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Soule EK, Rossheim ME, Livingston MD, LoParco CR, Tillett KK, Eissenberg T, Sussman S. Hidden flaws in e-cigarette industry-funded studies. Tob Control 2024:tc-2024-058609. [PMID: 38862233 DOI: 10.1136/tc-2024-058609] [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: 01/17/2024] [Accepted: 05/08/2024] [Indexed: 06/13/2024]
Abstract
Electronic cigarette (e-cigarette) use has increased since e-cigarettes were introduced to the market nearly 20 years ago. Researchers continue to conduct studies to understand the health risks and benefits of e-cigarettes to inform health education and promotion efforts as well as public policy. Studies funded by the tobacco industry examining the potential risks and benefits of e-cigarettes have also been conducted and are sometimes published in the scientific literature. Frequently, tobacco and e-cigarette industry-funded researchers report findings that contradict research funded by other sources. While many industry-funded studies may appear methodologically sound at first glance, in some cases, industry-funded studies include methodological flaws that result in misleading conclusions. The tobacco industry's use of biased research to influence tobacco-related policy decisions in the past is well-documented. This commentary provides specific examples of recent e-cigarette research funded by the tobacco/e-cigarette industry in which methodological flaws result in misleading conclusions that support industry goals. Given the long history of biased research conducted by the tobacco industry, there is a need to assess whether research funded by the e-cigarette industry similarly contains methodological flaws. We emphasise the need for tobacco and e-cigarette-funded research to be scrutinised by non-industry-funded subject matter experts and call for journals to not consider manuscripts that have received support from the tobacco or e-cigarette industry.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
- Virginia Commonwealth University, Richmond, Virginia, USA
| | | | | | | | - Kayla K Tillett
- University of North Texas Health Science Center, Fort Worth, Texas, USA
| | | | - Steve Sussman
- Departments of Preventive Medicine and Psychology, and School of Social Work, University of Southern California, Pasadena, California, USA
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Laestadius L, Vassey J, Kim M, Ozga J, Li D, Stanton C, Wipfli H, Unger JB. Themes in e-liquid concept names as a marketing tactic: evidence from Premarket Tobacco Product Applications in the USA. Tob Control 2024; 33:412-413. [PMID: 36171148 PMCID: PMC10043038 DOI: 10.1136/tc-2022-057657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Linnea Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Jenny Ozga
- Behavioral Health and Health Policy Practice, Westat, Inc, Rockville, Maryland, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat, Inc, Rockville, Maryland, USA
| | - Heather Wipfli
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
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3
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Leventhal AM, Tackett AP, Whitted L, Jordt SE, Jabba SV. Ice flavours and non-menthol synthetic cooling agents in e-cigarette products: a review. Tob Control 2023; 32:769-777. [PMID: 35483721 PMCID: PMC9613790 DOI: 10.1136/tobaccocontrol-2021-057073] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/19/2022] [Indexed: 01/21/2023]
Abstract
E-cigarettes with cooling flavours have diversified in ways that complicate tobacco control with the emergence of: (1) Ice-hybrid flavours (eg, 'Raspberry Ice') that combine cooling and fruity/sweet properties; and (2) Products containing non-menthol synthetic cooling agents (eg, Wilkinson Sword (WS), WS-3, WS-23 (termed 'koolada')). This paper reviews the background, chemistry, toxicology, marketing, user perceptions, use prevalence and policy implications of e-cigarette products with ice-hybrid flavours or non-menthol coolants. Scientific literature search supplemented with industry-generated and user-generated information found: (a) The tobacco industry has developed products containing synthetic coolants since 1974, (b) WS-3 and WS-23 are detected in mass-manufactured e-cigarettes (eg, PuffBar); (c) While safe for limited oral ingestion, inhalational toxicology and health effects from daily synthetic coolant exposure are unknown and merit scientific inquiry and attention from regulatory agencies; (d) Ice-hybrid flavours are marketed with themes incorporating fruitiness and/or coolness (eg, snow-covered raspberries); (e) WS-23/WS-3 concentrates also are sold as do-it-yourself additives, (f) Pharmacology research and user-generated and industry-generated information provide a premise to hypothesise that e-cigarette products with ice flavours or non-menthol cooling agents generate pleasant cooling sensations that mask nicotine's harshness while lacking certain aversive features of menthol-only products, (g) Adolescent and young adult use of e-cigarettes with ice-hybrid or other cooling flavours may be common and cross-sectionally associated with more frequent vaping and nicotine dependence in convenience samples. Evidence gaps in the epidemiology, toxicology, health effects and smoking cessation-promoting potential of using these products exist. E-cigarettes with ice flavours or synthetic coolants merit scientific and regulatory attention.
