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Dautzenberg B, Legleye S, Underner M, Arvers P, Pothegadoo B, Bensaidi A. Systematic Review and Critical Analysis of Longitudinal Studies Assessing Effect of E-Cigarettes on Cigarette Initiation among Adolescent Never-Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6936. [PMID: 37887674 PMCID: PMC10606427 DOI: 10.3390/ijerph20206936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
Prospective longitudinal studies mainly conclude on a causal role of e-cigarettes in the initiation of cigarettes in flagrant contradiction with conclusions drawn from epidemiology and other studies showing a sharp decline in cigarette use in parallel with the spread of e-cigarette use. This systematic review explores the reasons for this discrepancy. METHODS Among 84 publications on e-cigarette/cigarette association in adolescents identified in the Medline database from 2011 to 2022, 23 concern 22 never-smoker longitudinal sub-cohorts. RESULTS A link between e-cigarette experimentation at T1 and cigarette initiation at T2 is reported in sub-cohort analyses of never-smokers (AOR: 1.41 to 8.30). However, studies exclude 64.3% of T1 e-cigarette experimenters (because of dual-use) and 74.1% of T2 cigarette experimenters. With this study design, e-cigarettes contribute only to 5.3% of T2 cigarette experimentation, casting major doubt on the external validity of results and authors' conclusions that e-cigarettes have a significant effect on the initiation of cigarettes (Gateway effect) at the population level. This sub-cohort design prohibits highlighting any Diversion effect, which is the most likely mechanism accounting for the competition between these two products. CONCLUSIONS While nicotine abstinence remains the best medical option, over-regulation of e-cigarettes because of misinterpretation of longitudinal study results may be detrimental to public health and tobacco control.
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Affiliation(s)
- Bertrand Dautzenberg
- Sorbonne Université & ex CHU Pitié-Salpêtrière (APHP), 14 Avenue Bosquet, 75007 Paris, France
- Institut Arthur Vernes, Tabacologie, 75006 Paris, France
| | - Stéphane Legleye
- Ensai & Cesp, 35172 Bruz, France
- Université Paris-Saclay, Faculté de Médecine UVSQ, 91190 Gif-sur-Yvette, France
| | - Michel Underner
- Centre Hospitalier Laborit, Unité de Recherche Clinique Pierre Deniker, Tabacologie, 86000 Poitiers, France
| | - Philippe Arvers
- 7ème Centre Médical des Armées, Quartier De Reyniès, D1075, Consultation Addictologie et Tabacologie, 38760 Varces-Allières-et-Risset, France
| | - Bhavish Pothegadoo
- Hôpital Maison Lafitte, Unité de Cardiologie, 78600 Maison Lafitte, France
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Crosbie E, Severini G, Beem A, Tran B, Sebrie EM. New tobacco and nicotine products in Latin America and the Caribbean: assessing the market and regulatory environment. Tob Control 2023; 32:458-466. [PMID: 34916305 DOI: 10.1136/tobaccocontrol-2021-056959] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/04/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To document the regulatory environment of new tobacco and nicotine products (NTNPs), including electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs), in Latin America and the Caribbean (LAC). METHODS Review of market research reports and databases, regulatory websites, Campaign for Tobacco-Free Kids, relevant published literature and the 2021 WHO Report on the Global Tobacco Epidemic. RESULTS ENDS entered the LAC market in the 2010s and are now available in most LAC countries. A majority of LAC countries (n=18) have either banned the commercialisation of ENDS (n=7) or regulated ENDS as tobacco products (n=7), medicinal products (n=1) or consumer products (n=3). The remaining LAC countries (n=15) do not regulate ENDS. HTPs were first introduced in 2017 and have been officially launched in five countries (Colombia, Guatemala, Dominican Republic, Mexico and Costa Rica). Few countries have banned HTP commercialisation (n=3) or regulated commercialisation and use (n=7), while the majority of countries have existing legislation that applies to HTPs (n=19). A few countries (n=4) have no tobacco control legislation and therefore do not regulate HTPs. CONCLUSION NTNPs are emerging products in the LAC region. Governments should follow WHO guidance and the decisions of the Conference of Parties to the WHO Framework Convention on Tobacco Control and ban or regulate NTNPs as tobacco products; otherwise NTNPs could create a new generation of tobacco and nicotine users.
