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Zavala-Arciniega L, Hirschtick JL, Meza R, Fleischer NL. Dual and polytobacco use disparities at the intersection of age, sex, race and ethnicity, and income among US adults. Results from the 2018-2019 TUS-CPS. Prev Med Rep 2024; 39:102631. [PMID: 38352240 PMCID: PMC10862062 DOI: 10.1016/j.pmedr.2024.102631] [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: 11/20/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
Aim We aim to describe disparities in dual and polytobacco use at the intersection of age, sex, race and ethnicity, and income. Methods We used the 2018-2019 Tobacco Use Supplement to the Current Population Survey to estimate the prevalence of combinations of dual (two products) and polytobacco (three or more products) use for cigarettes, e-cigarettes, cigars, and smokeless tobacco (n = 135,268). We created five mutually exclusive categories: 1) cigarettes and e-cigarettes, 2) cigarettes and cigars, 3) cigarettes and smokeless tobacco, 4) dual/polyuse without cigarettes, and 5) polyuse with cigarettes. We estimated the dual/polyuse prevalence at the intersection of age (18-34, 35-54, 55+ years), sex (male, female), race and ethnicity (Non-Hispanic White, Non-Hispanic Black, Hispanic, and Non-Hispanic Other), and annual household income (<$50,000, $50,000-$99,999, ≥$100,000), resulting in 72 sociodemographic categories. We used a visualization tool that allowed for detailed characterization and identification of dual and polytobacco use disparities. Results Females were in three of the top four groups with the highest cigarette and e-cigarette dual use. Cigarette and cigar dual use was disproportionately high among low-income Non-Hispanic Black male adults aged 35-54 and 18-34. The highest prevalence of both polyuse with cigarettes and dual/polyuse without cigarettes was among low-income, Non-Hispanic White male adults aged 18-34 years. Conclusion We identified the population groups disproportionately using two or more tobacco products. This information is helpful for surveillance and for the implementation of tobacco control policies aimed at decreasing disparities in tobacco use.
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Affiliation(s)
- Luis Zavala-Arciniega
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA
| | - Jana L. Hirschtick
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA
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2
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Bhat TA, Kalathil SG, Leigh N, Hutson A, Goniewicz ML, Thanavala YM. Do alternative tobacco products induce less adverse respiratory risk than cigarettes? Respir Res 2023; 24:261. [PMID: 37907902 PMCID: PMC10617138 DOI: 10.1186/s12931-023-02568-2] [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: 09/08/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
RATIONALE Due to the relatively short existence of alternative tobacco products, gaps exist in our current understanding of their long-term respiratory health effects. We therefore undertook the first-ever side-by-side comparison of the impact of chronic inhalation of aerosols emitted from electronic cigarettes (EC) and heated tobacco products (HTP), and combustible cigarettes (CC) smoke. OBJECTIVES To evaluate the potential differential effects of alternative tobacco products on lung inflammatory responses and efficacy of vaccination in comparison to CC. METHODS Mice were exposed to emissions from EC, HTP, CC, or air for 8 weeks. BAL and lung tissue were analyzed for markers of inflammation, lung damage, and oxidative stress. Another group was exposed for 12 weeks and vaccinated and challenged with a bacterial respiratory infection. Antibody titers in BAL and sera and pulmonary bacterial clearance were assessed. MAIN RESULTS EC- and HTP-aerosols significantly augmented lung immune cell infiltrates equivalent to that achieved following CC-exposure. HTP and CC significantly increased neutrophil numbers compared to EC. All products augmented numbers of B cells, T cells, and pro-inflammatory IL17A+ T cells in the lungs. Decreased lung antioxidant activity and lung epithelial and endothelial damage was induced by all products. EC and HTP differentially augmented inflammatory cytokines/chemokines in the BAL. Generation of immunity following vaccination was impaired by EC and HTP but to a lesser extent than CC, with a CC > HTP > EC hierarchy of suppression of pulmonary bacterial clearance. CONCLUSIONS HTP and EC-aerosols induced a proinflammatory pulmonary microenvironment, lung damage, and suppressed efficacy of vaccination.
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Affiliation(s)
- Tariq A Bhat
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14263, USA
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Suresh G Kalathil
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14263, USA
| | - Noel Leigh
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alan Hutson
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Yasmin M Thanavala
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14263, USA.