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Affiliation(s)
- Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Lauren Whitted
- Department of Preventive Medicine, Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Sven Eric Jordt
- Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
- Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sairam V Jabba
- Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA
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Egan KL, Villani S, Soule EK. Absence of Age Verification for Online Purchases of Cannabidiol and Delta-8: Implications for Youth Access. J Adolesc Health 2023; 73:195-197. [PMID: 36870900 DOI: 10.1016/j.jadohealth.2023.01.020] [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: 09/13/2022] [Revised: 01/09/2023] [Accepted: 01/21/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE This study assessed the age verification process for purchasing and shipping cannabidiol (CBD) and Delta-8 tetrahydrocannabinol products from online retailers. METHODS We purchased CBD and Delta-8 products online from 20 brick-and-mortar shops located in the United States that sold products online and shipped products to consumers. We documented online age verifications at the time of purchase and whether identification or a signature was required at delivery. RESULTS 37.5% of the CBD and 70.0% of the Delta-8 websites required the customer to confirm their age (18 + or 21+ years). Age verification or contact with the customer was not requested at the point of home delivery for all products. DISCUSSION Methods for age verification at time of purchase are self-reported and easily circumvented. Policies and policy enforcement are needed to prevent youth access to CBD and Delta-8 products from online sources.
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Affiliation(s)
- Kathleen L Egan
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina.
| | - Sophia Villani
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina
| | - Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina
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Martinelli T, Candel MJJM, de Vries H, Talhout R, Knapen V, van Schayck CP, Nagelhout GE. Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders. Tob Control 2023; 32:170-178. [PMID: 34226262 PMCID: PMC9985733 DOI: 10.1136/tobaccocontrol-2021-056528] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/10/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders. DESIGN The longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes. FINDINGS Consistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups). CONCLUSION Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.
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Affiliation(s)
- Thomas Martinelli
- IVO, The Hague, The Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Reinskje Talhout
- Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Vera Knapen
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | | | - Gera E Nagelhout
- IVO, The Hague, The Netherlands
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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Venrick SJ, Kelley DE, O'Brien E, Margolis KA, Navarro MA, Alexander JP, O'Donnell AN. U.S. digital tobacco marketing and youth: A narrative review. Prev Med Rep 2022; 31:102094. [PMID: 36820374 PMCID: PMC9938337 DOI: 10.1016/j.pmedr.2022.102094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
We describe findings from peer-reviewed articles on digital tobacco marketing (DTM) using U.S. data related to youth, including research that examines use of age restrictions, DTM exposure and engagement, and associated tobacco use. We searched PubMed, EMBASE, Web of Science, and EBSCOhost in May 2019 and May 2020 for published English language peer-reviewed articles examining DTM that were published from January 2016 to May 2020. Inclusion coding occurred in three stages. The first search identified 519 articles; 167 were coded for inclusion. The second search identified 189 articles; 67 were coded for inclusion. Two coders then assessed whether the included articles mentioned youth (age 18 and younger) or age restrictions in the method and results sections of the full text. Ultimately, 47 articles were included in this review. A codebook was developed and tested through training. Each article was coded for age restrictions, youth exposure to DTM, youth engagement with DTM, and youth tobacco use associated with DTM exposure or engagement. The studies reviewed indicate that DTM on social media was infrequently age-restricted and the stringency of age restriction varied by tobacco product, site owner, and channel. Youth reported being exposed to DTM frequently via the Internet. While youth reported less frequently engaging with DTM compared to being exposed, engagement increased over time. DTM exposure and engagement were associated with tobacco product use. The studies reviewed document an association between DTM exposure and engagement and future tobacco use; thus, DTM may be contributing to the youth tobacco epidemic.
