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Strong DR, Leas E, Noble M, White M, Glasser A, Taylor K, Edwards KC, Frissell KC, Compton WM, Conway KP, Lambert E, Kimmel HL, Silveira ML, Hull LC, van Bemmel D, Schroeder MJ, Cummings KM, Hyland A, Feng J, Blount B, Wang L, Niaura R. Validation of the Wave 1 and Wave 2 Population Assessment of Tobacco and Health (PATH) Study Indicators of Tobacco Dependence Using Biomarkers of Nicotine Exposure Across Tobacco Products. Nicotine Tob Res 2022; 24:10-19. [PMID: 34383052 PMCID: PMC8666120 DOI: 10.1093/ntr/ntab162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examined the predictive relationships between biomarkers of nicotine exposure and 16-item self-reported level of tobacco dependence (TD) and subsequent tobacco use outcomes. AIMS AND METHODS The Population Assessment of Tobacco and Health (PATH) Study surveyed adult current established tobacco users who provided urine biospecimens at Wave 1 (September 2013-December 2014) and completed the Wave 2 (October 2014-October 2015) interview (n = 6872). Mutually exclusive user groups at Wave 1 included: Cigarette Only, E-cigarette Only, Cigar Only, Hookah Only, Smokeless Tobacco Only, Cigarette Plus E-cigarette, multiple tobacco product users who smoked cigarettes, and multiple tobacco product users who did not smoke cigarettes. Total Nicotine Equivalents (TNE-2) and TD were measured at Wave 1. Approximate one-year outcomes included frequency/quantity used, quitting, and adding/switching to different tobacco products. RESULTS For Cigarette Only smokers and multiple tobacco product users who smoked cigarettes, higher TD and TNE-2 were associated with: a tendency to smoke more, smoking more frequently over time, decreased likelihood of switching away from cigarettes, and decreased probability of quitting after one year. For other product user groups, Wave 1 TD and/or TNE-2 were less consistently related to changes in quantity and frequency of product use, or for adding or switching products, but higher TNE-2 was more consistently predictive of decreased probability of quitting. CONCLUSIONS Self-reported TD and nicotine exposure assess common and independent aspects of dependence in relation to tobacco use behaviors for cigarette smokers. For other product user groups, nicotine exposure is a more consistent predictor of quitting than self-reported TD. IMPLICATIONS This study suggests that smoking cigarettes leads to the most coherent pattern of associations consistent with a syndrome of TD. Because cigarettes continue to be prevalent and harmful, efforts to decrease their use may be accelerated via conventional means (eg, smoking cessation interventions and treatments), but also perhaps by decreasing their dependence potential. The implications for noncombustible tobacco products are less clear as the stability of tobacco use patterns that include products such as e-cigarettes continue to evolve. TD, nicotine exposure measures, and consumption could be used in studies that attempt to understand and predict product-specific tobacco use behavioral outcomes.
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Affiliation(s)
- David R Strong
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Eric Leas
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Madison Noble
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Martha White
- Cancer Prevention & Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Allison Glasser
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
| | | | | | | | | | - Kevin P Conway
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, USA
| | | | | | - Marushka L Silveira
- National Institute on Drug Abuse (NIDA/NIH), Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Lynn C Hull
- Center for Tobacco Products, FDA, Silver Spring, MD, USA
| | | | | | | | | | - June Feng
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin Blount
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lanqing Wang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ray Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
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O'Connor R, Watson CH, Swan GE, Nettles DS, Geisler RC, Hendershot TP. PhenX: Agent measures for tobacco regulatory research. Tob Control 2020; 29:s20-s26. [PMID: 31992660 PMCID: PMC8127628 DOI: 10.1136/tobaccocontrol-2019-054976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/04/2019] [Accepted: 02/11/2019] [Indexed: 11/04/2022]
Abstract
The current paper describes the PhenX (Phenotypes and eXposures) Toolkit Tobacco Regulatory Research Agent specialty area and the Agent Working Group's (WG's) 6-month consensus process to identify high-priority, scientifically supported measures for cross-study comparison and analysis. Eleven measures were selected for inclusion in the Toolkit. Eight of these are interviewer-administered or self-administered protocols: history of switching to lower tar and nicotine cigarettes, passive exposures to tobacco products, tobacco brand and variety (covering cigars, cigarettes and smokeless tobacco separately), tobacco product adulteration (vent-blocking or filter-blocking) and tobacco warning label exposure and recall. The remaining three protocols are either laboratory-based or visual inspection-based: measurement of nicotine content in smoked or smokeless tobacco products and the physical properties of these two classes of products. Supplemental protocols include a biomarker of exposure and smoking topography. The WG identified the lack of standard measurement protocols to assess subjective ratings of tobacco product flavours and their appeal to consumers as a major gap. As the characteristics of tobacco products that influence perception and use are tobacco regulatory research priorities, the reliable assessment of flavours remains an area requiring further development.
