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Henn SL, Martinasek MP, Lange M. Vaping Behavior in Young Adults During the COVID-19 Pandemic. Respir Care 2023; 68:1493-1501. [PMID: 37024281 PMCID: PMC10589117 DOI: 10.4187/respcare.10629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/05/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS) continue to be popular among young adults. These devices are often advertised as a healthy alternative to quitting tobacco cigarettes. However, young adults represent a population who view it as a novel behavior that provides a sense of popularity, social acceptance, and desired physiologic properties. The objective of this study was to examine characteristics of vaping behavior among college students and explore possible associations between groups of vaping behavior (stopped, initiated, increased, decreased, stayed the same). METHODS In a multi-center cross-sectional study, 656 students from University of Tampa in the United States and University of Applied Sciences in Germany (IST) were recruited to answer a 31-item online questionnaire. A chi-square test was used to evaluate associations between the groups. RESULTS Prevalence rates indicated approximately 31% of all students were currently using ENDS. Even though more negative than positive experiences with ENDS were reported, most students stated their vaping increased during COVID-19 lockdowns. Addiction and stress relief emerged to be predictors (P < .001) of an increase in vaping, whereas social motives were not statistically significant. Living situation (P = .63) and depression (P = .10) were not significantly associated with vaping behavior. CONCLUSIONS ENDS products continue to yield very high levels of nicotine creating addiction in young adults. Addiction counseling and evidenced-based practices should be employed at every level (individual, community, and school). Additionally, mental health counseling for students in pandemic and high-stress environments may help to combat stress in a more proactive manner than self-medicating.
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Affiliation(s)
- Stella L Henn
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany
| | - Mary P Martinasek
- Department of Health Science and Human Performance, The University of Tampa, Tampa, Florida
| | - Martin Lange
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany.
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Paolone G, Pavan F, Mandurino M, Baldani S, Guglielmi PC, Scotti N, Cantatore G, Vichi A. Color stability of resin-based composites exposed to smoke. A systematic review. J ESTHET RESTOR DENT 2023; 35:309-321. [PMID: 36602255 DOI: 10.1111/jerd.13009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/06/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To conduct a systematic review on color stability of dental resin-based composites (RBC) exposed to conventional and electronic cigarettes. MATERIALS AND METHODS In vitro studies reporting on the color stability of RBC exposed to conventional cigarettes or to e-cigarettes: both Tobacco Heating Systems (THS) and Electronic Nicotine Delivery Systems (ENDS). The quality of the included studies was assessed with the QUIN tool (risk-of-bias tool for assessing in vitro studies conducted in dentistry). A systematic search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed on four (n = 4) databases (Embase, Medline, Scopus, Web of Science) for articles published until March 28th, 2022. RESULTS Of the 365 screened articles, 13 were included in this review. All the included articles analyzed conventional cigarette smoke (CS), four analyzed Electronic Nicotine Delivery Systems (ENDS) and two Tobacco Heating Systems (THS). In terms of study design, smoke exposure time, smoke flow, type and number of cigarettes a high variability was reported. CONCLUSIONS The available evidence suggests that CS smoke significantly affects color stability. Electronic cigarettes show less color change that seems to be easily recovered under clinical acceptability thresholds, although evidence is scarce. CLINICAL SIGNIFICANCE Clinicians should be aware, and should therefore warn their patients, that RBCs are subjected to irreversible color change if exposed to smoke. Electronic cigarettes (both ENDS and THS) induce less color change that can be recovered with repolishing or whitening procedures.
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Affiliation(s)
- Gaetano Paolone
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Francesca Pavan
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Mauro Mandurino
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Sofia Baldani
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | | | - Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, Turin, Italy
| | - Giuseppe Cantatore
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
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Murukutla N, Magsumbol MS, Raskin H, Kuganesan S, Dini S, Martinez-Mejia C, Rachfiansyah, Aguilar BGR. A content analysis of e-cigarette marketing on social media: Findings from the Tobacco Enforcement and Reporting Movement (TERM) in India, Indonesia and Mexico. Front Public Health 2022; 10:1012727. [PMID: 36424977 PMCID: PMC9679495 DOI: 10.3389/fpubh.2022.1012727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background The use of e-cigarettes is proliferating globally, especially among youth and even children. Marketing is a known risk factor for e-cigarette initiation, yet little is known of e-cigarette marketing on social media in low- and middle-income countries. This study compares e-cigarette social media marketing in India, Indonesia, and Mexico, three such countries with different regulatory environments. Methods Instances of e-cigarette marketing on social media platforms were identified via the Tobacco Enforcement and Reporting Movement (TERM), a digital tobacco marketing monitoring system. Through systematic keyword-based searches, all tobacco marketing posts observed between 15 December 2021 and 16 March 2022 were included in the analysis. The final sample included 1,437 e-cigarette-related posts on Instagram, Facebook, Twitter, YouTube, and TikTok, which were systematically content analyzed by independent coders after inter-reliability (Cohen's Kappa K > 0.79) was established using a theory-derived codebook. The final data is represented in percentages and frequencies for ease of presentation. Results We observed e-cigarette marketing online in all countries studied, yet there was variation in the volume of marketing and types of accounts identified. In India, where e-cigarettes were comprehensively banned, we identified 90 (6%) posts; in Mexico, where e-cigarettes were partially restricted, 318 (22%) posts were observed; and in Indonesia, where there were no restrictions, 1,029 (72%) posts were observed. In both India and Mexico, marketing originated from retailer accounts (100%), whereas in Indonesia, it was primarily product brand accounts (86%). Across countries, e-cigarettes were mostly marketed directly to sell products (India: 99%, Indonesia: 69% and Mexico: 93%), though the sales channels varied. Product features, including e-liquid flavors, device colors and technical specifications, was the most prominent message framing (India: 86%; Mexico: 73%; Indonesia: 58%). Harm reduction messaging was most popular in Mexico (8%) and was not common in Indonesia (0.3%) or India (0%). Conclusion Our study provides important insights for tobacco control stakeholders on the evolving nature of e-cigarette marketing in low- and middle-income countries. It underscores the presence of e-cigarette marketing, including in countries where comprehensive regulations exist, and suggests the importance of continuous monitoring to keep up with industry practices and strengthen tobacco control stakeholder efforts to counter them.
