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Jackson SE, Tattan-Birch H, East K, Cox S, Shahab L, Brown J. Trends in Harm Perceptions of E-Cigarettes vs Cigarettes Among Adults Who Smoke in England, 2014-2023. JAMA Netw Open 2024; 7:e240582. [PMID: 38416490 PMCID: PMC10902732 DOI: 10.1001/jamanetworkopen.2024.0582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/07/2024] [Indexed: 02/29/2024] Open
Abstract
Importance Electronic cigarettes (e-cigarettes) are less harmful to users than combustible cigarettes. However, public health and media reporting have often overstated the potential risks of e-cigarettes, and inaccurate perceptions of the harms of vaping relative to smoking are pervasive. Objective To examine time trends in harm perceptions of e-cigarettes compared with combustible cigarettes among adults who smoke. Design, Setting, and Participants This nationally representative monthly cross-sectional survey study was conducted from November 2014 to June 2023 in England. Participants were adults who currently smoke. Main Outcomes and Measures Participants were asked whether they thought e-cigarettes were less harmful, equally harmful, or more harmful than cigarettes, or did not know, with the proportion responding less harmful (vs all other responses) as the primary outcome. Logistic regression was used to test associations between survey wave and participants' perceptions of the harms of e-cigarettes. Results Data were collected from 28 393 adults who smoke (mean [SD] age, 43.5 [17.3] years; 13 253 [46.7%] women). In November 2014, 44.4% (95% CI, 42.0%-46.8%) thought e-cigarettes were less harmful than cigarettes, 30.3% (95% CI, 28.2%-32.6%) thought e-cigarettes were equally harmful, 10.8% (95% CI, 9.4%-12.3%) thought they were more harmful, and 14.5% (95% CI, 12.9%-16.4%) did not know. However, by June 2023, the proportion who thought e-cigarettes were less harmful had decreased by 40% (prevalence ratio, 0.60; 95% CI, 0.55-0.66), and the proportion who thought e-cigarettes were more harmful had more than doubled (prevalence ratio, 2.16; 95% CI, 1.84-2.54). Changes over time were nonlinear: late 2019 saw a sharp decline in the proportion who thought e-cigarettes were less harmful and increases in the proportions who thought they were equally or more harmful. These changes were short-lived, returning to pre-2019 levels by the end of 2020. However, perceptions worsened again from 2021 up to the end of the study period: the proportion who thought e-cigarettes were more harmful increased to a new high, and the proportion who thought e-cigarettes were less harmful decreased to levels comparable to those in late 2019. As a result, in June 2023, the perception that e-cigarettes were equally as harmful as cigarettes was the most commonly held view among adults who smoke (33.7%; 95% CI, 31.4%-36.1%), with roughly similar proportions perceiving e-cigarettes to be less (26.7%; 95% CI, 24.6%-28.9%) and more (23.3%; 95% CI, 21.1%-25.7%) harmful. Conclusions and Relevance This survey study of adults who smoke in England found that harm perceptions of e-cigarettes have worsened substantially over the last decade, such that most adults who smoked in 2023 believed e-cigarettes to be at least as harmful as cigarettes. The timing of the 2 most notable changes in harm perceptions coincided with the e-cigarette, or vaping product, use-associated lung injury outbreak in 2019 and the recent increase in youth vaping in England since 2021.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, Edinburgh, United Kingdom
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, Edinburgh, United Kingdom
| | - Katherine East
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, Edinburgh, United Kingdom
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, Edinburgh, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, Edinburgh, United Kingdom
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Albarrak DA, Alotaibi AB, Alotaibi RF, Alramadhan SH, Bin Muhanna AI, Aldehan AM, Bin Abdulrahman KA. The Association Between Nicotine Dependence and Mental Health in the General Population of Saudi Arabia: A Cross-Sectional Analytical Study. Int J Gen Med 2023; 16:5801-5815. [PMID: 38106979 PMCID: PMC10723076 DOI: 10.2147/ijgm.s429609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