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3
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Issabakhsh M, Sánchez-Romero LM, Le TTT, Liber AC, Tan J, Li Y, Meza R, Mendez D, Levy DT. Machine learning application for predicting smoking cessation among US adults: An analysis of waves 1-3 of the PATH study. PLoS One 2023; 18:e0286883. [PMID: 37289765 PMCID: PMC10249849 DOI: 10.1371/journal.pone.0286883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
Identifying determinants of smoking cessation is critical for developing optimal cessation treatments and interventions. Machine learning (ML) is becoming more prevalent for smoking cessation success prediction in treatment programs. However, only individuals with an intention to quit smoking cigarettes participate in such programs, which limits the generalizability of the results. This study applies data from the Population Assessment of Tobacco and Health (PATH), a United States longitudinal nationally representative survey, to select primary determinants of smoking cessation and to train ML classification models for predicting smoking cessation among the general population. An analytical sample of 9,281 adult current established smokers from the PATH survey wave 1 was used to develop classification models to predict smoking cessation by wave 2. Random forest and gradient boosting machines were applied for variable selection, and the SHapley Additive explanation method was used to show the effect direction of the top-ranked variables. The final model predicted wave 2 smoking cessation for current established smokers in wave 1 with an accuracy of 72% in the test dataset. The validation results showed that a similar model could predict wave 3 smoking cessation of wave 2 smokers with an accuracy of 70%. Our analysis indicated that more past 30 days e-cigarette use at the time of quitting, fewer past 30 days cigarette use before quitting, ages older than 18 at smoking initiation, fewer years of smoking, poly tobacco past 30-days use before quitting, and higher BMI resulted in higher chances of cigarette cessation for adult smokers in the US.
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Affiliation(s)
- Mona Issabakhsh
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, United States of America
| | - Luz Maria Sánchez-Romero
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, United States of America
| | - Thuy T. T. Le
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Alex C. Liber
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, United States of America
| | - Jiale Tan
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Yameng Li
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, United States of America
| | - Rafael Meza
- Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | - David Mendez
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, United States of America
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4
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Raitasalo K, Bye EK, Pisinger C, Scheffels J, Tokle R, Kinnunen JM, Ollila H, Rimpelä A. Single, Dual, and Triple Use of Cigarettes, e-Cigarettes, and Snus among Adolescents in the Nordic Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:683. [PMID: 35055504 PMCID: PMC8775390 DOI: 10.3390/ijerph19020683] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 12/04/2022]
Abstract
New tobacco and nicotine products have emerged on the market in recent years. Most research has concerned only one product at a time, usually e-cigarettes, while little is known about the multiple use of tobacco and nicotine products among adolescents. We examined single, dual, and triple use of cigarettes, e-cigarettes, and snus among Nordic adolescents, using data of 15-16-year-olds (n = 16,125) from the European School Survey Project on Alcohol and other Drugs (ESPAD) collected in 2015 and 2019 from Denmark, Finland, Iceland, Norway, Sweden, and the Faroe Islands. Country-specific lifetime use of any of these products ranged between 40% and 50%, and current use between 17% and 31%. Cigarettes were the most common product in all countries except for Iceland, where e-cigarettes were remarkably more common. The proportion of dual and triple users was unexpectedly high among both experimental (24%-49%) and current users (31-42%). Triple use was less common than dual use. The users' patterns varied somewhat between the countries, and Iceland differed substantially from the other countries, with a high proportion of single e-cigarette users. More knowledge on the patterns of multiple use of tobacco and nicotine products and on the potential risk and protective factors is needed for targeted intervention and prevention efforts.
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Affiliation(s)
- Kirsimarja Raitasalo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland;
| | - Elin K. Bye
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (J.S.); (R.T.)
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark;
- Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
- Danish Heart Foundation, 1120 Copenhagen, Denmark
| | - Janne Scheffels
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (J.S.); (R.T.)
| | - Rikke Tokle
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (J.S.); (R.T.)
- Norwegian Social Research, Oslo Metropolitan University, 0170 Oslo, Norway
| | - Jaana M. Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.M.K.); (A.R.)
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland;
| | - Arja Rimpelä
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.M.K.); (A.R.)
- Department of Adolescent Psychiatry, Tampere University Hospital, 33521 Tampere, Finland
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5
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Abstract
Since the spread of tobacco from the Americas hundreds of years ago, tobacco cigarettes and, more recently, alternative tobacco products have become global products of nicotine addiction. Within the evolving alternative tobacco product space, electronic cigarette (e-cigarette) vaping has surpassed conventional cigarette smoking among adolescents and young adults in the United States and beyond. This review describes the experimental and clinical evidence of e-cigarette toxicity and deleterious health effects. Adverse health effects related to e-cigarette aerosols are influenced by several factors, including e-liquid components, physical device factors, chemical changes related to heating, and health of the e-cigarette user (e.g., asthmatic). Federal, state, and local regulations have attempted to govern e-cigarette flavors, manufacturing, distribution, and availability, particularly to underaged youths. However, the evolving e-cigarette landscape continues to impede timely toxicological studies and hinder progress made toward our understanding of the long-term health consequence of e-cigarettes.
