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Nicotine & Tobacco Research
Journal Prestige (SJR): 2.186  Citation Impact (citeScore): 3 Number of Followers: 14  Hybrid journal (It can contain Open Access articles)ISSN (Print) 1462-2203 - ISSN (Online) 1469-994X Published by Oxford University Press  [424 journals]
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- Wise Practices in Commercial Tobacco Research to Promote Racial Equity
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Pages: 603 - 604
Abstract: The society for research into nicotine and tobacco established the racial equity task force in 2020 to support the Society moving “… toward becoming anti-racist through the promotion of racial equity within Society for Research into Nicotine and Tobacco (SRNT), itself, as well as in the field of nicotine and commercial tobacco research”.1 In January 2022 the Task Force published its final report2 that included recommendations specifically for this journal. These recommendations are related to creating safe editorial processes, enhancing capability within the editorial team, and supporting wise practice in racial equity research. The Nicotine and Tobacco Research (N&TR) editorial teams are in the process of developing responses to these recommendations that we look forward to sharing in the near future. In the meantime, this edition of N&TR contains a number of wise practice exemplars for conducting racial equity research.3–7 All of these papers point to the importance of not only expanding the evidence base on causes and solutions to racial and ethnic inequities but also thinking about the way we go about doing this.
PubDate: Thu, 02 Feb 2023 00:00:00 GMT
DOI: 10.1093/ntr/ntad019
Issue No: Vol. 25, No. 4 (2023)
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- Meta-Analysis on Associations of Timing of Maternal Smoking Cessation
Before and During Pregnancy With Childhood Overweight and Obesity-
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Pages: 605 - 615
Abstract: IntroductionThere is a lack of comprehensive review on associations of maternal smoking cessation (versus nonsmokers) with childhood overweight and obesity.Aims and MethodsWe conducted a systematic review and meta-analysis of existing evidence in this field. Within PubMed, EMBASE, and CENTRAL databases, we identified and screened 1147 abstracts. We reviewed full-texts and extracted related information from 10 eligible articles. We pooled odds ratios for overweight/obesity and mean differences in BMI z-scores by maternal smoking status around pregnancy.ResultsAmong 10 eligible studies, 71 393 children were included from ages 2 to 18 years. Compared to children of nonsmokers, the pooled unadjusted odds ratio (OR) for overweight was 1.36 (95% Confidence Interval CI: 1.14, 1.62) in children of quitters and 1.44 (1.27, 1.64) in children of continued smokers. The pooled unadjusted OR for obesity was 1.65 (1.17, 2.32) in children of quitters and 1.94 (1.38, 2.73) in children of continued smokers. The pooled unadjusted mean difference in BMI z-score was 0.51 (0.41, 0.61) in children of quitters and 0.64 (0.58, 0.70) in children of continued smokers. The pooled unadjusted OR for overweight in children of mothers quitting before pregnancy was 1.46 (1.15, 1.85), during the first trimester was 1.52 (1.27, 1.82), and during pregnancy (mixed timing, mostly first trimester) was 0.97 (0.79, 1.20).ConclusionThe risk of offspring overweight and obesity was moderately higher for quitters during pregnancy compared to nonsmokers, although it might not be as high as continued smokers.ImplicationsMaternal smoking during pregnancy is an established risk factor of childhood overweight and obesity. Based on our systematic review, intervention to help mothers quit smoking has the potential to reduce the risk of childhood overweight and obesity in offspring related to prenatal tobacco exposure. Quitting before pregnancy is ideal, but quitting in early pregnancy is still helpful for reducing risk.
PubDate: Thu, 15 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac213
Issue No: Vol. 25, No. 4 (2022)
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- Variability in Urinary Nicotine Exposure Biomarker Levels Between Waves 1
(2013–2014) and 2 (2014–2015) in the Population Assessment of Tobacco
and Health Study-
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Pages: 616 - 623
Abstract: AbstractIntroductionTo date, no studies have evaluated the consistency of biomarker levels in people who smoke over a long-time period in real-world conditions with a large number of subjects and included use behavior and measures of nicotine metabolism. We evaluated the variability of biomarkers of nicotine exposure over approximately a 1-year period in people who exclusively smoke cigarettes, including intensity and recency of use and brand switching to assess impact on understanding associations with product characteristics.Aims and MethodsMultivariate regression analysis of longitudinal repeated measures of urinary biomarkers of nicotine exposure from 916 adults in the Population Assessment of Tobacco and Health (PATH) Study with demographic characteristics and use behavior variables. Intraclass correlation coefficients (ICCs) were calculated to examine individual variation of nicotine biomarkers and the uncertainty of repeat measures at two time points (Waves 1 and 2).ResultsAge, race, and urinary creatinine were significant covariates of urinary cotinine. When including use behavior, recency, and intensity of use were highly significant and variance decreased to a higher extent between than within subjects. The ICC for urinary cotinine decreased from 0.7530 with no use behavior variables in the model to 0.5763 when included. Similar results were found for total nicotine equivalents.ConclusionsUrinary nicotine biomarkers in the PATH Study showed good consistency between Waves 1 and 2. Use behavior measures such as time since last smoked a cigarette and number of cigarettes smoked in the past 30 days are important to include when assessing factors that may influence biomarker concentrations.ImplicationsThe results of this study show that the consistency of the nicotine biomarkers cotinine and total nicotine equivalents in spot urine samples from Waves 1 to 2 of the PATH Study is high enough that these data are useful to evaluate the association of cigarette characteristics with biomarkers of exposure under real-world use conditions.