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Affiliation(s)
- Nandita Murukutla
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Melina S Magsumbol
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Hana Raskin
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Sharan Kuganesan
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Silvia Dini
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Carlos Martinez-Mejia
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
| | - Rachfiansyah
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY, United States
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Gupte HA, Chatterjee N, Mandal G, D’Costa M. Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices. Asian Pac J Cancer Prev 2022; 23:2991-2997. [PMID: 36172661 PMCID: PMC9810289 DOI: 10.31557/apjcp.2022.23.9.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Global Youth Tobacco Survey-4, India conducted in 2019 showed 'ever use' of e-cigarettes among adolescents to be 2.8%. However, there is dearth of qualitative data on adolescent use of e-cigarettes in the country. This study was conducted to explore and gain better understanding on adolescents' perceptions and practices about e-cigarette use. METHODS In-depth interviews were conducted with 24 adolescents who self-reported use of e-cigarettes. The participants were recruited from ten municipal schools of Mumbai, India that cater to students from lower socio-economic background. Participants were from 7th to 9th grades, and aged 11-16 years. Data from in-depth interviews were analyzed using inductive thematic analysis. RESULTS Adolescents referred to 'e-cigarette' as 'pen-hookah.' E-cigarettes were perceived as relatively harmless compared to regular hookahs and conventional cigarettes. Initiation was influenced by a friend, peer, or sibling. A variety of flavors, the after-taste, the ability to perform playful tricks with smoke, and fun-time spent with friends were cited as reasons for continued use. Social media influenced both initiation and continuation. Most adolescents' regular use was with a group of friends; the device was shared with or obtained from friends or siblings. Adolescents were unclear about the presence of nicotine in refill liquids and the harmful health effects. CONCLUSION Increasing awareness among adolescents about the harms of e-cigarettes is urgently required through comprehensive tobacco-prevention programs. More research is needed to examine the role of flavors in increasing acceptability of e-cigarettes and how it affects perceived harmfulness of tobacco products.
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Affiliation(s)
- Himanshu A Gupte
- Narotam Sekhsaria Foundation, Mumbai, India. ,For Correspondence:
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Rossheim ME, Zhao X, Soule EK, Thombs DL, Suzuki S, Ahmad A, Barnett TE. Aerosol, vapor, or chemicals? College student perceptions of harm from electronic cigarettes and support for a tobacco-free campus policy. J Am Coll Health 2022; 70:1754-1760. [PMID: 32931725 PMCID: PMC9275670 DOI: 10.1080/07448481.2020.1819293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/07/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Objective: This study is the first to examine the influence of e-cigarette emission phrasing on perceived harm of secondhand exposure, and whether harm perception was associated with support for a tobacco-free campus policy. Participants: In the fall 2018 and spring 2019 semesters, 52 sections of a college English course (N = 791 students) were cluster randomized to one of three conditions ("vapor," "aerosol," or "chemicals") assessing harm of secondhand exposure to e-cigarette emissions. Methods: Regression models adjusted for demographic characteristics, tobacco use, and other potential confounders. Results: Compared to the "vapor" condition, "chemicals" and "aerosol" conditions were associated with increased odds of perceiving secondhand exposure to e-cigarettes to be harmful/very harmful (AOR = 2.0, p < 0.01). Greater perceived harm of secondhand e-cigarette exposure was associated with increased odds of supporting a tobacco-free campus policy (AOR = 2.22, p < 0.001). Conclusions: Health campaigns should use accurate terminology to describe e-cigarette emissions, rather than jargon that conveys lower risk.
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Affiliation(s)
- Matthew E. Rossheim
- Department of Global and Community Health, George Mason University, Fairfax, VA
| | - Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, VA
| | - Eric K. Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC
| | - Dennis L. Thombs
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
| | - Sumihiro Suzuki
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Asra Ahmad
- Department of Global and Community Health, George Mason University, Fairfax, VA
| | - Tracey E. Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
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Mahoney MC, Rivard C, Kimmel HL, Hammad HT, Sharma E, Halenar MJ, Sargent J, Cummings KM, Niaura R, Goniewicz ML, Bansal-Travers M, Hatsukami D, Gaalema D, Fong G, Gravely S, Christensen CH, Haskins R, Silveira ML, Blanco C, Compton W, Stanton CA, Hyland A. Cardiovascular Outcomes among Combustible-Tobacco and Electronic Nicotine Delivery System (ENDS) Users in Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) Study, 2013-2019. Int J Environ Res Public Health 2022; 19:4137. [PMID: 35409819 PMCID: PMC8998731 DOI: 10.3390/ijerph19074137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prior studies have not clearly established risk of cardiovascular disease (CVD) among smokers who switch to exclusive use of electronic nicotine delivery systems (ENDS). We compared cardiovascular disease incidence in combustible-tobacco users, those who transitioned to ENDS use, and those who quit tobacco with never tobacco users. METHODS This prospective cohort study analyzes five waves of Population Assessment of Tobacco and Health (PATH) Study data, Wave 1 (2013-2014) through Wave 5 (2018-2019). Cardiovascular disease (CVD) incidence was captured over three intervals (Waves 1 to 3, Waves 2 to 4, and Waves 3 to 5). Participants were adults (40+ years old) without a history of CVD for the first two waves of any interval. Change in tobacco use status, from exclusive past 30 day use of any combustible-tobacco product to either exclusive past 30 day ENDS use, dual past 30 day use of ENDS and combustible-tobacco, or no past 30 day use of any tobacco, between the first two waves of an interval was used to predict onset of CVD between the second and third waves in the interval. CVD incidence was defined as a new self-report of being told by a health professional that they had congestive heart failure, stroke, or a myocardial infarction. Generalized estimating equation (GEE) analyses combined 10,548 observations across intervals from 7820 eligible respondents. RESULTS Overall, there were 191 observations of CVD among 10,548 total observations (1.7%, standard error (SE) = 0.2), with 40 among 3014 never users of tobacco (1.5%, SE = 0.3). In multivariable models, CVD incidence was not significantly different for any tobacco user groups compared to never users. There were 126 observations of CVD among 6263 continuing exclusive combustible-tobacco users (adjusted odds ratio [AOR] = 1.44; 95% confidence interval (CI) 0.87-2.39), 15 observations of CVD among 565 who transitioned to dual use (AOR = 1.85; 0.78-4.37), and 10 observations of CVD among 654 who quit using tobacco (AOR = 1.18; 0.33-4.26). There were no observations of CVD among 53 who transitioned to exclusive ENDS use. CONCLUSIONS This study found no difference in CVD incidence by tobacco status over three 3 year intervals, even for tobacco quitters. It is possible that additional waves of PATH Study data, combined with information from other large longitudinal cohorts with careful tracking of ENDS use patterns may help to further clarify this relationship.
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Affiliation(s)
- Martin C. Mahoney
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Cheryl Rivard
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Hoda T. Hammad
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Eva Sharma
- Westat, Rockville, MD 20850, USA; (E.S.); (M.J.H.); (C.A.S.)
| | | | - Jim Sargent
- The C. Everette Koop Institute at Dartmouth, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA;
| | | | - Ray Niaura
- NYU School of Global Public Health, New York, NY 10003, USA;
| | - Maciej L. Goniewicz
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | - Maansi Bansal-Travers
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
| | | | | | - Geoffrey Fong
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Shannon Gravely
- University of Waterloo, Waterloo, ON N2L 3G1, Canada; (G.F.); (S.G.)
| | - Carol H. Christensen
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Ryan Haskins
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (H.T.H.); (C.H.C.); (R.H.)
| | - Marushka L. Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
- Kelly Government Solutions, Troy, MI 48084, USA
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | - Wilson Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MS 20892, USA; (H.L.K.); (M.L.S.); (C.B.); (W.C.)
| | | | - Andrew Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.C.M.); (M.L.G.); (M.B.-T.); (A.H.)
