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Liu J, Keller-Hamilton B, Patterson JG, Lee DN, Wedel AV, Vázquez-Otero C, Stevens EM. How Age and E-cigarette Use Status Interact to Influence E-cigarette Ad Perceptions. Subst Use Misuse 2022; 58:257-265. [PMID: 36510786 PMCID: PMC9877189 DOI: 10.1080/10826084.2022.2155479] [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] [Indexed: 12/14/2022]
Abstract
Background: The prevalence of e-cigarette use among young people remains high. Young people are susceptible to e-cigarette advertising, although potential heterogeneity in perceptions of e-cigarette ads with respect to age and e-cigarette use history remains unexplored. We aimed to assess differences in perceptions of e-cigarette ads and product use intention, by age and e-cigarette use status. Methods: Participants from an online convenience sample (N = 497, Mage=31.9) viewed two randomly selected e-cigarette ads and reported their perceptions of the ads and product use intention. We used mixed effects linear regression models to estimate associations between age group (18-20 years, 21-25 years, 26+ years), e-cigarette use status (never, former, and current use), and their interaction effects, on outcomes related to perceptions of ads and use intention. Models controlled for demographics and other tobacco use. Results: Current e-cigarette users (vs. never users) and participants who were 26+ years old (vs. 18-20 years old) had greater liking of the ads, perceived ad relevance, and perceived ad effectiveness. Among current e-cigarette users, participants who were 26+ years old (vs. 18-20 years old) had lower use intention. Conclusion: The effect of e-cigarette ad exposures on perceptions of the ad and use intention is heterogeneous with respect to age group and e-cigarette use history. While ads appealed more to adults who were 26+ years old across e-cigarette use groups, current e-cigarette users who were 18-20 years old demonstrated high use intention following ad exposure, suggesting a need for marketing interventions to mitigate continued e-cigarette use among young people.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, The Ohio State University College of Medicine, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Joanne G Patterson
- Division of Epidemiology, The Ohio State University College of Public Health, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Donghee N Lee
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School
| | - Amelia V. Wedel
- Department of Clinical Psychology, Syracuse University, Syracuse, NY
| | - Coralia Vázquez-Otero
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX
| | - Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School
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2
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Fahey MC, Talcott WG, Robinson LA, Mallawaarachchi I, Klesges RC, Little MA. Predictors of Cessation Outcomes Among Older Adult Smokers Enrolled in a Proactive Tobacco Quitline Intervention. J Aging Health 2022; 34:1144-1155. [PMID: 35506995 DOI: 10.1177/08982643221097679] [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: 11/15/2022]
Abstract
OBJECTIVES To identify predictors of older adults' likelihood of quitting following engagement in a proactive tobacco quit line. METHODS Older (>60 years) participants (N = 186) enrolled in a four-session quit line with 8-weeks of nicotine replacement therapy reported demographics, beliefs, and information about tobacco use. Point prevalence abstinence was reported at 3 and 12-months. RESULTS In final models, endorsement of quitting to take control of one's life and confidence in quitting were positively associated with 3-month cessation (OR = 1.74, 95% CI = 1.16, 2.62; OR = 1.75, 95% CI = 1.21, 2.52, respectively). At 12 months, stronger endorsement of quitting to take control of one's life and decreased nicotine dependence were associated with higher cessation (OR = 1.51, 95% CI = 1.05, 2.17; OR = 0.84, 95% CI = 0.71,0.99, respectively). DISCUSSION For tobacco cessation among older adults, programs should provide additional support to those with higher nicotine dependence, promote quitting self-efficacy, and encourage quitting as means to gain control of life and health.
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Affiliation(s)
- Margaret C Fahey
- 5415Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Wayne G Talcott
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
- 438578Joint Base San Antonio-Lackland, San Antonio, TX, USA
| | - Leslie A Robinson
- 5415Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
| | - Robert C Klesges
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
- 438578Joint Base San Antonio-Lackland, San Antonio, TX, USA
| | - Melissa A Little
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
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3
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Yao Y, Liu K, Zhang J(J, Iso H, Lam TH. Tobacco smoking and older people amid the COVID-19 pandemic: an elephant in the room. Age Ageing 2021; 50:1865-1867. [PMID: 34314479 PMCID: PMC8344474 DOI: 10.1093/ageing/afab170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Yao Yao
- Address correspondence to: Yao Yao, China Center for Health Development Studies and National School of Development, Peking University, China.