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Affiliation(s)
- Richard O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Clifford H Watson
- NCED/DLS/ERAT, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gary E Swan
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
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Omotoso GO, Kadir RE, Sulaimon FA, Jaji-Sulaimon R, Gbadamosi IT. Prenatal Exposure to Gestational Nicotine before Neurulation is Detrimental to Neurodevelopment of Wistar Rats' Offspring. Malays J Med Sci 2018; 25:35-47. [PMID: 30914861 PMCID: PMC6419881 DOI: 10.21315/mjms2018.25.5.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/14/2018] [Indexed: 12/26/2022] Open
Abstract
Background and aim This study aimed to determine the effect of gestational nicotine exposure before neurodevelopment on the morphology and histology of the prefrontal cortex (PFC) in rats. Methodology Adult female Wistar rats were time-mated and grouped into three categories: (a) control-given 0.1 mL of normal saline, (b) low-dose nicotine-given 6.88 mg/ kg/d/0.05 mL, and (c) high-dose nicotine-given 13.76 mg/kg/d/0.1 mL in two divided doses. Treatment was given intraperitoneally from gestational days 2 to 6. On postnatal day 15 (P15), the pups were separated from their mothers, anaesthetised and sacrificed, followed by intracardial perfusion with 4% paraformaldehyde. PFC was excised from the brain and processed for tissue histology, histochemistry, and morphology of brain cells. Results Gestational nicotine exposure during the first week of gestation in rats significantly reduced birth weights in nicotine-treated groups compared with control; it, however, accelerated body weights, altered neuronal morphology, and elevated astrocytic count significantly, while oligodendroglial count was slightly increased in the PFC of juvenile rats examined at P15. Conclusion These alterations revealed that gestational nicotine exposure before the commencement of the cellular processes involved in brain development negatively affects neurodevelopment, and this could result in neurological dysfunctions in later life.
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Affiliation(s)
- Gabriel Olaiya Omotoso
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Risikat Eniola Kadir
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Fatima A Sulaimon
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Rukayat Jaji-Sulaimon
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Ismail Temitayo Gbadamosi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
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MicroRNAs in Smoking-Related Carcinogenesis: Biomarkers, Functions, and Therapy. J Clin Med 2018; 7:jcm7050098. [PMID: 29723992 PMCID: PMC5977137 DOI: 10.3390/jcm7050098] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/21/2018] [Accepted: 04/25/2018] [Indexed: 12/11/2022] Open
Abstract
Long-term heavy cigarette smoking is a well-known high-risk factor for carcinogenesis in various organs such as the head and neck, lungs, and urinary bladder. Furthermore, cigarette smoking can systemically accelerate aging, and as the result, promoting carcinogenesis via changing the host microenvironment. Various inflammatory factors, hormones, and chemical mediators induced by smoking mediate carcinoma-related molecules and induce carcinogenesis. MicroRNAs (miRNAs) are a family of short noncoding RNA molecules that bind to mRNAs and inhibit their expression. Cigarette smoke induces the expression of various miRNAs, many of which are known to function in the post-transcriptional silencing of anticancer molecules, thereby leading to smoking-induced carcinogenesis. Analysis of expression profiles of smoking-induced miRNAs can help identify biomarkers for the diagnosis and prognosis of smoking-related cancers and prediction of therapeutic responses, as well as revealing promising therapeutic targets. Here, we introduce the most recent and useful findings of miRNA analyses focused on lung cancer and urinary bladder cancer, which are strongly associated with cigarette smoking, and discuss the utility of miRNAs as clinical biomarkers.
