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van der Zee K, Van Walbeek C. Interactions between ENDS and cigarette use: evidence from a 2022 national telephone survey in South Africa. Tob Control 2024:tc-2023-058521. [PMID: 38789264 DOI: 10.1136/tc-2023-058521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) may serve as a cessation tool for people who smoke cigarettes. However, for people who do not smoke, ENDS may be a gateway to nicotine addiction and cigarette use. This paper aims to quantify these behaviours in South Africa. METHODS We analysed a nationally representative telephone survey of 21 263 South Africans living in urban areas. For those respondents who had used both products (N=771), we developed a typology that describes the sequence in which cigarette and ENDS initiation occurred. 'On-rampers' describe people who used ENDS first and later initiated cigarette smoking. 'Off-rampers' describe people who used cigarettes first, took up ENDS and later quit cigarettes while still using ENDS. 'Failed off-rampers' describe people who started using ENDS while smoking cigarettes but later quit using ENDS. 'Continuing dual consumers' describe people still using both products at the time of the interview. RESULTS Of the overall sample (N=21 263), 1.7% used or had used ENDS but had no history of using cigarettes. Of dual consumers (N=771), 8.8% were classified as 'on-rampers', 13.9% as 'off-rampers', 20.9% as 'failed off-rampers' and 56.4% as 'continuing dual consumers'. Roughly half of those classified as off-rampers, failed off-rampers or continuing dual consumers stated that they started using ENDS to help them quit cigarettes. CONCLUSIONS The typology reveals a multifaceted relationship between ENDS and cigarette use in South Africa. Policy interventions should aim to minimise on-ramping and maximise off-ramping. Given the high prevalence of continued dual use and failed off-ramping, targeted cessation support should be provided for people who use ENDS and are trying to quit cigarettes.
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Affiliation(s)
- Kirsten van der Zee
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Corné Van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
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Wang Y, Sung HY, Max WB. Changes in e-cigarette use and subsequent cigarette smoking cessation in the USA: evidence from a prospective PATH study, 2013-2018. Tob Control 2024; 33:365-372. [PMID: 36601780 PMCID: PMC10244486 DOI: 10.1136/tc-2021-057225] [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: 12/13/2021] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
AIMS To examine the relationship between changes in electronic cigarette (e-cigarette) use and subsequent cigarette smoking cessation. METHODS Using data from the Population Assessment of Tobacco and Health Study (wave 1-wave 4), we analysed a study cohort of 3014 current adult cigarette smokers at wave 1 who tried to quit during the past 12 months. We categorised changes in e-cigarette use from wave 1 to wave 2 as: daily initiation, non-daily initiation, increase to daily use, increase to non-daily use, stable daily use, stable non-daily use, decrease from daily use, quit non-daily use and non-use. We estimated multivariable logistic regressions on short-term (≥1 month and <12 months) cigarette smoking cessation at wave 3 and long-term (≥12 months) cigarette smoking cessation at wave 4. We conducted sensitivity analyses using alternative study cohorts. RESULTS Among the study cohort, 2.4% initiated daily, 7.5% initiated non-daily, 1.0% increased to daily, 1.4% increased to non-daily, 1.5% maintained daily, 3.0% maintained non-daily, 2.4% decreased from daily and 3.8% quit non-daily e-cigarette use between waves 1 and 2; 7.9% and 6.9% reported short-term and long-term cigarette smoking cessation. 15.1% of short-term and 16.3% of long-term cigarette quitters used e-cigarettes. Compared with non-users, smokers who initiated daily, increased to daily or quit non-daily e-cigarette use between waves 1 and 2 had higher odds of short-term cigarette smoking cessation at wave 3. These results are robust to different study cohort specifications. CONCLUSION The findings suggest a complex relationship between changes in e-cigarette use and subsequent cigarette smoking cessation.
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Affiliation(s)
- Yingning Wang
- Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Hai-Yen Sung
- Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Wendy B Max
- Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Kasza KA, Tang Z, Seo YS, Benson AF, Creamer MR, Edwards KC, Everard C, Chang JT, Cheng YC, Das B, Oniyide O, Tashakkori NA, Weidner AS, Xiao H, Stanton C, Kimmel HL, Compton W, Hyland A. Divergence in Cigarette Discontinuation Rates by Use of Electronic Nicotine Delivery Systems (ENDS): Longitudinal Findings From the United States PATH Study Waves 1-6. Nicotine Tob Res 2024:ntae027. [PMID: 38566367 DOI: 10.1093/ntr/ntae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION We compare real-world trends in population-level cigarette discontinuation rates among adults (ages ≥21) who smoked cigarettes, by electronic nicotine delivery systems (ENDS) use. AIMS AND METHODS U.S nationally representative data from adults in the Population Assessment of Tobacco and Health (PATH) Study (2013/14-2021, Waves 1-6) who smoked cigarettes in the past 30 days (P30D) were analyzed (n = 13 640). The exposure was P30D ENDS use. The outcome was P30D cigarette discontinuation at biennial follow-up. Weighted trend analyses were conducted to test for differences in cigarette discontinuation trends by ENDS use. RESULTS Between 2013/14 and 2015/16, cigarette discontinuation rates were both 16% for those who used ENDS and for those who did not; between 2018/19 and 2021, rates were ~30% for those who used ENDS and ~20% for those who did not; the time by ENDS use interaction was significant. CONCLUSIONS The relationship between adults' ENDS use and cigarette discontinuation in the context of an expanded ENDS marketplace, new tobacco regulatory actions, and COVID-19 differs from the relationship in earlier years. IMPLICATIONS It is important for public health decisions to be informed by research based on the contemporary ENDS marketplace and circumstances.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy, Westat, Rockville, MD, USA
| | - Young Sik Seo
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Adam F Benson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - MeLisa R Creamer
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | | | - Colm Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Joanne T Chang
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Yu-Ching Cheng
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Babita Das
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Olusola Oniyide
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Nicole A Tashakkori
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Anna-Sophie Weidner
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Wilson 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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Hair EC, Do EK, Liu SM, Tulsiani S, Vallone DM, Pierce JP. Patterns of Daily Cigarette and E-cigarette Use among United States Youth and Young Adults: Insights from the Truth Longitudinal Cohort between 2018 and 2019. Prev Med Rep 2023; 36:102416. [PMID: 37753384 PMCID: PMC10518703 DOI: 10.1016/j.pmedr.2023.102416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Purpose Temporal patterns of daily tobacco product use among ever users from the Truth Longitudinal Cohort (TLC) between 2018 and 2019 were explored. Methods The sample (N = 5274) includes individuals (15-36 years), residing in the United States, who had ever used any tobacco product at Wave 7 (February - May 2018) and provided tobacco use information at Wave 9 (September - December 2019). Results There was a nonsignificant 1.1 percentage point increase in daily tobacco use (on at least 25 of the past 30 days), from 14.6% (95% CI: 12.8, 16.6) to 15.7% (95% CI: 13.8, 17.7). Tobacco product use remained stable over time, as 65.3% (95% CI: 56.4, 73.3) of daily cigarette smokers, 57.0% (95% CI: 43.6, 69.4) of daily e-cigarette vapers, and 8.5% (95% CI: 2.0, 29.3) of daily dual users stayed with their primary tobacco product. There was also some evidence of switching, as 7.5% (95% CI: 3.7, 14.8) of daily cigarette smokers became daily e-cigarette vapers and 2.3% (95% CI: 0.7, 6.8) of daily e-cigarette vapers became daily cigarette smokers. Discussion Although most daily tobacco users were likely to continue using their primary product, some daily users transitioned to daily use of other products - suggesting that policies and public education focused on reducing overall nicotine use are essential for addressing the nicotine epidemic among young people.
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Affiliation(s)
- Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Donna M. Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
| | - John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego Cancer, La Jolla, CA, USA
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
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5
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Westmaas JL, Kates I, Makaroff L, Henson R. Barriers to helping patients quit smoking: Lack of knowledge about cessation methods, E-cigarettes, and why nurse practitioners and physician assistants can help. PUBLIC HEALTH IN PRACTICE 2023; 6:100409. [PMID: 37554288 PMCID: PMC10405087 DOI: 10.1016/j.puhip.2023.100409] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/06/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Health care settings are ideal for addressing patients' smoking and quitting, but barriers may limit providers' assistance with cessation, including lack of knowledge about newer devices being used by some smokers to quit (e.g., e-cigarettes). Cessation practices among nurse practitioners (NPs) and physician assistants (PAs) are also unknown. STUDY DESIGN Cross-sectional. METHODS Participants (N = 459) were 151 oncologists, 150 primary care physicians (PCPs), 98 nurse practitioners (NPs), and 60 physician assistants (PAs) recruited from a national online panel who completed an online survey. RESULTS Four barriers were common across specialties: "patient doesn't want to quit, and it is their decision," "smoking is not reason for patient's visit; must treat the immediate problem first," "patient wants to quit on their own," and "lack of effective methods available." While a majority of oncologists (58%) were aware of free telephone counseling for cessation, only 29% of NPs were aware. Perceived knowledge of e-cigarettes was low. Greater comfort treating patients' smoking predicted greater frequency of engagement in 4 of 5 general cessation practices (βs = 0.15-0.26, all p ≤ .001). NPs and PAs more frequently asked patients about smoking and e-cigarette use compared to oncologists, but oncologists more frequently referred patients to effective quitting resources (e.g., quitlines). CONCLUSIONS NPs and PAs may be uniquely positioned to provide cessation assistance, but providers need more education on currently available, effective cessation methods, and about e-cigarettes. Addressing patient resistance to offers of cessation services and improving clinical workflows to enhance cessation service provision should be investigated in future research.