Background High prevalence of mental disorders is associated with psychoactive substances, significantly contributing to morbidity, disability, and premature mortality. Worldwide, individuals who use electronic-cigarettes (EC) and have a mental health diagnosis are more likely to experience stress, depression, and drug use. This study aims to measure the prevalence of both EC use and mental health disorders namely, anxiety and depression additionally to investigate the association between EC use and mental health status among the general population of Saudi Arabia. Methods A cross-sectional analytical study was conducted across Saudi Arabia from November 2022 to May 2023. The survey was divided into three sections. The first section focuses on the demographics, while the second part asked about both conventional and EC smoking and their frequency. The third section assessed mental health status using a Patient Health Questionnaire with a 9-item depression scale (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7). Results The study revealed 21.1% reporting EC use in the past thirty days. While 19.8% reported smoking tobacco one or more days within the last thirty days. Regarding mental health, 36.6% of individuals had minimal anxiety, while 42.4% experienced mild anxiety. Moreover, most of the participant were considered to have mild followed by minimal depression accounting for 36.7% and 31.9%, respectively. The results indicated a positive and significant correlation between perceived depression scores and nicotine dependence among EC users. Additionally, there was a strong relationship between gender and nicotine dependence, with men being more inclined than women. Conclusion There is a correlation between nicotine use and mental health outcomes; people who use nicotine products are more likely to experience anxiety and depression.
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Affiliation(s)
- Danah Abdullah Albarrak
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulrahman Bandar Alotaibi
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, 13317, Saudi Arabia
| | - Roaa Faisal Alotaibi
- Department of Medicine, College of Medicine, AlMaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | - Sara Hussain Alramadhan
- Department of Medicine, College of Medicine, AlMaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | | | - Abdulrahman Mohammed Aldehan
- Department of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, 13317, Saudi Arabia
| | - Khalid A Bin Abdulrahman
- Department of Medical Education, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 13317-4233, Saudi Arabia
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DeAtley T, Harrison A, Cassidy R, Kuo C, Higgins ST, Tidey JW. Subjective experiences, contexts, and risk perceptions of very low nicotine content cigarettes and electronic cigarettes among people with depression and anxiety disorders who smoke. Drug Alcohol Depend 2023; 244:109767. [PMID: 36638679 PMCID: PMC9974802 DOI: 10.1016/j.drugalcdep.2023.109767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/06/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND A low-nicotine product standard is currently under consideration by the U.S. Food and Drug Administration (FDA). This standard may be more effective if alternative, non-combusted sources of nicotine are concurrently available. This qualitative study explored the lived experiences of people with depression and anxiety disorders who used very low nicotine content (VLNC) cigarettes with or without e-cigarettes during a randomized controlled trial. METHODS We conducted semi-structured qualitative interviews with participants (n = 20) as they completed a 16-week blinded trial of VLNC cigarettes with or without electronic cigarettes. Interviews explored 1) experiences with these products, 2) social and environmental contexts for use and 3) relative risk perceptions. Interviews were transcribed and analyzed using a hybrid inductive and deductive thematic analysis. RESULTS Concurrent access to e-cigarettes helped to ease the transition from usual-brand cigarettes to VLNC cigarettes. Some participants held misperceptions that VLNC cigarettes could reduce cancer risk whereas others did not. Participants expressed skepticism about the safety of e-cigarettes and the authenticity of the VLNC cigarettes. Smoking restrictions influenced e-cigarette use in some instances, but product preference was the overriding factor that influenced use. Participants did not note effects on psychiatric symptoms. CONCLUSIONS Should a nicotine reduction policy be implemented with e-cigarettes concurrently available on the market, tailored messaging for people with anxiety and depression disorders may be necessary to educate people about and the availability of alternative sources of nicotine, such as e-cigarettes, as well as the relative risk of VLNC cigarettes and e-cigarettes.