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Abstract
INTRODUCTION Firearm violence injures or kills 100,000 Americans each year. This paper applies the Host-Agent-Vector-Environment model to this issue. Research on firearm violence tends to focus on two elements-the host (i.e., victims of firearm violence) and the environment (i.e., gun policies)-but little attention has been paid to the agent (the gun and ammunition) or the vector (firearm manufacturers, dealers, and the industry lobby). METHODS Using Bureau of Alcohol, Tobacco, Firearms and Explosives data, trends in firearm manufacturing were investigated from 1990 to 2015. Outcome measures included: (1) trends in domestic gun manufacturing by weapon type; (2) trends in production by firearm caliber; and (3) 2015 market share by type of firearm and company. Data were collected and analyzed in 2016. RESULTS Overall domestic firearms production decreased slightly from 1996 through 2004, and then steadily increased from 1.7% in 2005 to 13.8% in 2013, when >10 million firearms were produced for the domestic market. The increase in total firearm production was driven by the increased production of pistols and rifles. Within the pistol category, increased production was attributable to an increase in higher caliber weapons. Similar trends were observed in gun purchases and recovered and traced crime guns. CONCLUSIONS Trends in firearm manufacturing reveal a shift toward more-lethal weapons, and this trend is also observed in gun purchases and crime gun traces. This may reflect a societal shift in cultural practices and norms related to guns and could inform strategies to reduce firearm violence.
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Chung CJ, Chang CH, Liou SH, Liu CS, Liu HJ, Hsu LC, Chen JS, Lee HL. Relationships among DNA hypomethylation, Cd, and Pb exposure and risk of cigarette smoking-related urothelial carcinoma. Toxicol Appl Pharmacol 2016; 316:107-113. [PMID: 28025111 DOI: 10.1016/j.taap.2016.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/06/2016] [Accepted: 12/22/2016] [Indexed: 01/14/2023]
Abstract
Cigarette smoking and environmental exposure to heavy metals are important global health issues, especially for urothelial carcinoma (UC). However, the effects of cadmium and lead exposure, as well as the levels of DNA hypomethylation, on UC risk are limited. We evaluated the possible exposure sources of Cd and Pb and the relationship among DNA hypomethylation, urinary Cd and Pb levels, and UC risk. We recruited 209 patients with UC and 417 control patients for a hospital-based case-control study between June 2011 and August 2014. We collected environmental exposure-related information with questionnaires. Blood and urine samples were analyzed to measure the Cd and Pb exposure and 5-methyl-2'-deoxycytidine levels as a proxy for DNA methylation. Multivariate logistic regression and 95% confidence intervals were applied to estimate the risk for UC. Study participants with high Cd and Pb exposure in blood or urine had significantly increased risk of UC, especially among the smokers. After adjusting for age and gender, the possible connections of individual cumulative cigarette smoking or herb medicine exposure with the increased levels of Cd and Pb were observed in the controls. Participants with 8.66%-12.39% of DNA hypomethylation had significantly increased risk of UC compared with those with ≥12.39% of DNA hypomethylation. Environmental factors including cigarette smoking and herb medicine may contribute to the internal dose of heavy metals levels. Repeat measurements of heavy metals with different study design, detailed dietary information, and types of herb medicine should be recommended for exploring UC carcinogenesis in future studies.
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Affiliation(s)
- Chi-Jung Chung
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University and Hospital, Taichung, Taiwan
| | - Chao-Hsiang Chang
- Department of Urology, China Medical University and Hospital, Taichung, Taiwan; Department of Medicine, College of Medicine, China Medical University and Hospital, Taichung, Taiwan
| | - Saou-Hsing Liou
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University and Hospital, Taichung, Taiwan
| | - Huei-Ju Liu
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Li-Ching Hsu
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan
| | - Jhih-Sheng Chen
- Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hui-Ling Lee
- Department of Chemistry, Fu Jen Catholic University, New Taipei City, Taiwan.