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Affiliation(s)
- Eric Crosbie
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | | | | | - Brian Tran
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
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Essenmacher C, Baird C, Houfek J, Spielmann MR, Adams S. Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder. J Am Psychiatr Nurses Assoc 2022; 28:23-36. [PMID: 34763557 DOI: 10.1177/10783903211058785] [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: 11/15/2022]
Abstract
BACKGROUND Tobacco continues to have a deleterious impact on health outcomes in the United States. Professional nurses at all levels of practice have an opportunity to be a part of the solution. The development of nurse-specific competencies for treating tobacco use disorder (TUD) disorder is long overdue. A task force of American Psychiatric Nurses Association (APNA) subject matter experts was assembled to engage in the process of reviewing the available peer-reviewed literature and additional evidence-based resources (e.g., professional organization position statement, toolkits, national survey results) to create the Nursing Competencies for Treating Tobacco Use Disorders. OBJECTIVE The aim of this article is ultimately to improve patient access to quality, evidence-based TUD nursing care by all nurses who are competent, full partners in TUD multidisciplinary care. METHOD Search terms were defined and a scoping search and review of the TUD literature and resources was performed from November 2018 to November 2020. RESULTS Over 300 articles and evidence-based resources (e.g., professional organization position statements, toolkits, etc.) were discovered. Thirteen competencies were developed and were internally and externally reviewed prior to APNA Board of Director's approval. CONCLUSION TUD competencies have the potential to guide nursing education, practice, and research, allowing nurses to be full partners in the design, development, and implementation of effective TUD treatment.
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Affiliation(s)
- Carol Essenmacher
- Carol Essenmacher, PMHCNS-BC, DNP, Saginaw Valley State University, University Center, MI, USA
| | - Carolyn Baird
- Carolyn Baird, DNP, MBA, RN-BC, CARN-AP, CAADC, FIAAN, Meredith Counseling and Consulting, McMurray, PA, USA
| | - Julia Houfek
- Julia Houfek, PhD, APRN-CNS, University of Nebraska, Omaha, NE, USA
| | - M Rene Spielmann
- M. Rene Spielmann, DNP, ARNP, FNP-BC, PMHNP-BC, Gonzaga University, Spokane, WA, USA
| | - Sara Adams
- Sara Adams, PhD, RN, CNE, Rush University, Chicago, IL, USA
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Hyeon JH, Shelley C, Lee CM. Prevalence and correlates of prior experimentation with e-cigarettes over conventional cigarettes among adolescents: Findings from the 2015 Korea Youth Risk Behaviour Web-based Survey. Tob Prev Cessat 2019; 5:33. [PMID: 32411896 PMCID: PMC7205116 DOI: 10.18332/tpc/112595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION As concern is increasing about electronic cigarette use among never-smoking youth, we aimed to examine the prevalence and correlates of prior experimentation of electronic cigarettes (e-cigs) over conventional cigarettes (c-cigs). METHODS We used the 10th Korea Youth Risk Behavior Web-based Survey in 2015, including 67960 participants as study subjects. This survey was designed as stratified multistage clustered samples from middle schools and high schools. Weighted percentages of vaping and/or smoking status by the timing of experimentation were calculated and multivariate logistic regression analysis was conducted after adjustments for possible confounders (demographics, socioeconomic status, lifestyle, tobacco use pattern). RESULTS Youth who use e-cigs only or before c-cigs were 1.7% and 9.1% of any type user, respectively. In younger participants, the proportion tended to be increasing. Apart from being younger (AOR=2.23, 95% CI: 1.66–2.99; 12th grade vs 7th grade), male gender (AOR=1.20, 95% CI: 1.03–1.42), higher household income (AOR=1.21, 95% CI: 1.01–1.45), higher school performance (AOR=1.19, 95% CI: 1.02–1.39), exposure to smoke (AOR=1.63, 95% CI: 1.43–1.86) and caffeine drink (AOR=1.44, 95% CI: 1.24–1.68) were associated with experimentation with e-cigs prior to c-cigs in a fully-adjusted model. Alcohol abuse (AOR=0.57, 95% CI: 0.48–0.68) and weekday internet usage for recreation (AOR=0.69, 95% CI: 0.60–0.78) were negatively associated. CONCLUSIONS The characteristics of those who experiment with e-cigs over c-cigs may be different from the general characteristics of vaping. Considering recent e-cig epidemics, more attention should be paid to the adolescents who tend to start e-cigs first.