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Affiliation(s)
- Samantha J. Venrick
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States,Corresponding author.
| | - Dannielle E. Kelley
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Erin O'Brien
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
| | - Katherine A. Margolis
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Mario A. Navarro
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
| | - Jennifer P. Alexander
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States
| | - Allison N. O'Donnell
- US Food and Drug Administration, Center for Tobacco Products, Office of Health Communication and Education, Silver Spring, MD, United States
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Robertson L, Hoek J, Blank ML. A qualitative analysis of electronic nicotine delivery systems (ENDS) uptake and use among young adult never-smokers in New Zealand. PLoS One 2022; 17:e0268449. [PMID: 35622846 PMCID: PMC9140280 DOI: 10.1371/journal.pone.0268449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking. Yet ENDS uptake has increased among never-smoking young adults, who likely face greater health risks relative to non-users of ENDS. To date, few qualitative studies have explored ENDS uptake and use by never-smokers. METHODS We conducted in-depth, semi-structured interviews with 16 current ENDS users from New Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly. We explored participants' experimentation with conventional tobacco products, trial, uptake and patterns of ENDS use, and their future intentions regarding both ENDS and conventional tobacco products. We managed the data using NVivo12 and used thematic analysis to interpret the transcripts. RESULTS ENDS use enhanced connection and belonging by providing communal experiences and facilitating social interactions. Participants' mastery of tricks generated social cachet within friendship groups and counteracted the ENDS-related stigma they experienced. Flavours, clouds and devices' physical attributes provided stimulation and engagement, and some used ENDS for stress or appetite management. Lastly, participants rationalised ENDS uptake by referencing the far greater risks smoking posed. CONCLUSIONS ENDS uptake by young adult never-smokers is driven by both psycho-social and functional factors. ENDS provided shared hedonic experiences and physical pleasures, and generated both bonding and bridging social capital, although many participants had also experienced judgement from others for using ENDS. Policies that denormalise ENDS as recreational devices could discourage uptake by never-smokers, though measures will require careful nuancing to avoid deterring smokers from switching to ENDS.
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Affiliation(s)
- Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Peng Z, Wan Y. Generating business intelligence through automated textual analysis: measuring corporate image with online information. CHINESE MANAGEMENT STUDIES 2022. [DOI: 10.1108/cms-07-2021-0318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
In this age of extremely well-developed social media, it is necessary to detect any change in the corporate image of an enterprise immediately so as to take quick action to avoid the wide spread of a negative image. However, existing survey-based corporate image evaluation methods are costly, slow and static, and the results may quickly become outdated. User comments, news reports and we-media articles on the internet offer varied channels for enterprises to obtain public evaluations and feedback. The purpose of this study is to effectively use online information to timely and accurately measure enterprises’ corporate images.
Design/methodology/approach
A new corporate image evaluation method was built by first using a literature review to establish a corporate image evaluation index system. Next, an automatic text analysis of online public information was performed through a topic classification and sentiment analysis algorithm based on the dictionary. The accuracy of the topic classification and sentiment analysis algorithm is then calculated. Finally, three internet enterprises were chosen as cases, and their corporate image was evaluated.
Findings
The results show that the author’s corporate image evaluation method is effective.
Originality/value
First, in this study, a new corporate image evaluation index system is constructed. Second, a new corporate image evaluation method based on text mining is proposed that can support data-driven decision-making for managers with real-time corporate image evaluation results. Finally, this study improves the understanding of corporate image by generating business intelligence through online information. The findings provide researchers with specific and detailed suggestions that focus on the corporate image management of emerging internet enterprises.