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Junfeng (Jim) Zhang
- Global Health Institute and the Nicholas School of Environment, Duke University, Durham, NC, United States
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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4
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The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey. J Community Health 2021; 47:63-70. [PMID: 34357496 DOI: 10.1007/s10900-021-01019-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Dual use of conventional cigarettes and electronic cigarettes presents an emerging public health issue. Previous research has demonstrated a negative relationship between health literacy and conventional cigarette (CIG) use. However, the relationship between health literacy and e-cigarette (ECIG) use remains unclear. This studies examines the possible association of health literacy and CIG, ECIG, or dual use. A multinomial regression was used to model the association between health literacy and current CIG use, current ECIG use, or dual tobacco use status using state-optional data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 40,404). One-third of the sample (N = 13,478; 33.3%) had initiated tobacco use. Approximately 36.6% of participants exclusively used cigarettes. A smaller proportion of participants were dual users of ECIG and CIGs (7.0%) and e-cigarette exclusive users (4.5%). After adjusting for covariates, higher levels of oral health literacy was associated with lower odds of current dual use. However, there was no significant association between written HL and either conventional cigarette use or electronic cigarette use or after adjusting for covariates. Oral messaging around the dangers of CIG use may be effective at lowering odds of CIG or dual use, especially for those with higher levels of HL. Further research is needed to examine how to best disseminate information regarding the health risks of ECIGs.
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Lee YS, Yang K, Kameg B, Palmer J, Lee H. Characteristics of electronic cigarette user and traditional smokers: 2017 Youth risk behavior surveillance system. Public Health Nurs 2021; 38:1030-1038. [PMID: 34101886 DOI: 10.1111/phn.12936] [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: 12/30/2020] [Revised: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although electronic cigarette (e-cigarette) use among adolescents rapidly has increased over the past decade, which has raised concerns over the corresponding behavioral health risks, the current literature presents limited data for understanding the characteristics of adolescent e-cigarette users. OBJECTIVE The purpose of this study was to (1) identify general characteristics that may be shared between e-cigarette users and traditional cigarette smokers and (2) examine the unique characteristics of e-cigarette users vis-à-vis traditional cigarette smokers. DESIGN Cross-sectional descriptive study. SAMPLE AND DATA SOURCE A total of 14,765 9th- to 12-grade students drawn from the CDC 2017 Youth Risk Behavior Surveillance System. RESULTS We observed that the prevalence of marijuana, alcohol, and other illicit drug use was higher among e-cigarette users and traditional tobacco users than non-users. Moreover, physically active adolescents were more likely to use e-cigarettes than those who were physically inactive, although the level of the activity did not predict smoking status. CONCLUSION We recommend that primary prevention strategies for e-cigarette use should be incorporated in physical education programs and target adolescents who engage in not only health risk behaviors, but also health promoting behaviors, such as physical activity.
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Affiliation(s)
- Young-Shin Lee
- School of Nursing, San Diego State University, San Diego, California, USA
| | - Kyeongra Yang
- School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - Brayden Kameg
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Josh Palmer
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Heeyoung Lee
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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6
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Gallus S, Borroni E, Odone A, van den Brandt PA, Gorini G, Spizzichino L, Pacifici R, Lugo A. The Role of Novel (Tobacco) Products on Tobacco Control in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1895. [PMID: 33669394 PMCID: PMC7920305 DOI: 10.3390/ijerph18041895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
In Italy, electronic cigarettes have spread since 2010 and heated tobacco products (HTP) since 2016. We investigated their public health consequences on conventional cigarette smoking, taking advantage of a series of cross-sectional studies annually conducted between 2001 and 2019 in Italy. Every year, the sample, including around 3000 individuals, was representative of the general Italian population aged ≥15 years. In Italy, smoking prevalence steadily declined from 29.1% in 2001 to 20.6% in 2013, then increased to 22.0% in 2019. In 2017-2019, current electronic cigarette users were 2.1% and in 2019 current HTP users were 1.1%. Among 498 ever electronic cigarette users, 23.2% started or re-started smoking and 15.7% quit smoking after electronic cigarette use; of 49 ever HTP users, 19.1% started or re-started smoking combusted cigarettes and 14.6% quit smoking after HTP use. The availability of novel products in Italy resulted in a halt of the decreasing trend in smoking prevalence. For the first time, we observed an increase of Italians inhaling nicotine, concurrently with the spread of novel (tobacco) products. More importantly, the use of novel products appears to increase-rather than decrease-the likelihood of smoking conventional cigarettes. Considering this evidence, we see no argument to justify the huge fiscal and regulatory benefits these products continue to have, at least in Italy.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Elisa Borroni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Piet A. van den Brandt
- Department of Epidemiology, CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands;
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), 50139 Florence, Italy;
| | - Lorenzo Spizzichino
- Italian Ministry of Health, Center for Disease Prevention and Control, 00144 Rome, Italy;
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
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Abstract
Introduction: The rate of Jordanian tobacco smokers has been reported to be one of the highest rates in the world. The electronic cigarette (E-cig) has become an option, or an alternative, to tobacco cigarette smoking. This study was aimed to measure the perception of Jordanian adults toward E-cig use. Methods: A cross-sectional study design was used. A self-administered survey was developed and validated to solicit anonymous responses from the study participants. A convenience sample (n = 984) was recruited electronically through social media platforms. Descriptive statistics and correlation analyses were completed using the Statistical Package for the Social Sciences (SPSS). Results: More than half of the participants (53%) were females, and almost all participants had heard about E-cig (99.2%), mainly from their friends (40%) and social media (34.5%). About half of the participants were nonsmokers and around one-third of them (33.1%) were current E-cig users. The majority of the participating E-cig users had replaced tobacco with E-cig (56.4%)/All the E-cig users reported positive beliefs toward the E-cig as a safer alternative for tobacco smoking. About 45% of participants believed that the E-cig is helpful in tobacco smoking cessation, but should be highly regulated. Conclusion: This study illustrated a significant prevalence of E-cig usage among Jordanian adults. E-cig users perceived E-cig as a safer and cheaper alternative to tobacco smoking and that it helps in tobacco smoking cessation. However, health awareness campaigns are needed for the entire Jordanian community about E-cig use, related emerging health findings, and how to promote tobacco smoking cessation.
