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Masud N, Hamilton W, Tarasenko Y. Prevalence of Cigarette Smoking, E-cigarette Use, and Dual Use Among Urban and Rural Women During the Peripartum Period, PRAMS 2015-2020. Public Health Rep 2024; 139:708-716. [PMID: 38780023 DOI: 10.1177/00333549241251982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES Evidence has emerged on the health dangers of electronic cigarette (e-cigarette) use among pregnant women and neonates. We examined whether rural residence is a risk factor for smoking and e-cigarette use among women during the peripartum period in the United States. METHODS This study was based on pooled cross-sectional 2015-2020 data from the Pregnancy Risk Assessment Monitoring System. The outcome was exclusive smoking, exclusive e-cigarette use, and use of both products (ie, dual use) versus use of neither tobacco product by women with live infants aged 2 to 6 months. We examined rural-urban differences in outcome by using univariate and multivariable multinomial logistic regressions with post hoc contrasts and marginal analyses, adjusting for complex survey design and nonresponse. RESULTS During the peripartum period, 5.0% of women were smoking combustible cigarettes, 5.0% were using e-cigarettes, and 1.9% were using both tobacco products. The crude prevalence of e-cigarette use was 1.1 percentage point higher, and the adjusted prevalence was 0.8 percentage points lower for rural versus urban women (P < .001 for both). Among rural women, 6.7% (95% CI, 6.3%-7.1%) smoked combustible cigarettes exclusively and 2.6% (95% CI, 2.3%-2.8%) used both products, as compared with 4.5% (95% CI, 4.4%-4.8%) and 1.7% (95% CI, 1.6%-1.8%) of urban women, respectively, adjusting for sociodemographic and health-related characteristics. CONCLUSIONS Maternal sociodemographic and health-related characteristics differed by combustible smoking versus e-cigarette use during the peripartum period. The effect of residence on e-cigarette use was significantly confounded by sociodemographic and health-related characteristics, resulting in clinically comparable prevalence of e-cigarette use in rural and urban mothers with live infants aged 2 to 6 months.
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Affiliation(s)
- Nazish Masud
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Whitney Hamilton
- Health Services Administration, Middle Georgia State University, Macon, GA, USA
| | - Yelena Tarasenko
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Gallegos Carrillo K, Vidaña-Pérez D, Barrientos-Gutierrez I, Arillo-Santillán E, Cruz-Jiménez L, Rodríguez-Bolaños R, Thrasher JF. To use or not to use electronic cigarettes? Reasons for use, stopping use and their behavioural sequelae among Mexicans who smoke. Tob Control 2024:tc-2024-058596. [PMID: 39038950 DOI: 10.1136/tc-2024-058596] [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: 01/09/2024] [Accepted: 05/27/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Reasons for using and stopping the use of e-cigarettes and their associations with transitions in nicotine product use are relatively unknown in countries with e-cigarette bans, such as Mexico. METHODS Data comes from an open cohort of people who smoke in Mexico, surveyed every 4 months from November 2018 to November 2021. Those who smoked and used e-cigarettes at time t (n=904 individuals, 1653 observations) were categorised at 4-month follow-up (t+1): (1) continued 'dual use', (2) exclusive smoking, (3) exclusive use of e-cigarettes or neither product. For people who formerly used e-cigarettes at time t (n=332 individuals, 372 observations), follow-up categories were: (1) continued exclusive smoking; (2) re-initiated e-cigarette use. Multinomial and logistic models regressed follow-up status (ref=status at time t) on reasons for using or stopping e-cigarette use, respectively, at time t, adjusting for covariates. RESULTS The most prevalent reasons for current e-cigarette use were 'they were less harmful to others' (40.5%) and 'enjoyable' (39.0%). Those who reported using e-cigarettes because they were less harmful to others (Adjusted Relative Risk Ratio (ARRR)=0.67), more enjoyable (ARRR=0.52), could help them to quit smoking (ARRR=0.65), or to control weight (ARRR=0.46) were less likely to return to exclusively smoking. Among people who formerly used e-cigarettes, lack of satisfaction was the primary reason for stopping e-cigarette use (32%) and those who reported this were less likely to start using e-cigarettes again at follow-up (Adjusted Odds Ratio (AOR)=0.58). CONCLUSIONS Specific reasons for using and stopping e-cigarettes predict changes in smoking and e-cigarette use, and targeting these beliefs could promote desired behaviour changes.
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Affiliation(s)
- Katia Gallegos Carrillo
- Epidemiology and Health Services Research Unit, Mexican Social Security Institute, Cuernavaca, Mexico
| | - Dèsirée Vidaña-Pérez
- Department of Health Promotion, Education & Behavior, University of South Carolina Columbia, Columbia, South Carolina, USA
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Lizeth Cruz-Jiménez
- Department of Health Promotion, Education & Behavior, University of South Carolina Columbia, Columbia, South Carolina, USA
| | | | - James F Thrasher
- Department of Health Promotion, Education & Behavior, University of South Carolina Columbia, Columbia, South Carolina, USA
- Tobacco Research Department, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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He Y, Liber A, Driezen P, Thompson ME, Levy DT, Fong GT, Cummings KM, Shang C. How do users compare the costs between nicotine vaping products and cigarettes? Findings from the 2016-2020 International Tobacco Control United States surveys. Addiction 2024; 119:885-897. [PMID: 38186201 PMCID: PMC11009094 DOI: 10.1111/add.16425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/23/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND AIMS Nicotine vaping products (NVPs) can potentially help adult tobacco users quit smoking. This study evaluated how adult consumers compare the costs between NVPs and cigarettes. METHOD We used data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys to perform a multinomial logit model with two-way fixed effects to measure how perceived cost comparisons are associated with NVP and cigarette taxes, use patterns, NVP device types and individual sociodemographic factors. RESULTS Higher cigarette taxes are associated with a greater likelihood of perceiving NVPs and cigarettes as costing the same for the overall population and among people who exclusively smoke, and a lower likelihood of perceiving NVPs as more expensive among people who exclusively vape, compared with lower cigarette taxes. Pre-filled cartridge and tank users are more likely to perceive NVPs as less expensive than cigarettes, compared with people who use other types of NVPs. The associations between taxes and perceived cost comparison were more pronounced among males, younger and low-income populations. CONCLUSIONS Higher cigarette taxes are associated with perceived financial incentives for nicotine vaping products (NVPs) over cigarettes, whereas NVP taxes are not associated with perceived cost comparison between NVPs and cigarettes.