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Effect of prenatal exposure to nicotine/thiocyanate on the pituitary–adrenal axis of 1-month-old rat offspring. ACTA ACUST UNITED AC 2016. [DOI: 10.1097/01.ehx.0000512120.79296.60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chang CH, Liu CS, Liu HJ, Huang CP, Huang CY, Hsu HT, Liou SH, Chung CJ. Association between levels of urinary heavy metals and increased risk of urothelial carcinoma. Int J Urol 2015; 23:233-9. [PMID: 26663353 DOI: 10.1111/iju.13024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate possible sources of exposure to heavy metals in the general population, and to determine the association between urinary heavy metals and urothelial carcinoma risk. METHODS We recruited 205 patients with urothelial carcinoma and 406 control participants for a case-control study between June 2011 and December 2013. The control participants were frequency-matched with cases according to sex and age. We measured the urinary levels of arsenic, cadmium, chromium, nickel and lead by using inductively coupled plasma mass spectrometry. We collected environmental exposure-related information through questionnaires. Multivariate logistic regression and 95% confidence intervals were applied to estimate the urothelial carcinoma risk and potential effects of urothelial carcinoma-related risk factors on the levels of urinary heavy metals. RESULTS Patients with urothelial carcinoma showed higher urinary levels of arsenic, cadmium, chromium, nickel and lead than the controls. After considering other potential risk factors, a significantly increased risk for urothelial carcinoma was observed in patients with increased urinary levels of cadmium, chromium, nickel and lead. Smokers showed a high urinary cadmium level. In addition to cadmium, a high urinary lead level was associated with cumulative cigarette smoking and herbal medicine use. CONCLUSION Environmental factors might contribute to higher urinary levels of heavy metals and ultimately result in urothelial carcinoma carcinogenesis. These findings can promote proper environmental surveillance of exposure to heavy metals in the general population.
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Affiliation(s)
- Chao-Hsiang Chang
- Department of Medicine, China Medical University and Hospital, Taichung, Taiwan.,Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- Department of Medicine, China Medical University and Hospital, Taichung, Taiwan.,Department of Family Medicine, China Medical University and Hospital, Taichung, Taiwan
| | - Huei-Ju Liu
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chi-Ping Huang
- Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Tsung Hsu
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan
| | - Saou-Hsing Liou
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chi-Jung Chung
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Exposure to nicotine increases dopamine receptor content in the mesocorticolimbic pathway of rat dams and offspring during lactation. Pharmacol Biochem Behav 2015. [DOI: 10.1016/j.pbb.2015.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Younesi E, Ansari S, Guendel M, Ahmadi S, Coggins C, Hoeng J, Hofmann-Apitius M, Peitsch MC. CSEO - the Cigarette Smoke Exposure Ontology. J Biomed Semantics 2014; 5:31. [PMID: 25093069 PMCID: PMC4120729 DOI: 10.1186/2041-1480-5-31] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 07/03/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In the past years, significant progress has been made to develop and use experimental settings for extensive data collection on tobacco smoke exposure and tobacco smoke exposure-associated diseases. Due to the growing number of such data, there is a need for domain-specific standard ontologies to facilitate the integration of tobacco exposure data. RESULTS The CSEO (version 1.0) is composed of 20091 concepts. The ontology in its current form is able to capture a wide range of cigarette smoke exposure concepts within the knowledge domain of exposure science with a reasonable sensitivity and specificity. Moreover, it showed a promising performance when used to answer domain expert questions. The CSEO complies with standard upper-level ontologies and is freely accessible to the scientific community through a dedicated wiki at https://publicwiki-01.fraunhofer.de/CSEO-Wiki/index.php/Main_Page. CONCLUSIONS The CSEO has potential to become a widely used standard within the academic and industrial community. Mainly because of the emerging need of systems toxicology to controlled vocabularies and also the lack of suitable ontologies for this domain, the CSEO prepares the ground for integrative systems-based research in the exposure science.