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Affiliation(s)
- J. Lee Westmaas
- American Cancer Society, 250 Williams St. NW, Atlanta, GA, 30312, USA
| | | | - Laura Makaroff
- American Cancer Society, 250 Williams St. NW, Atlanta, GA, 30312, USA
| | - Rosie Henson
- Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
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Jackson AB, Gibbons FX, Fleischli ME, Haeny AM, Bold KW, Suttiratana SC, Fagan P, Krishnan-Sarin S, Gerrard M. Association of racial discrimination in health care settings and use of electronic cigarettes to quit smoking among Black adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 155:208985. [PMID: 36822270 PMCID: PMC10442461 DOI: 10.1016/j.josat.2023.208985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/28/2022] [Accepted: 02/12/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Black people are disproportionately burdened by tobacco-related diseases and are less successful at cigarette cessation with current treatments. We know little about the effectiveness of e-cigarettes as a smoking cessation method compared to currently approved methods in Black adults who smoke. Many Black adults report experiencing racial discrimination in health care, but if discrimination is related to utilization of smoking cessation aids including e-cigarettes and success with smoking cessation in this population is unclear. Therefore, this exploratory study aimed to understand how negative experiences and racial discrimination in health care influence use of e-cigarettes for cigarette cessation and success with cigarette cessation among Black adults. METHODS The study interviewed 201 Black adults who used cigarettes and tried to quit in their lifetime from the Family and Community Health Study in 2016. The study asked if they had tried and successfully quit cigarettes with e-cigarettes vs. other methods (support groups, medications, nicotine replacement therapies, call-in help lines, cold turkey [quit on their own], counseling) and asked about their negative experiences and racial discrimination in health care. We performed separate logistic regressions that evaluated the association of negative experiences and racial discrimination in health care with 1) use of e-cigarettes for cigarette cessation vs. other quitting methods and 2) success with cigarette cessation using any method among Black adults while controlling for age, sex, socioeconomic status, health insurance status, and age of onset of cigarette use. RESULTS More reported negative experiences and racial discrimination in health care were associated with ever trying to quit with e-cigarettes compared to other methods (OR:1.75, 95 % CI [1.05-2.91]), but negative experiences and racial discrimination in health care were not associated with cigarette quitting success. Interestingly, trying e-cigarettes was associated with being less successful at quitting compared to using other methods to quit smoking (OR: 0.40, 95 % CI [0.20, 0.81]). CONCLUSIONS These results suggest that educating health care professionals that anticipated discrimination in health care settings may be driving Black adults who smoke to engage in non-evidence-based smoking cessation practices, such as e-cigarettes instead of those that are evidence-based, and may be more effective in this population.
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Affiliation(s)
- Asti B Jackson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, United States of America
| | - Mary E Fleischli
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, United States of America
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Krysten W Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Sakinah C Suttiratana
- Department of Chronic Disease Epidemiology, Yale School of Public Health, United States of America
| | - Pebbles Fagan
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, United States of America
| | | | - Meg Gerrard
- Department of Psychological Sciences, University of Connecticut, United States of America
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Vassey J, Hendlin YH, Vora M, Ling P. Influence of Disclosed and Undisclosed Funding Sources in Tobacco Harm Reduction Discourse: A Social Network Analysis. Nicotine Tob Res 2023; 25:1829-1837. [PMID: 36308511 PMCID: PMC10664076 DOI: 10.1093/ntr/ntac250] [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: 03/01/2022] [Revised: 09/06/2022] [Accepted: 10/28/2022] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Tobacco harm reduction (THR) discourse has been divisive for the tobacco control community, partially because it sometimes aligns public health and tobacco industry interests. Industry funding is contentious as it influences study outcomes, and is not always disclosed in scientific publications. This study examines the role of disclosed and undisclosed industry support on THR publications via social network analysis. METHODS We reviewed 826 English-language manuscripts (1992-2016) to determine disclosed and undisclosed industry (pharmaceutical, tobacco, and e-cigarette) and non-industry (including government) support received by 1405 authors. We used social network analysis to identify the most influential authors in THR discourse by assessing the number of their collaborators on publications, the frequency of connecting other authors in the network, and tendency to form groups based on the presence of sponsorship disclosures, sources of funding, and THR stance. RESULTS About 284 (20%) out of 1405 authors were supported by industry. Industry-sponsored authors were more central and influential in the network: with twice as many publications (Median = 4), 1.25 as many collaborators on publications (Median = 5), and higher likelihood of connecting other authors and thus having more influence in the network, compared to non-industry-sponsored authors. E-cigarette industry-sponsored authors had the strongest association with undisclosed industry support. CONCLUSIONS Authors with industry support exerted a stronger influence on the THR scientific discourse than non-industry-supported authors. Journals should continue adhering to strict policies requiring conflicts of interest disclosures. An increase in public health spending on tobacco control research may be necessary to achieve funding parity.
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Affiliation(s)
- Julia Vassey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | | | - Manali Vora
- University of Connecticut, Farmington, CT, USA
| | - Pamela Ling
- University of California, San Francisco, San Francisco, CA, USA
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Fearon IM, Seltzer RGN, Houser TL, Tope A, Cahours X, Verron T, Malt L, Nahde T, O'Connell G, Nides M. Examination of the impact of myblu electronic nicotine delivery system e-liquid nicotine strength on self-reported measures of dependence. Drug Test Anal 2023; 15:1270-1280. [PMID: 35712897 DOI: 10.1002/dta.3335] [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: 04/13/2022] [Revised: 05/31/2022] [Accepted: 06/15/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Greater nicotine delivery is associated with higher nicotine concentrations in electronic nicotine delivery system (ENDS) liquids. However, there is a current debate as to whether this leads to increased dependence and mitigates ENDS public health potential. METHODS Self-reported dependence among users of myblu ENDS containing different nicotine concentrations was examined with data from a multiwave cross-sectional survey of US young adults and adults. Questions examined responses related to dependence measures and participants' most often used myblu ENDS nicotine concentration (low: 0%, 1% and 1.2%; medium: 2%, 2.4% and 2.5%; or high: 3.6% and 4%). RESULTS A global general linear model using nicotine concentration, age and days myblu that was used in the past 30 revealed a significant difference in PROMIS scores among nicotine concentration groups (F = 4.07, p = 0.02). However, pairwise comparisons to examine which specific groups differed significantly from others showed no significant differences. Logistic regression demonstrated that strong past 30-day cravings to use myblu among participants using high or medium nicotine concentrations were not significantly different from those using a low concentration (ORs 0.66 [0.42, 1.03], p = 0.07 and 0.95 [0.49, 1.82], p = 0.98, respectively). Time to daily first use for high or medium nicotine concentration users was not significantly different from those using a low concentration (ORs 0.89 [0.70, 1.14], p = 0.35 and 0.84 [0.57, 1.25], p = 0.40, respectively). CONCLUSIONS Use of myblu ENDS with different nicotine concentrations is not associated with differing levels of dependence. Our findings contradict the notion that high ENDS e-liquid nicotine levels generate increased dependence.
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Affiliation(s)
| | | | - Trisha L Houser
- Houser Clinical Research Writing and Consulting, LLC, Durham, North Carolina, USA
| | | | | | | | | | - Thomas Nahde
- Reemtsma Cigarettenfabriken GmbH, Hamburg, Germany
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9
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Fearon IM, Seltzer RGN, Houser TL, Tope A, Cahours X, Verron T, Malt L, Nahde T, O'Connell G, Nides M. Curiosity and intentions to use myblu e-cigarettes and an examination of the 'gateway' theory: Data from cross-sectional nationally representative surveys. Drug Test Anal 2023; 15:1257-1269. [PMID: 36876729 DOI: 10.1002/dta.3450] [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: 04/13/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 03/07/2023]
Abstract
Encouraging adult smokers who are uninterested or unwilling to quit, and would otherwise continue to smoke, to transition to potentially less harmful nicotine products such as electronic nicotine delivery systems (ENDS) may positively impact population health. However, counterbalancing this benefit is the societal concern that ENDS may be used by never smokers and youth and serve as a 'gateway' into cigarette smoking. Data were analysed from two independent surveys of the prevalence and perceptions of myblu ENDS use in the United States. Total sample size was 22,232 young adults and 23,264 adults. Being curious to use myblu was 1.6-2.0 times more likely in young adult current smokers than young adult never smokers. This likelihood was 2.8 times greater for adult current smokers compared with adult never smokers in the perceptions survey, while in the prevalence survey, there was no difference between adult current and never smokers. Intentions to use myblu were significantly greater in young adult current smokers compared with young adult never smokers in both surveys and in adults in the prevalence survey. In all surveys and age cohorts, 124 of 45,496 participants (0.1% of the total survey population) reported first using myblu prior to smoking cigarettes and went on to become established smokers. Curiosity and intentions to use myblu were generally higher in current smokers compared with never smokers. There was minimal evidence to suggest the existence of a 'gateway' effect to established cigarette smoking among never-smoking myblu users.
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Affiliation(s)
| | | | - Trisha L Houser
- Houser Clinical Research Writing and Consulting, LLC, Durham, North Carolina, USA
| | | | | | | | | | - Thomas Nahde
- Reemtsma Cigarettenfabriken GmbH, Hamburg, Germany
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Vedøy TF, Lund KE. How do Smokers in a Snus-Prevalent Society Consider E-cigarettes, Snus, and Nicotine Replacement Therapy Products as Relevant Replacements for Cigarettes in the Event They Should Stop Smoking? Nicotine Tob Res 2023; 25:1753-1761. [PMID: 37410922 PMCID: PMC10475606 DOI: 10.1093/ntr/ntad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Around 50 percent of the tobacco in Norway is consumed in the form of snus, a smokeless oral tobacco. We examined Norwegian smokers' openness, and thereby the potential reach, to use e-cigarettes, nicotine replacement therapy products (NRT), and snus in the event of quitting smoking, in a society where snus use is common. METHODS Using data from an online survey of 4073 smokers from 2019 to 2021, we calculated predicted probabilities of smokers' being open, undecided, and not open to use e-cigarettes, snus, and NRT in the event they should quit smoking. RESULTS Among daily smokers, the probability of being open to use e-cigarettes in the event of quitting smoking was .32. The corresponding probabilities for using snus and NRT were .22 and .19. Snus was the product with the highest probability of not being open (.60). NRT had the highest probability of being undecided (.39). Among smokers who had never used e-cigarettes or snus, the probabilities of being open were .13 for e-cigarettes, .02 for snus and .11 for NRT. CONCLUSIONS In a snus-friendly norm climate where smokers have traditionally used snus as an alternative to cigarettes, the probability of using e-cigarettes in the event of smoking cessation was higher compared to both snus and NRT. However, among smokers who had never used e-cigarettes or snus, the likelihood of being open to use of NRT was similar to e-cigarettes, and higher than snus, which suggests that NRT may still play a role in smoking cessation. IMPLICATIONS In a snus-prevalent country in the endgame phase of the cigarette epidemic, where robust infrastructure for tobacco control in combination with the availability of snus has reduced smoking to a minimum, the remaining smokers seem to prefer e-cigarettes to snus if they should quit smoking. This indicates that availability of several nicotine alternatives might increase the likelihood of a future product replacement within the small group of remaining smokers.