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8
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Gathright EC, Wu WC, Scott-Sheldon LAJ. Electronic cigarette use among heart failure patients: Findings from the Population Assessment of Tobacco and Health study (Wave 1: 2013-2014). Heart Lung 2020; 49:229-232. [PMID: 31812280 PMCID: PMC7266714 DOI: 10.1016/j.hrtlng.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Smoking cessation is recommended for adults with heart failure (HF). The prevalence of e-cigarette use among adults with HF is unknown. OBJECTIVE To determine prevalence of and reasons for e-cigarette use among adults with HF. METHODS Data from the Population Assessment of Tobacco and Health Study (Wave 1) were examined. RESULTS Of 484 respondents with HF, 1% (weighted) reported current e-cigarette use, and 5% (weighted) reported dual cigarette/e-cigarette use. Adults with HF had higher odds of dual use (OR = 1.76, 95% CI: 1.22-2.54) compared to those without HF, controlling for age, sex, race, and income. Dual users with HF reported using e-cigarettes because they may be less harmful to nearby people and to themselves than cigarettes. CONCLUSIONS E-cigarette use should be assessed and monitored to understand the safety and potential efficacy of e-cigarettes as a harm reduction approach for HF patients.
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Affiliation(s)
- Emily C Gathright
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, United States.
| | - Wen-Chih Wu
- Center forCardiac Fitness, The Miriam Hospital, Providence, RI, United States; Department of Medicine, Alpert School of Medicine, Brown University, Providence, RI, United States; Veterans Affairs Hospital, Providence, RI, United States
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Avenue, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, United States; Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
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9
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Collins L, Glasser AM, Abudayyeh H, Pearson JL, Villanti AC. E-Cigarette Marketing and Communication: How E-Cigarette Companies Market E-Cigarettes and the Public Engages with E-cigarette Information. Nicotine Tob Res 2020; 21:14-24. [PMID: 29315420 DOI: 10.1093/ntr/ntx284] [Citation(s) in RCA: 161] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 12/28/2017] [Indexed: 12/26/2022]
Abstract
Introduction Given the lack of regulation on marketing of electronic cigarettes (e-cigarettes) in the United States and the increasing exchange of e-cigarette-related information online, it is critical to understand how e-cigarette companies market e-cigarettes and how the public engages with e-cigarette information. Methods Results are from a systematic review of peer-reviewed literature on e-cigarettes via a PubMed search through June 1, 2017. Search terms included: "e-cigarette*" or "electronic cigarette" or "electronic cigarettes" or "electronic nicotine delivery" or "vape" or "vaping." Experimental studies, quasi-experimental studies, observational studies, qualitative studies, and mixed methods studies providing empirical findings on e-cigarette marketing and communication (ie, nonmarketing communication in the public) were included. Results One hundred twenty-four publications on e-cigarette marketing and communication were identified. They covered topics including e-cigarette advertisement claims/promotions and exposure/receptivity, the effect of e-cigarette advertisements on e-cigarette and cigarette use, public engagement with e-cigarette information, and the public's portrayal of e-cigarettes. Studies show increases in e-cigarette marketing expenditures and online engagement through social media over time, that e-cigarettes are often framed as an alternative to combustible cigarettes, and that e-cigarette advertisement exposure may be associated with e-cigarette trial in adolescents and young adults. Discussion Few studies examine the effects of e-cigarette marketing on perceptions and e-cigarette and cigarette use. Evidence suggests that exposure to e-cigarette advertisements affects perceptions and trial of e-cigarettes, but there is no evidence that exposure affects cigarette use. No studies examined how exposure to e-cigarette communication, particularly misleading or inaccurate information, impacts e-cigarette, and tobacco use behaviors. Implications The present article provides a comprehensive review of e-cigarette marketing and how the public engages with e-cigarette information. Studies suggest an association between exposure to e-cigarette marketing and lower harm perceptions of e-cigarettes, intention to use e-cigarettes, and e-cigarette trial, highlighting the need to for advertising regulations that support public health goals. Findings from this review also present the methodological limitations of the existing research (primarily due to cross-sectional and correlational analyses) and underscore the need for timely, rigorous research to provide an accurate understanding of e-cigarette marketing and communication and its impact on e-cigarette and tobacco product use.