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Affiliation(s)
- Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alex Liber
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC, USA
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - David T. Levy
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ce Shang
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, OH, USA
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Kimber C, Sideropoulos V, Cox S, Frings D, Naughton F, Brown J, McRobbie H, Dawkins L. E-cigarette support for smoking cessation: Identifying the effectiveness of intervention components in an on-line randomized optimization experiment. Addiction 2023; 118:2105-2117. [PMID: 37455014 PMCID: PMC10952247 DOI: 10.1111/add.16294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/06/2023] [Indexed: 07/18/2023]
Abstract
AIMS, DESIGN AND SETTING The aim of this study was to determine which combination(s) of five e-cigarette-orientated intervention components, delivered on-line, affect smoking cessation. An on-line (UK) balanced five-factor (2 × 2 × 2 × 2 × 2 = 32 intervention combinations) randomized factorial design guided by the multi-phase optimization strategy (MOST) was used. PARTICIPANTS A total of 1214 eligible participants (61% female; 97% white) were recruited via social media. INTERVENTIONS The five on-line intervention components designed to help smokers switch to exclusive e-cigarette use were: (1) tailored device selection advice; (2) tailored e-liquid nicotine strength advice; (3): tailored e-liquid flavour advice; (4) brief information on relative harms; and (5) text message (SMS) support. MEASUREMENTS The primary outcome was 4-week self-reported complete abstinence at 12 weeks post-randomization. Primary analyses were intention-to-treat (loss to follow-up recorded as smoking). Logistic regressions modelled the three- and two-way interactions and main effects, explored in that order. FINDINGS In the adjusted model the only significant interaction was a two-way interaction, advice on flavour combined with text message support, which increased the odds of abstinence (odds ratio = 1.55, 95% confidence interval = 1.13-2.14, P = 0.007, Bayes factor = 7.25). There were no main effects of the intervention components. CONCLUSIONS Text-message support with tailored advice on flavour is a promising intervention combination for smokers using an e-cigarette in a quit attempt.
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Affiliation(s)
| | | | - Sharon Cox
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | | | - Felix Naughton
- School of Health SciencesUniversity of East AngliaNorwichUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Hayden McRobbie
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
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Wen X, Chung MV, Liszewski KA, Todoro LD, Giancarlo EM, Zhang W, Berkelhamer SK, Goniewicz ML. Cigarette Smoking Abstinence Among Pregnant Individuals Using E-Cigarettes or Nicotine Replacement Therapy. JAMA Netw Open 2023; 6:e2330249. [PMID: 37698863 PMCID: PMC10498331 DOI: 10.1001/jamanetworkopen.2023.30249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/16/2023] [Indexed: 09/13/2023] Open
Abstract
Importance Smoking cigarettes during pregnancy can impair maternal and child health, and pregnant individuals have increasingly used electronic cigarettes (e-cigarettes) for various reasons, including quitting smoking. Objective To assess smoking abstinence rates among pregnant individuals who used e-cigarettes compared with those who used nicotine replacement therapy (NRT). Design, Setting, and Participants This cohort study is a secondary data analysis of phase 8 of the US Pregnancy Risk Assessment Monitoring System, conducted between 2016 and 2020. Eligible participants included pregnant individuals who smoked combustible cigarettes within the 3 months before pregnancy and either used e-cigarettes or NRT during pregnancy. Data analysis was conducted from March 2022 to April 2023. Exposures Combustible cigarette use within 3 months before pregnancy and use of either e-cigarettes or NRT during pregnancy. Main Outcomes and Measures The primary outcome was the individual's self-reported smoking abstinence status during the last 3 months of pregnancy. Weighted percentages were reported and weighted multivariable logistic regression models were used to examine the association of e-cigarette use vs NRT with smoking abstinence. A propensity score was used to control for confounding by sociodemographics, pregnancy characteristics, prepregnancy smoking intensity, depression, behavioral support, and hookah use. Results The cohort included 1329 pregnant individuals (759 ≥25 years [60.2%]; 766 non-Hispanic White individuals [79.8%]) of whom 781 had an education level of high school or lower (61.4%), and 952 had an annual household income of $48 000 or less (81.5%). Of the 1329 individuals, 890 (unweighted percentage, 67.0%) were existing e-cigarette users, 67 (unweighted percentage, 5.0%) were new e-cigarette users, and 372 (unweighted percentage, 28.0%) were NRT users. Compared with individuals who used NRT during pregnancy, individuals who used e-cigarettes had a higher rate of smoking abstinence in late pregnancy (456 individuals [50.8%] vs 67 individuals [19.4%]; propensity score adjusted odds ratio [OR], 2.47; 95% CI, 1.17-5.20; P = .02). In the secondary analysis stratified by the timing of e-cigarette use initiation, existing users of e-cigarettes who initiated before pregnancy had a higher smoking abstinence rate than NRT users (446 users [53.1%] vs 67 users [19.4%]; adjusted OR, 2.61; 95% CI, 1.23-5.51; P = .01). However, new e-cigarette users who initiated use during pregnancy had a similar smoking abstinence rate in late pregnancy when compared with NRT users (10 users [20.6%] vs 67 users [19.4%]; adjusted OR, 1.13; 95% CI, 0.22-5.87; P = .88). Conclusions and Relevance These findings suggest that individuals who used e-cigarettes during pregnancy had a higher smoking abstinence rate in late pregnancy than individuals who used NRT, especially for those who initiated e-cigarette use before pregnancy, indicating that replacement of cigarettes with e-cigarettes during pregnancy may be a viable strategy for harm reduction.
