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Li L, Yang C, Zhan S, Wilson KM, Taioli E, Mazumdar M, Liu B. Longitudinal Assessment of Association Between Tobacco Use and Tobacco Dependence Among Adults: Latent Class Analysis of the Population Assessment of Tobacco and Health Study Waves 1-4. Nicotine Tob Res 2024; 26:806-815. [PMID: 37496127 DOI: 10.1093/ntr/ntad114] [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: 10/10/2022] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION With increasing tobacco product varieties, understanding tobacco use (TU) profiles and their associations with tobacco dependence (TD) has also become increasingly challenging. AIMS AND METHODS We aimed to identify TU profiles and their associations with TD over time, and to identify subgroups with high risk of TD. We included 3463 adult recent tobacco users who had complete TU and TD data across waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study. We used a composite index of TD and a summed TD score from an established 16-item TD measure. We applied a latent class analysis to identify TU profiles based on participants' usage of eight common tobacco product groups at each survey wave and to check the stability of the TU profiles over time. We then used generalized estimating equations regressions to evaluate the longitudinal TU-TD association, adjusting for potential confounders. RESULTS We identified three distinct TU profiles that remained consistent across four survey waves: Dominant cigarette users (62%-68%), poly users with high propensity of using traditional cigarettes, e-cigarettes, and cigars (24%-31%), and dominant smokeless product users (7%-9%). Covariate-adjusted models showed that TD was significantly lower among the poly users and the dominant smokeless users, compared to that among the dominant cigarette users. CONCLUSIONS Both TU profiles and their associations with TD were stable over time at the population level. Poly users and smokeless product users were consistently associated with lower TD than cigarette-dominant users, suggesting the need for tailored tobacco cessation interventions for users with different TU profiles. IMPLICATIONS The finding of consistent TU profiles across four survey waves extends the current literature in capturing TU patterns in an evolving tobacco product landscape. The finding of the overall higher level of TD among the cigarette-dominant users compared to the other TU latent profiles (the Cig+eCig+Cigar dominant poly users and the dominant smokeless product users) can help identify high-risk groups for potential interventions. Our application of innovative statistical methods to high-quality longitudinal data from the PATH study helps improve the understanding of the dynamic TU-TD relationship over time.
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Affiliation(s)
- Lihua Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chen Yang
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serena Zhan
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karen M Wilson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Emanuela Taioli
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Madhu Mazumdar
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kasza KA, Tang Z, Xiao H, Marshall D, Stanton C, Gross A, Jackson K, Kelley D, Schroeder M, Vivar J, Hyland A. National longitudinal tobacco product discontinuation rates among US youth from the PATH Study: 2013-2019 (waves 1-5). Tob Control 2024; 33:511-517. [PMID: 37045605 PMCID: PMC10567990 DOI: 10.1136/tc-2022-057729] [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: 09/01/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Determine longitudinal tobacco product discontinuation rates among youth (ages 12-17 years) in the USA between 2013 and 2019. METHODS The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study, was used to determine annual/biennial rates of tobacco product discontinuation behaviours among youth across 2013-2019: (1) discontinuing product use (transition from past 30-day use to no past 30-day use), (2) attempting to quit product use and (3) discontinuing product use among those who attempted to quit. Discontinuing use was evaluated separately for cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah, smokeless tobacco and any tobacco. Attempting to quit and discontinuing use among those who attempted were each evaluated for cigarettes and ENDS. Generalised estimating equations were used to evaluate linear and non-linear trends in rates across the study period. RESULTS Between 2013 and 2019, biennial rates of discontinuing tobacco product use among youth increased for cigarettes from 29% to 40%, increased for smokeless tobacco from 39% to 60%, and decreased for ENDS from 53% to 27%. By 2018/2019, rates of discontinuing use among attempters were 30% for those who used ENDS and 30% for those who smoked cigarettes. CONCLUSIONS Findings show decreasing rates of discontinuing ENDS use among youth in the USA alongside the changing ENDS marketplace and increasing rates of discontinuing cigarette smoking and smokeless tobacco use. Findings will serve as benchmarks against which future tobacco product discontinuation rates can be compared with evaluating impacts of subsequent tobacco regulatory policies, ENDS product development and public education campaigns.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
- Axle Informatics, Rockville, Maryland, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Amy Gross
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kathy Jackson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dannielle Kelley
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Megan Schroeder
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Juan Vivar
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Klemperer EM, Kock L, Feinstein MJP, Coleman SRM, Gaalema DE, Higgins ST. Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study. Prev Med 2024; 185:108024. [PMID: 38849056 DOI: 10.1016/j.ypmed.2024.108024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
SIGNIFICANCE A growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. METHODS Data came from Waves 4-6 (12/2016-11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. RESULTS Among US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9-16.4) of females and 23.4% (20.0-26.9) of males were young adults (aged 18-24), 11.7% (9.2-14.2) of females and 14.4% (11.6-17.2) of males had CONCLUSION US females who dual use e-cigarettes and cigarettes were more likely to attempt to quit smoking, but not more likely to succeed at quitting, than males.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America.
| | - Loren Kock
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Marc Jerome P Feinstein
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Sulamunn R M Coleman
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
| | - Diann E Gaalema
- Division of Cardiovascular Medicine, University of Texas Medical Branch, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, United States of America
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Sharma E, Zebrak K, Lauten K, Gravely S, Cooper M, Gardner LD, Zaganjor I, Edwards KC, Kasza K, Marshall D, Kimmel HL, Stanton C, Hyland A, Fong G. Cigarette and ENDS dual use longitudinal transitions among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 4-5 (2016-2019). Addict Behav Rep 2024; 19:100528. [PMID: 38384864 PMCID: PMC10879705 DOI: 10.1016/j.abrep.2024.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The study assessed longitudinal transitions among adult (18 and older) past 30-day daily and non-daily dual users of cigarettes and electronic nicotine delivery systems (ENDS). Methods Using data from Wave 4 (W4; 2016/17) and Wave 5 (W5; 2018/19) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of US adults, multivariable regressions were conducted among W4 dual users of cigarettes and ENDS to examine past 30-day cigarette smoking at W5. The study also analyzed changes in frequency of past 30-day smoking and cigarettes smoked per day between W4 and W5, stratified by W4/W5 daily/non-daily ENDS use among W4 daily and non-daily cigarette smokers. Results Among W4 dual users, those smoking daily and using ENDS non-daily had higher odds of daily cigarette smoking at W5 than daily users of both products (AOR: 2.32, 95 % CI: 1.38-3.90). W4 daily smokers who used ENDS daily at Wave 5 smoked cigarettes on fewer days at Wave 5 than W4 daily smokers who were either daily ENDS users at Wave 4 (B = -4.59; SE = 1.43, p < 0.01) or non-daily ENDS users at Wave 4 (B = -4.55; SE = 1.24, p < 0.001). Among W4 non-daily cigarette smokers, W4 non-daily ENDS users who used daily at W5 smoked cigarettes on fewer days (B = -4.04, SE = 1.82) at W5 than those who were non-daily ENDS users at W4 and W5. Conclusions Findings highlight the importance of frequency of ENDS use in reducing cigarette smoking and could inform smoking cessation interventions among daily cigarette smokers.
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Affiliation(s)
| | | | | | | | - Maria Cooper
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lisa D. Gardner
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Ibrahim Zaganjor
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | | | - Karin Kasza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Axle Informatics, Rockville, MD, USA
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Geoff Fong
- University of Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Sharma E, Lauten K, Zebrak KA, Edwards KC, VanEtten S, Benson AF, Delnevo CD, Marshall D, Kimmel HL, Taylor KA, Bansal-Travers M, Hyland A, Cummings KM. Respiratory symptoms and outcomes among cigar smokers: findings from the Population Assessment of Tobacco and Health (PATH) study waves 2-5 (2014-2019). Respir Res 2024; 25:185. [PMID: 38678212 PMCID: PMC11055341 DOI: 10.1186/s12931-024-02818-x] [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: 01/26/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND The mechanisms by which cigarette smoking increases the risk of respiratory disease have been studied. However, less is known about risks of respiratory symptoms and outcomes associated with smoking cigars, and risks by cigar types have not been previously explored. The aim of this study was to examine associations between cigar use, including traditional cigars, cigarillos, filtered cigars, and dual cigar and cigarette use, and functionally important respiratory symptoms (FIRS), lifetime asthma diagnosis, uncontrolled asthma, and new cases of FIRS. METHODS Data from Waves 2-5 (2014-19) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal study, were analyzed in two ways. For cross-sectional analysis, the analytic sample included adults 18 and older at each wave, resulting in 44,040 observations. Separately, longitudinal analyses were assessed among adults 18 and older at Wave 2, resulting in 7,930 individuals. Both analyses excluded adults with chronic obstructive pulmonary disease (COPD) or non-asthma respiratory disease. RESULTS Current established cigarillo smokers had higher odds of having FIRS (Adjusted odds ratio (AOR): 1.72; 95% CI: 1.08, 2.74) compared to never smokers of cigarillos and cigarettes, after adjusting for covariates. Current established filtered cigar smokers had higher odds of asthma diagnosis (AOR: 1.35; 95% CI: 1.10, 1.66) while current established dual smokers of filtered cigars and cigarettes had higher odds of uncontrolled asthma (AOR: 5.13; 95% CI: 1.75, 15.02) compared to never smokers of filtered cigars or cigarettes. Both current established cigar smokers and current established dual smokers of cigarettes and cigars had higher odds of new FIRS compared to never cigar or cigarette smokers (AORs: 1.62; 95% CI: 1.02, 2.60 for exclusive cigars and 2.55; 95% CI 1.57, 4.14 for dual smokers). CONCLUSIONS This study provides evidence that cigar smokers or dual smokers of cigars and cigarettes have greater odds of FIRS, asthma, and uncontrolled asthma and that new incidence of FIRS is higher among any cigar smokers compared to never cigar or cigarette smokers. Understanding health impacts associated with cigar use provides information for supporting policy development, as well as for designing clinical interventions focused on smoking cessation for cigars.