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Affiliation(s)
- Tord Finne Vedøy
- Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Karl Erik Lund
- Department Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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11
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Chen R, Pierce JP, Leas EC, Benmarhnia T, Strong DR, White MM, Stone M, Trinidad DR, McMenamin SB, Messer K. Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017-2019. Tob Control 2023; 32:e145-e152. [PMID: 35131948 PMCID: PMC10423520 DOI: 10.1136/tobaccocontrol-2021-056901] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess the effectiveness of e-cigarettes in smoking cessation in the USA from 2017 to 2019, given the 2017 increase in high nicotine e-cigarette sales. METHODS In 2017, the PATH Cohort Study included data on 3578 previous year smokers with a recent quit attempt and 1323 recent former smokers. Respondents reported e-cigarettes or other products used to quit cigarettes and many covariates associated with e-cigarette use. Study outcomes were 12+ months of cigarette abstinence and tobacco abstinence in 2019. We report weighted unadjusted estimates and use propensity score matched analyses with 1500 bootstrap samples to estimate adjusted risk differences (aRD). RESULTS In 2017, 12.6% (95% CI 11.3% to 13.9%) of recent quit attempters used e-cigarettes to help with their quit attempt, a decline from previous years. Cigarette abstinence for e-cigarette users (9.9%, 95% CI 6.6% to 13.2%) was lower than for no product use (18.6%, 95% CI 16.0% to 21.2%), and the aRD for e-cigarettes versus pharmaceutical aids was -7.3% (95% CI -14.4 to -0.4) and for e-cigarettes versus any other method was -7.7% (95% CI -12.2 to -3.2). Only 2.2% (95% CI 0.0% to 4.4%) of recent former smokers switched to a high nicotine e-cigarette. Subjects who switched to e-cigarettes appeared to have a higher relapse rate than those who did not switch to e-cigarettes or other tobacco, although the difference was not statistically significant. CONCLUSIONS Sales increases in high nicotine e-cigarettes in 2017 did not translate to more smokers using these e-cigarettes to quit smoking. On average, using e-cigarettes for cessation in 2017 did not improve successful quitting or prevent relapse.
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Affiliation(s)
- Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - John P Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Eric C Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Martha M White
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Matthew Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Dennis R Trinidad
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Sara B McMenamin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
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12
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Kasza KA, Hammond D, Gravely S, O'Connor RJ, Meng G, East K, Borland R, Cummings KM, Fong GT, Hyland A. Associations between nicotine vaping uptake and cigarette smoking cessation vary by smokers' plans to quit: longitudinal findings from the International Tobacco Control Four Country Smoking and Vaping Surveys. Addiction 2023; 118:340-352. [PMID: 36110040 PMCID: PMC9812858 DOI: 10.1111/add.16050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/06/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Most population studies that evaluate the relationship between nicotine vaping and cigarette cessation focus on limited segments of the smoker population. We evaluated vaping uptake and smoking cessation considering differences in smokers' plans to quit. DESIGN Longitudinal International Tobacco Control (ITC) Four Country Smoking and Vaping Surveys were conducted in 2016, 2018 and 2020. SETTING This study was conducted in the United States, Canada, England and Australia. PARTICIPANTS Participants of this study were adult daily cigarette smokers who had not vaped in the past 6 months at baseline and had participated in two or more consecutive waves of the ITC Four Country Smoking and Vaping Surveys (n = 2815). MEASUREMENTS Plans to quit cigarette smoking was assessed at baseline (within 6 months, beyond 6 months, not planning to quit) and at follow-up (within 6 months vs not within 6 months), cigarette smoking cessation was assessed at follow-up (smoking less than monthly [including complete cessation] vs daily/weekly/monthly smoking) and inter-wave vaping uptake was assesed between baseline and follow-up (none, only non-daily vaping and any daily vaping). Generalized estimating equations were used to evaluate whether inter-wave vaping uptake was associated with smoking cessation at follow-up and with planning to quit at follow-up, each stratified by plans to quit smoking at baseline. FINDINGS Overall, 12.7% of smokers quit smoking. Smokers not initially planning to quit within 6 months experienced higher odds of smoking cessation when they took up daily vaping (32.4%) versus no vaping (6.8%; adjusted odds ratio [AOR], 8.58; 95% CI, 5.06-14.54). Among smokers planning to quit, smoking cessation rates were similar between those who did and did not take up daily vaping (25.1% vs 16.8%; AOR, 1.91; 95% CI, 0.91-4.00), although we could not account for potential use of cessation aids. Daily vaping uptake was associated with planning to quit smoking at follow-up among those initially not planning to quit (AOR,6.32; 95% CI, 4.17-9.59). CONCLUSIONS Uptake of nicotine vaping appears to be strongly associated with cigarette smoking cessation among smokers with no initial plans to quit smoking. Excluding smokers not planning to quit from studies on vaping and smoking cessation may underestimate potential benefit of daily vaping for daily smokers.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Katherine East
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Geoffrey T Fong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneuve P, Jemos C, Salè EO, Spina S, Bertolotti R, Busacchio D, Pravettoni G. Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year. Curr Oncol 2022; 29:8579-8590. [PMID: 36421329 PMCID: PMC9717729 DOI: 10.3390/curroncol29110676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/28/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of the present study was to determine whether the use of e-cigarettes to aid in quitting contributed to the increase in the pulmonary health of chronic smokers. The efficacy of e-cigarettes to support a successful smoking cessation attempt was also investigated. A total of 210 smokers (78 women) were enrolled in a screening program for the early detection of lung cancer and distributed in three arms: nicotine e-cigarette plus support, nicotine-free e-cigarette plus support, and support. Results showed that participants in the nicotine e-cigarette arm had a significant and fast decrease in daily cigarettes, but that later they resume smoking more than the other two groups. Conversely, participants in the other two arms showed similar daily consumption at the two evaluation points. Among abstinent participants, only 12.5% reported cough, while 48% of current smokers had pulmonary symptoms. Our study suggests that, in the long run, the use of a nicotine-free liquid may favor reducing smoking and could be considered a good option in a clinical setting.
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Affiliation(s)
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
- Correspondence: ; Tel.: +39-02-9437-2099
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Giulia Veronesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
- Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Costantino Jemos
- Division of Pharmacy, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Stefania Spina
- Division of Thoracic and General Surgery, Humanitas Research Hospital, 20089 Milan, Italy;
| | - Raffaella Bertolotti
- Division of Thoracic Surgery, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Derna Busacchio
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
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Svirsky L, Howard D, Berman ML. E-Cigarettes and the Multiple Responsibilities of the FDA. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:5-14. [PMID: 33871325 DOI: 10.1080/15265161.2021.1907478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This paper considers the responsibilities of the FDA with regard to disseminating information about the benefits and harms of e-cigarettes. Tobacco harm reduction advocates claim that the FDA has been overcautious and has violated ethical obligations by failing to clearly communicate to the public that e-cigarettes are far less harmful than cigarettes. We argue, by contrast, that the FDA's obligations in this arena are more complex than they may appear at first blush. Though the FDA is accountable for informing the public about the health risks and benefits of products it regulates, it also has other roles (and attendant responsibilities) that inform when and how it should disseminate information. In addition to being a knowledge purveyor, it is also a knowledge producer, an advisor to the public, and a practical agent shaping the material conditions in which people make health-related choices. In our view, those other roles call for caution in the way the FDA interprets and communicates the available evidence.
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Affiliation(s)
- Larisa Svirsky
- College of Public Health and Center for Bioethics, The Ohio State University
| | - Dana Howard
- Center for Bioethics, The Ohio State University
| | - Micah L Berman
- College of Public Health and Moritz College of Law, The Ohio State University
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15
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Gravely S, Meng G, Hammond D, Hyland A, Michael Cummings K, Borland R, Kasza KA, Yong HH, Thompson ME, Quah ACK, Ouimet J, Martin N, O'Connor RJ, East KA, McNeill A, Boudreau C, Levy DT, Sweanor DT, Fong GT. Differences in cigarette smoking quit attempts and cessation between adults who did and did not take up nicotine vaping: Findings from the ITC four country smoking and vaping surveys. Addict Behav 2022; 132:107339. [PMID: 35605409 PMCID: PMC9202449 DOI: 10.1016/j.addbeh.2022.107339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/10/2022] [Accepted: 04/17/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION There is mixed evidence as to whether nicotine vaping products (NVPs) can help adults who smoke transition away from cigarettes. This study investigated if self-reported attempts to quit smoking and smoking cessation, over a period of either 18 or 24 months, differed between respondents who initiated nicotine vaping versus those who did not. Outcome comparisons were made between those who: (1) initiated vaping vs. those who did not; (2) initiated daily or non-daily vaping vs. those who did not; and (3) initiated daily or non-daily vaping between surveys and continued to vape at follow-up (daily or non-daily) vs. those who did not initiate vaping. METHODS This cohort study included 3516 respondents from the ITC Four Country Smoking and Vaping Surveys (Australia, Canada, England, United Sates), recruited at Wave 1 (2016) or 2 (2018) and followed up at Wave 2 (18 months) and/or 3 (2020, 24 months). Adults who smoked daily at baseline and did not have a history of regular vaping were included. Initiation of vaping was defined as beginning to vape at least monthly between surveys. Respondents indicated whether they made an attempt to quit smoking between surveys. Smoking cessation was defined as those who self-reported no longer smoking cigarettes at follow-up. RESULTS Relative to those who did not initiate vaping, initiation of any daily vaping between surveys was associated with a greater likelihood of smokers making a cigarette quit attempt (p < 0.001) and quitting smoking (p < 0.001). Among smokers who attempted to quit smoking, initiation of daily vaping was associated with a greater likelihood of being abstinent from smoking at follow-up (p = 0.001). Respondents who initiated vaping between surveys and were vaping daily at follow up were significantly more likely to have attempted to quit smoking (p < 0.001) and to have quit smoking (p < 0.001) than those who did not initiate vaping. Respondents who initiated non-daily vaping did not differ significantly from those who did not initiate vaping on any of the outcome measures. CONCLUSIONS Daily NVP use was associated with increased attempts to quit smoking and abstinence from smoking cigarettes. These findings are consistent with the concept that complete cigarette substitution may be more likely to be achieved when smokers vape nicotine daily.
