1
|
Edwards S, Puljević C, Dean JA, Gilks C, Boyd MA, Watts P, Howard C, Gartner CE. Perceptions of nicotine vaping products among Australians living with HIV. AIDS Care 2024:1-11. [PMID: 39102745 DOI: 10.1080/09540121.2024.2372718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/21/2024] [Indexed: 08/07/2024]
Abstract
People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco. Surveys and semi-structured interviews explored participants' experiences and perceptions of NVPs, their features and functions, and support for various NVP regulatory policy options. Participants described seven reasons why NVPs were acceptable cessation aids: they satisfied nicotine cravings; differences between NVPs and cigarettes facilitated habit breaking; fewer adverse effects compared to traditional cessation aids; NVPs allowed for a "weaning process" rather than requiring abrupt abstinence; tobacco became increasingly unpleasant to smoke; NVPs provided an increased sense of control; and participants experienced a deeper understanding of personal smoking behaviours. This study provides valuable insight into the preferred features of NVPs among PLHIV and reasons why NVPs may be effective for promoting smoking cessation among PLHIV.
Collapse
Affiliation(s)
- Stephanie Edwards
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Judith A Dean
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Australia
| | - Charles Gilks
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Mark A Boyd
- Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, Australia
- Northern Adelaide Local Health Network (NALHN), Adelaide, Australia
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Peter Watts
- Queensland Positive People, Brisbane, Australia
| | | | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
| |
Collapse
|
2
|
Vedøy TF, Lund KE. How do Smokers in a Snus-Prevalent Society Consider E-cigarettes, Snus, and Nicotine Replacement Therapy Products as Relevant Replacements for Cigarettes in the Event They Should Stop Smoking? Nicotine Tob Res 2023; 25:1753-1761. [PMID: 37410922 PMCID: PMC10475606 DOI: 10.1093/ntr/ntad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Around 50 percent of the tobacco in Norway is consumed in the form of snus, a smokeless oral tobacco. We examined Norwegian smokers' openness, and thereby the potential reach, to use e-cigarettes, nicotine replacement therapy products (NRT), and snus in the event of quitting smoking, in a society where snus use is common. METHODS Using data from an online survey of 4073 smokers from 2019 to 2021, we calculated predicted probabilities of smokers' being open, undecided, and not open to use e-cigarettes, snus, and NRT in the event they should quit smoking. RESULTS Among daily smokers, the probability of being open to use e-cigarettes in the event of quitting smoking was .32. The corresponding probabilities for using snus and NRT were .22 and .19. Snus was the product with the highest probability of not being open (.60). NRT had the highest probability of being undecided (.39). Among smokers who had never used e-cigarettes or snus, the probabilities of being open were .13 for e-cigarettes, .02 for snus and .11 for NRT. CONCLUSIONS In a snus-friendly norm climate where smokers have traditionally used snus as an alternative to cigarettes, the probability of using e-cigarettes in the event of smoking cessation was higher compared to both snus and NRT. However, among smokers who had never used e-cigarettes or snus, the likelihood of being open to use of NRT was similar to e-cigarettes, and higher than snus, which suggests that NRT may still play a role in smoking cessation. IMPLICATIONS In a snus-prevalent country in the endgame phase of the cigarette epidemic, where robust infrastructure for tobacco control in combination with the availability of snus has reduced smoking to a minimum, the remaining smokers seem to prefer e-cigarettes to snus if they should quit smoking. This indicates that availability of several nicotine alternatives might increase the likelihood of a future product replacement within the small group of remaining smokers.