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Grants
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
- Contract Nos. HHSN271201100027C and HHSN271201600001C National Institute on Drug Abuse, National Institutes of Health (NIH NIDA), and the Center for Tobacco Products, Food and Drug Administration (FDA CTP)
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Affiliation(s)
- Eva Sharma
- Westat, 1600 Research Blvd., Rockville, MD, 20850, USA.
| | | | | | | | - Samantha VanEtten
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Adam F Benson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Cristine D Delnevo
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Daniela Marshall
- National Institute On Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Axle Informatics, Rockville, MD, USA
| | - Heather L Kimmel
- National Institute On Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Kasza KA, Tang Z, Xiao H, Marshall D, Stanton CA, Gross AL, Jackson KM, Kelley D, Schroeder MJ, Vivar JC, Hyland A. National longitudinal tobacco product cessation rates among US adults from the PATH Study: 2013-2019 (waves 1-5). Tob Control 2024; 33:186-192. [PMID: 35879095 PMCID: PMC10249338 DOI: 10.1136/tc-2022-057323] [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: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report on longitudinal tobacco product cessation rates, by product type, among adults (ages 18+ years) in the USA between 2013 and 2019. METHODS The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study was used to report on annual and biennial rates of the following three cessation behaviours across 2013-2019: (1) discontinuing tobacco product use (ie, transition from past 30-day use to no past 30-day use), (2) attempting to quit tobacco product use and (3) quitting tobacco product use among those who attempted to quit. Each cessation behaviour was evaluated separately for cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco. Generalised estimating equations were used to evaluate linear and nonlinear trends in cessation rates across the study period. RESULTS Between 2013 and 2019, rates of discontinuing cigarette smoking among adults in the USA statistically increased from 16% to 18%, though these were consistently lower than rates of discontinuing use of other tobacco products. Similarly, quit attempt rates and rates of quitting among attempters increased for cigarette smokers. However, rates of discontinuing ENDS use sharply declined across the study period, from 62% to 44%. CONCLUSIONS Findings show that tobacco product cessation rates have been changing in recent years in the USA alongside the changing tobacco product marketplace and regulatory environment, though rates of discontinuing cigarette smoking remain relatively low. Findings can serve as a benchmark against which future cessation rates can be compared to evaluate the impacts of future tobacco regulatory policies.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
- Axle Informatics, Rockville, MD, USA
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Amy L Gross
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kathy M Jackson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dannielle Kelley
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Megan J Schroeder
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Juan C Vivar
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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7
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Paulin LM, Halenar MJ, Edwards KC, Lauten K, Taylor K, Brunette M, Tanski S, MacKenzie T, Stanton CA, Hatsukami D, Hyland A, Mahoney MC, Niaura R, Trinidad D, Blanco C, Compton W, Gardner LD, Kimmel HL, Cummings KM, Lauterstein D, Roh EJ, Marshall D, Sargent JD. Relationship Between Tobacco Product Use and Health-Related Quality of Life Among Individuals With COPD in Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2024; 11:68-82. [PMID: 38113525 PMCID: PMC10913919 DOI: 10.15326/jcopdf.2023.0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
Introduction We examined the association between tobacco product use and health-related quality of life (HRQoL) among individuals with chronic obstructive pulmonary disease (COPD) in Waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study. Methods Adults ≥40 years with an ever COPD diagnosis were included in cross-sectional (Wave 5) and longitudinal (Waves 1 to 5) analyses. Tobacco use included 13 mutually exclusive categories of past 30-day (P30D) single use and polyuse with P30D exclusive cigarette use and ≥5-year cigarette cessation as reference groups. Multivariable linear regression and generalized estimating equations (GEE) were used to examine the association between tobacco use and HRQoL as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 questionnaire. Results Of 1670 adults, 79.4% ever used cigarettes; mean (standard error [SE]) pack years was 30.9 (1.1). In cross-sectional analysis, P30D exclusive cigarette use, and e-cigarette/cigarette dual use were associated with worse HRQoL compared to ≥5-year cigarette cessation. Compared to P30D exclusive cigarette use, never tobacco use and ≥5-year cigarette cessation were associated with better HRQoL, while e-cigarette/cigarette dual use had worse HRQoL. Longitudinally (n=686), e-cigarette/cigarette dual use was associated with worsening HRQoL compared to both reference groups. Only never tobacco use was associated with higher HRQoL over time compared to P30D exclusive cigarette use. Conclusions E-cigarette/cigarette dual use was associated with worse HRQoL compared to ≥5-year cigarette cessation and exclusive cigarette use. Never use and ≥5-year cigarette cessation were the only categories associated with higher HRQoL compared to exclusive cigarette use. Findings highlight the importance of complete smoking cessation for individuals with COPD.
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Affiliation(s)
- Laura M. Paulin
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Michael J. Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kathryn C. Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kristin Lauten
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Kristie Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Mary Brunette
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Susanne Tanski
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Todd MacKenzie
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
| | - Cassandra A. Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, Maryland, United States
| | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Martin C. Mahoney
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
| | - Ray Niaura
- School of Global Public Health, New York University, New York, New York, United States
| | - Dennis Trinidad
- University of California at San Diego, La Jolla, California, United States
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - Lisa D. Gardner
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Dana Lauterstein
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Esther J. Roh
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, United States
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, United States
- Axle Informatics, Rockville, Maryland, United States
| | - James D. Sargent
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, New Hampshire, United States
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Kim S, Shiffman S, Goldenson NI. Adult smokers' Complete Switching Away from Cigarettes at 6, 9, and 12 Months after Initially Purchasing a JUUL e-Cigarette. Subst Use Misuse 2024; 59:805-815. [PMID: 38238646 DOI: 10.1080/10826084.2024.2303990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Background: Electronic nicotine delivery systems (ENDS) have the potential to benefit public health if smokers completely switch from cigarettes to ENDS. Methods: A cohort of adult smokers (age ≥ 21) who purchased a JUUL Starter Kit was followed for 12 months after the initial purchase. We defined "switching" as past-30-day abstinence from smoking (even if JUUL use had stopped), and analyzed factors associated with achievement and maintenance of self-reported repeated point-prevalence switching (RPPS) at three follow-ups, i.e., no past-30-day smoking at months 6, 9, and 12. Results: RPPS was reported by 21.6% of the 12,537 evaluable smokers. Smokers with lighter smoking history and lower cigarette dependence at baseline were more likely to report RPPS. RPPS was also associated with daily use of JUUL (Month-3: OR = 2.32, 95% CI = 2.02-2.68; Month-6: OR = 1.73, 95% CI = 1.42-2.10), and with greater subjective reinforcing effects from JUUL use (assessed by the mCEQ, Month-3: OR = 1.46, 95% CI = 1.38-1.56; Month-6: OR = 1.11; 95% CI = 1.02-1.20). Even among smokers who did not meet the criteria of RPPS (i.e., who smoked at least once), 35.5% reported past 30-day point-prevalence switching on at least one follow-up, and their cigarette consumption was substantially reduced compared to baseline. Conclusions: Approximately one-fifth of adult smokers reported 30-day point-prevalence abstinence at 6, 9, and 12 months after purchasing JUUL. Greater use of JUUL and stronger subjective reinforcing effects were associated with nonsmoking, validating the potential for ENDS to substitute for smoking, with potential for positive impacts on individual and population health.
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Affiliation(s)
- Sooyong Kim
- PinneyAssociates, Inc., Pittsburgh, Pennsylvania, USA
| | - Saul Shiffman
- PinneyAssociates, Inc., Pittsburgh, Pennsylvania, USA
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9
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Ebrahimi Kalan M, Brewer NT. Longitudinal transitions in e-cigarette and cigarette use among US adults: prospective cohort study. LANCET REGIONAL HEALTH. AMERICAS 2023; 22:100508. [PMID: 37229421 PMCID: PMC10205448 DOI: 10.1016/j.lana.2023.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023]
Abstract
Background To support tobacco control efforts, this study sought to characterize longitudinal transitions in use of electronic nicotine delivery systems (ENDS) and cigarettes. Methods Participants were nationally representative samples of 53,729 US adults from Waves 3-5 (2015-2019) of the Population Assessment of Tobacco and Health Study. We examined behavioral transitions (initiation, relapse, progression, and cessation) in ENDS and cigarette use across waves. Weighted generalized estimating equation models adjusted for sociodemographic variables. Findings Of never ENDS users at baseline, an estimated 1.7% reported initiating ENDS use by follow-up. Of former ENDS users, an estimated 12.1% relapsed into ENDS use. Of periodic ENDS users at baseline, 13% progressed to established ENDS use. Of baseline current ENDS users, 46.3% discontinued ENDS use. The corresponding transitions for cigarette smoking were 1.6% (initiation), 4.8% (relapse), 21.1% (progression), and 14% (discontinuation). Adults aged 18-24 (vs. older age), Hispanics (vs. non-Hispanic white), and past 12-month cannabis users were more likely to initiate ENDS or cigarettes (all p < 0.05). Having any internalizing mental health symptoms increased the odds of ENDS initiation, while externalizing symptoms increased the odds of cigarette initiation. Those who perceived nicotine as very harmful (vs. none/low harm) were more likely to discontinue ENDS. Current cigarette users (vs. non-users) at baseline were more likely to initiate, relapse, or discontinue ENDS (all p < 0.05) and vice versa. Interpretation We observed high changeability in ENDS and cigarette use among US adults over time. In absolute terms, ENDS use grew, while smoking fell. Tobacco control programs should focus on priority populations, including young adults and people with internalizing and externalizing mental health symptoms. Funding National Institutes of Health, R01-CA246606-01A1, R01-DA048390.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- School of Health Professions, Eastern Virginia Medical School, Norfolk, VA, United States
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Noel T. Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
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10
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Pike Moore S, Masyn KE, Fryer C, Lee E, Gunzler D, Trapl E, Shang C, Sterling KL. Recency measures matter: Variability in reported last use of tobacco and marijuana products among a nationally representative study of U.S. young adults. Addict Behav 2023; 144:107746. [PMID: 37163886 DOI: 10.1016/j.addbeh.2023.107746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Current use of tobacco and marijuana products is largely defined as use within the past 30-days or more recently. These products are not used in the same manner, frequency, or context especially among young adults who are increasingly at risk for poly-product use. The purpose of this study was to examine patterns of most recent product use across select tobacco and marijuana products. MATERIALS AND METHODS Data used in this study come from a cross-sectional survey conducted among a nationally representative sample of young adults ages 18-34 (n = 1,189) in the U.S. from October-November 2020. Respondents were asked about past product and most recent use of select tobacco/nicotine products (cigarettes, little filtered cigars and cigarillos, large cigars, e-cigarettes, hookah/water pipes) and marijuana products (blunts, e-cigarettes with marijuana, and other products with marijuana). RESULTS A high proportion of young adults reported having used at least one tobacco (79.6%) or marijuana (68.6%) products. There is variability in the distribution of most recent use across different tobacco and marijuana users even within the past 3 to past 6 months where nearly one in five users of any product report last use. The average number of tobacco/nicotine products used as well as concurrent marijuana use were lowest when looking at those whose most recent use was within the past 30-days. As the measures of most recent use became more broad, the number of tobacco/nicotine products used increased as did the prevalence of concurrent marijuana use which extended through the past 6-months. CONCLUSION Measures of current use may need to be expanded beyond the past 30-days to include through the past 6-months to better encapsulate usage patterns when considering poly-tobacco and marijuana co-use.