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Affiliation(s)
| | - Gang Meng
- Department of Psychology, University of Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Canada
| | - Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, USA
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Australia
| | - Karin A Kasza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Australia
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Canada
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Canada
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Katherine A East
- School of Public Health Sciences, University of Waterloo, Canada; Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College London, England; Shaping Public Health Policies to Reduce Inequalities & Harm (SPECTRUM), UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, USA
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Canada; Ontario Institute for Cancer Research, Canada
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Lee PN, Fry JS. Investigating the effect of e-cigarette use on quitting smoking in adults aged 25 years or more using the PATH study. F1000Res 2022; 9:1099. [PMID: 35813077 PMCID: PMC9214270 DOI: 10.12688/f1000research.26167.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The evidence on harms and benefits of e-cigarettes partly concerns whether their use encourages smokers to quit. We addressed this using data from the nationally representative PATH study, with detailed accounting for potential confounding variables. Methods: We considered adults aged 25+. Our original analyses, reported in version 1 of this paper, used data for Waves 1 to 3, separate analyses considering Waves 1 to 2, 2 to 3 and 1 to 3. These related baseline ever e-cigarette use (or e-product use at Wave 2) to quitting at follow-up, adjusting for confounders derived from 55 candidates. Sensitivity analyses omitted ever other product users, linked quitting to current e-cigarette use, and used values of some predictors modified using follow-up data. Additional analyses used data for Waves 1 to 4, separately considering sustained, delayed and temporary quitting during Waves 1 to 3, 2 to 4 and 1 to 4. Sensitivity analyses considered 30-day quitting, restricted attention to smokers attempting to quit, and considered ever smokeless tobacco or snus use. Results: In the original analyses, unadjusted odds ratios (ORs) of quitting smoking for ever e-cigarette use were 1.29 (95% CI 1.01-1.66), 1.52 (1.26-1.83) and 1.47 (1.19-1.82) for the Wave 1 to 2, 2 to 3, and 1 to 3 analyses. These reduced after adjustment, to 1.23 (0.94-1.61), 1.51 (1.24-1.85) and 1.39 (1.11-1.74). Quitting rates remained elevated in users in all sensitivity analyses. The additional analyses found associations of e-cigarette use with sustained, delayed and temporary quitting, associations little affected by considering 30-day quitting, and only slightly reduced restricting attention to quit attempters. Ever use of smokeless tobacco or snus also predicted increased quitting. Conclusions: As does most evidence from clinical trials, other analyses of PATH, and other epidemiological studies, our results suggest using e-cigarettes helps adult smokers to quit.
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Affiliation(s)
- Peter N. Lee
- P.N.Lee Statistics and Computing, Sutton, Surrey, SM2 5DA, UK
| | - John S. Fry
- RoeLee Statistics Ltd, Sutton, Surrey, SM2 5DA, UK
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Lee A, Chang AA, Lyu JC, Ling PM, Hsia SL. Characterizing Participant Perceptions about Smoking-Cessation Pharmacotherapy and E-Cigarettes from Facebook Smoking-Cessation Support Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7314. [PMID: 35742557 PMCID: PMC9224383 DOI: 10.3390/ijerph19127314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/25/2023]
Abstract
The prevalence of smoking among young adults aged 19-28 years old in the United States persists at rates of 14.3%. Young adults underutilize pharmacotherapy for smoking cessation, and the use of e-cigarettes has increased. We analyzed comments from online smoking-cessation support groups to understand young-adult smokers' views of pharmacotherapy and e-cigarettes, to provide a more in-depth insight into the underutilization of pharmacotherapy. A qualitative analysis was performed on comments about pharmacotherapy and e-cigarettes from participants enrolled in online smoking-cessation support groups in 2016-2020. A codebook was developed with a deductive approach to code the comments, followed by thematic analysis. Eighteen themes were identified, with four dominant themes: interest, benefit, knowledge, and flavor. Participants expressed less interest in both nicotine-replacement therapy and e-cigarettes; moreover, they expressed unfamiliarity with and misconceptions about pharmacotherapy, and recognized the enticing flavors of e-cigarettes. Participants often felt e-cigarettes were not useful for smoking cessation, but the flavors of e-cigarettes were appealing for use. Participants had mixed opinions about the use of e-cigarettes for smoking cessation, but predominantly felt e-cigarettes were not useful for smoking cessation. The use of social media may be an effective way to address misconceptions about pharmacotherapy for smoking cessation and increase willingness to accept assistance.
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Affiliation(s)
- Allison Lee
- School of Pharmacy, University of California, San Francisco, CA 94143, USA; (A.L.); (A.A.C.)
| | - Angela A. Chang
- School of Pharmacy, University of California, San Francisco, CA 94143, USA; (A.L.); (A.A.C.)
| | - Joanne Chen Lyu
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143, USA; (J.C.L.); (P.M.L.)
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143, USA; (J.C.L.); (P.M.L.)
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of California, San Francisco, CA 94143, USA
| | - Stephanie L. Hsia
- School of Pharmacy, University of California, San Francisco, CA 94143, USA; (A.L.); (A.A.C.)
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18
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Chun HR, Cheon E, Hwang JE. Systematic review of changed smoking behaviour, smoking cessation and psychological states of smokers according to cigarette type during the COVID-19 pandemic. BMJ Open 2022; 12:e055179. [PMID: 35701057 PMCID: PMC9198387 DOI: 10.1136/bmjopen-2021-055179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions and associated psychological states among smokers are still scarce. This study aimed to systematically review the literature related to this subject. DESIGN A systematic review of published articles on cigarettes and COVID-19-related topics DATA SOURCES: Our search was conducted in January 2021. We used the keywords COVID-19, cigarettes, electronic cigarettes (e-cigarettes) and psychological factors in PubMed and ScienceDirect and found papers published between January and December 2020. DATA SELECTION We included articles in full text, written in English, and that surveyed adults. The topics included smoking behaviour, smoking cessation, psychological state of smokers and COVID-19-related topics. DATA EXTRACTION AND SYNTHESIS Papers of low quality, based on quality assessment, were excluded. Thirteen papers were related to smoking behaviour, nine papers were related to smoking cessation and four papers were related to psychological states of smokers. RESULTS Owing to the COVID-19 lockdown, cigarette users were habituated to purchasing large quantities of cigarettes in advance. Additionally, cigarette-only users increased their attempts and willingness to quit smoking, compared with e-cigarette-only users. CONCLUSIONS Owing to the COVID-19 outbreak, the intention to quit smoking was different among smokers, according to cigarette type (cigarette-only users, e-cigarette-only users and dual users). With the ongoing COVID-19 pandemic, policies and campaigns to increase smoking cessation intentions and attempts to quit smoking among smokers at high risk of COVID-19 should be implemented. Additionally, e-cigarette-only users with poor health-seeking behaviour require interventions to increase the intention to quit smoking.
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Affiliation(s)
- Hae-Ryoung Chun
- Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, Republic of Korea
| | - Eunsil Cheon
- Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, Republic of Korea
| | - Ji-Eun Hwang
- College of health science, Dankook University, Chungnam, Republic of Korea
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19
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Westmaas JL, Masters M, Bandi P, Majmundar A, Asare S, Diver WR. COVID-19 and Tweets About Quitting Cigarette Smoking: Topic Model Analysis of Twitter Posts 2018-2020. JMIR INFODEMIOLOGY 2022; 2:e36215. [PMID: 35611092 PMCID: PMC9118581 DOI: 10.2196/36215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023]
Abstract
Background The risk of infection and severity of illness by SARS-CoV-2 infection is elevated for people who smoke cigarettes and may motivate quitting. Organic public conversations on Twitter about quitting smoking could provide insight into quitting motivations or behaviors associated with the pandemic. Objective This study explored key topics of conversation about quitting cigarette smoking and examined their trajectory during 2018-2020. Methods Topic model analysis with latent Dirichlet allocation (LDA) identified themes in US tweets with the term “quit smoking.” The model was trained on posts from 2018 and was then applied to tweets posted in 2019 and 2020. Analysis of variance and follow-up pairwise tests were used to compare the daily frequency of tweets within and across years by quarter. Results The mean numbers of daily tweets on quitting smoking in 2018, 2019, and 2020 were 133 (SD 36.2), 145 (SD 69.4), and 127 (SD 32.6), respectively. Six topics were extracted: (1) need to quit, (2) personal experiences, (3) electronic cigarettes (e-cigarettes), (4) advice/success, (5) quitting as a component of general health behavior change, and (6) clinics/services. Overall, the pandemic was not associated with changes in posts about quitting; instead, New Year’s resolutions and the 2019 e-cigarette or vaping use–associated lung injury (EVALI) epidemic were more plausible explanations for observed changes within and across years. Fewer second-quarter posts in 2020 for the topic e-cigarettes may reflect lower pandemic-related quitting interest, whereas fourth-quarter increases in 2020 for other topics pointed to a late-year upswing. Conclusions Twitter posts suggest that the pandemic did not generate greater interest in quitting smoking, but possibly a decrease in motivation when the rate of infections was increasing in the second quarter of 2020. Public health authorities may wish to craft messages for specific Twitter audiences (eg, using hashtags) to motivate quitting during pandemics.
