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Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021. Tob Control 2024:tc-2023-058453. [PMID: 39174323 DOI: 10.1136/tc-2023-058453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 08/03/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the lung injuries outbreak, flavour bans, Tobacco 21 and the COVID-19 pandemic. METHODS Using the Population Assessment of Tobacco and Health Study, we applied a multistate transition model to 28 061 adults in waves 4-5 (2017-2019) and 24 584 adults in waves 5-6 (2019-2021), estimating transition rates for initiation, cessation and switching products for each period overall and by age group. RESULTS Cigarette initiation among adults who never used either product decreased from 2017-2019 to 2019-2021, but ENDS initiation did not significantly change. The persistence of ENDS-only use remained high (75%-80% after 1 year). Cigarette-only use transitions remained similar (88% remaining, 7% to non-current use and 5% to dual or ENDS-only use). In contrast, dual use to ENDS-only transitions increased from 9.5% (95% CI 7.3% to 11.7%) to 20.0% (95% CI 17.4% to 22.6%) per year, decreasing the persistence of dual use. The dual to cigarette-only use transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use. CONCLUSIONS The persistence of ENDS use among adults remained high in 2019-2021, but a larger fraction of dual users transitioned to ENDS-only use compared with 2017-2019. Because the fraction of cigarette-only users switching to dual use remained low, especially among older adults, the public health implications of this change are minimal.
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Affiliation(s)
| | - Jihyoun Jeon
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stephanie R Land
- Tobacco Control Research Branch, National Cancer Institute Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
| | | | - Abigail S Friedman
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Jamie Tam
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Ritesh Mistry
- Health Behavior Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Rafael Meza
- Integrative Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
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Klaiman T, Farrell N, Sheu D, Belk A, Silvestri J, Kim J, Coffman R, Hart J. Use of tobacco during COVID-19: A qualitative study among medically underserved individuals. PLoS One 2024; 19:e0308966. [PMID: 39159172 PMCID: PMC11332913 DOI: 10.1371/journal.pone.0308966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 08/02/2024] [Indexed: 08/21/2024] Open
Abstract
The COVID-19 pandemic produced stress for people around the world. The perception that tobacco can be a coping tool for stress relief suggests that the conditions during the COVID-19 pandemic can provide insight into the relationship between stress and tobacco use patterns, particularly among those most at risk for severe COVID-19 disease. The goal was to identify the impacts of the COVID-19 pandemic on tobacco use and preparedness for smoking cessation among individuals who smoke and are older and medically underserved. We conducted in-depth interviews with 39 patients to learn about individuals' smoking behavior during the COVID-19 pandemic. We used a modified grounded theory approach to code and analyze all qualitative data. We conducted thematic analysis to identify key factors associated with smoking behaviors during COVID-19. Our results indicated that increases in perceived stress and social isolation may have been associated with increased tobacco use during the COVID-19 pandemic. Pandemic-related social isolation contributed to increases in smoking, despite respondents being concerned about the severity of COVID-19. While many respondents felt that smoking relieved their stress from the pandemic, they appeared unaware of the stress-inducing properties of tobacco use. Our findings indicate that pandemic-related stress impacted smoking behavior among older, medically underserved smokers. Results may assist clinicians in addressing the role of tobacco use in response to highly stressful events. Smoking cessation strategies should consider the implications of stress on smoking behavior, including smoking relapse in response to highly stressful events-particularly for medically underserved populations.
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Affiliation(s)
- Tamar Klaiman
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Nsenga Farrell
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Dorothy Sheu
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Aerielle Belk
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jasmine Silvestri
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jannie Kim
- CHDI Foundation, New York, NY, United States of America
| | - Ryan Coffman
- Tobacco Policy and Control Program, Philadelphia Department of Public Health, Philadelphia, PA, United States of America
| | - Joanna Hart
- Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States of America
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Maglalang DD, Lyerly R, Scout N, Avila JC, Ahluwalia JS. Correlates of smoking during COVID-19 in the LGBTQI + cancer survivor population. J Cancer Surviv 2024; 18:1339-1346. [PMID: 37012576 PMCID: PMC10069945 DOI: 10.1007/s11764-023-01375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Stressors brought on by the pandemic may have further encouraged lesbian, gay, bisexual, transgender, queer, and intersex plus (LGBTQI +) cancer survivors to smoke. The purpose of this study is to examine factors associated with smoking among LGBTQI + cancer survivors during the pandemic. METHODS We used a secondary data analysis of OUT: The National Cancer Survey. We conducted logistic regression analysis to examine the associations between psychological distress, binge drinking, and socio-demographic factors with ever use and current use of cigarettes, other tobacco, and nicotine products. RESULTS Of the 1629 participants in our sample, 53% used in their lifetime and 13% reported current use. Correlates of increased ever use included being of older age (AOR = 1.02; 95% CI: 1.01, 1.03) and binge drinking (AOR = 2.47; 95% CI: 1.17, 5.20) while correlates of decreased ever use were among those with a graduate or professional degree (AOR = 0.40; 95% CI: 0.23, 0.71). Correlates of increased current use included being of Latine descent (AOR = 1.89; 95% CI: 1.07, 3.36), binge drinking (AOR = 3.18; 95% CI: 1.56, 6.48), without health insurance (AOR = 2.37; 95% CI: 1.10, 5.10), and being disabled (AOR = 1.64; 95% CI: 1.19, 2.26) while correlates of decreased current use were among cisgender women (AOR = 0.30; 95% CI: 0.12, 0.77), being of younger age (AOR = 0.98; 95% CI: 0.96, 0.99), and having a graduate or professional degree (AOR = 0.33; 95% CI: 0.15, 0.70). CONCLUSIONS Our findings demonstrate that a proportion of LGBTQI + cancer survivors continue to smoke during the pandemic despite the increased risk involved with smoking. Furthermore, individuals with intersecting marginalized identities experience additional stressors that may have been further exacerbated by the conditions of the pandemic that encourage them to smoke. IMPLICATIONS FOR CANCER SURVIVORS Quitting smoking after a cancer diagnosis can decrease the chances of recurrence and a new primary malignancy. In addition, practitioners and researchers should advocate towards examining and addressing systemic forms of oppression in institutions that LGBTQI + cancer survivors navigate during the pandemic.
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Affiliation(s)
- Dale Dagar Maglalang
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 S. Main Street, Box G-S121, Providence, RI, 02912, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Reece Lyerly
- National LGBT Cancer Network, Providence, RI, USA
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nfn Scout
- National LGBT Cancer Network, Providence, RI, USA
| | - Jaqueline C Avila
- Department of Gerentology, University of Massachusetts, Boston, MA, USA
| | - Jasjit S Ahluwalia
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 S. Main Street, Box G-S121, Providence, RI, 02912, USA
- Department of Medicine, Alpert Medical School, Brown University, Providence, RI, USA
- Legoretta Cancer Center, Brown University, Providence, RI, USA
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McDaniel AM, Cooley ME, Andrews JO, Bialous S, Buettner-Schmidt K, Heath J, Okoli C, Timmerman GM, Sarna L. Nursing leadership in tobacco dependence treatment to advance health equity: An American Academy of Nursing policy manuscript. Nurs Outlook 2024; 72:102236. [PMID: 39043053 DOI: 10.1016/j.outlook.2024.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/15/2024] [Accepted: 06/22/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Tobacco use remains the leading cause of preventable disease, disability, and death in the United States and is a significant cause of health disparities. PURPOSE The purpose of this paper is to update the Tobacco Control policy paper published over a decade ago by the American Academy of Nursing's Health Behavior Expert Panel Tobacco Control subcommittee. METHODS Members reviewed and synthesized published literature from 2012 to 2024 to identify the current state of the science related to nurse-led tobacco dependence treatment and implications for nursing practice, education, and research. FINDINGS The results confirmed that nurse-led tobacco dependence treatment interventions are successful in enhancing cessation outcomes across settings. DISCUSSION Recommendations for nursing leaders include: promote tobacco dependence treatment as standard care, accelerate research on implementation of evidence-based treatment guidelines, reduce health disparities by extending access to evidence-based treatment, increase nursing competency in providing tobacco treatment, and drive equity-focused tobacco control policies.
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Affiliation(s)
- Anna M McDaniel
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC.
| | - Mary E Cooley
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Jeannette O Andrews
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Stella Bialous
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Kelly Buettner-Schmidt
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Janie Heath
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Chizimuzo Okoli
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Gayle M Timmerman
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Linda Sarna
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
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Hawkins SS, Carey N, Levine Coley R, Baum CF. Associations between tobacco 21 and state flavour restrictions with young adult tobacco use. Tob Control 2024:tc-2023-058448. [PMID: 38527790 DOI: 10.1136/tc-2023-058448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND States have recently enacted tobacco-related age and flavour restrictions in addition to federal T21 laws. Little is known about the independent effects of these policies on young adult tobacco use. METHODS Linking 2011-2022 Behavioural Risk Factor Surveillance System data on 2 696 870, 18-59 years from 50 states and DC with policy data, we conducted probit regression models to evaluate the associations between state and federal T21 laws and state flavour restrictions with cigarettes, electronic nicotine delivery system (ENDS) and smokeless tobacco use. Models were adjusted for sociodemographics, additional tobacco policies, COVID-19-related factors, year and state. We tested two-way and three-way interactions between age, state T21 and federal T21 laws. RESULTS Although we did not find evidence that state T21 laws were associated with cigarette, smokeless tobacco or ENDS use overall, the federal T21 law was associated with lower use of all three tobacco products by 0.39-0.92 percentage points. State flavour restrictions were associated with lower use of cigarettes by 0.68 (-1.27 to -0.09) and ENDS by 0.56 (-1.11 to -0.00) percentage points, but not with smokeless tobacco. A three-way interaction revealed that state and federal T21 laws together were associated with a lower prevalence of ENDS use among 18-20 years, but there were no differences in cigarette use from both policies combined versus either alone. CONCLUSION State and federal T21 laws are broadly effective at reducing adult tobacco use, while state flavour restrictions specifically lower use of cigarettes and ENDS.