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Affiliation(s)
- Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Jennifer L Pearson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,School of Community Health Sciences, University of Nevada, Reno, NV
| | - Andrea C Villanti
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
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10
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Beard EV, West R, Jarvis M, Michie S, Brown J. 'S'-shaped curve: modelling trends in smoking prevalence, uptake and cessation in Great Britain from 1973 to 2016. Thorax 2019; 74:875-881. [PMID: 31391317 PMCID: PMC6824614 DOI: 10.1136/thoraxjnl-2018-212740] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/27/2019] [Accepted: 03/18/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND It is believed that declines in smoking prevalence naturally slow over time as the smoking population 'hardens' and that progress has come primarily from reducing uptake rather than increasing cessation. To address these issues, we undertook the first formal attempt to model the trajectory of smoking prevalence and indices of uptake and cessation in Great Britain from 1973 to 2016. METHODS Using data from the General Lifestyle Survey between 1973 and 2008, the Integrated Household Survey between 2009 and 2014 and the Annual Population Survey between 2015 and 2016, this study modelled year-on-year changes in smoking prevalence, ever-smoking in 18-24-year-olds as an index of uptake, and quit ratios as an index of cessation. RESULTS For all three outcomes, changes over time were best fitted by what may be broadly characterised as 'S'-shaped curves: segmented functions characterised by initial rapid progress, a slowing or reversal, then renewed progress. Smoking prevalence in Great Britain showed a decelerating decline over time between 1973 and 2000, but then, after the introduction of the National 'Smoking Kills' tobacco control plan, the decline accelerated again and has remained nearly linear at -0.67 percentage points per year. Ever-smoking showed a decelerating decline which eventually ceased and began increasing around 1994 but then declined again after 2000. Quit ratios rose rapidly then slowed and then accelerated around 2000 and again more recently in 2013. CONCLUSION Long-term trends in smoking prevalence, uptake and cessation have followed a broadly 'S'-shaped trend suggesting that they are responsive to major tobacco control initiatives. The decline in prevalence has resulted both from reductions in uptake and increases in cessation.
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Affiliation(s)
- Emma Victoria Beard
- Department of Behavioural Science and Health, University College London, London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Martin Jarvis
- Department of Behavioural Science and Health, University College London, London, UK
| | - Susan Michie
- Research Department of Clinical, Educational and Health Psychology, University College London, Sheffield, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
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11
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Chaffee BW. Electronic Cigarettes: Trends, Health Effects and Advising Patients Amid Uncertainty. JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION 2019; 47:85-92. [PMID: 30976150 PMCID: PMC6454567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dental professionals can be effective tobacco prevention and cessation partners. Electronic cigarettes (e-cigarettes), which deliver aerosolized nicotine but fewer toxicants than found in cigarette smoke, present new and contentious questions for clinicians, patients, and researchers. Evidence suggests e-cigarettes are not harmless but are less dangerous than cigarettes. Smoking cessation effectiveness is unproven and oral and systemic health effects remain under study. Dental professionals must stay informed to provide patients truthful information as new data emerge.
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12
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Haddad C, Salman R, El-Hellani A, Talih S, Shihadeh A, Saliba NA. Reactive Oxygen Species Emissions from Supra- and Sub-Ohm Electronic Cigarettes. J Anal Toxicol 2019; 43:45-50. [PMID: 30192935 PMCID: PMC6376456 DOI: 10.1093/jat/bky065] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/25/2018] [Indexed: 12/24/2022] Open
Abstract
Electronic cigarettes (ECIGs) are battery-powered devices that heat and vaporize solutions containing propylene glycol (PG) and/or vegetable glycerin (VG), nicotine and possible trace flavorants to produce an inhalable aerosol. The heating process can lead to the formation of reactive oxygen species (ROS), which are linked to various oxidative damage-initiated diseases. Several studies in the literature have addressed ROS emissions in ECIG aerosols, but the effects of power, ECIG device design and liquid composition on ROS are relatively unknown. In addition, ROS emissions have not been examined in the emerging high power, sub-Ohm device (SOD) category. In this study, an acellular 2',7'-dichlorofluorescin (DCFH) probe technique was optimized to measure ROS in ECIG aerosols. The technique was deployed to measure ROS emissions in SOD and supra-Ohm ECIGs while varying power, heater coil head design and liquid composition (PG/VG ratio and nicotine concentration). Liquids were made from analytical standards of PG, VG and nicotine and contained no flavorants. At high powers, ROS emissions in ECIGs and combustible cigarettes were similar. Across device designs, ROS emissions were uncorrelated with power (R2 = 0.261) but were highly correlated with power per unit area (R2 = 0.78). It was noticed that an increase in the VG percentage in the liquid yielded higher ROS flux, and nicotine did not affect ROS emissions. ROS emissions are a function of device design and liquid composition at a given power. For a given liquid composition, a promising metric for predicting ROS emissions across device designs and operating conditions is power per unit area of the heating coil. Importantly, ROS formation is significant even when the ECIG liquid consists of pure analytical solutions of PG and VG; it can therefore be viewed as intrinsic to ECIG operation and not solely a by-product of particular flavorants, contaminants or additives.