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Anic GM, Rostron BL, Hammad HT, van Bemmel DM, Del Valle-Pinero AY, Christensen CH, Erives G, Faulcon LM, Blount BC, Wang Y, Wang L, Bhandari D, Calafat AM, Kimmel HL, Everard CD, Compton WM, Edwards KC, Goniewicz ML, Wei B, Hyland A, Hatsukami DK, Hecht SS, Niaura RS, Borek N, Ambrose BK, Chang CM. Changes in Biomarkers of Tobacco Exposure among Cigarette Smokers Transitioning to ENDS Use: The Population Assessment of Tobacco and Health Study, 2013-2015. Int J Environ Res Public Health 2022; 19:1462. [PMID: 35162490 PMCID: PMC8835100 DOI: 10.3390/ijerph19031462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 02/01/2023]
Abstract
Limited data are available for how biomarkers of tobacco exposure (BOE) change when cigarette smokers transition to using electronic nicotine delivery systems (ENDS). Using biomarker data from Waves 1 (2013-2014) and 2 (2014-2015) of the PATH Study, we examined how mean BOE concentrations, including metabolites of nicotine, tobacco-specific nitrosamines (TSNA), polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOC) and metals, changed when 2475 adult smokers transitioned to using ENDS or quit tobacco products. Exclusive smokers who transitioned to dual use had a significant decrease in NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), but not nicotine metabolites, most PAHs, metals, or VOCs. Exclusive smokers who became dual users had significant reductions in total nicotine equivalents, NNAL, and 2CyEMA (acrylonitrile metabolite), but only in those who reduced cigarettes per day (CPD) by >=50%. Smokers who transitioned to exclusive ENDS use had significant reductions in most TSNAs, PAHs, and VOCs; however, nicotine metabolites did not decrease in dual users who became exclusive ENDS users. Smokers who quit tobacco use had significant decreases in nicotine metabolites, all TSNAs, most PAHs, and most VOCs. Cigarette smokers who became dual users did not experience significant reductions in most BOEs. Reductions were impacted by changes in CPD. However, transitioning from smoking to no tobacco or exclusive ENDS use was associated with reduced exposure to most BOEs measured. Future analyses could incorporate additional waves of PATH data and examine changes in biomarker exposure by ENDS device type and CPD.
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Affiliation(s)
- Gabriella M. Anic
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Brian L. Rostron
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Hoda T. Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Dana M. van Bemmel
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Arseima Y. Del Valle-Pinero
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Carol H. Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Gladys Erives
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Lisa M. Faulcon
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Benjamin C. Blount
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (B.C.B.); (Y.W.); (L.W.); (D.B.); (A.M.C.)
| | - Yuesong Wang
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (B.C.B.); (Y.W.); (L.W.); (D.B.); (A.M.C.)
| | - Lanqing Wang
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (B.C.B.); (Y.W.); (L.W.); (D.B.); (A.M.C.)
| | - Deepak Bhandari
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (B.C.B.); (Y.W.); (L.W.); (D.B.); (A.M.C.)
| | - Antonia M. Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (B.C.B.); (Y.W.); (L.W.); (D.B.); (A.M.C.)
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA; (H.L.K.); (C.D.E.); (W.M.C.)
| | - Colm D. Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA; (H.L.K.); (C.D.E.); (W.M.C.)
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA; (H.L.K.); (C.D.E.); (W.M.C.)
| | | | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (B.W.); (A.H.)
| | - Binnian Wei
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (B.W.); (A.H.)
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA; (M.L.G.); (B.W.); (A.H.)
| | - Dorothy K. Hatsukami
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA; (D.K.H.); (S.S.H.)
| | - Stephen S. Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA; (D.K.H.); (S.S.H.)
| | - Raymond S. Niaura
- College of Global Public Health, New York University, New York, NY 10003, USA;
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Bridget K. Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
| | - Cindy M. Chang
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (G.M.A.); (H.T.H.); (D.M.v.B.); (A.Y.D.V.-P.); (C.H.C.); (G.E.); (L.M.F.); (N.B.); (B.K.A.); (C.M.C.)
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Brett E, Krissinger R, King A. The rise and fall of e-cigarette cloud chasing appealing to youth. Prev Med Rep 2021; 24:101644. [PMID: 34849332 PMCID: PMC8609162 DOI: 10.1016/j.pmedr.2021.101644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/29/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022] Open
Abstract
Electronic cigarette (e-cigarette) use continues to rise among youth with new devices and technology outpacing regulation. The "cloud chasing" phenomenon, whereby vapers compete or otherwise showcase the production of large or artistic exhaled aerosols from e-cigarettes, played a role in the early appeal of e-cigarette use in youth. This paper describes the sudden rise in the phenomenon of cloud chasing on social media and at vaping conventions due to the proliferation of second and third-generation powerful e-cigarette devices in their peak in 2015 and then their subsequent decline in the past few years. We describe four distinct factors that affected both the rise and fall in cloud chasing, including: 1) the rapid evolution of powerful e-cigarette devices, 2) the increase in social media promotions, 3) an inability of regulatory bodies to keep up with evolving ENDS technology, and 4) two recent widespread health concerns and conditions. Conclusions highlight the importance of swift regulation and effective health communication to mitigate unintended consequences of product evolution. It remains unknown whether such vape tricks and related competitions will reemerge and appeal to youth as store fronts reopen and devices continue to evolve.
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Affiliation(s)
- Emma Brett
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
| | - Robert Krissinger
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
| | - Andrea King
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, United States
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9
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Lal P, Kapoor R, Singh RJ. Compliance to Online Retail of Electronic Nicotine Delivery Systems (ENDS) in India before and after the 2018 Ban Order of the Government of India. Asian Pac J Cancer Prev 2021; 22:13-17. [PMID: 34780134 DOI: 10.31557/apjcp.2021.22.s2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Indexed: 11/25/2022] Open
Abstract
Since their launch globally in 2012, electronic nicotine delivery systems (ENDS) were positioned as a harm reduction strategy and cessation device but it is yet to be proven to have clinical safety or public health benefits. Instead, recent reports suggest that the tobacco industry targeted youth and sponsored research whose evidence was used to mislead policymaking. On August 28, 2018, Ministry of Health & Family Welfare's advisory banned the sale, purchase, and trade of ENDS. A survey was done in two waves. The first survey was done between August 10 and 25 2018 all websites which sold ENDS product were mapped and documented. The survey was repeated (November 30, 2018) were after the restriction to trade on ENDS was proposed by the Department of Customs. The two waves of survey found that no website, whether comprehensive e-commerce portals or dedicated ENDS marketing platforms fully complied with government orders. National and states government enforcement agencies are currently unaware of internet-based sale of ENDS. Although some states have given specific directions to stop the sale and delivery of ENDS within the state through e-commerce, there is limited monitoring and legal compliance by seller. Public health advocates need to stay vigilant and monitor the online sale and point of sale retail of ENDS to ensure strict compliance of national and state regulations.