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Martinelli TF, De Vries H, Talhout R, van Schayck OCP, Nagelhout GE. Do e-cigarettes attract youths who are otherwise unlikely to use addictive substances? Cross-sectional analyses of Dutch and Flemish secondary school students. Tob Prev Cessat 2021; 7:74. [PMID: 35083393 PMCID: PMC8697506 DOI: 10.18332/tpc/144181] [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: 09/02/2021] [Revised: 11/08/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION E-cigarettes are popular among youth. There are concerns that e-cigarettes attract youth that would otherwise not use addictive substances. While e-cigarettes are thought to be less harmful than tobacco, there is reason for caution. We examined to what extent adolescent e-cigarette users have characteristics associated with increased risk of substance use. METHODS We collected cross-sectional survey data in 2018 among 10 schools throughout the Netherlands and Belgium (N=2794; age 10-18 years). We examined differences in characteristics and behaviors between e-cigarette ever users and never users, and former users and current users. We also explored differences in use of flavors and use of nicotine. RESULTS Compared to never-users, e-cigarettes users more often were boys, older, had lower education level, non-Dutch or non-Belgian ethnicity, reported more combustible tobacco use, more smoking family members or family with problematic substance use, more smoking friends, more depressive symptoms, more impulsivity, more delinquent behavior, were more susceptible to smoking, had more positive smoking expectancies, and more ever use of substances. Users of non-tobacco flavored e-cigarettes and e-cigarettes without nicotine had fewer characteristics known to be related to an increased risk of substance use, compared to users of tobacco-flavored e-cigarettes and e-cigarettes with nicotine. CONCLUSIONS Adolescent e-cigarette users are more like youths who experiment with addictive substances compared to non-users. Thus, e-cigarettes users were more likely to use substances, regardless of whether they used e-cigarettes first. This may not be true for all types of e-cigarettes, as users of e-cigarettes without nicotine or with non-tobacco flavors were less like youths who experiment with substances.
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Affiliation(s)
- Thomas F. Martinelli
- IVO Research Institute, The Hague, The Netherlands
- Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Hein De Vries
- Department of Health Promotion, CAPHRI Institute, Maastricht University, Maastricht, The Netherlands
| | - Reinskje Talhout
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Onno C. P. van Schayck
- Department of Family Medicine, CAPHRI Institute, Maastricht University, Maastricht, The Netherlands
| | - Gera E. Nagelhout
- IVO Research Institute, The Hague, The Netherlands
- Department of Health Promotion, CAPHRI Institute, Maastricht University, Maastricht, The Netherlands
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Gupta A, Sharda S, Yogitha P, Goel S, Goyal A, Gauba K. Systematic content analysis of online information on herbal smoking products. Indian J Tuberc 2021; 68S:S71-S79. [PMID: 34538396 DOI: 10.1016/j.ijtb.2021.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Herbal smoking products (HSPs) are marketed as a safer alternative to tobacco. These are easily available at affordable prices in the online retail websites. This study aimed to analyze the HSP-related informational content available in the most popular online platforms. METHODS Google, Yahoo, Bing and YouTube online platforms were searched for HSP related content using appropriate keywords. First 50 search results were retrieved and screened for potential eligibility. The included web-pages were categorized as video and still records. From each included record, information regarding source, primary theme, health benefits/hazards and tone was abstracted. Additionally, video production quality, like ratio and video power index was also computed for each video record. All included records were subjected to descriptive statistics and Chi-square test, as appropriate. Level of significance was set at <0.05. RESULTS 174 still and 94 video records were included. 35.6% of the included still records were sourced by manufacturers/suppliers while that of scientific origin was 12.1%. 83% of the video-records were posted by general public. About 90% of the included records had not mentioned anything regarding age restrictions. 67.8% of the still records and 87.2% of the video records promoted the use of HSPs. CONCLUSIONS The informational content presented online is huge, mostly posted by the general public without any scientific rationale and exclusively favors the use of HSPs. There is no age restriction as to who can access the information, making this content easily accessible to people of all ages. Such spread of information may mislead the public in adopting the smoking of these herbal products. Since HSPs may act as a potential gateway to tobacco smoking, there is an urgent need to regulate the content available online.