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Affiliation(s)
| | - Naoka Carey
- Lynch School of Education & Human Development, Boston College, Chestnut Hill, Massachusetts, USA
| | - Rebekah Levine Coley
- Department of Counseling, Developmental, and Educational Psychology, Boston College Lynch School of Education, Chestnut Hill, Massachusetts, USA
| | - Christopher F Baum
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
- Department of Economics, Boston College, Chestnut Hill, Massachusetts, USA
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Andersen AJ, Wallez S, Melchior M, Mary-Krause M. Our perception may not be reality: A longitudinal study of the relationship between perceived and actual change in smoking behavior. PLoS One 2024; 19:e0301515. [PMID: 38557563 PMCID: PMC10984459 DOI: 10.1371/journal.pone.0301515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Results of the impact of lockdowns and stay-at-home orders during the COVID-19 pandemic on changes in cigarette smoking are mixed. Previous studies examining smoking changes during the early stages of the pandemic in 2020 have mainly focused on smoker's perception of changes in cigarette consumption. Such measure has not been widely used in other contexts, and therefore we aim to compare the discrepancy between smokers' perceived changes in cigarette smoking and the actual change in the number of cigarettes smoked, using repeated measurements. METHODS We included 134 smokers from the French TEMPO cohort with repeated measurements of their perceived changes in smoking habits during the first phase of the COVID-19 pandemic and the number of cigarettes smoked repeatedly from March to May 2020. We used generalized estimation equations (GEE) to examine the association between changes in the number of cigarettes smoked and the odds of mismatched answers. RESULTS The results suggest that at each study wave, 27-45% of participants provided mismatching answers between their perceived change in smoking habits and the actual change in the number of cigarettes smoked daily, measured repeatedly. Results from GEE analysis demonstrated that a mismatching assessment of smoking behavior was elevated among those who had an increase (OR = 2.52 [1.37;4.65]) or a decrease (OR = 5.73 [3.27;10.03]) in number of cigarettes smoked. DISCUSSION Our findings highlight the possibility of obtaining different results depending on how changes in tobacco smoking are measured. This highlights the risk of underestimating the actual changes in cigarette smoking during the COVID-19 pandemic, but also more generally when validating public health interventions or smoking cessation programs. Therefore, objective measures such as the actual consumption of psychoactive substances should be utilized, preferably on a longitudinal basis, to mitigate recall bias.
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Affiliation(s)
- Astrid Juhl Andersen
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Solène Wallez
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Maria Melchior
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Murielle Mary-Krause
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
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Ju H, Lee H, Choi J, Kim S, Kang E. The online promotion strategies of e-cigarette and heated tobacco product retailers in South Korea following the COVID-19 pandemic: Implications for regulation. Tob Induc Dis 2024; 22:TID-22-37. [PMID: 38356660 PMCID: PMC10865470 DOI: 10.18332/tid/178380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/21/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION The surge in popularity of e-cigarettes and heated tobacco products (HTPs) in South Korea, driven by perceived health benefits and COVID-19-related concerns, has led to increased advertising claims about their safety despite ongoing debates about their health effects. This study explores the marketing strategies of online e-cigarette and HTP retailers in South Korea pre- and post-COVID-19, examining potential misleading claims and providing a foundation for future regulatory measures. METHODS We conducted a comprehensive study of eight major e-commerce platforms and three dominant search engines in South Korea to analyze the marketing and advertising strategies of e-cigarettes and heated tobacco products (HTPs) (n=774). Using specific keywords, promotional strategies were identified and categorized, after which statistical analysis was conducted to understand the frequency and proportion of these strategies, highlighting differences between HTP and e-cigarette sellers. RESULTS Our analysis reveals a significant rise in the number of online retailers selling e-cigarettes and HTPs following the COVID-19 pandemic, with the promotional strategies 'Stay home and vape' and 'Trendy' being the most prevalent. Trends also indicate a shift in promotional strategies over the years, with a marked increase in health reassurance themes and appeals to trendiness, particularly targeting female consumers, which were used significantly more at HTPs stores. CONCLUSIONS The study highlights the need for stricter regulation due to the potential health risks posed by the aggressive marketing strategies of e-cigarette and HTP online retailers in South Korea, amplified by the COVID-19 pandemic.
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Affiliation(s)
- HyoRim Ju
- Department of Family Medicine, Dankook University Hospital, Cheonan, South Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - HyeWon Lee
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Juyoung Choi
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Soojeong Kim
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
| | - EunKyo Kang
- National Cancer Control Institute, National Cancer Center, Goyang, South Korea
- Department of Family Medicine, National Cancer Center, Goyang, South Korea
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Zhang L, Harris Ao S, Francis Ye J, Zhao X. How does health communication on social media influence e-cigarette perception and use? A trend analysis from 2017 to 2020. Addict Behav 2024; 149:107875. [PMID: 37820562 DOI: 10.1016/j.addbeh.2023.107875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE E-cigarettes have achieved a high prevalence rapidly. While social media is among the most influential platforms for health communication, its impact on attitudes and behaviors of e-cigarettes and its changes over time remain underexplored. This study aims to address the gap. METHODS Four years of data (2017-2020) were derived from the U.S. Health Information National Trends Survey (HINTS) (aged 18-64 years, n = 9,914). Initially, key variables were compared across years. Furthermore, guided by the health belief model, we employed a moderated mediation model to examine the influence of social media health communication on the public's perceptions and behaviors related to e-cigarettes, distinguishing between smokers and non-smokers throughout the four-year period. RESULTS The evidence shows a process of dynamic interaction between communication, perception, and behavior. (1) We observed an increasing trend of social media health communication (SMH) and perceived relative harm of e-cigarettes (PHE). (2) Higher SMH was associated with more e-cigarette use directly in 2019. (3) Higher SMH was associated with less e-cigarette use indirectly through PHE in 2020. (4) Smokers consistently displayed heightened sensitivity in responding to harm perception compared to non-smokers. CONCLUSIONS The findings support two mechanisms underlying the association between SMH and e-cigarette use: direct and indirect. The changes in the pathways during the timespan may have been influenced by increased e-cigarette information on social media and public health events like COVID-19. Stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media are called for to curtail e-cigarette use.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau
| | - Jizhou Francis Ye
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau.
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Pike Moore S, Gunzler DD, Spears CA, Shaikh NI, Kim-Mozeleski JE. Longitudinal experience of food insecurity & cigarette use in the early COVID-19 Pandemic, United States. Prev Med Rep 2024; 38:102624. [PMID: 38375176 PMCID: PMC10874846 DOI: 10.1016/j.pmedr.2024.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Food insecurity is associated with cigarette smoking, yet little is known about how variability in the experience of food insecurity may relate to patterns of cigarette use. We sought to examine patterns of food insecurity and cigarette use during the COVID-19 pandemic (April 2020-March 2021). We analyzed longitudinal survey data from a nationally representative panel of adults in the United States (N = 7,880) from the Understanding Coronavirus in America Study. The primary independent variable was ten trajectories of food insecurity. Our dependent variable was past 7-day cigarette use (count of days used cigarettes). Poisson regression using generalized estimating equations was run controlling for key covariates. The prevalence of cigarette use on at least one day in the past week was lowest (17.5 %) for those who Remained Food Secure, and highest (57.9 %) among those who Became Fully Food Insecure, a group characterized by having high probability of becoming food insecure during the study period. Among those who reported at least one day of cigarette use in the past week, fewer than half (40.1 %) reported sustained use across all waves of the study. Those who Became Fully Food Insecure had an incidence rate ratio (IRR) of 1.73 (95 % CI: 1.18, 2.54) compared to those who Remained Food Secure with respect to number of smoking days. While different patterns of food insecurity are related to cigarette smoking at the population level, these results highlight that food insecurity, a key social need, may represent a novel strategy for informing reduction of tobacco use disparities.
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Affiliation(s)
- Stephanie Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
| | - Claire A. Spears
- Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Nida I. Shaikh
- Department of Nutrition, Byrdine F. Lewis College of Nursing & Health, Georgia State University, Atlanta, GA, USA
| | - Jin E. Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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Jagielo AD, Chieng A, Tran C, Pirkl A, Cao-Nasalga A, Bragg A, Mirkin R, Prochaska JJ. Predictors of Patient Engagement in Telehealth-Delivered Tobacco Cessation Treatment during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:131. [PMID: 38397622 PMCID: PMC10887648 DOI: 10.3390/ijerph21020131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Smoking causes one in three cancer deaths and may worsen COVID-19 outcomes. Telehealth tobacco cessation treatment is offered as a covered benefit for patients at the Stanford Cancer Center. We examined predictors of engagement during the COVID-19 pandemic. Data were abstracted from the Electronic Health Record between 3/17/20 (start of pandemic shelter-in-place) and 9/20/22, including patient tobacco use, demographics, and engagement in cessation treatment. Importance of quitting tobacco was obtained for a subset (53%). During the first 2.5 years of the pandemic, 2595 patients were identified as recently using tobacco, and 1571 patients were contacted (61%). Of the 1313 patients still using tobacco (40% women, mean age 59, 66% White, 13% Hispanic), 448 (34%) enrolled in treatment. Patient engagement was greater in pandemic year 1 (42%) than in year 2 (28%) and year 3 (19%). Women (41%) engaged more than men (30%). Patients aged 36-45 (39%), 46-55 (43%), 56-65 (37%), and 66-75 (33%) engaged more than patients aged 18-35 (18%) and >75 (21%). Hispanic/Latinx patients (42%) engaged more than non-Hispanic/Latinx patients (33%). Engagement was not statistically significantly related to patient race. Perceived importance of quitting tobacco was significantly lower in pandemic year 1 than year 2 or 3. Nearly one in three cancer patients engaged in telehealth cessation treatment during the COVID-19 pandemic. Engagement was greater earlier in the pandemic, among women, Hispanic/Latinx individuals, and patients aged 36 to 75. Sheltering-in-place, rather than greater perceived risk, may have facilitated patient engagement in tobacco cessation treatment.
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Affiliation(s)
- Annemarie D. Jagielo
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA 94304, USA;
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Amy Chieng
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA;
| | - Cindy Tran
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Amy Pirkl
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Ann Cao-Nasalga
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Ashley Bragg
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Rachelle Mirkin
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA;
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Lozano P, Peters A, Southworth A, Mo Y, Lam H, Randal FT, Kim KE. Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression. Tob Induc Dis 2024; 22:TID-22-28. [PMID: 38274001 PMCID: PMC10809060 DOI: 10.18332/tid/176923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic. METHODS We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms. RESULTS We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts. CONCLUSIONS The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use.
