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Rivard C, Brown A, Kasza K, Bansal-Travers M, Hyland A. Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9719. [PMID: 34574640 PMCID: PMC8465197 DOI: 10.3390/ijerph18189719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The 2006 Surgeon General's Report recommended the elimination of smoking in homes as an effective protective measure against the harmful effects of secondhand tobacco smoke exposure. This study aims to examine trends in the prevalence and levels of the adoption of home tobacco use policies specifically for cigarettes, e-cigarettes, smokeless tobacco, and the relationships between home tobacco use policies and self-reported exposure to secondhand tobacco smoke. METHODS This study utilizes data from Wave 1 (2013-2014) through Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health (PATH) Study, a large prospective cohort study of youths and adults in the United States which collected information about both smoke-free and tobacco-free home policies. We present the weighted, population-based, self-reported prevalence of home tobacco use policies overall and by product, and the average number of self-reported hours of secondhand smoke (SHS) exposure by levels of home tobacco policy and by survey wave. In addition, we examine the characteristics of those who adopted (by yes or no) a home tobacco use ban between survey waves. RESULTS We found a high prevalence of completely tobacco-free home policies (69.5%). However, 10.6% of adults allow the use of any type of tobacco product inside their homes, and 19.8% have a policy allowing the use of some types of tobacco products and banning the use of others. Adults with a complete tobacco use ban inside their homes were more likely to be nonusers of tobacco (79.9%); living with children in the home (71.8%); at or above the poverty level (70.8%); non-white (76.0%); Hispanic (82.7%); and aged 45 or older (71.9%). The adoption of 100% tobacco-free home policies is associated with a 64% decrease in secondhand smoke exposure among youths and a 69% decrease in exposure among adults. CONCLUSIONS Most US adults have implemented tobacco-free home policies; however, there is still exposure to SHS in the home, for both adults and children, particularly in the homes of tobacco users. Additional research should investigate tobacco-free home policies for different types of products and what effect they have on future tobacco use behaviors.
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Affiliation(s)
- Cheryl Rivard
- Cheryl Rivard, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY 14263, USA; (A.B.); (K.K.); (M.B.-T.); (A.H.)
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Buettner‐Schmidt K, Miller D, Orr M, Rykal K, Swanson K, Berry M. Compliance with North Dakota's smoke-free law among vape and tobacco specialty shops. Public Health Nurs 2021; 38:879-884. [PMID: 33938043 PMCID: PMC8453536 DOI: 10.1111/phn.12916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/11/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine compliance with North Dakota's smoke-free law in vape shops and other tobacco specialty shops selling electronic nicotine delivery systems (ENDS) or e-liquids. DESIGN In this 2019 descriptive study, shops (n = 35) were assessed for compliance with the smoke-free law by observation of indoor and outdoor areas for smoking or vaping, or evidence of such activity in prohibited areas, and the presence of required no-smoking signs. RESULTS Only two shops (5.7%) were fully compliant with the smoke-free law. Full compliance for indoor and outdoor environments was 8.5% and 42.8%, respectively. Vaping occurred inside five shops (14.3%), and smoking occurred outdoors within required smoke-free areas in two (5.7%) shops. Four (11.4%) and 17 (48.6%) shops complied with indoor and outdoor signage requirements, respectively. CONCLUSIONS Overall compliance remained low, although much of the noncompliance was related to signage. Use or evidence of ENDS use occurred both indoors and outdoors where prohibited by law. Classifying ENDS as tobacco products would require tobacco licensure of shops selling ENDS and e-liquids, aiding in identification of the shops for education and enforcement efforts to ensure compliance with the law and to improve public health protection.
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Affiliation(s)
| | - Donald Miller
- School of PharmacyNorth Dakota State UniversityFargoNDUSA
| | - Megan Orr
- Department of StatisticsNorth Dakota State UniversityFargoNDUSA
| | - Katelyn Rykal
- School of NursingNorth Dakota State UniversityFargoNDUSA
| | | | - Missy Berry
- School of NursingNorth Dakota State UniversityFargoNDUSA
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Levy DT, Sánchez-Romero LM, Travis N, Yuan Z, Li Y, Skolnick S, Jeon J, Tam J, Meza R. US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4876. [PMID: 34063672 PMCID: PMC8124578 DOI: 10.3390/ijerph18094876] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022]
Abstract
The public health impact of nicotine vaping products (NVPs) is subject to a complex set of uncertain transitions between NVP and cigarette use. Instead, we apply an indirect method to gauge the impact of NVP use on smoking prevalence and smoking-attributable deaths (SADs) using the well-established SimSmoke tobacco control policy simulation model. Upon validating the model before NVPs were more widely used, we project a No-NVP (i.e., in the absence of NVPs) while controlling for the impact of cigarette-oriented policies. The net impact of NVPs on smoking prevalence is inferred by comparing the projected No-NVP smoking trends to corresponding trends from two US national surveys. Using the TUS-CPS estimates for the period 2012-2018, we estimate that adult smoking prevalence declined in relative terms by 9.7% (95% CI: 7.5-11.7%) for males and 10.7% (95% CI: 9.1-13.0%) for females. Compared to NHIS, smoking prevalence declined by 10.7% (95% CI: 6.8-14.6%) for males and 11.3% (95% CI: 7.4-15.6%) for females. These impacts were confined mainly to ages 18-44. Vaping-related reductions in smoking prevalence were projected to avert nearly 0.4 million SADs between 2012 and 2052. Our analysis indicates that NVP use is associated with substantial reductions in US smoking prevalence among younger adults.