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Affiliation(s)
- Pranay Lal
- International Union Against TB and Lung Disease C 6 Qutub Institutional Area, India
| | - Ragini Kapoor
- International Union Against TB and Lung Disease C 6 Qutub Institutional Area, India
| | - Rana Jugdeep Singh
- International Union Against TB and Lung Disease C 6 Qutub Institutional Area, India
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Patel A, Hirschtick JL, Cook S, Usidame B, Mistry R, Levy DT, Meza R, Fleischer NL. Sociodemographic Patterns of Exclusive and Dual Use of ENDS and Menthol/Non-Menthol Cigarettes among US Youth (Ages 15-17) Using Two Nationally Representative Surveys (2013-2017). Int J Environ Res Public Health 2021; 18:7781. [PMID: 34360077 DOI: 10.3390/ijerph18157781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022]
Abstract
The use of electronic nicotine delivery systems (ENDS) among youth in the United States has increased rapidly in the past decade. Simultaneously, while youth cigarette smoking has declined considerably, youth are still more likely to use menthol cigarettes than any other age group. We used nationally representative data on 15–17-year-olds from the Population Assessment of Tobacco and Health (PATH) Study and the National Youth Tobacco Survey (NYTS) (2013–2017) to better understand current cigarette (by menthol flavoring) and ENDS use in the US. We calculated weighted population prevalence estimates across years for multiple patterns of current cigarette and ENDS use (i.e., exclusive menthol cigarette, exclusive non-menthol cigarette, exclusive ENDS, dual ENDS and menthol cigarette, and dual ENDS and non-menthol cigarette) by sex, race/ethnicity, parental education level, household income, and homeownership. Overall, both exclusive menthol and non-menthol cigarette use declined from 2013–2017. Exclusive ENDS use increased, particularly among youth who were non-Hispanic White or had a higher socioeconomic status (measured by parental education, household income, and homeownership). Dual use of ENDS with either menthol or non-menthol cigarettes did not change significantly. Monitoring changes in these sociodemographic patterns will help inform future youth tobacco prevention strategies.
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Abstract
Objectives In this study, we examined whether visual exposure to the heated tobacco product (HTP) IQOS, which was authorized for sale by the US Food and Drug Administration in 2019, acts as a cue to increase cigarette craving and smoking behavior among smokers. Methods Young adult smokers (N = 105) were randomly assigned to view a video depicting use of either IQOS or bottled water. Main outcomes were changes in cigarette and e-cigarette desire and latency to smoke between the groups. We also examined participants' attitudes about the actors using IQOS and drinking water in the videos. Results Exposure to the use of IQOS acutely increased observers' ratings of smoking urge and desire for a cigarette and an e-cigarette. The IQOS cue, compared with the water cue, also produced a marginally significant shorter latency to smoke. Participants perceived actors as less likeable and friendly when using IQOS than when drinking water. Conclusions Results showed that exposure to IQOS produced smoking urge and behavior in young adult smokers, implicating IQOS use as a smoking and vaping cue. As HTPs gain popularity, product impact on passive observers should be included in their risk-benefit profile.
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Venugopal PD, Morse AL, Tworek C, Chang HW. Socioeconomic Disparities in Vape Shop Density and Proximity to Public Schools in the Conterminous United States, 2018. Health Promot Pract 2020; 21:9S-17S. [PMID: 31908194 DOI: 10.1177/1524839919887738] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We conducted an environmental justice assessment examining the distribution of specialty vape shops in relation to where minority and low-income youth live and attend school. We collated and examined the density of vape shops in public school districts in 2018 throughout the conterminous United States using geographic information systems. We calculated the proximity of vape shops to public middle and high schools through nearest neighbor analysis in QGIS software. We examined the statistical relationships between the density of vape shops in school districts, and proximity to schools, with the proportion of racial/ethnic minorities and those living in poverty. We found that vape shops are more densely distributed, and are in closer proximity to schools, in school districts with higher proportions of Asian and Black or African American populations. However, vape shops were further away from schools in school districts with higher proportions of the population in poverty. The proximity and higher density of vape shops in relationship to schools in Asian and Black or African American communities may result in disproportionate health impacts due to greater access and exposure to vape products and advertisements. Our results may help school district administrators prioritize and target efforts to curb youth vaping (e.g., health education curricula) in these school districts with high density and closer proximity of vape shops to schools. Policy efforts, such as local ordinances restricting the promotion and sale of vaping products close to schools, could help prevent disproportionate human and environmental health impacts to minorities.
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Affiliation(s)
| | - Aura Lee Morse
- United States Food and Drug Administration, Beltsville, MD, USA
| | - Cindy Tworek
- United States Food and Drug Administration, Beltsville, MD, USA
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13
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Rayner RE, Makena P, Prasad GL, Cormet-Boyaka E. Cigarette smoke preparations, not electronic nicotine delivery system preparations, induce features of lung disease in a 3D lung repeat-dose model. Am J Physiol Lung Cell Mol Physiol 2020; 320:L276-L287. [PMID: 33207918 DOI: 10.1152/ajplung.00452.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Cigarette smoking is a risk factor for several lung diseases, including chronic obstructive pulmonary disease, cardiovascular disease, and lung cancer. The potential health effects of chronic use of electronic nicotine delivery systems (ENDS) is unclear. This study utilized fully differentiated primary normal human bronchial epithelial (NHBE) cultures in a repeat-dose exposure to evaluate and compare the effect of combustible cigarette and ENDS preparations. We show that 1-h daily exposure of NHBE cultures over a 10-day period to combustible cigarette whole smoke-conditioned media (WS-CM) increased expression of oxidative stress markers, cell proliferation, airway remodeling, and cellular transformation markers and decreased mucociliary function including ion channel function and airway surface liquid. Conversely, aerosol conditioned media (ACM) from ENDS with similar nicotine concentration (equivalent-nicotine units) as WS-CM and nicotine alone had no effect on those parameters. In conclusion, primary NHBE cultures in a repeat-dose exposure system represent a good model to assess the features of lung disease. This study also reveals that cigarette and ENDS preparations differentially elicit several key endpoints, some of which are potential biomarkers for lung cancer or chronic obstructive pulmonary disease (COPD).