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Affiliation(s)
- Jung Hyeon Hyeon
- Department of Family Medicine, BHS Hanseo Hospital, Busan, South Korea
| | - Cameron Shelley
- Cancer Epidemiology Intelligence Division, Cancer Council Victoria, Melbourne, Australia
| | - Cheol Min Lee
- Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
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Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, Jiménez-Ruiz CA, Katsaounou P, Lindberg A, Metz C, Schober W, Spira A, Blasi F. Electronic cigarettes: a task force report from the European Respiratory Society. Eur Respir J 2019; 53:13993003.01151-2018. [PMID: 30464018 DOI: 10.1183/13993003.01151-2018] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/09/2018] [Indexed: 01/10/2023]
Abstract
There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives.ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.
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Affiliation(s)
- Robert Bals
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | | | - Susanna Esposito
- Pediatric Clinic, Dept of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Robert Foronjy
- Pulmonary and Critical Care Medicine, SUNY Downstate Medical Center, New York, NY, USA
| | - Pieter S Hiemstra
- Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Paraskevi Katsaounou
- 1st ICU Evangelismos Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Anne Lindberg
- Dept of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| | - Carlos Metz
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | - Wolfgang Schober
- Bavarian Health and Food Safety Authority, Dept of Chemical Safety and Toxicology, Munich, Germany
| | - Avrum Spira
- Boston University School of Medicine, Boston, MA, USA
| | - Francesco Blasi
- Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Auf R, Trepka MJ, Selim M, Ben Taleb Z, De La Rosa M, Bastida E, Cano MÁ. E-cigarette use is associated with other tobacco use among US adolescents. Int J Public Health 2019; 64:125-134. [PMID: 30413840 PMCID: PMC6585986 DOI: 10.1007/s00038-018-1166-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine whether tobacco initiation via e-cigarettes increases the likelihood of subsequent tobacco use among a large representative sample of US adolescents. METHODS This study is a retrospective longitudinal analysis from a representative sample of US middle and high school students (n = 39,718) who completed the 2014 and 2015 National Youth Tobacco Survey. The adjusted odds ratios of lifetime and current use of tobacco use were estimated by logistic regression analysis while controlling for important socio-ecological factors associated with tobacco use. RESULTS E-cigarette initiators were more likely to report current use of cigarettes (AOR 2.7; 1.9-4.0, p < 0.001), cigars (AOR 1.7; 1.2-2.4, p < 0.01), or smokeless tobacco (AOR 3.1; 2.2-5.4, p < 0.001), and lifetime use of the same products as well. Also, lifetime and current use of e-cigarettes significantly increased the likelihood of cigarettes, cigars, and smokeless tobacco use. CONCLUSIONS Initiation of tobacco via e-cigarette, lifetime, and current use of e-cigarettes are associated with higher odds of lifetime and current use of cigarettes, cigars, and smokeless tobacco. Collectively this suggests e-cigarettes may lead to an increased use of tobacco among adolescents.
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Affiliation(s)
- Rehab Auf
- Department of Health, Human Performance, and Leisure (HHPL), College of Arts and Science (COAS), Howard University, Washington, DC, 20059, USA.
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
| | - Mazen Selim
- Jackson South Community Hospital, Miami, FL, 33176, USA
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Elena Bastida
- Department of Health Promotion, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
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Dueck K, Morrison R, Brown K, Lobo D, Loh LC. Innovative public health response to an event on the fringe of regulatory changes. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2018; 109:338-341. [PMID: 29981079 PMCID: PMC6964372 DOI: 10.17269/s41997-018-0073-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 01/03/2018] [Indexed: 06/08/2023]
Abstract
SETTING During a period of regulatory uncertainty, a local public health unit in Ontario was notified of an exhibition for electronic nicotine delivery systems (ENDS) and novel tobacco delivery products (NTDs), specifically e-cigarettes and waterpipes, which have seen increasing use particularly among youth. Relevant statutes creating regulatory uncertainty included a new provincial Electronic Cigarettes Act (ECA) with certain sections awaiting proclamation, and a local waterpipe bylaw awaiting approval, which would have prohibited the use of these products in public spaces if they entered into force ahead of the exhibition date. Public health staff had concerns the event would normalize use of ENDS/NTDs, particularly among youth, and also planned to enforce already proclaimed ECA sections, as well as the existing Smoke-Free Ontario Act (SFOA) with regulations applicable to use of tobacco shisha in waterpipes. INTERVENTION Public health staff contacted event organizers and proprietors to communicate obligations under the SFOA and ECA, as well as share hypothetical implications from pending regulatory changes, including risk of charges for regulatory non-compliance if regulations came into force ahead of the planned event. OUTCOMES Following discussion with health unit staff and legal consultation, the exhibition was cancelled. IMPLICATIONS By directly communicating regulatory uncertainty, a public health unit was able to achieve local health goals. In this situation, public health advised exhibition proprietors of potential event disruption implicated by forthcoming regulatory changes. Subsequent cancellation of the event prevented potential adverse health impacts for at-risk groups. A similar communications approach could be used to achieve public health goals during a period of regulatory uncertainty.