PubDate: Fri, 25 Mar 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac056
Issue No: Vol. 25, No. 4 (2022)
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- A Comparison of Use Topography and Nicotine Pharmacokinetics Among Loose
and Portioned Smokeless Tobacco Users-
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Pages: 624 - 630
Abstract: AbstractIntroductionMoist snuff smokeless tobacco (ST) products are available in the United States in both “loose” and “portioned” (ie, pouched) formats, but no published study to date has clinically evaluated the associations between ST format, use behavior, and nicotine exposure.Aims and MethodsParticipants used their usual brand of ST (loose ST [n = 30] or portioned ST [n = 20]) during an experimental visit wherein use behavior and plasma nicotine pharmacokinetic parameters were measured following single use (first hour of the session) and ad libitum use (remaining 7 h of the session). Participants’ ST products were chemically characterized prior to use for pH and nicotine content.ResultsThe average amount per use (2.99 vs. 1.52 g; p = .005) and total amount used (11.45 vs. 5.4 g; p = .002) were significantly higher among the loose ST group. Maximum plasma nicotine concentration (Cmax; 33.4 vs. 19.1 ng/ml) and area under the nicotine concentration versus time curve (AUC) were significantly higher for the loose ST group for the first hour (1474.8 vs. 807.2 min* ng/ml; p = .003) and throughout the 8-hour session (15827.9 vs. 8155.3 min* ng/ml; p < .001). Significant associations were observed between free nicotine content and first use Cmax (rs = .488, loose ST group) and AUC0–1 h (rs = 0.448, loose ST group; rs = .441, portioned ST group).ConclusionsThe loose ST group used more product and had a greater average deposition time per use than the portioned ST group. Nicotine exposure was more strongly associated with free nicotine content than total nicotine content.ImplicationsTo our knowledge, the current investigation was the first study to date to clinically evaluate the associations between usual-brand smokeless format, use behavior, and nicotine exposure. We observed meaningful differences in use behavior and subsequent nicotine exposure between loose and portioned ST users. Further, we observed that nicotine exposure was more strongly associated with free nicotine content than total nicotine content.
PubDate: Mon, 15 Aug 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac195
Issue No: Vol. 25, No. 4 (2022)
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- Measuring the impact of state and local Tobacco 21 policies in the United
States: A longitudinal study of youth and young adults ages 15–21-
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Pages: 631 - 638
Abstract: AbstractIntroductionTobacco 21 (T21) policies, which prohibit tobacco sales to individuals under 21, aim to reduce youth tobacco use by limiting youth access to these products. Little, however, is known about the longitudinal effect of T21 policies on youth tobacco use behaviors at the national level.MethodsParticipants aged 15–21 years from a longitudinal study conducted between May 2014 and May 2019 (n = 13,990) were matched to geocoded T21 policies. Generalized linear mixed models examined the association of direct and bordering T21 policy exposure and cigarette and e-cigarette use and intention to use, accounting for individual characteristics.ResultsControlling for sociodemographic and psychosocial covariates, there were statistically significant positive associations between T21 exposure and e-cigarette use (OR = 1.45 [1.03,2.06], p < .003) and intention to use e-cigarettes (OR = 1.54 [1.05,2.26], p < .027). We found no association between T21 policy exposure and cigarette use or intention to use cigarettes. Furthermore, exposure to T21 policies did not significantly modify the relationship between age and either cigarette outcome.ConclusionsThis is the first longitudinal study to evaluate state and local T21 policies at the national level. Our analyses demonstrate that existing T21 policies are not sufficient to reduce youth tobacco use and intentions to use, and suggest that T21 policies need to be a part of a comprehensive tobacco policy landscape. Our findings suggest further research is warranted on state and local T21 policy enforcement and implementation, including how T21 may differentially impact cigarette and e-cigarette use, and may have implications for the federal T21 policy.ImplicationsThis research evaluates state and local T21 policies in the United States longitudinally, finding that T21 policies are not sufficient to stem e-cigarette use among adolescents and young adults. These findings support further policy action and suggest that local and state T21 policies are not sufficient to reduce tobacco use and rather, need to be part of a broader, more comprehensive set of tobacco control policies. Further research on enforcement and implementation challenges of T21 policies and the impacts of the new federal T21 policy is warranted.
PubDate: Thu, 27 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac248
Issue No: Vol. 25, No. 4 (2022)
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- Disparities in Nicotine Addictiveness and Cancer Harm Perceptions Among
U.S. Adults: A Trend Analysis Using the Health Information National Trends
Survey-
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Pages: 639 - 647
Abstract: AbstractIntroductionRecent research has found widespread misperceptions about nicotine. This study tests perceptions among U.S. adults with respect to nicotine addictiveness and cancer harm, while distinguishing between nicotine misperceptions (ie an incorrect response) and “don’t know” (DK) responses.Aims and Methods Data from three cycles of the Health Information National Trends Survey, fielded in 2015, 2017, and 2019 were merged for analysis. Weighted multinominal logistic regression models were conducted where nicotine addictiveness and cancer harm beliefs (DK, incorrect, and correct responses) were regressed on survey year and demographic variables. We also tested for interactions between survey year and demographic variables to assess if previously identified disparities had evolved during these years.ResultsAnalyses showed lower odds of misperceptions about nicotine addictiveness, but higher odds of misperceptions about nicotine cancer harm in 2019 compared to 2015. There was no change in DK responses during these years. Disparities by sociodemographics and tobacco use status were observed, mostly for cancer harm. Survey year significantly interacted with age in the model for cancer harm, which was driven primarily by increased incorrect responses and decreased DK responses over time among the youngest age group (18–34 years). There were no significant interactions between survey year and race and ethnicity or level of educational attainment.ConclusionsDisparities in nicotine addictiveness and cancer harm perceptions reflect the uneven distribution of knowledge in the U.S. adult population. Nicotine cancer harm misperceptions are increasing and educational efforts to address this misperception are warranted.ImplicationsFuture educational efforts targeting nicotine addictiveness beliefs may benefit by focusing on DK responders. The growing trend of misperceptions of nicotine’s role in cancer harm may negatively impact perceptions about nicotine replacement therapy and low nicotine content cigarettes. Future efforts should focus on correcting nicotine cancer harm misperception, particularly among young adults.
