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Hayrumyan V, Sargsyan Z, Torosyan A, Dekanosidze A, Grigoryan L, Alayan N, Kegler MC, Sturua L, Petrosyan V, Bazarchyan A, Haardörfer R, Cui Y, Berg CJ. The inclusion of e-cigarettes and heated tobacco products in smoke-free home and car rules: A cross-sectional survey of adults in Armenia and Georgia. Tob Induc Dis 2024; 22:TID-22-99. [PMID: 38835513 PMCID: PMC11149400 DOI: 10.18332/tid/189200] [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: 02/20/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Understanding who includes e-cigarettes and heated tobacco products (HTPs) in smoke-free home or car rules could inform public health interventions, particularly in countries with high smoking prevalence and recently implemented national smoke-free laws, like Armenia and Georgia. METHODS In 2022, we conducted a cross-sectional survey among 1468 adults in 28 Armenian and Georgian communities (mean age=42.92 years; 51.4% female, 31.6% past-month smoking). Multilevel regression (accounting for clustering within communities; adjusted for sociodemographics and cigarette use) examined e-cigarette/HTP perceptions (risk, social acceptability) and use intentions in relation to: 1) including e-cigarettes/HTPs in home and car rules among participants with home and car rules, respectively (logistic regressions); and 2) intention to include e-cigarettes/HTPs in home rules (linear regression, 1 = 'not at all' to 7 = 'extremely') among those without home rules. RESULTS Overall, 72.9% (n=1070) had home rules, 86.5% of whom included e-cigarettes/HTPs; 33.9% (n=498) had car rules, 81.3% of whom included e-cigarettes/HTPs. Greater perceived e-cigarette/HTP risk was associated with including e-cigarettes/HTPs in home rules (AOR=1.28; 95% CI: 1.08-1.50) and car rules (AOR=1.46; 95% CI: 1.14-1.87) and next-year intentions to include e-cigarettes/HTPs in home rules (β=0.38; 95% CI: 0.25-0.50). Lower e-cigarette/HTP use intentions were associated with including e-cigarettes/HTPs in home rules (AOR=0.75; 95% CI: 0.63-0.88). While perceived social acceptability was unassociated with the outcomes, other social influences were: having children and no other household smokers was associated with including e-cigarettes/HTPs in car rules, and having children was associated with intent to include e-cigarettes/HTPs in home rules. CONCLUSIONS Interventions to address gaps in home and car rules might target e-cigarette/HTP risk perceptions.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Republic of Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Republic of Armenia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health, Yerevan, Republic of Armenia
| | - Ana Dekanosidze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
- Tbilisi State Medical University, Tbilisi, Georgia
| | - Lilit Grigoryan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health, Yerevan, Republic of Armenia
| | - Nour Alayan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Republic of Armenia
| | - Michelle C Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States
| | - Lela Sturua
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Republic of Armenia
| | - Alexander Bazarchyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health, Yerevan, Republic of Armenia
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University
- George Washington Cancer Center, George Washington University, Washington, United States
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Amalia B, Fu M, Tigova O, Ballbè M, Paniello-Castillo B, Castellano Y, Vyzikidou VK, O'Donnell R, Dobson R, Lugo A, Veronese C, Pérez-Ortuño R, Pascual JA, Cortés N, Gil F, Olmedo P, Soriano JB, Boffi R, Ruprecht A, Ancochea J, López MJ, Gallus S, Vardavas C, Semple S, Fernández E. Exposure to secondhand aerosol from electronic cigarettes at homes: A real-life study in four European countries. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158668. [PMID: 36099951 DOI: 10.1016/j.scitotenv.2022.158668] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
Electronic cigarette (e-cigarette) use emits potentially hazardous compounds and deteriorates indoor air quality. Home is a place where e-cigarettes may frequently be used amid its increasing prohibition in public places. This study assessed the real-life scenario of bystanders' exposure to secondhand e-cigarette aerosol (SHA) at home. A one-week observational study was conducted within the TackSHS project in four countries (Greece, Italy, Spain, and the United Kingdom) in 2019 including: 1) homes of e-cigarette users living together with a non-user/non-smoker; and 2) control homes with no smokers nor e-cigarette users. Indoor airborne nicotine, PM2.5, and PM1.0 concentrations were measured as environmental markers of SHA. Biomarkers, including nicotine and its metabolites, tobacco-specific nitrosamines, propanediol, glycerol, and metals were measured in participants' saliva and urine samples. E-cigarette use characteristics, such as e-cigarette refill liquid's nicotine concentration, e-cigarette type, place of e-cigarette use at home, and frequency of ventilation, were also collected. A total of 29 e-cigarette users' homes and 21 control homes were included. The results showed that the seven-day concentrations of airborne nicotine were quantifiable in 21 (72.4 %) out of 29 e-cigarette users' homes; overall, they were quite low (geometric mean: 0.01 μg/m3; 95 % CI: 0.01-0.02 μg/m3) and were all below the limit of quantification in control homes. Seven-day concentrations of PM2.5 and PM1.0 in e-cigarette and control homes were similar. Airborne nicotine and PM concentrations did not differ according to different e-cigarette use characteristics. Non-users residing with e-cigarette users had low but significantly higher levels of cotinine, 3'-OH-cotinine and 1,2-propanediol in saliva, and cobalt in urine than non-users living in control homes. In conclusion, e-cigarette use at home created bystanders' exposure to SHA regardless of the e-cigarette use characteristics. Further studies are warranted to assess the implications of SHA exposure for smoke-free policy.