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Affiliation(s)
- Teresa DeAtley
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA.
| | - Abigail Harrison
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Rachel Cassidy
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Caroline Kuo
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Stephen T Higgins
- Department of Psychological Science, University of Vermont, VT 05405, USA
| | - Jennifer W Tidey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
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Cox S, Bauld L, Brown R, Carlisle M, Ford A, Hajek P, Li J, Notley C, Parrott S, Pesola F, Robson D, Soar K, Tyler A, Ward E, Dawkins L. Evaluating the effectiveness of e-cigarettes compared with usual care for smoking cessation when offered to smokers at homeless centres: protocol for a multi-centre cluster-randomized controlled trial in Great Britain. Addiction 2022; 117:2096-2107. [PMID: 35194862 PMCID: PMC9313612 DOI: 10.1111/add.15851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/03/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Smoking is extremely common among adults experiencing homelessness, but there is lack of evidence for treatment efficacy. E-cigarettes are an effective quitting aid, but they have not been widely tested in smokers with complex health and social needs. Here we build upon our cluster feasibility trial and evaluate the offer of an e-cigarette or usual care to smokers accessing a homeless centre. DESIGN, SETTING AND PARTICIPANTS Multi-centre two-arm cluster-randomized controlled trial with mixed-method embedded process and economic evaluation in homeless centres in England, Scotland and Wales. Adult smokers (18+ years; n = 480) accessing homeless centres and who are known to centre staff and willing to consent. INTERVENTION AND COMPARATOR Clusters (n = 32) will be randomized to either an e-cigarette starter pack with weekly allocations of nicotine containing e-liquid for 4 weeks [choice of flavours (menthol, fruit and tobacco) and strengths 12 mg/ml and 18 mg/ml] or the usual care intervention, which comprises very brief advice and a leaflet signposting to the local stop smoking service. MEASUREMENTS The primary outcome is 24-week sustained carbon monoxide-validated smoking cessation (Russell Standard defined, intention-to-treat analysis). SECONDARY OUTCOMES (i) 50% smoking reduction (cigarettes per day) from baseline to 24 weeks; (ii) 7-day point prevalence quit rates at 4-, 12- and 24-week follow-up; (iii) changes in risky smoking practices (e.g. sharing cigarettes, smoking discarded cigarettes) from baseline to 4, 12 and 24 weeks; (iv) cost-effectiveness of the intervention; and (v) fidelity of intervention implementation; mechanisms of change; contextual influences and sustainability. CONCLUSIONS This is the first study, to our knowledge, to randomly assign smokers experiencing homelessness to an e-cigarette and usual care intervention to measure smoking abstinence with embedded process and economic evaluations. If effective, its results will be used to inform the larger-scale implementation of offering e-cigarettes throughout homeless centres to aid smoking cessation.
