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Picanço JMA, Limberger RP, Apel MA. Where should I start? A scoping review about the publications on clove cigarettes. Crit Rev Toxicol 2022; 52:259-293. [PMID: 35971813 DOI: 10.1080/10408444.2022.2097053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The general lack of knowledge about the composition of clove cigarettes and the large number of terms that can be used to define different types of cigarettes that contain cloves makes it difficult to find scientific articles focused on the subject. We reviewed the publications that cited clove cigarettes to assess their relevance. METHODS We searched publications on Scopus, ScienceDirect, PubMed, and Portal CAPES during the first semester of 2021, without date restrictions. Through a quality assessment, the studies found were assorted in ten different categories. RESULTS Indonesian clove cigarettes-also known as kretek-are a mixture of tobacco and cloves rolled in a cigarette and sprayed with oils, plant extract, and food flavorings, in an unknown quantity and composition, different from each brand, which is usually kept in secret. Due to the relatively low prevalence of use in the general population, most publications on tobacco products tend to ignore clove cigarettes or place them in an existing category. Clove cigarettes can be hand-rolled, machine-made, filtered, unfiltered, and each form can be named differently. The interchangeable use of each term, sometimes grouping conventional cigarettes in the mix, can lead the researcher to consider a publication that should be excluded. CONCLUSION The existing regulations on flavored cigarettes, although well-intentioned, are still somewhat vague and broad, leaving possible loopholes that can be exploited by the tobacco industries. Fully understanding the precise effects caused by clove cigarettes can be an important tool in future discussions about tobacco control.
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Affiliation(s)
| | | | - Miriam Anders Apel
- Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Christofferson DE, Blalock DV, Knoeppel J, Beckham JC, Hamlett-Berry K, Hertzberg JS. A real-world evaluation of a smokeless tobacco cessation text message program for veterans: Outcomes and comparison to cigarette smokers. Nicotine Tob Res 2021; 24:186-195. [PMID: 34545940 DOI: 10.1093/ntr/ntab191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/17/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smokeless tobacco (ST) use and cessation rates have remained unchanged while cigarette smoking has declined, and cessation rates have increased. Text message programs have proved effective for cigarette smokers but have not been evaluated for ST users. The Veterans Health Administration (VHA) created a ST-specific arm of its SmokefreeVET automated text message program to help veteran ST users quit. METHODS A retrospective evaluation was conducted on a real-world sample of veteran ST users (n=1,139) who subscribed to SmokefreeVET between 2017 and 2020. Time in program, abstinence, and nicotine replacement therapy (NRT) use were evaluated and compared to 9,764 cigarette smokers who subscribed to SmokefreeVET. RESULTS Younger subscribers were more likely to opt out early; 54% of ST users and 60% of cigarette smokers completed the 6-week program. ST users were more likely to report abstinence than cigarette smokers at all time points: the primary outcome, 30-day abstinence at 6 months, was 3.9% in ST users and 2.6% in cigarette smokers (p=.05) and the secondary outcome, abstinence at 3 months, was 5.3% in ST users and 3.4% in cigarette smokers (p=.03). NRT was used by 17% of ST users and was associated with a trend toward higher abstinence compared to ST users who did not use NRT. CONCLUSION A real-world sample of ST users were more likely to report abstinence after using the SmokefreeVET text program than cigarette smokers. Automated text message programs may be effective for increasing cessation among ST users and warrant further investigation. IMPLICATIONS Smokeless tobacco (ST) cessation is an important public health priority and of importance for veteran and military populations that have higher rates of ST use. There have been relatively few studies conducted investigating the effectiveness of text message interventions for ST cessation, despite the proven efficacy for cigarette smokers. This study provides evidence from a large, real-world sample that text message programs may be effective for ST users and suggests that further research into this treatment modality for ST users is needed.