PubDate: Sat, 22 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac245
Issue No: Vol. 25, No. 4 (2022)
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- The Impact of the Danish National Smoking Ban From 2007 on the Incidence
of Eight Smoking-related Diseases: A Nationwide Register-based Interrupted
Time Series Analysis-
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Pages: 648 - 656
Abstract: AbstractBackgroundPrevious research has documented the effect of comprehensive smoking bans on preventing various adverse health outcomes in the years post-ban. In 2007, Denmark implemented a national smoking ban that prohibited indoor smoking in workplaces and public settings, although only partial restrictions applied in specific premises such as small bars, one-person offices, and in psychiatric units. We tested the hypothesis that the implementation of the national smoking ban was associated with a decrease in incidence of smoking-related morbidity in the Danish population compared to the pre-ban period.MethodsInterrupted time series analyses including the entire Danish population (≥30 years) was conducted. Information of hospitalizations and cause-specific mortality due to acute myocardial infarction, heart failure, hemorrhagic stroke, ischemic stroke, chronic obstructive pulmonary disease, cancer in bronchus and lung, cancer in lip, mouth, oral cavity, and pharynx, and bladder cancer were obtained from population-based registers. Poisson regression models accounting for seasonal variations and secular trends quantified immediate changes in incidence rates occurring at the time of the smoking ban as well as changes in the post-ban trend compared to pre-ban levels.ResultsOverall, we observed no consistent declines in incidence of cardiovascular diseases, chronic obstructive pulmonary disease, or the specific types of cancer in the post-ban period compared with the pre-ban period.ConclusionNo consistent reduction in incidence of smoking-related diseases was observed after the smoking ban was introduced in Denmark. This probably reflects that the Danish smoking ban included several exemptions, resulting in a less comprehensive ban compared to those introduced in other countries.ImplicationsIn this study, we found that the Danish national smoking ban from 2007 did not consistently reduced the incidence of eight smoking-related outcomes in the post-ban period compared to pre-ban levels. We argue that due to the exemptions in the smoking ban, which for example allowed smoking in specific premises of the care and nursing sector, in one-person offices, and small bars, the ban was not sufficiently comprehensive to influence smoking behavior and thereof the incidence of smoking-related morbidity. Our findings highlight the importance of introducing comprehensive legislative measures to yield largest health benefits at a population level.
PubDate: Fri, 11 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac257
Issue No: Vol. 25, No. 4 (2022)
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- Stepwise Tobacco Price Increase and Smoking Behavioral Changes in Japan:
The Japan “Society and New Tobacco” Internet Survey 2017–2021
Longitudinal Study-
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Pages: 657 - 664
Abstract: AbstractIntroduction Tobacco price increase is an effective measure to reduce tobacco smoking. In Japan, the price of combustible cigarettes increased in 2018 and 2020, and that of heated tobacco products increased every year from 2018 to 2020 by tobacco excise taxation. Also, the general consumption tax increase in 2019 slightly raised the retail prices of tobacco products. We investigated the impact of this stepwise tobacco price increase on combustible cigarette smoking status among Japanese adults.Aims and MethodsFive waves of annual longitudinal data (2017–2021) from The Japan “Society and New Tobacco” Internet Survey (JASTIS) (31 930 observations of 11 896 individuals) were analyzed. Multivariable logistic regression with a generalized estimating equation was fitted, adjusting for the prefecture of residence, age, sex, socioeconomic status, health status, alcohol drinking, former smoker’s duration of smoking cessation, and the current smoker’s number of cigarettes smoked per day.ResultsThe 2018 price increase was associated with a reduction in relapse (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.42–0.68) and an increment in cessation (aOR 1.20, 95% CI 1.02–1.42). The price increase in 2019 was not associated with relapse (aOR 0.84, 95% CI 0.63–1.10) or cessation (aOR 0.95, 95% CI 0.80–1.13). The 2020 price increase was associated with a reduction in relapse (aOR 0.59, 95% CI 0.42–0.81) and an increment in cessation (aOR 1.45, 95% CI–1.21, 1.73).ConclusionThe price increase caused by tobacco excise taxation was associated with a reduction in combustible cigarette smoking.ImplicationsJapan introduced a policy of stepwise increase in tobacco excise taxation in 2018. We analyzed five-wave longitudinal data to investigate the impact of the policy. Tobacco price increases in 2018 and 2020 were associated with a reduction in combustible cigarette smoking. Tobacco price increases in 2019 by general consumption tax were not associated with a change in combustible cigarette smoking.
PubDate: Fri, 04 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac254
Issue No: Vol. 25, No. 4 (2022)
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- Manipulation of Menthol and Nicotine Content in Cigarettes: Effects on
Smoking Behavior and Toxicant Exposure in Women Menthol Smokers-
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Pages: 665 - 673
Abstract: AbstractBackgroundThe purpose of this study was to determine the effects of smoking and other outcomes of assigning cigarettes with reduced nicotine and/or no menthol to female menthol smokers.Aims and Methods Nontreatment-seeking female menthol smokers (N = 263) participated in a randomized controlled trial in which levels of menthol and nicotine in cigarettes were manipulated using experimental cigarettes. After a baseline period, participants were assigned to the following conditions for 6 weeks: (1) their own brand of cigarette (conventional nicotine with menthol), (2) a conventional nicotine cigarette with no menthol, (3) a cigarette with reduced nicotine (RNC) with menthol, or (4) a RNC cigarette and no menthol. Participants then returned to using their own brand and were followed for another 6 weeks. Outcomes included cigarettes smoked, biomarkers of exposure, and dependence measures.ResultsResults indicated that, after an initial increase, rates of smoking of all three experimental cigarettes were at or below baseline rates of smoking of one’s own brand. Levels of biomarkers also decreased during the experimental phase but rebounded somewhat after participants resumed smoking their own brand. There was evidence that the overall amount of smoking decreased similarly among women who switched to non-menthol and/or RNC cigarettes.ConclusionsThese results suggest that no detrimental effect will occur in nicotine or toxicant exposure levels with a ban on characterizing menthol and/or a product standard on nicotine content in cigarettes.ImplicationsThe implication of this work is that there would be no risk to women menthol smokers associated with regulations restricting nicotine and eliminating menthol in cigarettes.
PubDate: Mon, 26 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac225
Issue No: Vol. 25, No. 4 (2022)
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- Motivations to Change Smoking Behaviors Between 2007 and 2019 in
Australia: A Repeated Cross-sectional Study-
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Pages: 674 - 681
Abstract: AbstractIntroductionIn 2010, Australian tobacco excise (administered federally) increased by 25%, and by 12.5% annually from 2013 to 2020, with additional increases on roll-your-own (RYO) tobacco between 2017 and 2020. We estimated past year changes in smoking behavior among Australian adults who smoked (daily and non-daily) in the past year, and the association between consumer characteristics and stated motivations to change/attempt to change smoking behavior between 2007 and 2019.MethodsLogistic regression analysis of combined data from national representative triennial cross-sectional surveys in Australia (N = 22 977).ResultsThe main motivation cited for changing smoking behavior switched from health-related from 2007 to 2010 to cost-related from 2013 to 2019. Among those who quit between one and 12 months ago, living in a lower socioeconomic area (odds ratio (OR) = 1.61, 95% CI = 1.18% to –2.18%), was associated with reporting the cost of smoking motivated them to quit. Among those who reduced their smoking, smoking daily and >20 cigarettes/day vs. non-daily smoking (OR = 2.11, 95% CI = 1.60% to 2.78%), having high/very high psychological distress (OR = 1.33, 95% CI = 1.12% to 1.59%), and alcohol consumption (ORdaily drinking = 1.38, 95% CI = 1.05% to 1.81%) was associated with cost as a motivation. Exclusive (OR = 0.65, 95% CI = 0.53% to 0.80%) and non-exclusive (OR = 0.77, 95% CI = 0.65% to 0.91%) RYO use was associated with being less likely to report the cost of tobacco as motivation for cutting down.ConclusionsThe cost of smoking became the most cited motivator to change smoking behavior (eg, quitting and cutting down), particularly for those who lived in low socioeconomic areas, smoked more cigarettes per day, drank alcohol, and had high/very high psychological distress.ImplicationsA change in the main federal tobacco control intervention implemented in Australia from mass-media campaigns to tobacco tax increases has likely led to cost, rather than health, being the main motivation cited for changing smoking behavior in Australia since 2013. Further monitoring is needed to ensure the harmonization in tax rates for RYO and factory-made cigarettes has effectively reduced the price difference between these products because the lower cost of RYO may have reduced the effectiveness of tax increases as a motivator to change smoking behavior.