Collapse
Affiliation(s)
- Tord Finne Vedøy
- Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Karl Erik Lund
- Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
3
|
Lund I, Sæbø G. Vaping among Norwegians who smoke or formerly smoked: reasons, patterns of use, and smoking cessation activity. Harm Reduct J 2023; 20:35. [PMID: 36944994 PMCID: PMC10031918 DOI: 10.1186/s12954-023-00768-z] [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: 01/03/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The majority of Norwegians who use e-cigarettes are adults who have smoked. Little is known about vaping reasons and -patterns in this group. The aim of this paper was to study vaping prevalence, patterns, and motivations among adults who smoke. Furthermore, to investigate smoking intensity and smoking cessation behaviour differences between those who vape and those who do not. METHODS This study was based on two separate Norwegian samples: People who had ever smoked, from 2017 (N = 2099), and people who currently smoked and recent quitters, from 2018/2019 (N = 1336). Measures of vape frequencies, vape motives, and smoking cessation behaviours were utilised in descriptive analyses of relationships between vaping and smoking behaviour. RESULTS Less than 1 in 10 in the ever-smoked group, 1 in 5 of the currently smoked or recently quit group, were currently vaping. Ever trial rates for vaping were much higher at 1 in 3 in the ever-smoked group, and 1 in 2 in the currently smoked or recently quit group. Dual use with combustible cigarettes was common, but people who smoked tended to use e-cigarettes less frequently while those who formerly smoked tended to use them more frequently. Both quitting attempts and smoking intensity reduction were positively associated with vaping, and the most common reasons for e-cigarette use were reported to be desires to reduce harm, to stop smoking, or to reduce smoking intensity. CONCLUSION The results indicate that Norwegians who smoke tend to see e-cigarettes as a tool to reduce or completely stop smoking. The predominance of use-motivations related to reducing harm points at the importance of conveying correct information about relative harmfulness of tobacco- and nicotine products.
Collapse
Affiliation(s)
- Ingeborg Lund
- Department for Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), Folkehelseinstituttet, Postboks 222, 0213, Skøyen, Oslo, Norway.
| | - Gunnar Sæbø
- Department for Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health (NIPH), Folkehelseinstituttet, Postboks 222, 0213, Skøyen, Oslo, Norway
| |
Collapse
|
4
|
Gravely S, Meng G, Hammond D, Hyland A, Michael Cummings K, Borland R, Kasza KA, Yong HH, Thompson ME, Quah ACK, Ouimet J, Martin N, O'Connor RJ, East KA, McNeill A, Boudreau C, Levy DT, Sweanor DT, Fong GT. Differences in cigarette smoking quit attempts and cessation between adults who did and did not take up nicotine vaping: Findings from the ITC four country smoking and vaping surveys. Addict Behav 2022; 132:107339. [PMID: 35605409 PMCID: PMC9202449 DOI: 10.1016/j.addbeh.2022.107339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/10/2022] [Accepted: 04/17/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION There is mixed evidence as to whether nicotine vaping products (NVPs) can help adults who smoke transition away from cigarettes. This study investigated if self-reported attempts to quit smoking and smoking cessation, over a period of either 18 or 24 months, differed between respondents who initiated nicotine vaping versus those who did not. Outcome comparisons were made between those who: (1) initiated vaping vs. those who did not; (2) initiated daily or non-daily vaping vs. those who did not; and (3) initiated daily or non-daily vaping between surveys and continued to vape at follow-up (daily or non-daily) vs. those who did not initiate vaping. METHODS This cohort study included 3516 respondents from the ITC Four Country Smoking and Vaping Surveys (Australia, Canada, England, United Sates), recruited at Wave 1 (2016) or 2 (2018) and followed up at Wave 2 (18 months) and/or 3 (2020, 24 months). Adults who smoked daily at baseline and did not have a history of regular vaping were included. Initiation of vaping was defined as beginning to vape at least monthly between surveys. Respondents indicated whether they made an attempt to quit smoking between surveys. Smoking cessation was defined as those who self-reported no longer smoking cigarettes at follow-up. RESULTS Relative to those who did not initiate vaping, initiation of any daily vaping between surveys was associated with a greater likelihood of smokers making a cigarette quit attempt (p < 0.001) and quitting smoking (p < 0.001). Among smokers who attempted to quit smoking, initiation of daily vaping was associated with a greater likelihood of being abstinent from smoking at follow-up (p = 0.001). Respondents who initiated vaping between surveys and were vaping daily at follow up were significantly more likely to have attempted to quit smoking (p < 0.001) and to have quit smoking (p < 0.001) than those who did not initiate vaping. Respondents who initiated non-daily vaping did not differ significantly from those who did not initiate vaping on any of the outcome measures. CONCLUSIONS Daily NVP use was associated with increased attempts to quit smoking and abstinence from smoking cigarettes. These findings are consistent with the concept that complete cigarette substitution may be more likely to be achieved when smokers vape nicotine daily.