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Affiliation(s)
- Dana E Christofferson
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, 810 Vermont Avenue NW, Washington, DC 20420, United States
| | - Dan V Blalock
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham NC.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2301 Erwin Road, Durham, NC 27705, United States
| | - Jennifer Knoeppel
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, 810 Vermont Avenue NW, Washington, DC 20420, United States
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2301 Erwin Road, Durham, NC 27705, United States.,Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, United States.,VA Mid-Atlantic Mental Illness Research Education and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States
| | - Kim Hamlett-Berry
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, 810 Vermont Avenue NW, Washington, DC 20420, United States
| | - Jeffrey S Hertzberg
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2301 Erwin Road, Durham, NC 27705, United States.,Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, United States
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Jitnarin N, Poston WSC, Haddock CK, Jahnke SA. Tobacco Use among Women Firefighters. Womens Health Issues 2019; 29:432-439. [PMID: 31229361 PMCID: PMC6755060 DOI: 10.1016/j.whi.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/30/2019] [Accepted: 05/16/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Firefighters play a crucial role in protecting the lives and property of the communities they serve. Health and readiness for duty among women firefighters is of great concern because they are a significantly understudied group in this critical occupation. A tobacco-free fire service has been strongly promoted, but there are no published data on the extent and types of tobacco use among women firefighters. METHODS Data were collected as part of a national online study of the health of women in the fire service. RESULTS A total of 1,712 women firefighters completed questions regarding tobacco use. Unadjusted smoking and smokeless tobacco rates were 5.1% and 1.2%, respectively. Age standardized smoking rates were lower than those of male firefighters and U.S. adult women. Smokeless tobacco use prevalence was very low compared with male firefighters, but comparable with U.S. adult women. Tobacco users were more likely to have lower education and income and were younger when compared with those who did not use tobacco. There was a strong association between tobacco use and problem and binge drinking. CONCLUSIONS Current findings suggest that the rates of cigarette and smokeless tobacco use are relatively low among women firefighters. Unhealthy lifestyle behaviors such as problem and binge drinking were strongly associated with tobacco use.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas.
| | - Walker S C Poston
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
| | - Christopher K Haddock
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
| | - Sara A Jahnke
- Center for Fire, Rescue & EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, Kansas
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Feirman SP, Lock D, Cohen JE, Holtgrave DR, Li T. Flavored Tobacco Products in the United States: A Systematic Review Assessing Use and Attitudes. Nicotine Tob Res 2015; 18:739-49. [PMID: 26315475 DOI: 10.1093/ntr/ntv176] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 08/07/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVES We systematically reviewed research examining use of and attitudes toward nonmenthol-flavored tobacco products to provide information relevant to a decision to regulate these products in the future. METHODS To identify eligible studies, we searched PubMed, CINHAL, Embase, LILACS, and PsycINFO on September 19, 2013, without date restrictions. We obtained additional studies via gray literature searches, expert contacts, and hand-searching citations of included articles. We included participants of all ages. We conducted a qualitative synthesis for included studies. RESULTS The 32 studies included in this review exhibited substantial heterogeneity and were of varied methodological quality. Findings from observational, experimental, and quasiexperimental studies suggest that flavored tobacco use is associated with young age and that consumers may perceive flavored products more favorably than nonflavored products. Evidence from qualitative studies indicates that flavoring in tobacco is viewed favorably by users and nonusers of these products. CONCLUSIONS The Food and Drug Administration has expressed interest in regulating flavored tobacco products. This systematic review strengthens the evidence base relating to this issue by synthesizing the literature from the United States on the use of and attitudes toward flavored tobacco. To address gaps in the literature, more research is needed to understand how flavoring impacts tobacco use over time. The evidence base would further be strengthened with the collection of brand-, flavor-, and product-specific data.