PubDate: Tue, 16 Aug 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac176
Issue No: Vol. 25, No. 4 (2022)
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- Prevalence and Correlates of Tobacco Use in Young People Presenting to
Australian Primary Mental Health Services-
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Pages: 682 - 691
Abstract: AbstractIntroductionIn Australian youth primary mental health settings it is unclear as to the rates and correlates of tobacco use at service entry.Aims and MethodsWe aimed to delineate the prevalence and correlates of recent tobacco use (eg, cigarettes, chewing tobacco, cigars, etc) in the past 3 months in young people at their first presentation to primary mental health services as a function of age. Cross-sectional self-report measures were collected using a tablet device from young people presenting to one of five Australian primary mental health (headspace) services. Logistic regression assessed correlates of past 3-month tobacco use in adolescents (12–17 years) and young adults (18–25 years).ResultsRegular (at least monthly) tobacco use in the past 3 months was found in 23.4% (n = 247, N = 1055) of the sample. Increasing age (odds ratio [OR] =1.47 per year; 95% confidence interval [CI]: 1.15 to 1.89), male sex (OR = 1.98; 95% CI: 1.02 to 3.83), being in a relationship (OR = 1.96; 95% CI: 1.01 to 3.82), and poorer functioning (OR = 0.95 per unit Social and Occupational Functioning Assessment Scale increase; 95% CI: 0.91 to 0.99) predicted regular tobacco use in adolescents, but not in young adults. Living in a regional location (OR = 2.10; 95% CI: 1.40 to 3.13) and not studying (OR = 0.47; 95% CI: 0.31 to 0.73) predicted tobacco use in young adults. Having a diagnosed mental illness other than depression and/or anxiety predicted tobacco use in both groups (adolescents OR = 2.49; 95% CI: 1.26 to 4.94; young adults OR = 1.80; 95% CI: 1.13 to 2.89).ConclusionsNearly a quarter of young people with mental illness are using tobacco, supporting the need for early intervention approaches. Adapting treatment targets by age could improve the impact of interventions in adolescents versus young adults. Poor functioning and lack of engagement in education were associated with tobacco use in both age groups, respectively; however, more research is needed to determine the direction of these relationships.ImplicationsYoung people with mental illness have a high prevalence of recent tobacco use and this is evident when they first present to youth primary mental health services. Youth-oriented mental health settings may provide a unique window for tobacco use prevention and early intervention to reduce smoking in people with mental illness, a priority population. Age-specific targeted approaches might be needed in adolescents and young adults.
PubDate: Mon, 06 Jun 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac039
Issue No: Vol. 25, No. 4 (2022)
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- Menthol Cigarette Use Among Adults Who Smoke Cigarettes, 2008–2020:
Rapid Growth and Widening Inequities in the United States-
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Pages: 692 - 698
Abstract: AbstractIntroductionIn April 2021, the U.S. Food and Drug Administration announced its intention to issue a product standard banning menthol as a characterizing flavor in cigarettes. Given the potential relevance of national estimates of menthol use to pending legislation, this study estimated the prevalence of menthol use among U.S. adults who smoke cigarettes in 2020 and investigated changes in menthol use from 2008 to 2019 by sociodemographics, mental health, and substance use.Aims and MethodsNationally representative annual, cross-sectional data from the National Survey on Drug Use and Health, which included participants ages 18 years and older residing in the United States from 2008 to 2019 and the 2020. Data were analyzed using logistic and linear regression models to estimate trends in menthol use among adults who smoke cigarettes by sociodemographic, mental health and substance use variables (total analytic sample 2008–2019 n = 128 327).ResultsIn 2020, 43.4% of adults who smoked cigarettes in the past month used menthol. Menthol use was most common among black adults (80%) and over 50% of those Hispanic, female, young (ages 18–34 years), lesbian/gay, with serious psychological distress, and with cigar use used menthol. Menthol use increased among adults who used cigarettes from 2008 to 2019, overall, and grew more rapidly among adults ages 26–34 years, Hispanic, light cigarette use (1–5 per day), and those who smoked cigars.ConclusionsMenthol use has increased among U.S. adults who smoke cigarettes over the past decade. Enacting menthol bans could have a widespread public health impact, especially among younger and minoritized groups.ImplicationsMenthol cigarette use increased among individuals who smoke cigarettes from 2008 to 2019 in the United States. In 2020, over 40% of smokers used menthol, and menthol use was considerably higher among adult smokers from racial/ethnic minoritized groups, who were younger and who reported mental health problems. The U.S. Food and Drug Administration seeks to ban menthol as a characterizing flavor in cigarettes; our results suggest that such a ban is likely to have a wide-ranging impact on public health.
