201
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Kaufman AR, Mays D, Koblitz AR, Portnoy DB. Judgments, awareness, and the use of snus among adults in the United States. Nicotine Tob Res 2014; 16:1404-8. [PMID: 25098672 DOI: 10.1093/ntr/ntu116] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Alternative tobacco products, such as snus, are emerging in the U.S. market. Understanding correlates of awareness and use, particularly judgments about harm and addictiveness, can inform public health communications about these products. METHODS Data were collected from a web panel representative of the U.S. population in March 2013 (N = 2,067). The survey assessed awareness and use of snus among adults. Absolute and comparative snus judgments, intentions, smoking status, and sociodemographic variables were measured. Bivariate and multivariable logistic regression analyses were conducted to examine associations between these variables and snus awareness and use. RESULTS Nearly 36% of the population was aware of snus, and 5.2% reported ever using snus. Current cigarette smokers were about 4 times more likely as nonsmokers to report snus awareness and use. Sociodemographic correlates of snus awareness and use included being male, employed full time, and younger. Compared with respondents who perceived snus to be as harmful and as addictive as cigarettes, those who perceived snus to be less harmful and less addictive than cigarettes were more likely to have used snus. CONCLUSIONS Current smokers are more likely to be aware of and have used snus. Multiple tobacco product use poses a significant challenge for public health efforts to reduce tobacco-associated morbidity and mortality. Perceptions that snus is less harmful and less addictive compared with cigarettes are associated with snus use. These judgments can inform public health communications about emerging tobacco products and multiple product use.
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Affiliation(s)
- Annette R Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD;
| | - Darren Mays
- U.S. Food and Drug Administration, Tobacco Regulatory Science Fellowship Program, Silver Spring, MD; Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Amber R Koblitz
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD
| | - David B Portnoy
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD
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202
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Pepper JK, Eissenberg T. Waterpipes and electronic cigarettes: increasing prevalence and expanding science. Chem Res Toxicol 2014; 27:1336-43. [PMID: 25338174 PMCID: PMC4137989 DOI: 10.1021/tx500200j] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
The
prevalence of noncigarette tobacco product use is on the rise
across the globe, especially for waterpipes (also known as hookah,
narghile, and shisha) and electronic cigarettes (e-cigarettes). The
scientific literature reveals that waterpipe tobacco smoking is associated
with exposure to a variety of toxicants that can cause short- and
long-term adverse health events. In contrast, there is far less evidence
of health harms related to e-cigarette use, although the variety of
products in this category makes it difficult to generalize. We searched
the PubMed database for all publications on waterpipes and e-cigarettes
from January 2000 to March 2014. The number of publications on waterpipes
rose in a slow, linear pattern during this time, while the number
of publications on e-cigarettes showed exponential growth. The different
trends suggest there may be more interest in studying a novel nicotine
product (the e-cigarette) over a traditional tobacco product (the
waterpipe). We posit that, although the specific research needs for
these products are different, public health would be served best by
a more equitable research approach. Scientists should continue to
devote attention to understanding the unknown long-term health effects
of e-cigarettes and their potential to serve as harm reduction or
smoking cessation tools while simultaneously investigating how to
reduce waterpipe smoking given that it exposes users to toxicants
known to cause harm to health. Recent regulatory action in the United
States, which proposes to include waterpipes and e-cigarettes under
some of the same regulations as tobacco cigarettes, makes such research
particularly timely.
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Affiliation(s)
- Jessica K Pepper
- Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer Center, University of North Carolina , 319D Rosenau Hall, CB #7400, Chapel Hill, North Carolina 27599, United States
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203
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Sargent JD. Teen tobacco use: research and regulatory gaps. Am J Prev Med 2014; 47:S90-2. [PMID: 25044201 DOI: 10.1016/j.amepre.2014.04.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 11/29/2022]
Affiliation(s)
- James D Sargent
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire..