Collapse
Affiliation(s)
| | - Gang Meng
- Department of Psychology, University of Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Canada
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, USA
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Australia
| | - Karin A Kasza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Australia
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Canada
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Canada
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Katherine A East
- School of Public Health Sciences, University of Waterloo, Canada; Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England; Shaping Public Health Policies to Reduce Inequalities & Harm (SPECTRUM), UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, USA
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Canada; Ontario Institute for Cancer Research, Canada
| |
Collapse
|
5
|
Cabral P. E-cigarette use and intentions related to psychological distress among cigarette, e-cigarette, and cannabis vape users during the start of the COVID-19 pandemic. BMC Psychol 2022; 10:201. [PMID: 35971158 PMCID: PMC9376900 DOI: 10.1186/s40359-022-00910-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study examines associations between psychological distress, intentions to use e-cigarettes, and cigarette smoking, e-cigarette use, and cannabis consumption through e-cigarette use among a diverse sample of U.S. young adults. Procedures Young adults (N = 314; 72.5% female) were recruited to complete an online survey during the first few months of the COVID-19 pandemic. Results Associations between psychological distress and cigarette smoking, e-cigarette use, cannabis vaping, and intentions to use e-cigarettes were found. Current e-cigarette use (OR = 1.23, 95% CI 1.17, 1.28, p < .001; 7.5%) and cannabis vaping (OR = 2.03, 95% CI 1.88, 2.18, p < .001; 10%) was higher among female, possibly due to the significantly higher psychological distress reported among females. Interactions between intentions to use e-cigarettes and psychological distress variables were found for all smoking and vaping behaviors. Conclusions Public health efforts should increase focus on providing psychological services for young adults to improve coping strategies that are alternative to smoking and vaping behaviors.
Collapse
Affiliation(s)
- Patricia Cabral
- Department of Psychology, Occidental College, 1600 Campus Road, Los Angeles, CA, 90041, USA.
| |
Collapse
|
6
|
East K, Reid JL, Burkhalter R, Wackowski OA, Thrasher JF, Tattan-Birch H, Boudreau C, Bansal-Travers M, Liber AC, McNeill A, Hammond D. Exposure to negative news stories about vaping, and harm perceptions of vaping, among youth in England, Canada, and the US before and after the outbreak of E-cigarette or Vaping-Associated Lung Injury (EVALI). Nicotine Tob Res 2022; 24:1386-1395. [PMID: 35368062 PMCID: PMC9356695 DOI: 10.1093/ntr/ntac088] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 02/02/2023]
Abstract
Introduction Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’) on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16–19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the ‘EVALI’ outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and February–March 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the United States (18.0% to 64.6%), accelerating during (2019) and immediately after (February–March 2020) the outbreak (p < .001) before returning to 2019 levels by August 2020. Similarly, the accurate perception that vaping is less harmful than smoking declined between 2017 and February–March 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the United States (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p < .001). The perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p ≤ .001). Time trends were most pronounced in the United States. Exposure to negative news stories predicted the perception that vaping takes less than a year to harm health (Adjusted Odds Ratio = 1.55, 1.48-1.61) and worry that vaping will damage health (Adjusted Odds Ratio = 1.32, 1.18-1.48). Conclusions Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the United States. Implications This is the first study examining changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the United States before, during, and after ‘EVALI’. Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of the three harm perception measures. Overall, findings suggest that ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.