PubDate: Thu, 13 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac214
Issue No: Vol. 25, No. 4 (2022)
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- The Short-Term and Long-Term Associations Between Receiving Tobacco
Discounts or Coupons and Smoking Cessation Among U.S. Adult Cigarette
Smokers With Intention to Quit-
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Pages: 699 - 708
Abstract: AbstractIntroductionTo examine the associations between baseline receipt of cigarette and non-cigarette tobacco discounts or coupons and smoking cessation at follow-up among US adult cigarette smokers with the intention to quit at baseline.Aims and Methods Data were from the Population Assessment of Tobacco and Health (PATH) study wave 3 (October 2015–October 2016), wave 4 (December 2016–January 2018), and wave 5 (December 2018–November 2019) surveys. Two separate sets of analyses were conducted using wave 3–4 data (N = 3707) and wave 4–5 data (N = 6251). Specifically, wave 4 was used as the 1-year follow-up of wave 3 to examine the short-term association, and wave 5 was used as the 2-year follow-up of wave 4 to examine the longer-term association. Study population were current established cigarette smokers with the intention to quit (within 1 year for wave 3–4 data) at baseline. Exposure was self-reported past 12-month receipt of discounts or coupons for cigarettes and non-cigarette tobacco products at baseline, and outcome was self-reported completely quitting cigarette smoking at follow-up. Baseline single-wave weights were applied, and multivariate logistic regressions were used to estimate the adjusted associations.ResultsParticipants who received cigarette discounts or coupons at baseline were less likely to quit completely for both 1-year follow-up (aOR = 0.66, 95% CI: 0.48 to 0.90) and 2-year follow-up (aOR = 0.74, 95% CI: 0.61 to 0.90). Baseline receipt of discounts or coupons for non-cigarette tobacco products were not consistently associated with cigarette smoking cessation at follow-up.ConclusionsReceipt of cigarette discounts or coupons was associated with a reduced likelihood of successful quitting among cigarette smokers with intention to quit. Policies restricting cigarette coupons may help them quit completely.ImplicationsThis study found that among baseline current established cigarette smokers with intention to quit in the United States, baseline receipt of cigarette discounts or coupons was negatively associated with cigarette smoking cessation for both 1-year follow-up and 2-year follow-up. Baseline receipt of discounts or coupons for e-cigarettes, cigars, and other tobacco products were not consistently significantly associated with cigarette smoking cessation at follow-up. Our study results indicated that policies restricting cigarette coupons may help increase the likelihood of successful smoking cessation for smokers with intention to quit.
PubDate: Sat, 17 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac216
Issue No: Vol. 25, No. 4 (2022)
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- Socio-Economic Status Differences in Changing Affordability of Tobacco
Products from 2011–2012 to 2018–2019 in India-
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Pages: 709 - 717
Abstract: AbstractIntroductionWe studied the change in affordability of tobacco products, an important determinant of tobacco use, across the different socio-economic status (SES) in India.Aims and MethodsWe calculated affordability in the form of relative income price (RIP-cost of tobacco products relative to income) for the years 2011–2012 and 2018–2019 using three different denominators, that is per capita gross domestic product (GDP) and net state domestic product at national and state levels, respectively; monthly per capita consumer expenditure (MPCE); and individual wages. We investigated RIP for cigarettes, bidis, and smokeless tobacco (SLT) across different SES groups (caste groups, type of employment, and education).ResultsRIP increased marginally for cigarettes, bidis and remained almost constant for SLT across casual workers. However, when RIP was adjusted with SES variables, there was no significant change (p > .05) in the affordability of products for casual workers in the year 2018–2019 as compared to 2011–2012. For regular workers, cigarettes and bidis became marginally less affordable (β < 1), whereas affordability remained constant for SLT. All products became more affordable for backward caste groups within regular workers. When RIP was calculated using MPCE all tobacco products became less affordable in the year 2018–2019. However, after adjusting for SES variables SLT reported no change in affordability. There was a marginal increase in affordability for all products when RIP was calculated with GDP.ConclusionsAlthough implementation of GST has increased the price of tobacco products, it is still not sufficient to reduce the affordability of tobacco products, particularly SLT and especially for the lower SES group.ImplicationsTobacco use and economic disadvantage conditions of the population are intricately linked. Affordability of tobacco products is influenced by socio-economic indicators like age, sex, income, education, etc. The literature measuring the affordability of tobacco products across different SES groups is scant in India. Additionally, existing literature measures affordability of tobacco products based on per capita GDP as a proxy for income. This is the first study in Indian context to report the change in affordability of tobacco products across different SES groups after adjusting for SES indicators, using individual-level income data. We have calculated the change in affordability of tobacco products between the year 2011–2012 and 2018–2019 using GDP, household income, and individual wages as a proxy for income.
PubDate: Tue, 04 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac230
Issue No: Vol. 25, No. 4 (2022)
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- Trends in Education-Related Smoking Disparities Among U.S. Black or
-
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Pages: 718 - 728
Abstract: AbstractIntroductionDespite its overall decline in the United States, trends in cigarette smoking could vary by intersection with demographic characteristics. We explored trends in education-related disparities in current smoking among U.S. adults by race (Black or African American and White), sex, and U.S. census region.Aims and Methods Data were from U.S. civilian non-institutionalized adults (aged ≥18 years) who self-identified as Black or African American and White and participated in the 1995–2019 Tobacco Use Supplement to the Current Population Survey. We estimated average annual percent changes in current cigarette smoking by the intersections of race, sex, census region, and educational attainment. We calculated educated-related prevalence differences in current cigarette smoking by subtracting the prevalence of bachelor’s degrees from that of <high school in 1995–1996 and 2018–2019, then examined their variations by the intersection of sex, race, and region. Weighted multivariable logistic regression models were used to test education*survey year interactions across sexes, races, and regions.ResultsEducation-related disparities in current cigarette smoking increased over time, especially among Black or African American male (PD1995–1996 = 22.8%; PD2018–2019 = 27.2%) and female adults (PD1995–1996 = 12.1%; PD2018–2019 = 16.5%). By region, Black or African American male adults in the Midwest showed the largest increase in education-related current cigarette smoking disparities, followed by Black or African American male and female adults in the South, and White male and female adults in the Midwest. These findings were because of small to no declines in the prevalence of current cigarette smoking among those with <high school education.Conclusion and RelevanceThe gap in the prevalence of current cigarette smoking by education widened over time, especially among Black or African American adults in certain regions.ImplicationsDespite the decline in the prevalence of current cigarette smoking in the U.S. population overall, such public health gain may not benefit all individuals equally. Using the data from a U.S. representative serial cross-sectional survey study during 1995–2019, we found that disparities in current cigarette smoking prevalence between those with <high school versus bachelor’s degree education widened especially among Black or African American adults. Future research to investigate the barriers to progress among Black or African American adults with <high school education could inform interventions to reduce racial and education-related cigarette smoking disparities.