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Affiliation(s)
- Christina Haddad
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Najat Aoun Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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13
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Nabi-Burza E, Regan S, Walters BH, Drehmer JE, Rigotti NA, Ossip DJ, Gorzkowski JA, Levy DE, Winickoff JP. Parental Dual Use of e-Cigarettes and Traditional Cigarettes. Acad Pediatr 2019; 19:842-848. [PMID: 30981026 PMCID: PMC6732020 DOI: 10.1016/j.acap.2019.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/02/2019] [Accepted: 04/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND E-cigarettes are growing in popularity. Dual use of e-cigarettes and cigarettes is an increasingly common practice, but little is known about patterns of dual use in parents. We sought to describe smoking-related behaviors among dual-users. METHODS Parent exit surveys were conducted following their child's visit in 5 control pediatric practices in 5 states participating in the Clinical Effort Against Secondhand Smoke Exposure trial. We examined factors associated with dual use of e-cigarettes and cigarettes versus cigarette-only smokers, assessed by self-report. RESULTS Of 1382 smokers or recent quitters screened after their child's visit between April and October 2017, 943 (68%) completed the survey. Of these, 727 parents reported current use of cigarettes; of those, 81 (11.1%) also reported e-cigarette use, meeting the definition of dual use. Compared with cigarette-only smokers, dual users were more likely to have a child younger than 1 year old, planned to quit in the next 6 months, and had tried to quit in the past (had a quit attempt in the past 3 months, called the quitline, or used medicine to quit in the past 2 years; P < .05 for each). CONCLUSIONS Parents who use both e-cigarettes and cigarettes may have greater rates of contemplating smoking cessation than parents who only smoke cigarettes. These parents may be using e-cigarettes for harm reduction or as a step toward cessation. Identification of these parents may provide an opportunity to deliver effective treatment, including nicotine-replacement therapies that do not expose infants and children to e-cigarette aerosol.
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Affiliation(s)
- Emara Nabi-Burza
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Susan Regan
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Bethany Hipple Walters
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Jeremy E. Drehmer
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Nancy A. Rigotti
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,Massachusetts General Hospital, Mongan Institute Health Policy Center
| | - Deborah J. Ossip
- University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY
| | - Julie A. Gorzkowski
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL
| | - Douglas E. Levy
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,Massachusetts General Hospital, Mongan Institute Health Policy Center
| | - Jonathan P. Winickoff
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL
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14
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Goldberg RL, Dankiewicz C, Cataldo JK. Older Smokers' Beliefs About e-Cigarettes and Intent to Quit Conventional Cigarettes. J Gerontol Nurs 2018; 44:17-24. [PMID: 30484844 DOI: 10.3928/00989134-20181018-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 09/13/2018] [Indexed: 11/20/2022]
Abstract
To explore associations between older smokers' attitudes and beliefs about electronic cigarettes (e-cigarettes) and tobacco use behavior, descriptive and correlational analysis of a cross-sectional survey of a random national sample of current smokers (age ≥45 years [considered "older" herein]) was performed. Of 498 older smokers, 75% wanted to quit smoking cigarettes and 60% had tried e-cigarettes. The 108 current e-cigarette users believed e-cigarettes help quit cigarettes (p < 0.001), are safer than cigarettes (p = 0.002), and are acceptable to friends (p = 0.010) and family (p = 0.007). Smokers not considering cessation believed friends and family think it is okay to smoke cigarettes (p < 0.001). Among older smokers: (a) most want to quit cigarettes; (b) e-cigarette use is increasing; (c) most believe e-cigarettes are healthier than cigarettes and effective for cessation; and (d) perceived social acceptability modifies tobacco use behavior by influencing initiation and maintenance of conventional cigarette and e-cigarette use. [Journal of Gerontological Nursing, 44(12), 17-24.].
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15
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King JL, Reboussin D, Cornacchione Ross J, Wiseman KD, Wagoner KG, Sutfin EL. Polytobacco Use Among a Nationally Representative Sample of Adolescent and Young Adult E-Cigarette Users. J Adolesc Health 2018; 63:407-412. [PMID: 30115508 PMCID: PMC6388402 DOI: 10.1016/j.jadohealth.2018.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/02/2018] [Accepted: 04/18/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Electronic nicotine delivery systems (ENDS) are adolescents' most commonly used tobacco product and young adults' second most used. Little is known about ENDS use alongside other tobacco products (polytobacco use) and whether exclusive ENDS users differ from polytobacco ENDS users. METHODS In spring 2016, we surveyed a nationally representative sample of 3,517 13-25-year olds (36.9% 13-17-year olds), and examined sociodemographic and relative risk perceptions between two groups of past 30-day ENDS users: exclusive (only ENDS) and polytobacco (ENDS and at least one other tobacco product). RESULTS 4.5% of adolescents and 10% of young adults reported past 30-day ENDS use (n = 281; analytic sample). ENDS users were 38.8% female and 70.6% white. Over half (55.9%) were polytobacco ENDS users. The most common patterns of polytobacco ENDS use were ENDS and cigarettes (11.5%), ENDS and cigars (7.7%), and ENDS, cigars, and waterpipe (5.2%). Those who perceived ENDS to be less harmful than cigarettes were more likely to be exclusive ENDS users than those who perceived ENDS to be as or more harmful than cigarettes (adjusted odds ratio = 2.6, confidence interval = 1.2, 5.7). There were no differences between ENDS groups on age, race, sex, parental education, sexual orientation, or ENDS use frequency. CONCLUSIONS Just over half of ENDS users also used other tobacco products, increasing their risk for nicotine addiction and other health harms. The Food and Drug Administration is responsible for communicating product risk to consumers and should consider common patterns of use and relative risk perceptions in its ENDS public education efforts.