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Affiliation(s)
- Shari P Feirman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC;
| | - Diana Lock
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - David R Holtgrave
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Tianjing Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Hermes EDA, Wells TS, Smith B, Boyko EJ, Gackstetter GG, Miller SC, Smith TC. Smokeless tobacco use related to military deployment, cigarettes and mental health symptoms in a large, prospective cohort study among US service members. Addiction 2012; 107:983-94. [PMID: 22126651 DOI: 10.1111/j.1360-0443.2011.03737.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIMS To characterize smokeless tobacco initiation and persistence in relation to deployment, combat, occupation, smoking and mental health symptoms. DESIGN Prospective cohort, utilizing self-reported survey data from the Millennium Cohort Study. SETTING US military service members in all branches including active duty, reserve and National Guard. PARTICIPANTS Population-based sample of 45,272 participants completing both baseline (July 2001-June 2003; n = 77,047) and follow-up (June 2004-January 2006; n = 55,021) questionnaires (follow-up response rate = 71.4%). MEASUREMENTS Self-reported smokeless tobacco initiation and persistence. FINDINGS Over the study period, 72.4% did not deploy, 13.7% deployed without combat exposures and 13.9% deployed with combat exposures, while 1.9% were smokeless tobacco initiators and 8.9% were persistent users. The odds of initiation were greater for deployers with combat exposure [odds ratio (OR), 1.76; 95% confidence interval (CI), 1.49-2.09], deployers without combat exposure (OR, 1.31; 95% CI, 1.07-1.60) and those who deployed multiple times (OR, 1.67; 95% CI, 1.31-2.14), as well as in smoking recidivists/initiators (OR, 4.65; 95% CI, 3.82-5.66) and those reporting post-traumatic stress disorder symptoms (OR, 1.54; CI, 1.15-2.07). A similar pattern for higher odds of persistent use was observed for deployment and combat exposure, but not for smoking and mental health symptoms. Military occupation was not significantly associated with initiation or persistence. CONCLUSIONS Deployment and combat exposure in the US military are associated with increased risk of smokeless tobacco initiation and persistence while smoking and symptoms of post-traumatic stress disorder increase the odds for initiation. Research is needed on aspects of military service amenable to the reduction or prevention of tobacco consumption.
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Affiliation(s)
- Eric D A Hermes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
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Sawchuk CN, Roy-Byrne P, Noonan C, Bogart A, Goldberg J, Manson SM, Buchwald D. Smokeless tobacco use and its relation to panic disorder, major depression, and posttraumatic stress disorder in American Indians. Nicotine Tob Res 2012; 14:1048-56. [PMID: 22345318 DOI: 10.1093/ntr/ntr331] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Rates of nicotine use are high in American Indians. Anxiety and depression tend to be associated with cigarette use, but the association of anxiety and depression with smokeless tobacco (ST) is less clear. We asked if panic disorder, major depression, and posttraumatic stress disorder (PTSD) are related to lifetime ST use in 2 American Indian tribes. METHODS Logistic regression analyses examined the association between lifetime panic disorder, major depression, and PTSD and the odds of lifetime ST use status after controlling for sociodemographic characteristics, smoking status, and alcohol use disorders in 1,506 Northern Plains and 1,268 Southwest tribal members. RESULTS Odds of lifetime ST use was 1.6 times higher in Northern Plains tribal members with a lifetime history of PTSD after controlling for sociodemographic variables and smoking (95% CI: 1.1, 2.3; p = .01). This association remained significant after further adjustment for panic disorder and major depression (odds ratio [OR] = 1.5; 95% CI: 1.0, 2.2; p = .04) but was diminished after accounting for alcohol use (OR = 1.3; 95% CI: 0.9, 1.9; p = .23). In the Southwest, lifetime psychiatric disorders were not associated with lifetime ST use status. Increasing psychiatric comorbidity was significantly linked to increased odds of ST use in both tribes. CONCLUSIONS This study is the first to examine psychiatric conditions and lifetime ST use in a large, geographically diverse American Indian community sample. Although approximately 30% of tribal members were lifetime users of ST, the association with lifetime psychiatric disorders was not as strong as those observed with cigarette smoking. Understanding shared mechanisms between all forms of tobacco use with anxiety and depressive disorders remains an important area for investigation.