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Affiliation(s)
- Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Minseon V. Chung
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Kayla A. Liszewski
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Lauren D. Todoro
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Eve M. Giancarlo
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Wenxin Zhang
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | | | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Kim S, Shiffman S, Sembower MA. US adult smokers' perceived relative risk on ENDS and its effects on their transitions between cigarettes and ENDS. BMC Public Health 2022; 22:1771. [PMID: 36123722 PMCID: PMC9484256 DOI: 10.1186/s12889-022-14168-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Perceived risk reduction motivates smokers to switch to electronic nicotine delivery systems (ENDS). This research examines US smokers' relative risk perceptions and their prospective association with various behavioral stages of switching to ENDS. METHODS Data from the nationally representative, longitudinal Population Assessment of Tobacco and Health (PATH) Adult survey, Waves 1 (2014) through 5 (2019), were analyzed. We assessed the association between the perceived risk of ENDS relative to cigarettes ("less harmful" vs. "equally harmful" or "more harmful") and 1) adoption of ENDS (among never-ENDS-using smokers), 2) complete switching to ENDS (i.e., stopping smoking, among ever-ENDS-using smokers), and 3) avoiding reversion to smoking (among smokers who had switched to ENDS), at the next wave. RESULTS The proportion of US smokers perceiving ENDS as less harmful than cigarettes continually decreased, reaching 17.4% in Wave 5 (2019). Current smokers with such belief were more likely to adopt ENDS (aOR 1.31; 95% CI 1.15-1.50) and switch completely to ENDS (aOR 2.24; 95% CI 1.89-2.65) in the subsequent wave. Among smokers who had switched within the past year, such beliefs predicted avoidance of resumption of smoking in the next wave (aOR 0.55; 95% CI 0.33-0.93). CONCLUSIONS Smokers' beliefs about the relative risk of ENDS compared to cigarettes had a strong and consistent association with transitions between smoking and ENDS use. Addressing the growing misperception about ENDS has the potential to contribute to public health by encouraging smokers' switching to ENDS.
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Affiliation(s)
- Sooyong Kim
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA.
| | - Saul Shiffman
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA
| | - Mark A Sembower
- PinneyAssociates Inc, 201 N. Craig St, Ste 320, Pittsburgh, PA, 15213, USA
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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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Gaca M, Williamson J, Digard H, Adams L, Hawkridge L, Proctor C. Bridging: Accelerating Regulatory Acceptance of Reduced-Risk Tobacco and Nicotine Products. Nicotine Tob Res 2022; 24:1371-1378. [PMID: 35171296 PMCID: PMC9356683 DOI: 10.1093/ntr/ntac041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The number and variety of alternative tobacco and nicotine products that can potentially provide reduced-risk choices for cigarette smokers who switch completely to such products instead of continued smoking have grown substantially in the past decade. Innovation and choice are likely to improve the prospects of smokers making the switch, but this provides challenges to regulators and manufacturers to ensure that changes to regulations and products promote and do not hinder contributions to tobacco harm reduction. AIMS AND METHODS This paper looks at where bridging data sets for tobacco heating products, closed system vaping products, and oral nicotine products might enable innovation while protecting the interests of consumers. RESULTS We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones. CONCLUSIONS Bridging across specific product ranges can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality. IMPLICATIONS Bridging partial data sets is an established practice within other industries, that aims to improve efficiency with regulatory approvals, accepts natural product variation, and supports product innovation. We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones. This in turn can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality.
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Affiliation(s)
- Marianna Gaca
- British American Tobacco (Holdings) Ltd, Globe House, 4 Temple Place, London WC2R 2PG, UK
| | - Justine Williamson
- British American Tobacco (Holdings) Ltd, Globe House, 4 Temple Place, London WC2R 2PG, UK
| | - Helena Digard
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
| | - Louise Adams
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
| | - Lauren Hawkridge
- Research and Development, British American Tobacco (Investments) Ltd, Regent’s Park Road, Southampton SO15 8TL, UK
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Kinchen G, Cox S, Kale D, Shahab L. Facilitators and barriers for harm reduction after first use of novel nicotine delivery devices: a qualitative investigation of cigarette smokers. BMC Psychol 2022; 10:190. [PMID: 35906688 PMCID: PMC9336076 DOI: 10.1186/s40359-022-00874-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Novel nicotine delivery devices (NNDDs) are a safer alternative to combustible tobacco smoking. Understanding what factors can facilitate people who smoke to use NNDDs can inform intervention design and public health messaging. This study aims to explore the facilitators and barriers to NNDD use from the perspective of smokers without prior use, after trialling two NNDDs. METHOD UK adults who smoke combustible cigarettes (n = 11) were recruited from a larger quantitative study after trialling two NNDDs, an electronic cigarette and a heated tobacco product (order randomly allocated). Semi-structured interviews were conducted, transcribed and thematically analysed, using the COM-B model of behaviour and NVivo12 pro software. RESULTS Five main themes were identified: health knowledge, availability of and accessibility to NNDD products, cost, social acceptance, and NNDD use experience. There was curiosity and interest in the uptake and use of NNDDs, but the absence of centralised product information was identified as a barrier. Other themes were related to the design and functionality of the NNDD products. For example, the e-cigarette with its low maintenance was seen as easier to use than the heated tobacco product, which offered too short a single use duration and was described as 'cumbersome'. Throat discomfort and high anticipated cost were among additional barriers identified for both product types. CONCLUSION This study highlights the need for reliable objective information on the health effects of NNDDs compared with combustible cigarettes, which could facilitate their regular use. Product adjustment such as single use duration alignment with combustible cigarette smoking duration may encourage uptake. Interventions offering opportunity for experience of NNDD use and knowledge dissemination of NNDDs could increase motivation to adopt harm reducing behaviours as demonstrated in this study.