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204
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E-cigarette awareness and perceived harmfulness: prevalence and associations with smoking-cessation outcomes. Am J Prev Med 2014; 47:141-9. [PMID: 24794422 PMCID: PMC4107147 DOI: 10.1016/j.amepre.2014.02.011] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 01/31/2014] [Accepted: 02/14/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND Electronic cigarettes, or e-cigarettes, are increasingly advertised as replacements for regular cigarettes or cessation aids for smokers. PURPOSE To describe the prevalence and correlates of e-cigarette awareness and perceived harmfulness among U.S. adults and analyze whether these variables are associated with smokers' past-year quit attempts and intention to quit. METHODS Data were obtained from the Health Information National Trends Survey (HINTS 4 Cycle 2), conducted from October 2012 to January 2013. Data analyses were performed from June to August 2013. RESULTS Overall, 77% of respondents were aware of e-cigarettes. Of these, 51% believed e-cigarettes were less harmful than cigarettes. Younger, white (compared with Hispanic), more educated respondents and current or former smokers (compared with non-smokers) were more likely to be aware of e-cigarettes. Among those who were aware of e-cigarettes, younger; men (compared with women); white (compared with African-American); more educated respondents; and current smokers (compared with former and non-smokers) were more likely to believe that e-cigarettes were less harmful. [corrected]. CONCLUSIONS Overall e-cigarette awareness increased whereas the proportion of smokers who perceived less harm of e-cigarettes declined compared with earlier surveys. However, awareness and perceived harm of e-cigarettes did not show evidence of promoting smoking cessation at the population level.
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205
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Physicians' attitudes and use of e-cigarettes as cessation devices, North Carolina, 2013. PLoS One 2014; 9:e103462. [PMID: 25072466 PMCID: PMC4114778 DOI: 10.1371/journal.pone.0103462] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 07/01/2014] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are not currently approved or recommended by the Food and Drug Administration (FDA) or various medical organizations; yet, they appear to play a substantial role in tobacco users' cessation attempts. This study reports on a physician survey that measured beliefs, attitudes, and behavior related to e-cigarettes and smoking cessation. To our knowledge this is the first study to measure attitudes toward e-cigarettes among physicians treating adult smokers. METHODS Using a direct marketing company, a random sample of 787 North Carolina physicians were contacted in 2013 through email, with 413 opening the email and 128 responding (response rate = 31%). Physicians' attitudes towards e-cigarettes were measured through a series of close-ended questions. Recommending e-cigarettes to patients served as the outcome variable for a logistic regression analysis. RESULTS Two thirds (67%) of the surveyed physicians indicated e-cigarettes are a helpful aid for smoking cessation, and 35% recommended them to their patients. Physicians were more likely to recommend e-cigarettes when their patients asked about them or when the physician believed e-cigarettes were safer than smoking standard cigarettes. CONCLUSIONS Many North Carolina physicians are having conversations about e-cigarettes with their patients, and some are recommending them. Future FDA regulation of e-cigarettes may help provide evidence-based guidance to physicians about e-cigarettes and will help ensure that patients receive evidence-based recommendations about the safety and efficacy of e-cigarettes in tobacco cessation.
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206
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Pepper JK, Emery SL, Ribisl KM, Southwell BG, Brewer NT. Effects of advertisements on smokers' interest in trying e-cigarettes: the roles of product comparison and visual cues. Tob Control 2014; 23 Suppl 3:iii31-6. [PMID: 24935896 PMCID: PMC4078668 DOI: 10.1136/tobaccocontrol-2014-051718] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 05/05/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery devices that have become popular among smokers. We conducted an experiment to understand adult smokers' responses to e-cigarette advertisements and investigate the impact of ads' arguments and imagery. METHODS A U.S. national sample of smokers who had never tried e-cigarettes (n=3253) participated in a between-subjects experiment. Smokers viewed an online advertisement promoting e-cigarettes using one of three comparison types (emphasising similarity to regular cigarettes, differences or neither) with one of three images, for nine conditions total. Smokers then indicated their interest in trying e-cigarettes. RESULTS Ads that emphasised differences between e-cigarettes and regular cigarettes elicited more interest than ads without comparisons (p<0.01), primarily due to claims about e-cigarettes' lower cost, greater healthfulness and utility for smoking cessation. However, ads that emphasised the similarities of the products did not differ from ads without comparisons. Ads showing a person using an e-cigarette created more interest than ads showing a person without an e-cigarette (p<0.01). CONCLUSIONS Interest in trying e-cigarettes was highest after viewing ads with messages about differences between regular and electronic cigarettes and ads showing product use. If e-cigarettes prove to be harmful or ineffective cessation devices, regulators might restrict images of e-cigarette use in advertising, and public health messages should not emphasise differences between regular and electronic cigarettes. To inform additional regulations, future research should seek to identify what advertising messages and features appeal to youth.