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Affiliation(s)
- Terry Gordon
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
| | - Emma Karey
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
| | - Meghan E Rebuli
- Department of Pediatrics and Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Yael-Natalie H Escobar
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Ilona Jaspers
- Department of Pediatrics and Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Lung Chi Chen
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
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6
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Hart JL, Payne TJ, Groom A, Tran H, Walker KL, Kesh A, Robertson RM, Vu THT. Association between electronic nicotine delivery systems (ENDS) device and E-liquid alterations and flavor use with clinical and EVALI-like symptoms. Prev Med Rep 2022; 24:101619. [PMID: 34976675 PMCID: PMC8683991 DOI: 10.1016/j.pmedr.2021.101619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/02/2022] Open
Abstract
Studies reporting clinical symptoms related to electronic nicotine delivery systems (ENDS) usage, especially types of devices and e-liquids, are sparse. The sample included 1,432 current ENDS users, ages 18-64, from a nationwide online survey conducted in 2016. ENDS use included device types, nicotine content, flavors, and e-liquid used. Outcomes included any e-cigarette, or vaping, product use-associated lung injury (EVALI)-like symptoms (e.g., cough, shortness of breath, nausea) as well as any clinical symptoms. Of the sample, 50% were female, 23% non-Hispanic (NH) White, 23% NH Black, 54% Hispanic, 18% aged 18-24, 17% LGBTQ, 41% with <$50 K income, 55% 1 + any symptoms, and 33% 1 + any EVALI-like symptoms. Cough and nausea were most prevalent among EVALI-like symptoms (27% and 7.3%, respectively). The proportion having any EVALI-like symptoms was higher in the following groups: younger, Hispanic, current smokers, and current other product users. With multiple adjustments, participants who used refillable devices, varied nicotine content, used flavored products, or made their own e-liquids were more likely to have clinical symptoms than their counterparts. For example, the odds (95% CI) of having 1 + EVALI-like symptoms in participants who used refillable devices with e-liquid pour or e-liquid cartridge replacement were 1.70 (1.13, 2.56) and 1.95 (1.27, 2.99), respectively, compared to the non-refillable group. Use of products (devices and e-liquids) that can be altered and flavored products are associated with higher odds of having clinical symptoms, including EVALI-like symptoms.
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Affiliation(s)
- Joy L Hart
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,Department of Communication, University of Louisville, Louisville, KY, USA
| | - Thomas J Payne
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA
| | - Allison Groom
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,American Heart Association, Dallas, TX, USA
| | - Hy Tran
- NORC at the University of Chicago, Chicago, IL, USA
| | - Kandi L Walker
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,Department of Communication, University of Louisville, Louisville, KY, USA
| | - Anshula Kesh
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,American Heart Association, Dallas, TX, USA
| | - Rose Marie Robertson
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,American Heart Association, Dallas, TX, USA
| | - Thanh-Huyen T Vu
- American Heart Association Tobacco Center for Regulatory Science (A-TRAC), Dallas, TX, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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7
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Mistry R, Bondarenko I, Jeon J, Brouwer AF, Mattingly DT, Hirschtick JL, Jimenez-Mendoza E, Levy DT, Land SR, Elliott MR, Taylor JMG, Meza R, Fleischer NL. Latent class analysis of use frequencies for multiple tobacco products in US adults. Prev Med 2021; 153:106762. [PMID: 34358593 PMCID: PMC8595688 DOI: 10.1016/j.ypmed.2021.106762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
A persistent challenge is characterizing patterns of tobacco use in terms of product combinations and frequency. Using Wave 4 (2016-17) Population Assessment of Tobacco and Health Study adult data, we conducted latent class analyses (LCA) of past 30-day frequency of use for 9 tobacco products. One-step LCA with joint multinomial logistic regression models compared sociodemographic factors between users (n = 13,716) and non-users (n = 17,457), and between latent classes of users. We accounted for survey design and weights. Our analyses identified 6 classes: in addition to non-users (C0: 75.7%), we found 5 distinct latent classes of users: daily exclusive cigarette users (C1: 15.5%); occasional cigarette and polytobacco users (C2: 3.8%); frequent e-product and occasional cigarette users (C3: 2.2%); daily smokeless tobacco (SLT) and infrequent cigarette users (C4: 2.0%); and occasional cigar users (C5: 0.8%). Compared to C1: C2 and C3 had higher odds of being male (versus female), younger (especially 18-24 versus 55 years), and having higher education; C2 had higher, while C3 and C4 had lower, odds of being a racial/ethnic minority (versus Non-Hispanic White); C4 and C5 had much higher odds of being male (versus female) and heterosexual (versus sexual minority) and having higher income; and C5 had higher odds of college or more education. We identified three classes of daily or frequent users of a primary product (cigarettes, SLT or e-products) and two classes of occasional users (cigarettes, cigars and polytobacco). Sociodemographic differences in class membership may influence tobacco-related health disparities associated with specific patterns of use.
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Affiliation(s)
- Ritesh Mistry
- University of Michigan, Department of Health Behavior and Health Education, Ann Arbor, MI, United States of America.