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Affiliation(s)
- Paula Lozano
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | - Aven Peters
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Yicklun Mo
- Asian Health Coalition, Chicago, United States
| | - Helen Lam
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Karen E. Kim
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
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12
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Deng R, Yang C, Yuan Y, Liang L, Yang X, Wang X, Tian J, Zhang Y, Wu X, Dai H. A cross-sectional survey of medical and other groups' awareness, perceptions, and willingness to use e-cigarettes during the COVID-19 pandemic. Front Public Health 2024; 11:1323804. [PMID: 38259797 PMCID: PMC10800479 DOI: 10.3389/fpubh.2023.1323804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background In China, people's perceptions towards electronic cigarettes during Corona Virus Disease 2019 (COVID-19) pandemic compared with pre-pandemic conditions have not been explored. Exploring the perceptions of medical workers regarding e-cigarettes is crucial, as they serve as a trusted source of information and providers of smoking cessation counselling for smokers. This cross-sectional study was designed to explore the awareness and perceptions of e-cigarettes among Chinese medical and other groups in the context of the COVID-19 pandemic. Methods A cross-sectional survey was performed using an online, anonymous, and self-administered questionnaire. The questionnaire contained sections for collecting participants' general information and Likert scale questions regarding smoking status, perceptions of e-smoking, attitude, and willingness to use e-cigarettes. The respondents included medical students, clinical doctors, and other occupations. Data analysis was performed using tools such as descriptive analysis, binary logistic regression, and multivariate regression. Results A total of 952 people completed the questionnaire, and 96.54% of them reported to have heard about e-cigarettes. The most common source of information about e-cigarettes was advertising. Notably, 28 of the 116 smokers reported that they had used e-cigarettes. Independent-samples T-tests results showed that medical groups believed e-cigarettes contained tar (p = 0.03). Most of the medical and non-medical participants maintained neutral attitudes towards e-cigarette policies (38.3%) and prices (49.2%) but their views were significantly different (p < 0.001). Multivariate logistic regression indicated that highly educated people had higher knowledge about e-cigarettes relative to those with lower education (undergraduate, OR = 1.848, 95CI% = 1.305-2.616, p = 0.001; master's degree or doctoral degree, OR = 1.920, 95CI% = 1.230-2.997, p = 0.004). The medical group used fewer e-cigarettes compared to non-medical group (OR = 1.866, 95CI% = 1.185-2.938, p = 0.007), the non-traditional cigarette users showed lower utilization compared to traditional cigarette users (18-40, OR = 4.797, 95CI% = 0.930-24.744, p = 0.061; > 40, OR = 9.794, 95CI% = 1.683-56.989, p = 0.011) and the older adult used fewer than the young (18-40, OR = 4.797, 95CI% = 0.930-24.744, p = 0.061; > 40, OR = 9.794, 95CI% = 1.683-56.989, p = 0.011). Conclusion This study found that individuals tend to hold negative attitudes towards the awareness, perceptions, and willingness to use e-cigarettes. Medical groups are less likely to use e-cigarettes, but misperceptions are still prevalent among them. This calls for additional training for such medical personnel to improve their capacity to provide necessary counselling to smokers. E-cigarettes advertisements were the main source of information for young individuals to learn about e-cigarettes, and hence measures should be taken to restrict exposure of young individuals to e-cigarettes.
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Affiliation(s)
- Ruihang Deng
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Chuang Yang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Yifang Yuan
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Lifang Liang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xin Yang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xinyu Wang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Jiao Tian
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Yuxin Zhang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xuekai Wu
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Haiyun Dai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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13
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Siu C, Stephenson E, Christie CD, Selby P, Tu K. The impact of the COVID-19 pandemic on the rate of primary care visits for substance use among patients in Ontario, Canada. PLoS One 2023; 18:e0288503. [PMID: 38127861 PMCID: PMC10734921 DOI: 10.1371/journal.pone.0288503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/27/2023] [Indexed: 12/23/2023] Open
Abstract
The COVID-19 pandemic has led to an increase in the prevalence of substance use presentations. This study aims to assess the impact of the COVID-19 pandemic on the rate of primary care visits for substance use including tobacco, alcohol, and other drug use among primary care patients in Ontario, Canada. Diagnostic and service fee code data were collected from a longitudinal cohort of family medicine patients during pre-pandemic (March 14, 2019-March 13, 2020) and pandemic periods (March 14, 2020-March 13, 2021). Generalized linear models were used to compare the rate of substance-use related visits pre-pandemic and during the pandemic. The effects of demographic characteristics including age, sex, and income quintile were also assessed. Relative to the pre-pandemic period, patients were less likely to have a primary care visit during the pandemic for tobacco-use related reasons (OR = 0.288, 95% CI [0.270-0.308]), and for alcohol-use related reasons (OR = 0.851, 95% CI [0.780-0.929]). In contrast, patients were more likely to have a primary care visit for other drug-use related reasons (OR = 1.150, 95% CI [1.080-1.225]). In the face of a known increase in substance use during the COVID-19 pandemic, a decrease in substance use-related primary care visits likely represents an unmet need for this patient population. This study highlights the importance of continued research in the field of substance use, especially in periods of heightened vulnerability such as during the COVID-19 pandemic.
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Affiliation(s)
- Colin Siu
- Temerty Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
| | - Ellen Stephenson
- Temerty Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Chelsea D. Christie
- Temerty Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Temerty Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Research Institute and Krembil Centre for Neuroinformatics, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Karen Tu
- Temerty Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
- Toronto Western Family Health Team, University Health Network, Toronto, Ontario, Canada
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14
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Doumi R, Khaytan S, Alobaidan AS, Alqahtany BM, Aldosari NM, Almutairi AA, Alanazi AA, Fayed A. Knowledge, Attitude, and Practice of E-Cigarettes of Adolescents and Adults in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2998. [PMID: 37998490 PMCID: PMC10671544 DOI: 10.3390/healthcare11222998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
E-cigarettes have gained enormous popularity, and their use has increased drastically worldwide. However, little is known regarding adolescents' and adults' knowledge, attitudes, and practices in Saudi Arabia. We conducted a cross-sectional study using a self-administered online-modified WHO GATS questionnaire on a convenience sample approach. Data were collected between January and March 2021 after the alleviation of COVID-19 lockdown measures in Saudi Arabia. Univariate and multivariate regression models were developed to identify independent factors associated with knowledge, attitude, and practice. Our sample (1335) had a mean age of 26.45 ± 10.5 years; nearly half of the participants had poor knowledge about e-cigarettes. The usage and positive attitude were reported by 18.6% and 19.4%, respectively. Around 43.5% of e-cigarette users reported starting or increased use during the COVID-19 pandemic, while 9.5% of participants would recommend it to others. Logistic regressions showed that older participants were more likely to have poor knowledge (OR = 1.02, 95% C.I. = 1.01-1.03) and positive attitudes (OR = 0.98, 95% C.I. = 0.91-0.96). Male participants and smokers (OR = 3.0, 95% C.I. = 2.3-3.8) were more likely to have a positive attitude. However, younger participants were less likely to go for e-cigarettes (OR = 0.95, 95% C.I. = 0.93-0.97), while males (OR = 2.53, 95% C.I. = 1.65-3.86) and smokers (OR = 4.63, 95% C.I. = 3.47-6.18) were more likely to use them. This study indicated a high level of poor knowledge about e-cigarettes. A considerable proportion of participants reported usage and a positive attitude towards them. Older age, male gender, and being a smoker were the main elicited predictors for e-cigarette use.
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Affiliation(s)
- Rasha Doumi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (A.S.A.); (B.M.A.); (N.M.A.); (A.A.A.); (A.A.A.); (A.F.)
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15
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Dalibalta S, Ghader N, Rabah L, Shaban S, Al Mheiri N. Impact of COVID-19 restrictions on health and well-being in the United Arab Emirates. Front Psychol 2023; 14:1259974. [PMID: 38022961 PMCID: PMC10657631 DOI: 10.3389/fpsyg.2023.1259974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Restrictions during the COVID-19 pandemic are thought to have impacted both the physical health and well-being of individuals where lockdown was applied. The United Arab Emirates (UAE) was one of the leading countries in implementing the international guidelines to limit the intensely contagious nature of the outbreak. Aim To identify the impact of COVID-19 on changes to exercise and general physical activity habits, changes to the consumption of various foods and potential weight gain, as well as any differences in smoking habits among individuals residing in the UAE during the COVID-19 quarantine. Methods This is a cross-sectional analytical study that used a quantitative electronic questionnaire sent by the Ministry of Health and Prevention to individuals on its platform in order to collect data on the physical health and well-being of a UAE sample population. A total of 2,362 responses were received to specific questions on physical activity, eating habits, and tobacco use for the period before, during, and after the COVID-19 lockdown. Descriptive statistical analysis was used to display the sample's demographic data and the changes in physical health and well-being. Paired t-test was used to show the changes in dietary habits. Results This study reveals concerning changes in health risk behaviors during the COVID-19 lockdown in the UAE. Physical activity levels declined across mild, moderate and vigorous ranges in most participants. Alarmingly, sedentary behavior dramatically increased with 71% of participants spending an average of 4-8 h per day sitting and over 54% of participants spending more than 4 h watching TV on an average day during lockdown. Fast-food consumption and snacking rose, hence weight gain was observed in over 53% of participants. Smoking habits, especially among cigarette smokers, may have worsened, with 45.2% reporting an increase in cigarette smoking, 16.8% declaring an increase in shisha smoking and 35.3% reporting an increase in smoking other tobacco products. These unfavorable behaviors during confinement could have serious long-term health consequences. Conclusion This study demonstrates that long periods of home quarantine may have led to unhealthy consequences that increase the risk of developing disease. This study therefore aims to highlight these health impacts, and recommend strategies and policies that can encourage healthy habits.
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Affiliation(s)
- Sarah Dalibalta
- College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Nariman Ghader
- Department of Mental Health, Medical Services Sector, Emirates Health Services, Dubai, United Arab Emirates
| | - Layal Rabah
- College of Arts and Sciences, American University of Sharjah, University City, Sharjah, United Arab Emirates
| | - Sami Shaban
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Noor Al Mheiri
- Department of Mental Health, Medical Services Sector, Emirates Health Services, Dubai, United Arab Emirates
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16
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Amin S, Pokhrel P, Elwir T, Mettias H, Kawamoto CT. A systematic review of experimental and longitudinal studies on e-cigarette use cessation. Addict Behav 2023; 146:107787. [PMID: 37393697 PMCID: PMC10527397 DOI: 10.1016/j.addbeh.2023.107787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The present study addresses the need to synthesize the findings in the current literature on e-cigarette use cessation. METHODS PubMed, MEDLINE, and EMBASE databases were searched in November 2022 to systematically review studies focused on intentions, attempts, and successful e-cigarette use cessation. Three authors independently reviewed the full-texts of the initial pool of potentially eligible articles. Narrative data synthesis was conducted, and the risk of bias was evaluated. RESULTS A total of 12 studies were selected for review, 7 of which were experimental and 5longitudinal. The majority of the studies focused on participants' intentions to quit e-cigarette use. The experimental studies varied in sample size, intervention type, and length of participant follow-up. Findings across the experimental studies were mixed, with only one full-fledged trial having examined cessation as an outcome. The experimental studies that assessed cessation outcomes utilized mobile technology as an intervention tool. Results from longitudinal studies indicated sociodemographic characteristics (gender, race/ethnicity), vaping frequency, and cigarette smoking status as predictors of intentions, attempts and e-cigarette use cessation. CONCLUSION This review highlights the current paucity of methodologically rigorous research on e-cigarette use cessation. Our findings suggest that vaping cessation programs that employ mobile health technology to provide personalized cessation services may help promote intentions, attempts, and e-cigarette use cessation. Limitations of the current studies on vaping cessation include small sample sizes, heterogeneous cohorts that limit comparisons, and inconsistent ways of assessing vaping cessation. Future research needs to test long-term intervention effects using experimental and prospective designs among representative samples.