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Affiliation(s)
- Jessica K Pepper
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sherry L Emery
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian G Southwell
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- School of Journalism and Mass Communication, University of North Carolina, Chapel Hill, North Carolina, USA
- RTI International, Durham, North Carolina, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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207
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Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control 2014. [PMID: 24935895 DOI: 10.1136/tobaccocontrol‐2014‐051670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION E-cigarettes are largely unregulated and internet sales are substantial. This study examines how the online market for e-cigarettes has changed over time: in product design and in marketing messages appearing on websites. METHODS Comprehensive internet searches of English-language websites from May-August 2012 and December 2013-January 2014 identified brands, models, flavours, nicotine strengths, ingredients and product claims. Brands were divided into older and newer groups (by the two searches) for comparison. RESULTS By January 2014 there were 466 brands (each with its own website) and 7764 unique flavours. In the 17 months between the searches, there was a net increase of 10.5 brands and 242 new flavours per month. Older brands were more likely than newer brands to offer cigalikes (86.9% vs. 52.1%, p<0.01), and newer brands more likely to offer the more versatile eGos and mods (75.3% vs. 57.8%, p<0.01). Older brands were significantly more likely to claim that they were healthier and cheaper than cigarettes, were good substitutes where smoking was banned and were effective smoking cessation aids. Newer brands offered more flavours per brand (49 vs. 32, p<0.01) and were less likely to compare themselves with conventional cigarettes. CONCLUSIONS The number of e-cigarette brands is large and has been increasing. Older brands tend to highlight their advantages over conventional cigarettes while newer brands emphasise consumer choice in multiple flavours and product versatility. These results can serve as a benchmark for future research on the impact of upcoming regulations on product design and advertising messages of e-cigarettes.
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Affiliation(s)
- Shu-Hong Zhu
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Jessica Y Sun
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Erika Bonnevie
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Sharon E Cummins
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Anthony Gamst
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Lu Yin
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Madeleine Lee
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
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208
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Harrell PT, Simmons VN, Correa JB, Padhya TA, Brandon TH. Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy. Otolaryngol Head Neck Surg 2014; 151:381-93. [PMID: 24898072 DOI: 10.1177/0194599814536847] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems ("e-cigarettes") are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking. DATA SOURCES The authors searched PubMed, Web of Science, and additional sources for published empirical data on safety and use of electronic cigarettes as an aid to quit smoking. REVIEW METHODS We conducted a structured search of the current literature up to and including November 2013. RESULTS E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure. Data on the use of e-cigarettes for quitting smoking are suggestive but ultimately inconclusive. CONCLUSIONS Clinicians are advised to be aware that the use of e-cigarettes, especially among cigarette smokers, is growing rapidly. These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking. IMPLICATIONS FOR PRACTICE In the absence of further data or regulation, oncologists are advised to discuss the known and unknown safety and efficacy information on e-cigarettes with interested patients and to encourage patients to first try FDA-approved pharmacotherapies for smoking cessation.