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Affiliation(s)
- Gill Kinchen
- Department of Behavioural Science and Health, University College London, 1–19 Torrington Place, London, WC1E 6BT UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, 1–19 Torrington Place, London, WC1E 6BT UK
| | - Dimitra Kale
- Department of Behavioural Science and Health, University College London, 1–19 Torrington Place, London, WC1E 6BT UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1–19 Torrington Place, London, WC1E 6BT UK
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Wee LH, Tee GH, Chan CMH, Draman S, Jamalludin AR, Ho BK, Yn Ling JM, Lim KH, Mohd Yusoff MF, Baharom N, Robson N, Kartiwi M, Ab Rahman NS, Siau CS, Nik Mohamed MH. The Role of Media and Retailer Message Recall on Malaysian Male Perceptions of E-Cigarette Use: The 2016 National Study of E-Cigarettes Prevalence. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221079683. [PMID: 35225040 PMCID: PMC8891842 DOI: 10.1177/00469580221079683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceptions of current smokers on electronic cigarette (EC) use, after exposure to information on EC use and its potential harms from various media and retail outlets. This cross-sectional study is a sub-analysis of the National Study of Electronic Cigarettes Prevalence (N = 4289) using the multi-stage stratified sampling method. Respondents were interviewed face-to-face by a trained data collector using a structured questionnaire printed in both Bahasa Malaysia and English. The analysis included 376 males who smoked conventional cigarettes and/or used ECs and reported ever seeing messages on ECs/vape in various platforms were analyzed using weighted simple and multiple logistic regression. Our findings showed different media types resulted in differing perceptions among smokers towards EC use especially between social media and conventional media. Those exposed to messages promoting EC in social media had higher odds of believing that ECs help people quit smoking (OR: 2.28), the urge to smoke is reduced by ECs (OR: 1.86), ECs are more effective than medication for quitting smoking (OR: 1.96), breathing is improved after using ECs (OR: 2.85), the smell of EC is better than a tobacco cigarette (OR: 2.73), and ECs should be regulated rather than banned completely (OR: 3.08). Vape shops, social, and conventional media provided very different perceptions among smokers towards EC use. Beyond using traditional communication channels, EC promoters have successfully utilized social media to promote ECs among smokers.
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Affiliation(s)
- Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Samsul Draman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ab Rahman Jamalludin
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Jane Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Noorzurani Robson
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mira Kartiwi
- Kulliyyah of ICT, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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11
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Peraza N, Bello MS, Schiff SJ, Cho J, Zhang Y, Callahan C, Tackett A, Leventhal AM. Drug and alcohol dependence acute effects of pod-style e-cigarettes in vaping-naïve smokers. Drug Alcohol Depend 2021; 228:109083. [PMID: 34600262 PMCID: PMC8631487 DOI: 10.1016/j.drugalcdep.2021.109083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study investigated the acute effects of exposure to pod-style e-cigarettes on subjective, behavioral, and physiological outcomes indicative of the potential to encourage vaping-naïve smokers to switch to e-cigarettes. METHODS In a within-subject experiment, never-vaping adult smokers interested in trying e-cigarettes (n = 24) completed 4 laboratory visits following 16-hr tobacco abstinence. Visits involved controlled puffing from preferred brand cigarettes (OwnCig) or a standardized pod-style e-cigarette with either no nicotine (NoNic), nicotine freebase (NicFreebase; 0.5% nicotine concentration), or nicotine salt (NicSalt E-Cig; 2.8% concentration) solutions. Outcomes included smoking urge, mood, user experience, plasma nicotine, and a behavioral task assessing ability to delay smoking. RESULTS NoNic, NicFreebase, and NicSalt pod-style e-cigarettes were significantly less effective than OwnCig at reducing smoking urge and increasing plasma nicotine, positive affect, satisfying user experience ratings, and ability to delay smoking on the behavioral task. Differences among pod-style e-cigarette conditions were limited to: (a) NicFreebase (vs. NoNic) preferentially suppressed participants' urge to smoke to alleviate negative mood, (b) NicFreebase (vs. NicSalt) slightly preferentially increased plasma nicotine; and (c) NicFreebase and NicSalt (vs. NoNic) produced higher aversive user experience ratings. CONCLUSIONS In tobacco deprived smokers' initial vaping experience, controlled administration of certain pod-style e-cigarettes with 0.5% NicFreebase or 2.8% NicSalt may be deficient comparators to cigarettes in terms of their capacity to acutely improve mood, deliver nicotine, suppress smoking motivation, and offer a satisfying user experience. Future research is needed to test pod-style e-cigarettes with higher nicotine doses and confirm whether NicFreebase vs. NicSalt enhances nicotine absorption.
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Affiliation(s)
- Natalia Peraza
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Sara J Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Yi Zhang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Carly Callahan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Alayna Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, USA.
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12
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Wilson GL, Keenan J, Grogan S, Porcellato L, Powell S, Gee I. An investigation of factors encouraging and deterring EC use: a thematic analysis of accounts from UK adults. Psychol Health 2021; 37:1379-1395. [PMID: 34279128 DOI: 10.1080/08870446.2021.1952583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to explore E-cigarette (EC) accounts from a small sample of UK adults with varied smoking/EC experiences. This was to contribute to existing knowledge of adult perceptions and understand the factors that encourage or deter use to inform health messaging aimed at professionals, policy makers and the general public. DESIGN Twelve participants, five men and seven women aged 23-55 years (mean age 32.43) with mixed smoking/EC backgrounds took part in face-to-face interviews, analysed using semantic-level inductive thematic analysis. RESULTS The analysis identified three key themes. Social influence (1) relates to the understanding of the social representations of ECs. Representation and knowledge (2) captures the impact of varied EC related communication on perception. Aspects of addiction (3) conveys aspects of nicotine addiction and how this influences EC use. CONCLUSION ECs were generally perceived as more socially acceptable than cigarettes by non-smokers, although there were varying levels of acceptability depending on the type of EC device used. There was also unanimity concerning uncertainty surrounding the devices. Behavioural/sensory elements and personal enjoyment of ECs were consistent elements that encouraged or deterred use. Although non-smokers/vapers did not use the devices, they expressed similar apprehensions to those who did.
