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Panagiotakos DB, Georgoulis M, Kapetanstrataki M, Behrakis P. Prevalence, patterns, and determinants of electronic cigarette and heated tobacco product use in Greece: A cross-sectional survey. Hellenic J Cardiol 2023; 70:10-18. [PMID: 36681120 DOI: 10.1016/j.hjc.2023.01.002] [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: 09/01/2022] [Revised: 12/15/2022] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Electronic cigarettes (EC) and heated tobacco products (HTP) have been introduced in the global market as safer nicotine delivery systems; however, there is skepticism about their link to smoking and long-term risks. The aim of this study was to evaluate the prevalence, patterns, and determinants of EC/HTP use in Greece. METHODS This was a cross-sectional survey of 1,044 individuals aged ≥15 years old, who were randomly selected from the general Greek population. The study was conducted in May 2022, and participants were assessed through face-to-face interviews using a questionnaire designed to collect information on smoking and EC/HTP use, as well as their sociodemographic, lifestyle, and medical data. RESULTS The use of EC/HTP was reported by 16.2% of the participants, slightly more prevalent in males (17.2%) than in females (15.2%), and significantly more prevalent in <40-year-olds (21.3%) than ≥40-year-olds (11.3%). Most EC/HTP users (72.8%) were current smokers, 13.0% were former smokers, and 14.2% were never smokers. Among users, 60.6% used nicotine-containing products, 30.2% used EC/HTP in parallel with conventional tobacco, and 56.9% used EC/HTP for the first time while being <25 years old. In multiple logistic regression analysis, younger age, being employed, being a former/current smoker, adopting a Western-type diet, and believing that EC/HTP are less harmful than conventional tobacco products and can help toward smoking cessation emerged as significant determinants of EC/HTP use. CONCLUSIONS EC/HTP are commonly used in combination with conventional tobacco, are quite popular among the youth, and also appeal to a small fraction of nonsmokers.
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Affiliation(s)
- Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 176 76 Athens, Greece.
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 176 76 Athens, Greece
| | | | - Panagiotis Behrakis
- "George D. Behrakis" Research Lab, Hellenic Cancer Society, 105 57 Athens, Greece
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Greer AE, Morgan K, Samuolis J, Diaz G, Merighi J, Mahoney P. An examination of electronic nicotine delivery system use among college students using social cognitive theory. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1839-1847. [PMID: 33253007 DOI: 10.1080/07448481.2020.1835922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/02/2020] [Accepted: 02/29/2020] [Indexed: 06/12/2023]
Abstract
Objective: Using social cognitive theory as a framework, this study examined electronic nicotine delivery systems (ENDS) use, related cognitions, and context among college students. Participants: Respondents were 1229 students attending a mid-sized, northeastern university. Methods: A cross-sectional survey was administered and SPSS was used for analysis. Results: Almost 41% of respondents reported ENDS use in the prior month (past-month user), 26.8% reported trying ENDS but no use in the prior month (occasional user), and 32.3% reported never trying ENDS. The results highlight significant associations in past-month versus occasional use and reasons for initation, location for ENDS use, perceived norms for ENDS use, and outcome expectations for ENDS use. Conclusions: This study highlights a need for theory-based, multi-level strategies to reduce ENDS use. Interventions should increase awareness about the risks of ENDS, include peer-based interventions to foster health-promoting campus social environments, and explore the use of policies restricting campus ENDS use.