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Affiliation(s)
- Sharon Cox
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- Spectrum Research ConsortiumUK
| | - Linda Bauld
- Spectrum Research ConsortiumUK
- Usher Institute, College of Medicine and Veterinary MedicineUniversity of EdinburghUK
| | - Rachel Brown
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement, (DECIPHer), School of Social SciencesCardiff UniversityCardiffUK
| | | | - Allison Ford
- Institute for Social Marketing and HealthUniversity of StirlingStirlingUK
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Jinshuo Li
- Department of Health SciencesUniversity of YorkUK
| | - Caitlin Notley
- Addiction Research Group, Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | | | - Francesca Pesola
- Spectrum Research ConsortiumUK
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Deborah Robson
- Spectrum Research ConsortiumUK
- Addictions DepartmentInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Kirstie Soar
- Centre for Addictive Behaviours Research, School of Applied ScienceLondon South Bank UniversityLondonUK
| | - Allan Tyler
- Centre for Addictive Behaviours Research, School of Applied ScienceLondon South Bank UniversityLondonUK
| | - Emma Ward
- Department of Health SciencesUniversity of YorkUK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied ScienceLondon South Bank UniversityLondonUK
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Perman-Howe PR, Horton M, Robson D, McDermott MS, McNeill A, Brose LS. Harm perceptions of nicotine-containing products and associated sources of information in UK adults with and without mental ill health: A cross-sectional survey. Addiction 2022; 117:715-729. [PMID: 34338387 DOI: 10.1111/add.15657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS People with mental ill health are more likely to smoke and experience smoking-related harm than those without. Switching from combustible tobacco to lower-risk nicotine-containing products may be of benefit; however, misperceptions of harm may prevent their use. We aimed to assess, among adults with and without mental ill health, (1) perceptions of harm from nicotine and relative harm and addictiveness of different nicotine-containing products and (2) sources of information associated with harm perceptions. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS On-line survey of adults (n = 3400) who smoke cigarettes and/or use e-cigarettes, or have recently stopped, in the United Kingdom. MEASUREMENTS Outcomes: harm perceptions of nicotine; relative perceived harm and addictiveness of different nicotine-containing products; sources of information for harm perceptions of nicotine, cigarette smoking and e-cigarettes. Demographics: sex, age, education, ethnic group and region. Other measures: self-reported smoking, vaping and mental health status. ANALYSES frequencies and logistic regressions adjusting for demographic/other measures. FINDINGS Among those with serious mental distress (versus no/low mental distress): 9.6% [13.9%, adjusted odds ratio (aOR) = 0.69, 95% confidence interval (CI) = 0.50-0.97] correctly identified that none/a very small amount of the health risks of smoking cigarettes come from nicotine; 41.7% (53.5%, aOR = 0.67, 95% CI = 0.54-0.84) perceived e-cigarettes and 53.2% (70.3%, aOR = 0.62, 95% CI = 0.50-0.77) perceived nicotine replacement therapy to be less harmful than cigarettes; and 42.1% (51.3%, aOR = 0.77, 95% CI = 0.62-0.95) perceived e-cigarettes as being less likely than cigarettes to cause cancer, 35.4% (45.5%, aOR = 0.71, 95% CI = 0.57-0.88) heart attacks and 34.9% (42.3%, aOR = 0.80, 95% CI = 0.64-0.99) lung problems. The most popular sources of information for cigarette smoking, e-cigarettes and nicotine were scientific experts' opinions and media reports, with little variation by mental distress. CONCLUSIONS Among adults with a history of tobacco and/or e-cigarette use, those with serious mental distress appear to have less accurate harm perceptions of nicotine and nicotine-containing products than those with no/low distress, despite reporting similar sources of information.
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Affiliation(s)
- Parvati R Perman-Howe
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | - Marie Horton
- Public Health UK, South Bank, London, UK
- SPECTRUM Consortium, UK
| | - Deborah Robson
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | | | - Ann McNeill
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
| | - Leonie S Brose
- King's College London, Addiction Sciences Building, London, UK
- SPECTRUM Consortium, UK
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6
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Development and testing of relative risk-based health messages for electronic cigarette products. Harm Reduct J 2021; 18:96. [PMID: 34496865 PMCID: PMC8424813 DOI: 10.1186/s12954-021-00540-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products; (2) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and (3) explore differences between smokers, non-smokers and dual users. METHOD Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. RESULTS On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages "Completely switching to e-cigarettes lowers your risk of smoking related diseases", "Use of this product is much less harmful than smoking", "Completely switching to e-cigarettes is a healthier alternative to smoking", and "This product presents substantially lower risks to health than cigarettes" which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated "This product is a safer alternative to smoking" significantly higher than non-smokers. Messages did not differ on understandability. CONCLUSIONS These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling.