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Affiliation(s)
| | - Joseph Keenan
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Sarah Grogan
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Susan Powell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Ivan Gee
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
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13
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Kimber CF, Soar K, Dawkins LE. Changes in puffing topography and subjective effects over a 2-week period in e-cigarette naïve smokers: Effects of device type and nicotine concentrations. Addict Behav 2021; 118:106909. [PMID: 33756301 DOI: 10.1016/j.addbeh.2021.106909] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/11/2021] [Accepted: 03/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to document changes in puffing topography and, the effects of device type and nicotine concentration on puffing topography, subjective effects and smoking behaviour over two weeks of e-cigarette (EC) use. METHODS EC naïve smokers (N = 50; 64% female) were randomly allocated to a cigalike (18 mg/mL) or tank containing either 18 (Tank18) or 6 mg/mL nicotine concentrations (Tank6). In 3 separate sessions (Baseline, 1 and 2 weeks post-baseline), participants vaped 20 min ad-libitum. Puff duration, puff number, inter-puff intervals (IPI), exhaled carbon monoxide (CO), cigarettes per day (CPD), cigarette dependence, craving, withdrawal, and subjective effects were recorded. RESULTS Two weeks post-baseline, puff duration and IPI significantly increased whilst puff number decreased. Cigalikes were associated with greater puff number and shorter IPI compared to Tanks; there was no difference between Tank18 and Tank6. CPD, CO and cigarette dependence reduced significantly from baseline to week1 but did not differ between conditions. During each session, there was a significant reduction in craving, whilst withdrawal symptoms were only alleviated in week1 and 2; there was no difference between conditions. Tank18 consistently rated highest on positive effects including satisfaction; satisfaction scores for Cigalikes and Tank6 declined overtime. CONCLUSIONS Cigalikes and tanks were both effective for reducing craving, withdrawal symptoms and CPD although for the former, this may only be achieved through more frequent puffing. That the Tank18 yielded greater satisfaction suggests tank devices and higher nicotine concentrations may be more suitable in the early stage of a smoking cessation attempt.
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Affiliation(s)
- C F Kimber
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - K Soar
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
| | - L E Dawkins
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
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14
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Evans AT, Henderson KC, Geier A, Weaver SR, Spears CA, Ashley DL, Fritz M, John L, Pechacek TF. What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238865. [PMID: 33260570 PMCID: PMC7729446 DOI: 10.3390/ijerph17238865] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/20/2022]
Abstract
Switching completely from cigarettes to electronic nicotine delivery systems (ENDS) may reduce health risks for addicted smokers. This paper provides information about perceptions and other factors that may influence smokers’ ENDS use and substitution for cigarettes. We conducted 12 online focus groups (N = 61) among smokers who had never tried using ENDS (Never Users, N = 11), currently used both cigarettes and ENDS (Dual Users, N = 21), used but discontinued ENDS (Rejectors, N = 14), and switched completely to ENDS use (Switchers, N = 15). Thematic analysis was used to interpret the transcripts. Participants described initial interest in trying ENDS in hopes of quitting smoking and because of convenience (i.e., due to rules, regulations, or social norms). Risk perceptions and higher prices relative to cigarettes were reported as disadvantages of ENDS that discouraged initiation. Dual Users and Rejectors reported product problems (e.g., products breaking) and dissatisfaction (i.e., inability to satisfy cravings for cigarettes) as factors that lowered their substitutability for cigarettes or led to discontinuing ENDS use. Switchers indicated that satisfaction, lack of product problems, and perceived safety facilitated successfully switching from cigarette smoking to exclusive ENDS use. However, Switchers reported trying many products before they found ones that satisfied their needs. We recommend that policymakers consider the potential impact of tobacco control policies on smokers’ motivation and ability to switch completely from cigarettes to ENDS.
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Affiliation(s)
- Abigail T. Evans
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
- Correspondence: (A.T.E.); (K.C.H.); Tel.: +1-319-621-7968 (A.T.E.); +1-678-827-3434 (K.C.H.)
| | - Katherine C. Henderson
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
- Correspondence: (A.T.E.); (K.C.H.); Tel.: +1-319-621-7968 (A.T.E.); +1-678-827-3434 (K.C.H.)
| | - Anna Geier
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - Claire Adams Spears
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - David L. Ashley
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
| | - Meredith Fritz
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Lisa John
- Battelle Memorial Institute, Baltimore, MD 21209, USA; (A.G.); (M.F.); (L.J.)
| | - Terry F. Pechacek
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (S.R.W.); (C.A.S.); (D.L.A.); (T.F.P.)
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15
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Persoskie A, O'Brien EK, Poonai K. Perceived relative harm of using e-cigarettes predicts future product switching among US adult cigarette and e-cigarette dual users. Addiction 2019; 114:2197-2205. [PMID: 31278802 DOI: 10.1111/add.14730] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/29/2019] [Accepted: 06/28/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS People's perceptions of the harmfulness of e-cigarettes, compared with cigarettes, may influence their product use decisions. We tested if perceiving e-cigarettes as less harmful than cigarettes predicted whether cigarette and e-cigarette dual users switched their product use status 1 year later, becoming exclusive e-cigarette users, exclusive cigarette smokers, or non-users of both product types. DESIGN Longitudinal analyses of waves 2 (2014-15) and 3 (2015-16) of the prospective, national Population Assessment of Tobacco and Health (PATH) Study. SETTING United States. PARTICIPANTS Adults who reported using both cigarettes and e-cigarettes within the past 30 days at wave 2 reported their perceptions of e-cigarette harm at wave 2, and reported whether they used cigarettes and e-cigarettes within the past 30 days at wave 3 (n = 2211). MEASUREMENTS The key predictor was wave 2 perceptions of e-cigarette harm compared with cigarettes ('less harmful,' 'about the same', 'more harmful' or 'don't know'). The key outcome was wave 3 past 30-day use of e-cigarettes and cigarettes, classified into four categories: exclusive e-cigarette use (i.e. use of e-cigarettes but not cigarettes), exclusive cigarette smoking (i.e. use of cigarettes but not e-cigarettes), dual use of both product types and non-use of both product types. FINDINGS At wave 2, 59.4% of dual users perceived e-cigarettes as less harmful than cigarettes [95% confidence interval (CI) = 56.9, 61.9]. Compared with those with other perceptions of e-cigarette harm, dual users who perceived e-cigarettes as less harmful than cigarettes were more likely to become exclusive e-cigarette users 1 year later [7.5 versus 2.7%; adjusted odds ratio (aOR) = 2.9, 95% CI = 1.7-4.8], more likely to remain dual users (39.6 versus 29.9%; aOR = 1.5, 95% CI = 1.2-1.8), less likely to become exclusive cigarette smokers (44.8 versus 59.4%; aOR = 0.6, 95% CI = 0.5-0.7) and similarly likely to become non-users of both product types (8.2 versus 8.0%; aOR = 1.1, 95% CI = 0.7-1.7). CONCLUSIONS US adult dual users of e-cigarettes and cigarettes who perceive e-cigarettes as less harmful than cigarettes appear to be more likely to switch to exclusive e-cigarette use, more likely to remain dual users and less likely to switch to exclusive cigarette use 1 year later than dual users with other perceptions of e-cigarette harm.