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Affiliation(s)
- Anna E Greer
- Department of Public Health, Sacred Heart University, Fairfield, Connecticut, USA
| | - Kerry Morgan
- Department of Health Science, Sacred Heart University, Fairfield, Connecticut, USA
| | - Jessica Samuolis
- Department of Psychology, Sacred Heart University, Fairfield, Connecticut, USA
| | - Gabrielle Diaz
- Department of Public Health, Sacred Heart University, Fairfield, Connecticut, USA
| | - Julianna Merighi
- Department of Exercise Science, Sacred Heart University, Fairfield, Connecticut, USA
| | - Patrick Mahoney
- Department of Biology, Sacred Heart University, Fairfield, Connecticut, USA
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Intravia J, Vito AG, Rocheleau GC. Low Self-Control and Vaping: The Mediating Role of Health and Risk Perceptions. Subst Use Misuse 2022; 57:956-966. [PMID: 35341458 DOI: 10.1080/10826084.2022.2052102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Research has shown independent attention in the role of self-control and health/risk perceptions toward vaping in predicting vaping use among youth and young adults. Yet, there are good theoretical notions to believe that low self-control, perceptions toward vaping, and self-reported vaping are intertwined. OBJECTIVES To examine whether three different health/risk perceptions toward vaping mediate the effect of low self-control on vaping use among young adults. METHODS A survey was administered to 325 undergraduate students attending a large university in the Midwest (Mean age = 19.5; 60.4% female; 73.1% White). Single and multiple mediation modeling strategies were used to assess the mediation hypothesis. RESULTS Logistic regression results indicate that individuals with low self-control are more likely to vape (O.R. = 1.041, p < .05). Further, when health/risk perceptions are included in the models individually and simultaneously, it reduces the effect of low self-control on vaping between 15% and 37.5%, and renders low self-control to become non-significant. CONCLUSIONS Findings suggest the impact that harm/risk perceptions toward vaping have in engaging in this behavior. Thus, preventative efforts should target potential sources, such as media and advertisements, that may shape young adults' perceptions toward vaping.
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Affiliation(s)
- Jonathan Intravia
- Department of Criminal Justice and Criminology, Ball State University, Muncie, IN, USA
| | - Anthony G Vito
- Department of Criminal Justice and Criminology, Ball State University, Muncie, IN, USA
| | - Gregory C Rocheleau
- Department of Criminal Justice and Criminology, Ball State University, Muncie, IN, USA
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Buettner-Schmidt K, Swanson K, Maack B, Barnacle M, Miller D, Orr M, Gag MH. E-cigarettes for tobacco cessation: Not the solution. Nurse Pract 2021; 46:7-11. [PMID: 34808639 DOI: 10.1097/01.npr.0000798228.69915.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lotrean LM, Man M, Gavrilescu C, Florea M. Electronic Cigarette Use and Its Relationship with Smoking and Alcohol and Illicit Drug Consumption among Romanian University Students. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:137. [PMID: 33557228 PMCID: PMC7913983 DOI: 10.3390/medicina57020137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. Materials and methods: A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. Results: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. Conclusions: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth.
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Affiliation(s)
- Lucia Maria Lotrean
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.M.L.); (M.F.)
| | - Milena Man
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Cristina Gavrilescu
- First Medical Department, Gr. T. Popa, University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mira Florea
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.M.L.); (M.F.)
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Dang YH. Attitudes and Perceptions of Tobacco-Related Products in College Students. Innov Pharm 2020; 11:10.24926/iip.v11i3.3215. [PMID: 34007628 PMCID: PMC8075141 DOI: 10.24926/iip.v11i3.3215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the highly publicized health consequences, some college students do not perceive tobacco consumption as harmful. Historically-Black College and Universities (HBCUs) have the lowest rates of tobacco-free policies compared to other colleges, universities, and minority-serving institutions, making their students at higher risk for tobacco abuse. A campus Alcohol, Tobacco, and Other Drug Prevention Committee (ATDP) was formed and led by a pharmacist to develop all tobacco cessation policies at the HBCU. OBJECTIVES (1) To determine the knowledge and attitudes of cigarettes, cigars, smokeless tobacco, electronic cigarettes, and hookah among college students in a rural area with high tobacco usage; (2) To assess perceptions on the effectiveness of smoking cessation resources on the college campus led by the ATDP committee. METHODS A cross-sectional study was conducted on 99 students between 18 - 26 years attending a HBCU in Maryland. The online survey was disseminated to assess student's health behaviors and attitudes towards tobacco products and their successfulness in abstinence using campus resources with the Health Belief Model. RESULTS Participants had more perceived harms with smoking tobacco (cigarettes and cigars) and smokeless tobacco, and greater perceived benefits with using electronic cigarettes and hookah (P < 0.001). Most students had limited knowledge of the four tobacco categories (5.8 ± 2.6 on a 10-point Likert scale). Self-efficacy to quit was 4.2 ± 1.7 on a 10-point Likert scale despite the current resources at the HBCU. CONCLUSION Students had a perceived benefits sequential rank order with hookah, e-cigarettes, smokeless tobacco, followed by smoking tobacco. Campuses should investigate barriers for abstinence, raise awareness about the dangers of tobacco, and create programs that enhance self-efficacy when quitting. INNOVATION AND PRACTICE IMPLICATION This is the first study of its kind that compares all major tobacco products head-to-head in a rural and underrepresented population. Additionally, the development of a campus-wide tobacco policy was novel as it was pharmacist-led. The results show this population has limited knowledge of tobacco products with more perceived benefits among newer nicotine delivery systems. Targeted education and public health programs should be implemented to prevent this susceptible group from initiating and continuing tobacco products.