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Affiliation(s)
- Erfan Younesi
- Fraunhofer Institute for Algorithms and Scientific Computing SCAI, Schloss Birlinghoven, 53754 Sankt Augustin, Germany
| | - Sam Ansari
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000 Neuchâtel, Switzerland
| | - Michaela Guendel
- Fraunhofer Institute for Algorithms and Scientific Computing SCAI, Schloss Birlinghoven, 53754 Sankt Augustin, Germany
| | - Shiva Ahmadi
- Fraunhofer Institute for Algorithms and Scientific Computing SCAI, Schloss Birlinghoven, 53754 Sankt Augustin, Germany
| | - Chris Coggins
- Carson Watts Consulting, 1266 Carson Watts Rd, King, NC 27021-7453, USA
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000 Neuchâtel, Switzerland
| | - Martin Hofmann-Apitius
- Fraunhofer Institute for Algorithms and Scientific Computing SCAI, Schloss Birlinghoven, 53754 Sankt Augustin, Germany
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000 Neuchâtel, Switzerland
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Giovino GA, Kulak JA, Kalsbeek WD, Leischow SJ. Research priorities for FCTC Articles 20, 21, and 22: surveillance/evaluation and information exchange. Nicotine Tob Res 2013; 15:847-61. [PMID: 23335488 PMCID: PMC3601915 DOI: 10.1093/ntr/nts336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 11/19/2012] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Framework Convention on Tobacco Control (FCTC) Articles 20, 21, and 22 call for strong monitoring and reporting of tobacco use and factors influencing use and disease (Articles 20 and 21) and for collaboration among the Parties and relevant organizations to share resources, knowledge, and expertise on all relevant tobacco control strategies (Article 22). METHODS This paper provides background information and discusses research strategies that would strengthen these efforts and better inform the parties. By necessity, Articles 20 and 21 are discussed separately from Article 22, although 1 example that relates to both 20/21 and 22 is discussed at the end. RESULTS Twelve important research opportunities on surveillance and evaluation are recognized, along with 4 on collaboration. The authors believe that the 6 most important areas for research would study (a) possible underreporting of tobacco use among certain demographic groups in some countries, (b) measures of industry activities, (c) optimal sampling strategies, (d) sentinel surveillance, (e) networks of tobacco companies and their partners as they promote tobacco use and interfere with implementation of the FCTC, and (f) network/relationship factors that impact diffusion of knowledge and decision making on the implementation of the FCTC. In addition, we call for a review process of existing surveillance and evaluation strategies to coordinate activities to make optimal use of existing resources. This activity would involve networking as prescribed in Article 22. CONCLUSIONS Studies and activities such as these would facilitate control of the tobacco epidemic.
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Affiliation(s)
- Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Saunders C, Geletko K. Adolescent cigarette smokers' and non-cigarette smokers' use of alternative tobacco products. Nicotine Tob Res 2012; 14:977-85. [PMID: 22318693 DOI: 10.1093/ntr/ntr323] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study uses the most recent data from the nationally representative National Youth Tobacco Survey (NYTS) to examine the use of alternative tobacco products among U.S. cigarette smokers and non-cigarette smokers aged 14-17. Alternative tobacco product use is defined as use of one or more of the following products: smokeless tobacco, cigars, pipes, bidis, or kreteks. METHODS Using the results from the 2004, 2006, and 2009 NYTS, multivariate logistic regressions were used to investigate separately the extent of alternative tobacco product use in current cigarette smokers and in those who reported not smoking cigarettes controlling for demographic and other independent influences. RESULTS The results indicate that for adolescent smokers and nonsmokers, the use of one type of alternative tobacco product made it much more likely the individual would use one or more of the other alternative tobacco products. Non-cigarette smokers using these tobacco products appeared to exhibit symptoms of nicotine dependence comparable to those of cigarette smokers. CONCLUSIONS More information on adolescent use of alternative tobacco products is needed. Current cigarette use declined 3.4% annually over 2004-2009 for the NYTS 14- to 17-year-old population, but this cohort's use of alternative tobacco products was unchanged. The number of adolescents aged 14-17 who did not smoke cigarettes but used alternative tobacco products increased 5.9% per year over the same period. Current surveillance measures need to be expanded in order to gain a more comprehensive understanding of adolescent alternative tobacco use.
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Affiliation(s)
- Charles Saunders
- Division of Health Affairs, College of Medicine, Florida State University, 1115 W. Call Street, Tallahassee, FL 32306, USA.