Collapse
Affiliation(s)
- Katherine East
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jessica L Reid
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Olivia A Wackowski
- School of Public Health, Rutgers, The State University of New Jersey, NJ, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alex C Liber
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Hammond
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| |
Collapse
|
7
|
Morphett K, Fraser D, Borland R, Hall W, Walker N, Bullen C, Gartner C. A pragmatic randomised comparative trial of e-cigarettes and other nicotine products for quitting or long-term substitution in smokers. Nicotine Tob Res 2021; 24:1079-1088. [PMID: 34929031 DOI: 10.1093/ntr/ntab266] [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: 05/27/2021] [Revised: 11/30/2021] [Accepted: 12/16/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Tobacco harm reduction has potential to improve individual and population health. However, little research exists on low-intensity interventions, such as encouraging longer-term NRT or e-cigarette use. We aimed to determine whether: 1) encouraging use of nicotine products as long-term tobacco substitutes is more effective for smoking abstinence than standard treatment, and 2) offering e-cigarettes is more effective than NRT. METHODS An open-label, parallel group randomised trial was conducted in Australia between 2014 and 2015, with 1563 adult daily smokers, randomised to: A) Standard cessation advice and NRT: advice to use NRT short-term B) Quit or substitute advice and NRT: advice to use NRT as a longer-term substitute for smoking if required to maintain smoking cessation or C) Quit or substitute advice and NRT and/or e-cigarettes. Participants were offered an initial supply of products they could then purchase for up to 7 months. The primary outcome was self-reported continuous smoking abstinence at 7 months. Point prevalence, dual use, and cigarette reduction were secondary outcomes. RESULTS At 7 months, 2.8% (N=9) of group A (N=324) were abstinent, compared with 1.8% (N=11) in B (N=620) and 1.3% (N=8) in C (N=619) (Adjusted ORs: B vs A 0.66, 95% CI: 0.27-1.63; C vs A 0.46, 95% CI: 0.17-1.21; C vs B 0.69, 95% CI 0.27-1.73). There were no suspected unexpected serious adverse reactions associated with trial products. CONCLUSION A free trial of NRT and first generation e-cigarettes and advice on long-term substitution was no better for smoking abstinence than usual care. IMPLICATIONS This pragmatic trial allowed the comparison of existing and alternative policy options under semi-realistic conditions, such as product choice and financial cost. All trial arms had low rates of smoking cessation. The findings suggest that providing unflavoured cigalike e-cigarettes without additional support may not increase quitting compared with advice to use standard NRT in a general population of Australians who smoke. More intensive support and education, and/or opportunity to try a range of e-cigarette products, may be required to motivate quit attempts using e-cigarettes.
Collapse
Affiliation(s)
| | - Doug Fraser
- The University of Queensland, School of Public Health
| | - Ron Borland
- The University of Melbourne, School of Psychological Sciences.,Cancer Council Victoria
| | - Wayne Hall
- The University of Queensland, National Centre for Youth Substance Use Research
| | - Natalie Walker
- The University of Auckland, School of Population Health, National Institute for Health Innovation
| | - Chris Bullen
- The University of Auckland, School of Population Health, National Institute for Health Innovation
| | - Coral Gartner
- The University of Queensland, School of Public Health.,The University of Queensland, Queensland Alliance for Environmental Health Sciences
| |
Collapse
|
8
|
Jenkins M, Hoek J, Jenkin G, Gendall P, Stanley J, Beaglehole B, Bell C, Rapsey C, Every-Palmer S. Silver linings of the COVID-19 lockdown in New Zealand. PLoS One 2021; 16:e0249678. [PMID: 33793672 PMCID: PMC8016296 DOI: 10.1371/journal.pone.0249678] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/22/2021] [Indexed: 01/11/2023] Open
Abstract
The COVID-19 pandemic has caused significant disruption, distress, and loss of life around the world. While negative health, economic, and social consequences are being extensively studied, there has been less research on the resilience and post-traumatic growth that people show in the face of adversity. We investigated New Zealanders’ experiences of benefit-finding during the COVID-19 pandemic and analysed qualitative responses to a survey examining mental well-being during the New Zealand lockdown. A total of 1175 of 2010 eligible participants responded to an open-ended question probing ‘silver linings’ (i.e., positive aspects) they may have experienced during this period. We analysed these qualitative responses using a thematic analysis approach. Two thirds of participants identified silver linings from the lockdown and we developed two overarching themes: Surviving (coping well, meeting basic needs, and maintaining health) and thriving (self-development, reflection, and growth). Assessing positive as well as negative consequences of the pandemic provides more nuanced insights into the impact that New Zealand’s response had on mental well-being.
