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Marx JM, Miller A, Windsor A, Locke J, Frazier E. Perceptions of cigarettes and e-cigarettes: does health literacy matter? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2595-2603. [PMID: 34635027 DOI: 10.1080/07448481.2021.1979008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 06/01/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study assessed the relationship between health literacy, perceptions of traditional and electronic cigarettes, and smoking status among college students. PARTICIPANTS Participants (N = 150; Mage= 20.41 years, SD 3.48), included nonsmokers (78%) and smokers (21%) of traditional (12%) and e-cigarettes (17%). METHOD Participants completed a novel questionnaire to assess perceptions of traditional and e-cigarettes, and the Health Literacy Skills Instrument to evaluate health literacy. RESULTS Traditional cigarettes were perceived as having a greater negative impact on physical health than e-cigarettes, whereas e-cigarettes were perceived as having a greater positive impact on social-emotional health than traditional cigarettes. Most participants (57%) had below basic health literacy skills. CONCLUSIONS This study did not find a relationship between health literacy skills and smoking status or smoking perceptions. Further research is needed to investigate correlates of smoking status and perceptions to inform prevention and cessation efforts.
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Affiliation(s)
- Jenna M Marx
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Alyssa Miller
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Alexa Windsor
- Loyola University of Maryland, Baltimore, Maryland, USA
| | - Jasmine Locke
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Emily Frazier
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
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Hung M, Spencer A, Hon ES, Licari FW, Cheever VJ, Moffat R, Goh C, Raymond B, Lipsky MS. E-cigarette addiction and harm perception: Does initiation flavor choice matter? BMC Public Health 2022; 22:1780. [PMID: 36127670 PMCID: PMC9487027 DOI: 10.1186/s12889-022-14166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The 21st century was marked by a dramatic increase in adolescent e-cigarette use in the United States (US). The popularity of non-traditional flavor types, including fruit and pastry, is thought to contribute toward growing product use nationally, leading to a variety of federal and state regulations limiting the use of non-traditional flavors in the US. The relationship between flavor type and increased adolescent use suggests a possible link between flavor use and addiction and harm perception. This study assessed if the flavor type used when initiating e-cigarette use predicted addiction and harm perceptions. Methods The study utilized data from the multi-wave youth Population Assessment of Tobacco Health Study. It explored the impact initiating e-cigarette use with traditional versus non-traditional flavor types among cigarette users on the outcome variables: e-cigarette addiction and harm perception. Both e-cigarette addiction and harm perception were measured using self-report, Likert scale questionnaires. Descriptive statistics characterized the study variables and linear regression analyses performed to test whether flavor initiation type is associated with addiction and harm perception. Results The study sample consisted of 1,043 youth (weighted N = 1,873,617) aged 12 to 17 years who reported at least one instance of e-cigarette use. After adjusting for age, age of onset, sex, race and annual household income there was no statistically significant difference in addiction levels between those initiating with traditional versus non-traditional flavors (p = 0.294). Similarly, traditional versus non-traditional flavor initiation did not show a statistically significant difference in adolescent e-cigarette harm perceptions (p = 0.601). Conclusions Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions.
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Affiliation(s)
- Man Hung
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA. .,University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Andrew Spencer
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Emory University, Atlanta, GA, USA
| | - Eric S Hon
- University of Chicago Department of Economics, Chicago, IL, USA
| | - Frank W Licari
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Val Joseph Cheever
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Ryan Moffat
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Clarissa Goh
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Riverton High School, Riverton, UT, USA
| | - Ben Raymond
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Martin S Lipsky
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Portland State University Institute on Aging, Portland, OR, USA
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Watten RG, Watten VP. Snus and Alcohol: Mutually Rewarding Effects in the Brain? A Matched Controlled Population Study. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211027124. [PMID: 34366668 PMCID: PMC8317241 DOI: 10.1177/11782218211027124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/28/2021] [Indexed: 12/02/2022]
Abstract
Background: The use of moist smokeless tobacco (snus) is increasing in the U.S. and other Western countries, and especially among young people. Snus is associated with several health problems, but the relationship between use of snus and alcohol is scarcely explored. Neuro-cognitive and psychological research suggest an association due to possible mutually rewarding effects in the limbic brain. We investigated this issue in a matched controlled population study. Methods: Matched control group design where drinking habits and alcohol consumption in a group of users of snus (n = 1043, mean age = 35.20; n men = 749, n women = 294) were compared to a control group of non-users matched on age and gender (n = 1043, mean age = 35.65; n men = 749, n women = 294). In addition, we registered background variables such as level of education, income, self-perceived general, dental health, mental health, current depressive symptoms, and BMI. In estimation of alcohol consumption, the background variables were used as covariates in factorial analyses of variance (ANCOVA). Results: Users of snus had lower level of education, lower income, poorer general, dental, and mental health status than non-users, but there were no differences in BMI. Differences in mental health status were related to drinking habits. Users of snus had a higher frequency of drinking, higher frequency of intoxication, and showed more excess drinking. Controlled for background variables users of snus had a 25.2% higher estimated yearly consumption of alcohol in terms of standard units of alcohol on the weekdays, 26.4% higher on weekends and a 60.2% higher yearly excess consumption. Conclusion: Users of snus had an elevated alcohol consumption and another drinking style than non-users. The findings are discussed according to neuro-cognitive and psychopharmacological mechanisms, reward learning and conditioning. The results have implications for prevention, treatment and rehabilitation of alcohol and nicotine dependence.