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O'Connor RJ. Postmarketing surveillance for "modified-risk" tobacco products. Nicotine Tob Res 2012; 14:29-42. [PMID: 21330282 PMCID: PMC3242968 DOI: 10.1093/ntr/ntq243] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 12/10/2010] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The U.S. Food and Drug Administration (FDA) acquired authority to regulate tobacco products in 2009. This authority will provide a structured process for manufacturers to introduce products that may have "modified-risk" for morbidity or mortality relative to traditional tobacco products, with postmarketing surveillance and studies a condition of marketing. METHOD A narrative review approach was taken. The author searched and integrated publicly accessible literature on tobacco product surveillance as well as drug and medical device postmarket activities currently performed by FDA. RESULTS FDA relies on active and passive methods for postmarket surveillance and can require specific studies and risk evaluation and mitigation strategies for certain products, including those with abuse liability. Past efforts at examining the individual and population effects of reduced harm tobacco products provide an example of integrating different data streams. DISCUSSION Postmarket surveillance can be viewed in terms of the Agent-Host-Vector-Environment model, and concepts from diffusion of innovations are relevant to understanding factors associated with the adoption of new products by the population. Given that active and passive surveillance approaches have different strengths and weaknesses, multiple approaches may be necessary to evaluate population-level effects. Assuring that required studies are properly conducted and reported and that data indicating significant public health harms are quickly recognized will be important going forward. CONCLUSIONS The advent of broad regulatory authority over tobacco provides opportunities for policy evaluation research. The research community can provide FDA with the independent science it needs to evaluate the public health impact of novel tobacco products.
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Affiliation(s)
- Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
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June KM, Norton KJ, Rees VW, O'Connor RJ. Influence of measurement setting and home smoking policy on smoking topography. Addict Behav 2012; 37:42-6. [PMID: 21862228 DOI: 10.1016/j.addbeh.2011.07.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 04/25/2011] [Accepted: 07/27/2011] [Indexed: 11/16/2022]
Abstract
While cigarette puffing style, measured by smoking topography, is highly variable between individuals, smoking behavior or style tends to vary relatively little within individuals. Recent research has demonstrated that certain situational factors may produce variation in smoking topography, including location of smoking. Smoking topography directly observed by researchers in a laboratory may differ from that indirectly observed via portable measurement devices at participants' homes. The introduction of clean indoor air laws may also influence smokers' puffing styles, as smokers modify their smoking topography to ensure a quicker, more efficient smoking style. The goal of this analysis was to examine whether directly observed laboratory measures are representative of indirectly observed smoking behavior and to examine the influence of smokers' preference for indoor or outdoor home smoking on puffing style. Overall, participants smoked more intensively in the directly observed setting than when in the indirectly observed setting in terms of total volume intake, inter-puff interval, and total time spent smoking. This difference was most pronounced among individuals who reported smoking indoors when at home. The data suggest that adherence to an indoor home smoking policy may further influence an individual's smoking behavior.
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Affiliation(s)
- Kristie M June
- Department of Health Behavior, Roswell Park Cancer Institute, Carlton House, Elm & Carlton Streets, Buffalo, NY 14263, USA.
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Suter M, Abramovici A, Aagaard-Tillery K. Genetic and epigenetic influences associated with intrauterine growth restriction due to in utero tobacco exposure. PEDIATRIC ENDOCRINOLOGY REVIEWS : PER 2010; 8:94-102. [PMID: 21150839 PMCID: PMC5084836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
While many fetuses are exposed to tobacco in utero, not all experience adverse outcomes as a result of this exposure. Mechanisms leading to the attenuation of fetal birth weight and adverse pregnancy outcomes are complex. Therefore many studies have begun to focus, not only on the contribution of maternal and fetal genes to phenotypic outcome, but also on epigenetic changes associated with exposure to maternal tobacco smoke. In this review, we detail the epidemiologic evidence associating an adverse pregnancy outcome to maternal tobacco use. We provide a brief summary of studies demonstrating an association between maternal and fetal gene polymorphisms with low birth weight in response to maternal tobacco exposure. We also review the literature showing epigenetic changes in the offspring associated with in utero tobacco exposure. The complex interplay of genomic and epigenomic factors may contribute to specific phenotypic outcomes and can help begin to elucidate the differential susceptibilities to tobacco smoke in utero.