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Affiliation(s)
- Craig N Sawchuk
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
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Bergman HE, Hunt YM, Augustson E. Smokeless tobacco use in the United States military: a systematic review. Nicotine Tob Res 2011; 14:507-15. [PMID: 22123789 DOI: 10.1093/ntr/ntr216] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Smokeless tobacco (ST) use represents an important target for intervention in the U.S. military population because it impairs "military readiness" and harms the health of the military. This paper aims to provide a systematic review of ST studies conducted in the U.S. military population in order to assess the content of existing ST research in this population, provide estimates of prevalence and clinically relevant use patterns, and discuss how these findings might be used to guide future ST research among this population. METHODS We reviewed articles published through December 2010 using PubMed and PsycINFO databases, Google Scholar, and any relevant articles' reference lists. Inclusion criteria included focus on a U.S. military sample, English language, measured tobacco use, and ST prevalence was reported or could be calculated. To the extent possible, each article was coded for demographics, socioeconomic status, prevalence, amount, frequency, and length of use, and quit intentions/attempts. RESULTS Thirty-nine articles met criteria for inclusion. Less than half focused primarily on ST use among military personnel. The remaining studies measured ST use in the context of other behaviors. Findings related to clinically relevant behaviors included a need for more cohort and intervention studies, a better understanding of ST use in combination with cigarettes (i.e., concurrent use), and identifying risk factors for ST initiation and use. DISCUSSION ST use is prevalent among military personnel, as is concurrent use of cigarettes and ST. We provide a number of recommendations to guide future research in this important, yet understudied, area.
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Affiliation(s)
- Hannah E Bergman
- Department of Psychological Sciences, Psychology Program, Case Western Reserve University, 11220 Belleflower Road, Mather Memorial 109, Cleveland, OH 44106, USA.
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Timberlake DS, Huh J. Demographic profiles of smokeless tobacco users in the U.S. Am J Prev Med 2009; 37:29-34. [PMID: 19524142 DOI: 10.1016/j.amepre.2009.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 12/22/2008] [Accepted: 03/10/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Users of smokeless tobacco (chew or snuff) in the U.S. are viewed demographically as being homogeneous. Prior studies have demonstrated such homogeneity in national survey data but have not utilized latent-variable methods. The objective of this study was to determine whether a single group or underlying subgroups best characterize users of smokeless tobacco. METHODS Men aged >17 years who had used smokeless tobacco in the past month (n=4583) were selected from the 2003, 2004, and 2005 National Surveys on Drug Use and Health. A latent-class analysis, conducted in 2008, was based on individual response patterns from six demographic variables and three items pertaining to the use of smokeless tobacco. RESULTS Four latent classes were identified: older chew users (17.2%); younger poly-tobacco users (28.7%); skilled laborers with a high school diploma (27.5%); and educated professionals (26.6%). External validation of these classes indicated that older chew users and younger poly-tobacco users were more likely than the educated professionals to be former and current smokers, respectively. CONCLUSIONS While users of smokeless tobacco in the U.S. are predominantly white men, they are more heterogeneous with respect to education, occupation, and residency than commonly is perceived.
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Affiliation(s)
- David S Timberlake
- Program in Public Health, University of California Irvine, Irvine, California 92697-7555, USA.
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Severson HH, Peterson AL, Andrews JA, Gordon JS, Cigrang JA, Danaher BG, Hunter CM, Barckley M. Smokeless tobacco cessation in military personnel: A randomized controlled trial. Nicotine Tob Res 2009; 11:730-8. [DOI: 10.1093/ntr/ntp057] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Use of propensity score matching in evaluating smokeless tobacco as a gateway to smoking. Nicotine Tob Res 2009; 11:455-62. [DOI: 10.1093/ntr/ntp008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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