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Affiliation(s)
- Rachael E Rayner
- Department of Veterinary Biosciences, The Ohio State University, Columbus, Ohio
| | | | - G L Prasad
- RAI Services Company, Winston-Salem, North Carolina
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Wagoner KG, Berman M, Rose SW, Song E, Cornacchione Ross J, Klein EG, Kelley DE, King JL, Wolfson M, Sutfin EL. Health claims made in vape shops: an observational study and content analysis. Tob Control 2019; 28:e119-e125. [PMID: 31123104 PMCID: PMC8142343 DOI: 10.1136/tobaccocontrol-2018-054537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Prior to the final deeming rule, federal law in the USA prohibited electronic cigarettes (e-cigarettes) from being marketed as smoking cessation products; for other therapeutic purposes and in ways that conveyed Food and Drug Administration (FDA) approval/endorsement. After August 2016, additional federal prohibitions were added including false/misleading and unauthorised modified risk tobacco product (MRTP) claims. No systematic investigation of e-cigarette health claims has been conducted in the retail environment. We sought to document and characterise claims made in vape shops. METHODS Between November 2015 and February 2016, before final deeming rule implementation, two trained data collectors conducted unannounced observational assessments of 46 vape shops in North Carolina. Data collectors used wearable imaging technology to document health claims about e-cigarettes. Photos were coded for five claim types: (1) cessation device; (2) drug effect/device; (3) FDA-approved/endorsed; (4) false/misleading and (5) MRTP. Photos were double coded; differences between coders were adjudicated and reviewed by an expert panel. RESULTS At least one health claim was displayed in 41.3% (n=19) of retailers, ranging from 0 to 27 claims per retailer. All claim types were found. Cessation device claims were the most prevalent (62.2%, n=84), followed by MRTP (27.4%, n=37), drug effect/device (8.1%, n=11), false/misleading (1.5%, n=2), and FDA approved/endorsed (0.7%, n=1). Retail chains made the majority of claims compared with independent shops (88.9% vs 11.1%). CONCLUSIONS Many vape shops displayed e-cigarette health claims, which are all now FDA prohibited. These claims could mislead consumers and influence behaviour. Findings highlight the need for retailer education, continued surveillance, enforcement specific to advertising and research on consumer perceptions of claims.
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Affiliation(s)
- Kimberly G Wagoner
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Micah Berman
- Health Services Management and Policy, The Ohio State University College of Public Health and Moritz College of Law, Columbus, Ohio, USA
| | - Shyanika W Rose
- Truth Initiative, Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, USA
| | - Eunyoung Song
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Elizabeth G Klein
- Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Dannielle E Kelley
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessica L King
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark Wolfson
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Erin L Sutfin
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Tamulevicius N, Martinasek MP, Moss SJ, Pfeffer I, Gibson-Young LM, Yahaya M. An Analysis of Associations Between Electronic Nicotine Delivery System Users. Respir Care 2019; 65:355-361. [PMID: 31719188 DOI: 10.4187/respcare.07172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Electronic nicotine-delivery systems have been increasing in prevalence among young adults. Although these devices are marketed to aid in quit smoking, young adults who do not smoke traditional cigarettes are using these devices. This study explored associations between individuals' quit type (ie, no plans to quit, plans to quit, or quit > 6 months ago) and perceived health status, perception of harm compared to cigarettes, perception of secondhand vapor harm, and reasons for first use. METHODS We utilized a cross-sectional study design using a 33-item electronic survey questionnaire. The total sample size was 2,792. Out of these the ENDS users were 1,217. The survey was distributed to university students in 5 areas in 3 countries: the United States (ie, Florida, Alabama, and Illinois), Germany (ie, Hamburg) and South Africa (ie, Potchefstroom). RESULTS Quantitative data analysis indicated that, regardless of quit status, there was a general lack of knowledge regarding secondhand vapor effects. Additionally, young adults are utilizing these products primarily due to peer influence and stress relief. Harm perception may factor into quit attempts using electronic nicotine-delivery systems. CONCLUSIONS Education provided by respiratory therapists (and to respiratory therapy students) would be valuable as they inform patients and communities of the scholarly literature on vaping devices.
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Affiliation(s)
- Nauris Tamulevicius
- Department of Health Science and Human Performance, The University of Tampa, Tampa, Florida.
| | - Mary P Martinasek
- Department of Health Science and Human Performance, The University of Tampa, Tampa, Florida
| | - Sarah J Moss
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Ines Pfeffer
- Department of Pedagogy, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | | | - Musa Yahaya
- Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, Illinois
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16
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Abstract
OBJECTIVES The current study adds to the literature on vape shops by evaluating vape shop growth in an urban community over a 3-year period, assessing similarities and differences across the vape shop context, and addressing whether socialization spaces within vape shops are associated with a vape shop's ultimate success - remaining operational. As e-cigarette/vaping use enters its second decade in the US market, its regulation and status as a novel form of substance use is evolving; accordingly, it is unknown whether the presence of vape shops has changed as well. METHODS In this study, we tracked and observed 19 vape shops over a 3-year period in Long Beach, California. RESULTS Vape shop presence declined by 53% between September 2015 and September 2018. A comparison of vape shops remaining open versus those closing in the 3-year period indicated that shops with designated socialization spaces (lounges/tasting bars) were more likely to remain operational. CONCLUSIONS The substantial decline in vape shop presence in this community may reflect an entrepreneurial response to increased regulation, as well as a dynamic market for e-cigarette/vape products. Findings suggest vape users support Electronic Nicotine Delivery Systems (ENDS) retailers that promote community-building or recreational activity.
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Affiliation(s)
- H Isabella Lanza
- H. Isabella Lanza, Associate Professor, Department of Human Development, California State University, Long Beach, CA. Patricia S. Pittman, Department of Human Development and Family Science, The Ohio State University, Columbus, OH
| | - Patricia S Pittman
- H. Isabella Lanza, Associate Professor, Department of Human Development, California State University, Long Beach, CA. Patricia S. Pittman, Department of Human Development and Family Science, The Ohio State University, Columbus, OH
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17
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Coleman B, Chang JT, Rostron BL, Johnson SE, Das B, Del Valle-Pinero AY. An Examination of Device Types and Features Used by Adult Electronic Nicotine Delivery System (ENDS) Users in the PATH Study, 2015-2016. Int J Environ Res Public Health 2019; 16:ijerph16132329. [PMID: 31269633 PMCID: PMC6651074 DOI: 10.3390/ijerph16132329] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 11/16/2022]
Abstract
To date no study has reported U.S. nationally representative estimates of current ENDS users by device category (“open” vs. “closed” systems) nor their detailed use behaviors. We examined the proportion of current adult ENDS users (unweighted n = 2671) using either “closed” or “open” systems during Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health (PATH) Study. Demographic characteristics, use patterns, and device characteristics were examined overall and by device type. Among the 5.0% of current users at Wave 3, 43.9% used closed systems and 53.7% used open systems. Compared to closed system users, open system users were more likely to be male (60.7% vs. 48.4%), aged 18–24 (30.4% vs. 21.4%), and non-Hispanic White (76.2% vs. 65.4%), recent former (9.9% vs. 5.6%) or long-term former (20.2% vs. 10.9%) smokers, and use ENDS daily (44.1% vs. 22.5%); they were less likely to be to be current daily smokers (31.7% vs. 48.0%) or never smokers (15.2% vs. 19.5%). Adult ENDS users were nearly evenly split on their use of closed versus open systems; however, several group differences were observed. Disentangling the relationship between device selection and subsequent use patterns remains a public health priority.