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Affiliation(s)
- David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA; (L.M.S.-R.); (N.T.); (Z.Y.); (Y.L.)
| | - Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA; (L.M.S.-R.); (N.T.); (Z.Y.); (Y.L.)
| | - Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA; (L.M.S.-R.); (N.T.); (Z.Y.); (Y.L.)
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA; (L.M.S.-R.); (N.T.); (Z.Y.); (Y.L.)
| | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA; (L.M.S.-R.); (N.T.); (Z.Y.); (Y.L.)
| | - Sarah Skolnick
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA; (S.S.); (J.J.); (R.M.)
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA; (S.S.); (J.J.); (R.M.)
| | - Jamie Tam
- Department of Health Policy and Management, Yale University School of Public Health, Hartford, CT 06520, USA;
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA; (S.S.); (J.J.); (R.M.)
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Amalia B, Rodríguez A, Henderson E, Fu M, Continente X, Tigova O, Semple S, Clancy L, Gallus S, Fernández E, López MJ. How widespread is electronic cigarette use in outdoor settings? A field check from the TackSHS project in 11 European countries. ENVIRONMENTAL RESEARCH 2021; 193:110571. [PMID: 33278471 DOI: 10.1016/j.envres.2020.110571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 06/12/2023]
Abstract
Exposure to secondhand aerosol from electronic cigarettes (e-cigarettes) may pose harms to bystanders, but they are used in many indoor settings. Less evidence exists on e-cigarette use in outdoor settings. This study aims to assess the use of e-cigarettes in outdoor settings in Europe. A cross-sectional study was conducted at the entrances of primary schools (N = 200), children's playgrounds (N = 200), and outdoor hospitality venues (N = 220) during 2017-2018 in major cities of 11 European countries. We performed 30-min observations and recorded e-cigarette use at three-time points: at 0 min, 15 min, and 30 min. We described the number and proportion of settings with e-cigarette use observed at any of the three-time points according to country and other contextual variables. Results showed that there were 22 (11.0%) school entrances, eight (4.0%) playgrounds, and 47 (21.3%) outdoor hospitality venues where e-cigarette use was observed at any time point. School entrances and outdoor hospitality venues with observed e-cigarette use were more frequently found in countries with a higher prevalence (≥1.4%) of e-cigarette use (school entrances: 18.0% vs. 4.0%; p = 0.002, outdoor hospitality venues: 26.7% vs. 15.0%, p = 0.036). In conclusion, the outdoor setting with the highest visibility of e-cigarette use was outdoor areas of hospitality venues. Although still limited, e-cigarettes were also used in outdoor settings frequented by children. Governments should consider measures to restrict e-cigarette use outdoors to protect the health of bystanders, particularly in areas where children may be present.
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Affiliation(s)
- Beladenta Amalia
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | | | - Elisabet Henderson
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Sean Semple
- Institute for Social Marketing, University of Stirling, Stirling, Scotland, United Kingdom
| | - Luke Clancy
- TobaccoFree Research Institute Ireland (TFRI), Dublin, Ireland
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain; School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain.
| | - Maria J López
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
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Pierce JP, Chen R, Leas EC, White MM, Kealey S, Stone MD, Benmarhnia T, Trinidad DR, Strong DR, Messer K. Use of E-cigarettes and Other Tobacco Products and Progression to Daily Cigarette Smoking. Pediatrics 2021; 147:peds.2020-025122. [PMID: 33431589 PMCID: PMC7849197 DOI: 10.1542/peds.2020-025122] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To identify predictors of becoming a daily cigarette smoker over the course of 4 years. METHODS We identified 12- to 24-year-olds at wave 1 of the US Population Assessment of Tobacco and Health Study and determined ever use, age at first use, and daily use through wave 4 for 12 tobacco products. RESULTS Sixty-two percent of 12- to 24-year-olds (95% confidence interval [CI]: 60.1% to 63.2%) tried tobacco, and 30.2% (95% CI: 28.7% to 31.6%) tried ≥5 tobacco products by wave 4. At wave 4, 12% were daily tobacco users, of whom 70% were daily cigarette smokers (95% CI: 67.4% to 73.0%); daily cigarette smoking was 20.8% in 25- to 28-year-olds (95% CI: 18.9% to 22.9%), whereas daily electronic cigarette (e-cigarette) vaping was 3.3% (95% CI: 2.4% to 4.4%). Compared with single product triers, the risk of progressing to daily cigarette smoking was 15 percentage points higher (adjusted risk difference [aRD] 15%; 95% CI: 12% to 18%) among those who tried ≥5 products. In particular, e-cigarette use increased the risk of later daily cigarette smoking by threefold (3% vs 10%; aRD 7%; 95% CI: 6% to 9%). Daily smoking was 6 percentage points lower (aRD -6%; 95% CI: -8% to -4%) for those who experimented after age 18 years. CONCLUSIONS Trying e-cigarettes and multiple other tobacco products before age 18 years is strongly associated with later daily cigarette smoking. The recent large increase in e-cigarette use will likely reverse the decline in cigarette smoking among US young adults.