| | - Irina Bondarenko
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Jihyoun Jeon
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Andrew F Brouwer
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Delvon T Mattingly
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Jana L Hirschtick
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Evelyn Jimenez-Mendoza
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - David T Levy
- Georgetown University, School of Medicine, Washington, DC, United States of America
| | - Stephanie R Land
- National Institutes of Health, National Cancer Institute, Bethesda, MD, United States of America
| | - Michael R Elliott
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Jeremy M G Taylor
- University of Michigan, Department of Biostatistics, Ann Arbor, MI, United States of America
| | - Rafael Meza
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
| | - Nancy L Fleischer
- University of Michigan, Department of Epidemiology, Ann Arbor, MI, United States of America
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8
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Nguyen N, Kapiteni K, Straus ER, Guydish J. Factors associated with dual and polytobacco use among people in residential substance use disorder treatment. Am J Addict 2021; 30:496-504. [PMID: 34427005 PMCID: PMC10039644 DOI: 10.1111/ajad.13206] [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: 02/10/2021] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about whether people in substance use disorder (SUD) treatment are at risk for multiple-tobacco use. We examined the factors associated with dual- and polytobacco use among clients in SUD treatment. METHODS A cross-sectional survey was conducted in 2019 among 562 clients (Mage = 39, 74% male) in 20 residential SUD treatment programs in California, USA. The outcomes included single-, dual- (use of two products), and polytobacco use (use of three of more products). Independent variables were nicotine dependence, quitting-related factors, blunt/spliff use, and health-related factors. A multinomial model examined associations between the independent variables and the outcome, controlling for demographics, and time in treatment. RESULTS Overall, 32.6%, 18.9%, and 14.0% of the sample were single-, dual-, and polytobacco users, respectively. Factors associated with increased odds of polytobacco use included greater nicotine dependence (adjusted odds ratio [AOR] = 1.60; 95% CI = 1.19, 2.16), ever using e-cigarettes for quitting (AOR = 4.56; 95% CI = 2.23, 9.34), and past 30-day use of blunt/spliff (AOR = 2.96; 95% CI = 1.48, 5.89). Factors associated with increased odds of dual use were ever using e-cigarettes for quitting (AOR = 3.19; 95% CI = 1.79, 5.66) and reporting more mentally unhealthy days (AOR = 1.05; 95% CI = 1.02, 1.07). CONCLUSION AND SCIENTIFIC SIGNIFICANCE This study extends the literature on tobacco use among people in SUD treatment by revealing the high prevalence of dual- and polytobacco use and the unique characteristics of users. The findings have implications for interventions reducing all types of tobacco use in this understudied population.
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, CA, USA
- Correspondence: Nhung Nguyen, PhD; Center for Tobacco Control Research and Education, University of California San Francisco, 530 Parnassus Ave, San Francisco, CA, USA 94143. . Phone: 415-502-1488. Fax: 415-476-2265
| | - Kwinoja Kapiteni
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
| | - Elana R Straus
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA
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9
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Bonner E, Chang Y, Christie E, Colvin V, Cunningham B, Elson D, Ghetu C, Huizenga J, Hutton SJ, Kolluri SK, Maggio S, Moran I, Parker B, Rericha Y, Rivera BN, Samon S, Schwichtenberg T, Shankar P, Simonich MT, Wilson LB, Tanguay RL. The chemistry and toxicology of vaping. Pharmacol Ther 2021; 225:107837. [PMID: 33753133 PMCID: PMC8263470 DOI: 10.1016/j.pharmthera.2021.107837] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/19/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
Vaping is the process of inhaling and exhaling an aerosol produced by an e-cigarette, vape pen, or personal aerosolizer. When the device contains nicotine, the Food and Drug Administration (FDA) lists the product as an electronic nicotine delivery system or ENDS device. Similar electronic devices can be used to vape cannabis extracts. Over the past decade, the vaping market has increased exponentially, raising health concerns over the number of people exposed and a nationwide outbreak of cases of severe, sometimes fatal, lung dysfunction that arose suddenly in otherwise healthy individuals. In this review, we discuss the various vaping technologies, which are remarkably diverse, and summarize the use prevalence in the U.S. over time by youths and adults. We examine the complex chemistry of vape carrier solvents, flavoring chemicals, and transformation products. We review the health effects from epidemiological and laboratory studies and, finally, discuss the proposed mechanisms underlying some of these health effects. We conclude that since much of the research in this area is recent and vaping technologies are dynamic, our understanding of the health effects is insufficient. With the rapid growth of ENDS use, consumers and regulatory bodies need a better understanding of constituent-dependent toxicity to guide product use and regulatory decisions.
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Affiliation(s)
- Emily Bonner
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Chang
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Emerson Christie
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Victoria Colvin
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brittany Cunningham
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Daniel Elson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Christine Ghetu
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Juliana Huizenga
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Sara J Hutton
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Siva K Kolluri
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Stephanie Maggio
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Ian Moran
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Bethany Parker
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Rericha
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brianna N Rivera
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Samantha Samon
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Trever Schwichtenberg
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Prarthana Shankar
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Michael T Simonich
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Lindsay B Wilson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Robyn L Tanguay
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA.
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10
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Powers JM, LaRowe LR, Lape EC, Zvolensky MJ, Ditre JW. Anxiety sensitivity, pain severity and co-use of cigarettes and e-cigarettes among adults with chronic pain. J Behav Med 2021; 44:392-401. [PMID: 33675503 PMCID: PMC11163874 DOI: 10.1007/s10865-021-00210-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
Anxiety sensitivity (fear of potential negative consequences of anxiety-related symptoms/sensations) has been identified as a transdiagnostic factor in comorbid pain and nicotine dependence and evidence suggests that anxiety sensitivity may be indirectly associated with nicotine use via greater pain severity. Therefore, this study tested the hypothesis that anxiety sensitivity is associated with cigarette and e-cigarette use/co-use directly and indirectly via greater pain severity. Participants included 273 online survey respondents with chronic musculoskeletal pain (34% female; Mage = 32.9). Anxiety sensitivity was positively associated with cigarette smoking, e-cigarette use and cigarette/e-cigarette co-use (ps < .05). Furthermore, anxiety sensitivity was indirectly and positively associated with cigarette smoking, e-cigarette use and co-use via greater chronic pain severity. Pain severity may play an important role in associations between anxiety sensitivity and nicotine dependence and prospective research should examine temporal/causal effects of anxiety sensitivity in relation to pain severity and nicotine/tobacco use.