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Affiliation(s)
- J Lee Westmaas
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Matthew Masters
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Priti Bandi
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Anuja Majmundar
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Samuel Asare
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - W Ryan Diver
- Population Science Department American Cancer Society Kennesaw, GA United States
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20
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Does Smoking Explain the Association Between Use of E-Cigarettes and Self-Reported Periodontal Disease? J Dent 2022; 122:104164. [DOI: 10.1016/j.jdent.2022.104164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023] Open
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Streck JM, Regan S, Kalkhoran S, Kalagher KM, Bearnot B, Gupta PS, Wakeman S, Rigotti NA. Perceptions of E-cigarettes among adults in treatment for opioid use disorder. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 2:100023. [PMID: 36845890 PMCID: PMC9949332 DOI: 10.1016/j.dadr.2022.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
Background Individuals with opioid use disorder (OUD) have a high prevalence of smoking and limited success quitting smoking with existing tools. There is ongoing debate about whether electronic cigarettes (e-cigarettes) may be a viable harm reduction strategy. We sought to determine the potential acceptability of e-cigarettes for cigarette harm reduction among individuals receiving medication treatment for opioid use disorder (MOUD) with buprenorphine. Among individuals receiving MOUD we investigated health harm perceptions of cigarettes, nicotine e-cigarettes, and nicotine replacement therapy (NRT), and perceptions of the helpfulness of e-cigarettes and NRT for quitting cigarettes. Methods Cross-sectional telephone survey conducted among adults in buprenorphine treatment at five community health centers in the Boston, MA metropolitan area from February to July 2020. Results 93% and 63% of participants rated cigarettes and e-cigarettes, respectively, as very or extremely harmful to health, and 62% rated NRT as not to slightly harmful to health. Over half (58%) rated cigarettes as more harmful than e-cigarettes; 65% and 83% perceived e-cigarettes and NRT, respectively, to be helpful for reducing/quitting cigarette use. In bivariate analyses, nicotine e-cigarette users, compared to nonusers, perceived e-cigarettes to be less harmful to health and more often rated e-cigarettes as helpful for reducing/quitting cigarette use (both p<0.05). Conclusions This study suggests that Massachusetts patients receiving MOUD with buprenorphine have concerns about the health harms of e-cigarettes yet rate them as helpful tools for reducing or quitting cigarette smoking. Future research is needed to test the efficacy of e-cigarettes for cigarette harm reduction.
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Affiliation(s)
- Joanna M. Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan Regan
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kelly M. Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Priya S. Gupta
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Wakeman
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Nancy A. Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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22
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Keijsers M, Vega-Corredor MC, Hoermann S, Tomintz M. Cue Reactivity to Electronic Cigarettes: A Systematic Review. Subst Abuse 2022; 16:11782218221114971. [PMID: 35923180 PMCID: PMC9340385 DOI: 10.1177/11782218221114971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 04/20/2023]
Abstract
Cue reactivity to Electronic Nicotine Delivery Systems (ENDS) has been studied by several researchers, yet the variability in user types (smokers, former smokers, dual users, exclusive ENDS users) and ENDS designs used between the studies may have undermined consistent results. This systematic review aims to give an overview of ENDS cue reactivity and how smoking status and device design may moderate this. A systematic search of Medline, Embase, Web of Science, PubMed and Cochrane was completed. All studies which reported findings on reactivity to ENDS cues in the form of craving or desire for ENDS or cigarettes, attention to cue, delay of gratification or economic decisions were included. Exclusion criteria were non-human subjects, non-adult participants or participants with comorbidities. Literature selection was carried out by 2 independent reviewers. The risk of bias and study quality were assessed using tools developed by Cochrane, BMJ and NHLBI. A total of 711 papers were screened and 22 studies were included in the current review. Study design, research question(s), population of interest, number of participants, dependent variable(s), ENDS generation and nicotine content used and study results were extracted. ENDS cues reliably induced ENDS craving, with no clear moderation by smoking status and no apparent moderation by device generation. In about half of the studies, ENDS cues induced craving for conventional cigarettes. Most studies used a smoker sample, thus limiting the conclusions that can be drawn on the moderation of cue reactivity by smoking status. The quality varied among studies but comparing the findings against the outcomes of only high-quality studies did not yield any different results. The results of this review support the notion of cue reactivity to ENDS, identifies gaps in current research on different user types and implies that ENDS design iterations have little impact on cue reactivity.
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Affiliation(s)
- Merel Keijsers
- Human Interface Technology Laboratory,
University of Canterbury, Christchurch, New Zealand
| | | | - Simon Hoermann
- School of Product Design, University of
Canterbury, Christchurch, New Zealand
- Simon Hoermann, School of Product Design,
University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
| | - Melanie Tomintz
- Geospatial Research Institute,
University of Canterbury, Christchurch, New Zealand
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23
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Kasza KA, Edwards KC, Anesetti-Rothermel A, Creamer MR, Cummings KM, Niaura RS, Sharma A, Pitts SR, Head SK, Everard CD, Hatsukami DK, Hyland A. E-cigarette use and change in plans to quit cigarette smoking among adult smokers in the United States: Longitudinal findings from the PATH Study 2014-2019. Addict Behav 2022; 124:107124. [PMID: 34598012 PMCID: PMC8511329 DOI: 10.1016/j.addbeh.2021.107124] [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] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Much of the population-based e-cigarette use and cigarette cessation literature is restricted to smokers who have expressed intention to quit smoking, though experimental studies suggest e-cigarette use might motivate some smokers to change their quit intentions. We used U.S. nationally representative data to evaluate whether e-cigarette use by smokers initially not planning to ever quit is associated with change in plans to quit. METHODS Longitudinal Population Assessment of Tobacco and Health (PATH) Study data collected between 2014 and 2019 were analyzed. Main analyses were conducted among adult daily cigarette smokers not currently using e-cigarettes with no plans to ever quit smoking (n = 2366 observations from n = 1532 individuals). Generalized estimating equations were used to evaluate the association between change in e-cigarette use and change in plans to quit smoking within the next six months, over three assessment pairs. RESULTS Daily cigarette smokers with no plans to quit had a higher rate of change to plan to quit if at follow-up they used e-cigarettes daily (41.4%, 95% CI: 27.1-57.3%) versus not at all (12.4%, 95% CI: 10.6-14.5%; aOR = 5.7, 95% CI: 2.9-11.2). Rate of change to plan to quit did not statistically differ between those who at follow-up used e-cigarettes some days versus not at all. CONCLUSIONS Among adult daily cigarette smokers initially not planning to ever quit, subsequent daily e-cigarette use is associated with subsequent plans to quit smoking. Population-level research on e-cigarette use that is focused on smokers already motivated to quit may limit a complete evaluation of the smoker population.
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Affiliation(s)
- Karin A Kasza
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States.
| | | | | | - MeLisa R Creamer
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States.
| | | | | | - Akshika Sharma
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States.
| | - Stephanie R Pitts
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States.
| | - Sara K Head
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, United States.
| | - Colm D Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States; Kelly Government Solutions, Rockville, MD, United States.
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States.
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24
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Buettner-Schmidt K, Swanson K, Maack B, Barnacle M, Miller D, Orr M, Gag MH. E-cigarettes for tobacco cessation: Not the solution. Nurse Pract 2021; 46:7-11. [PMID: 34808639 DOI: 10.1097/01.npr.0000798228.69915.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Tam J, Warner KE, Zivin K, Taylor GMJ, Meza R. The Potential Impact of Widespread Cessation Treatment for Smokers With Depression. Am J Prev Med 2021; 61:674-682. [PMID: 34244005 PMCID: PMC8541898 DOI: 10.1016/j.amepre.2021.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/23/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios. METHODS Cessation interventions were simulated for U.S. adult smokers seeing a health professional for depression from 2020 to 2100. Interventions included (1) Any Treatment (behavioral counseling, pharmacological, combination) and (2) Pharmacological Treatment (including counseling), combined with increased mental health service utilization each. These were compared with a maximum potential cessation scenario where all patients with major depression quit smoking. Analyses were conducted in 2016-2020. RESULTS Widespread uptake of Any Treatment among patients with depression would avert 32,000 deaths and result in 138,000 life-years gained by 2100; Any Treatment combined with 100% mental health service utilization would result in 53,000 and 231,000, respectively. Pharmacological Treatment would avert 125,000 deaths, with 540,000 life-years gained. Pharmacological Treatment combined with 100% mental health service utilization would result in 203,000 deaths averted and 887,000 life-years gained. Health gains under best-case treatment scenarios represent modest fractions of those projected under maximum potential cessation scenarios at current mental health service utilization levels (835,000 deaths averted, 3.73 million life-years gained) and at 100% utilization (1.11 million deaths averted, 5.07 million life years gained). CONCLUSIONS Providing smoking-cessation treatment to patients with depression and increasing mental health service utilization would reduce the toll of tobacco on this population. These gains would be considerably larger if cessation treatments were more effective.
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Affiliation(s)
- Jamie Tam
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Kara Zivin
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan; Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Gemma M J Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Cancer Epidemiology and Prevention Program, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
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26
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Struik L, Yang Y. e-Cigarette Cessation: Content Analysis of a Quit Vaping Community on Reddit. J Med Internet Res 2021; 23:e28303. [PMID: 34694229 PMCID: PMC8576600 DOI: 10.2196/28303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background e-Cigarette use, also known as vaping, has increased dramatically over the past few years, especially among younger demographics. However, researchers have found that a large number of e-cigarette users want to quit. Little is known about the unique aspects of vaping cessation, which is critical to informing the development of relevant resources and interventions for e-cigarette users who want to quit. Social media forums such as Reddit provide opportunities to understand the experiences of behavior change such as quitting vaping from the perspective of end users. Objective This study aims to examine a quit vaping subreddit to understand how e-cigarette users are experiencing and approaching vaping cessation. Specifically, we examine methods used to approach quitting, reasons for quitting, and barriers and facilitators to quitting. Methods A total of 1228 posts were collected. The posts were inductively coded to generate categories and subcategories using conventional content analysis. Data were analyzed using the NVivo 12 qualitative data analysis software. Results Most users reported a preference for approaching quitting through gradual reduction, particularly through the use of their own devices by tapering the nicotine content. Their reasons for quitting were primarily related to experiencing negative physical consequences associated with vaping, especially in relation to their lungs (eg, tight chest), and tired of feeling stuck to the vape because of nicotine addiction. Top barriers to quitting were related to withdrawal symptoms and intensity of addiction. The top facilitators to quitting were related to using distraction techniques (eg, hobby, gaming, and mindfulness exercises), as well as having a positive mindset. Conclusions The findings of this study reveal unique aspects that encompass the process of quitting vaping. These findings have significant implications for both policy and intervention development.