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Affiliation(s)
- Blair Coleman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA.
| | - Joanne T Chang
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Brian L Rostron
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Sarah E Johnson
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Babita Das
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Arseima Y Del Valle-Pinero
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
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18
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Cardenas VM, Fischbach LA, Chowdhury P. The use of electronic nicotine delivery systems during pregnancy and the reproductive outcomes: A systematic review of the literature. Tob Induc Dis 2019; 17:52. [PMID: 31582941 PMCID: PMC6770636 DOI: 10.18332/tid/104724] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/18/2018] [Accepted: 02/27/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Use of electronic nicotine delivery systems (ENDS) among pregnant women is of great concern. To our knowledge the current literature provides conflicting views regarding the uncertainties of the effects of ENDS use during pregnancy on the health of the fetus. METHODS We searched PubMed, CINAHL, and EMBASE, for the period 2007 to October 2017 for terms to identify publications on ENDS use during pregnancy and the reproductive outcomes. We updated the search for the period November 2017 to November 2018 using Ovid Medline. We obtained full text of articles and present a summary of the contents. RESULTS We found no studies of pregnant women exposed to ENDS use and its effect on their fetus or neonates. However, there is a growing body of experimental studies in animals that suggest that nicotine in ENDS alters DNA methylation, induces birth defects, reduces the birth weight, and affects the development of the heart and lungs of their offspring. A large population-based cohort study in the United States estimated that 5% of pregnant women were current ENDS users in 2014; most of them also smoked cigarettes. Surveys conducted among practitioners indicate that there is a need to screen and counsel pregnant women. Systematic reviews and meta-analysis of studies of women who used smokeless tobacco during pregnancy suggest that prenatal nicotine alone is a risk factor for low birth weight, premature delivery, and stillbirth. CONCLUSIONS There were no previous studies assessing the reproductive effects of ENDS use during pregnancy. However, prenatal exposure to nicotine is known to be harmful to the fetus and the pregnancy.
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Affiliation(s)
- Victor M Cardenas
- University of Arkansas for Medical Sciences, Little Rock, United States
| | - Lori A Fischbach
- University of Arkansas for Medical Sciences, Little Rock, United States
| | - Parimal Chowdhury
- University of Arkansas for Medical Sciences, Little Rock, United States
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Abstract
The smoking of tobacco cigarettes by millions of people over the past 100 or more years has had devastating public health consequences around the world. In some countries, this has been mitigated by the introduction of multiple regulatory strategies that have taken decades to implement. But even in the countries with most success at tobacco cigarette regulation, some smokers find it very hard to quit and need better treatment. Electronic cigarettes and other electronic nicotine delivery systems (ENDS) have emerged in the last decade or so. Initially designed to help smokers quit and produced by small independent entities, ENDS have become big business, with major transnational tobacco companies competing hard for market share where, for example, in the United States, a single device came to dominate the market within a couple of years and where soaring uptake by adolescents reached levels high enough to alarm the FDA. No doubts remain about the damaging health consequences of tobacco cigarettes. Controversies persist about e-cigarettes-their efficacy, health impacts, development of addiction and whether or not they provide a "gateway" to tobacco cigarette smoking. The regulation of tobacco cigarettes falls under a global WHO treaty, the Framework Convention on Tobacco Control (FCTC); over 180 countries are party to the FCTC. The regulation of ENDS has no such treaty, varies considerably around the world and in many countries remains completely untrammelled by specific directives. This paper will not discuss the evidence for or against the of e-cigarettes in smoking cessation (effectively discussed in this issue by Dr. Wallace) but aims to review the current state of tobacco regulation around the world, identify key differences in ENDS regulation, examine the impact of industry influence on public health policy and determine how the lessons of tobacco control should apply to ENDS.
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Affiliation(s)
- Emily Stone
- Department of Thoracic Medicine and Kinghorn Cancer Centre, St Vincent's Hospital Sydney, University of New South Wales, Sydney, Australia
| | - Henry Marshall
- Department of Thoracic Medicine, University of Queensland Thoracic Research Centre, The Prince Charles Hospital, Brisbane, Australia
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Trigger S, Coleman B. Social Media Mentions of Electronic Nicotine Delivery Systems (ENDS) Battery-Related Overheating, Fires, and Explosions: Findings from a Pilot Study. Int J Environ Res Public Health 2019; 16:E1308. [PMID: 31013680 DOI: 10.3390/ijerph16081308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 11/17/2022]
Abstract
Serious injuries may result from electronic nicotine delivery systems (ENDS) battery malfunctions, including overheating, fires, and explosions (O/F/E). This pilot study assessed the usefulness of social media monitoring as a tool for gathering information surrounding ENDS battery O/F/E, including changes in the volume and nature of social media mentions over time. Brandwatch, a social media monitoring tool, was queried to examine ENDS battery-related O/F/E over a one-month period, annually, from 2013–2017. Two researchers qualitatively coded the social media mentions for relevance and coded the relevant mentions by event type and theme. The total number of mentions coded as relevant (n = 947) for the one-month period increased each year. Mentions of first-person events were relatively infrequent (3.6% of relevant mentions), while mentions describing events that happened to someone else increased over time (60.4% of relevant mentions). A relatively small proportion of mentions expressed concern around a potential event and advice on how to prevent future events (4.8% and 10.5% of relevant mentions, respectively). Findings suggest that social media mentions around ENDS battery O/F/E events have increased over recent years. Social media monitoring can complement traditional surveillance systems to elucidate the extent to which ENDS O/F/E events are occurring.