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Affiliation(s)
- Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA.
| | - Katherine E Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Craig Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Eugenia Lee
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, 2777 North Stemmons Freeway, Suite 8400, Dallas, TX, USA
| | - Douglas Gunzler
- Department of Medicine, Case Western Reserve University at The MetroHealth System, Cleveland, OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA
| | - Ce Shang
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Kymberle L Sterling
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, 2777 North Stemmons Freeway, Suite 8400, Dallas, TX, USA
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11
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Li L, Borland R, Cummings KM, Hyland A, Le Grande M, Fong GT, McNeill A. Non-cigarette combustible tobacco use and its associations with subsequent cessation of smoking among daily cigarette smokers: findings from the International Tobacco Control Four Country Smoking and Vaping Surveys (2016-20). Addiction 2023; 118:140-148. [PMID: 35938219 PMCID: PMC11164548 DOI: 10.1111/add.16023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine whether polyuse of cigarettes and other smoked products (polysmoking) is predictive of quit attempts and quit success. DESIGN A prospective multi-country cohort design. SETTING Australia, Canada, England and the United States. PARTICIPANTS A total of 3983 adult daily cigarette smokers were surveyed in 2016 (wave 1 of data collection) and were re-contacted in 2018 (wave 2) (i.e. waves 1-2 cohort) in the International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys; and 3736 smokers were surveyed in 2018 and re-contacted in 2020 (wave 3) (i.e. waves 2-3 cohort). MEASUREMENTS Participants were asked about their cigarette smoking and use of cigars, cigarillos, pipes and waterpipes. Outcomes were quit attempts between two survey waves and success, defined as having quit smoking all the combustible tobacco at the subsequent survey for 1 month or more. FINDINGS Levels of polysmoking were 12.7% in the waves 1-2 cohort and 10.5% for the waves 2-3 cohort. Compared with cigarette-only smokers, polysmokers were more likely to attempt to quit between waves 1 and 2 [54.9 versus 42.7%, adjusted odds ratio (aOR) = 1.37, 95% confidence interval (CI) = 1.08-1.74, P < 0.01], but not between waves 2 and 3 (43.8 versus 40.1%, aOR = 0.94, 95% CI = 0.72-1.22). Polysmoking predicted reduced likelihood of success in both cohorts among attempters and the overall samples. Between waves 2 and 3 there were significantly more transitions to non-daily smoking among the polysmokers (12.4 versus 5.3%, χ2 = 40.4, P < 0.001). CONCLUSIONS There is a consistent association between polysmoking (use of cigarettes together with other smoked products) and reduced quit success for combustible tobacco, but it is probably due to increased likelihood of transitioning to non-daily use rather than complete cessation.
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Affiliation(s)
- Lin Li
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne Parkville Campus, Parkville, VIC, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne Parkville Campus, Parkville, VIC, Australia
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne Parkville Campus, Parkville, VIC, Australia
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Shaping Public hEalth poliCies To Reduce ineqUalities and harm (SPECTRUM), London, UK
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12
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Paulin LM, Halenar MJ, Edwards KC, Lauten K, Stanton CA, Taylor K, Hatsukami D, Hyland A, MacKenzie T, Mahoney MC, Niaura R, Trinidad D, Blanco C, Compton WM, Gardner LD, Kimmel HL, Lauterstein D, Marshall D, Sargent JD. Association of tobacco product use with chronic obstructive pulmonary disease (COPD) prevalence and incidence in Waves 1 through 5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study. Respir Res 2022; 23:273. [PMID: 36183112 PMCID: PMC9526897 DOI: 10.1186/s12931-022-02197-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We examined the association of non-cigarette tobacco use on chronic obstructive pulmonary disease (COPD) risk in the Population Assessment of Tobacco and Health (PATH) Study. METHODS There were 13,752 participants ≥ 40 years with Wave 1 (W1) data for prevalence analyses, including 6945 adults without COPD for incidence analyses; W1-5 (2013-2019) data were analyzed. W1 tobacco use was modeled as 12 mutually-exclusive categories of past 30-day (P30D) single and polyuse, with two reference categories (current exclusive cigarette and never tobacco). Prevalence and incidence ratios of self-reported physician-diagnosed COPD were estimated using weighted multivariable Poisson regression. RESULTS W1 mean (SE) age was 58.1(0.1) years; mean cigarette pack-years was similar for all categories involving cigarettes and exclusive use of e-cigarettes (all > 20), greater than exclusive cigar users (< 10); and COPD prevalence was 7.7%. Compared to P30D cigarette use, never tobacco, former tobacco, and cigar use were associated with lower COPD prevalence (RR = 0.33, (95% confidence interval-CI) [0.26, 0.42]; RR = 0.57, CI [0.47, 0.70]; RR = 0.46, CI [0.28, 0.76], respectively); compared to never tobacco use, all categories except cigar and smokeless tobacco use were associated with higher COPD prevalence (RR former = 1.72, CI [1.33, 2.23]; RR cigarette = 3.00, CI [2.37, 3.80]; RR e-cigarette = 2.22, CI [1.44, 3.42]; RR cigarette + e-cigarette = 3.10, CI [2.39, 4.02]; RR polycombusted = 3.37, CI [2.44, 4.65]; RR polycombusted plus noncombusted = 2.75, CI]1.99, 3.81]). COPD incidence from W2-5 was 5.8%. Never and former tobacco users had lower COPD risk compared to current cigarette smokers (RR = 0.52, CI [0.35, 0.77]; RR = 0.47, CI [0.32, 0.70], respectively). Compared to never use, cigarette, smokeless, cigarette plus e-cigarette, and polycombusted tobacco use were associated with higher COPD incidence (RR = 1.92, CI [1.29, 2.86]; RR = 2.08, CI [1.07, 4.03]; RR = 1.99, CI [1.29, 3.07]; RR = 2.59, CI [1.60, 4.21], respectively); exclusive use of e-cigarettes was not (RR = 1.36, CI [0.55, 3.39]). CONCLUSIONS E-cigarettes and all use categories involving cigarettes were associated with higher COPD prevalence compared to never use, reflecting, in part, the high burden of cigarette exposure in these groups. Cigarette-but not exclusive e-cigarette-use was also strongly associated with higher COPD incidence. Compared to cigarette use, only quitting tobacco was protective against COPD development.
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Affiliation(s)
- Laura M Paulin
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH, USA.
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristin Lauten
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | | | - Kristie Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Todd MacKenzie
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH, USA
| | - Martin C Mahoney
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ray Niaura
- New York University School of Global Public Health, New York, NY, 10012, USA
| | - Dennis Trinidad
- University of California at San Diego, La Jolla, CA, 92037, USA
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Lisa D Gardner
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Dana Lauterstein
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - James D Sargent
- Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH, USA
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13
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Gallegos-Carrillo K, Barrientos-Gutiérrez I, Arillo-Santillán E, Rodríguez-Bolaños R, Cruz-Jiménez L, Desirée VP, Cho YJ, Thrasher JF. Transitions between tobacco products: Correlates of changes in cigarette smoking and e-cigarette use among exclusive adult smokers and dual users in Mexico. Prev Med Rep 2022; 29:101869. [PMID: 35911576 PMCID: PMC9326312 DOI: 10.1016/j.pmedr.2022.101869] [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: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
This study examined transitions in tobacco products use among Mexican smokers and dual users. Data were analyzed from exclusive smokers (n = 2,946) and dual users (n = 1,643) recruited from an online consumer research panel and surveyed every-four months from November 2018 to April 2021. For exclusive smokers, estimated transitions were (time "t + 1" four months after prior survey): a) remain as exclusive smokers; b) dual use; c) exclusive e-cigarette use or quit both products. Among dual users, transitions analyzed were: a) remain as dual user; b) exclusive smoker; c) exclusive e-cigarette user or quit both products. Multinomial models regressed transitions at "t + 1" on time "t" for control variables. Most exclusive smokers (81%) remained as such, 12.6% transitioned to dual use, 2.3% to exclusive e-cigarette use, and 4% quitted both products. Exclusive smokers were more likely to transition to dual use if they recently attempted to quit (AOR = 1.45) or had partners/family or friends who used e-cigarettes (AOR = 2.47 & 2.56 respectively). Most dual users (74.8%) remained as dual users, 20.4% transitioned to exclusive smoking, 1.6% transitioned to exclusive e-cigarette use, and 3.2% quitted both products. Dual users were more likely to transition to exclusive smoking if they had lower educational attainment, recently attempted to quit e-cigarettes (AOR = 1.70). Having friends who use e-cigarettes (AOR = 0.29) and higher smoking dependence (AOR = 0.55) were associated with a lower likelihood of quitting. Recent quit attempts and e-cigarette use among close social network members may explain the short-term transitions, though longer follow-up is needed to assess sustained smoking cessation.