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Affiliation(s)
- Laura Struik
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Youjin Yang
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
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27
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Chaffee BW, Couch ET, Vora MV, Holliday RS. Oral and periodontal implications of tobacco and nicotine products. Periodontol 2000 2021; 87:241-253. [PMID: 34463989 PMCID: PMC8444622 DOI: 10.1111/prd.12395] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tobacco use contributes to more mortality and morbidity globally than any other behavioral risk factor. Adverse effects do not spare the oral cavity, with many oral diseases more common, and treatments less successful, in the tobacco-using patient. Many of the oral health effects of cigarette smoking are well established, but other forms of tobacco, including cigars and smokeless tobacco, merit dental professionals' attention. Recently, an expanding variety of new or emerging tobacco and/or nicotine products has been brought to market, most prominently electronic cigarettes, but also including heated tobacco and other noncombustible nicotine products. The use of cannabis (marijuana) is increasing and also has risks for oral health and dental treatment. For the practicing periodontist, and all dental professionals, providing sound patient recommendations requires knowledge of the general and oral health implications associated with this wide range of tobacco and nicotine products and cannabis. This review provides an overview of selected tobacco and nicotine products with an emphasis on their implications for periodontal disease risk and clinical management. Also presented are strategies for tobacco use counselling and cessation support that dental professionals can implement in practice.
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Affiliation(s)
- Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Manali V. Vora
- Division of Periodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Richard S. Holliday
- NIHR Clinical Lecturer in Restorative Dentistry, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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28
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Pierce JP, Chen R, Kealey S, Leas EC, White MM, Stone MD, McMenamin SB, Trinidad DR, Strong DR, Benmarhnia T, Messer K. Incidence of Cigarette Smoking Relapse Among Individuals Who Switched to e-Cigarettes or Other Tobacco Products. JAMA Netw Open 2021; 4:e2128810. [PMID: 34665239 PMCID: PMC8527352 DOI: 10.1001/jamanetworkopen.2021.28810] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Although e-cigarettes are not approved as a cessation device, many who smoke believe that e-cigarettes will help them quit cigarette smoking successfully. OBJECTIVE To assess whether people who recently quit smoking and who had switched to e-cigarettes or another tobacco product were less likely to relapse to cigarette smoking compared with those who remained tobacco free. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed a nationally representative sample of US households that participated in 4 waves of the Population Assessment of Tobacco and Health Study (conducted 2013 through 2017), combining 2 independent cohorts each with 3 annual surveys. Eligible participants were individuals who smoked at baseline, had recently quit at the first follow-up, and completed the second follow-up survey. EXPOSURES Use of e-cigarettes or alternate tobacco products at follow-up 1 after recently quitting smoking. MAIN OUTCOMES AND MEASURES Weighted percentage of participants with over 12 months abstinence by follow-up 2. RESULTS Of a total of 13 604 participants who smoked cigarettes at baseline, 9.4% (95% CI, 8.7%-10.0%) recently had quit smoking (mean age, 41.9; 95% CI, 39.7-46.6 years; 641 [43.2%] women) Of these, 22.8% (95% CI, 19.7%-26.0%) had switched to e-cigarettes, with 17.6% (95% CI, 14.8%-20.5%) using them daily. A total of 37.1% (95% CI, 33.7%-40.4%) used a noncigarette tobacco product and 62.9% (95% CI, 59.6%-66.3%) were tobacco free. Rates of switching to e-cigarettes were highest for those who were in the top tertile of tobacco dependence (31.3%; 95% CI, 25.0%-37.7%), were non-Hispanic White (26.4%; 95% CI, 22.3%-30.4%), and had higher incomes (annual income ≥$35 000, 27.5%; 95% CI, 22.5%-32.4% vs <$35 000, 19.3%; 95% CI, 16.3%-22.3%). At follow-up 2, unadjusted relapse rates were similar among those who switched to different tobacco products (for any tobacco product: successfully quit, 41.5%; 95% CI, 36.2%-46.9%; relapsed with significant requit, 17.0%; 95% CI, 12.4%-21.6%; currently smoking, 36.2%; 95% CI, 30.9%-41.4%). Controlled for potential confounders, switching to any tobacco product was associated with higher relapse rate than being tobacco free (adjusted risk difference, 8.5%; 95% CI, 0.3%-16.6%). Estimates for those who switched to e-cigarettes, whether daily or not, were not significant. While individuals who switched from cigarettes to e-cigarettes were more likely to relapse, they appeared more likely to requit and be abstinent for 3 months at follow-up 2 (17.0%; 95% CI, 12.4%-21.6% vs 10.4%; 95% CI, 8.0%-12.9%). CONCLUSIONS AND RELEVANCE This large US nationally representative study does not support the hypothesis that switching to e-cigarettes will prevent relapse to cigarette smoking.
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Affiliation(s)
- John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Sheila Kealey
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - Eric C. Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - Martha M. White
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - Matthew D. Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Sara B. McMenamin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Dennis R. Trinidad
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - David R. Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Moores Cancer Center, University of California, San Diego, La Jolla
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29
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Kaplan B, Galiatsatos P, Breland A, Eissenberg T, Cohen JE. Effectiveness of ENDS, NRT and medication for smoking cessation among cigarette-only users: a longitudinal analysis of PATH Study wave 3 (2015-2016) and 4 (2016-2017), adult data. Tob Control 2021; 32:302-307. [PMID: 34526410 PMCID: PMC10176346 DOI: 10.1136/tobaccocontrol-2020-056448] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 08/20/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Research is inconclusive on the effectiveness of electronic nicotine delivery systems (ENDS) as cigarette cessation aids compared with nicotine replacement therapy (NRT) or non-NRT medication. This study compared the cigarette cessation rates for ENDS, NRT and non-NRT medication. METHOD Population Assessment of Tobacco and Health Study wave 3 cigarette-only users who used ENDS, NRT or non-NRT medication (varenicline and bupropion) to quit smoking between wave 3 and 4 were included. 'Cessation' was defined as being a former cigarette smoker in wave 4. χ2, logistic regression, and a sensitivity analysis with Bayes factor assessed the association between quitting smoking and method used. RESULTS Among 6794 cigarette-only users, 532 used ENDS (n=75), NRT (n=289), non-NRT medication (n=68), or a combination of NRT and non-NRT medication (n=100) to quit smoking between wave 3 and 4. The percentages of quitting smoking among those who used ENDS, NRT, non-NRT medication, and a combination of NRT and non-NRT medication were 16.2% (n=14), 16.1% (n=47), 17.7% (n=13), and 14.8% (n=12), respectively (p=0.97). None of the cigarette-only users who used ENDS to quit smoking became ENDS-only users in wave 4; 37.6% became dual users of ENDS and cigarettes. CONCLUSION No differences were found when cessation rates of ENDS, NRT or non-NRT medication were compared. Given uncertainty about the long-term health effect of ENDS and the likelihood of becoming dual users, people who smoke and need assistance quitting should be encouraged to use current Food and Drug Administration-approved cessation methods until more effective methods are developed.
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Affiliation(s)
- Bekir Kaplan
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Panagis Galiatsatos
- Division of Pulmonary & Critical Care Medicine, Tobacco Treatment Clinic, Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA
| | - Alison Breland
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Alshanberi AM, Baljoon T, Bokhari A, Alarif S, Madani A, Hafiz H, Altayyar A, Abo-Ali EA. The prevalence of E-cigarette uses among medical students at Umm Al-Qura University; a cross-sectional study 2020. J Family Med Prim Care 2021; 10:3429-3435. [PMID: 34760769 PMCID: PMC8565129 DOI: 10.4103/jfmpc.jfmpc_1496_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/26/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Electronic cigarette (e-cigarette) is becoming increasingly popular worldwide, and commercially a commonplace in the media. Health concerns and the avoidance of smoking are the most frequently reported factors for conventional smokers to turn to e-cigarettes. However, there is insufficient information about the use of e-cigarettes in Makkah city; therefore, this study aims to determine the prevalence of electronic cigarette uses among medical students at Umm al-Qura University (UQU). METHODS A cross-sectional study was conducted in February 2020 among medical students at UQU, Makkah, Saudi Arabia. Data were collected using a prevalidated printed version of a self-questionnaire to determine the prevalence and the main factors that influence medical students to smoke e-cigarettes and to evaluate their awareness, knowledge, and attitude. RESULTS Out of 1249medical students, 910 participated in the survey, about 31.8 % of them confirmed using e-cigarette regularly. 14.7% think e-cigarettes are medically approved method for smoking cessation, while 59.5% believe it can cause addiction similar to tobacco cigarettes. Among the regular users, 24.3% used it to quit tobacco smoking, 18.9% think it is less harmful, 20.3 % use it because it is less costly, and 18.9% because of stress. Also, 28.4% found it tasty. 30.8% believed that it is less harmful, about 74% stated that they received information about e-cigarettes and only 16% of them received it from medical school. CONCLUSION The prevalence of e-cigarette uses among medical student in UQU found to be relatively high, and their overall knowledge is insufficient, which conflict our hypothesis.