Collapse
Affiliation(s)
- Matthew Jenkins
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- * E-mail:
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Gabrielle Jenkin
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Philip Gendall
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Charlene Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| |
Collapse
|
9
|
McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Jancey J. "Is it banned? Is it illegal?": Navigating Western Australia's regulatory environment for e-cigarettes. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103177. [PMID: 33713966 DOI: 10.1016/j.drugpo.2021.103177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Australia, there is no Federal legislation that directly applies to e-cigarettes, instead, several existing laws relating to poisons, therapeutic goods and tobacco control apply. Across all Australian States and Territories, it is illegal to sell nicotine-containing e-cigarettes, however, users can legally import nicotine-containing vaporisers through the Personal Importation Scheme. Western Australia differs from other Australian States and Territories in that products which resemble tobacco products are banned, effectively prohibiting the use of e-cigarettes. This study aimed to understand how e-cigarette users navigate Western Australia's regulatory environment to access vaping products and the health and safety issues encountered. METHODS Working from a constructionist epistemology and a symbolic interaction framework, in-depth interviews were conducted with a purposive sample of 37 current (89%) and former (11%) adult vapers (70% male, mean age of 32.5). Data was analysed via thematic analysis. RESULTS Vape retailers were said to be circumventing Western Australia's e-cigarette restrictions by selling the components of 'open system' devices that do not resemble a tobacco product when sold individually. Participants were unsure of the legality of importing, accessing and using nicotine and e-cigarettes, however, the majority continued to use nicotine-containing vaporisers and implemented strategies in an attempt to avoid detection and safeguard their health. The internet facilitated access to desired products, information on health and safety, and discussions of personal experiences. CONCLUSIONS The Australian Therapeutic Goods Administration has recently (21 December 2020) confirmed that from 1 October 2021 smokers who have tried quitting with other approved cessation pharmacotherapies will be required to obtain a prescription for nicotine-containing vaporiser products from a registered medical practitioner. The results of this study suggest further consideration of regulatory measures are however required to support the different characteristics of vapers and to mitigate the health and safety concerns experienced by e-cigarette users.
Collapse
Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia.