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Wright C, Williams P, Elizarova O, Dahne J, Bian J, Zhao Y, Tan ASL. Effects of brief exposure to misinformation about e-cigarette harms on twitter: a randomised controlled experiment. BMJ Open 2021; 11:e045445. [PMID: 34470790 PMCID: PMC8413940 DOI: 10.1136/bmjopen-2020-045445] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To assess the effect of exposure to misinformation about e-cigarette harms found on Twitter on adult current smokers' intention to quit smoking cigarettes, intention to purchase e-cigarettes and perceived relative harm of e-cigarettes compared with regular cigarettes. SETTING An online randomised controlled experiment conducted in November 2019 among USA and UK current smokers. PARTICIPANTS 2400 adult current smokers aged ≥18 years who were not current e-cigarette users recruited from an online panel. Participants' were randomised in a 1:1:1:1 ratio using a least-fill randomiser function. INTERVENTIONS Viewing 4 tweets in random order within one of four conditions: (1) e-cigarettes are just as or more harmful than smoking, (2) e-cigarettes are completely harmless, (3) e-cigarette harms are uncertain, and (4) a control condition of tweets about physical activity. PRIMARY OUTCOMES MEASURES Self-reported post-test intention to quit smoking cigarettes, intention to purchase e-cigarettes, and perceived relative harm of e-cigarettes compared with smoking. RESULTS Among US and UK participants, after controlling for baseline measures of the outcome, exposure to tweets that e-cigarettes are as or more harmful than smoking versus control was associated with lower post-test intention to purchase e-cigarettes (β=-0.339, 95% CI -0.487 to -0.191, p<0.001) and increased post-test perceived relative harm of e-cigarettes (β=0.341, 95% CI 0.273 to 0.410, p<0.001). Among US smokers, exposure to tweets that e-cigarettes are completely harmless was associated with higher post-test intention to purchase e-cigarettes (β=0.229, 95% CI 0.002 to 0.456, p=0.048) and lower post-test perceived relative harm of e-cigarettes (β=-0.154, 95% CI -0.258 to -0.050, p=0.004). CONCLUSIONS US and UK adult current smokers may be deterred from considering using e-cigarettes after brief exposure to tweets that e-cigarettes were just as or more harmful than smoking. Conversely, US adult current smokers may be encouraged to use e-cigarettes after exposure to tweets that e-cigarettes are completely harmless. These findings suggest that misinformation about e-cigarette harms may influence some adult smokers' decisions to consider using e-cigarettes. TRIAL REGISTRATION NUMBER ISRCTN16082420.
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Affiliation(s)
- Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Philippa Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jennifer Dahne
- Psychiatry and Behavioral Sciences, Medical University of South Carolina College of Medicine, Charleston, South Carolina, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jiang Bian
- Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Yunpeng Zhao
- Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Weinberger AH, Zhu J, Barrington-Trimis JL, Wyka K, Goodwin RD. Cigarette Use, E-Cigarette Use, and Dual Product Use Are Higher Among Adults With Serious Psychological Distress in the United States: 2014-2017. Nicotine Tob Res 2021; 22:1875-1882. [PMID: 32285121 DOI: 10.1093/ntr/ntaa061] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/27/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Cigarette use is declining yet remains common among adults with mental health conditions. In contrast, e-cigarette use may be on the rise. This study investigated the relationship between serious psychological distress (SPD) and the exclusive and dual use of cigarettes and e-cigarettes among US adults from 2014 to 2017. AIMS AND METHODS Data came from 2014 to 2017 National Health Interview Survey, an annual, cross-sectional survey of nationally representative samples of US adults (total combined analytic sample n = 125 302). Past-month SPD was assessed using the Kessler Psychological Distress Scale (K6) and cigarette and e-cigarette use were assessed at each wave. Logistic regressions examined product use by SPD status in 2017 and trends in product use by SPD status from 2014 to 2017. Analyses adjusted for demographic covariates. RESULTS The prevalence of cigarette use, e-cigarette use, and dual use was higher among adults with SPD than without SPD in each year including the most recent data year 2017 (cigarette use, 39.50% vs. 13.40%, p < .001; e-cigarette use, 7.41% vs. 2.65%, p < .001; dual use, 5.30% vs. 1.26%, p < .001). Among adults with SPD, the prevalence of cigarette, e-cigarette, and dual product use did not change from 2014 to 2017 in contrast to a decreasing prevalence in cigarette, e-cigarette, and dual product use among individuals without SPD. CONCLUSIONS US adults with SPD report higher levels of