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Affiliation(s)
- Jessica L King
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - David Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly G Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
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16
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Kim B, Yoo S, Cho SI. Association between stages of change for smoking cessation and electronic cigarette use among adult smokers: A nationwide cross-sectional study in Korea. PLoS One 2018; 13:e0204244. [PMID: 30235294 PMCID: PMC6147483 DOI: 10.1371/journal.pone.0204244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 09/04/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate whether smokers who are ready to quit are more likely to use electronic cigarette (e-cigarette) than those who are not. The association between the ever and current use of e-cigarettes with the stages of change (SOC) model was examined, which reflects the readiness to quit smoking. Current smokers were categorized based on the SOC (precontemplation, contemplation, and preparation). We investigated the associations between quit attempts, intention to quit, and stage of change with e-cigarette use in the general population and different age groups. We used data from the Korea Community Health Survey that was conducted nationwide in 2014, and 45,378 current smokers were included in the study. Adult smokers were more likely to use e-cigarettes simultaneously in the preparation and contemplation stages than in the precontemplation stage (adjusted odds ratio [AOR] of preparation stage: 2.88 and 95% confidence interval [CI]: 2.26–3.66; AOR of contemplation stage: 1.93 and 95% CI: 1.67–2.24). Ever use of e-cigarette was significantly associated with the contemplation stage in smokers younger than 50 years, while current e-cigarette use was greater in the contemplation stage than in the precontemplation stage at all ages. Both ever and current use of e-cigarettes were significantly related with the preparation stage among all age groups except 50–59 years. Because the use of e-cigarette among smokers may continually increase, public health guidance must be provided to different types of dual users. Previous studies on the association between e-cigarette use and the cognitive and behavioral aspects of smokers have conflicting results. This study highlights whether the use of e-cigarettes can be used as an indicator for the readiness to quit smoking. Thus, counselors can encourage smoking cessation and provide tailored interventions.
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Affiliation(s)
- Boram Kim
- Bureau of Public Health Policy, Office for Healthcare Policy, Ministry of Health and Welfare, Sejong-si, Korea
| | - Seunghyun Yoo
- Department of Public Health Science, Graduate School of Public Health, and Institute of Health and Environment, Seoul National University, Seoul, Korea
- * E-mail:
| | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, and Institute of Health and Environment, Seoul National University, Seoul, Korea
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17
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Goldberg RL, Cataldo JK. Using an e-Cigarette is Like Eating Tofu When You Really Want Meat. Am J Health Behav 2018; 42:54-64. [PMID: 30688641 DOI: 10.5993/ajhb.42.5.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective Whereas controversy about the e-cigarette's effectiveness and safety as a smoking cessation tool continues, e-cigarette use prevalence continues rising. In this study, we sought to describe experiences of adult e-cigarette users and to examine their motivations, beliefs, and use patterns. Methods This qualitative study included one-on-one semi-structured phone interviews with 20 current California e-cigarette users (mean age = 38 ± 9.44 years). Interviews were transcribed and thematically analyzed using MAXQDA. Results E-cigarettes initially addressed participants' problems related to smoking; they no longer smelled like cigarette smoke and could avoid smoke-free regulations. Participants highlighted the importance of e-cigarette flavors and of "receiving moral credit" for harm reduction by using e-cigarettes to quit smoking cigarettes. Many described eventual dissatisfaction with e-cigarettes, which resulted in relapse to cigarette smoking and/or dual use with cigarettes. The convenience of e-cigarettes coupled with the pattern of constant use left participants increasingly reliant on e-cigarettes. Conclusion Ultimately, failed cessation and dual use exposes smokers to greater levels of nicotine, while still exposing them to cigarette smoke. Public health campaigns should promote awareness of the risks of using e-cigarettes, including failed cessation attempts, dual use, addiction, and other health consequences.