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Western Australia, Australia
| | - Katharina Wolf
- School of Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| |
Collapse
|
10
|
Notley C, Ward E, Dawkins L, Holland R. User pathways of e-cigarette use to support long term tobacco smoking relapse prevention: a qualitative analysis. Addiction 2021; 116:596-605. [PMID: 33463849 DOI: 10.1111/add.15226] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 08/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS E-cigarettes are the most popular consumer choice for support with smoking cessation in the United Kingdom. However, there are concerns that long-term e-cigarette use may sustain concurrent tobacco smoking or lead to relapse to smoking in ex-smokers. We aimed to explore vaping trajectories, establishing e-cigarette users' perspectives on continued e-cigarette use in relation to smoking relapse or abstinence. DESIGN Qualitative longitudinal study collecting detailed subjective data at baseline and ~12 months later. SETTING United Kingdom. PARTICIPANTS E-cigarette users (n = 37) who self-reported that they had used e-cigarettes to stop smoking at baseline. MEASUREMENTS Semi-structured qualitative interviews (face-to-face or telephone) collected self-reported patterns of e-cigarette use. Thematic analysis of transcripts and a mapping approach of individual pathways enabled exploration of self-reported experiences, motives, resources, and environmental and social influences on vaping and any concurrent tobacco smoking. FINDINGS Three broad participant pathways were identified: 'maintainer' (e-cigarette use and not smoking), 'abstainer' (neither smoking nor using e-cigarettes), and 'relapser' (dual-using, or relapsed back to tobacco smoking only). In each pathway, individual experiences with vaping nicotine appeared to play an important role and appeared to be related to psychological and social factors. A social context supportive of vaping was important for the maintainers, as was a belief in the need to overcome nicotine addiction for the abstainers, and dislike of the 'vaping culture' expressed by some in the relapser group. Dual-users held beliefs such as a need for cigarettes at time of acute stress that affirmed dependence on tobacco. CONCLUSIONS In a sample of UK e-cigarette users who report having used e-cigarettes to quit smoking, a social context that supports continued vaping was perceived to be helpful in preventing relapse to smoking.
Collapse
Affiliation(s)
- Caitlin Notley
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom, UK
| | - Emma Ward
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom, UK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Richard Holland
- Leicester Medical School, University of Leicester, Leicester, UK
| |
Collapse
|
11
|
Morphett K. Commentary on Notley et al. : Understanding transitions in the use of nicotine and tobacco products-the value of qualitative longitudinal research. Addiction 2021; 116:606-607. [PMID: 33241632 DOI: 10.1111/add.15307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Kylie Morphett
- School of Public Health, Faculty of Medicine, The University of Queensland, QLD, 4061, Australia
| |
Collapse
|
12
|
Abstract
JUUL is a popular electronic cigarette (e-cig) that is capable of delivering nicotine similarly to a cigarette. While known to deliver high doses of nicotine, there is little systematic evidence to show how the nicotine delivery of JUUL translates to user dependence. Purpose: The purpose of the study was to evaluate self-reported dependence of JUUL users and examine the relationship of dependence to user behaviors. Methods: Current JUUL users were recruited via Amazon Mechanical Turk to complete an online survey about their use of JUUL. Participants were asked to complete the Penn State Electronic Cigarette Dependence Index (PSECDI) and to answer questions about their use patterns and other tobacco use. Means and frequencies were used to describe the sample. A linear regression model was used to predict user dependence. Results: Participants (n = 76) were 65.4% male with a mean age of 31.9 (SD = 8.3) years. The mean PSECDI score was 7.8 (SD = 4.2) and ranged from no (15.8%) to high (14.5%) dependence. Overall predictors of a greater PSECDI score included reporting ever stealth vaping (β = 2.8, p < .01) and reporting greater use days in the past 30 (β = 3.5, p < .01). Conclusions: On average, JUUL users reported low to medium nicotine dependence on the PSECDI. JUUL user dependence may be more similar to e-cig user dependence than cigarette smoker dependence. These preliminary findings should be followed up in studies of larger samples of Juul users, collecting multiple measures of dependence, as well as biomarkers of nicotine intake (e.g. cotinine).