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Affiliation(s)
| | - Tebra Baljoon
- Umm AL-Qura University, Mecca, Kingdom of Saudi Arabia
| | - Aziza Bokhari
- Umm AL-Qura University, Mecca, Kingdom of Saudi Arabia
| | - Sara Alarif
- Umm AL-Qura University, Mecca, Kingdom of Saudi Arabia
| | - Abrar Madani
- Umm AL-Qura University, Mecca, Kingdom of Saudi Arabia
| | - Haneen Hafiz
- Umm AL-Qura University, Mecca, Kingdom of Saudi Arabia
| | | | - Ehab A. Abo-Ali
- Community Medicine Department, Faculty of Medicine, Tanta University, Egypt
- Batterjee Medical College, Jeddah, Saudi Arabia
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31
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Gravely S, Cummings KM, Hammond D, Borland R, McNeill A, East KA, Loewen R, Martin N, Yong HH, Li L, Liber A, Levy DT, Quah ACK, Ouimet J, Hitchman SC, Thompson ME, Boudreau C, Fong GT. Self-Reported Quit Aids and Assistance Used By Smokers At Their Most Recent Quit Attempt: Findings from the 2020 International Tobacco Control Four Country Smoking and Vaping Survey. Nicotine Tob Res 2021; 23:1699-1707. [PMID: 33837435 PMCID: PMC8403237 DOI: 10.1093/ntr/ntab068] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/06/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION This study retrospectively describes smoking cessation aids, cessation services, and other types of assistance used by current and ex-smokers at their last quit attempt in four high-income countries. AIMS AND METHODS Data are from the Wave 3 (2020) International Tobacco Control Four Country Smoking and Vaping Survey in Australia, Canada, England, and the United States (US). Eligible respondents were daily smokers or past-daily recent ex-smokers who made a quit attempt/quit smoking in the last 24-months, resulting in 3614 respondents. Self-reported quit aids/assistance included: nicotine vaping products (NVPs), nicotine replacement therapy (NRT), other pharmacological therapies (OPT: varenicline/bupropion/cytisine), tobacco (noncombustible: heated tobacco product/smokeless tobacco), cessation services (quitline/counseling/doctor), other cessation support (e.g., mobile apps/website/pamphlets, etc.), or no aid. RESULTS Among all respondents, at last quit attempt, 28.8% used NRT, 28.0% used an NVP, 12.0% used OPT, 7.8% used a cessation service, 1.7% used a tobacco product, 16.5% other cessation support, and 38.6% used no aid/assistance. Slightly more than half of all smokers and ex-smokers (57.2%) reported using any type of pharmacotherapy (NRT or OPT) and/or an NVP, half-used NRT and/or an NVP (49.9%), and 38.4% used any type of pharmacotherapy (NRT and/or OPT). A quarter of smokers/ex-smokers used a combination of aids. NVPs and NRT were the most prevalent types of cessation aids used in all four countries; however, NRT was more commonly used in Australia relative to NVPs, and in England, NVPs were more commonly used than NRT. The use of NVPs or NRT was more evenly distributed in Canada and the US. CONCLUSIONS It appears that many smokers are still trying to quit unassisted, rather than utilizing cessation aids or other forms of assistance. Of those who did use assistance, NRT and NVPs were the most common method, which appears to suggest that nicotine substitution is important for smokers when trying to quit smoking. IMPLICATIONS Clinical practice guidelines in a number of countries state that the most effective smoking cessation method is a combination of pharmacotherapy and face-to-face behavioral support by a health professional. Most quit attempts however are made unassisted, particularly without the use of government-approved cessation medications. This study found that about two in five daily smokers used approved cessation medications (nicotine replacement therapy (NRT) or other approved pharmacotherapies, such as varenicline). Notably, nicotine substitution in the form of either NRT and nicotine vaping products (NVPs) were the most common method of cessation assistance (used by one in two respondents), but the proportion using NRT and/or NVPs varied by country. Few smokers who attempted to quit utilized cessation services such as stop-smoking programs/counseling or quitlines, despite that these types of support are effective in helping smokers manage withdrawals and cravings. Primary healthcare professionals should ask their patients about smoking and offer them evidence-based treatment, as well as be prepared to provide smokers with a referral to trained cessation counselors, particularly when it comes to tailoring intensive treatment programs for regular daily smokers. Additionally, healthcare providers should be prepared to discuss the use of NVPs, particularly if smokers are seeking advice about NVPs, wanting to try/or already using an NVP to quit smoking, have failed repeatedly to quit with other cessation methods, and/or if they do not want to give up tobacco/nicotine use completely.
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Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne VIC, Australia
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Shaping Public Health Policies to Reduce Inequalities & Harm (SPECTRUM), UK
| | - Katherine A East
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Ruth Loewen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, 3220, Australia
| | - Lin Li
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne VIC, Australia
| | - Alex Liber
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, NW, Washington, DC, USA
| | - David T Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, NW, Washington, DC, USA
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Sara C Hitchman
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
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Andreas S, Pankow W. [Smoking cessation - achievable and effective]. Dtsch Med Wochenschr 2021; 146:748-751. [PMID: 34062591 DOI: 10.1055/a-1259-8353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In hospital, effective smoking cessation can be organized through counselling, pharmacological aids and, above all, continuous care in outpatient structures following discharge. Pharmacological treatment has proven to be effective and safe with nicotine replacement therapy as well as varenicline. Counselling plus pharmacotherapy is more effective in combination than either therapy is on its own. To better implement structures medical societies in Germany are seeking adequate funding e. g. in the DRG system for hospitalised patients.There are obvious and relevant benefits in smoking cessation. Not only for the main tobacco-related diseases such as coronary heart disease or chronic obstructive pulmonary disease (COPD), positive effects of quitting on morbidity and mortality have been confirmed by high-quality meta-analyses. Furthermore, quality of life is increasing following cessation. Presently, smoking is found to be a significant risk factor for severe disease and mortality following coronavirus infection.Do e-cigarettes offer an alternative in smoking cessation? No. Animal and human data are suggesting toxic effects especially following longer use. The long-term effectiveness of e-cigarettes in tobacco cessation is still uncertain and epidemiologic data clearly point toward ineffectiveness. Furthermore, dual use with potentiation of the toxic effects is common. Therefore, e-cigarettes cannot be recommended for tobacco cessation.
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Affiliation(s)
- Stefan Andreas
- Lungenfachklinik Immenhausen.,Abteilung Kardiologie und Pneumologie, Universitätsmedizin Göttingen
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Al-Hamdani M, Manly E. Smoking cessation or initiation: The paradox of vaping. Prev Med Rep 2021; 22:101363. [PMID: 33868902 PMCID: PMC8044675 DOI: 10.1016/j.pmedr.2021.101363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 10/28/2022] Open
Abstract
In recent years, there has been a rapid expansion of the vaping market which has led many to question whether vaping can assist people in smoking cessation, or if it in fact paves the way for new smokers. While there has not been conclusive evidence regarding vaping as a smoking cessation tool, there is striking evidence that vaping is linked to new smoking addictions, especially in teenagers and young adults. Despite the prevalent belief that tobacco is more harmful to the body, early research on vaping has already shown very detrimental effects, and the comprehensive effects may become much clearer in the years to come. To curtail the rapidly increasing number of teenagers and young adults vaping, strict action must be taken. Legalization with tight control of vaping products would focus the efforts on those attempting to quit, while helping to prevent acquisition by teenagers and young adults that are not of legal age. In the years to come, vaping controls should be carefully considered to ensure that the purported benefits of helping those overcome a smoking addiction are not outweighed by the unintended consequences of creating a teenage demographic addicted to vaping.
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Affiliation(s)
- Mohammed Al-Hamdani
- Saint Mary’s University, Halifax, Nova Scotia, Canada
- The Lung Association of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Eden Manly
- Dalhousie University, Halifax, Nova Scotia, Canada
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Bjurlin MA, Kamecki H, Gordon T, Krajewski W, Matulewicz RS, Małkiewicz B, Demkow T, Sosnowski R. Alternative tobacco products use and its impact on urologic health - will the lesser evil still be evil? A commentary and review of literature. Cent European J Urol 2021; 74:152-160. [PMID: 34336232 PMCID: PMC8318020 DOI: 10.5173/ceju.2021.0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Alternative tobacco products, including electronic cigarettes (e-cigarettes) and non-combustible tobacco products or heat-not-burn (HNB) products, are substitutes to conventional combustible cigarettes with the potential to impact urologic health, similar to traditional smoking. Most urologists, however, have limited knowledge of these products and are unfamiliar with their potential health implications. We conducted a review to assess the impact of e-cigarettes and HNB products on urologic health. MATERIAL AND METHODS A bibliographic search covering the period up to April, 2021 was conducted using MEDLINE®/PubMed® and Google Scholar. Articles were reviewed and categorized based on the potential impact on erectile dysfunction, semen quality, lower urinary tract symptoms, genitourinary malignancies, and smoking cessation. Data were extracted, analyzed and summarized. RESULTS Mature data on the long-term impact of e-cigarette and HNB product use on urologic health are lacking. E-cigarette and HNB vapors appear to contain decreased concentrations of chemicals responsible for erectile dysfunction compared to tobacco smoke but may play a role through endothelial damage. Use of e-cigarettes is associated with lower sperm counts. No definitive data has shown a link between e-cigarette or HNB product use and lower urinary tract symptoms. Multiple carcinogens including those specifically linked to bladder cancer have been identified in the urine of e-cigarette and HNB product users. Limited data suggest e-cigarettes may aid in smoking cessation. CONCLUSIONS Urologists may benefit from understanding the urologic health concerns surrounding e-cigarettes and HNB product use and patients may benefit from being properly educated.