PubDate: Fri, 14 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac238
Issue No: Vol. 25, No. 4 (2022)
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- Promoting and Maintaining Changes in Smoking Behavior for Patients
Following Discharge from a Smoke-free Mental Health Inpatient Stay:
Development of a Complex Intervention Using the Behavior Change Wheel-
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Pages: 729 - 737
Abstract: AbstractIntroductionEvidence suggests that smokers can successfully quit, remain abstinent or reduce smoking during a smoke-free mental health inpatient stay, provided behavioral/pharmacological support are offered. However, few evidence-based strategies to prevent the return to prehospital smoking behaviors post-discharge exist.Aims and Methods We report the development of an intervention designed to support smoking-related behavior change following discharge from a smoke-free mental health stay. We followed the Behavior Change Wheel (BCW) intervention development process. The target behavior was supporting patients to change their smoking behaviors following discharge from a smoke-free mental health stay. Using systematic reviews, we identified the barriers and enablers, classified according to the Theoretical Domains Framework (TDF). Potential intervention functions to address key influences were identified by consulting the BCW and Behavior Change Technique (BCT) taxonomy. Another systematic review identified effectiveness of BCTs in this context. Stakeholder consultations were conducted to prioritize and refine intervention content.ResultsBarriers and enablers to supporting smoking cessation were identified within the domains of environmental context and resources (lack of staff time); knowledge (ill-informed interactions about smoking); social influences, and intentions (lack of intention to deliver support). Potential strategies to address these influences included goal setting, problem-solving, feedback, social support, and information on health consequences. A strategy for operationalizing these techniques into intervention components was agreed upon: Pre-discharge evaluation sessions, a personalized resource folder, tailored behavioral and text message support post-discharge, and a peer interaction group, delivered by a trained mental health worker.ConclusionsThe intervention includes targeted resources to support smoking-related behavior change in patients following discharge from a smoke-free mental health setting.ImplicationsUsing the BCW and TDF supported a theoretically and empirically informed process to define and develop a tailored intervention that acknowledges barriers and enablers to supporting smoking cessation in mental health settings. The result is a novel complex theory- and evidence-based intervention that will be formally tested in a randomized controlled feasibility study.
PubDate: Mon, 17 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac242
Issue No: Vol. 25, No. 4 (2022)
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- The Longitudinal Association Between Cigarette Coupon Receipt and
Short-term Smoking Cessation Among US Adults-
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Pages: 738 - 745
Abstract: AbstractIntroductionTo help offset the increased price of cigarettes and promote brand loyalty, tobacco companies distribute coupons, particularly to price-sensitive consumers. Few studies, however, have examined the longitudinal association between coupon receipt and smoking cessation.Aims and MethodsUsing adult data from waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study, we examined the longitudinal association between coupon receipt and short-term smoking cessation. Multivariable discrete-time survival models were fit to an unbalanced person-period dataset for adult respondents (≥18 years) with current established smoking status at baseline (person n = 9472, risk period n = 29 784). Short-term smoking cessation was measured as discontinued cigarette use (no past 30-day cigarette use at follow-up) and self-reported complete quitting. Coupon receipt was measured as a time-varying exposure, measured in the wave preceding the outcome. Tobacco dependence and time-varying cigarette use intensity were controlled as potential confounders. Effect modification by age, sex, race-ethnicity, and education was assessed by examining interaction terms.ResultsWe found that adults who received a coupon were 19% less likely to quit smoking compared to adults who did not receive a coupon, adjusting for covariates (adjusted hazard rate [aHR]: 0.81, 95% CI: 0.74–0.89). None of the interaction terms were statistically significant, suggesting that the association between coupon receipt and short-term smoking cessation may not differ across the sociodemographic groups that we examined.ConclusionsTaken together, our results reveal that coupon receipt reduces the likelihood of short-term smoking cessation, and that this association does not differ by age, sex, race-ethnicity, or education.Implications (97/100)Tobacco companies distribute coupons for tobacco products to price-sensitive customers in the United States, and these coupons can be particularly effective in partly offsetting the impact of a tax increases and promoting brand loyalty. This study provides longitudinal evidence that coupon receipt is associated with a decrease in short-term smoking cessation among US adults who smoke cigarettes after adjusting for covariates and tobacco-related confounders. The findings from this study suggest that coupons are an effective tool for tobacco companies to prevent adults who smoke from quitting, and a national ban on coupons may help to facilitate smoking cessation.
PubDate: Tue, 15 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac258
Issue No: Vol. 25, No. 4 (2022)
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- Trends in Individualized Affordability of Factory-Made Cigarettes:
Findings of the 2008–2020 International Tobacco Control Netherlands
Surveys-
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Pages: 746 - 754
Abstract: AbstractIntroductionCigarette affordability, the price of tobacco relative to consumer income, is a key determinant of tobacco consumption.Aims and Methods This study examined trends over 12 years in individualized factory-made cigarette affordability in the Netherlands, and whether these trends differed by sex, age, and education. Data from 10 waves (2008–2020) of the International Tobacco Control Netherlands Surveys were used to estimate individualized affordability, measured as the percentage of income required to buy 100 cigarette packs (Relative Income Price [RIP]), using self-reported prices and income. The higher the RIP, the less affordable cigarettes are. Generalized estimating equation regression models assessed trends in individualized affordability over time and by sex, age, and education.ResultsAffordability decreased significantly between 2008 and 2020, with RIP increasing from 1.89% (2008) to 2.64% (2020) (p ≤ .001), except for 2008–2010, no significant year-on-year changes in affordability were found. Lower affordability was found among subgroups who have a lower income level: Females (vs. males), 18–24 and 25–39-year-olds (vs. 55 years and over) and low or moderate-educated individuals (vs. highly educated). Interactions between wave and education (p = .007) were found, but not with sex (p = .653) or age (p = .295). A decreasing linear trend in affordability was found for moderately (p = .041) and high-educated (p = .025), but not for low-educated individuals (p = .149).ConclusionsCigarettes in the Netherlands have become less affordable between 2008 and 2020, yet this was mostly because of the decrease in affordability between 2008 and 2010. There is a need for more significant increases in tax to further decrease affordability.ImplicationsOur findings suggest that cigarettes have become less affordable in the Netherlands between 2008 and 2020. But, this appears to be the result of a steep decrease in affordability between 2008 and 2010. Affordability was lower among groups who have on average lower incomes (females, young adults, and low- and moderate-educated individuals), and differences in trends across education levels could be explained by per capita income changes. Our individualized measure indicated lower affordability than published aggregate affordability estimations. Future tax increases should be large enough to result in a lower affordability.