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Affiliation(s)
- Jessica M Powers
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Lisa R LaRowe
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Emma C Lape
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA.
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11
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Panta P, Dhopathi SR, Gilligan G, Seshadri M. Invasive oral squamous cell carcinoma induced by concurrent smokeless tobacco and creamy snuff use: A case report. Oral Oncol 2021; 118:105354. [PMID: 34023217 DOI: 10.1016/j.oraloncology.2021.105354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 11/15/2022]
Abstract
Oral squamous cell carcinomas (OSCC) are caused by chronic tobacco abuse. In this regard, the carcinogenic potential of smoking and smokeless forms of tobacco, including chewing tobacco and moist/dry snuff, has been widely documented. However, the effects of tobacco-containing products such as creamy snuff on oral health have not been widely reported. Here, we report on the clinical presentation of a patient with OSCC induced by concurrent chewing tobacco and creamy snuff use. The development and progression of mucosal carcinogenesis in the context of mixed tobacco use habits is discussed. With the increased availability of newer tobacco-containing products, it is important for clinicians to be aware of these products in the marketplace, including dentifrices and nicotine pouches, and counsel their patients regarding their health risks.
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Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Narsapur Road, Sangareddy 502294, Telangana, India.
| | - Sravya Reddy Dhopathi
- Department of Periodontics, MNR Dental College and Hospital, Narsapur Road, Sangareddy 502294, Telangana, India
| | - Gerardo Gilligan
- Oral Medicine Department, Facultad de Odontologia, Universidad Nacional de Cordoba, Haya de la Torre SN, PC: 5000, Ciudad Universitaria, Cordoba, Argentina
| | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, United States
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12
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Hirschtick JL, Mattingly DT, Cho B, Arciniega LZ, Levy DT, Sanchez-Romero LM, Jeon J, Land SR, Mistry R, Meza R, Fleischer NL. Exclusive, Dual, and Polytobacco Use Among US Adults by Sociodemographic Factors: Results From 3 Nationally Representative Surveys. Am J Health Promot 2021; 35:377-387. [PMID: 33047619 PMCID: PMC8256439 DOI: 10.1177/0890117120964065] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To provide tobacco product use patterns for US adults by sociodemographic group. DESIGN A secondary analysis of Tobacco Use Supplement to the Current Population Survey (2014-15), National Health Interview Survey (2015), and Population Assessment of Tobacco and Health (2015-16). SETTING United States. SAMPLE Three nationally representative samples of adults (N = 28,070-155,067). MEASURES All possible combinations of cigarette, Electronic Nicotine Delivery Systems (ENDS), other combustible product, and smokeless tobacco use, defined as current use every day or some days. ANALYSIS Weighted population prevalence and proportion among tobacco users of exclusive, dual, and polyuse patterns by sex, race/ethnicity, education, income, and age. RESULTS Exclusive cigarette use was the most prevalent pattern (10.9-12.8% of US population). Dual and polyuse were less prevalent at the population level (2.6-5.2% and 0.3-1.3%, respectively) but represented 16.7-25.5% of product use among tobacco users. Cigarette plus ENDS use was similar by sex, but men were more likely to be dual users of cigarettes plus other combustibles or smokeless tobacco. Among race/ethnic subgroups, non-Hispanic (NH) Whites were most likely to use cigarettes plus ENDS, while NH Blacks were most likely to use cigarettes plus other combustibles. Dual and polyuse were generally less common among adults with higher education, income, and age. CONCLUSION Differences in product use patterns by sociodemographic group likely represent different risk profiles with important implications for resulting health disparities.
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Affiliation(s)
- Jana L. Hirschtick
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Delvon T. Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Beomyoung Cho
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Luis Zavala Arciniega
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Luz Maria Sanchez-Romero
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Stephanie R. Land
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, MD, USA
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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13
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Chau SL, Wang MP, Wu Y, Cheung DYT, Kong A, Lai V, Lam TH, Ho SY. Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015-17). BMC Public Health 2021; 21:307. [PMID: 33549071 PMCID: PMC7866759 DOI: 10.1186/s12889-021-10341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. METHOD A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. RESULTS Eighty-four point one percent (95% CI 81.4-86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4-18.6%) were current polytobacco product users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75-8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44-2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97). CONCLUSIONS Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.
