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Muthumalage T, Noel A, Thanavala Y, Alcheva A, Rahman I. Challenges in current inhalable tobacco toxicity assessment models: A narrative review. Tob Induc Dis 2024; 22:TID-22-102. [PMID: 38860150 PMCID: PMC11163881 DOI: 10.18332/tid/188197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 06/12/2024] Open
Abstract
Emerging tobacco products such as electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) have a dynamic landscape and are becoming widely popular as they claim to offer a low-risk alternative to conventional smoking. Most pre-clinical laboratories currently exploit in vitro, ex vivo, and in vivo experimental models to assess toxicological outcomes as well as to develop risk-estimation models. While most laboratories have produced a wide range of cell culture and mouse model data utilizing current smoke/aerosol generators and standardized puffing profiles, much variation still exists between research studies, hindering the generation of usable data appropriate for the standardization of these tobacco products. In this review, we discuss current state-of-the-art in vitro and in vivo models and their challenges, as well as insights into risk estimation of novel products and recommendations for toxicological parameters for reporting, allowing comparability of the research studies between laboratories, resulting in usable data for regulation of these products before approval by regulatory authorities.
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Affiliation(s)
| | - Alexandra Noel
- School of Veterinary Medicine Louisiana State University, Baton Rouge, United States
| | - Yasmin Thanavala
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Aleksandra Alcheva
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
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Hrywna M, Ozga JE, Stanton CA, Chaffee BW, Delnevo CD, Fucito LM, Jabba SV, Morean ME, Tackett AP. Prioritizing Common Terminology and Measures to Advance Research on Oral Nicotine Product Use. Nicotine Tob Res 2024; 26:645-648. [PMID: 37846819 PMCID: PMC11033571 DOI: 10.1093/ntr/ntad206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/16/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Mary Hrywna
- Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, USA
- Department of Health Behavior, Society, & Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Jenny E Ozga
- Behavioral Health and Health Policy, Westat, Rockville, MD, USA
| | | | - Benjamin W Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - Cristine D Delnevo
- Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, USA
- Department of Health Behavior, Society, & Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Lisa M Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sairam V Jabba
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA
| | - Meghan E Morean
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alayna P Tackett
- Department of Internal Medicine, Division of Medical Oncology, The Center for Tobacco Research, The James – Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Sharma A, Fix B, Hyland A, Bansal-Travers M, Quisenberry A, O’Connor R. Exposure to IQOS ads and reduced exposure claims, and association with perceived risk from COVID-19 on IQOS purchase and use intentions: results from a web-based survey. Front Public Health 2024; 11:1307484. [PMID: 38269390 PMCID: PMC10805831 DOI: 10.3389/fpubh.2023.1307484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction IQOS was authorized to be marketed as a reduced exposure product by the Food and Drug Administration in October 2020 during the global COVID-19 pandemic. Those who smoke may be more sensitive to reduced exposure marketing claims and may have an increased inclination toward IQOS use. We evaluated the likelihood of trying and purchasing IQOS as a function of exposure to ads, product appeal, and COVID-19 risk perceptions using the original IQOS ads with reduced exposure marketing. Method An online cross-sectional survey recruited 604 US adults (18-45 years), both who smoke and do not smoke. Participants saw one of the six randomly assigned IQOS ads with or without reduced exposure claims, and they answered questions about product appeal and likelihood to try and purchase IQOS. Generalized linear models were used to examine associations. Results A per unit increase in product appeal was associated with a greater likelihood of purchasing (B = 0.17, 95% CI: 0.15-0.18) and trying IQOS (B = 0.16, 95% CI = 0.14-0.18). Current smokers and former e-cigarette users reported greater intentions to try IQOS than never-smokers and never e-cigarette users, respectively. Likelihood to purchase IQOS was associated with greater confidence in not contracting COVID-19 (B = 0.11, 95% CI: 0.01-0.21). No significant differences were observed between different ad conditions. Current (B = -0.34, 95% CI = -0.50-(-0.19)) and former (B = -0.92, 95% CI = -0.15-(-0.68)) cigarette smokers who were someday e-cigarette users reported less intentions to purchase IQOS than never e-cigarette users. However, never smokers who were someday (B = 0.58, 95% CI = 0.27-0.89; B = 0.68, 95% CI = 0.39-0.98) and former e-cigarette (B = 0.38, 95% CI = 0.15-0.61) users reported greater intentions to purchase and try IQOS, respectively. Discussion IQOS may have a higher product appeal, especially for those who currently smoke and those who have lower risk perceptions from COVID-19. Among never smokers, those who currently use or have used e-cigarettes in the past may be more receptive to IQOS marketing. The data are informative for potential trends in the use of IQOS in the future and may have implications for marketing regulations of heated tobacco products (HTPs).