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Affiliation(s)
- Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Morelos, Mexican Institute of Social Security, Mexico
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Lizeth Cruz-Jiménez
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Vidaña-Pérez Desirée
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James F. Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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14
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Steeger CM, Harlow AF, Barrington-Trimis JL, Simon P, Hill KG, Leventhal AM. Longitudinal associations between flavored tobacco use and tobacco product cessation in a national sample of adults. Prev Med 2022; 161:107143. [PMID: 35803351 PMCID: PMC9994601 DOI: 10.1016/j.ypmed.2022.107143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/05/2022] [Accepted: 07/02/2022] [Indexed: 11/28/2022]
Abstract
Use of flavored tobacco has been associated with lower likelihood of short-term abstinence from tobacco. It is unknown whether longer-term associations exist, particularly for a variety of products and specific flavor categories. This study used adult survey data from the Population Assessment of Tobacco and Health (PATH) Study (2013-2018). We tested associations of past 30-day tobacco product use at wave 2 using both a 2-category any flavor versus unflavored variable and 4-category specific flavor (menthol/mint, sweet, and both menthol/mint and sweet) versus unflavored variable with past 12-month cessation from the same product two years later at wave 4. Separate models were run for each product (combustible cigarettes, cigars, hookah, e-cigarettes, and smokeless), adjusting for wave 1 sociodemographic characteristics. For all five products, past 30-day use of any flavored (versus unflavored) product at wave 2 was associated with reduced likelihood of same-product cessation at wave 4. Most specific flavor categories were associated with reduced odds of same-product cessation across all products. Any flavor use was also associated with reduced likelihood of longer-term cessation (i.e., past 24-months at both waves 3 and 4) and cessation from all five tobacco products in several analyses. Exploratory moderation results indicated that the association between e-cigarette flavor use and lower likelihood of cessation was stronger for young adults (18-24) versus older adults (25+). Current use of flavored tobacco products is associated with lower likelihood of product cessation. Flavored tobacco products warrant consideration in regulatory policy to reduce the adverse public health impact of tobacco use.
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Affiliation(s)
- Christine M Steeger
- Institute of Behavioral Science, University of Colorado Boulder, 1440 15(th) St., Boulder, CO 80309, USA.
| | - Alyssa F Harlow
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Jessica L Barrington-Trimis
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
| | - Karl G Hill
- Institute of Behavioral Science, University of Colorado Boulder, 1440 15(th) St., Boulder, CO 80309, USA.
| | - Adam M Leventhal
- School of Medicine, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA 90033, USA; Institute for Addiction Science, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
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15
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Lau YK, Okawa S, Meza R, Katanoda K, Tabuchi T. Nicotine dependence of cigarette and heated tobacco users in Japan, 2019: a cross-sectional analysis of the JASTIS Study. Tob Control 2022; 31:e50-e56. [PMID: 33741741 PMCID: PMC9340029 DOI: 10.1136/tobaccocontrol-2020-056237] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/28/2020] [Accepted: 01/06/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Japan is currently the biggest market of heated tobacco products (HTPs) in the world. Little is known about nicotine dependence among HTP users. Thus, the objective was to assess the association of type of tobacco use and time-to-first-use, a marker of nicotine dependence. METHODS A cross-sectional analysis of the 2019 data from an internet cohort study was conducted. The analytical sample consisted of 2147 current (≥1 day use in the past 30 days) HTP and/or conventional cigarette users, aged 25+ years. Marginal structural binomial regression was used to estimate nicotine dependence prevalence ratios (PRs) for each category of tobacco use (exclusive daily cigarette, exclusive HTP (≥1 day), dual HTP+daily cigarette, dual HTP+non-daily cigarette), relative to exclusive, non-daily cigarette smoking. RESULTS Using a 5 min cut-off for time-to-first-use, the prevalence of nicotine dependence was higher among dual users of HTP and daily cigarettes (PR=1.38; 95% CI: 1.05 to 1.82) and exclusive, daily cigarette users (PR=1.48; 95% CI: 1.15 to 1.91), relative to exclusive, non-daily cigarette users. However, nicotine dependence among exclusive HTP users, and dual HTP+non-daily cigarette users, did not differ from that of exclusive, non-daily cigarette users. When using 15 and 30 min cut-offs, all types of users, including exclusive HTP, had higher levels of nicotine dependence relative to exclusive, non-daily cigarette users. CONCLUSIONS Regardless of HTP use, daily cigarette users had higher prevalence of nicotine dependence compared with non-daily cigarette users. Exclusive HTP users had similar (or potentially higher) dependence compared with exclusive, non-daily cigarette users. Longitudinal studies are needed to interrogate the public health implications of growing HTP use worldwide.
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Affiliation(s)
- Yan Kwan Lau
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sumiyo Okawa
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kota Katanoda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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16
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Harper LA, Beck KC, Drazdowski TK, Li C. Sex and Sexual Identity Differences in Poly-tobacco Use and Psychological Distress in U.S. Adults: Results From the National Health Interview Survey. Nicotine Tob Res 2022; 25:19-27. [PMID: 35894290 PMCID: PMC9717376 DOI: 10.1093/ntr/ntac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/31/2022] [Accepted: 07/21/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations. AIMS AND METHODS The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016-2018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity. RESULTS PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts. CONCLUSIONS The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies. IMPLICATIONS Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.
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Affiliation(s)
- Leia A Harper
- Corresponding Author: Leia A. Harper, PhD, Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA. E-mail:
| | - Kira C Beck
- Department of Psychology, Reed College, Portland, OR, USA
| | | | - Christina Li
- Department of Psychology, Reed College, Portland, OR, USA
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17
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Bennett B, Romm KF, Berg CJ. Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors. Tob Prev Cessat 2022; 8:18. [PMID: 35601562 PMCID: PMC9074834 DOI: 10.18332/tpc/148245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION COVID-19 impacted cigarette and e-cigarette use behaviors among some individuals. This study examined COVID-19 factors and prior substance use as predictors of cigarette and e-cigarette cessation and initiation among US young adults from before to during the COVID-19 pandemic. METHODS We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas. We examined COVID-19 news exposure, perceived smoking and e-cigarette use risk, and prior substance use, as predictors of cigarette and e-cigarette cessation and initiation, respectively. RESULTS Of W3 cigarette users (n=516), 37.8% (n=195) quit cigarettes at W5; predictors of cessation included younger age, fewer days of W3 past-month cigarette use, and no W3 e-cigarette use. Of W3 e-cigarette users (n=687), 38.7% (n=266) quit e-cigarettes at W5; predictors included greater COVID-19 news exposure, fewer days of W3 past-month e-cigarette use, and no W3 cigarette use. Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. CONCLUSIONS These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions.
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Affiliation(s)
- Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Katelyn F. Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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18
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Glasser AM, Hinton A, Wermert A, Macisco J, Nemeth JM. Characterizing tobacco and marijuana use among youth combustible tobacco users experiencing homelessness - considering product type, brand, flavor, frequency, and higher-risk use patterns and predictors. BMC Public Health 2022; 22:820. [PMID: 35468777 PMCID: PMC9036780 DOI: 10.1186/s12889-022-13244-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention. METHODS This study included 96 youth (ages 14-24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana. RESULTS Most youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one's housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors. CONCLUSIONS Young combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Alice Hinton
- Division of Biostatistics, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Joseph Macisco
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
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Loukas A, Marti CN, Harrell MB. Electronic nicotine delivery systems use predicts transitions in cigarette smoking among young adults. Drug Alcohol Depend 2022; 231:109251. [PMID: 34999270 PMCID: PMC8810737 DOI: 10.1016/j.drugalcdep.2021.109251] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/13/2021] [Accepted: 12/05/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although cigarette smoking during young adulthood is characterized by volatility, few studies examine if use of electronic nicotine delivery systems (ENDS) impacts transitions in cigarette use behaviors across this developmental period. The purpose of this longitudinal study was to examine the role of ENDS use on three transitions in cigarette smoking among young adults; initiation, desistance, and re-uptake. METHODS Participants were 5029 18-29-year-olds (64.2% female) enrolled in one of 24 Texas colleges at baseline and involved in an eight-wave, 4.5-year study. A multi-state, continuous time Markov model was used to assess the role of current/past 30-day and ever ENDS use on three transitions, spanning at least six months 1) never to current smoking (initiation); 2) current to non-current smoking (desistance); and 3) non-current to current smoking (re-uptake). The model also contained time-invariant socio-demographic, and time-varying intrapersonal (other tobacco use, nicotine dependence, sensation seeking, depressive symptoms) and interpersonal (peer cigarette use) covariates. RESULTS Both current and ever ENDS use increased the probability of transitioning from never to current cigarette use (initiation) and decreased the probability of transitioning from current to non-current use (desistance). Current, but not ever, ENDS use also increased the probability of transitioning from non-current to current use (re-uptake). Adjustment for socio-demographic, intrapersonal, and interpersonal covariates did not alter these findings. DISCUSSION ENDS use in young adulthood increases the risk for cigarette smoking behaviors across the continuum of uptake and progression. Prevention and cessation efforts targeting both ENDS and cigarette use during young adulthood are needed.