cigarette, e-cigarette, and dual product use than adults without SPD. Use of these products has not declined over the past several years in contrast to decreasing trends among adults without SPD. IMPLICATIONS These data extend our knowledge of tobacco product use and mental health disparities by showing that in addition to higher levels of cigarette use, US adults with SPD also use e-cigarettes and dual products (cigarette and e-cigarette) more commonly than those without SPD. Furthermore, the use of these products has not declined over the past several years in contrast to continuing declines among adults without SPD. More research is needed to understand the potential positive and negative consequences of e-cigarette use among adults with SPD.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Jiaqi Zhu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY
| | - Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Fucito LM, Malinosky H, Baldassarri SR, Herbst RS. Clearing the Haze: What Do We Still Need to Learn about Electronic Nicotine Delivery Systems? Cancer Prev Res (Phila) 2021; 14:5-10. [PMID: 33148678 PMCID: PMC8324047 DOI: 10.1158/1940-6207.capr-20-0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022]
Abstract
Electronic nicotine delivery systems (ENDS; i.e., electronic cigarettes, e-cigarettes, vaping devices, vape pens) were introduced to the U.S. market in 2007 as a potential harm reduction alternative for people who smoked combustible cigarettes. Since that time, ENDS popularity grew very quickly, particularly among individuals who smoke cigarettes. However, young people and never smokers also started using ENDS, cohorts for whom these products were not intended. There are now a broad range of devices and e-liquid constituents. ENDS devices vary considerably in their design and generation of potentially toxic chemicals, with higher power devices likely much more hazardous than lower power devices. This landscape may further change after September 9, 2020, when all ENDS manufacturers are required to submit a premarket tobacco product application to the FDA to obtain authorization for marketing. Research has not kept pace with this rapidly changing technology and important questions remain regarding the relative benefits versus risks of ENDS. In light of these challenges, we propose key ENDS research priorities to address these gaps.
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Affiliation(s)
- Lisa M Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
- Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut
| | - Hannah Malinosky
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Stephen R Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care & Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Roy S Herbst
- Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut
- Department of Internal Medicine, Section of Medical Oncology, Yale University School of Medicine, New Haven, Connecticut
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10
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Caponnetto P, Polosa R. A qualitative study of the views about smoking, licensed cessation aids and e-cigarettes in people with schizophrenia spectrum disorders. J Addict Dis 2020; 39:152-165. [PMID: 33043838 DOI: 10.1080/10550887.2020.1826097] [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: 10/23/2022]
Abstract
Smoking prevalence remains high among people with a mental health condition compared to those without. Understanding people's motivation to quit and their views of smoking cessation support may help to develop future interventions. We conducted a qualitative study to explore the perceptions of 30 people with schizophrenia spectrum disorders who were current smokers, about smoking traditional cigarettes, the appeal of licensed medicines and e-cigarettes for smoking cessation or smoking reduction. The experiences of participants who were motivated to quit were compared with those who were not motivated to quit. Findings suggest traditional cigarettes were pleasurable and licensed cessation aids and e-cigarettes unappealing to participants who were unmotivated to quit. Whereas nicotine replacement products and e-cigarettes may be an appealing smoking cessation or reduction strategy for those motivated to quit. There is a need to find ways of making traditional cigarettes less appealing and alternative less harmful nicotine products (licensed and unlicensed) more appealing and accessible to this group of high risk smokers.
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Affiliation(s)
- Pasquale Caponnetto
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.,Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-S. Marco," University of Catania, Catania, Italy.,Department of Educational Sciences, University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, Catania, Italy
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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