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Affiliation(s)
| | | | - Karl Poonai
- Office of Science, FDA Center for Tobacco Products, Calverton, MD, USA
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16
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Boyle RG, Richter S, Helgertz S. Who is using and why: Prevalence and perceptions of using and not using electronic cigarettes in a statewide survey of adults. Addict Behav Rep 2019; 10:100227. [PMID: 31832535 PMCID: PMC6889732 DOI: 10.1016/j.abrep.2019.100227] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/26/2019] [Accepted: 10/05/2019] [Indexed: 01/03/2023] Open
Abstract
E-cigarettes continue to generate curiosity among smokers and nonsmokers. Higher nicotine content devices have sustained interest in e-cigarettes. Nonsmokers were 37% of users and flavors were a primary reason for trying. Users were young adults , curious adults, smokers trying to quit, and dual users.
A statewide survey examined prevalence, reasons for using, discontinuing use, and not wanting to try e-cigarettes. Methods Participants (n = 6052) were adult Minnesota residents. E-cigarette initiation and current use prevalence rates were calculated for demographic characteristics and smoking status. The percent of respondents endorsing a reason for trying e-cigarettes are reported overall and by smoking status. The percent of respondents endorsing each reason for discontinuing or not using e-cigarettes are reported for daily and occasional smokers. All descriptive analyses were weighted. To develop profiles of e-cigarette users, a latent class analysis (LCA) was undertaken. Results Overall, 20.7% of adults reported ever use and 4.6% were current users. Use varied notably by age and smoking status. Only 2.8% of never smokers were current e-cigarette users. Among young adults, 14.6% reported current use but most (70.0%) were never smokers. The reasons given for using e-cigarettes varied by smoking status. Curiosity was the top reason for all groups except recent former smokers, for whom cutting down or quitting other tobacco products was primary. Most smokers discontinuing e-cigarettes preferred cigarettes, and four-fifths of smokers who never tried e-cigarettes lacked interest. From the LCA four profiles were evident: young adult experimenters, curious adults, smokers trying to quit cigarettes, and dual users. Conclusions Innovative higher nicotine content devices have sustained interest in e-cigarettes especially among young adults and smokers with a goal of cutting down or quitting smoking. Future regulations and communication should focus on reducing e-cigarette use among young adult nonsmokers.
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17
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Pacek LR, Rass O, Sweitzer MM, Oliver JA, McClernon FJ. Young adult dual combusted cigarette and e-cigarette users' anticipated responses to hypothetical e-cigarette market restrictions. Subst Use Misuse 2019; 54:2033-2042. [PMID: 31305213 PMCID: PMC6764889 DOI: 10.1080/10826084.2019.1626435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: The aim of this exploratory study was to assess young adult dual e-cigarette (EC) and combusted cigarette (CC) users' anticipated responses to hypothetical market restrictions regarding key EC characteristics. Methods: Data came from 240 young adult dual EC and CC users recruited via Amazon Mechanical Turk in June 2017. Descriptive statistics were used to report sociodemographic, CC smoking, and EC use characteristics. McNemar's chi-square tests and chi-square tests were used to assess differences between groups in terms of anticipated responses to hypothetical EC market restrictions. Results: Hypothetical regulations resulted in reported intentions to reduce EC use and increase CC use; the greatest impact was found for restrictions regarding e-liquid nicotine content, followed by flavor and ability to modify EC devices. Moreover, individuals reporting use of flavored e-liquid, high nicotine content e-liquid, and customizable EC were most likely to report intentions to reduce EC use and increase CC use. Conclusions: This work provides preliminary evidence that restrictive regulations regarding key EC characteristics may increase intentions to increase CC use among young adult dual EC and CC users.
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Affiliation(s)
- Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham , North Carolina , USA
| | - Olga Rass
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration , Silver Spring , Maryland , USA
| | - Maggie M Sweitzer
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham , North Carolina , USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham , North Carolina , USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine , Durham , North Carolina , USA
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18
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Adriaens K, Gucht DV, Baeyens F. IQOS TM vs. e-Cigarette vs. Tobacco Cigarette: A Direct Comparison of Short-Term Effects after Overnight-Abstinence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2902. [PMID: 30567400 PMCID: PMC6313326 DOI: 10.3390/ijerph15122902] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/16/2022]
Abstract
Introduction: Research from Philip Morris International's science division on its Heat-not-Burn product IQOSTM focused on its chemical, toxicological, clinical, and behavioral aspects. Independent research on the experiences and behavioral aspects of using IQOSTM, and how it compares to e-cigarettes, is largely lacking. The current randomized, cross-over behavioral trial tried to bridge the latter gaps. Methods: Participants (n = 30) came to the lab on three consecutive days after being overnight smoking abstinent. During each session, participants used one of three products (cigarette, e-cigarette, or IQOSTM) for five minutes. Exhaled CO (eCO) measurements and questionnaires were repeatedly administered throughout the session. Results: Smoking a cigarette for five minutes resulted in a significant increase of eCO, whereas using an IQOSTM resulted in a small but reliable increase (0.3 ppm). Vaping did not affect eCO. Cigarette craving reduced significantly after product use, with the decline being stronger for smoking than for e-cigarettes or IQOSTM. Withdrawal symptoms declined immediately after smoking or using IQOSTM, and with some delay after vaping. IQOSTM scored higher in terms of subjective reward/satisfaction and was slightly preferred to the e-cigarette. Discussion: Short-term use of IQOSTM has a minimal impact on eCO, is equally effective in reducing cigarette craving and withdrawal symptoms as an e-cigarette, and is slightly preferred.