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Affiliation(s)
- Alexandra Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA.
| | - C Nathan Marti
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA
| | - Melissa B Harrell
- Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health in Austin, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA
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20
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Miller CR, Sutanto E, Smith DM, Hitchman SC, Gravely S, Yong HH, Borland R, O’Connor RJ, Cummings KM, Fong GT, Hyland A, Quah AC, Goniewicz ML. Awareness, trial and use of heated tobacco products among adult cigarette smokers and e-cigarette users: findings from the 2018 ITC Four Country Smoking and Vaping Survey. Tob Control 2022; 31:11-18. [PMID: 32994299 PMCID: PMC8005508 DOI: 10.1136/tobaccocontrol-2020-055985] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/04/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate heated tobacco product (HTP) awareness, trial and current use among adult cigarette smokers and vaping product users in four countries with varying regulations governing HTP sales. DESIGN Data came from Wave 2 of the ITC Four Country Smoking and Vaping Survey, collected from February to July 2018. Respondents were current and former smokers and/or users of vaping products (18 years or older) from Canada (CA; n=3778), England (EN; n=4848), the USA (US; n=2846) and Australia (AU; n=1515). At the time of the survey, only Canada and England permitted the sale of contemporary HTPs (eg, IQOS). RESULTS Overall, 30.2% of respondents reported being aware of HTPs (CA=30.4%; EN=31.0%; US=30.2%; AU=27.4%; p=0.346), 2.4% had ever tried HTPs (CA=3.3%; EN=2.4%; US=2.0%; AU=0.9%; p=0.001) and 0.9% currently used HTPs at least monthly (CA=0.8%; EN=1.2%; US=0.7%; AU=0.2%; p<0.001). Trial and current use were higher among those who concurrently smoked and vaped (at least monthly) versus other nicotine use categories (trial: 10.9% v. 1.2%-2.0%, p<0.001; current use: 8.4% v. 0.1%-1.0%, p<0.001). In multivariable analyses, HTP awareness did not differ across countries, whereas odds of trial and current use were lower where HTPs were unavailable. Odds of HTP trial did not differ by regulatory environment when restricting analysis to HTP-aware concurrent smokers-vapers. CONCLUSION Approximately one third of respondents were aware of HTPs, even in the USA and Australia, where contemporary HTPs were not yet on the market. Trial and use were uncommon, except among concurrent smokers-vapers. Restrictions on availability may have limited HTP use generally, but less so for concurrent smokers-vapers.
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Affiliation(s)
- Connor R. Miller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Edward Sutanto
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Danielle M. Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Sara C. Hitchman
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Ron Borland
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada;,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Anne C.K. Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Cantrell J, Xu S, Kreslake J, Liu M, Hair E. Cigar Use Progression Among New Cigar Initiators: A Two-Part Growth Curve Analysis Among a Youth and Young Adult Cohort. Nicotine Tob Res 2022; 24:28-36. [PMID: 34259873 DOI: 10.1093/ntr/ntab143] [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: 03/08/2021] [Accepted: 07/06/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Youth and young adults (YYAs) are at high risk of cigar use. This study's objective was to examine progression and sociodemographic differences in current cigar use and frequency among new cigar initiators. AIMS AND METHODS We conducted a two-part latent growth model among a nationally representative cohort of cigar initiators (aged 15-25) to examine 24-month trajectories of current cigar use and frequency (n = 1483). The cohort was recruited via address-based sampling with online data collection from 2014 to 2019 and surveyed approximately every 6 months. RESULTS The unconditional odds of current cigar use (ie, past 30-day use) within 6 months of initiation was 0.72 (95% confidence interval: 0.63, 0.82), corresponding to a probability of 42%. The odds of current use among recent cigar initiates declined 6 months after initiation and was followed by a stabilization in use over time. Among continued users, frequency (# days used in past 30 days) increased linearly over time but remained low (3.47 days/months at 24 months). Younger individuals, non-Hispanic African Americans, those with lower subjective financial status, and current users of cigarettes, other tobacco products and/or marijuana were at highest risk within 6 months of initiation. Males, younger users, and current cigarette smokers had the highest risk for cigar progression over time. CONCLUSIONS This study is the first to examine longitudinal cigar use patterns among YYA cigar initiators. Findings emphasize the need for research across the cigar use spectrum and the importance of interventions targeted by age, stage of use, cigarette, other tobacco, and marijuana use and key sociodemographics to interrupt use pathways. IMPLICATIONS This study is the first to examine progression of cigar use among YYAs who have newly initiated cigars. Results show a high probability of current cigar use within 6 months of initiation followed by a rapid decline and stabilization over time. Frequency increases among those who continue using cigars. Males, younger users, and current cigarette smokers had the highest risk for cigar progression over time. Findings emphasize the need for targeting interventions by age, stage of use, cigarette, other tobacco, and marijuana use and key sociodemographics to interrupt use pathways.
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Affiliation(s)
- Jennifer Cantrell
- Department of Social and Behavioral Sciences, New York University, School of Global Public Health, New York, NY, USA
| | - Shu Xu
- Department of Biostatistics, New York University, School of Global Public Health, New York, NY, USA
| | | | - Michael Liu
- Schroeder Institute, Truth Initiative, Washington D.C., USA
| | - Elizabeth Hair
- Schroeder Institute, Truth Initiative, Washington D.C., USA
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22
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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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Johnson AC, Mercincavage M, Souprountchouk V, Rogelberg S, Sidhu AK, Delnevo CD, Strasser AA. Responses to reduced nicotine cigarette marketing features: a systematic review. Tob Control 2021; 32:tobaccocontrol-2021-056826. [PMID: 34620718 PMCID: PMC8986886 DOI: 10.1136/tobaccocontrol-2021-056826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/20/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To systematically review the literature regarding responses to commercial and public health marketing features for reduced nicotine cigarettes (RNCs) to anticipate potential industry and regulatory actions should an RNC product standard be issued. DATA SOURCES We searched PubMed for English-language articles using several keywords for reduced nicotine products, cigarettes and marketing features published through 2020. STUDY SELECTION Of 4092 records, 26 studies were retained for review that met criteria focusing on responses to RNC marketing features. DATA EXTRACTION Search terms created by the research team were used for review and included independent extraction and coding by two reviewers. Coding was categorised using study design terminology, commercial and public health features in tobacco regulatory science, and their association with individual responses outlined by several message processing outcomes. DATA SYNTHESIS Most studies focused on current cigarette smokers and were cross-sectional. Reactions to RNCs and attitudes and beliefs were the most common outcomes measured. For commercial features, articles generally studied RNC advertisements, products and/or descriptors. For public health features, articles studied counter-messaging (eg, warning labels) or general descriptors about nicotine or a reduced nicotine product standard. Commercial features were generally associated with favourable responses. Public health features offset favourable responses across most outcomes, though their efficacy was mixed. Contrasts in results by smoking status are discussed. CONCLUSIONS Commercial marketing of RNCs is appealing and may need stronger regulations or communication campaigns to accurately convey risks. Opportunities exist for future research within tobacco regulatory science.
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Affiliation(s)
- Andrea C Johnson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
| | - Melissa Mercincavage
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
| | - Valentina Souprountchouk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
| | - Sasha Rogelberg
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anupreet K Sidhu
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
| | - Cristine D Delnevo
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, Pennsylvania, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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East KA, Reid JL, Rynard VL, Hammond D. Trends and Patterns of Tobacco and Nicotine Product Use Among Youth in Canada, England, and the United States From 2017 to 2019. J Adolesc Health 2021; 69:447-456. [PMID: 33839006 PMCID: PMC8403620 DOI: 10.1016/j.jadohealth.2021.02.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE The tobacco and nicotine market is diversifying. Implications for public health will depend on trends in use, including overall use, and who is using these products. This study examined differences over time (2017-2019), across countries (Canada, England, the United States (US)), and by smoking and vaping, in use of other tobacco/nicotine products and overall use. METHODS The study includes online repeat cross-sectional surveys of youth aged 16-19 years in Canada (N = 11,714), England (N = 11,170), US (N = 11,838) in 2017, 2018, and 2019. Past 30-day use of tobacco/nicotine products (any, cigarette, e-cigarette, other combusted [cigars/cigarillos/waterpipe], other non-combusted [smokeless tobacco/nicotine replacement therapies) were examined by country, year, and, for other combusted and non-combusted products, past 30-day cigarette smoking and vaping. Use of emerging products (IQOS, nicotine pouches) was explored in 2018-2019. RESULTS From 2017 to 2019, use of any product increased in Canada (17.1%-23.2%, AOR = 1.07 [95% CI = 1.04-1.09]) and the US (18.0%-24.0%, AOR = 1.06 [1.04-1.09]) but not England (20.8%-21.7%, AOR = 1.01 [.99-1.03]). Use of other combusted products (cigars/cigarillos/waterpipe) showed little change (Canada: 8.1%-7.8%; England: 6.3%-7.3%; US: 8.6%-8.5%; p ≥ .151). Use of other non-combusted products (smokeless/nicotine replacement therapies) increased in all countries (Canada: 1.5%-3.2%, AOR = 1.02 [1.01-1.02]; England: 1.4%-2.6%, AOR = 1.02 [1.01-1.03]; US: 3.3%-4.9%, AOR = 1.02 [1.01-1.02]). Vaping increased in all countries (Canada: 8.4%-17.8%; England: 8.7%-12.6%; United States: 11.1%-18.5%; all p < .001). Smokers and vapers reported greater use of other combusted and non-combusted products than those who neither smoked/vaped (p < .001). Emerging product use was rare (≤1.5%). CONCLUSIONS Youth past 30-day tobacco and nicotine product use increased from 2017 to 2019 in Canada and the United States, largely due to increases in vaping and other non-combusted products. "Other" tobacco/nicotine products were used predominantly by youth who smoked cigarettes and/or vaped.