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Affiliation(s)
- Samia Amin
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States.
| | - Pallav Pokhrel
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Taha Elwir
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Hannah Mettias
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Crissy T Kawamoto
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
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17
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Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.20.23297320. [PMID: 37905028 PMCID: PMC10614990 DOI: 10.1101/2023.10.20.23297320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Introduction The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the outbreak of lung injuries related to vaping THC, flavor bans, and the COVID pandemic. We analyzed patterns of initiation, cessation, and transitions between cigarettes, ENDS, and dual use before and after 2019. Methods Using the Population Assessment of Tobacco and Health (PATH) Study, we applied a multistate transition model to 28,061 adults in Waves 4-5 (2017-19) and 24,751 adults in Waves 5-6 (2019-21), estimating transition rates for initiation, cessation, and switching products for each period overall and by age group. Results Cigarette initiation among adults who never used either product decreased from 2017-19 to 2019-21, but ENDS initiation did not significantly change. Persistence of ENDS-only use remained high, with 75-80% still using ENDS only after 1 year. Cigarette-only use transitions remained similar, with about 88% remaining, 7% transitioning to non-current use, and 5% transitioning to dual or ENDS-only use. In contrast, dual use to ENDS-only transitions increased from 9.5% (95%CI: 7.3-11.7%) to 20.1% (95%CI: 17.5-22.7%) per year from 2017-19 to 2019-21, decreasing the persistence of dual use. The dual use to cigarette-only transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use. Conclusions Persistence of ENDS use among adults remained high in 2019-21, but a larger fraction of dual users transitioned to ENDS-only use compared to 2017-19. Because the fraction of cigarette-only users switching to dual use remained low, the public health implications of the increased dual use to ENDS-only transition are minimal.
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Affiliation(s)
- Andrew F. Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Stephanie R. Land
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD, United States
| | | | - Abigail S. Friedman
- Department of Health Management and Policy, Yale University, New Haven, CT, United States
| | - Jamie Tam
- Department of Health Management and Policy, Yale University, New Haven, CT, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States
| | - David T. Levy
- Department of Oncology, Georgetown University, Washington, DC, United States
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
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18
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Peña S, Ilmarinen K, Kestilä L, Ruokolainen O, Ollila H, Parikka S, Karvonen S. Changes in prevalence and sociodemographic correlates of tobacco and nicotine use in Finland during the COVID-19 pandemic. Eur J Public Health 2023; 33:844-850. [PMID: 37400989 PMCID: PMC10567130 DOI: 10.1093/eurpub/ckad104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on tobacco and nicotine use remains debated. We examined whether the prevalence of tobacco and nicotine use and nicotine-replacement therapy (NRT) changed during the COVID-19 pandemic and whether changes differed by sociodemographic groups. METHODS Repeated cross-sectional study of three national surveys in Finland (2018, 2019 and 2020; n = 58 526 adults aged 20 and over). Outcomes were daily and occasional smoking, smokeless tobacco (snus) use, e-cigarettes use, total tobacco or nicotine use and NRT use. We examined changes for each outcome by sex, age, educational tertiles, marital status, mother tongue and social participation. RESULTS Daily smoking decreased among males by 1.15 percentage points (pp) [95% confidence interval (CI) -2.10 to -0.20] between 2018 and 2020 and 0.86 pp among females (95% CI -1.58 to -0.15). Daily snus use remained stable in both sexes. Daily e-cigarette use was below 1% and remained stable. We found weak evidence of a reduction in total tobacco or nicotine use between 2018 and 2020 (males -1.18 pp, 95% CI -2.68 to 0.32 and females -0.8 pp, 95% CI -1.81 to 0.22). NRT use remained stable. Snus and NRT use decreased among 60- to 74-year-olds but remained stable in other age groups. We did not find evidence of interactions by subgroup for other outcomes. CONCLUSIONS Daily smoking decreased in Finland between 2018 and 2020, but other forms of tobacco use did not experience a reduction. The COVID-19 pandemic does not seem to have altered the sustained reduction of smoking in Finland, although substantial sociodemographic differences persist.
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Affiliation(s)
- Sebastián Peña
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Ilmarinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Kestilä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Parikka
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sakari Karvonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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19
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Sung J, Shrestha SS, Kim Y, Emery S, Wang X. Changes in Sales of Tobacco and Nicotine Replacement Therapy Products Before and During the COVID-19 Pandemic. Prev Chronic Dis 2023; 20:E71. [PMID: 37590902 PMCID: PMC10457104 DOI: 10.5888/pcd20.220406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic and its associated social distancing policies such as lockdowns and quarantine influenced people's lives and health behaviors. We comprehensively assessed national trends in sales of cigarettes, cigars, e-cigarettes, and over-the-counter nicotine replacement therapy (NRT) products before and during the pandemic, allowing for cross-product comparisons. Stockpiling behavior was also assessed. METHODS We used US national tobacco and over-the-counter NRT retail store scanner data (excluding internet, specialty/vape store, and prescription sales) collected at 4-week intervals by NielsenIQ from December 2018 to June 2021. We applied an interrupted time-series model to assess differences in tobacco product and NRT unit sales before and during the pandemic. We defined the prepandemic period as December 16, 2018, through April 4, 2020, pandemic as starting on April 5, 2020, through June 26, 2021, and the stockpiling period as one 4-week period before the pandemic started. RESULTS Four-week cigarette, e-cigarette, and cigar unit sales on average increased by 11.5% (P = .006), 37.1% (P < .001), and 26.1% (P < .001) respectively, while 4-week NRT unit sales decreased on average by 13.1% (P < .001), during the pandemic compared with the prepandemic period. Stockpiling was associated with increases in sales of all tobacco products and NRT products. CONCLUSION Unit sales of assessed tobacco products increased while NRT unit sales decreased during the COVID-19 pandemic, compared with the prepandemic period. These changes may suggest an increase in the intensity of tobacco product use or stockpiling of tobacco products among people who use tobacco.
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Affiliation(s)
- Jaesang Sung
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sundar S Shrestha
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-7, Atlanta, GA 30341
| | - Yoonsang Kim
- NORC at the University of Chicago, Chicago, Illinois
| | - Sherry Emery
- NORC at the University of Chicago, Chicago, Illinois
| | - Xu Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Tam CC, Qiao S, Garrett C, Zhang R, Aghaei A, Aggarwal A, Litwin AH, Li X. Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model. PLoS One 2023; 18:e0289413. [PMID: 37535623 PMCID: PMC10399860 DOI: 10.1371/journal.pone.0289413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (βs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (βs = -0.61 to -0.43, ps < 0.001). CONCLUSION Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Camryn Garrett
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Ran Zhang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Atefeh Aghaei
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Abhishek Aggarwal
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Alain H. Litwin
- School of Health Research, Clemson University, Greenville, SC, United States of America
- Department of Medicine, School of Medicine Greenville, University of South Carolina, Greenville, SC, United States of America
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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21
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Liu T, Phan L, Chen-Sankey J, Ajith A, Hacker K, Jewett B, Choi K. Race, Concern About COVID-19 Discrimination, and Cigarette Smoking Behavior: Comparison Between US Asian and White Adults Who Use Commercial Tobacco. J Racial Ethn Health Disparities 2023; 10:1955-1961. [PMID: 35994174 PMCID: PMC9395842 DOI: 10.1007/s40615-022-01377-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
Anti-Asian discrimination incidents in the USA have resurged during the COVID-19 pandemic. It is unclear how concern about being discriminatorily treated due to the COVID-19 pandemic varies between Asian and Asian American (A&AsA) and White adults. We examined A&AsA vs. White differences in concern about COVID-19 discrimination and associations of this concern with changes in cigarette smoking behaviors before and during the pandemic. Data were from a US representative sample of A&AsA and White adults (≥ 21 years) who currently and formerly used commercial tobacco (n = 1052), collected through an online panel oversampling A&AsA adults in January-February 2021. Participants reported their concern, worry, and stress about COVID-19 discrimination and past-30-day cigarette consumption before and during the pandemic. We examined the association between race and overall concern about COVID-19 discrimination, and this concern's associations with changes in past-30-day cigarette smoking consumption, smoking continuation, and return to smoking using weighted multivariable logistic and linear regression models. Overall concern about COVID-19 discrimination was higher (adjusted mean = 1.7, standard error = 0.16) among A&AsA adults who currently and formerly used commercial tobacco than their White counterparts (adjusted mean = 0.60, standard error = 0.04; p < 0.01). Overall concern about COVID-19 discrimination was associated with increased past-30-day cigarette consumption by 26.5 cigarettes (95% confidence interval [CI] = 1.2-51.9) and 4.4 times (95% CI = 2.3-8.5) greater odds of return to smoking among adults who smoke cigarettes. A&AsA adults who currently and formerly used commercial tobacco disproportionately bore higher concern about COVID-19 discrimination, and in turn could lead to increased smoking behavior and related morbidity and mortality among A&AsA adults.
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Affiliation(s)
- Tina Liu
- Department of Stem Cell and Regenerative Biology, Harvard College, Cambridge, MA, USA
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Lilianna Phan
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA.
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kiana Hacker
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Bambi Jewett
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
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22
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Cunningham JA, Schell C, Godinho A. Has interest in smoking cessation declined during the COVID-19 pandemic? Perspect Public Health 2023; 143:193-195. [PMID: 37589324 PMCID: PMC10467010 DOI: 10.1177/17579139221136720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- JA Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - C Schell
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - A Godinho
- Institute of Mental Health and Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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23
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Sharma RH, Rodberg D, Struik LL. Experiences of nicotine users motivated to quit during the COVID-19 pandemic: a secondary qualitative analysis. BMJ Open 2023; 13:e070906. [PMID: 37369394 PMCID: PMC10410857 DOI: 10.1136/bmjopen-2022-070906] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has brought to light a variety of key factors that affect tobacco use, including behavioural patterns, social support and connection, and physical and mental health. What we do not know is how those motivated to quit were impacted by the pandemic. As such, understanding the unique experiences and needs of people motivated to quit smoking or vaping during the COVID-19 pandemic is critical. The aim of this study was to examine the cessation experiences of nicotine users during the COVID-19 pandemic. DESIGN We conducted a supplementary secondary analysis of primary qualitative data, i.e., semi-structured interviews with individuals engaged in cigarette use (smoking), e-cigarette use (vaping) and dual use. SETTING British Columbia, Canada. PARTICIPANTS Relevant data were drawn from 33 participants out of the primary study's 80-participant sample pool. MEASURES Interview questions explored barriers and facilitators to quitting nicotine use. We then used conventional content analysis to identify relevant and additional emergent themes and subthemes surrounding pandemic-specific barriers and facilitators to quitting, and unique needs for cessation support in the context of the COVID-19 pandemic. RESULTS Pandemic-specific barriers included lifestyle limitations and poor mental health due to isolation. Facilitators to quitting during the pandemic included reduced access and opportunities to use nicotine products, as well as time for personal reflection on nicotine use behaviours. Suggestions for cessation programming included a primary focus on enhancing social support features (e.g., discussion forums, support groups), followed by increasing awareness of the benefits of quitting, and enhancing visibility of resources available to support quitting. CONCLUSIONS The findings provide directions for how cessation supports can be tailored to better meet the needs of users motivated to quit during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Ramona H Sharma
- School of Social Work, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Danielle Rodberg
- School of Nursing, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Laura L Struik
- School of Nursing, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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24
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Cioe PA, Schnoll R, Hoeppner BB, Gross R, Hitsman BL, Leone FT, Ashare R, Vilardaga R, Tashima K, Pinkston M, Kahler CW. The Impact of the COVID-19 Pandemic on Stress, Isolation, Smoking Behaviors, and Motivation to Quit in People with HIV Who Smoke. AIDS Behav 2023; 27:1862-1869. [PMID: 36357808 PMCID: PMC9649403 DOI: 10.1007/s10461-022-03917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/12/2022]
Abstract
People with HIV (PWH) smoke at higher rates compared with the general population and have lower cessation rates. The primary aim of this study was to examine the impact of the COVID-19 pandemic on smoking in PWH. A survey was administered to participants in two smoking cessation trials in the United States. Mean cigarettes per day was 13.9 (SD 8.6), and participants reported they had smoked on average for 30.93 years (SD 10.4). More than half (55.7%) of participants (N = 140) reported not changing their smoking during the pandemic, while 15% reported decreasing, and 25% reported increasing their smoking. In bivariate analyses, worrying about food due to lack of money (χ2 = 9.13, df 2, p = 0.01) and greater Covid-related worry (rs = 0.19, p = 0.02) were significantly associated with increased smoking. Qualitative research may be needed to more clearly elucidate factors related to smoking behaviors among PWH.