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Affiliation(s)
- Marc A. Bjurlin
- Department of Urology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hubert Kamecki
- Department of Urooncology, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, Poland
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Wojciech Krajewski
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Richard S. Matulewicz
- Department of Urology and Department of Population Health, New York University, New York, USA
| | - Bartosz Małkiewicz
- Department of Urology and Oncologic Urology, Wrocław Medical University, Wrocław, Poland
| | - Tomasz Demkow
- Department of Urooncology, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, Poland
| | - Roman Sosnowski
- Department of Urooncology, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, Poland
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Teriba A, Mbama U, Sharma S, Abraham A, Ndefo UA. Evidence against e-cigarettes for smoking cessation. J Am Pharm Assoc (2003) 2021; 61:e55-e58. [PMID: 34034964 DOI: 10.1016/j.japh.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 11/17/2022]
Abstract
Electronic cigarettes (e-cigarettes) have been touted as a safer alternative to cigarettes and even as a smoking cessation aid. The health risks associated with smoking are well known, and smoking cessation has been studied extensively with options including behavioral therapy and pharmacotherapy (nicotine replacement therapy [NRT], varenicline, and bupropion). Several studies analyzed the effects of e-cigarettes as a smoking cessation aid. When used for smoking cessation, those who successfully abstain from cigarette smoking have a higher rate of continuation on e-cigarettes than NRT or pharmacotherapy. Other risks of e-cigarettes are highlighted including e-cigarette or vaping product use-associated lung injury. There is no approved pharmacotherapy for e-cigarette cessation. Two of the analyzed studies demonstrated the use of varenicline as a potential pharmacotherapy for e-cigarette cessation. The proposed benefits of e-cigarettes as a smoking cessation aid should be weighed against their probable detrimental effects. E-cigarette use should be discouraged as a whole and notably, as a smoking cessation aid.
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Pierce JP, Leas EC, Benmarhnia T, McMenamin SB, Strong DR, Chen R, Messer K. E-cigarettes and Cessation: The Introduction of Substantial Bias in Analyses of PATH Study. Nicotine Tob Res 2021; 23:876-877. [PMID: 33188408 PMCID: PMC8522440 DOI: 10.1093/ntr/ntaa234] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/11/2020] [Indexed: 08/13/2023]
Affiliation(s)
- John P Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
- Moores Cancer Center, University of California San Diego,
La Jolla, CA
| | - Eric C Leas
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
- Moores Cancer Center, University of California San Diego,
La Jolla, CA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
- Moores Cancer Center, University of California San Diego,
La Jolla, CA
- Scripps Institution of Oceanography, University of California San
Diego, La Jolla, CA
| | - Sara B McMenamin
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
- Moores Cancer Center, University of California San Diego,
La Jolla, CA
| | - Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science,
University of California San Diego, La Jolla, CA
- Moores Cancer Center, University of California San Diego,
La Jolla, CA
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37
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Glasser A, Giovenco DP, Levy DT, Vojjala M, Cantrell J, Abrams D, Niaura R. E-cigarettes and Cessation: Asking Different Questions Requires Different Methods. Nicotine Tob Res 2021; 23:878-879. [PMID: 33244606 DOI: 10.1093/ntr/ntaa249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Allison Glasser
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY.,College of Public Health, Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, OH
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY
| | - David T Levy
- Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Mahathi Vojjala
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
| | - Jennifer Cantrell
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
| | - David Abrams
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
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Abstract
Novel nicotine products, particularly electronic cigarettes (e-cigarettes), have become increasingly popular over the past decade. E-cigarettes are sometimes regarded as a less harmful alternative to tobacco smoking, and there is some evidence of their potential role as a smoking cessation aid. However, there are concerns about their health consequences, particularly in users who are not tobacco smokers, and also when used long term. Given the mode of delivery of these products, there is potential for oral health consequences. Over the past few years, there have been an increasing number of studies conducted to explore their oral health effects. In vitro studies have reported a range of cellular effects, but these are much less pronounced than those resulting from exposure to tobacco smoke. Microbiological studies have indicated that e-cigarette users have a distinct microbiome, and there is some indication this may be more pathogenic compared to nonusers. Evidence of oral health effects from clinical trials is still limited, and most studies to date have been small in scale and usually cross-sectional in design. Epidemiological studies highlight concerns over oral dryness, irritation, and gingival diseases. Interpreting data from e-cigarette studies is challenging, given the different populations that have been investigated and the continual emergence of new products. Overall, studies reveal potential oral health harms, underscoring the importance of efforts to reduce use in nonsmokers. However, in smokers who are using e-cigarettes as an aid to help them quit, the benefits of quitting tobacco smoking may outweigh any negative oral health impacts of e-cigarette use, particularly in the short term. Future research is needed to understand the clinical significance of some of the biological changes observed by following different cohorts of users longitudinally in carefully designed clinical studies and pragmatic trials supported by high-quality in vitro studies.
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Affiliation(s)
- R. Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- R. Holliday, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE1 7RU, UK.
| | - B.W. Chaffee
- School of Dentistry, University of California, San Francisco, CA, USA
| | - N.S. Jakubovics
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - R. Kist
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P.M. Preshaw
- School of Dentistry, University of Dundee, Dundee, UK
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Eisenberg MJ, Hébert-Losier A, Filion KB. Use of e-Cigarettes for Smoking Cessation-Reply. JAMA 2021; 325:1006-1007. [PMID: 33687460 DOI: 10.1001/jama.2020.27210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Mark J Eisenberg
- Jewish General Hospital, McGill University, Montréal, Québec, Canada
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Yingst JM, Bordner CR, Hobkirk AL, Hoglen B, Allen SI, Krebs NM, Houser KR, Livelsberger C, Foulds J. Response to Flavored Cartridge/Pod-Based Product Ban among Adult JUUL Users: "You Get Nicotine However You Can Get It". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010207. [PMID: 33396598 PMCID: PMC7795757 DOI: 10.3390/ijerph18010207] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022]
Abstract
In order to curb increasing youth electronic cigarette (e-cig) use, the United States Food and Drug Administration (FDA) banned the sale of flavored cartridge/pod-based products in February 2020. This mixed-methods study aimed to evaluate the impact of the FDA ban on adult JUUL users. The samples of current adult JUUL users were surveyed via Amazon Mechanical Turk at three time-points n = 76 (Sample 1); n = 128 (Sample 2); n = 86 (Sample 3) before and after the FDA flavored/pod ban. The participants were asked to report the JUUL flavored pod used most often and answer questions on purchasing generic pods or refilling (Quantitative). JUUL users were then interviewed in order to explore their perceptions and behaviors related to the FDA ban of flavored cartridge/pod-based products (Qualitative; n = 16). Quantitative data analysis evaluated the differences in variables by time-point. Qualitative data were coded into themes while using the constant comparative method. We found a significant decrease in the use of mint pods (43.4%, 22.7%, 16.3%) (p < 0.01), while there was a significant increase in the use of menthol pods (6.6%, 26.6%, 37.2%) (p < 0.01). Themes that emerged from the qualitative data included switching from mint to menthol pods, refilling pods, and switching to other products that are available in the desired flavors, such as generic pods or disposable e-cigs. Future research is needed in order to evaluate the impact of these behaviors on public health.
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Affiliation(s)
- Jessica M. Yingst
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
| | - Candace R. Bordner
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
- Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, Hershey, PA 17033, USA; (A.L.H.); (B.H.); (K.R.H.)
- Correspondence:
| | - Andréa L. Hobkirk
- Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, Hershey, PA 17033, USA; (A.L.H.); (B.H.); (K.R.H.)
| | - Brianna Hoglen
- Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, Hershey, PA 17033, USA; (A.L.H.); (B.H.); (K.R.H.)
| | - Sophia I. Allen
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
| | - Nicolle M. Krebs
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
| | - Kenneth R. Houser
- Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, Hershey, PA 17033, USA; (A.L.H.); (B.H.); (K.R.H.)
| | - Craig Livelsberger
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA; (J.M.Y.); (S.I.A.); (N.M.K.); (C.L.); (J.F.)
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Patterson JG, LaPolt DT, Miranda AR, Zettler PJ, Berman M, Roberts ME, Keller-Hamilton B, Ferketich AK. Switching stories: user testimonials on juul.com continue to contradict JUUL's switch ≠ cessation narrative. Tob Control 2020; 30:e37-e40. [PMID: 33154067 DOI: 10.1136/tobaccocontrol-2020-055816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND In January 2019, electronic nicotine delivery systems (ENDS) market leader Juul Labs (JUUL) launched an advertising campaign encouraging adult smokers to 'make the switch' from combustible cigarettes to JUUL. Our primary aim was to describe consumer perceptions of JUUL as communicated by members of JUUL's online social community via testimonials promoted on JUUL's website. METHODS User testimonials that were displayed on the JUUL website in December 2019 and January 2020 were collected and coded by three reviewers. A total of 220 testimonials were coded for primary and secondary themes (eight codes within four broader themes). RESULTS Testimonial writers were, on average, 43.0 years old (range 28 to 74) and reported using JUUL for an average of 21.8 months (range 9 to 59 months). The most prominent theme, present in nearly half of the testimonials, was a description of how to use JUUL, with a mention of JUUL's benefits and tips on how to use the product. Nearly four in 10 statements encouraged smokers to give JUUL a try or noted that JUUL is a better product compared with cigarettes. About one in 10 statements focused on switching from smoking cigarettes to using JUUL. CONCLUSION This study presents a foundation for understanding how adult users describe JUUL, including their experiences using JUUL to 'switch' or stop smoking. Currently, the effectiveness of ENDS for smoking cessation is not supported by substantial evidence; however, if cessation is defined as 'quitting combustible tobacco products', then regulators should be aware that switch and cessation messages may not be distinct.
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Affiliation(s)
- Joanne G Patterson
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Devin T LaPolt
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Alexis R Miranda
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Patricia J Zettler
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA.,Moritz College of Law, The Ohio State University, Columbus, Ohio, USA.,The Ohio State University Drug Enforcement and Policy Center, Columbus, OH, United States
| | - Micah Berman
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA.,Moritz College of Law, The Ohio State University, Columbus, Ohio, USA.,College of Public Health, Division of Health Services Management and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Megan E Roberts
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA.,College of Public Health, Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, Ohio, USA
| | - Brittney Keller-Hamilton
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA
| | - Amy K Ferketich
- The Ohio State University Comprehensive Cancer Center Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA.,College of Public Health, Division of Epidemiology, The Ohio State University, Columbus, Ohio, USA
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