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Affiliation(s)
- Melissa Suter
- Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Adi Abramovici
- Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Kjersti Aagaard-Tillery
- Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
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Radmacher PG, Looney SW, Myers SR. Polycyclic Aromatic Hydrocarbons in Maternal and Cord Blood Plasma. Polycycl Aromat Compd 2010. [DOI: 10.1080/10406631003800639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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O'Connor RJ, Cummings KM, Rees VW, Connolly GN, Norton KJ, Sweanor D, Parascandola M, Hatsukami DK, Shields PG. Surveillance methods for identifying, characterizing, and monitoring tobacco products: potential reduced exposure products as an example. Cancer Epidemiol Biomarkers Prev 2009; 18:3334-48. [PMID: 19959680 PMCID: PMC4637821 DOI: 10.1158/1055-9965.epi-09-0429] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tobacco products are widely sold and marketed, yet integrated data systems for identifying, tracking, and characterizing products are lacking. Tobacco manufacturers recently have developed potential reduced exposure products (PREP) with implied or explicit health claims. Currently, a systematic approach for identifying, defining, and evaluating PREPs sold at the local, state, or national levels in the United States has not been developed. Identifying, characterizing, and monitoring new tobacco products could be greatly enhanced with a responsive surveillance system. This article critically reviews available surveillance data sources for identifying and tracking tobacco products, including PREPs, evaluating strengths and weaknesses of potential data sources in light of their reliability and validity. With the absence of regulations mandating disclosure of product-specific information, it is likely that public health officials will need to rely on a variety of imperfect data sources to help identify, characterize, and monitor tobacco products, including PREPs.
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Affiliation(s)
- Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. Richard.O'
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Stellman SD, Djordjevic MV. Monitoring the tobacco use epidemic II: The agent: Current and emerging tobacco products. Prev Med 2009; 48:S11-5. [PMID: 18848577 PMCID: PMC2667905 DOI: 10.1016/j.ypmed.2008.09.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 09/11/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This Agent paper (II of V on monitoring the tobacco use epidemic) summarizes the findings and recommendations of the Agent (product) Working Group of the November, 2002, National Tobacco Monitoring, Research and Evaluation Workshop. METHODS The Agent Working Group evaluated the need to develop new surveillance systems for quantifying ingredients and emissions of tobacco and tobacco smoke and to improve methods to assess uptake and metabolism of these constituents taking into account variability in human smoking behavior. RESULTS The toxic properties of numerous tobacco and tobacco smoke constituents are well known, yet systematic monitoring of tobacco products has historically been limited to tar, nicotine, and CO in mainstream cigarette smoke using a machine-smoking protocol that does not reflect human smoking behavior. Toxicity of smokeless tobacco products has not been regularly monitored. Tobacco products are constantly changing and untested products are introduced into the marketplace with great frequency, including potential reduced-exposure products (PREPs). The public health impact of new or modified tobacco products is unknown. CONCLUSIONS Systematic surveillance is recommended for mainstream smoke constituents such as polycyclic aromatic hydrocarbons (PAH), tobacco-specific nitrosamines (TSNA), total and free-base nicotine, volatile organic compounds, aromatic amines, and metals; and design attributes including tobacco blend, additives, and filter ventilation. Research on smoking topography is recommended to help define machine-smoking protocols for monitoring emissions reflective of human smoking behavior. Recommendations are made for marketplace product sampling and for population monitoring of smoking topography, emissions of toxic constituents, biomarkers of exposure and, eventually, risk of tobacco-related diseases.
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Affiliation(s)
- Steven D Stellman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, New York, USA.