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de Andrade M, Angus K, Hastings G, Angelova N. Hostage to fortune: an empirical study of the tobacco industry's business strategies since the advent of e-cigarettes. Crit Public Health 2018; 30:280-293. [PMID: 32536808 PMCID: PMC7254526 DOI: 10.1080/09581596.2018.1552778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 11/20/2018] [Indexed: 11/27/2022]
Abstract
The tobacco market has been transformed by the arrival of e-cigarettes and array of alternative nicotine delivery systems (ANDS). Public health has struggled to cope with these changes and clear divisions are apparent, but less is known about the tobacco industry (TI) response. This first empirical study to examine TI and independent ANDS companies' business strategies fills this gap. Primary data were collected through 28 elite interviews with senior/influential TI and independent stakeholders, triangulated with a documentary analysis of company reports, investor analyses, market research, and consultation responses (1022 documents). A deliberately emic analysis shows that tobacco multinationals were initially disconcerted by ANDS, but logic provided by the fiduciary imperative is enabling them to turn a potential threat into profitable opportunities. Interviewees argue market changes played to their strengths: customer links, expertise in nicotine, and enormous financial resources. This enabled portfolio diversification in which combustible and ANDS coexist; providing potential to develop robust scientific and regulatory positions and hope of retrieving corporate reputations. The principal threat for major tobacco players comes from the independent sector, which is prepared and able to satisfy bespoke consumer needs. Multinationals by contrast need to turn ANDS into a genuinely mass-market product appealing to its global customers. They are making progress. Given the continued buoyancy of the combustibles market, they have extensive resources to continue their efforts. Disruptive innovations are not unique to tobacco control. Equivalent technological solutions - with concomitant business opportunities - are emerging in obesity and alcohol fields with implications for public health.
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Affiliation(s)
- Marisa de Andrade
- School of Health in Social Science, Counselling, Psychotherapy and Applied Social Sciences, University of Edinburgh, Edinburgh, UK
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Group for Research on Inequalities and Tobacco (GRIT), University of Edinburgh, Edinburgh, UK
| | - Kathryn Angus
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Gerard Hastings
- UK Centre for Tobacco and Alcohol Studies (UKCTAS), UK
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
- Centre for Tobacco Control Research, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
- The Open University Business School, Milton Keynes, UK
- Ecole des hautes études en santé publique (EHESP), Rennes, France
| | - Nikolina Angelova
- School of Health in Social Science, Counselling, Psychotherapy and Applied Social Sciences, University of Edinburgh, Edinburgh, UK
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Kasza KA, Coleman B, Sharma E, Conway KP, Cummings KM, Goniewicz ML, Niaura RS, Lambert EY, Schneller LM, Feirman SP, Donaldson EA, Cheng YC, Murphy I, Pearson JL, Trinidad DR, Bansal-Travers M, Elton-Marshall T, Gundersen DA, Stanton CA, Abrams DB, Fong GT, Borek N, Compton WM, Hyland AJ. Correlates of Transitions in Tobacco Product Use by U.S. Adult Tobacco Users between 2013⁻2014 and 2014⁻2015: Findings from the PATH Study Wave 1 and Wave 2. Int J Environ Res Public Health 2018; 15:E2556. [PMID: 30441875 PMCID: PMC6266124 DOI: 10.3390/ijerph15112556] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/07/2018] [Accepted: 11/10/2018] [Indexed: 11/16/2022]
Abstract
More than half of adult tobacco users in the United States (U.S.) transitioned in tobacco product use between 2013⁻2014 and 2014⁻2015. We examine how characteristics of adult tobacco users in the U.S. relate to transitions in tobacco product use. Population Assessment of Tobacco and Health (PATH) Study data were analyzed from 12,862 adult current tobacco users who participated in Wave 1 (W1, 2013⁻2014) and Wave 2 (W2, 2014⁻2015). Three types of transitions were examined-(1) adding tobacco product(s); (2) switching to non-cigarette tobacco product(s); and (3) discontinuing all tobacco use-among those currently using: (1) any tobacco product; (2) cigarettes only (i.e., exclusive cigarette); and (3) cigarettes plus another tobacco product(s) (i.e., poly-cigarette). Multinomial logistic regression analyses determined relative risk of type of transition versus no transition as a function of demographic and tobacco use characteristics. Transitions in tobacco product use among adult tobacco users were common overall, but varied among different demographic groups, including by age, sex, sexual orientation, race/ethnicity, educational attainment, and poverty level. Further, cigarette smokers with higher dependence scores were more likely to add product(s) and less likely to discontinue tobacco use compared to those with low dependence scores. That high nicotine dependence is a barrier to discontinuing tobacco use adds evidence to support policy to lower nicotine content of cigarettes and to evaluate new products for their potential to reduce cigarette use.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Blair Coleman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | | | - Kevin P Conway
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC 20001, USA.
| | - Elizabeth Y Lambert
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Liane M Schneller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Shari P Feirman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Yu-Ching Cheng
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Iilun Murphy
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC 20001, USA.
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, La Jolla, CA 92093, USA.
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, ON M5T 1R8, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada.
- Ontario Tobacco Research Unit, Toronto, ON M5S 2S1, Canada.
| | - Daniel A Gundersen
- Department of Family Medicine and Community Health, Robert Wood Johnson Medical School, Rutgers, Somerset, NJ 08873, USA.
- Survey and Data Management Core, Dana-Farber Cancer Institute, Boston, MA 02215, USA.
| | | | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC 20001, USA.
| | - Geoffrey T Fong
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada.
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Andrew J Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
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Kasza KA, Borek N, Conway KP, Goniewicz ML, Stanton CA, Sharma E, Fong GT, Abrams DB, Coleman B, Schneller LM, Lambert EY, Pearson JL, Bansal-Travers M, Murphy I, Cheng YC, Donaldson EA, Feirman SP, Gravely S, Elton-Marshall T, Trinidad DR, Gundersen DA, Niaura RS, Cummings KM, Compton WM, Hyland AJ. Transitions in Tobacco Product Use by U.S. Adults between 2013⁻2014 and 2014⁻2015: Findings from the PATH Study Wave 1 and Wave 2. Int J Environ Res Public Health 2018; 15:E2515. [PMID: 30423998 DOI: 10.3390/ijerph15112515] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/01/2018] [Accepted: 11/06/2018] [Indexed: 11/30/2022]
Abstract
In 2013–2014, nearly 28% of adults in the United States (U.S.) were current tobacco users with cigarettes the most common product used and with nearly 40% of tobacco users using two or more tobacco products. We describe overall change in prevalence of tobacco product use and within-person transitions in tobacco product use in the U.S. between 2013–2014 and 2014–2015 for young adults (18–24 years) and older adults (25+ years). Data from Wave 1 (W1, 2013–2014) and Wave 2 (W2, 2014–2015) of the Population Assessment of Tobacco and Health (PATH) Study were analyzed (N = 34,235). Tobacco product types were categorized into: (1) combustible (cigarettes, cigars, pipe tobacco, hookah), (2) noncombustible (smokeless tobacco, snus pouches, dissolvable tobacco), and (3) electronic nicotine delivery systems (ENDS). Transitions for individual combustible-product types, and for single- and multiple-product use, were also considered. Overall prevalence of current tobacco use decreased from 27.6% to 26.3%. Among W1 non-tobacco users, 88.7% of young adults and 95.8% of older adults were non-tobacco users at W2. Among W1 tobacco users, 71.7% of young adults transitioned, with 20.7% discontinuing use completely, and 45.9% of older adults transitioned, with 12.5% discontinuing use completely. Continuing with/transitioning toward combustible product(s), particularly cigarettes, was more common than continuing with/transitioning toward ENDS. Tobacco use behaviors were less stable among young adults than older adults, likely reflecting greater product experimentation among young adults. Relative stability of cigarette use compared to other tobacco products (except older adult noncombustible use) demonstrates high abuse liability for cigarettes.
