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Reynolds RM, Trasher JF, Yang B, Henderson KC, Ashley DL, Hackworth EE, Ntansah CA, Pei D, Popova L. Perceptions of a reduced nicotine policy and predictors of policy support: A nationally representative U.S. survey. Prev Med 2024; 184:107952. [PMID: 38657684 DOI: 10.1016/j.ypmed.2024.107952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The U.S. Food and Drug Administration is considering a policy to reduce nicotine in cigarettes to non-addictive levels. Although current evidence supports the public-health benefits of a reduced-nicotine policy, almost half of people who smoke (∼ 40%) do not support the policy. This study estimates the factors most strongly associated with support or opposition toward the policy, including tobacco use status, perceived effects of a reduced nicotine policy, trust in the FDA, and psychological distress. The study aims to inform messaging campaigns and policy makers. METHODS Data were collected in 2021 with nationally representative samples of U.S. adults (n = 1763). After receiving information about the reduced nicotine policy, participants indicated their beliefs and support for or opposition to the policy, along with other individual difference characteristics. Univariate population parameters and multinomial logistic regression coefficients were estimated. RESULTS In adjusted models, people who formerly or never smoked were less likely to oppose the policy compared to those who currently smoke; people with higher psychological distress and those who believe the policy will promote switching to e-cigarettes were more likely to oppose the policy. In addition, people were more likely to support the policy if they believed it would make quitting easier or that the FDA is trustworthy. CONCLUSIONS Educational campaigns about reduced nicotine policy should expect higher impact by targeting prevalent perceptions and those more strongly associated with policy sentiment. In anticipation of the policy rollout, there may be a critical window to shape public opinion.
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Affiliation(s)
- Reed M Reynolds
- Communication Department, University of Massachusetts, Boston, MA, USA.
| | - James F Trasher
- Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, SC, USA
| | - Bo Yang
- Department of Communication, University of Arizona, Tucson, AZ, USA
| | | | | | - Emily E Hackworth
- Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, SC, USA
| | - Charity A Ntansah
- Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, SC, USA
| | - Di Pei
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, GA, USA
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La Rosa GRM, Qureshi MA, Frittitta L, Anastasi E, Polosa R. Effects of Electronic Nicotine Delivery Systems Substitution on Body Weight Status: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2024; 13:e56324. [PMID: 38530329 PMCID: PMC11005425 DOI: 10.2196/56324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Weight gain following smoking cessation is a well-documented concern, often attributed to the absence of nicotine's metabolic influence. The adoption of Electronic Nicotine Delivery Systems (ENDS) has been used to achieve smoking cessation, with claims of aiding weight control. However, existing reviews present conflicting conclusions on ENDS' impact on weight status, necessitating a rigorous evaluation. OBJECTIVE We aim to conduct a systematic review with meta-analysis to assess the actual impact of ENDS on weight status in individuals who have ceased or reduced conventional smoking. The primary goal is to provide clinicians with evidence-based insights into the potential effects of ENDS use as a smoking substitute on weight control. METHODS Adhering to PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines, our systematic review will analyze randomized and nonrandomized controlled trials, clinical trials (quasi-experimental), and prospective or retrospective cohort studies on the weight status effects of ENDS among individuals who have either quit or reduced smoking. Searches will include PubMed, Scopus, and Cochrane Library, covering the period from 2010 to January 2024. A gray literature search and supplementary searches will be performed. Data will be extracted independently by 2 reviewers and quality assessments will be conducted concurrently. Quality assessments will use Joanna Briggs Institute tools, 2020 version, along with bias assessments for internal validity and reporting bias based on the Catalogue of Bias. The included studies will be examined for any internal data reporting discrepancies by using Puljak's checklist. Meta-analysis and subgroup analyses (ie, general ENDS usage, ENDS use coupled with a reduction in smoking exceeding 50%, and exclusive ENDS use for achieving smoking cessation) are planned. Certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. RESULTS The protocol has been registered in PROSPERO (CRD42023494974) and the entire systematic review is expected to be completed by April 2024. The main goal of this review is to retrieve all current human research studies investigating the influence of ENDS on weight management among individuals who have quit or reduced smoking. Furthermore, the review will assess the quality of these studies and examine potential biases to identify the most dependable evidence available. Dissemination strategies will include traditional journal publications, social media announcements, and a white paper. The latter, available for download and distributed at conferences, aims to reach a broad audience, including clinicians and ENDS users. CONCLUSIONS The review will address the importance of informing health care professionals and patients about the current and robust evidence regarding the effects of transitioning to ENDS for smoking cessation on weight status. TRIAL REGISTRATION PROSPERO CRD42023494974; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=494974. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/56324.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
| | - Maria Ahmed Qureshi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
| | - Lucia Frittitta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
- Diabetes and Obesity Center, Garibaldi Hospital, Catania, Italy
| | - Erika Anastasi
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction, University Hospital, University of Catania, Catania, Italy
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Lipperman-Kreda S, Sanders E, Annechino R, Peterkin E, Antin TMJ. Harm perceptions of vaping nicotine relative to cigarette smoking among sexual and gender minority young adults. Drug Alcohol Rev 2024; 43:371-380. [PMID: 38258463 DOI: 10.1111/dar.13812] [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: 08/08/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION To address gaps in existing research, the current study used a mixed-methods approach to describe, contextualise and understand harm perceptions of vaping nicotine relative to cigarette smoking and associations with nicotine and tobacco (NT) use among young adults who identify their genders and sexualities in ways that classify them as sexual and gender minorities (SGM). METHODS Results are based on cross-sectional surveys and online qualitative interviews with 98 SGM young adults (18-25 years old) in California's San Francisco Bay Area who currently or formerly used combustible tobacco. We generated a measure assessing participants' relative harm perceptions of e-cigarette use versus cigarette smoking and identified those who perceived cigarette smoking as more harmful than e-cigarette use compared to those who perceived it to be equally or less harmful. RESULTS We found that relative harm perceptions of cigarette smoking versus e-cigarette use are likely related to much uncertainty and confusion about the harms of e-cigarette use. Moreover, findings illustrate that public health messages regarding the risks of e-cigarette use may have unintended consequences of increasing cigarette use to replace e-cigarette use for some SGM young adults, a practice that is incongruent with scientific evidence demonstrating that cigarettes and other combustible tobacco products are riskier than e-cigarettes and other forms of NT use. DISCUSSION AND CONCLUSIONS Results suggest the need for evidence-based, clear, and direct messaging about the relative harms of cigarettes versus e-cigarettes to reduce NT-related inequities in SGM populations.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, USA
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Emile Sanders
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Rachelle Annechino
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Elaina Peterkin
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
| | - Tamar M J Antin
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, USA
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Ahmadi A, Rahimi A, Wardak MF, Ahmadi H, Lucero-Prisno DE. Tobacco harm reduction in Afghanistan: a recipe for improving smokers' health. Subst Abuse Treat Prev Policy 2023; 18:7. [PMID: 36683028 PMCID: PMC9867861 DOI: 10.1186/s13011-023-00517-2] [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: 06/15/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023] Open
Abstract
Tobacco Harm Reduction (THR) offers a promising approach to addressing the significant burden of smoking in Afghanistan. Over three million Afghans smoke daily, making it a leading cause of preventable deaths in the country. While the previous Afghan government implemented various tobacco cessation policies and strategies, these measures were only partially effective in reducing the number of smokers or smoking-related deaths. In 2021, community-based initiatives in Kabul and Herat started advocating for Tobacco Harm Reduction (THR) as a novel, realistic, and practical approach proven to promote smoking abstinence and minimize tobacco harm. However, implementing THR strategies in Afghanistan faces numerous challenges, including a lack of governmental support, funding issues, unfavorable market conditions, the high cost-effectiveness of THR products, and misconceptions about these products. To effectively promote THR in Afghanistan and overcome these challenges, it will be necessary to implement THR policies that support THR products for smokers, regulate the market for these products, produce them locally with healthcare professional oversight, conduct more engaging advocacy campaigns, and secure domestic sponsors.