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Affiliation(s)
- Katherine A East
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
| | - Jessica L Reid
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Vicki L Rynard
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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25
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Klemperer EM, Hughes JR, Callas PW, West JC, Villanti AC. Tobacco and Nicotine Use Among US Adult "Never Smokers" in Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2021; 23:1199-1207. [PMID: 33433608 PMCID: PMC8186421 DOI: 10.1093/ntr/ntab009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A common criterion for being labeled a "never smoker" is having smoked <100 lifetime cigarettes. This category is often used as an unexposed reference group to estimate the relative harm from cigarettes. We examined the amount of current and past cigarette and non-cigarette tobacco/nicotine use among adults who met this "never smoker" criterion. METHODS We analyzed cross-sectional data from 17 179 adult "never smokers" (ie, reported <100 lifetime cigarettes) in Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health (PATH) Study, a United States nationally representative sample. We used PATH-derived variables to describe "never smokers'" demographics as well as cigarette and non-cigarette tobacco/nicotine use. RESULTS Approximately half of "never smokers" were young adults (49.3%). Most were white (68.6%) with some college or more (64.4%). Most "never smokers" had tried any cigarette or non-cigarette tobacco/nicotine in their lifetime (66.7%), 8.5% smoked cigarettes in the past 30 days, and 5.3% were current experimental (ie, some days or every day) cigarette smokers. By definition, "never smokers" reported smoking <100 lifetime cigarettes. One fifth (22.8%) had a lifetime history of established regular non-cigarette tobacco/nicotine use and 8.6% were current established regular non-cigarette tobacco/nicotine users. In total, 9.4% of "never smokers" were current experimental or established regular users of combustible tobacco. CONCLUSIONS The 100-cigarette lifetime threshold includes substantial amounts of current and past tobacco use and thus does not represent lack of exposure to cigarette or non-cigarette tobacco. "Never smoker" reference groups may produce underestimates of the relative harms from cigarettes. IMPLICATIONS The <100 lifetime cigarettes criterion may not capture what many would consider true "never smokers." Relying on the current definition of "never smokers" as a reference group will include a substantial number of those currently and recently using combustible tobacco and thus produce data that may underestimate the relative harm from cigarettes. Prospective longitudinal research is needed to compare how the 100-cigarette lifetime threshold versus other definitions of regular cigarette smoking differ in predictive validity of clinically meaningful outcomes and health harms to determine the optimal criteria to define established cigarette smoking.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - John R Hughes
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - Peter W Callas
- Department of Biostatistics, University of Vermont, Burlington, VT
| | - Julia C West
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
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Hyland A, Kasza KA, Borek N, Kimmel HL, Taylor KA, Compton WM, Day H, Donaldson EA, Sharma E, Anic G, Edwards KC, Halenar MJ, Hull LC, Kissin W, Limpert J, Seaman EL, Bansal-Travers M, Gardner LD, Hammad HT, Stanton CA. Overview of tobacco use transitions for population health. Tob Control 2021; 29:s134-s138. [PMID: 32321846 DOI: 10.1136/tobaccocontrol-2019-055367] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 11/03/2022]
Abstract
The Family Smoking Prevention and Tobacco Control Act provided the US Food and Drug Administration authority to regulate tobacco products using a population health standard. Models have been developed to estimate the population health impacts of tobacco initiation, cessation and relapse transitions. Models should be informed by high-quality, longitudinal data to estimate these constructs. Simulation studies have generated data to predict the impact of various tobacco control interventions, including the influence of regulations on tobacco use behaviours and health. The purpose of this paper is to provide a high-level conceptual overview for understanding tobacco transition behaviours and correlates of these behaviours using data from the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative longitudinal tobacco study of about 46 000 persons aged 12+ years. The papers that follow in this journal issue build and expand on this conceptual overview using data from the first three waves of the PATH Study. These papers describe use patterns of different tobacco products and their correlates, and can serve as foundations for more in-depth papers that will help the research community better understand the population health impacts and drivers of different tobacco use patterns.
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Affiliation(s)
- Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Hannah Day
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Gabriella Anic
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Lynn C Hull
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Wendy Kissin
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Elizabeth L Seaman
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Hoda T Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA.,Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
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27
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Edwards KC, Sharma E, Halenar MJ, Taylor KA, Kasza KA, Day H, Hammad HT, Anic G, Bansal-Travers M, Limpert J, Gardner LD, Borek N, Kimmel HL, Compton WM, Hyland A, Stanton CA. Longitudinal pathways of exclusive and polytobacco cigar use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2021; 29:s163-s169. [PMID: 32321850 DOI: 10.1136/tobaccocontrol-2020-055624] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The goal of this study is to examine the cross-sectional prevalence of use and 3-year longitudinal pathways of cigar use in US youth (12-17 years), young adults (18-24 years), and adults 25+ (25 years or older). 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 Weighted cross-sectional prevalence of past 30-day (P30D) use was stable for adults 25+ (~6%), but decreased in youth (Wave 1 (W1) to Wave 3 (W3)=2.5% to 1.2%) and young adults (W1 to W3=15.7% to 14.0%). Among W1 P30D cigar users, over 50% discontinued cigar use (irrespective of other tobacco use) by Wave 2 (W2) or W3. Across age groups, over 70% of W1 P30D cigar users also indicated P30D use of another tobacco product, predominantly cigar polytobacco use with cigarettes. Discontinuing all tobacco use by W2 or W3 was greater in adult exclusive P30D cigar users compared with polytobacco cigar users. CONCLUSIONS Although the majority of P30D cigar users discontinued use by W3, adult polytobacco users of cigars were less likely to discontinue all tobacco use than were exclusive cigar users. Tracking patterns of cigar use will allow further assessment of the population health impact of cigars.
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Affiliation(s)
- Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Hannah Day
- 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
| | - Gabriella Anic
- 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
| | - 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
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA.,Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
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Edwards KC, Kasza KA, Tang Z, Stanton CA, Sharma E, Halenar MJ, Taylor KA, Donaldson EA, Hull LC, Bansal-Travers M, Limpert J, Zandberg I, Gardner LD, Borek N, Kimmel HL, Compton WM, Hyland A. Correlates of tobacco product reuptake and relapse among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2021; 29:s216-s226. [PMID: 32321855 DOI: 10.1136/tobaccocontrol-2020-055660] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study examines sociodemographic and tobacco use correlates of reuptake and relapse to tobacco use across a variety of tobacco products (cigarettes, electronic nicotine delivery systems, cigars, hookah and smokeless tobacco) among the US population. 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 (ages 12-17) and adults (ages 18+). Reuptake (past 30-day use among previous tobacco users) and relapse (current use among former established users; adults only) were examined among previous users of at least one type of tobacco product at Wave 1 (W1) or Wave 2 (W2) (n=19 120 adults, n=3039 youth). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with reuptake/relapse at follow-up, over two 1-year periods (W1-W2 and W2-Wave 3). RESULTS Any tobacco product reuptake occurred in 7.8% of adult previous users and 30.3% of youth previous users. Correlates of any tobacco reuptake included being male, non-Hispanic black and bisexual in adults, but race and sexual orientation were not consistent findings in youth. Among recent former users, relapse rates were greater (32.9%). Shorter time since last use and greater levels of tobacco dependence showed the strongest association with any tobacco relapse. DISCUSSION Continued clinical and public health efforts to provide adults with tools to cope with tobacco dependence symptoms, especially within the first year or two after quitting, could help prevent relapse.