PubDate: Wed, 16 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac259
Issue No: Vol. 25, No. 4 (2022)
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- What Cigarillo Companies are Putting on Instagram: A Content Analysis of
Swisher Sweets’ Marketing from 2013 to 2020-
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Pages: 755 - 762
Abstract: AbstractIntroductionTobacco marketing includes text and visual content, which conveys important meaning to consumers and influences use. Little is known about the marketing tactics used by a popular brand of cigarillos on social media to promote their products, including their visual design.MethodsA content analysis was conducted to analyze text and visuals for all posts on Swisher Sweets’ official Instagram account from Jan 23, 2013 to Feb 28, 2020. We assessed product depictions (e.g. warnings, smoking cues), presence of FDA-prohibited or potentially misleading claims (e.g. lower risk, organic), marketing tactics (e.g. celebrities, selling propositions), flavors, and demographic representation.ResultsWe coded 1402 posts. Smoking cues (e.g. images of people smoking, product imagery) were in 764 posts (54.5%), and a warning appeared in 690 (49.2%) posts, but obscured in 29.4% of those instances (n = 203). No posts included FDA-prohibited claims, but some potentially misleading language was identified, including the use of words or visual depictions of smooth (n = 254, 18.1%) and quality/well-made (n = 239, 17%). Marketing tactics such as scarcity (n = 159, 11.3%), event promotion (n = 586, 41.8%), and alcohol depictions (n = 171, 12.2%) were common, and flavor names appeared in 598 posts (42.7%). People depicted were often young adults (n = 709, 50.6%), Black/African American (n = 549, 39.2%), and in groups (n = 473, 33.7%).ConclusionsBoth text and visuals are used to market Swisher Sweets on their Instagram account. Using social images of young adults, especially Black individuals, signals the intended use of the product. These images of visual-based social media may influence appeal, glamorization, and normalization of cigarillo smoking among vulnerable populations.ImplicationsTobacco marketing, including from popular cigarillo brands like Swisher Sweets, is widely used to influence consumer perceptions and behavior. Social media marketing includes text and visual, both of which increase product appeal and encourage use. Visual-based social media from the industry itself have been understudied, particularly for cigarillos. This study characterizes the ways in which Swisher Sweets uses text and visuals to market their products through their Instagram account, including smoking cues, potentially misleading language, use of celebrity endorsers, and promotion and sponsorship of events.
PubDate: Thu, 03 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac255
Issue No: Vol. 25, No. 4 (2022)
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- Examining the Effectiveness of the 2012 Canadian Graphic Warning Label
Policy Change by Sex, Income, and Education-
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Pages: 763 - 772
Abstract: AbstractIntroductionWe examined the differential impact of the 2012 Canadian GWL policy changes on key indicators of warning label impact and quit intentions using national cohorts of Canadian and U.S. adults who smoke.Aims and MethodsWe used data from all waves of the International Tobacco Control surveys (2002–2020) in Canada and the United States. Our key measures were quit intentions and an index of warning label effectiveness (salience, cognitive and behavioral reactions). We estimated overall policy impact by comparing Canada (treatment group) with the United States (control group) using controlled interrupted time series (CITS) regression models, with interactions to examine whether policy impact varied by sex, education, and income.ResultsThe CITS model showed a statistically significant increase in the warning label effectiveness in Canada post-policy, compared to the United States (β = 0.84, 95% CI 0.35,1.33). Similarly, the odds of quit intentions were relatively higher among adults who smoked in Canada compared to the United States (OR = 1.89, 95% CI 1.51,2.36) post-policy. The three-way interaction model showed that these associations were greater among adults from low socioeconomic status (SES) groups than in high SES groups.ConclusionsThe 2012 change in the Canadian GWL policy was associated with stronger cognitive and behavioral responses to GWLs and higher odds of quit intentions among adults who smoked in Canada when compared to the United States, specifically among individuals from low SES groups, suggesting a positive equity impact. Our findings affirm the need for countries to implement or enhance GWLs, in line with the WHO Framework Convention on Tobacco Control (FCTC).ImplicationsThe evidence on the potential health equity benefit of GWL policies is mixed. To further understand the influence of GWL policies on tobacco use disparities, more systematic research using pre/post-policy designs with control groups is needed. Using a CITS model, we aimed to strengthen the available evidence on the causal influence of this tobacco control approach. Our findings show that the 2012 GWL policy change had a greater impact on adults who smoked from low SES groups than it did on adults who smoked from high SES groups, indicating a potentially positive equity impact and confirming the need for countries to implement or maximize the size of GWLs, as recommended by the WHO FCTC.
PubDate: Fri, 07 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac235
Issue No: Vol. 25, No. 4 (2022)
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- A Pilot Randomised Trial Investigating the Effects of Including Efficacy
Messaging on Tobacco Warning Labels-
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Pages: 773 - 780
Abstract: AbstractIntroductionSmokers can respond defensively to health risk communication such as on-pack warning labels, potentially reducing their effectiveness. Theory suggests that risk perception together with self-efficacy reduces defensive responses and predicts target behaviors. Currently, tobacco warning labels globally predominantly target risk and do not explicitly consider efficacy.AimsThis study explores the effectiveness of combining Australian tobacco warning labels with efficacy content to increase quitting intentions.MethodsRCT in 83 smokers over 3 weeks. After a seven-day baseline phase (smoking from usual tobacco packaging), participants were randomized to one of two adhesive labels groups for the remaining 14 days: Standard health warning labels (HWLs) featuring enhanced efficacy messages (experimental group) or unmodified standard HWLs (control group). Participants attached these labels to their tobacco packaging and recorded their cognitions and smoking behavior once daily using Smartphones. Multilevel structural equation modeling was used to test theorized effects of the labels on self-efficacy, risk perception, and intentions to quit.ResultsThere was no effect of exposure to efficacy messages on either self-efficacy, risk perceptions, or intentions to quit. However, self-efficacy and risk perceptions were positively associated with quitting intentions at the within-person level.ConclusionsThe predictive relationships between self-efficacy, risk perception, and intention to quit were supported, however, supplementing standard warning labels with efficacy messages had no effect on these cognitions. Whether this is due to conditioned avoidance of HWLS, characteristics of the messages, or limitations imposed by format are unclear.ImplicationsSelf-efficacy and risk perception predict intentions to quit smoking. Adding efficacy content to tobacco health warnings may have the potential to bolster these cognitions but more research is required to determine the contexts in which this would be effective and who would be likely to benefit. The time course by which exposure to efficacy content might influence cessation self-efficacy and downstream quitting intentions also needs to be investigated.