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Affiliation(s)
- Beladenta Amalia
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, University of Barcelona - UB, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, University of Barcelona - UB, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain.
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, University of Barcelona - UB, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Montse Ballbè
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Blanca Paniello-Castillo
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, University of Barcelona - UB, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Vergina K Vyzikidou
- Hellenic Cancer Society - George D. Behrakis Research Lab - HCS, Athens, Greece
| | - Rachel O'Donnell
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, United Kingdom of Great Britain and Northern Ireland
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, United Kingdom of Great Britain and Northern Ireland
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milan, Italy
| | - Chiara Veronese
- IRCCS Istituto Nazionale dei Tumori - INT Foundation, Milan, Italy
| | - Raúl Pérez-Ortuño
- Hospital del Mar Medical Research Institute - IMIM, Barcelona, Spain
| | - José A Pascual
- Hospital del Mar Medical Research Institute - IMIM, Barcelona, Spain; Department of Experimental and Health Sciences, University Pompeu Fabra - UPF, Barcelona, Spain
| | - Nuria Cortés
- Agència de Salut Pública de Barcelona - ASPB, Barcelona, Spain
| | - Fernando Gil
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada - UG, Granada, Spain
| | - Pablo Olmedo
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada - UG, Granada, Spain
| | - Joan B Soriano
- CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Respiratory Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Roberto Boffi
- IRCCS Istituto Nazionale dei Tumori - INT Foundation, Milan, Italy
| | - Ario Ruprecht
- IRCCS Istituto Nazionale dei Tumori - INT Foundation, Milan, Italy
| | - Julio Ancochea
- CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Respiratory Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Maria J López
- Agència de Salut Pública de Barcelona - ASPB, Barcelona, Spain; CIBER de Epidemiología y Salud Pública - CIBERESP, Madrid, Spain; Institut d'Investigació Biomèdica Sant Pau - IIB St. Pau, Barcelona, Spain
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milan, Italy
| | - Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, United Kingdom of Great Britain and Northern Ireland
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, University of Barcelona - UB, Barcelona, Spain; CIBER Respiratory Diseases - CIBERES, Instituto de Salud Carlos III, Madrid, Spain
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Krishnan N, Abroms LC, Berg CJ. Electronic Nicotine Product Cessation and Cigarette Smoking: Analysis of Waves 3 and 4 From the PATH Study. Nicotine Tob Res 2022; 24:324-332. [PMID: 34313780 PMCID: PMC8842438 DOI: 10.1093/ntr/ntab155] [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: 10/29/2020] [Accepted: 07/26/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Identifying predictors of electronic nicotine product (ENP) cessation can inform ENP cessation interventions. High rates of cooccurring ENP and cigarette (dual) use and transitions between these products underscore the importance of considering cigarette smoking status when assessing and addressing ENP cessation. AIMS AND METHODS We analyzed waves 3 (W3) and 4 (W4) of the Population Assessment of Tobacco and Health (PATH) study to identify (1) W3 socio-demographics, tobacco and ENP use characteristics, and psychosocial correlates of W3 cigarette smoking status (non-smoker, former, and current) among W3 adult ENP users, and (2) W3 predictors of W4 combined ENP and cigarette smoking abstinence relative to use of one or both products. RESULTS At W3, 65.6% of ENP users concurrently smoked cigarettes. Adjusted multinomial regression results indicated that different W3 socio-demographics, tobacco and ENP use characteristics, and psychosocial correlates were significantly associated with distinct W3 cigarette use profiles. At W4, 9.9% of individuals were abstinent from both products. These individuals were less likely to: (1) be current smokers (vs. non-smokers) or be advised to quit using tobacco, compared with cigarette only or dual users, and (2) use ENPs daily or live in a household allowing ENP use, compared with ENP only or dual users (p < .05). CONCLUSIONS ENP cessation approaches need to be tailored to the distinct cigarette use profiles of ENP users. Dual users and daily ENP users may require more intensive interventions to achieve the cessation of both products. Supportive physical environments, such as home vape-free policies, may facilitate ENP cessation. IMPLICATIONS This analysis contributes to advancing the nascent literature on predictors of electronic nicotine product (ENP) cessation, which can guide the development of ENP cessation interventions by indicating which populations, psychosocial and environmental constructs, and cooccurring behaviors interventions should target. This research also highlights the importance of considering cigarette smoking status when designing ENP cessation interventions and defining intervention outcomes.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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