10.1080/10826084.2024.2374975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Background: Vaping is popular among adolescents and emerging adults; however, little is known about regular vaping patterns in older adolescents and emerging adults. Objective: The current study explored whether gender and age are associated with nicotine-based vaping frequency to ascertain ascertaining which subgroups of youth are most at-risk for frequent use. Methods: In a cross-sectional survey, participants using nicotine-based vaping devices (N=535, age range 16-24) reported frequency measured as vaping days in a week, number of episodes during which participants vaped, and puff numbers for each episode. A two-way multivariate analysis of variance was used to test the effects and interactions of gender and age groups on the three frequency outcomes. Results: Emerging adults and males vaped more frequently than their older adolescent and female counterparts, respectively. Specifically, emerging adults vaped more days per week in comparison to older adolescents, whereas males vaped more days per week and had more vaping episodes per day relative to females. Further, emerging adult males had more vaping episodes in comparison to other subgroups, and adolescent females as well as emerging adult males took more puffs per episode in comparison to emerging adult females. Conclusion: Vaping differences among subgroups suggests the need for policies to reduce regular nicotine vaping targeted toward specific gender and age groups.
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Affiliation(s)
- Jennifer McArthur
- Department of Psychology, Saint Mary's University, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Sherry Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Mohammed Al-Hamdani
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Schneller LM, Reid JL, Kasza KA, O'Connor RJ, Hyland A, Hammond D. Awareness and perceived behaviour changes following the New York state vaping flavour ban, 2021-2022. Tob Control 2024:tc-2023-058569. [PMID: 39025659 DOI: 10.1136/tc-2023-058569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/30/2024] [Indexed: 07/20/2024]
Abstract
SIGNIFICANCE Despite an electronic cigarette (e-cigarette) flavour ban in New York (NY) since May 2020, most youth who vape continue to report vaping restricted flavours. This study aims to examine youth awareness and perceived behaviour change associated with the NY vaping flavour ban. METHODS NY cross-sectional data from 2021 and 2022 ITC Youth Survey were combined and analysed (N=1014). Weighted analyses were used to describe awareness and understanding of the e-cigarette flavour ban, as well as changes in tobacco use behaviour. RESULTS Only 0.9% (n=8) of NY youth understood the flavour ban, in that they were both aware of the flavour ban in all stores and accurately reported that all non-tobacco flavours were banned. Awareness and understanding of the flavour ban differed by vaping status (p<0.01): respondents who had vaped in the past 12 months or 30 days were more likely (adjusted OR (aOR)=2.15, 95% CI 1.34, 3.45; aOR=2.07, 95% CI 1.17, 3.64, respectively) to be aware of the flavour ban but misunderstand the stores or flavours included. Of the majority of youth who reported awareness of a flavour ban and vaped (n=122) or smoked (n=78) in the past 12 months reported no changes in behaviour (64.0% and 69.7%, respectively). CONCLUSIONS Less than one-third of NY youth, regardless of vaping status, reported that an e-cigarette flavour ban was present where they live. Further, most youth who were aware of the ban misunderstood which flavours were restricted and/or that the ban applied to all stores that sold e-cigarettes. Increased enforcement and educational efforts could improve awareness and understanding of the NY e-cigarette flavour ban.
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Affiliation(s)
- Liane M Schneller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Smethells JR, S W, P M, MG L, AP H. The role of β-Nicotyrine in E-Cigarette abuse liability I: Drug Discrimination. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.12.603310. [PMID: 39071347 PMCID: PMC11275838 DOI: 10.1101/2024.07.12.603310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background β-Nicotyrine (β-Nic) is a unique minor alkaloid constituent in electronic nicotine delivery systems (ENDS) that is derived from nicotine (Nic) degradation and can reach 25% of Nic concentrations in ENDS aerosol. β-Nic slows Nic metabolism and prolongs systemic Nic exposure, which may alter the discriminability of Nic. The present study sought to examine β-Nic has interoceptive effects itself, and if it alters the subjective effects ENDS products within a drug-discrimination paradigm. Methods The pharmacodynamics of β-Nic were examined in vitro, and a nicotine discrimination paradigm was used to determine if β-Nic (0 - 5.0 mg/kg) shares discriminative stimulus properties with Nic (0.2 mg/kg) in male (n = 13) and female (n = 14) rats after 10- & 60-min β-Nic pretreatment delays. A second group of rats was trained to discriminate β-Nic and Nornicotine (Nornic) from saline to determine if β-Nic alone has interoceptive properties and whether they are similar to Nornic. Results β-Nic had similar binding affinity and efficacy at the α4β2 nicotinic receptor subtype as Nornic, ~50% of Nic efficacy. However, β-Nic only weakly substituted for Nic during substitution testing in female rats, but not males, whereas Nornic fully substituted for Nic. Combination testing at the 10 and 60-min pretreatment intervals showed that β-Nic dose-dependently increased the duration of nicotine's discriminative stimulus effects, especially at the 60-min delay. Drug naïve rats could reliably discriminate Nornic, but not β-Nic, from Sal. Conclusion β-Nic increased and prolonged the interoceptive stimulus properties of Nic, suggesting it may alter to the abuse liability of ENDS through its ability to slow Nic metabolism.
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Affiliation(s)
- JR Smethells
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Wilde S
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Muelken P
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - LeSage MG
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Harris AP
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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