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Affiliation(s)
- Arpit Gupta
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012, India.
| | - Shweta Sharda
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012, India
| | - Pothamsetty Yogitha
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Public Health Masters Program, School of Medicine, University of Limerick, Ireland; Faculty of Human and Health Sciences, Swansea University, United Kingdom
| | - Ashima Goyal
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012, India
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Agaku IT, Egbe CO, Ayo-Yusuf OA. Geospatial spread of e-cigarette vape shops in South Africa and the relationship with tobacco product use among adults. Health Place 2021; 68:102507. [PMID: 33486331 DOI: 10.1016/j.healthplace.2021.102507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/21/2020] [Accepted: 01/05/2021] [Indexed: 12/01/2022]
Abstract
We estimated the spatial distribution of e-cigarette vape shops in South Africa and measured associations with tobacco use among adults. We linked geocoordinates of identified vape shops to internet protocol addresses of individual participants in the 2018 Health 24 survey (n = 18,208). We used logistic regression to measure the associations between proximity to vape shops and tobacco-related behaviors. In total, we identified 240 vape shops; 49.6% of these were within a 5 km radius of a higher educational institution. Proximity to vape shops was associated with ever e-cigarette use among young adults aged 18-29 years (AOR = 1.33, 95%CI = 1.16-1.54). Efforts to regulate e-cigarette marketing can benefit public health.
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Affiliation(s)
- Israel T Agaku
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
| | - Catherine O Egbe
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Olalekan A Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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12
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McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Thomson K, Jancey J. E-Cigarette Promotion on Twitter in Australia: Content Analysis of Tweets. JMIR Public Health Surveill 2020; 6:e15577. [PMID: 33151159 PMCID: PMC7677022 DOI: 10.2196/15577] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/20/2019] [Accepted: 09/12/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The sale of electronic cigarettes (e-cigarettes) containing nicotine is prohibited in all Australian states and territories; yet, the growing availability and convenience of the internet enable the promotion and exposure of e-cigarettes across countries. Social media's increasing pervasiveness has provided a powerful avenue to market products and influence social norms and risk behaviors. At present, there is no evidence of how e-cigarettes and vaping are promoted on social media in Australia. OBJECTIVE This study aimed to investigate how e-cigarettes are portrayed and promoted on Twitter through a content analysis of vaping-related tweets containing an image posted and retweeted by Australian users and how the portrayal and promotion have emerged and trended over time. METHODS In total, we analyzed 1303 tweets and accompanying images from 2012, 2014, 2016, and 2018 collected through the Tracking Infrastructure for Social Media Analysis (TrISMA), a contemporary technical and organizational infrastructure for the tracking of public communication by Australian users of social media, via a list of 15 popular e-cigarette-related terms. RESULTS Despite Australia's cautious approach toward e-cigarettes and the limited evidence supporting them as an efficacious smoking cessation aid, it is evident that there is a concerted effort by some Twitter users to promote these devices as a health-conducive (91/129, 70.5%), smoking cessation product (266/1303, 20.41%). Further, Twitter is being used in an attempt to circumvent Australian regulation and advocate for a more liberal approach to personal vaporizers (90/1303, 6.90%). A sizeable proportion of posts was dedicated to selling or promoting vape products (347/1303, 26.63%), and 19.95% (260/1303) were found to be business listings. These posts used methods to try and expand their clientele further than immediate followers by touting competitions and giveaways, with those wanting to enter having to perform a sequence of steps such as liking, tagging, and reposting, ultimately exposing the post among the user's network and to others not necessarily interested in vaping. CONCLUSIONS The borderless nature of social media presents a clear challenge for enforcing Article 13 of the World Health Organization Framework Convention on Tobacco Control, which requires all ratifying nations to implement a ban on tobacco advertising, promotion, and sponsorship. Countering the advertising and promotion of these products is a public health challenge that will require cross-border cooperation with other World Health Organization Framework Convention on Tobacco Control parties. Further research aimed at developing strategies to counter the advertising and promotion of e-cigarettes is therefore needed.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