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Affiliation(s)
- Patricia A Cioe
- Center for Alcohol & Addiction Studies, Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA.
| | - Robert Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Bettina B Hoeppner
- Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Gross
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
- Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Brian L Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank T Leone
- Pulmonary, Allergy, & Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ashare
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Roger Vilardaga
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Karen Tashima
- Division of Infectious Diseases, Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Megan Pinkston
- Division of Infectious Diseases, Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Christopher W Kahler
- Center for Alcohol & Addiction Studies, Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
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25
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Wedel AV, Patterson JG, Lee DN, Stevens EM, Wagener TL, Keller-Hamilton B. E-Cigarette Use among Sexual Minoritized Women and Nonbinary People Assigned Female at Birth: Assessing the Roles of Discrimination, Perceived Stress, and Social Support. Subst Use Misuse 2023; 58:1102-1109. [PMID: 37199173 PMCID: PMC10247437 DOI: 10.1080/10826084.2023.2212056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Background: Young adult sexual minoritized women (SMW) are at disproportionate risk for e-cigarette use, which may in part be due to excess minority stress imposed by discrimination exposure. While discrimination exposure is associated with risk for combustible tobacco/nicotine use among SMW, similar associations have yet to be tested with e-cigarettes. Moreover, it is unknown if discrimination-related risk may be mitigated by protective factors such as social support. This study examined concurrent associations of discrimination, perceived stress, and social support with past 30-day e-cigarette use in a sample of young adult SMW during the COVID-19 pandemic. Methods: N = 501 SMW and nonbinary people assigned female at birth (AFAB) aged 18-30 completed an online survey. A series of logistic regressions examined associations of discrimination, perceived stress, and four forms of social support received during the COVID-19 pandemic with past-30-day e-cigarette use. Results: Among SMW, greater perceived stress (OR = 1.10, p = .03), but not discrimination exposure, was associated with e-cigarette use. Associations of discrimination with e-cigarette use were nonsignificant when most forms of social support (emotional, material/financial, and virtual) were accounted for. Associations of perceived stress with e-cigarette use were strongest among those who needed but did not receive material support. Conclusions: Perceived stress, but not discrimination exposure, was associated with risk for e-cigarette use among young SMW during the COVID-19 pandemic. Effects of nonspecific stress may be compounded by insufficient material/financial support.
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Affiliation(s)
- Amelia V. Wedel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Joanne G. Patterson
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Donghee N. Lee
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Elise M. Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
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26
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Mamudu HM, Adzrago D, Dada O, Odame EA, Ahuja M, Awasthi M, Weierbach FM, Williams F, Stewart DW, Paul TK. Examining Disparities in Current E-Cigarette Use among U.S. Adults before and after the WHO Declaration of the COVID-19 Pandemic in March 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095649. [PMID: 37174168 PMCID: PMC10177985 DOI: 10.3390/ijerph20095649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
This paper aims to estimate the prevalence of e-cigarette use before and after the COVID-19 pandemic declaration and to delineate disparities in use across subpopulations. Data were derived from the 2020 Health Information National Trends Survey (N = 3865) to conduct weighted multivariable logistic regression and marginal analyses. The overall prevalence of current e-cigarette use increased from 4.79% to 8.63% after the COVID-19 pandemic declaration. Furthermore, non-Hispanic Black people and Hispanic people had lower odds of current e-cigarette use than non-Hispanic White people, but no significant differences were observed between groups before the pandemic. Compared to heterosexual participants, sexual minority (SM) participants had higher odds of current e-cigarette use after the declaration, with insignificant differences before. People who had cardiovascular disease conditions, relative to those without, had higher odds of current e-cigarette use after the declaration, but no group differences were found before the declaration. The marginal analyses showed that before and after the pandemic declaration, SM individuals had a significantly higher probability of using e-cigarettes compared to heterosexual individuals. These findings suggest the importance of adopting a subpopulation approach to understand and develop initiatives to address substance use, such as e-cigarettes, during pandemics and other public health emergencies.
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Affiliation(s)
- Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - David Adzrago
- Center for Health Promotion and Prevention Research and School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Oluwabunmi Dada
- Department of Occupational Safety and Health, Murray State University, 157 Industry and Technology Center, Murray, KY 42071, USA
| | - Emmanuel A Odame
- Department of Environmental Health Sciences, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA
| | - Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Manul Awasthi
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Florence M Weierbach
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
| | - David W Stewart
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Timir K Paul
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Division of Medicine, University of Tennessee at Nashville/Ascension Saint Thomas Hospital, Nashville, TN 37205, USA
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27
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McLeish AC, Hart JL, Walker KL. Long-term impact of the COVID-19 pandemic on use behavior and risk perceptions of college student E-cigarette users. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 36996419 PMCID: PMC10544669 DOI: 10.1080/07448481.2023.2194441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 06/01/2023]
Abstract
Objective: Work examining the long-term impact of the COVID-19 pandemic on e-cigarette use among college students is limited. Therefore, the current study examined differences in college student e-cigarette users' changes in use behavior and risk perceptions as the pandemic continues. Participants: 129 undergraduate current e-cigarette users (Mage = 19.68, SD = 1.85; 72.1% female; 85.3% White). Methods: Participants completed an online survey between October 2020 and April 2021. Results: In terms of changes in frequency of e-cigarette use, 30.5% of participants increased their use and 23.4% decreased their use. Greater e-cigarette dependence and anxiety were associated with increased use. Nearly half of e-cigarette users reported increased motivation to quit, and 32.5% had made at least one quit attempt. Conclusions: A substantial number of students increased their e-cigarette use as a result of the COVID-19 pandemic. Cessation efforts targeting increased anxiety and dependence may be useful in this population.
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Affiliation(s)
- Alison C. McLeish
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association, Tobacco Center for Regulatory Science, Dallas, TX
| | - Joy L. Hart
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association, Tobacco Center for Regulatory Science, Dallas, TX
- Department of Communication, University of Louisville, Louisville, KY
| | - Kandi L. Walker
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY
- American Heart Association, Tobacco Center for Regulatory Science, Dallas, TX
- Department of Communication, University of Louisville, Louisville, KY
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28
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Montiel Ishino FA, Villalobos K, Williams F. Substance Use From Social Distancing and Isolation by US Nativity During the Time of COVID-19: Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e38163. [PMID: 36265162 PMCID: PMC10473437 DOI: 10.2196/38163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/17/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic had many unprecedented secondary outcomes resulting in various mental health issues leading to substance use as a coping behavior. The extent of changes in substance use in a US sample by nativity has not been previously described. OBJECTIVE This study aimed to design a web-based survey to assess the social distancing and isolation issues exacerbated by the COVID-19 pandemic to describe substance use as a coping behavior by comparing substance use changes before and during the pandemic. METHODS A comprehensive 116-item survey was designed to understand the impact of COVID-19 and social distancing on physical and psychosocial mental health and chronic diseases. Approximately 10,000 web-based surveys were distributed by Qualtrics LLC between May 13, 2021, and January 09, 2022, across the United States (ie, continental United States, Hawaii, Alaska, and territories) to adults aged ≥18 years. We oversampled low-income and rural adults among non-Hispanic White, non-Hispanic Black, Hispanic or Latino, and foreign-born participants. Of the 5938 surveys returned, 5413 (91.16%) surveys were used after proprietary expert review fraud detection (Qualtrics) and detailed assessments of the completion rate and the timing to complete the survey. Participant demographics, substance use coping behaviors, and substance use before and during the pandemic are described by the overall US resident sample, followed by US-born and foreign-born self-reports. Substance use included the use of tobacco, e-cigarettes or nicotine vapes, alcohol, marijuana, and other illicit substances. Marginal homogeneity based on the Stuart-Maxwell test was used to assess changes in self-reported substance use before and during the pandemic. RESULTS The sample mostly included White (2182/5413, 40.31%) and women participants (3369/5406, 62.32%) who identified as straight or heterosexual (4805/5406, 88.88%), reported making ≥US $75,000 (1405/5355, 26.23%), and had vocational or technical training (1746/5404, 32.31%). Similarities were observed between the US-born and the foreign-born participants on increased alcohol consumption: from no alcohol consumption before the pandemic to consuming alcohol once to several times a month and from once to several times per week to every day to several times per day. Although significant changes were observed from no prior alcohol use to some level of increased use, the opposite was also observed and was more pronounced among foreign-born participants. That is, there was a 5.1% overall change in some level of alcohol use before the pandemic to no alcohol use during the pandemic among foreign-born individuals, compared with a 4.3% change among US-born individuals. CONCLUSIONS To better prepare for the inadvertent effects of public health policies meant to protect individuals, we must understand the mental health burdens that can precipitate into substance use coping mechanisms that not only have a deleterious effect on physical and mental health but also exacerbate morbidity and mortality in a disease like COVID-19.
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Affiliation(s)
- Francisco Alejandro Montiel Ishino
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
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29
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Mat Salleh R, Baharom N, Siau CS, Chan CMH, Amit N, Sia PY, Wee LH. E-Cigarette Users' Profiles and Their Association with Identified Impacts of COVID-19 on Vaping among Young Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11030434. [PMID: 36767009 PMCID: PMC9914650 DOI: 10.3390/healthcare11030434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Electronic cigarettes (ECs) users' profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users' profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia's west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.