Collapse
Affiliation(s)
- Jessica Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.,Center for Research on Tobacco and Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.,Center for Research on Tobacco and Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Andrea L Hobkirk
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA.,Center for Research on Tobacco and Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
13
|
Bateman J, Robertson LA, Marsh L, Cameron C, Hoek J. An Analysis of E-Cigarette Marketing in New Zealand Tobacco Retail Outlets Prior to Legislative Change. Nicotine Tob Res 2020; 22:1221-1224. [PMID: 31811294 DOI: 10.1093/ntr/ntz226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/04/2019] [Indexed: 11/14/2022]
Abstract
INTRODUCTION In 2017, the New Zealand (NZ) Government announced its intention to liberalize the sale and promotion of electronic nicotine delivery systems (ENDS), including permitting any outlet to sell ENDS. This research estimated the proportion of tobacco outlets selling ENDS prior to legislative change, documented ENDS point-of-sale (POS) marketing, and examined associations between ENDS availability and outlet type, area-level deprivation, study region, and proximity to a secondary school. AIMS AND METHODS After drawing a proportional random sample of 281 tobacco outlets from two NZ regions that included convenience stores, supermarkets, and petrol stations, we conducted observational in-store assessments to record ENDS product ranges and promotions. Data were collected between October and December 2017 and analyzed using descriptive statistics and regression modeling. RESULTS Of tobacco outlets sampled, 22% sold ENDS; these were typically convenience stores (85%) and located in high deprivation areas (53%). Of stores selling ENDS, products were visible at POS in 89% of stores, including 15% with self-service displays and 15% with displays adjacent to children's products. ENDS advertising was present in 31% of the outlets and generally promoted ENDS as cheaper than smoked cigarettes. CONCLUSIONS Liberalizing access to ENDS could reduce harms caused by smoking; however, extensive use of POS promotions will reach children and young people as well as smokers. While reducing harm among smokers is important, policy makers also need to ensure that regulations protect children from ENDS promotions. IMPLICATIONS Careful regulation is required to ensure increases in ENDS availability are not accompanied by an increase in young people's exposure to ENDS marketing at the POS.
Collapse
Affiliation(s)
- Jerram Bateman
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Louise Marsh
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Claire Cameron
- Centre for Biostatistics, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand.,Department of Marketing, University of Otago, Dunedin, New Zealand
| |
Collapse
|
14
|
Zhao D, Zuo Y, Urmi DS, Liu Y, Zheng P, Fan W, Abdullah AS. Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2754. [PMID: 32316185 PMCID: PMC7216171 DOI: 10.3390/ijerph17082754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/29/2020] [Accepted: 04/02/2020] [Indexed: 11/21/2022]
Abstract
The use of electronic cigarettes (ECs) is increasing rapidly in China, but the perception of these products and their health impact among Chinese users have received little research attention. This study collected semi-structured in-depth interview data from experienced adult EC (including heated tobacco products also named ECs on the Chinese market) users in the Shanghai area. The subjects were recruited from those who participated in a previous online survey on EC use. A thematic narrative approach was used to analyze the data. Thirty current EC users were interviewed for evaluation of their perception of EC use in a variety of categories, including reasons for using, concerns, social acceptance, satisfaction, and health impacts. Participants' common reasons for using ECs were the ease of use and carrying, hygiene, no fire hazard, reduced smoke exposure, aiding quitting smoking, reduced health hazard, palatable flavor, being fashionable, and substituting cigarettes in non-smoking areas. Most (90%; 27/30) participants reduced (77%) or quit smoking (13%) after using ECs, and 80% were willing to recommend these products to others. Most (90%) of the participants reportedly noticed positive health changes after using ECs. Regulatory concerns were expressed by 33% participants. Participants predominately viewed ECs as a viable substitute for smoking, with substantial effects on tobacco harm reduction. These findings lend support to EC use as a promising opportunity for public health promotion in China through engaging smokers in smoking cessation attempts. However, overall public health benefits/risks of EC use, and its regulatory affairs need to be considered.
Collapse
Affiliation(s)
- Duan Zhao
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Yantao Zuo
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Dilshat S. Urmi
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Yangyujin Liu
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
| | - Pinpin Zheng
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai 20032, China;
| | - Wang Fan
- Department of Politics, East China Normal University, Shanghai 200241, China;
| | - Abu S. Abdullah
- Global Health Research Center, Duke Kunshan University, Suzhou 215347, China; (D.Z.); (D.S.U.); (Y.L.)
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
- Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
| |
Collapse
|
15
|
A critical analysis of Australia’s ban on the sale of electronic nicotine delivery systems. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09402-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|