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Affiliation(s)
- John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science
| | - Eric C. Leas
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | | | | | - Matthew D. Stone
- Herbert Wertheim School of Public Health and Human Longevity Science
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and,Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California
| | - Dennis R. Trinidad
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - David R. Strong
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science,,Moores Cancer Center, and
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Wamamili B, Wallace-Bell M, Richardson A, Grace RC, Coope P. Electronic cigarette use among university students aged 18-24 years in New Zealand: results of a 2018 national cross-sectional survey. BMJ Open 2020; 10:e035093. [PMID: 32571858 PMCID: PMC7311043 DOI: 10.1136/bmjopen-2019-035093] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To examine electronic cigarette use, reasons for use and perceptions of harm among university students. DESIGN Cross-sectional study. SETTING University students across New Zealand. METHODS We analysed data from a 2018 cross-sectional survey of university students, weighted to account for undersampling and oversampling by gender and university size. χ2 tests were used to compare e-cigarette use, reasons for use and perceptions of harm by age, gender, ethnicity and cigarette smoking. PARTICIPANTS The sample comprised 1476 students: 62.3% aged 18-20 years, 37.7% aged 21-24 years; 38.6% male, 61.4% female; 7.9% Māori and 92.1% non-Māori. RESULTS 40.5% of respondents (95% CI 37.9 to 43.1) reported ever, 6.1% (4.9-7.4) current and 1.7% (1.1-2.5) daily use. Regardless of frequency, 11.5% of vapers had vaped daily for ≥1 month, 70.2% of whom used nicotine-containing devices; 80.8% reported not vaping in indoor and 73.8% in outdoor smoke-free spaces. Among ever vapers, curiosity (67.4%), enjoyment (14.4%) and quitting (2.4%) were common reasons for vaping. 76.1% (73.4-78.7) of respondents believed e-cigarettes were less harmful than cigarettes.More males than females reported vaping (ever, current, daily and daily for ≥1 month), nicotine use and belief that e-cigarettes were less harmful than cigarettes. More participants aged 18-20 years reported not vaping in outdoor smoke-free spaces, vaping out of curiosity and belief that e-cigarettes were less harmful than cigarettes, while more participants aged 21-24 years vaped daily for ≥1 month and for enjoyment. More Māori than non-Māori ever vaped. More cigarette smokers than non-smokers vaped (ever, current, daily and daily for ≥1 month), used nicotine and vaped to quit, while more non-smokers did not vape in smoke-free spaces and vaped out of curiosity. CONCLUSIONS Our results suggest high prevalence of e-cigarette ever and current use, particularly among males and smokers. Many vaped out of curiosity and perceived e-cigarettes as less harmful than cigarettes.
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Affiliation(s)
- Ben Wamamili
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Mark Wallace-Bell
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Ann Richardson
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Randolph C Grace
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Pat Coope
- College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand
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Passive Exposure to Pollutants from a New Generation of Cigarettes in Real Life Scenarios. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103455. [PMID: 32429196 PMCID: PMC7277352 DOI: 10.3390/ijerph17103455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 01/25/2023]
Abstract
The use of electronic cigarettes (e-cigarettes) and heat-not-burn tobacco (HNBT), as popular nicotine delivery systems (NDS), has increased among adult demographics. This study aims to assess the effects on indoor air quality of traditional tobacco cigarettes (TCs) and new smoking alternatives, to determine the differences between their potential impacts on human health. Measurements of particulate matter (PM1, PM2.5 and PM10), black carbon, carbon monoxide (CO) and carbon dioxide (CO2) were performed in two real life scenarios, in the home and in the car. The results indicated that the particle emissions from the different NDS devices were significantly different. In the home and car, the use of TCs resulted in higher PM10 and ultrafine particle concentrations than when e-cigarettes were smoked, while the lowest concentrations were associated with HNBT. As black carbon and CO are released by combustion processes, the concentrations of these two pollutants were significantly lower for e-cigarettes and HNBT because no combustion occurs when they are smoked. CO2 showed no increase directly associated with the NDS but a trend linked to a higher respiration rate connected with smoking. The results showed that although the levels of pollutants emitted by e-cigarettes and HNBT are substantially lower compared to those from TCs, the new smoking devices are still a source of indoor air pollutants.
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