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Affiliation(s)
- Karolien Adriaens
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
| | - Dinska Van Gucht
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
- Applied Psychology Unit, Thomas More University of Applied Sciences, Molenstraat 8, 2018 Antwerp, Belgium.
| | - Frank Baeyens
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
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Gaalema DE, Pericot-Valverde I, Bunn JY, Villanti AC, Cepeda-Benito A, Doogan NJ, Keith DR, Kurti AN, Lopez AA, Nighbor T, Parker MA, Quisenberry AJ, Redner R, Roberts ME, Stanton CA, Ades PA, Higgins ST. Tobacco use in cardiac patients: Perceptions, use, and changes after a recent myocardial infarction among US adults in the PATH study (2013-2015). Prev Med 2018; 117:76-82. [PMID: 29746974 PMCID: PMC6195824 DOI: 10.1016/j.ypmed.2018.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/30/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Abstract
Smoking status following cardiac events strongly predicts future morbidity and mortality. Using a nationally representative sample of United States adults, aims of this study were (1) to estimate use of, and attitudes towards, tobacco products as a function of level of cardiac risk, and (2) to explore changes in attitudes and tobacco use among adults experiencing a recent myocardial infarction (MI). Data were obtained from the first and second waves of the Population Assessment of Tobacco and Health (PATH) study. Use and attitudes towards tobacco products were examined at Wave 1 among adults with no chronic health condition (n = 18,026), those with risk factors for heart disease (n = 4593), and those who reported ever having had an MI (n = 643). Changes in perceived risk of tobacco and use between the two waves and having an MI in the last 12 months (n = 240) were also examined. Those who reported lifetime MI were more likely to believe that smoking/using tobacco was causing/worsening a health problem. Having had a recent MI event increased perceived tobacco-related risk and attempts at reduction/quitting, but did not significantly impact combusted tobacco cessation/reduction or uptake of non-combusted tobacco products. Sociodemographic characteristics and use of other tobacco products were associated with change in use of tobacco products. Those who have an MI are sensitized to the harm of continued smoking. Nonetheless, having an MI does not predict quitting combusted tobacco use or switching to potentially reduced harm products. Intense intervention is necessary to reduce combusted use in this high-risk population.
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Affiliation(s)
- Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA.
| | - Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Janice Y Bunn
- Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Antonio Cepeda-Benito
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Diana R Keith
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Alexa A Lopez
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA
| | - Tyler Nighbor
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Maria A Parker
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Amanda J Quisenberry
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Rehabilitation Institute, Southern Illinois University, Carbondale, IL, USA
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Cassandra A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Philip A Ades
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Division of Cardiology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA
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Popova L, Majeed B, Owusu D, Spears CA, Ashley DL. Who are the smokers who never plan to quit and what do they think about the risks of using tobacco products? Addict Behav 2018; 87:62-68. [PMID: 29958136 PMCID: PMC6109416 DOI: 10.1016/j.addbeh.2018.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Smoking cigarettes is the most harmful way to use tobacco. Smokers who do not plan to quit present a particular challenge in reducing the morbidity and mortality from tobacco use. Switching to a lower harm product might encourage them to end their use of combusted cigarettes. This study aimed to better understand smokers who do not intend to quit (including their demographic and worldviews as indicators of their social, cultural, and political dispositions) and their perceived risks of cigarettes and possible lower-risk products such as e-cigarettes. METHODS Participants were 2572 current smokers. Data were pooled from 2015 and 2016 cross-sectional surveys of national probability samples of U.S. adults and analyzed with multivariable logistic regressions. RESULTS Smokers who never plan to quit comprise 14.3% of current U.S. smokers and are more likely to be older (24.2% among 65+ years old vs. 9.8% among 18-24) and less likely to have ever used e-cigarettes. A one-unit increase in hierarchical worldview (measured on a 1-6 scale) was associated with a 20% increase in the odds of never planning to quit. Those who denied that cigarettes cause disease or death (aORs between 1.6 and 2.0) or were uncertain (aORs: 2.5-2.7) were more likely to never plan to quit compared to those who agreed. They did not view risks of e-cigarettes substantially different compared to smokers who plan to quit. CONCLUSION One in seven U.S. smokers never plans to quit and might benefit from interventions which reflect their hierarchical worldviews and increase their risk perceptions of combustible cigarettes.
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Affiliation(s)
- Lucy Popova
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, Georgia 30302, USA.
| | - Ban Majeed
- Department of Population Health Sciences, Medical College of Georgia, 1120 15th Street, Augusta, Georgia 30912, USA
| | - Daniel Owusu
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, Georgia 30302, USA
| | - Claire Adams Spears
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, Georgia 30302, USA
| | - David L Ashley
- School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, Georgia 30302, USA
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About One in Five Novice Vapers Buying Their First E-Cigarette in a Vape Shop Are Smoking Abstinent after Six Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091886. [PMID: 30200290 PMCID: PMC6163307 DOI: 10.3390/ijerph15091886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 01/29/2023]
Abstract
Background: E-cigarette use is rising with the majority of vapers purchasing their e-cigarettes in vape shops. We investigated the smoking/vaping trajectories and quit-smoking success rates of smokers deciding to start vaping for the first time and buying their e-cigarette in brick-and-mortar vape shops in Flanders. Methods: Participants filled out questionnaires assessing smoking/vaping behaviour at three moments (intake, after three and six months) and smoking status was biochemically verified using eCO measurements. Results: Participants (n = 71) were regular smokers (MeCO-intake = 22 ppm), half of whom reported a motivation to quit smoking in the near future. Participants bought 3rd/4th generation e-cigarettes and e-liquid with a nicotine concentration averaging 7 mg/mL. A smoking reduction of 53% (17 cigarettes per day (CPD) at intake to 8 CPD after six months) was observed, whereas eCO decreased to 15 ppm. Eighteen percent of participants had quit smoking completely (eCO = 2 ppm), another 25% had at least halved CPD, whereas 57% had failed to reduce CPD by at least 50% (including 13% lost to follow-up). Quitters consumed more e-liquid than reducers and those who continued to smoke. Conclusions: Around one in five smoking customers buying their first e-cigarette in a brick-and-mortar vape shop had quit smoking completely after six months.