| | - Bruce Maycock
- College of Medicine and Health, University of Exeter, Devon, United Kingdom
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, Australia
| | - Katie Thomson
- School of Public Health, Curtin University, Bentley, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Australia
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13
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Rossheim ME, McDonald KK, Soule EK, Gimm GW, Livingston MD, Barnett TE, Jernigan DH, Thombs DL. Electronic cigarette explosion/burn and poisoning related emergency department visits, 2018-2019. Am J Emerg Med 2020; 38:2637-2640. [PMID: 33041151 DOI: 10.1016/j.ajem.2020.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/24/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Electronic cigarette (ECIG) use has increased dramatically in recent years. Negative ECIG-related acute health effects have included explosion/burn injuries from battery failure and child ingestion/poisoning of liquid nicotine. However, there is an urgent need for continued surveillance of ECIG health effects to determine whether these outcomes change as ECIG devices and liquids rapidly evolve. This study updates national estimates of ECIG-related emergency department (ED) visits and describes the context of these injuries. METHODS A keyword search of case narrative text was used to identify ECIG-related ED visits in the National Electronic Injury Surveillance System (NEISS) data. These cross-sectional data are designed to be weighted to provide national estimates of consumer product-related injuries treated in EDs. ECIG-related injuries were described and categorized, and sampling weights applied to model national estimates. RESULTS From 2015 to 2019 there were an estimated 3369 ED visits from ECIG explosion/burn injuries (95% CI = 2020, 4718), and an estimated 676 visits from 2019 alone (95% CI = 315, 1036). In 2018-2019, there were an estimated 1550 cases of children <5 years old ingesting ECIG liquids (95% CI = 778, 2322). CONCLUSIONS Despite a notable shift in the US market towards ECIG devices that use lower electrical power and disposable "pods" (e.g., JUUL), liquid chemical ingestion among young children and ECIG explosion/burn injuries persist. Improved product regulations are urgently needed to prevent negative health effects caused by ECIGs, as well as prevent their ingestion and use by children.
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Affiliation(s)
- Matthew E Rossheim
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA.
| | - Kayla K McDonald
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Gilbert W Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | | | - Tracey E Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - David H Jernigan
- Department of Health Law, Policy and Management, Boston University, Boston, MA, USA
| | - Dennis L Thombs
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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14
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Shi H, Tavárez ZQ, Xie Z, Schneller LM, Croft DP, Goniewicz ML, McIntosh S, O'Connor RJ, Ossip DJ, Rahman I, Li D. Association of flavored electronic nicotine delivery system (ENDS) use with self-reported chronic obstructive pulmonary disease (COPD): Results from the Population Assessment of Tobacco and Health (PATH) study, Wave 4. Tob Induc Dis 2020; 18:82. [PMID: 33082739 PMCID: PMC7549379 DOI: 10.18332/tid/127238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Flavors other than tobacco flavor have been identified as a major reason for electronic nicotine delivery system (ENDS) initiation in youth and are thought to contribute to the continued use of ENDS in users of all ages. Our previous research showed a significant association between overall ENDS use and COPD. This study aims to identify the association of ENDS flavor categories with self-reported COPD. METHODS The data analysis included 4909 adults from Population Assessment of Tobacco and Health (PATH) Wave 4 data who were ever established ENDS users and responded to an item about diagnosis of COPD. Weighted multivariable logistic regression models were used to examine the association between different ENDS flavors and self-reported COPD considering complex sampling design. RESULTS Among 4909 ever established ENDS users, 418 adults (weighted percentage 9.8%) had self-reported COPD. Self-reported COPD prevalence differed between different ENDS flavor categories, with the highest (weighted percentage 19.9%) occurring among tobacco flavor users. Compared to non-tobacco flavor categories, tobacco flavor category showed significantly higher association with self-reported COPD (AOR=2.05; 95% CI: 1.20–3.53), after adjusting for potential confounding variables. No significant associations with self-reported COPD were found for other examined ENDS flavor categories including menthol/mint, fruit, candy/ desserts/other-sweets, and other flavors, compared to their corresponding non-users. CONCLUSIONS Tobacco flavored ENDS use was significantly associated with self-reported COPD. Future studies are needed to confirm the biological and epidemiological association of flavored ENDS use with COPD.