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Affiliation(s)
- Paul Truman Harrell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Vani Nath Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - John Bernard Correa
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Tapan Ashvin Padhya
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Thomas Henry Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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209
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Knight-West O, O'Brien B, Walker N, Bullen C. Context on use is needed before public health recommendations are made about e-cigarettes. Am J Prev Med 2014; 46:e57-8. [PMID: 24842745 DOI: 10.1016/j.amepre.2014.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/14/2014] [Accepted: 03/04/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Oliver Knight-West
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Brigid O'Brien
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Natalie Walker
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
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210
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211
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Pokhrel P, Little MA, Fagan P, Muranaka N, Herzog TA. Electronic cigarette use outcome expectancies among college students. Addict Behav 2014; 39:1062-5. [PMID: 24630824 DOI: 10.1016/j.addbeh.2014.02.014] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 01/31/2014] [Accepted: 02/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND E-cigarette use outcome expectancies and their relationships with demographic and e-cigarette use variables are not well understood. Based on past cigarette as well as e-cigarette use research, we generated self-report items to assess e-cigarette outcome expectancies among college students. The objective was to determine different dimensions of e-cigarette use expectancies and their associations with e-cigarette use and use susceptibility. METHODS Self-report data were collected from 307 multiethnic 4- and 2-year college students [M age=23.5 (SD=5.5); 65% Female; 35% current cigarette smokers] in Hawaii. Data analyses were conducted by using factor and regression analyses. RESULTS Exploratory factor analysis among e-cigarette ever-users indicated 7 factors: 3 positive expectancy factors (social enhancement, affect regulation, positive sensory experience) and 4 negative expectancy factors (negative health consequences, addiction concern, negative appearance, negative sensory experience). Confirmatory factor analysis among e-cigarette never-users indicated that the 7-factor model fitted reasonably well to the data. Being a current cigarette smoker was positively associated with positive expectancies and inversely with negative expectancies. Higher positive expectancies were significantly associated with greater likelihood of past-30-day e-cigarette use. Except addiction concern, higher negative expectancies were significantly associated with lower likelihood of past-30-day e-cigarette use. Among e-cigarette never-users, positive expectancy variables were significantly associated with higher intentions to use e-cigarettes in the future, adjusting for current smoker status and demographic variables. CONCLUSIONS E-cigarette use expectancies determined in this study appear to predict e-cigarette use and use susceptibility among young adults and thus have important implications for future research.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, 701 Illalo St., Honolulu, HI 96822, United States.
| | - Melissa A Little
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, 701 Illalo St., Honolulu, HI 96822, United States
| | - Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, 701 Illalo St., Honolulu, HI 96822, United States
| | - Nicholas Muranaka
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, 701 Illalo St., Honolulu, HI 96822, United States
| | - Thaddeus A Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, 701 Illalo St., Honolulu, HI 96822, United States
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212
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Stepanov I, Fujioka N. Bringing attention to e-cigarette pH as an important element for research and regulation. Tob Control 2014; 24:413-4. [PMID: 24827979 DOI: 10.1136/tobaccocontrol-2014-051540] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 11/04/2022]
Affiliation(s)
- Irina Stepanov
- Division of Environmental Health Sciences, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Naomi Fujioka
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
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213
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Cummins SE, Zhu SH, Tedeschi GJ, Gamst AC, Myers MG. Use of e-cigarettes by individuals with mental health conditions. Tob Control 2014; 23 Suppl 3:iii48-53. [PMID: 24824516 PMCID: PMC4145659 DOI: 10.1136/tobaccocontrol-2013-051511] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Individuals with mental health conditions (MHC) have disproportionately high tobacco-related morbidity and mortality due to high smoking prevalence rates. As high consumers of cigarettes, smokers with MHC may consider using e-cigarettes as an alternative form of nicotine delivery. Objective Examination of the susceptibility to use e-cigarettes by individuals with MHC. Methods A US population survey with a national probability sample (n=10 041) was used to assess ever use and current use of regular cigarettes, e-cigarettes, and US Food and Drug Administration-approved pharmacotherapy for smoking cessation. Survey respondents provided information about whether they had been diagnosed with an anxiety disorder, depression, or other MHC. Results Individuals with MHC were more likely to have tried e-cigarettes (14.8%) and to be current users of e-cigarettes (3.1%) than those without MHC (6.6% and 1.1%, respectively; p<0.01). Ever smokers with MHC were also more likely to have tried approved pharmacotherapy (52.2% vs 31.1%, p<0.01) and to be currently using these products (9.9% vs 3.5%, p<0.01) than those without MHC. Additionally, current smokers with MHC were more susceptible to future use of e-cigarettes than smokers without MHC (60.5% vs 45.3%, respectively, p<0.01). Conclusions Smokers with MHC are differentially affected by the rise in popularity of e-cigarettes. Clinical interventions and policies for tobacco control on e-cigarettes should take into account the possible outcomes and their implications for this priority population.