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Affiliation(s)
- Rachel L Goldberg
- Clinical Research Coordinator, Department of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
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18
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Auf R, Trepka MJ, Selim M, Ben Taleb Z, De La Rosa M, Cano MÁ. E-cigarette marketing exposure and combustible tobacco use among adolescents in the United States. Addict Behav 2018; 78:74-79. [PMID: 29127787 DOI: 10.1016/j.addbeh.2017.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/27/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022]
Abstract
E-cigarette advertising has been shown to be associated with use of e-cigarettes, but its association with tobacco use has not been studied. Therefore, we examined the association between e-cigarettes advertisement and tobacco use. Data from nationally representative 22,007 middle and high school students (grades 6-12) were used to conduct the analysis. Logistic regression models estimated the adjusted odds ratios (AOR) of ever and current use of cigarette, hookah, cigar, and polytobacco use. Odds ratios were weighted and adjusted for study design, non-response rates, school level, gender, race/ethnicity, e-cigarette use, and smoking at home. E-cigarette marketing exposure was significantly associated with ever use of cigarettes (AOR: 1.3, 95% CI: 1.1-1.5), hookah (AOR: 1.4, 95% CI: 1.2-1.7), cigars (AOR: 1.5, 95% CI: 1.4-1.6), and polytobacco (AOR: 1.7, 95% CI: 1.5-1.8). Likewise, E-cigarette marketing exposure was significantly associated with current use of cigarettes (AOR: 1.3, 95% CI: 1.1-1.6), hookah (AOR: 1.3, 95% CI: 1.03-1.7), cigars (AOR: 1.3, 95% CI: 1.1-1.6), and polytobacco use (AOR: 1.8, 95% CI: 1.5-2.1). The results suggest that e-cigarette advertisement is associated with use of cigarettes, hookah, cigars, and polytobacco products. These results add to the evidence about the risks of e-cigarette marketing and highlight the need for stricter regulation of e-cigarette advertisements.
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Affiliation(s)
- Rehab Auf
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA; Center for Research on U.S. Latino HIV/AIDS and Drug Abuse [CRUSADA], Florida International University, Miami, FL 33199, USA
| | - Moaz Selim
- Jackson South Community Hospital, Miami, FL 33176, USA
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse [CRUSADA], Florida International University, Miami, FL 33199, USA; School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA; Center for Research on U.S. Latino HIV/AIDS and Drug Abuse [CRUSADA], Florida International University, Miami, FL 33199, USA
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19
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Qasim H, Karim ZA, Rivera JO, Khasawneh FT, Alshbool FZ. Impact of Electronic Cigarettes on the Cardiovascular System. J Am Heart Assoc 2017; 6:JAHA.117.006353. [PMID: 28855171 PMCID: PMC5634286 DOI: 10.1161/jaha.117.006353] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Jose O Rivera
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
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20
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Rousu MC, O'Connor R, Corrigan J. Effect of brand and advertising medium on demand for e-cigarettes: Evidence from an experimental auction. Prev Med Rep 2017; 7:11-15. [PMID: 28540162 PMCID: PMC5432678 DOI: 10.1016/j.pmedr.2017.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/23/2017] [Accepted: 04/23/2017] [Indexed: 11/03/2022] Open
Abstract
Print and television advertisements for e-cigarettes are currently legal in the United States. Given that e-cigarettes are a lower-risk alternative to cigarettes, these ads could have a positive public health impact if they motivate smokers to switch to e-cigarettes. However, the public health impact of e-cigarette ads could be negative if ads increase demand for both e-cigarettes and cigarettes. We use experimental auctions -in which participants bid in real auctions and winners pay for the items they purchase - to study the effect of print and TV e-cigarettes ads on demand for the brand from the ad, for another e-cigarettes brand, and for cigarettes. We ran experiments with 288 Pennsylvania smokers in November 2014-March 2015 and we found that in cases where an ad affects demand for e-cigarettes, the ad moves demand for cigarettes in the same direction. For example, the Blu print ad increases demand for Blu e-cigarettes and cigarettes among non-white participants. The Vuse TV ad reduces demand for both types of e-cigarettes and for cigarettes. We also find that non-white participants are willing to pay more for e-cigarettes in the absence of advertising, and that smokers who worry most about their health are willing to pay more for e-cigarettes. The results of this study point to the need for greater scrutiny of advertising for e-cigarette products such that they do not also induce demand for tobacco cigarettes.