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Chiamulera C, West RJ. What role does dopamine really play in tobacco addiction? Addiction 2018; 113:1379-1380. [PMID: 29766605 DOI: 10.1111/add.14235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/21/2018] [Accepted: 04/04/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Cristiano Chiamulera
- Department of Diagnostics and Public Health, Section Pharmacology, University of Verona, Verona, Italy
| | - Robert J West
- Department of Behavioural Science and Health, University College London, London, UK
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Sumner W, Farsalinos K. Lessons and Guidance from the Special Issue on Electronic Cigarette Use and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071338. [PMID: 29949861 PMCID: PMC6068822 DOI: 10.3390/ijerph15071338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Walton Sumner
- Retired from Department of Internal Medicine, School of Medicine, Washington University, School of Medicine, Washington University, 660 S Euclid Ave, St. Louis, MO 63110, USA.
| | - Konstantinos Farsalinos
- Department of Cardiology, Onassis Cardiac Surgery Center, Sygrou 356, 17674 Kallithea, Greece.
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Perceptions and Reasons Regarding E-Cigarette Use among Users and Non-Users: A Narrative Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061190. [PMID: 29882828 PMCID: PMC6025300 DOI: 10.3390/ijerph15061190] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
This paper aims to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth. MEDLINE® and Scopus were used to search for relevant articles, and references of included studies were also investigated. Two reviewers screened all titles and abstracts independently, blinded to authors and journal titles (Cohen’s Kappa = 0.83), resulting in 72 eligible articles. Risk perceptions, perceived benefits, and reasons for e-cigarette use were categorized in themes and sub-themes. Risk perceptions included harmfulness in general, and specific health risks. Perceived benefits included improved taste and smell, and safety for bystanders. Reasons for use included (health) benefits, curiosity, smoking cessation, and friends using e-cigarettes. The findings highlight that there is a variety of perceptions and reasons mentioned by adult and youth e-cigarette users, cigarette smokers, dual users, and non-users. As such, this overview provides valuable information for scientists, public health professionals, behavior change experts, and regulators to improve future research, risk communication, and possibilities to effectively regulate e-cigarettes.
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Robertson L, Hoek J, Blank ML, Richards R, Ling P, Popova L. Dual use of electronic nicotine delivery systems (ENDS) and smoked tobacco: a qualitative analysis. Tob Control 2018; 28:13-19. [PMID: 29419488 PMCID: PMC6317506 DOI: 10.1136/tobaccocontrol-2017-054070] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) arguably pose fewer health risks than smoking, yet many smokers adopt ENDS without fully relinquishing smoking. Known as 'dual use', this practice is widespread and compromises the health benefits that ENDS may offer. To date, few studies have explored how dual use practices arise and manifest. METHODS We conducted in-depth, semi-structured interviews with 20 current ENDS users from New Zealand who reported smoking tobacco at least once a month. We explored participants' smoking history, their recent and current smoking, trial, uptake and patterns of ENDS use, and future smoking and vaping intentions. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts. RESULTS Dual use practices among participants evolved in four ways. First, as an attempt to manage the 'inauthenticity' of vaping relative to smoking and to retain meaningful rituals. Second, as complex rationalisations that framed decreased tobacco use, rather than smoking cessation, as 'success'. Third, as a means of alleviating the financial burden smoking imposed and to circumvent smoke-free policies. Lastly, dual use reflected attempts to comply with social group norms and manage stigma. CONCLUSIONS Dual use reflects both social and physical cues. It assisted participants to navigate smoking restrictions and allowed them to manage divergent norms. Policies that discourage smoking, particularly excise tax increases on smoked tobacco and smoke-free space restrictions, appear important in prompting ENDS use. Future research could explore whether these policies also help foster complete transition from smoking to exclusive ENDS use.
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Affiliation(s)
- Lindsay Robertson
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
| | - Mei-Ling Blank
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
| | - Rosalina Richards
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pamela Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Adriaens K, Van Gucht D, Baeyens F. Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010012. [PMID: 29295483 PMCID: PMC5800112 DOI: 10.3390/ijerph15010012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 11/16/2022]
Abstract
(1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use; (2) Methods: Using an online questionnaire we assessed behavioral, cognitive and attitudinal aspects of e-cig use in smoking and ex-smoking vapers; (3) Results: Our sample consisted of 19% dual users and 81% switchers. Before e-cig initiation, both groups smoked on average 22 cigarettes per day (CPD). After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent. Both groups had been vaping for on average 22 months, were highly e-cig dependent, used state-of-the-art e-cigs, nicotine concentrations of 4–8 mg/mL and often flavors other than tobacco. Dual users used substantially less e-liquid per week than switchers but reported a similar number of puffs/day, experienced less e-cig efficacy, more practical problems, more negative and less positive consequences, and endorsed smoking reduction (rather than quitting) as a more important reason to start vaping. For both groups, e-cig risk perception was low and little stigmatization was experienced. Dual users preferred tobacco cigarettes in stressful situations and when rapid nicotine uptake is required. E-cigs were preferred where cigarettes are prohibited and to reduce second-hand smoke; (4) Conclusions: Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes.
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Affiliation(s)
- Karolien Adriaens
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
| | - Dinska Van Gucht
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
- Applied Psychology Unit, Thomas More University of Applied Sciences, Molenstraat 8, 2018 Antwerp, Belgium.
| | - Frank Baeyens
- Faculty of Psychology and Educational Sciences, KU Leuven-University Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
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