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Affiliation(s)
- Sharon E Cummins
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Shu-Hong Zhu
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Gary J Tedeschi
- Cancer Center, University of California, San Diego, La Jolla, California, USA
| | - Anthony C Gamst
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Mark G Myers
- Psychology Service, Veteran Affairs San Diego Healthcare System, Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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214
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Vakkalanka JP, Hardison LS, Holstege CP. Epidemiological trends in electronic cigarette exposures reported to U.S. Poison Centers. Clin Toxicol (Phila) 2014; 52:542-8. [DOI: 10.3109/15563650.2014.913176] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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215
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Pepper JK, Emery SL, Ribisl KM, Brewer NT. How U.S. adults find out about electronic cigarettes: implications for public health messages. Nicotine Tob Res 2014; 16:1140-4. [PMID: 24755397 DOI: 10.1093/ntr/ntu060] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that have become increasingly popular in the United States. We sought to understand how U.S. adults hear about e-cigarettes. METHODS A national sample of 17,522 U.S. adults (≥ 18 years old) completed an online survey in March 2013 assessing their awareness of and sources of information about e-cigarettes. RESULTS Most respondents (86%) had heard of e-cigarettes. Current and former smokers were more likely to be aware of e-cigarettes than non-smokers. Males, younger adults, non-Hispanic Whites, and those with higher education were also more likely to have heard of e-cigarettes. The most commonly reported sources of information were another person, ads on television, and seeing e-cigarettes being sold, although the relative frequency of these sources differed for current, former, and never-smokers. Former and current smokers were more likely to have heard about e-cigarettes from e-cigarette users than were never-smokers. Adults age 30 years or younger were more likely than adults older than 30 years to have heard about e-cigarettes online. CONCLUSIONS Nearly all U.S. adults had heard of e-cigarettes in 2013. By focusing on the most common channels of information, public health campaigns can more efficiently communicate information about e-cigarette safety and consider necessary regulations should companies use these channels for marketing that targets youth, non-tobacco users, and other at-risk groups.
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Affiliation(s)
- Jessica K Pepper
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC;
| | - Sherry L Emery
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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216
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Smoking: Tobacco trends. Br Dent J 2014; 216:266. [DOI: 10.1038/sj.bdj.2014.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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217
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Jo CL, Ayers JW, Althouse BM, Emery S, Huang J, Ribisl KM. US consumer interest in non-cigarette tobacco products spikes around the 2009 federal tobacco tax increase. Tob Control 2014; 24:395-9. [PMID: 24500270 DOI: 10.1136/tobaccocontrol-2013-051261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/29/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This quasi-experimental longitudinal study monitored aggregate Google search queries as a proxy for consumer interest in non-cigarette tobacco products (NTP) around the time of the 2009 US federal tobacco tax increase. METHODS Query trends for searches mentioning common NTP were downloaded from Google's public archives. The mean relative increase was estimated by comparing the observed with expected query volume for the 16 weeks around the tax. RESULTS After the tax was announced, queries spiked for chewing tobacco, cigarillos, electronic cigarettes ('e-cigarettes'), roll-your-own (RYO) tobacco, snuff, and snus. E-cigarette queries were 75% (95% CI 70% to 80%) higher than expected 8 weeks before and after the tax, followed by RYO 59% (95% CI 53% to 65%), snus 34% (95% CI 31% to 37%), chewing tobacco 17% (95% CI 15% to 20%), cigarillos 14% (95% CI 11% to 17%), and snuff 13% (95% CI 10% to 14%). Unique queries increasing the most were 'ryo cigarettes' 427% (95% CI 308% to 534%), 'ryo tobacco' 348% (95% CI 300% to 391%), 'best electronic cigarette' 221% (95% CI 185% to 257%), and 'e-cigarette' 205% (95% CI 163% to 245%). CONCLUSIONS The 2009 tobacco tax increase triggered large increases in consumer interest for some NTP, particularly e-cigarettes and RYO tobacco.
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Affiliation(s)
- Catherine L Jo
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - John W Ayers
- Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Sherry Emery
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jidong Huang
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kurt M Ribisl
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Berg CJ, Barr DB, Stratton E, Escoffery C, Kegler M. Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers. ACTA ACUST UNITED AC 2014; 4:789-800. [PMID: 25621193 PMCID: PMC4304080 DOI: 10.4236/ojpm.2014.410089] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes. Methods We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively. Results Participants reduced cigarette consumption from baseline to week 4 and 8 (p’s < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p’s = ns). At week 8, the majority reported improved health (65.4%), reduced smoker’s cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%). Conclusions Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Erin Stratton
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Michelle Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
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