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Affiliation(s)
- Karalyn Dueck
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Reed Morrison
- Northern Ontario School of Medicine, Sudbury, Canada
| | - Kathie Brown
- Region of Peel Public Health, 7120 Hurontario Street, RPO 667 Streetsville, Mississauga, ON, L5W 1N4, Canada
| | | | - Lawrence C Loh
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
- Region of Peel Public Health, 7120 Hurontario Street, RPO 667 Streetsville, Mississauga, ON, L5W 1N4, Canada.
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Sylvestre MP, Wellman RJ, O'Loughlin EK, Dugas EN, O'Loughlin J. Gender differences in risk factors for cigarette smoking initiation in childhood. Addict Behav 2017; 72:144-150. [PMID: 28399489 DOI: 10.1016/j.addbeh.2017.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/09/2017] [Accepted: 04/01/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender. METHODS In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys. RESULTS 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade. CONCLUSIONS Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use.
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Affiliation(s)
- Marie-Pierre Sylvestre
- University of Montréal, Montréal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | | | | | - Erika N Dugas
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Jennifer O'Loughlin
- University of Montréal, Montréal, QC, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada; Institut National de Santé Publique du Québec, Montréal, QC, Canada.
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Wang Y, Wilson FA, Larson J, Chen LW. The Use of E-Cigarettes Among U.S. Immigrants: The 2014 National Health Interview Survey. Public Health Rep 2017; 131:605-13. [PMID: 27453606 DOI: 10.1177/0033354916662220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Although e-cigarette popularity has increased substantially in recent years in the United States, it is unclear whether e-cigarette use has extended to immigrants in the United States. We characterized differences in ever and current use of e-cigarettes among non-U.S. citizens, naturalized U.S. citizens, and U.S. natives. METHODS We used cross-sectional data from the 2014 National Health Interview Survey to measure the prevalence of e-cigarette ever and current use by immigration status, characterized as U.S. native, naturalized U.S. citizen, and non-U.S. citizen. We used multivariate logistic regression to examine the association between e-cigarette use and immigration status adjusting for demographic characteristics, socioeconomic status, and history of tobacco use. We also stratified the use of e-cigarettes by cigarette smoking status and analyzed the impact of length of residency and country of origin on e-cigarette use among immigrants. RESULTS Naturalized U.S. citizens and non-U.S. citizens had a similar prevalence of e-cigarette use, which was significantly lower than the prevalence among U.S. natives. After adjusting for covariates, naturalized U.S. citizens had 38% lower odds and non-U.S. citizens had 54% lower odds of ever using e-cigarettes than U.S. natives. Non-U.S. citizens were less likely than U.S. natives to currently use e-cigarettes. Among both current smokers and nonsmokers of tobacco cigarettes, non-U.S. citizens were less likely than U.S. natives to indicate current e-cigarette use. U.S. immigrants with >5 years residency were more likely than U.S. immigrants with <5 years residency to try e-cigarettes. CONCLUSION Although non-U.S. citizens are less likely than U.S. natives to currently use e-cigarettes, e-cigarette use may increase with length of residency in the United States.