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Affiliation(s)
- Yen H. Dang
- University of Maryland Eastern Shore, School of Pharmacy and Health Professions, Department of Pharmacy Practice
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Knowledge, Attitudes, and Perceptions of Young Adults About Electronic Nicotine Delivery Systems in the United States: An Integrative Review. J Cardiovasc Nurs 2020; 37:86-97. [PMID: 32740220 DOI: 10.1097/jcn.0000000000000731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The causal link between cigarettes and cardiovascular disease is well known. The long-term effects of e-cigarettes are yet unknown, although early studies show biomarkers indicating inflammation and damage to endothelial cells associated with later development of cardiovascular disease. With the rapid rise in e-cigarette use, especially in young adults, it is imperative that health professionals understand the knowledge, perceptions, and motivations for use among young adults. OBJECTIVES The purpose of this integrative review is to explore existing literature on young adults' knowledge, attitudes, values, and perceptions about e-cigarettes, as well as the social norms they experience. METHODS The Whittemore and Knafl model for integrative review guided the methodology. Three databases were searched from January 2010 through December 2018. The study selection process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion and exclusion criteria were applied. Studies were evaluated for quality and strength. Key themes were extracted, coded, and synthesized. RESULTS Seventy-one full-text studies were assessed for inclusion criteria; 15 articles were included, coded, and analyzed for quality and thematic content. Current e-cigarette users represented just 3% to 35% of study participants. Three themes arose from a synthesis of the literature: "Is it bad for me?," "I just like it," and "Is it cool or not?" CONCLUSIONS Young adults are not armed with the accurate knowledge to make informed choices about using e-cigarettes. E-cigarette users are understudied and tend to value appearance and physical sensation over health. Social norms related to e-cigarette use are linked to perception of identity and the current technology-focused culture.
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Rocheleau GC, Vito AG, Intravia J. Peers, Perceptions, and E-Cigarettes: A Social Learning Approach to Explaining E-Cigarette Use Among Youth. JOURNAL OF DRUG ISSUES 2020. [DOI: 10.1177/0022042620921351] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study uses social learning theory to examine whether differential associations with e-cigarette-using peers is related to personal e-cigarette use among youth, and the extent to which this relationship is explained by personal risk perceptions of e-cigarettes. Moreover, this study tests whether the mediation process is moderated by type of e-cigarette user. This study uses a sample of high school seniors from the 2016 Monitoring the Future Study ( N = 2,100), and a subsample of e-cigarette users ( n = 523). Analyses are carried out using OLS and logistic regression. Findings demonstrate that higher levels of peer e-cigarette use are related to higher odds of personal e-cigarette use, but that risk perceptions of e-cigarettes only explain a modest portion of that relationship (about 10%). Furthermore, the mediation process does not appear to vary by type of e-cigarette user. Future directions and policy implications are discussed.