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Affiliation(s)
- Kathryn C Edwards
- 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
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - 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
| | - 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
| | - Elisabeth A Donaldson
- 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
| | - Izabella Zandberg
- 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
| | - 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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Pérez A, Kuk AE, Bluestein MA, Penedo E, N’hpang RS, Chen B, Perry CL, Sterling KL, Harrell MB. Prospective estimation of the age of initiation of cigarettes among young adults (18-24 years old): Findings from the Population Assessment of Tobacco and Health (PATH) waves 1-4 (2013-2017). PLoS One 2021; 16:e0251246. [PMID: 33951097 PMCID: PMC8099124 DOI: 10.1371/journal.pone.0251246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/22/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To prospectively estimate the age of cigarette initiation among young adults (18-24 years old) who were never cigarette users at their first wave of adult study participation overall, by sex, and by race/ethnicity given recent increases in cigarette initiation occurring in young adulthood. METHODS Secondary analyses were conducted using the PATH restricted-use adult datasets among young adult never users of cigarettes in waves 1-3 (2013-2016) with outcomes followed-up in waves 2-4 (2014-2017). Interval censoring survival methods were used to estimate the age of initiation of (i) ever, (ii) past 30-day, and (iii) fairly regular cigarette use. Among never cigarette users when they first entered the adult study, interval censoring Cox proportional hazard models were used to explore differences in the estimated age of initiation of the three cigarette use outcomes by sex and by race/ethnicity, controlling for the effect of previous e-cigarette use and the total number of other tobacco products ever used (0-5 products) before cigarette initiation outcomes. RESULTS Among the young adults who were never cigarette users at their first wave of adult participation, the highest increase in cigarette initiation occurred between 18 and 19 years old. By age 21, 10.6% (95% CI: 9.5-11.7) initiated ever cigarette use, 7.7% (95% CI: 6.1-8.1) initiated past 30-day of cigarette use, and 1.9% (95% CI: 1.4-2.5) initiated fairly regular cigarette use. After controlling for other tobacco products: (a) males were 83% more likely to initiate past 30-day cigarette use at earlier ages than females; (b) Hispanic and Non-Hispanic Black young adults had increased risk to initiate past 30-day cigarette use at earlier ages than Non-Hispanic White young adults (62% and 34%, respectively). CONCLUSIONS The substantial amount of cigarette initiation among young adults reinforces the need for prevention strategies among this population. Although, interventions are needed for all young adult populations, strategies should target 18-21-year-olds, with potentially differential prevention targets by sex and by race/ethnicity.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Arnold E. Kuk
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Elena Penedo
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Roi San N’hpang
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Cheryl L. Perry
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
| | - Kymberly L. Sterling
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, United State of America
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America
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Levy DT, Tam J, Sanchez-Romero LM, Li Y, Yuan Z, Jeon J, Meza R. Public health implications of vaping in the USA: the smoking and vaping simulation model. Popul Health Metr 2021; 19:19. [PMID: 33865410 PMCID: PMC8052705 DOI: 10.1186/s12963-021-00250-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/31/2021] [Indexed: 12/05/2022] Open
Abstract
Background Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), a user-friendly model which estimates the public health implications of NVPs in the USA. Methods SAVM adopts a cohort approach. We derive public health implications by comparing smoking- and NVP-attributable deaths and life-years lost under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former, and never smoking rates via smoking initiation and cessation rates, with their respective mortality rates. The NVP Scenario allows for smoking- and NVP-specific mortality rates, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. After validating the model against recent US survey data, we present the base model with extensive sensitivity analyses. Results The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 1.8 million premature smoking- and vaping-attributable deaths avoided and 38.9 million life-years gained between 2013 and 2060. When the NVP relative risk is set to 5%, the results are sensitive to the level of switching and smoking cessation rates and to a lesser extent smoking initiation rates. When the NVP relative risk is raised to 40%, the public health gains in terms of averted deaths and LYL are reduced by 42% in the base case, and the results become much more sensitive to variations in the base case parameters. Discussion Policymakers, researchers, and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources. In developing new simulation models involving NVPs, it will be important to conduct extensive sensitivity analysis and continually update and validate with new data. Conclusion The SAVM indicates the potential benefits of NVP use. However, given the uncertainty surrounding model parameters, extensive sensitivity analysis becomes particularly important. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00250-7.
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Affiliation(s)
- David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St, NW, Suite 4100, Washington, DC, 20007, USA.
| | - Jamie Tam
- School of Public Health, Yale University, New Haven, CT, USA
| | - Luz María Sanchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St, NW, Suite 4100, Washington, DC, 20007, USA
| | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St, NW, Suite 4100, Washington, DC, 20007, USA
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven St, NW, Suite 4100, Washington, DC, 20007, USA
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
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Pierce JP, Chen R, Leas EC, White MM, Kealey S, Stone MD, Benmarhnia T, Trinidad DR, Strong DR, Messer K. Use of E-cigarettes and Other Tobacco Products and Progression to Daily Cigarette Smoking. Pediatrics 2021; 147:peds.2020-025122. [PMID: 33431589 PMCID: PMC7849197 DOI: 10.1542/peds.2020-025122] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To identify predictors of becoming a daily cigarette smoker over the course of 4 years. METHODS We identified 12- to 24-year-olds at wave 1 of the US Population Assessment of Tobacco and Health Study and determined ever use, age at first use, and daily use through wave 4 for 12 tobacco products. RESULTS Sixty-two percent of 12- to 24-year-olds (95% confidence interval [CI]: 60.1% to 63.2%) tried tobacco, and 30.2% (95% CI: 28.7% to 31.6%) tried ≥5 tobacco products by wave 4. At wave 4, 12% were daily tobacco users, of whom 70% were daily cigarette smokers (95% CI: 67.4% to 73.0%); daily cigarette smoking was 20.8% in 25- to 28-year-olds (95% CI: 18.9% to 22.9%), whereas daily electronic cigarette (e-cigarette) vaping was 3.3% (95% CI: 2.4% to 4.4%). Compared with single product triers, the risk of progressing to daily cigarette smoking was 15 percentage points higher (adjusted risk difference [aRD] 15%; 95% CI: 12% to 18%) among those who tried ≥5 products. In particular, e-cigarette use increased the risk of later daily cigarette smoking by threefold (3% vs 10%; aRD 7%; 95% CI: 6% to 9%). Daily smoking was 6 percentage points lower (aRD -6%; 95% CI: -8% to -4%) for those who experimented after age 18 years. CONCLUSIONS Trying e-cigarettes and multiple other tobacco products before age 18 years is strongly associated with later daily cigarette smoking. The recent large increase in e-cigarette use will likely reverse the decline in cigarette smoking among US young adults.
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Affiliation(s)
- John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science
| | - Eric C. Leas
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | | | | | - Matthew D. Stone
- Herbert Wertheim School of Public Health and Human Longevity Science
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and,Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California
| | - Dennis R. Trinidad
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - David R. Strong
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
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32
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Li X, Borodovsky JT, Kasson EM, Fentem A, Cavazos-Rehg PA. An analysis of within-subject and population level risk related to substance use and mental health outcomes among adolescents in the PATH study. Drug Alcohol Depend 2021; 218:108385. [PMID: 33168340 DOI: 10.1016/j.drugalcdep.2020.108385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The objective of this study was to understand how adolescent substance use patterns may lead to negative mental health outcomes. METHODS Data from adolescents (12-17 years old at baseline, Wave 1) who participated in the first 3 waves of the Population Assessment of Health and Tobacco (PATH) study were used. Self-reported data on past 30-day substance use and internalizing/externalizing problems were used to conduct within-subject (fixed-effects model) and population-averaged (GEE model) analyses. RESULTS In both within-subject and between-subject analyses, the use of other illicit drugs (e.g., opioids, cocaine, prescription drugs for non-medical use) was positively associated with internalizing problems (within-subject estimate, AOR: 1.65, 95 % CI = 1.36-2.01; between-subject estimate, AOR: 1.53, 95 % CI = 1.32-1.78) and alcohol use was positively associated with externalizing problems (within-subject estimate, AOR: 1.66, 95 % CI = 1.43-1.93; between-subject estimate, AOR: 1.67, 95 % CI = 1.48-1.89). Additionally, within-subject analysis suggested that alcohol, marijuana, and other illicit drugs were associated with increased odds of comorbid internalizing and externalizing problems (ranging from marijuana, AOR: 1.18, - alcohol, AOR: 1.58). DISCUSSION Using within-subject and between-subject comparisons, this study demonstrated associations between adolescent substance use and internalizing and externalizing problems. Results suggest not only the need for individual level assessment and early intervention, but also the development and implementation of public health policy aimed at preventing or mitigating the negative effects of substance use in adolescence to promote improved mental health outcomes for this at-risk group.
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Affiliation(s)
- Xiao Li
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, United States
| | - Jacob T Borodovsky
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, United States
| | - Erin M Kasson
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, United States
| | - Andrea Fentem
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, United States
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, United States.
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Brouwer AF, Jeon J, Hirschtick JL, Jimenez-Mendoza E, Mistry R, Bondarenko IV, Land SR, Holford TR, Levy DT, Taylor JM, Fleischer NL, Meza R. Transitions between cigarette, ENDS and dual use in adults in the PATH study (waves 1-4): multistate transition modelling accounting for complex survey design. Tob Control 2020; 31:tobaccocontrol-2020-055967. [PMID: 33199541 PMCID: PMC8124082 DOI: 10.1136/tobaccocontrol-2020-055967] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Even prior to 2018, electronic nicotine delivery systems (ENDS) began to dramatically change the landscape of tobacco products and product use patterns in the USA. METHODS Using a Markov multistate transition model accounting for complex survey design, transition rates between never, non-current, cigarette, ENDS and dual use states were estimated for 23 253 adult participants in waves 1-4 (approximately 2013-2017) of the Population Assessment of Tobacco and Health study. We made short-term transition projections and estimated HRs for age, sex, race/ethnicity, education and income. RESULTS Cigarette use was persistent among adults, with 89.7% (95% CI 89.1% to 90.3%) of exclusive cigarette users and 86.1% (95% CI 84.4% to 87.9%) of dual users remaining cigarette users (either exclusive or dual) after one wave. In contrast, ENDS use was less persistent, with 72.1% (95% CI 69.6% to 74.6%) of exclusive ENDS users and 50.5% (95% CI 47.8% to 53.3%) of dual users remaining ENDS users (with or without cigarettes) after one wave. Exclusive ENDS users were more likely to start cigarette use after one wave than either never users (HR 25.2; 95% CI 20.9 to 30.5) or non-current users (HR 5.0; 95% CI 4.3 to 5.8). Dual users of ENDS and cigarettes were more likely to stop using cigarettes than exclusive cigarette users (HR 1.9; 95% CI 1.6 to 2.3). Transition rates varied among sociodemographic groups. CONCLUSIONS Multistate transition models are an effective tool for uncovering and characterising longitudinal patterns and determinants of tobacco use from complex survey data. ENDS use among US adults was less persistent than cigarette use prior to 2018.