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Affiliation(s)
- Yang Wang
- University of Nebraska Medical Center, College of Public Health, Omaha, NE
| | - Fernando A Wilson
- University of Nebraska Medical Center, College of Public Health, Omaha, NE
| | - Jamie Larson
- University of Nebraska Medical Center, College of Public Health, Omaha, NE
| | - Li-Wu Chen
- University of Nebraska Medical Center, College of Public Health, Omaha, NE
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Montreuil A, MacDonald M, Asbridge M, Wild TC, Hammond D, Manske S, Rutherford E. Prevalence and correlates of electronic cigarette use among Canadian students: cross-sectional findings from the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey. CMAJ Open 2017; 5. [PMID: 28625973 PMCID: PMC5498187 DOI: 10.9778/cmajo.20160167] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Over the past decade, youth tobacco use has declined, and electronic cigarettes (e-cigarettes) have entered the market. The aims of this study were to describe the prevalence of e-cigarette use among youth in Canada, by province, across sociodemographic variables and smoking-related correlates; and to examine associations among e-cigarette use, sociodemographic variables and smoking-related correlates, with adjustment for other factors. METHODS The 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey, a biennial, school-based survey, was administered to students in grades 6-12 in all Canadian provinces. Logistic regression models were fitted to estimate odds of ever and past 30-day e-cigarette use by sociodemographic variables and smoking-related correlates. RESULTS A total of 336 schools from 128 school boards (47% of eligible schools approached) and 42 094 students (66% of eligible students approached) participated in the survey. In Canada, 17.7% (95% confidence interval [CI] 16.4%-18.9%) of students in grades 6-12 reported ever using e-cigarettes, and 5.7% (95% CI 5.2%-6.3%) reported past 30-day use. Substantial variation was observed across provinces. Female students had decreased odds of past 30-day use relative to male students (odds ratio [OR] 0.71, 95% CI 0.59-0.86), whereas current smokers (OR 10.0, 95% CI 6.66-15.02) and experimental smokers (OR 3.61, 95% CI 2.40-5.42) had increased odds relative to never smokers. Students who perceived that access was easy also had increased odds of using e-cigarettes relative to students who perceived that access was difficult (OR 3.86, 95% CI 2.96-5.03). Students who believed that regular use entailed slight risk (OR 0.68, 95% CI 0.52-0.88) and those who did not know risk levels (OR 0.31, 95% CI 0.21-0.46) had decreased odds compared with those perceiving no risk. INTERPRETATION Our data confirm that many youth used e-cigarettes in the 30 days preceding the survey, although rates were substantially higher among current and experimental smokers than among students who had never tried smoking.
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Affiliation(s)
- Annie Montreuil
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - Marjorie MacDonald
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - Mark Asbridge
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - T Cameron Wild
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - David Hammond
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - Steve Manske
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
| | - Erin Rutherford
- Affiliations: Institut national de santé publique du Québec (Montreuil); Département de psychologie (Montreuil), Université du Québec à Montréal, Montréal, Que.; School of Nursing (MacDonald), University of Victoria, Victoria, BC; Department of Community Health and Epidemiology (Asbridge), Dalhousie University, Halifax, NS; School of Public Health (Wild), University of Alberta, Edmonton, Alta.; School of Public Health and Health Systems (Hammond) and Propel Centre for Population Health Impact (Manske), University of Waterloo, Waterloo, Ont.; Health Canada (Rutherford), Ottawa, Ont
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Majeed BA, Weaver SR, Gregory KR, Whitney CF, Slovic P, Pechacek TF, Eriksen MP. Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012-2015. Am J Prev Med 2017; 52:331-338. [PMID: 28341303 PMCID: PMC5373478 DOI: 10.1016/j.amepre.2016.08.039] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/18/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Although the impact of long-term use of electronic cigarettes (e-cigarettes) on health is still unknown, current scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes. The study examined whether perceived relative harm of e-cigarettes and perceived addictiveness have changed during 2012-2015 among U.S. adults. METHODS Data were from Tobacco Products and Risk Perceptions surveys of probability samples representative of U.S. adults in 2012, 2014, and 2015. Changes over time in perceived harmfulness of e-cigarettes were examined using pairwise comparisons of proportions and multinomial logistic regression analysis. Analyses were conducted in January 2016. RESULTS Whereas 11.5% and 1.3% of adults perceived e-cigarettes to have about the same level of harm and to be more harmful than cigarettes, respectively, in 2012, 35.7% and 4.1% did so in 2015. The proportion of adults who thought e-cigarettes were addictive more than doubled during 2012-2015 (32.0% in 2012 vs 67.6% in 2015). Compared with 2012, the odds of perceiving e-cigarettes to be equally or more harmful (than to be less harmful) doubled (95% CI=1.64, 2.41) in 2014, and tripled (95% CI=2.60, 3.81) in 2015. CONCLUSIONS There is an increase in the proportion of U.S. adults who misperceive the harm of e-cigarettes and consider them to be as harmful as combustible cigarettes. The study highlights the need to design public health messages that accurately interpret the scientific data on the potential harm of e-cigarettes and clearly differentiate the absolute from the relative harm of e-cigarettes.