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Affiliation(s)
- Reidulf G Watten
- Department of Psychology, Inland Norway University of Applied Sciences, INN University, Norway
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Felicione NJ, Ozga-Hess JE, Ferguson SG, Dino G, Kuhn S, Haliwa I, Blank MD. Cigarette smokers' concurrent use of smokeless tobacco: dual use patterns and nicotine exposure. Tob Control 2020; 30:24-29. [PMID: 32051253 DOI: 10.1136/tobaccocontrol-2019-055345] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The concurrent use of cigarettes with other tobacco products, such as smokeless tobacco (SLT), is increasingly common. Extant work with cigarette smokers who also use SLT is based heavily on retrospective reports and between-group comparisons. The purpose of this study was to assess prospectively the patterns of dual users' product use and nicotine exposure on days when cigarettes were smoked exclusively (single use) versus concurrently with SLT (dual use). DESIGN Forty-six dual cigarette-SLT users recorded their product use in real time via ecological momentary assessment for a 2-week longitudinal design. They responded to questions about situational factors (eg, location, mood) using this same diary, and collected saliva samples each night for later cotinine measurement. At the end of this 2-week period, users reported on their reasons for and beliefs about SLT use. RESULTS Cotinine levels were significantly higher on dual versus single use days (mean±SEM=374.48±41.08 ng/mL vs 300.17±28.13 ng/mL, respectively; p<0.01), and the number of cigarettes logged was higher on dual versus single use days (11.13±0.98 vs 9.13±1.11, respectively; p<0.01). Product use was distinguished by situational factors, with the strongest predictor being location of use. Moreover, the most common reason for initiating (56.52%) and continuing (67.39%) SLT use was to circumvent indoor smoking restrictions. CONCLUSIONS Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for SLT use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished.
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Affiliation(s)
| | - Jenny E Ozga-Hess
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Stuart G Ferguson
- School of Medicine, University of Tasmania Faculty of Health, Hobart, Tasmania, Australia
| | - Geri Dino
- Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, West Virginia, USA.,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Summer Kuhn
- Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia, USA
| | - Ilana Haliwa
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Melissa D Blank
- Psychology, West Virginia University, Morgantown, West Virginia, USA .,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
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Natto ZS. Dental Students' Knowledge and Attitudes About Electronic Cigarettes: A Cross-Sectional Study at One Saudi University. J Dent Educ 2020; 84:27-33. [PMID: 31977086 DOI: 10.21815/jde.019.162] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/16/2019] [Indexed: 12/23/2022]
Abstract
There is limited information about what dental students know about the risks and effects of e-cigarettes, and there is even less information regarding their attitudes about e-cigarettes. The aim of this study was to assess dental students' knowledge, education, and attitudes regarding e-cigarettes and their confidence in discussing e-cigarettes with patients. All fourth- to sixth-year students registered at the King Abdulaziz University Faculty of Dentistry were invited to participate in this cross-sectional study conducted during a three-week period in December 2018. The focus was a comparison of never versus ever e-smokers ("ever" meaning current or former e-smokers). The response rate was 38.7% (193/498). Among the responding students, 43.2% (n=83) had ever used an e-cigarette, and 11 (5.7%) reported being current users. Almost 95% (n=183) of the total participants said they did not feel confident about their e-cigarette education in dental school. Students who had ever used an e-cigarette said they were more confident discussing e-cigarettes with patients than did students who had never used them and also demonstrated greater belief that e-cigarettes lower the risk of cancer for patients who use them as an alternative to smoking traditional cigarettes (p<0.001). This study provides evidence of a gap in dental students' attitudes and knowledge regarding e-cigarettes, making it necessary to integrate e-cigarette education into future curricula.
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Verhaegen A, Van Gaal L. Vaping and Cardiovascular Health: the Case for Health Policy Action. CURRENT CARDIOVASCULAR RISK REPORTS 2019. [DOI: 10.1007/s12170-019-0634-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224458. [PMID: 31766232 PMCID: PMC6888184 DOI: 10.3390/ijerph16224458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 01/08/2023]
Abstract
Socioeconomic inequalities in conventional cigarette smoking are well established in developed countries. The aim of this study was to investigate socioeconomic inequalities in e-cigarette use in Korea, in comparison with inequalities in conventional cigarette use. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Community Health Survey (KCHS) were analyzed. The years of data collected were 2013 to 2016 for the KNHANES and 2014 to 2016 for the KCHS, respectively. The age-adjusted prevalence of ever and current e-cigarette use and conventional cigarette use was calculated according to socioeconomic status indicators, including education, occupation, and income. The prevalence of ever e-cigarette use in men increased from 12.1% in 2013 to 19.2% in 2016 in the KNHANES, and from 13.4% in 2014 to 17.9% in 2016 in the KCHS. Ever and current e-cigarette use was concentrated among current smokers and was much more prevalent among men and also more common among younger age groups in men and women. There was higher prevalences of conventional cigarette use among men and women with less education, manual occupational class and lower income, with the differences more pronounced for women. There was higher ever and current use of e-cigarettes among women with less education, manual occupational class and lower income, but among men there was much less difference in e-cigarette use by these indicators of socio-economic status.