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Comiford AL, Rhoades DA, Dvorak JD, Ding K, Mehta T, Spicer P, Wagener T, Doescher MP. Use of Potentially Reduced Exposure Tobacco Products Among American Indian Smokeless Tobacco Users: Associations With Cessation Behaviors and Cotinine Levels. Public Health Rep 2020; 135:141-149. [PMID: 31835016 DOI: 10.1177/0033354919893031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES American Indian/Alaska Native (AI/AN) adults use smokeless tobacco products (eg, chewing and dip tobacco) more often than other racial/ethnic groups do. Although US adults increasingly use potentially reduced exposure tobacco products (PREPs), such as electronic cigarettes and snus, no studies have examined the use of PREPs among AI/AN smokeless tobacco users. We examined associations between current PREPs use and smokeless tobacco-related measures, including cessation attempts and cotinine levels, in a sample of American Indian adults who currently use smokeless tobacco. METHODS We collected survey and tobacco biomarker data from 299 adult American Indian smokeless tobacco users at Cherokee Nation health care facilities and events in 2016 and 2017. We used multivariable analyses to determine associations between current PREPs use and smokeless tobacco-related characteristics. RESULTS Current PREPs users were younger, less likely to be married or living with a partner, less likely to report a chronic medical condition, and more likely to report other tobacco use than PREPs nonusers. Among participants with annual household incomes ≤$30 000, current PREPs users were less likely than PREPs nonusers to report a definite desire to quit smokeless tobacco (P = .02). PREPs use was not associated with planning to quit smokeless tobacco, past 12-month smokeless tobacco quit attempts, amount of smokeless tobacco used per week, cotinine levels, or scores on the Fagerström Test for Nicotine Dependence-Smokeless Tobacco. CONCLUSIONS Our study suggests that American Indian smokeless tobacco users may not be using PREPs as a smokeless tobacco cessation aid. Future studies should take this finding into consideration when evaluating the role of PREPs use in smokeless tobacco cessation and in total tobacco cessation in this population.
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Affiliation(s)
- Ashley L Comiford
- Department of Community Health Promotions, Cherokee Nation, Tahlequah, OK, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Toral Mehta
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus OH, USA
| | - Paul Spicer
- Department of Anthropology and Center for Applied Social Research, University of Oklahoma, Norman, OK, USA
| | - Theodore Wagener
- Center for Tobacco Research and Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Mark P Doescher
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus OH, USA.,Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Javadi-Paydar M, Kerr TM, Harvey EL, Cole M, Taffe MA. Effects of nicotine and THC vapor inhalation administered by an electronic nicotine delivery system (ENDS) in male rats. Drug Alcohol Depend 2019; 198:54-62. [PMID: 30878767 PMCID: PMC6467722 DOI: 10.1016/j.drugalcdep.2019.01.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS, e-cigarettes) are increasingly used for the self-administration of nicotine by various human populations, including previously nonsmoking adolescents. Studies in preclinical models are necessary to evaluate health impacts of ENDS including the development of nicotine addiction, effects of ENDS vehicles, flavorants and co-administered psychoactive substances such as Δ9-tetrahydrocannabinol (THC). This study was conducted to validate a rat model useful for the study of nicotine effects delivered by inhalation of vapor created by ENDS. METHODS Male Sprague-Dawley rats (N = 8) were prepared with radio telemetry devices for the reporting of temperature and activity. Experiments subjected rats to inhalation of vapor generated by an electronic nicotine delivery system (ENDS) adapted for rodents. Inhalation conditions included vapor generated by the propylene glycol (PG) vehicle, Nicotine (1, 10, 30 mg/mL in the PG) and THC (12.5, 25 mg/mL). RESULTS Nicotine inhalation increased spontaneous locomotion and decreased body temperature of rats. Pretreatment with the nicotinic cholinergic receptor antagonist mecamylamine (2 mg/kg, i.p.) prevented stimulant effects of nicotine vapor inhalation and attenuated the hypothermic response. Combined inhalation of nicotine and THC resulted in apparently independent effects which were either additive (hypothermia) or opposed (activity). CONCLUSIONS These studies provide evidence that ENDS delivery of nicotine via inhalation results in nicotine-typical effects on spontaneous locomotion and thermoregulation in male rats. Effects were blocked by a nicotinic antagonist, demonstrating mechanistic specificity. This system will therefore support additional studies of the contribution of atomizer/wick design, vehicle constituents and/or flavorants to the effects of nicotine administered by ENDS.
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Affiliation(s)
| | - Tony M. Kerr
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Eric L. Harvey
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Maury Cole
- La Jolla Alcohol Research, Inc., La Jolla, CA, USA
| | - Michael A. Taffe
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA,Correspondence: Michael A. Taffe, Department of Neuroscience, The Scripps Research Institute, SP30-2400 10550 North Torrey Pines Road, La Jolla, CA 92037, Phone: +1.858.784.7228 Fax: +1.858.784.7405
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