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Affiliation(s)
- Akshika Sharma
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Brian Fix
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Amanda Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Richard O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Dunbar MS, Davis JP, Tucker JS, Seelam R, Rodriguez A, D'Amico EJ. Parallel trajectories of vaping and smoking cannabis and their associations with mental and physical well-being among young adults. Drug Alcohol Depend 2023; 251:110918. [PMID: 37611482 PMCID: PMC10538384 DOI: 10.1016/j.drugalcdep.2023.110918] [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: 05/12/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Vaping and smoking are common modes of using cannabis (THC) among young adults, but little is known about how patterns of cannabis vaping and smoking unfold over time or how using one or both types of products may differently affect mental and physical well-being. This study examines parallel processes of cannabis vaping and smoking over 5 years and mental and physical outcomes in a sample of young adults. METHODS Annual surveys were conducted between 2016 and 2022 with a mostly California-based cohort of 2428 young adults. Parallel process growth mixture models examined trajectories of past-month frequency of cannabis vaping and smoking from ages 20 - 25. Classes were extracted based on parallel trajectories of vaped and smoked product use. Models assessed differences in self-reported mental (anxiety, depression) and physical (ailments, subjective overall) well-being outcomes in young adulthood across classes, adjusting for demographic characteristics and mental and physical well-being at pre-baseline (average age 19). RESULTS Four cannabis vaping/smoking classes emerged: low use of cannabis (84.7%), decreasing smoking, low-moderate vaping (7.1%), stable moderate smoking, decreasing vaping (4.6%), and rapid increasing dual use (3.4%). Classes were similar on physical well-being indicators in young adulthood. The rapid increasing dual use class showed higher anxiety and depressive symptoms compared to other classes. CONCLUSION Progression to higher frequency of both vaping and smoking cannabis in young adulthood may contribute to poorer mental well-being compared to other use patterns. Targeted efforts to reduce dual vaping and smoking in young people who use cannabis may be needed.
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Affiliation(s)
- Michael S Dunbar
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, United States.
| | - Jordan P Davis
- University of Southern California, Los Angeles, CA 90089, United States
| | - Joan S Tucker
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, United States
| | - Rachana Seelam
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States
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East KA, Miller CR, Hitchman SC, McNeill A, Tompkins CNE. 'It's not what you'd term normal smoking': a qualitative exploration of language used to describe heated tobacco product use and associated user identity. Addiction 2023; 118:533-538. [PMID: 36148622 PMCID: PMC9898082 DOI: 10.1111/add.16051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/26/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Tobacco and nicotine marketplaces have diversified over the past decade, including with the introduction of heated tobacco products (HTPs), such as the brand IQOS. HTPs typically heat tobacco to generate an aerosol that is inhaled. HTP nomenclature is lacking, and how HTP users define and identify themselves remains understudied. Research in this area is important because language can construct identity, and identity can shape behaviour. This study aimed to explore users' language choice when describing IQOS use, and how language relates to user identity. METHODS Qualitative interviews in London, United Kingdom, with 30 adult current and former IQOS users. Analyses were guided by Iterative Categorization. RESULTS Overall, participants expressed confusion and a lack of suitable terminology for how to describe IQOS use. Verbs such as heating and IQOSing were rarely endorsed. Most often, participants reverted to smoking when describing IQOS use and commonly referred to HEETS (tobacco sticks) as cigarettes. Yet the lack of combustion, electronic device, cleaner experience and perceived reductions in health risks led some to frame IQOS as distinct from smoking. Vaping was generally considered inappropriate for describing IQOS use. Participants also manipulated language to suit their circumstances and manage their identity, whereas some IQOS users embraced the terms smoking and smoker, most were eager to distinguish between using IQOS and being labelled a smoker because of the associated negative connotations and to align with perceptions of IQOS use as a better, less harmful behaviour. Instead, when describing their identity, IQOS users more willingly identified as vapers, or ex-smokers, or created new identities (e.g. HEET user). CONCLUSIONS People who use or have used IQOS (a brand of heated tobacco product) are ambiguous about IQOS terminology. Participants in this study commonly referred to IQOS use as smoking for lack of a more suitable term, but also resisted being labelled as smokers, a choice that may influence smoking cessation. Clear terminology must be used in surveys and by healthcare professionals when asking about cigarette smoking and e-cigarette and heated tobacco product use.
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Affiliation(s)
- Katherine A East
- National Addiction Centre, Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Connor R Miller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Sara C Hitchman
- National Addiction Centre, Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Communication and Media Research, University of Zurich, Zurich, Switzerland
| | - Ann McNeill
- National Addiction Centre, Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Charlotte N E Tompkins
- National Addiction Centre, Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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