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Akinkugbe AA. Cigarettes, E-cigarettes, and Adolescents' Oral Health: Findings from the Population Assessment of Tobacco and Health (PATH) Study. JDR Clin Trans Res 2019; 4:276-283. [PMID: 30931714 DOI: 10.1177/2380084418806870] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Adolescents are a population group that actively uses tobacco products; however, limited reports are available on the effects of tobacco products on adolescents' oral health. OBJECTIVES This study investigated associations between self-reported use of cigarettes and e-cigarettes on the oral health status of a representative sample of US adolescents. METHODS Data came from 13,650 adolescents aged 12 to 17 y who participated in the 2013-2014 wave of the Population Assessment of Tobacco and Health study. Participants self-reported current use (i.e., past 30 d) and ever use of cigarettes and e-cigarettes, as well as past-year diagnoses with dental problems by a doctor, dentist, or other health professional (self-reported by parent or emancipated youth). Survey-adjusted logistic regression was used to estimate prevalence odds ratios (PORs) and 95% CIs. RESULTS The proportion of adolescents who self-reported current use of only cigarettes was 3.2%, while 1.7% reported current use of only e-cigarettes. Similarly, 1.4% reported current use of both cigarettes and e-cigarettes, while 7.1% reported ever use of both. About 22% self-reported a provider diagnosis with dental problems in the past year. The covariate-adjusted associations between current cigarette and e-cigarette use on self-reported provider-diagnosed dental problems in the past year were, respectively, POR = 1.50 (95% CI, 1.18 to 1.90) and POR = 1.11 (95% CI, 0.79 to 1.55), while self-reported current use of both was associated with POR = 1.72 (95% CI, 1.24 to 2.38). Ever use of cigarettes and e-cigarettes was likewise associated with increased prevalence odds of self-reported past-year diagnosis with dental problems, although to a lesser magnitude. CONCLUSION Findings suggest that dual use of e-cigarettes and conventional cigarettes is associated with poor oral health outcomes among adolescents. However, studies of a longitudinal nature are needed to confirm these findings. KNOWLEDGE TRANSFER STATEMENT The results of this study are relevant to public health and oral health practitioners seeking to intervene during developmental periods in which adolescents may have access to tobacco products in the home and in social settings.
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Affiliation(s)
- A A Akinkugbe
- 1 Oral Health Services Research Core, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
- 2 Oral Health in Childhood and Adolescence Transdisciplinary Core, Institute for Inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, VA, USA
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Gravely S, Driezen P, Ouimet J, Quah ACK, Cummings KM, Thompson ME, Boudreau C, Hammond D, McNeill A, Borland R, Thrasher JF, Edwards R, Omar M, Hitchman SC, Yong H, Barrientos‐Gutierrez T, Willemsen MC, Bianco E, Boado M, Goma FM, Seo HG, Nargis N, Jiang Y, Perez CDA, Fong GT. Prevalence of awareness, ever-use and current use of nicotine vaping products (NVPs) among adult current smokers and ex-smokers in 14 countries with differing regulations on sales and marketing of NVPs: cross-sectional findings from the ITC Project. Addiction 2019; 114:1060-1073. [PMID: 30681215 PMCID: PMC6510648 DOI: 10.1111/add.14558] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/21/2018] [Accepted: 01/14/2019] [Indexed: 11/30/2022]
Abstract
AIMS This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS A cross-sectional analysis of adult (≥ 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily). FINDINGS NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries. CONCLUSIONS With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK Centre for Tobacco and Alcohol StudiesUniversity of NottinghamNottinghamUK
| | | | - James F. Thrasher
- National Institute of Public HealthCuernavacaMorelosMexico
- Arnold School of Public HealthColumbiaSCUSA
| | | | | | | | - Hua‐Hie Yong
- Cancer Council VictoriaMelbourneAustralia
- Deakin UniversityGeelongVictoriaAustralia
| | | | | | - Eduardo Bianco
- Centro de Investigación para la Epidemia del TabaquismoMontevideoUruguay
| | | | | | - Hong Gwan Seo
- National Cancer CenterGoyang‐siGyeonggi‐doRepublic of Korea
| | | | - Yuan Jiang
- Chinese Center for Disease Control and Prevention (China CDC)BeijingChina
| | | | - Geoffrey T. Fong
- University of WaterlooWaterlooOntarioCanada
- Ontario Institute for Cancer ResearchTorontoCanada
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