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Affiliation(s)
- S L Chau
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - M P Wang
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Y Wu
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - D Y T Cheung
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - A Kong
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - V Lai
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - T H Lam
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
| | - S Y Ho
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
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14
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Powers JM, LaRowe LR, Garey L, Zvolensky MJ, Ditre JW. Pain intensity, e-cigarette dependence, and cessation-related outcomes: The moderating role of pain-related anxiety. Addict Behav 2020; 111:106548. [PMID: 32745941 PMCID: PMC7484173 DOI: 10.1016/j.addbeh.2020.106548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/05/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
Pain and nicotine dependence are prevalent, co-occurring conditions posited to interact in the manner of a positive feedback loop; however, most research to date has been conducted among tobacco cigarette smokers. Initial evidence suggests that pain is a risk factor for greater e-cigarette dependence, and additional research is needed to examine covariation between pain and e-cigarette use. There is reason to suspect that pain-related anxiety (i.e., the tendency to respond to pain with anxiety or fear) may be associated with greater e-cigarette dependence and difficulty quitting, and that pain intensity and pain-related anxiety may interact to confer greater risk for e-cigarette use. The current study represents the first examination of cross-sectional associations between pain intensity, pain-related anxiety, and e-cigarette dependence, motivation to quit, history of lifetime e-cigarette quit attempts, perceived barriers to cessation, and negative expectancies during abstinence from e-cigarettes. Participants (N = 520 e-cigarette users, 52.1% female, Mage = 34.85) completed an online survey assessing health behaviors. Results indicated that pain-related anxiety was positively associated with e-cigarette dependence and perceived barriers to cessation (ps < 0.05). Pain-related anxiety was found to moderate relations between pain intensity and primary outcomes, such that pain intensity was positively associated with motivation to quit, likelihood of past failed quit attempt, and negative abstinence expectancies among participants who endorsed high (but not moderate or low) levels of pain-related anxiety. Future research would benefit from examining prospective associations between pain-related anxiety, pain intensity, and e-cigarette use/cessation trajectories among individuals with chronic pain.
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Affiliation(s)
- Jessica M Powers
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Lisa R LaRowe
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, USA
| | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA.
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15
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Gomez Y, Creamer M, Trivers KF, Anic G, Morse AL, Reissig C, Agaku I. Patterns of tobacco use and nicotine dependence among youth, United States, 2017-2018. Prev Med 2020; 141:106284. [PMID: 33068604 DOI: 10.1016/j.ypmed.2020.106284] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 08/26/2020] [Accepted: 10/10/2020] [Indexed: 01/03/2023]
Abstract
This study examined patterns of tobacco product use and their association with nicotine dependence among U.S. youth. Combined data from the 2017-2018 National Youth Tobacco Surveys were analyzed for students that reported current (past-30-day) use of e-cigarettes, cigarettes, cigars, smokeless tobacco, or hookah (n = 6106). Analyses assessed multiple product use (≥2 tobacco products) overall and by sex, school level, race/ethnicity, current use, and frequent use (use of a product for ≥20 of the preceding 30 days). Multivariable logistic regression was used to identify correlates of nicotine dependence. During 2017-2018, 40.8% of tobacco product users reported use of multiple products. Multiple product use ranged from 47.0% among e-cigarette users to 80.7% among cigarette smokers. Among frequent users of each respective product, 80.0% of cigarette smokers, 74.9% of cigar smokers, 73.6% of smokeless tobacco users, 70.7% of hookah smokers, and 40.3% of e-cigarette users reported use of multiple products. Most youth who reported nicotine dependence (64.0%) were multiple product users. E-cigarettes were the most common single product used (36.3%) and the product most commonly used in combination with other products; e-cigarettes plus cigarettes (6.7%) was the most common product combination. Combustible product use, smokeless tobacco use, multiple product use and frequent use were associated with greater odds of nicotine dependence. Nicotine dependence among youth is especially influenced by cigarette use, smokeless tobacco use, frequent use of any tobacco product, and multiple product use. Proven tobacco control interventions in coordination with regulatory efforts can reduce youth tobacco product use.