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Affiliation(s)
- Matthew C Rousu
- Susquehanna University, 514 University Avenue, Selinsgrove, PA 17870, United States
| | - Richard O'Connor
- Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, United States
| | - Jay Corrigan
- Kenyon College, 103 College Road, Gambier, OH 43022, United States
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21
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Majeed BA, Weaver SR, Gregory KR, Whitney CF, Slovic P, Pechacek TF, Eriksen MP. Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012-2015. Am J Prev Med 2017; 52:331-338. [PMID: 28341303 PMCID: PMC5373478 DOI: 10.1016/j.amepre.2016.08.039] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/18/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Although the impact of long-term use of electronic cigarettes (e-cigarettes) on health is still unknown, current scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes. The study examined whether perceived relative harm of e-cigarettes and perceived addictiveness have changed during 2012-2015 among U.S. adults. METHODS Data were from Tobacco Products and Risk Perceptions surveys of probability samples representative of U.S. adults in 2012, 2014, and 2015. Changes over time in perceived harmfulness of e-cigarettes were examined using pairwise comparisons of proportions and multinomial logistic regression analysis. Analyses were conducted in January 2016. RESULTS Whereas 11.5% and 1.3% of adults perceived e-cigarettes to have about the same level of harm and to be more harmful than cigarettes, respectively, in 2012, 35.7% and 4.1% did so in 2015. The proportion of adults who thought e-cigarettes were addictive more than doubled during 2012-2015 (32.0% in 2012 vs 67.6% in 2015). Compared with 2012, the odds of perceiving e-cigarettes to be equally or more harmful (than to be less harmful) doubled (95% CI=1.64, 2.41) in 2014, and tripled (95% CI=2.60, 3.81) in 2015. CONCLUSIONS There is an increase in the proportion of U.S. adults who misperceive the harm of e-cigarettes and consider them to be as harmful as combustible cigarettes. The study highlights the need to design public health messages that accurately interpret the scientific data on the potential harm of e-cigarettes and clearly differentiate the absolute from the relative harm of e-cigarettes.
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Affiliation(s)
- Ban A Majeed
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia.
| | - Scott R Weaver
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Kyle R Gregory
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia
| | - Carrie F Whitney
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia
| | - Paul Slovic
- Decision Research, Eugene, Oregon; Department of Psychology, University of Oregon, Eugene, Oregon
| | - Terry F Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, Georgia; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia
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22
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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23
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Popova L, So J, Sangalang A, Neilands TB, Ling PM. Do Emotions Spark Interest in Alternative Tobacco Products? HEALTH EDUCATION & BEHAVIOR 2017; 44:598-612. [PMID: 28071144 DOI: 10.1177/1090198116683169] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exposure to advertisements for tobacco products and tobacco warning labels evokes emotions. This study evaluated the association of discrete positive and negative emotions with interest in alternative tobacco products. METHOD In 2013, 1,226 U.S. adult nonsmokers and current smokers viewed advertisements for moist snuff, snus, and electronic cigarettes (e-cigarettes) with various warning labels and then indicated their emotional responses in terms of anger, anxiety, sadness, guilt, disgust, discouragement, hope, and contentment. Outcomes were openness to using moist snuff, snus, and e-cigarettes in the future and interest in a free sample of each product. Data were analyzed in 2016. RESULTS Hope was positively associated with openness and interest across all alternative tobacco products as was contentment for moist snuff and snus. Anger was negatively associated with openness to moist snuff and e-cigarettes, disgust negatively to moist snuff and snus, and anxiety negatively to e-cigarettes. Being a current smoker, ever trying a corresponding product, being male, and younger age were associated with greater openness to and interest in moist snuff and snus. For e-cigarettes, being a current smoker, ever trying e-cigarettes, and being female were associated with greater openness, and being a current smoker was associated with greater odds of selecting a free sample. CONCLUSIONS Positive emotions, particularly hope, were consistently positively associated with interest in alternative tobacco products. Hope is widely used by tobacco and e-cigarette companies to advertise their products. Antitobacco messages should aim to lower hope associated with tobacco products but increase hope for cessation or life without tobacco.
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Affiliation(s)
- Lucy Popova
- 1 Georgia State University, Atlanta, GA, USA
| | - Jiyeon So
- 2 University of Georgia, Athens, GA, USA
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24
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Wang JB, Cataldo JK. Medical Marijuana Legalization and Co-use in Adult Cigarette Smokers. Am J Health Behav 2016; 40:205-14. [PMID: 26931752 DOI: 10.5993/ajhb.40.2.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We examined effects of long-term medical marijuana legalization on cigarette co-use in a sample of adults. METHODS We conducted secondary analysis using data from the 2014 US Tobacco Attitudes and Beliefs Survey, which consisted of cigarette smokers, aged ≥ 45 years (N = 506). Participants were categorized by their state residence, where medical marijuana was (1) illegal, (2) legalized < 10 years, and (3) legalized ≥ 10 years. The Web-based survey assessed participants' marijuana use, beliefs and attitudes on marijuana, and nicotine dependence using Fagerstrom Tolerance for Nicotine Dependence (FTND) and Hooked on Nicotine Checklist (HONC) scores. RESULTS In cigarette smokers aged ≥ 45 years, long-term legalization of medical marijuana was associated with stable positive increases in marijuana use prevalence (ever in a lifetime) (p = .005) and frequency (number of days in past 30 days) (unadjusted p = .005; adjusted p = .08). Those who reported marijuana co-use had greater FTND and HONC scores after adjusting for covariates (p = .05). CONCLUSIONS These preliminary findings warrant further examination of the potential impact of long-term legalization of medical marijuana on greater cigarette and marijuana co-use in adults and higher nicotine dependence among co-users at the population level.
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Affiliation(s)
- Julie B Wang
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA.
| | - Janine K Cataldo
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
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