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Affiliation(s)
- Ban A Majeed
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia.
| | - Scott R Weaver
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Kyle R Gregory
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia
| | - Carrie F Whitney
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia
| | - Paul Slovic
- Decision Research, Eugene, Oregon; Department of Psychology, University of Oregon, Eugene, Oregon
| | - Terry F Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Fischer F, Kraemer A. Secondhand smoke exposure at home among middle and high school students in the United States - does the type of tobacco product matter? BMC Public Health 2017; 17:98. [PMID: 28103827 PMCID: PMC5248465 DOI: 10.1186/s12889-017-4019-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A decline in the prevalence of secondhand smoke (SHS) exposure has been observed in the United States of America (USA) during the past few decades. Nevertheless, nearly half of non-smoking students are still exposed to SHS. This paper aims to describe the factors associated with SHS exposure stratified by type of exposure (overall, cigarettes and electronic cigarettes). METHODS The analysis is based on secondary data taken from the National Youth Tobacco Survey 2014. Overall, 22,007 middle and high school students from the USA are included in the sample. Descriptive and bivariate statistics as well as binary logistic regression models were performed. RESULTS Overall, 44.5% (n=9,798) of the study participants declared themselves to be exposed to SHS, 29.1% (n=6,394) declared to be exposed to SHS caused by cigarette smoke and 9.4% (n=2,067) claimed that a person who lives with them uses electronic cigarettes. There is a considerable overlap between the two types of SHS exposure, because 74.9% (n=1,548) of students declaring that a person within their household uses electronic cigarettes also declare a person in the household smoking cigarettes. The strengths of association between independent variables and SHS exposure differs by type of exposure and also by smoking status of respondents. CONCLUSIONS Although only small differences are obvious in the factors associated with SHS exposure stratified by the type of tobacco product, there are still some variations which should be considered in policy making to allow for a targeted approach in prevention campaigns or legislation.
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Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501 Bielefeld, Germany
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501 Bielefeld, Germany
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Unger JB, Soto DW, Leventhal A. E-cigarette use and subsequent cigarette and marijuana use among Hispanic young adults. Drug Alcohol Depend 2016; 163:261-4. [PMID: 27141841 PMCID: PMC7453602 DOI: 10.1016/j.drugalcdep.2016.04.027] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/04/2016] [Accepted: 04/19/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Electronic cigarettes (e-cigarettes) could have a multifaceted effect on public health by changing the likelihood that: (a) non-smokers and non-users of marijuana subsequently transition to cigarette and marijuana use, respectively, and/or: (b) cigarette smokers subsequently quit smoking. We analyzed data from a longitudinal study of Hispanic young adults in Los Angeles, California to determine whether e-cigarette use is associated with subsequent cigarette or marijuana use over a one-year period. METHODS Survey data were collected from 1332 Hispanic young adults (59% female, mean age=22.7 years, SD=0.39 years) in 2014 and 2015. Logistic regression analyses examined the association between e-cigarette use in 2014 and cigarette/marijuana use in 2015, controlling for age, sex, and other substance use. RESULTS In 2014, prevalence of past-month use was 9% for e-cigarettes, 21% for cigarettes, and 23% for marijuana. Among past-month cigarette nonsmokers in 2014, those who were past-month e-cigarette users in 2014 were over 3 times more likely to be past-month cigarette smokers in 2015, compared with those who did not report past-month e-cigarette use in 2014 (26% vs. 7%; OR=3.32, 95% CI=1.55, 7.10). Among past-month marijuana non-users in 2014, those who were past-month e-cigarette users in 2014 were nearly 2 times more likely to be past-month marijuana users in 2015 (24% vs. 12%;OR=1.97, 95% CI=1.01, 3.86). Among past-month cigarette and marijuana users in 2014, e-cigarette use in 2014 was not associated with a change cigarette and marijuana use, respectively, in 2015. CONCLUSIONS Among Hispanic young adults, e-cigarettes could increase the likelihood of transitioning from non-user to user of cigarettes or marijuana and was not associated with smoking cessation.
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Affiliation(s)
- Jennifer B Unger
- University of Southern California Keck School of Medicine, 2001 N. Soto St., SSB 302, Los Angeles, CA 90089, United States.
| | - Daniel W Soto
- University of Southern California Keck School of Medicine, 2001 N. Soto St., SSB 302, Los Angeles, CA 90089, United States
| | - Adam Leventhal
- University of Southern California Keck School of Medicine, 2001 N. Soto St., SSB 302, Los Angeles, CA 90089, United States
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