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Affiliation(s)
- Yessica Gomez
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - MeLisa Creamer
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gabriella Anic
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Aura Lee Morse
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Chad Reissig
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Israel Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Powers JM, Heckman BW, LaRowe LR, Ditre JW. Smokers with pain are more likely to report use of e-cigarettes and other nicotine products. Exp Clin Psychopharmacol 2020; 28:601-608. [PMID: 31724418 PMCID: PMC7220837 DOI: 10.1037/pha0000335] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Pain and tobacco cigarette smoking frequently co-occur, and smokers report using cigarettes to self-medicate pain. Despite the growing popularity of e-cigarettes and alternative nicotine products, no research has examined their use as a function of pain status. The goal of this study was to test cross-sectional relations between the presence of pain and current use of e-cigarettes, lifetime polynicotine use, and lifetime use of individual nicotine products. The sample was comprised of current daily smokers (N = 301) who were recruited to participate in a web-based longitudinal study examining predictors of cessation milestones. Results indicated that smokers who endorsed past-2-week significant pain (vs. no past-2-week pain) were 3 times more likely to endorse current e-cigarette use, reported having used a greater number of nicotine products in their lifetime, and were nearly 3 times more likely to endorse lifetime polynicotine use. In terms of individual products, smokers with pain were approximately 4 times as likely to have tried e-cigarettes and 7 times more likely to have tried cigars. This is the first study to demonstrate that smokers who endorse significant pain are also more likely to endorse use of e-cigarettes and other combustible nicotine products. Future research is needed to examine polynicotine use in relation to pain reporting among more varied samples of smokers and nonsmokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Jessica M. Powers
- Department of Psychology, Syracuse University, Syracuse, NY 13244, United States
| | - Bryan W. Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Lisa R. LaRowe
- Department of Psychology, Syracuse University, Syracuse, NY 13244, United States
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY 13244, United States
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17
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Hinds JT, Loukas A, Perry CL. Characterizing the polytobacco behaviors of sexual minority young adult college students. Drug Alcohol Depend 2020; 213:108126. [PMID: 32590213 DOI: 10.1016/j.drugalcdep.2020.108126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Polytobacco use is a growing concern; users are exposed to cumulatively more nicotine, increasing their risk for dependence and long-term use. More sexual minority (SM) young adults report polytobacco use than their heterosexual peers, yet no studies explore how their tobacco patterns vary across the diverse product landscape. The purpose of this study was to characterize SM young adults' patterns of tobacco use and nicotine dependence, and explore co-occurring risk factors for polytobacco use. METHODS Participants were 609 SM Texas college students. Latent class analysis identified subgroups of tobacco users based on their tobacco use behaviors and an indicator of nicotine dependence. Multinomial logistic regression identified associations between individual-level variables and the probability of membership in various user classes. RESULTS Tobacco use clustered in four classes: non-users, non-addicted cigarette users, non-addicted e-cigarette users, and addicted polytobacco users. Polytobacco users had an increased probability of depressive symptoms and cannabis use relative to non-users, and more binge alcohol use than all other groups. Non-addicted cigarette users had an increased probability of binge alcohol use, cannabis use, and being non-Hispanic White relative to non-users, and an increased likelihood of cannabis use relative to non-addicted e-cigarette users. Non-addicted e-cigarette users had an increased probability of binge alcohol use relative to non-users. CONCLUSIONS SM young adults' tobacco use varies across the diverse product landscape. Failing to account for a range of tobacco behaviors and nicotine dependence prevents tailoring interventions that should also address concerns such as depressive symptoms, cannabis use, and binge alcohol use.
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Affiliation(s)
- Josephine T Hinds
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd. D3700, Austin, TX, 78712 USA.
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd. D3700, Austin, TX, 78712 USA.
| | - Cheryl L Perry
- The Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, 1616 Guadalupe St Suite 6.300, Austin, TX 78701 USA.
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18
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Mattingly DT, Hart JL, Wood LA, Walker KL. Sociodemographic differences in single, dual, and poly tobacco use among Appalachian youth. Tob Prev Cessat 2020; 6:45. [PMID: 33083678 PMCID: PMC7549506 DOI: 10.18332/tpc/124782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/10/2020] [Accepted: 06/29/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patterns of youth tobacco use, including use of multiple products, have likely shifted as e-cigarettes have grown in popularity. However, there is limited understanding of dual and poly tobacco use and the associated disparities, especially among Appalachian youth. METHODS We analyzed Youth Appalachian Tobacco Study data (n=1116) to estimate prevalence of current (past-30 day) cigarette, e-cigarette, and smokeless tobacco use by gender, race/ethnicity, age, school type, state, smartphone use, and number of household tobacco users. We created a pattern of tobacco use variable (i.e. never, former, single, dual, poly) based on all possible combinations of the included products. Using multivariable multinomial logistic regression (outcome reference: never use), we evaluated associations between sociodemographic characteristics and patterns of tobacco use. RESULTS Former (16.2%) was the most common tobacco use group, followed by single (10.8%), dual (4.5%), and poly (2.4%) use. Dual and poly use were more prevalent among males, Whites/Caucasians, older participants, and participants living in households with tobacco users. Kentucky residents (vs New York) had higher odds of dual use (OR=5.15; 95% CI: 1.72–15.44), and youth who used smartphones for ≥20hours/week (vs <20 hours/week) had greater odds of poly use (OR=3.02; 95% CI: 1.34–6.80). CONCLUSIONS Differences in single, dual, and poly tobacco use were evidenced by sociodemographic characteristics. Additional inquiry should further examine these disparities so that tobacco prevention interventions can be appropriately tailored.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Lindsey A Wood
- Department of Communication, University of Louisville, Louisville, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States.,School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
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19
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Stanton CA, Sharma E, Seaman EL, Kasza KA, Edwards KC, Halenar MJ, Taylor KA, Day H, Anic G, Hull LC, Bansal-Travers M, Limpert J, Gardner LD, Hammad HT, Borek N, Kimmel HL, Compton WM, Hyland A. Initiation of any tobacco and five tobacco products across 3 years among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s178-s190. [PMID: 32321852 PMCID: PMC7534279 DOI: 10.1136/tobaccocontrol-2019-055573] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study reports weighted cross-sectional prevalence of never use of tobacco, and longitudinal past 12-month (P12M), past 30-day (P30D) and frequent P30D any tobacco or specific tobacco product initiation across three 1-year waves. Longitudinal three-wave pathways are examined to outline pathways of exclusive and polytobacco initiation, as well as pathways of new initiators of electronic nicotine delivery systems (ENDS) or cigarettes. DESIGN Data were drawn from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, N = 11 046; young adults, N = 6478; adults 25+, N = 17 188) were included in longitudinal analyses. RESULTS Across the three age groups, weighted cross-sectional analyses revealed never any tobacco use decreased each year from 2013 to 2016, reflecting overall increases in tobacco initiation in the population during this time. Compared with cigarettes, cigars, hookah and smokeless tobacco, ENDS had the highest proportion of P12M initiation from Wave 1 to Wave 3 (W3) for each age group. Among youth Wave 2 P30D initiators of exclusive ENDS or cigarettes, the most common W3 outcome was not using any tobacco (ENDS: 59.0% (95% CI 48.4 to 68.8); cigarettes: 40.3% (95% CI 28.7 to 53.1)). CONCLUSIONS Initiation rates of ENDS among youth and young adults have increased the number of ever tobacco users in the US prevention strategies across the spectrum of tobacco products which can address youth initiation of tobacco products.