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Robertson L, Hoek J, Blank ML, Richards R, Ling P, Popova L. Dual use of electronic nicotine delivery systems (ENDS) and smoked tobacco: a qualitative analysis. Tob Control 2018; 28:13-19. [PMID: 29419488 PMCID: PMC6317506 DOI: 10.1136/tobaccocontrol-2017-054070] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) arguably pose fewer health risks than smoking, yet many smokers adopt ENDS without fully relinquishing smoking. Known as 'dual use', this practice is widespread and compromises the health benefits that ENDS may offer. To date, few studies have explored how dual use practices arise and manifest. METHODS We conducted in-depth, semi-structured interviews with 20 current ENDS users from New Zealand who reported smoking tobacco at least once a month. We explored participants' smoking history, their recent and current smoking, trial, uptake and patterns of ENDS use, and future smoking and vaping intentions. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts. RESULTS Dual use practices among participants evolved in four ways. First, as an attempt to manage the 'inauthenticity' of vaping relative to smoking and to retain meaningful rituals. Second, as complex rationalisations that framed decreased tobacco use, rather than smoking cessation, as 'success'. Third, as a means of alleviating the financial burden smoking imposed and to circumvent smoke-free policies. Lastly, dual use reflected attempts to comply with social group norms and manage stigma. CONCLUSIONS Dual use reflects both social and physical cues. It assisted participants to navigate smoking restrictions and allowed them to manage divergent norms. Policies that discourage smoking, particularly excise tax increases on smoked tobacco and smoke-free space restrictions, appear important in prompting ENDS use. Future research could explore whether these policies also help foster complete transition from smoking to exclusive ENDS use.
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Affiliation(s)
- Lindsay Robertson
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
| | - Mei-Ling Blank
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
| | - Rosalina Richards
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pamela Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Lanza HI, Teeter H. Electronic Nicotine Delivery Systems (E-cigarette/Vape) use and Co-Occurring Health-Risk Behaviors Among an Ethnically Diverse Sample of Young Adults. Subst Use Misuse 2018; 53:154-161. [PMID: 28777675 PMCID: PMC5825211 DOI: 10.1080/10826084.2017.1327975] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prevalence rates of electronic nicotine delivery systems (ENDS; i.e., e-cigarette/vape) use has grown exponentially in the past few years. College students present a particularly vulnerable group for ENDS use. The current study sought to expand the literature by examining the context in which college students use ENDS, co-occurring health risks beyond traditional tobacco use, and the role of ethnicity in ENDS use. METHODS Health-risk behavior survey data was collected from 452 undergraduates attending a large, public urban university during the 2015-2016 academic year. Ever ENDS users vs. non-ENDS users were compared across potential demographic, health-risk, and other health-related correlates. RESULTS Almost 40% of participants reported lifetime use of ENDS. No ethnic or sex differences were found. The primary source for obtaining ENDS was friends and ENDS were most often used with friends vs. alone or with others not considered friends. Participants engaging in risky alcohol use and cigarette smoking had a higher likelihood of endorsing ENDS use. Conclusions/Importance: The current study indicated that a large proportion of college students have tried ENDS irrespective of ethnicity or sex. An increasingly normative social context may inform the popularity of ENDS use across ethnicity and sex, but additional research using ethnically diverse samples is warranted. Risky alcohol use appears to be a significant correlate of ENDS use, even after accounting for the robust relationship between ENDS use and cigarette smoking. The robust relationship between alcohol and tobacco use likely extends to ENDS use.
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Affiliation(s)
- H Isabella Lanza
- a Department of Human Development , California State University , Long Beach , California , USA
| | - Heather Teeter
- a Department of Human Development , California State University , Long Beach , California , USA
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Brasky TM, Hinton A, Doogan NJ, Cooper SE, Nagaraja HN, Xi W, Shields PG, Wewers ME. Characteristics of the Tobacco User Adult Cohort in Urban and Rural Ohio. TOB REGUL SCI 2018; 4:614-30. [PMID: 29862311 DOI: 10.18001/TRS.4.1.8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Identifying characteristics associated with the use of new and emerging tobacco products is a priority. The enumeration and baseline characteristics of a new cohort of adult tobacco users are described. Methods Residents, ≥18 years of age, in urban Franklin County, or one of 6 rural Appalachian counties, and who were exclusive users of combustible, smokeless (SLT), or electronic nicotine delivery systems (ENDS) tobacco products, or were dual users, were targeted for recruitment. Participants were interviewed in-person at baseline on sociodemographic characteristics, tobacco product use, and cognitive/affective and purchasing factors. Results We recruited 1210 participants (urban, N = 595; rural, N = 615). Urban participants were less likely to use tobacco daily, began using tobacco later, used tobacco for less time, and had higher cessation interest. ENDS users were significantly less likely to have made a quit attempt than users of other tobacco products. Duration of tobacco use and nicotine dependence also differed by product type. Conclusion This cohort's enumeration allowed us to compare factors associated with tobacco product preferences and the use of novel products. The inclusion of rural Appalachia-a region with high tobacco use and disease burden-may provide additional insights into the implementation of tobacco control interventions.
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Hall MG, Pepper JK, Morgan JC, Brewer NT. Social Interactions as a Source of Information about E-Cigarettes: A Study of U.S. Adult Smokers. Int J Environ Res Public Health 2016; 13:E788. [PMID: 27527199 DOI: 10.3390/ijerph13080788] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 11/17/2022]
Abstract
The novelty of e-cigarettes and ambiguity about their effects may foster informal sharing of information, such as through social interactions. We aimed to describe smokers' social interactions about e-cigarettes and their recommendations that others use e-cigarettes. Data were collected from 2149 adult smokers in North Carolina and California who participated in a study of the impact of pictorial cigarette pack warnings. In the previous month, almost half of participants (45%) reported talking to at least one person about e-cigarettes and nearly a third of participants (27%) recommended e-cigarettes to someone else. Smokers recommended e-cigarettes to cut back on smoking (57%), to quit smoking (48%), for health reasons (36%), and for fun (27%). In adjusted analyses, more frequent e-cigarette use, positive views about typical e-cigarette users, and attempting to quit smoking in the past month were associated with recommending e-cigarettes for health reasons (all p < 0.05). Social interactions appear to be a popular method of information-sharing about e-cigarettes among smokers. Health communication campaigns may help to fill in the gaps of smokers' understanding of e-cigarettes and their long-term effects.
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