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Affiliation(s)
- Rawaida Mat Salleh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Nizam Baharom
- Primer Care Health Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Pei Yin Sia
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylors University Lakeside Campus, No. 1 Jalan Taylor’s, Subang Jaya 47500, Selangor, Malaysia
- Correspondence: or
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30
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Çok İ, İyıgündoğdu İ. Impact of the COVID-19 pandemic on alcohol use and smoking habits. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2167745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- İsmet Çok
- Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - İrem İyıgündoğdu
- Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
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Laddu DR, Biggs E, Kaar J, Khadanga S, Alman R, Arena R. The impact of the COVID-19 pandemic on cardiovascular health behaviors and risk factors: A new troubling normal that may be here to stay. Prog Cardiovasc Dis 2023; 76:38-43. [PMID: 36481209 PMCID: PMC9722238 DOI: 10.1016/j.pcad.2022.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
In March 2020, the Coronavirus disease 2019 (COVID-19) outbreak was officially declared a global pandemic, leading to closure of public facilities, enforced social distancing and stay-at-home mandates to limit exposures and reduce transmission rates. While the severity of this "lockdown" period varied by country, the disruptions of the pandemic on multiple facets of life (e.g., daily activities, education, the workplace) as well as the social, economic, and healthcare systems impacts were unprecedented. These disruptions and impacts are having a profound negative effect on multiple facets of behavioral health and psychosocial wellbeing that are inextricably linked to cardiometabolic health and associated with adverse outcomes of COVID-19. For example, adoption of various cardiometabolic risk behavior behaviors observed during the pandemic contributed to irretractable trends in weight gain and poor mental health, raising concerns on the possible long-term consequences of the pandemic on cardiometabolic disease risk, and vulnerabilities to future viral pandemics. The purpose of this review is to summarize the direct and indirect effects of the pandemic on cardiometabolic health risk behaviors, particularly related to poor diet quality, physical inactivity and sedentary behaviors, smoking, sleep patterns and mental health. Additional insights into how the pandemic has amplified cardiovascular risk behaviors, particularly in our most vulnerable populations, and the potential implications for the future if these modifiable risk behaviors do not become better controlled, are described.
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Affiliation(s)
- Deepika R Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Elisabeth Biggs
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Jill Kaar
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Sherrie Khadanga
- Department of Medicine, Division of Cardiology, Larner College of Medicine, University of Vermont, Burlington, VT, United States of America
| | - Rocio Alman
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
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Clausen M, Romm KF, Berg CJ, Ciceron AC, Fuss C, Bennett B, Le D. Exploring young adults' e-cigarette use behavior during COVID-19. Tob Prev Cessat 2022; 8:45. [PMID: 36568488 PMCID: PMC9753572 DOI: 10.18332/tpc/155332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/11/2022] [Accepted: 10/29/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Changes in daily life related to COVID-19 have impacted e-cigarette use, particularly in young adults. This cross-sectional mixed-methods study explored young adults' perceptions regarding how COVID-19 influenced their e-cigarette use. METHODS We analyzed Fall 2020 survey data from 726 past 6-month e-cigarette users (mean age=24.15 years, 51.1% female, 35.5% sexual minority, 4.4% Black, 10.2% Asian, 12.1% Hispanic) and Spring 2021 semi-structured interview data among a subset of 40 participants (mean age=26.30 years, 35.0% female, 45.0% sexual minority, 5.0% Black, 22.5% Asian, 12.5% Hispanic). Participants were drawn from 6 metropolitan statistical areas with varied tobacco and cannabis legislative contexts. RESULTS Among survey participants, 44.4% also smoked cigarettes, 54.0% other tobacco products, and 60.1% used cannabis. They reported various changes in their daily lives, including changes in the nature and/or status of employment (e.g. 15.3% were laid off, 72.8% experienced household income loss). Regarding changes in e-cigarette use since COVID-19, 22.6% tried to cut down and 16.0% tried to quit. Interview participants commonly indicated that they increased their use due to stress, boredom, changes in accessibility, and/or changes to daily environment that made e-cigarette use more feasible. CONCLUSIONS Results highlight the importance of promoting opportunities for young adults to build relationships to decrease stress, foster a sense of belonging, and increase quality of life (e.g. increasing the accessibility to mental health and social support services, intentionally engaging young adults in pandemic-appropriate community-building and extracurricular activities). This research may help to inform future e-cigarette cessation interventions that consider the unique challenges of societal stressors, such as pandemics.
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Affiliation(s)
- Michelle Clausen
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington, United States
| | - Katelyn F. Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
| | - Annie C. Ciceron
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington, United States
| | - Caroline Fuss
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Daisy Le
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, Washington, United States
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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Austin-Datta RJ, Chaudhari PV, Cheng TYD, Klarenberg G, Striley CW, Cottler LB. Electronic Nicotine Delivery Systems (ENDS) use Among Members of a Community Engagement Program. J Community Health 2022; 48:338-346. [PMID: 36436165 PMCID: PMC9702843 DOI: 10.1007/s10900-022-01169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/28/2022]
Abstract
Electronic nicotine delivery systems (ENDS) are relatively new and ENDS use data from community engagement programs may help us understand usage patterns and facilitate targeted longitudinal studies. Community members in Florida, USA, were asked about ENDS use, tobacco use, and health history/concerns by Community Health Workers. Among 7253 members recruited during 2014 to 2021 into our HealthStreet program, 1177 had ever used ENDS; the proportion increased from 12 to 27% from 2014 to 2021 (adjusted odds ratio (aOR) 2.5; 95% CI 1.7-3.5; Ever versus never used ENDS). Ever tobacco use was strongly associated with ENDS use; 69% of ever users were current tobacco users. Demographic determinants (sex, age, race) and food insecurity were strongest predictors of ENDS use. Most who had ever used ENDS were aged 18-25 (aOR 5.9; 95% CI 4.6-7.6; vs. aged 60 + years), White (aOR 3.7; 95% CI 3.2-4.3; vs. Black/African American), male (aOR 1.5; 95% CI 1.3-1.7; vs. female), and recently food insecure (aOR 1.8; 95% CI 1.5-2.0; vs. not recently food insecure). Those with respiratory issues were more likely to have used ENDS compared to those without (aOR 2.0; 95% CI 1.6-2.6; aOR 1.3; 95% CI 1.1-1.5). Members concerned about hypertension were less likely to have used ENDS (aOR 0.7; 95% CI 0.5-0.9). In this relatively rural, micropolitan sample, tobacco use, socio-economic determinants, and certain health history/concerns were strongly associated with ENDS use. Community outreach approaches are needed to further understand these factors and implement interventions.
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Affiliation(s)
- Rebecca J Austin-Datta
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA.
| | - Piyush Vilas Chaudhari
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
| | - Ting-Yuan David Cheng
- Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus, OH, 43201, USA
| | - Geraldine Klarenberg
- UF/IFAS School of Forest, Fisheries, and Geomatics Sciences, Gainesville, FL, 32611, USA
| | - Catherine Woodstock Striley
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
| | - Linda B Cottler
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
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Tam CC, Qiao S, Garrett C, Zhang R, Aghaei A, Aggarwal A, Li X. Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.11.23.22282679. [PMID: 36451878 PMCID: PMC9709789 DOI: 10.1101/2022.11.23.22282679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( β s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( β s = -.61 to -.43, p s < .001). CONCLUSION Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Camryn Garrett
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Ran Zhang
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Atefeh Aghaei
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Abhishek Aggarwal
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I, 915 Greene Street, Columbia, SC, 29208, United States
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Sterling KL, Masyn K, Moore SP, Fryer CS, Trapl E, Shang C, Gunzler D. Tobacco Whack-A-Mole: A Consumption Taxonomy of Cigar & Other Combustible Tobacco Products among a Nationally Representative Sample of Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215248. [PMID: 36429968 PMCID: PMC9690741 DOI: 10.3390/ijerph192215248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/01/2022] [Accepted: 11/11/2022] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). METHODS Data come from the baseline C'RILLOS study, a U.S. nationally representative sample of young adults aged 18-34 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents' modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). RESULTS Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. DISCUSSION The tobacco use field currently classifies 'tobacco users' based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered 'discontinued use' and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.
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Affiliation(s)
- Kymberle Landrum Sterling
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Sciences Center, Dallas, TX 75207, USA
| | - Katherine Masyn
- Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Craig S. Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ce Shang
- Department of Internal Medicine, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA
| | - Douglas Gunzler
- Department of Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, OH 44106, USA
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Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study. Addict Behav Rep 2022; 16:100470. [PMCID: PMC9661417 DOI: 10.1016/j.abrep.2022.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in California in April 2021 were held to discuss tobacco and cannabis use patterns, adverse events, and the effect of COVID-19 on tobacco and cannabis product use. Factors affecting changes in use were largely similar between tobacco products and cannabis products. Drivers of increased cannabis use distinct from tobacco or nicotine product use included feeling greater freedom to disengage and perceptions of less harm. Increases in product use were a result of changing social environment, coping with emotional and psychological distress, and product related factors. Decreases in product use were a result of social isolation, COVID-19-related health concerns, disruptions in daily patterns of living, and reduced access. Improved understanding of how the pandemic has affected tobacco and cannabis use can inform tailored interventions to both support those who have decreases or quit and assist those who have increased use during the pandemic to reduce or cease their consumption.
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Chen-Sankey J, Cruz-Cano R, Pakdaman S, Wong N, Unger JB, Barrington-Trimis J, Pentz MA. Associations between living in localities with e-cigarette sales restrictions and e-cigarette use change among young adults in Los Angeles County. Tob Control 2022; 31:s187-s196. [PMID: 36328463 PMCID: PMC9639823 DOI: 10.1136/tc-2022-057478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Local e-cigarette sales restrictions (ESRs) may impact e-cigarette use. This study examined the associations between living in localities with various ESR policies and changes in e-cigarette use among young adults in Los Angeles (LA) County, California, USA. METHODS Data were from a cohort of LA County young adults (18-21 years; n=2100) who completed two waves of surveys (Fall 2018-Summer 2019 and Summer-Fall 2020). Local flavoured (n=9) and comprehensive (n=2) ESRs in LA County implemented between June 2019 and May 2020 were identified, coded and merged with the baseline data. Multivariable logistic regressions were used to examine the associations between living in ESR localities and e-cigarette use at follow-up, controlling for covariates and stratified by cigarette smoking at baseline. RESULTS Overall, 20.9% and 14.3% of participants lived in localities with flavoured and comprehensive ESRs, respectively. Participants who were non-Hispanic, had higher socioeconomic statuses and were currently using e-cigarettes were generally more likely to live in ESR localities than their counterparts. The associations between living in ESR localities and e-cigarette use at follow-up were not found among baseline non-e-cigarette users regardless of their cigarette smoking status; a positive relationship was found among baseline e-cigarette users who also smoked cigarettes but not among non-smokers. DISCUSSION Participants who lived in localities with various ESR policies were different in their baseline e-cigarette use and socioeconomic backgrounds. Future research examining the potential impact of ESRs on e-cigarette use change should consider the localities' overall sociodemographic and tobacco-using characteristics and individuals' cigarette smoking histories.