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Affiliation(s)
- Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Elizabeth L Seaman
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Hannah Day
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Gabriella Anic
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Lynn C Hull
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Hoda T Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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20
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Kang SY, Lee S, Cho HJ. Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents. Tob Control 2020; 30:192-198. [PMID: 32108085 DOI: 10.1136/tobaccocontrol-2019-055114] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/23/2019] [Accepted: 01/21/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Heated tobacco products (HTPs) have been available in the Korean market since June 2017. In this study, we examined the prevalence and predictors of HTP use among Korean adolescents and the association between HTP and electronic cigarette (EC) use and attempts to quit conventional cigarette (CC) smoking. METHODS We analysed the data of a representative sample (n=60 040) of 13-18-year-old middle-school and high-school students in Korea who had participated in the 14th Korea Youth Risk Behavior Web-based Survey in 2018. RESULTS The prevalence of ever HTP use among Korean adolescents was 2.9% (men: 4.4%, women: 1.2%), a year after the introduction of HTPs in the Korean market. Furthermore, 81.3% of the 1568 ever HTP users were triple users of HTPs, ECs and CCs. Multivariate analysis revealed that ever HTP use was greater among men, higher-grade students, current CC and/or EC users and risky alcohol drinkers. Among current CC smokers, ever users of ECs (28%-30%) and ever HTP users and current EC users (48%) were more likely to have attempted to quit CC smoking than those who had never used HTPs and ECs. However, there were fewer HTP and/or EC ever users among ever CC smokers who successfully quit smoking. CONCLUSIONS Many adolescents, especially CC and EC users, had already used HTPs shortly after the introduction of HTPs in Korea. The use of newer types of tobacco products is associated with lower odds of abstinence from CCs; therefore, it is important to protect adolescents from them.
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Affiliation(s)
- Seo Young Kang
- International Healthcare Center, Asan Medical Center, Seoul, Republic of Korea
| | - Sungkyu Lee
- National Tobacco Control Centre, Korean Health Promotion Institute, Seoul, Republic of Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Vu THT, Hart JL, Groom A, Landry RL, Walker KL, Giachello AL, Tompkins L, Ma JZ, Kesh A, Robertson RM, Payne TJ. Age differences in electronic nicotine delivery systems (ENDS) usage motivations and behaviors, perceived health benefit, and intention to quit. Addict Behav 2019; 98:106054. [PMID: 31336264 DOI: 10.1016/j.addbeh.2019.106054] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 07/04/2019] [Accepted: 07/14/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Data from comprehensive studies are sparse regarding age differences in issues related to electronic nicotine delivery systems (ENDS) usage. This study examined age differences in usage motivations and behaviors, perceived health benefit, and quit intentions in a large and diverse sample recruited online. METHODS The sample included 1,432 current ENDS users, ages 18-64, drawn from a national online survey conducted in 2016. Descriptive and multivariable analyses were used. RESULTS The sample included participants in the following age groups: 18-24 (17.5%), 25-34 (38.6%), 35-44 (23.3%), and 45-64 (20.7%). With multiple adjustments, the 18-24 age group was more likely to vape for reasons such as flavors or friends' use, and to use multiple flavors and products with varying nicotine content. For example, the odds (95% CI) of vaping initiation due to flavor attraction vs. other reasons in the 18-24 age group were 1.40 (1.02-1.92), 2.73 (1.85-3.99), and 2.12 (1.41-3.18) compared to the 25-34, 35-44, and 45-64 age groups, respectively. In contrast, compared to older age groups, the 18-24 age group was less likely to use ENDS as an alternative to cigarettes or as a quitting device; they also used ENDS less frequently and perceived less health benefit of ENDS use. The 18-24 age group, especially those who had only used ENDS, had the lowest odds of likely quitting use of tobacco/nicotine products compared to other groups (lower by 44-73%). CONCLUSION There were significant age differences in ENDS usage motivations and behaviors, perceived health benefit, and quit intentions.
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