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Morabia A, Costanza MC. Let's not have to hear it through the grapevine. Prev Med 2009; 48:S1-2. [PMID: 19185769 DOI: 10.1016/j.ypmed.2009.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giovino GA, Biener L, Hartman AM, Marcus SE, Schooley MW, Pechacek TF, Vallone D. Monitoring the tobacco use epidemic I. Overview: Optimizing measurement to facilitate change. Prev Med 2009; 48:S4-10. [PMID: 18809429 DOI: 10.1016/j.ypmed.2008.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Revised: 08/25/2008] [Accepted: 08/31/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This Overview paper (I of V) summarizes research work to date on monitoring the tobacco use epidemic, discusses the recommendations made at the November, 2002 National Tobacco Monitoring, Research and Evaluation Workshop sponsored by the U.S. National Cancer Institute (NCI), Centers for Disease Control and Prevention (CDC), the American Legacy Foundation, and the Robert Wood Johnson Foundation on the topic of tobacco surveillance and evaluation, and discusses the current state of affairs. METHODS A conceptual model based on the classical infectious diseases framework/paradigm focusing on the Agent, Host, Vector and Environment is used to integrate the work presented in the four other papers that appear in this supplemental issue of Preventive Medicine. RESULTS The Agent paper (II) describes surveillance on tobacco products and biomarkers; the Host paper (III) describes surveillance on the smoker/user, or potential smoker/user; the Vector paper (IV) describes monitoring of industry activity; and the Environment paper (V) describes several key strategies for monitoring influential environmental factors. Overall, some improvements to the nation's surveillance system have been made in recent years. However, additional steps are needed to optimize measurement of tobacco use and factors influencing use in the United States. CONCLUSIONS Tobacco monitoring efforts play a vital role in combating the epidemic of addiction and disease produced by various tobacco products. The knowledge and experience gained by the tobacco use prevention and control community through this commitment to linkages of data collected in the domains of Vector and Environment, in addition to Agent and Host, could inform monitoring of a wide range of other public health issues as well, including diet and nutrition, physical activity, overweight and obesity, and substance abuse.
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Affiliation(s)
- Gary A Giovino
- Department of Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, 312 Kimball Tower, Buffalo, New York 14214-8028, USA.
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Cruz TB. Monitoring the tobacco use epidemic IV. The vector: Tobacco industry data sources and recommendations for research and evaluation. Prev Med 2009; 48:S24-34. [PMID: 18976685 DOI: 10.1016/j.ypmed.2008.10.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 09/30/2008] [Accepted: 10/01/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This Vector paper (IV of V on monitoring the tobacco use epidemic) presents the data sources and methods that can be used to monitor tobacco marketing and makes recommendations for creating a national surveillance system. METHODS In 2002, the Vector Work Group of the National Tobacco Monitoring, Research and Evaluation Workshop identified priority indicators of tobacco marketing: tobacco brand pricing strategies, retail environment advertising and promotional allowances, gray market or smuggling activities, lobbying, direct mail marketing, tobacco brand placements in films, Internet promotions, and sponsorship at bars and events. This paper reviews and identifies data sources and gaps for these priority indicators and for 12 other indicators of interest. RESULTS There are 38 commercial data sites and Internet sources, as well as individual research efforts that address the priority indicators. These sources are not integrated, often costly, and limited in standardization. CONCLUSIONS Tobacco marketing could be more effectively monitored with the development of a national research network. Surveillance of the tobacco industry's methods to push tobacco and pull consumers can help the public health community identify new markets and campaigns, justify and tailor effective tobacco control strategies, and evaluate existing counter-marketing efforts.
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Affiliation(s)
- Tess Boley Cruz
- Institute for Prevention Research, Keck School of Medicine, University of Southern California, 1000 S. Fremont, Los Angeles, California 91803, USA.
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Monitoring the tobacco use epidemic III: The host: data sources and methodological challenges. Prev Med 2009; 48:S16-23. [PMID: 18851990 DOI: 10.1016/j.ypmed.2008.09.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Revised: 09/15/2008] [Accepted: 09/16/2008] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This Host paper (III of V) reviews key surveillance and evaluation systems that monitor the characteristics, attitudes and behaviors of tobacco users that are crucial for tobacco control efforts. METHODS We summarize and expand on the recommendations from the Host Working Group of the National Tobacco Monitoring, Research and Evaluation Workshop. We also discuss research challenges and make additional recommendations for improving tobacco control surveillance and evaluation. RESULTS We reviewed 10 major US surveys that collect data on tobacco use. A great deal of data is collected but gaps exist. Data collection on cigars, smokeless tobacco, brand, menthols, and PREPs is sparse and infrequent. Also, a number of factors, including, but not limited to, changes in US population composition, declines in survey response rates, and increases in cell phone use present research challenges that may impact the ongoing utility of these systems. CONCLUSIONS Although the field of tobacco control research is an advanced area of public health, improvements in data systems are necessary to accurately evaluate progress and continue tobacco control gains. A coordinated surveillance and evaluation network would increase efficiency and improve the overall utility, quality and timeliness of the current data systems.
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