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Affiliation(s)
- Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Raul Cruz-Cano
- School of Public Health, University of Maryland at College Park, College Park, Maryland, USA
| | - Sheila Pakdaman
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Nicholas Wong
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Mary Ann Pentz
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Institute for Health Promotion and Disease Prevention Research, University of Southern California, Los Angeles, California, USA
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Bandi P, Asare S, Majmundar A, Xue Z, Han X, Westmaas JL, Nargis N, Jemal A. Changes in Smoking Cessation-Related Behaviors Among US Adults During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2225149. [PMID: 35913738 PMCID: PMC9344362 DOI: 10.1001/jamanetworkopen.2022.25149] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Smoking cessation is an urgent public health priority given that smoking is associated with increased risk of severe COVID-19 outcomes and other diseases. It is unknown how smoking cessation changed nationally during the COVID-19 pandemic. OBJECTIVE To investigate changes in smoking cessation-related behaviors in the US during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted using 2011 to 2020 data on 788 008 individuals who had smoked in the past year from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. Representative retail scanner sales data between January 2017 and July 2021 for 1004 unique nicotine replacement therapy (NRT) universal product codes in 31 US states from NielsenIQ were also used. EXPOSURES Calendar year and 4-week sales periods. MAIN OUTCOMES AND MEASURES Changes in annual self-reported prevalence of past-year quit attempts and recent successful cessation before (ie, 2011-2019) and during (ie, 2020) the COVID-19 pandemic and changes in sales volumes in millions of pieces of nicotine gum, lozenge, and patch brands before (1271 four-week sales periods between January 2017 and February 2020) and during (558 four-week sales periods between March 2020 and July 2021) the COVID-19 pandemic were calculated. RESULTS The 2011 to 2020 pooled BRFSS sample (response rate range, 45.2%-49.9%) included 788 008 respondents (243 061 individuals ages 25-44 years [weighted percentage, 42.5%]; 374 519 men [weighted percentage, 55.7%]). For the first time since 2011, annual past-year quit attempt prevalence decreased between 2019 and 2020, from 65.2% (95% CI, 64.5% to 65.9%) to 63.2% (95% CI, 62.3% to 64.0%), with the largest relative decreases among individuals ages 45 to 64 years (61.4% [95% CI, 60.3% to 62.5%] vs 57.7% [95% CI, 56.3% to 59.2%]), those with 2 or more comorbidities (67.1% [95% CI, 66.0% to 68.2%] to 63.0% [95% CI, 61.6% to 64.4%]), and Black individuals (72.5% [95% CI, 70.3 to 74.6] vs 68.4% [95% CI, 65.3% to 71.3%]). Recent successful cessation remained unchanged during 2019 to 2020. Observed mean (SD) 4-week NRT sales volume in the prepandemic period was 105.6 (66.2) million gum pieces, 51.9 (31.6) million lozenges, and 2.0 (1.1) million patches. Compared with expected sales, observed sales during the COVID-19 pandemic were lower by 13.0% (95% CI, -13.7% to -12.3%) for lozenges, 6.4% (95% CI, -7.3% to -5.5%) for patches, and 1.2% (95% CI, -1.7% to -0.7%) for gum. CONCLUSIONS AND RELEVANCE This study found that serious smoking cessation activity among US adults decreased immediately and remained depressed for more than a year during the COVID-19 pandemic. These findings suggest that smokers experiencing disproportionately negative outcomes during the pandemic should be reengaged and assisted in quit attempts.
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Affiliation(s)
- Priti Bandi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Samuel Asare
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Anuja Majmundar
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zheng Xue
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - J. Lee Westmaas
- Population Science, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Bandi P, Asare S, Majmundar A, Nargis N, Jemal A, Fedewa SA. Relative Harm Perceptions of E-Cigarettes Versus Cigarettes, U.S. Adults, 2018-2020. Am J Prev Med 2022; 63:186-194. [PMID: 35868816 DOI: 10.1016/j.amepre.2022.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION It is unknown how U.S. adults' relative harm perceptions of E-cigarettes versus cigarettes and associated behaviors changed during the E-cigarette or vaping product use‒associated lung injury epidemic (late 2019) and COVID-19 pandemic (since early 2020). METHODS Data from cross-sectional nationally representative Health Information National Trends Survey collected in 2018 (n=3,360), 2019 (n=3,217), and 2020 (n=3,677) (analyzed in 2021) were used to estimate changes in relative harm perceptions of E-cigarettes versus cigarettes (less harmful, as harmful, more harmful, don't know as a measure of uncertainty). In addition, changes in exclusive cigarette smoking, exclusive E-cigarette use, and dual use were estimated for each relative harm perception level. RESULTS Perceptions of E-cigarettes as more harmful than cigarettes doubled year on year, increasing most between 2019 and 2020 (2018: 6.8%, 2019: 12.8%, 2020: 28.3%), whereas uncertainty in relative harm declined (2018: 38.2%, 2019: 34.2%, 2020: 24.7%). Less harmful relative perceptions declined (2018:17.6%, 2019:15.3%, 2020:11.4%), whereas as harmful perceptions remained steady (2018: 37.4%, 2019: 37.7%, 2020: 35.6%). Exclusive cigarette smoking increased between 2019 and 2020 among those who perceived E-cigarettes as relatively more harmful (2018: 18.5%; 2019: 8.4%; 2020: 16.3%), exclusive E-cigarette use increased linearly among those who perceived them as relatively less harmful (7.9%, 15.3%, 26.7%), and dual use increased linearly in those who perceived them relatively as harmful (0.1%, 1.4%, 2.9%). CONCLUSIONS Perceptions of E-cigarettes as more harmful than cigarettes increased sharply between 2019 and 2020. Increases in tobacco product use were potentially guided by product-specific relative harm perceptions because changes occurred primarily in individuals who perceived their preferred product as relatively less harmful, suggesting the need for accurate messaging of relative and absolute product risks.
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Affiliation(s)
- Priti Bandi
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Samuel Asare
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Anuja Majmundar
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Stacey A Fedewa
- Department of Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
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Nkosi L, Odani S, Agaku IT. 20-Year Trends in Tobacco Sales and Self-Reported Tobacco Use in the United States, 2000-2020. Prev Chronic Dis 2022; 19:E45. [PMID: 35900882 PMCID: PMC9336190 DOI: 10.5888/pcd19.210435] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction In the past 2 decades, many tobacco control policies were enacted, and several new or modified products were introduced into the US marketplace. Continued tobacco surveillance is critical in this evolving landscape. We examined 20-year trends in tobacco use from sales and self-reported data. Methods We obtained data on taxable removals (sales) of cigarettes, cigars, roll-your-own (RYO) tobacco, and pipe tobacco from the US Department of the Treasury. We assessed self-reported past 30-day tobacco use from the National Survey on Drug Use and Health among people aged 18 years or older. Volume sales were standardized to cigarette packs and cigarette pack equivalents (CPEs) and trends measured by using joinpoint and logistic regression. Results From 2000 to 2019–2020, declines occurred in per capita sales of cigarettes (101.01 to 42.29 packs/capita), little cigars (0.54 to 0.03 CPEs/capita), and RYO tobacco (1.34 to 0.21 CPEs/capita). Volume sales also decreased for chewing tobacco and scotch/dry snuff (all P < .05). Conversely, volume sales increased for pipe tobacco, moist snuff, and snus for the respective assessed periods. Large cigar volume sales did not change significantly. We found consistent trends in self-reported use, except for RYO tobacco (decreased volume sales but increased self-reported use) and pipe smoking (increased volume sales, but trivial self-reported use <1% throughout the study period). Current use of any tobacco product decreased from 32.2% to 22.9% during the assessed period. Conclusion Harmonizing the tax and regulatory structure within and across the diversity of tobacco products may help reduce aggregate tobacco consumption in the US.
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Affiliation(s)
- Lungile Nkosi
- Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Satomi Odani
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Israel T Agaku
- Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115.
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Dasgupta N, Morabia A. Experimental Forum 2: Two Years After the 2020 Food and Drug Administration Guidance on E-Cigarette Flavors. Am J Public Health 2022; 112:995-998. [PMID: 35728030 PMCID: PMC9222451 DOI: 10.2105/ajph.2022.306921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Nabarun Dasgupta
- Nabarun Dasgupta is with the Gillings School of Global Public Health, University of North Carolina at Chapel Hill and is an AJPH associate editor. Alfredo Morabia is the AJPH editor in chief and is with the Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Flushing, and the Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY
| | - Alfredo Morabia
- Nabarun Dasgupta is with the Gillings School of Global Public Health, University of North Carolina at Chapel Hill and is an AJPH associate editor. Alfredo Morabia is the AJPH editor in chief and is with the Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Flushing, and the Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY
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Goldman N, Andrasfay T. Life expectancy loss among Native Americans during the COVID-19 pandemic. DEMOGRAPHIC RESEARCH 2022; 47:233-246. [PMID: 36506651 PMCID: PMC9733701 DOI: 10.4054/demres.2022.47.9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There has been little systematic research on the mortality impact of COVID-19 in the Native American population. OBJECTIVE We provide estimates of loss of life expectancy in 2020 and 2021 relative to 2019 for the Native American population. METHODS We use data on age-specific all-cause mortality rates from CDC WONDER and the 2019 life table recently released by the National Vital Statistics System for Native Americans to calculate life tables for the Native American population in 2020 and 2021 and to obtain estimates of life expectancy reductions during the COVID-19 pandemic. RESULTS The pandemic has set Native Americans further behind other major racial/ethnic groups in terms of life expectancy. The estimated loss in life expectancy at birth for Native Americans is 4.5 years in 2020 and 6.4 years in 2021 relative to 2019. CONCLUSIONS These results underscore the disproportionate share of deaths experienced by Native Americans: a loss in life expectancy at birth in 2020 that is more than three years above that for Whites and about 1.5 years above the losses for the Black and Latino populations. Despite a successful vaccination campaign among Native Americans, the estimated loss in life expectancy at birth in 2021 unexpectedly exceeds that in 2020. CONTRIBUTION The increased loss in life expectancy in 2021, despite higher vaccination rates than in other racial/ethnic groups, highlights the huge challenges faced by Native Americans in their efforts to control the deleterious consequences of the pandemic.
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Affiliation(s)
- Noreen Goldman
- Office of Population Research and Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
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43
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Goldman N, Andrasfay T. Life Expectancy Loss among Native Americans During the COVID-19 Pandemic. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.03.15.22272448. [PMID: 35313582 PMCID: PMC8936100 DOI: 10.1101/2022.03.15.22272448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND There has been little systematic research on the mortality impact of COVID-19 in the Native American population. OBJECTIVE We provide estimates of loss of life expectancy in 2020 and 2021 for the Native American population. METHODS We use data on age-specific all-cause mortality rates from CDC WONDER and the 2019 life table recently released by the National Vital Statistics System for Native Americans to calculate life tables for the Native American population in 2020 and 2021 and obtain estimates of life expectancy reductions during the COVID-19 pandemic. RESULTS The pandemic has set Native Americans further behind other major racial/ethnic groups in terms of life expectancy: the estimated loss in life expectancy at birth for Native Americans is 4.5 years in 2020 and 6.4 years in 2021. CONCLUSIONS These results underscore the disproportionate share of deaths experienced by Native Americans: a loss in life expectancy at birth in 2020 that is more than three years larger than that for Whites and about 1.5 years greater than the losses for the Black and Latino populations. Despite a successful vaccination campaign among Native Americans, the estimated loss in life expectancy at birth in 2021 unexpectedly exceeds that in 2020. Contribution: The increased loss in life expectancy in 2021, despite higher vaccination rates than in other racial/ethnic groups, highlights the huge challenges faced by Native Americans in their efforts to control the deleterious consequences of the pandemic.