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Affiliation(s)
- Attaullah Ahmadi
- École des Hautes Études en Santé Publique, Paris, France
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Ali Rahimi
- Medical Faculty, Herat University, Students Street, Herat, 3001 Afghanistan
| | | | | | - Don Eliseo Lucero-Prisno
- Faculty of Management and Development Studies, University of the Philippines Open University, Los Banos, Laguna Philippines
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Silver NA, Kierstead EC, Briggs J, Schillo B. Charming e-cigarette users with distorted science: a survey examining social media platform use, nicotine-related misinformation and attitudes towards the tobacco industry. BMJ Open 2022; 12:e057027. [PMID: 35649587 PMCID: PMC9160585 DOI: 10.1136/bmjopen-2021-057027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/15/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To examine the role of social media in promoting recall and belief of distorted science about nicotine and COVID-19 and whether recall and belief predict tobacco industry beliefs. DESIGN Young adults aged 18-34 years (N=1225) were surveyed cross-sectionally via online Qualtrics panel. The survey assessed recall and belief in three claims about nicotine and COVID-19 and three about nicotine in general followed by assessments of industry beliefs and use of social media. Ordinal logistic regression with robust standard errors controlling for gender, race/ethnicity, education, current e-cigarette use and age was used to examine relationships between variables. RESULTS Twitter use was associated with higher odds of recall (OR=1.21, 95% CI=1.01 to 1.44) and belief (OR=1.26, 95% CI=1.04 to 1.52) in COVID-19-specific distorted science. YouTube use was associated with higher odds of believing COVID-19-specific distorted science (OR=1.32, 95% CI=1.09 to 1.60). Reddit use was associated with lower odds of believing COVID-19-specific distorted science (OR=0.72, 95% CI=0.59 to 0.88). Recall (OR=1.26, 95% CI=1.07 to 1.47) and belief (OR=1.28, 95% CI=1.09 to 1.50) in distorted science about nicotine in general as well as belief in distorted science specific to COVID-19 (OR=1.61, 95% CI=1.34 to 1.95) were associated with more positive beliefs about the tobacco industry. Belief in distorted science about nicotine in general was also associated with more negative beliefs about the tobacco industry (OR=1.18, 95% CI=1.02 to 1.35). CONCLUSIONS Use of social media platforms may help to both spread and dispel distorted science about nicotine. Addressing distorted science about nicotine is important, as it appears to be associated with more favourable views of the tobacco industry which may erode public support for effective regulation.
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Affiliation(s)
- Nathan A Silver
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Elexis C Kierstead
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Jodie Briggs
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
| | - Barbara Schillo
- Schroeder Institute, Truth Initiative, Washington, District of Columbia, USA
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Janmohamed K, Walter N, Sangngam N, Hampsher S, Nyhan K, De Choudhury M, Kumar N. Interventions to Mitigate Vaping Misinformation: A Meta-Analysis. JOURNAL OF HEALTH COMMUNICATION 2022; 27:84-92. [PMID: 35220901 DOI: 10.1080/10810730.2022.2044941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The impact of misinformation about vapes' relative harms compared with smoking may lead to increased tobacco-related burden of disease and youth vaping. Unfortunately, vaping misinformation has proliferated. Despite growing attempts to mitigate vaping misinformation, there is still considerable ambiguity regarding the ability to effectively curb the negative impact of misinformation. To address this gap, we use a meta-analysis to evaluate the relative impact of interventions designed to mitigate vaping-related misinformation. We searched (from January 2020 till August 2021) various databases and gray literature. Only English language, original studies that employed experimental designs where participants were randomly assigned either to receive mitigating information or to a no-mitigation condition (either misinformation-only or neutral control) were included. Meta-analysis was conducted for the four eligible studies. The mean effect size of attempts to mitigate vaping misinformation was positive but not statistically significant (d = 0.383, 95% CI [-0.029, 0.796], p = .061, k = 5) with lack of evidence for publication bias. Given limited studies included, we were unable to determine factors affecting the efficacy of interventions. The limited focus on non-US studies and youth populations is concerning given the popularity of vaping in low- to middle-income countries (LMICs) and among youth. The findings of this meta-analysis describe the current state of the literature and prescribe specific recommendations to better address the proliferation of vaping misinformation, providing insights helpful in limiting the tobacco mortality burden and curtailing youth vaping.
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Affiliation(s)
| | - Nathan Walter
- Department of Communication Studies, Northwestern University, Evanston, Illinois, USA
| | | | - Sam Hampsher
- BOTEC Analysis, LLC, Woodland Hills, California, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Navin Kumar
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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