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Affiliation(s)
- Hangchuan Shi
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, United States.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, United States
| | - Zahíra Quiñones Tavárez
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, United States.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, United States
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, United States
| | - Liane M Schneller
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, United States.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, United States
| | - Daniel P Croft
- Department of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, United States
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, United States
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, United States
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15
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Havermans A, Krüsemann EJZ, Pennings J, de Graaf K, Boesveldt S, Talhout R. Nearly 20 000 e-liquids and 250 unique flavour descriptions: an overview of the Dutch market based on information from manufacturers. Tob Control 2019. [PMID: 31685584 DOI: 10.1136/tobaccocontrol‐2019‐055303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Flavours increase attractiveness of electronic cigarettes and stimulate use among vulnerable groups such as non-smoking adolescents. It is important for regulators to monitor the market to gain insight in, and regulate the range of e-liquid flavours that is available to consumers. E-liquid manufacturers are required to report key product information to authorities in the European Member States in which they plan to market their products. This information was used to provide an overview of e-liquid flavour descriptions marketed in the Netherlands in 2017. METHODS Two researchers classified 19 266 e-liquids into the 16 main categories of the e-liquid flavour wheel, based on information from four variables in the European Common Entry Gate system. Flavour descriptions were further specified in subcategories. RESULTS For 16 300 e-liquids (85%), sufficient information was available for classification. The categories containing the highest number of e-liquids were fruit (34%), tobacco (16%) and dessert (10%). For all e-liquids, excluding unflavoured ones, 245 subcategories were defined within the main categories. In addition to previously reported subcategories, various miscellaneous flavours such as sandwich, buttermilk and lavender were identified. CONCLUSIONS In 2017, ~20 000 e-liquids were reported to be marketed in the Netherlands, in 245 unique flavour descriptions. The variety of marketed flavour descriptions reflects flavour preference of e-cigarette users as described in literature. Our systematic classification of e-liquids by flavour description provides a tool for organising the huge variety in market supply, serves as an example for other countries to generate similar overviews and can support regulators in developing flavour regulations.
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Affiliation(s)
- Anne Havermans
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Erna J Z Krüsemann
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Jeroen Pennings
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Kees de Graaf
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Reinskje Talhout
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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16
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Havermans A, Krüsemann EJZ, Pennings J, de Graaf K, Boesveldt S, Talhout R. Nearly 20 000 e-liquids and 250 unique flavour descriptions: an overview of the Dutch market based on information from manufacturers. Tob Control 2019; 30:57-62. [PMID: 31685584 PMCID: PMC7803909 DOI: 10.1136/tobaccocontrol-2019-055303] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Flavours increase attractiveness of electronic cigarettes and stimulate use among vulnerable groups such as non-smoking adolescents. It is important for regulators to monitor the market to gain insight in, and regulate the range of e-liquid flavours that is available to consumers. E-liquid manufacturers are required to report key product information to authorities in the European Member States in which they plan to market their products. This information was used to provide an overview of e-liquid flavour descriptions marketed in the Netherlands in 2017. METHODS Two researchers classified 19 266 e-liquids into the 16 main categories of the e-liquid flavour wheel, based on information from four variables in the European Common Entry Gate system. Flavour descriptions were further specified in subcategories. RESULTS For 16 300 e-liquids (85%), sufficient information was available for classification. The categories containing the highest number of e-liquids were fruit (34%), tobacco (16%) and dessert (10%). For all e-liquids, excluding unflavoured ones, 245 subcategories were defined within the main categories. In addition to previously reported subcategories, various miscellaneous flavours such as sandwich, buttermilk and lavender were identified. CONCLUSIONS In 2017, ~20 000 e-liquids were reported to be marketed in the Netherlands, in 245 unique flavour descriptions. The variety of marketed flavour descriptions reflects flavour preference of e-cigarette users as described in literature. Our systematic classification of e-liquids by flavour description provides a tool for organising the huge variety in market supply, serves as an example for other countries to generate similar overviews and can support regulators in developing flavour regulations.
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Affiliation(s)
- Anne Havermans
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Erna J Z Krüsemann
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Jeroen Pennings
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Kees de Graaf
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Reinskje Talhout
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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17
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McKelvey K, Halpern-Felsher B. From tobacco-endgame strategizing to Red Queen's race: The case of non-combustible tobacco products. Addict Behav 2019; 91:1-4. [PMID: 30642577 PMCID: PMC6541479 DOI: 10.1016/j.addbeh.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
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