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Affiliation(s)
- Noreen Goldman
- Office of Population Research School of Public and International Affairs Princeton University
| | - Theresa Andrasfay
- Leonard Davis School of Gerontology University of Southern California
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44
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Agaku IT, Nkosi L, Agaku QD, Gwar J, Tsafa T. A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons From Statewide T21 Policies: Findings From Population-Level Surveys. Prev Chronic Dis 2022; 19:E29. [PMID: 35653765 PMCID: PMC9165472 DOI: 10.5888/pcd19.210430] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND On December 20, 2019, the minimum age for purchasing tobacco in the US was raised nationally to 21 years. We evaluated this law (Tobacco 21 [T21]) 1 year after implementation. We also compared states with versus without T21 policies during 2019 to explore potential equity impacts of T21 policies. METHODS We examined shifts in tobacco access among 6th through 12th graders using the National Youth Tobacco Survey. To explore equity of state T21 policies among youths and young adults, the associations with tobacco use were explored separately for race and ethnicity by using data from the 2019 Behavioral Risk Factor Surveillance System (for persons aged 18 to 20 years) and the 2019 Youth Risk Behavior Survey (for high school students). RESULTS The overall percentage of 6th to 12th graders perceiving that it was easy to buy tobacco products from a store decreased from 2019 (67.2%) to 2020 (58.9%). However, only 17.0% of students who attempted buying cigarettes in 2020 were unsuccessful because of their age. In the 2019 BRFSS, those aged 18 to 20 years living in a state with T21 policies had a lower likelihood of being a current cigarette smoker (adjusted prevalence ratio [APR], 0.58) or smoking cigarettes daily (APR, 0.41). Similar significant associations were seen when analyses were restricted to only non-Hispanic White participants but not for participants who were non-Hispanic Black, non-Hispanic Asian, Hispanic, or of other races or ethnicities. Consistent findings were seen among high school students. CONCLUSION Greater compliance with the federal T21 law is needed as most youth who attempted buying cigarettes in 2020 were successful. Comparative analysis of states with versus states without statewide T21 policies in 2019 suggest the policies were differentially more protective of non-Hispanic White participants than other participants. Equitable and intensified enforcement of T21 policies can benefit public health.
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Affiliation(s)
- Israel T Agaku
- Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115.
| | - Lungile Nkosi
- Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | | | - Joy Gwar
- Federal Medical Center, Makurdi, Benue, Nigeria
| | - Tina Tsafa
- Federal Medical Center, Makurdi, Benue, Nigeria
- Benue State University, Makurdi, Benue, Nigeria
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45
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Chagué F, Boulin M, Eicher JC, Bichat F, Saint-Jalmes M, Cransac A, Soudry A, Danchin N, Laurent G, Cottin Y, Zeller M. Smoking in Patients With Chronic Cardiovascular Disease During COVID-19 Lockdown. Front Cardiovasc Med 2022; 9:845439. [PMID: 35557527 PMCID: PMC9086588 DOI: 10.3389/fcvm.2022.845439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/14/2022] [Indexed: 01/04/2023] Open
Abstract
Objectives This cross-sectional study aims to investigate health-related behaviors including tobacco consumption among patients with cardiovascular diseases (CVD), during the first COVID-19-related lockdown. Methods After 5 weeks of COVID-19 lockdown, 220 patients with chronic coronary syndromes (CCS) and 124 with congestive heart failure (CHF) answered a phone questionnaire. Results Among these 344 patients, 43 (12.5%) were current smokers, and none had quit during the lockdown. When compared with non-smokers, smokers were 15 years younger, more often diabetic, more likely to live in an urban than a rural lockdown location, and more often in the CCS cohort (p = 0.011). Smokers described greater psychological impairment, but their rates of decrease in physical activity and of increase in screen time were similar to non-smokers. More than one-third (13/43) increased their tobacco consumption, which was mainly related to stress or boredom, but not driven by media messages on a protective effect of nicotine. Conclusions During the first COVID-19 lockdown, we found a decrease in favorable lifestyle behaviors among patients with CVD. Strikingly, one-third of smokers with CCS or CHF increased their tobacco consumption. Given the major impact of persistent smoking in patients with CVD, this highlights the need for targeted prevention strategies, in particular during such periods.
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Affiliation(s)
- Frédéric Chagué
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France.,Réseau Français d'Excellence de Recherche sur le tabac, la nicotine et les produits connexes, Paris, France
| | - Mathieu Boulin
- Département de Pharmacie, Centre Hospitalier Universitaire, Dijon, France
| | | | - Florence Bichat
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | | | - Amélie Cransac
- Département de Pharmacie, Centre Hospitalier Universitaire, Dijon, France
| | - Agnès Soudry
- Département de Recherche Clinique, Centre Hospitalier Universitaire, Dijon, France
| | - Nicolas Danchin
- Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France
| | - Gabriel Laurent
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | - Yves Cottin
- Service de Cardiologie, Centre Hospitalier Universitaire, Dijon, France
| | - Marianne Zeller
- Réseau Français d'Excellence de Recherche sur le tabac, la nicotine et les produits connexes, Paris, France.,PEC2, EA 7460, Université Bourgogne Franche-Comté, Dijon, France
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46
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Wang X, Ma Z, Wang C. A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105979. [PMID: 35627516 PMCID: PMC9141667 DOI: 10.3390/ijerph19105979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China;
| | - Zaifei Ma
- School of Statistics, Renmin University of China, Beijing 100872, China;
| | - Chunan Wang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beihang Hangzhou Innovation Institute Yuhang, Hangzhou 310023, China
- MoE Key Laboratory of Complex System Analysis and Management Decision, Beijing 100191, China
- Correspondence:
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47
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Streck JM, Regan S, Bearnot B, Gupta PS, Kalkhoran S, Kalagher KM, Wakeman S, Rigotti NA. Prevalence of Cannabis Use and Cannabis Route of Administration among Massachusetts Adults in Buprenorphine Treatment for Opioid Use Disorder. Subst Use Misuse 2022; 57:1104-1110. [PMID: 35410577 PMCID: PMC10091221 DOI: 10.1080/10826084.2022.2063899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Recent prevalence estimates of cannabis use among individuals receiving medication treatment for OUD (MOUD) are lacking, and no study has characterized cannabis route of administration (cROA) in this population. These knowledge gaps are relevant because cannabis' effects and health outcomes vary by cROA and the availability and perceptions of cROA (e.g., vaping devices) are changing. METHODS The Vaping In Buprenorphine-treated patients Evaluation (VIBE) cross-sectional survey assessed the prevalence and correlates of cannabis use and cROA among adults receiving buprenorphine MOUD from 02/20 to 07/20 at five community health centers in Massachusetts, a state with legal recreational and medical cannabis use. RESULTS Among the 92/222 (41%) respondents reporting past 30-day cannabis use, smoking was the most common cROA (75%), followed by vaping (38%), and eating (26%). Smoking was more often used as a single cROA vs. in combination others (p = 0.01), whereas vaping, eating, and dabbing were more often used in combination with another cROA (all p < 0.05). Of the 39% of participants reporting multiple cROA, smoking and vaping (61%), and smoking and eating (50%), were the most prevalent combinations. Nonwhite race (vs. white) and current cigarette smoking (vs. no nicotine use) were associated with past 30-day cannabis use in multiple logistic regression. CONCLUSIONS Prevalence of past 30-day cannabis use among individuals receiving buprenorphine MOUD in Massachusetts in 2020 was nearly double the prevalence of cannabis use in Massachusetts' adult general population in 2019 (21%). Our data are consistent with state and national data showing smoking as the most common cROA.
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Affiliation(s)
- Joanna M Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Regan
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Priya S Gupta
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly M Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah Wakeman
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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48
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Clendennen SL, Case KR, Sumbe A, Mantey DS, Mason EJ, Harrell MB. Stress, Dependence, and COVID-19-related Changes in Past 30-day Marijuana, Electronic Cigarette, and Cigarette Use among Youth and Young Adults. Tob Use Insights 2021; 14:1179173X211067439. [PMID: 34987299 PMCID: PMC8721399 DOI: 10.1177/1179173x211067439] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/29/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Studies show smoking and vaping behaviors increase risk of contracting and worse symptoms of COVID-19. This study examines whether past 30-day youth and young adult users of marijuana, e-cigarettes, and cigarettes self-reported changes in their use of these substances due to the COVID-19 pandemic; and cross-sectional associations between perceived stress, nicotine or marijuana dependence, and COVID-19-related changes in use. METHODS Participants were 709 past 30-day self-reported substance users from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS; mean age = 19; 58% female; 38% Hispanic, 35% white). Multiple logistic regression models assessed cross-sectional associations between perceived stress and dependence and increased, decreased, or sustained past 30-day use of marijuana, e-cigarettes, and cigarettes due to COVID-19 (e.g., "Has your marijuana use changed due to the COVID-19 outbreak?"). Covariates included age, race/ethnicity, socio-economic status (SES), dependence (exposure: stress), and stress (exposure: dependence). RESULTS Most participants reported sustained (41%, 43%, 49%) or increased (37%, 34%, 25%) use of marijuana, e-cigarettes, and cigarettes due to COVID-19, respectively. Participants who reported symptoms of dependence were significantly more likely than their non-dependent peers to report increasing their marijuana (AOR: 1.66; 95% CI: 1.15-2.39) and e-cigarette (AOR: 2.57; 95% CI: 1.38-4.77) use. Those who reported higher perceived stress were significantly more likely to report increasing their marijuana use (AOR: 1.55; 95% CI: 1.01-2.42). CONCLUSIONS Most youth and young adults did not decrease their substance use amid a global, respiratory disease pandemic. Health messaging and interventions that address the health effects of smoking and vaping as well as factors like stress and dependence that may be barriers to decreasing use are vital in curbing the COVID-19 pandemic.
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Affiliation(s)
- Stephanie L Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Austin, TX, USA
| | - Kathleen R Case
- Center for Research to Advance Community Health (ReACH), UTHealth San Antonio, San Antonio, TX, USA
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Austin, TX, USA
| | - Dale S Mantey
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Austin, TX, USA
| | - Emily J Mason
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Austin, TX, USA
| | - Melissa B Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Austin, TX, USA
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