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Affiliation(s)
- Andrew F. Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Jana L. Hirschtick
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States
| | - Irina V. Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Stephanie R. Land
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD, United States
| | | | - David T. Levy
- Department of Oncology, Georgetown University, Washington, DC, United States
| | - Jeremy M.G. Taylor
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
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Gravely S, Meng G, Cummings KM, Hyland A, Borland R, Hammond D, O’Connor RJ, Goniewicz ML, Kasza KA, McNeill A, Thompson ME, Hitchman SC, Levy DT, Thrasher JF, Quah AC, Martin N, Ouimet J, Boudreau C, Fong GT. Changes in Smoking and Vaping over 18 Months among Smokers and Recent Ex-Smokers: Longitudinal Findings from the 2016 and 2018 ITC Four Country Smoking and Vaping Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197084. [PMID: 32992667 PMCID: PMC7579485 DOI: 10.3390/ijerph17197084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022]
Abstract
This descriptive study of smokers (smoked at least monthly) and recent ex-smokers (quit for ≤2 years) examined transitions over an 18 month period in their smoking and vaping behaviors. Data are from Waves 1 (W1: 2016) and 2 (W2: 2018) of the ITC Four Country Smoking and Vaping Survey, a cohort study of adult (≥18+) smokers, concurrent users (smoke and vape), and recent ex-smokers from Australia, Canada, England, and the United States (US). Respondents (N = 5016) were classified according to their smoking and vaping status, which resulted in eight subgroups: (1) exclusive daily smokers (2) exclusive non-daily smokers; (3–6) concurrent users (subdivided into four groups by each combination of daily/non-daily smoking and daily/non-daily vaping); (7) ex-smokers who vape; (8) ex-smokers not vaping. The analyses focused first on describing changes between groups from W1 to W2. Second, transition outcomes were assessed based on changes in smoking and vaping between W1 and W2. Transitions focused on smoking were: no change in smoking (continued smoking at the same frequency); decreased smoking; increased smoking; discontinued smoking; relapsed (ex-smokers at W1 who were smoking at W2). Transitions focused on vaping were: initiated vaping; switched from smoking to vaping. Overall, this study found that the vast majority of smokers were smoking 18 months later. Non-daily smokers were more likely than daily smokers to have discontinued smoking (p < 0.0001) and to have switched to exclusive vaping (p = 0.034). Exclusive non-daily smokers were more likely than exclusive daily smokers to have initiated vaping (p = 0.04). Among all W1 daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers; however, concurrent users were more likely than exclusive daily smokers to have decreased to non-daily smoking (p < 0.001) or to have switched to vaping by W2 (p < 0.001). Among all W1 non-daily smokers, there were no significant differences in increased smoking or discontinued smoking between concurrent users or exclusive smokers. Most ex-smokers remained abstinent from smoking, and there was no difference in relapse back to smoking between those who vaped and those who did not.
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Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - K. Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Ron Borland
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (A.M.); (S.C.H.)
- Shaping public health policies to reduce inequalities & harm (SPECTRUM), The University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, ON N2L 3G1, Canada; (M.E.T.); (C.B.)
| | - Sara C. Hitchman
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (A.M.); (S.C.H.)
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA;
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
- Tobacco Research Department, Center for Population Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Anne C.K. Quah
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, ON N2L 3G1, Canada; (M.E.T.); (C.B.)
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
- Correspondence:
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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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36
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Stanton CA, Sharma E, Edwards KC, Halenar MJ, Taylor KA, Kasza KA, Day H, Anic G, Gardner LD, Hammad HT, Bansal-Travers M, Limpert J, Borek N, Kimmel HL, Compton WM, Hyland A. Longitudinal transitions of exclusive and polytobacco electronic nicotine delivery systems (ENDS) use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s147-s154. [PMID: 32321848 PMCID: PMC7530834 DOI: 10.1136/tobaccocontrol-2019-055574] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Electronic nicotine delivery systems (ENDS; including e-cigarettes) are rapidly evolving in the US marketplace. This study reports cross-sectional prevalence and longitudinal pathways of ENDS use across 3 years, among US youth (12-17 years), young adults (18-24 years) and adults 25+ (25 years and older). DESIGN Data were 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 Weighted cross-sectional ever use of ENDS increased at each wave. Across all three waves, young adults had the highest percentages of past 12-month, past 30-day (P30D) and daily P30D ENDS use compared with youth and adults 25+. Only about a quarter of users had persistent P30D ENDS use at each wave. Most ENDS users were polytobacco users. Exclusive Wave 1 ENDS users had a higher proportion of subsequent discontinued any tobacco use compared with polytobacco ENDS users who also used cigarettes. CONCLUSIONS ENDS use is most common among young adults compared with youth and adults 25+. However, continued use of ENDS over 2 years is not common for any age group. Health education efforts to reduce the appeal and availability of ENDS products might focus on reducing ENDS experimentation, and on reaching the smaller subgroups of daily ENDS users to better understand their reasons for use.
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Affiliation(s)
- Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 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
| | - 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
| | - 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
| | - 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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Kasza KA, Edwards KC, Tang Z, Stanton CA, Sharma E, Halenar MJ, Taylor KA, Donaldson EA, Hull LC, Bansal-Travers M, Limpert J, Zandberg I, Gardner LD, Hammad HT, Borek N, Kimmel HL, Compton WM, Hyland A. Correlates of tobacco product cessation among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s203-s215. [PMID: 32321854 PMCID: PMC7520817 DOI: 10.1136/tobaccocontrol-2019-055255] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report on demographic and tobacco use correlates of cessation behaviours across tobacco products (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population. 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 (ages 12-17) and adults (ages 18+) . Past 30-day (P30D) tobacco users at Wave 1 (W1) or Wave 2 (W2) were included (n=1374 youth; n=14 389 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with cessation behaviours at follow-up (discontinuing use, attempting to quit, quitting), over two 1-year periods (W1-W2, W2-Wave 3). RESULTS Among adult users of each type of tobacco product, frequency of use was negatively associated with discontinuing use. Among adult cigarette smokers, non-Hispanic white smokers, those with lower educational attainment and those with lower household income were less likely to discontinue cigarette use; ENDS use was positively associated with making quit attempts but was not associated with cigarette quitting among attempters; smokeless tobacco use was positively associated with quitting among attempters; tobacco dependence was negatively associated with quitting among attempters. Among youth cigarette smokers, tobacco dependence was negatively associated with making quit attempts. DISCUSSION Demographic correlates of tobacco cessation behaviours underscore tobacco use disparities in the USA. Use of ENDS and use of smokeless tobacco products are positively associated with some adult cigarette cessation behaviours.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lynn C Hull
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Hoda T Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Sharma E, Bansal-Travers M, Edwards KC, Halenar MJ, Taylor KA, Kasza KA, Day H, Hammad HT, Anic G, Limpert J, Gardner LD, Borek N, Kimmel HL, Compton WM, Hyland A, Stanton CA. Longitudinal pathways of exclusive and polytobacco hookah use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s155-s162. [PMID: 32321849 PMCID: PMC7523186 DOI: 10.1136/tobaccocontrol-2020-055625] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The goal of this study is to examine cross-sectional rates of use and longitudinal pathways of hookah use among US youth (ages 12-17), young adults (ages 18-24), and adults 25+ (ages 25 and older). 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 adults and youth. 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 Young adults had higher ever, past 12-month (P12M) and past 30-day cross-sectional prevalence of hookah use at each wave than youth or adults 25+. The majority of Wave 1 (W1) hookah users were P12M users of other tobacco products (youth: 73.9%, young adults: 80.5%, adults 25+: 83.2%). Most youth and adult W1 P12M hookah users discontinued use in Wave 2 or Wave 3 (youth: 58.0%, young adults: 47.5%, adults 25+: 63.4%). Most W1 P12M hookah polytobacco users used cigarettes (youth: 49.4%, young adults: 59.4%, adults 25+: 63.2%) and had lower rates of quitting all tobacco than exclusive hookah users or hookah polytobacco users who did not use cigarettes. CONCLUSIONS Hookah use is more common among young adults than among youth or adults 25+. Discontinuing hookah use is the most common pathway among exclusive or polytobacco hookah users. Understanding longitudinal transitions in hookah use is important in understanding behavioural outcomes at the population level.
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Affiliation(s)
- Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Maansi Bansal-Travers
- 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
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Hannah Day
- 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
| | - Gabriella Anic
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, 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
| | - 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
| | - 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
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Sharma E, Edwards KC, Halenar MJ, Taylor KA, Kasza KA, Day H, Gardner LD, Anic G, Bansal-Travers M, Limpert J, Hammad HT, Borek N, Kimmel HL, Compton WM, Hyland A, Stanton CA. Longitudinal pathways of exclusive and polytobacco smokeless use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s170-s177. [PMID: 32321851 PMCID: PMC7534605 DOI: 10.1136/tobaccocontrol-2020-055628] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Use of smokeless tobacco (SLT) with other tobacco products is growing, yet gaps in understanding transitions among SLT and other product use remain. The aim of this study is to examine cross-sectional prevalence and longitudinal pathways of SLT use among US youth (12-17 years), young adults (18-24 years) and adults 25+ (25 years and older). 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 Young adults had the highest current SLT use compared with other age groups. Among Wave 1 (W1) past 30-day youth and young adult SLT users, most were SLT and cigarette polytobacco users compared with adults 25+, who more often used SLT exclusively. Among W1 exclusive SLT users, persistent exclusive use across all three waves was more common among adults 25+, while transitioning from exclusive SLT use to SLT polytobacco use at Wave 2 or Wave 3 was more common among youth and young adults. Among W1 SLT and cigarette polytobacco users, a common pathway was discontinuing SLT use but continuing other tobacco use. CONCLUSIONS Our results showed distinct longitudinal transitions among exclusive and SLT polytobacco users. Deeper understanding of these critical product transitions will allow for further assessment of population health impact of these products.
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Affiliation(s)
- Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, 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
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Hannah Day
- 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
| | - Gabriella Anic
- 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
| | - 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
| | - 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
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King BA. The chicken or the egg? The value of longitudinal research in an increasingly diverse tobacco product landscape. Tob Control 2020; 29:s131-s133. [PMID: 32321845 DOI: 10.1136/tobaccocontrol-2020-055694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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