PubDate: Tue, 04 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac229
Issue No: Vol. 25, No. 4 (2022)
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- Association of Non-Cigarette Tobacco Advertisements and Racial
Discrimination With Non-Cigarette Tobacco Product Use Among Black Adults-
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Pages: 781 - 787
Abstract: AbstractIntroductionBlack communities are targeted by more cigarette advertisements than White communities and racial discrimination among Black people is related to cigarette use. However, little is known about these factors with non-cigarette tobacco product use among Black adults. Therefore, this study assessed the association of non-cigarette advertisement exposure and racial discrimination with use of non-cigarette tobacco products among Black adults.Aims and MethodsBlack adults (n = 533) from The Family and Community Health Study in 2016 were asked if they had seen advertisements for e-cigarettes, snus pouches, filtered cigars, large cigars, cigarillos, dissolvable tobacco, smokeless tobacco, hookah, and tobacco pipe and if they used these in the past month. For products with the highest past month use and significant correlations with advertisement exposure, separate logistic regression models were performed that evaluated the association between advertisement exposure, racial discrimination, and non-cigarette tobacco product use while controlling for cigarette use, sex, socioeconomic status, and age.ResultsUse of cigarillos, large cigars, and hookah were higher than other non-cigarette tobacco products assessed. Logistic regressions revealed that more advertisement exposure in the past month was associated with higher odds of using cigarillos, large cigars, and hookah (p < .01). More experiences of racial discrimination were associated with past month cigarillo use, but not hookah or large cigars (p < .01).ConclusionsNon-cigarette tobacco advertisement exposure was associated with the use of non-cigarette tobacco products. Experiences of racial discrimination were associated with the most used non-cigarette tobacco product among Black adults, cigarillos.ImplicationsThis is the first time that a specific type of cigar (ie cigarillos) has been associated with experiences of racial discrimination among Black adults. Efforts to reduce non-cigarette tobacco marketing and eradicate exposure to racial discrimination among Black adults may aid in eliminating tobacco-related health disparities.
PubDate: Wed, 28 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac226
Issue No: Vol. 25, No. 4 (2022)
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- Which Way' Indigenous-led Smoking Cessation Care: Knowledge, Attitudes
and Practices of Aboriginal and Torres Strait Islander Health Workers and
Practitioners – A National Cross-sectional Survey-
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Pages: 788 - 795
Abstract: AbstractIntroductionTobacco is the leading preventable cause of morbidity and mortality for Aboriginal and Torres Strait Islander people. Accordingly, the provisions of culturally safe and effective smoking cessation strategies are crucial. While previous research has suggested Aboriginal Health Workers/Practitioners are well placed to provide smoking cessation care, no research to date has explored the workforce knowledge, attitudes and practices in offering best practice cessation care.MethodsA cross-sectional study was conducted among Aboriginal Health Workers/Practitioners from June to September 2021. Descriptive and inferential statistics were conducted to examine participant characteristics, provision of smoking cessation care, and explore the factors associated with smoking cessation care.ResultsOut of 1052 registered Aboriginal Health Workers/Practitioners, 256 participants completed the full survey (24.3%). Smoking cessation counseling was always provided by 41.9%; provided some of the time by 42.4%, and never provided by 12.9%. Combination NRT and Quitline referral were always offered by 23.1% and 44.9% of participants, respectively. Those that received training, felt smoking cessation care was part of their role, and were based in Aboriginal Community Controlled Health Organization were significantly more likely to offer best practice smoking cessation care.ConclusionAboriginal Health Workers/Practitioners and Aboriginal Community Controlled Health Organizations play a critical role in delivering high quality, evidence based and culturally safe care to Aboriginal and Torres Strait Islander people. Aboriginal Health Workers/Practitioners are well placed to offer smoking cessation care. Ongoing funding and implementation of a targeted smoking cessation workforce with appropriate training and resources are urgently required.ImplicationsAboriginal Health Workers/Practitioners are well placed to offer culturally safe, best practice smoking cessation care. However, due to the magnitude and complexity of Aboriginal Health Workers/Practitioners roles, it is challenging for smoking cessation care to be consistently and feasibly integrated into usual care. Acknowledging Australia’s National Preventative Health Strategy target of 27% or less Aboriginal and Torres Strait Islander people smoking by 2030, urgent investment and resourcing must be directed to building a skilled workforce to support quitting and maintaining smokefree behaviors, ensuring equitable access to smoking cessation care for Aboriginal and Torres Strait Islander peoples.
PubDate: Sat, 05 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac256
Issue No: Vol. 25, No. 4 (2022)
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- Re-engagement of Low-Income Smokers in Quitline Services: Effects of
Incentives and Method of Contact-
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Pages: 796 - 802
Abstract: AbstractIntroductionFinancial incentives have been shown to improve recruitment of low-income smokers into tobacco quitline services and to improve cessation outcomes. The present study evaluated their use to re-engage low-income smokers who had already used a quitline.Aims and MethodsRandomly selected Medicaid smokers (N = 5200) who had previously enrolled in a quitline were stratified by time since enrollment (3, 6, 9, or 12 months) and randomly assigned in a 2 × 4 factorial design to receive, by mail or telephone, an invitation to reengage, with an offer of no financial incentive or $10, $20, or $40. The primary outcome measure was re-engagement, defined as use of an additional evidence-based quitline service within 90 days. Data were collected from May 2014 to October 2015 and analyzed in 2022.ResultsOf 5200 participants invited to reengage in quitline services, 9.3% did so within 90 days, compared to 6.3% of a randomly selected comparison group (n = 22 614, p < .0001). Letters resulted in greater re-engagement than calls (10.9% vs. 7.8%, respectively, p = .0001). Among letters, there was a dose–response relationship between incentive level and re-engagement rates (p = .003). Re-engagement decreased as time since enrollment increased, from 13.7% at 3 months to 5.7% at 12 months (all p’s < 0.0001).ConclusionsLow-income smokers who previously used quitline services can be motivated to reengage in treatment. Mailed letters and automated calls are effective re-engagement strategies. Financial incentives can increase the effectiveness of re-engagement letters. Inviting Medicaid smokers to re-engage with quitline treatment may help to address socioeconomic health disparities and should be standard practice.ImplicationsNicotine addiction is a chronic relapsing disorder, yet most cessation services are designed to help smokers through only one quit attempt. Smoking is increasingly concentrated in populations with physical and psychological co-morbidities, which can make quitting more difficult and impact whether smokers reach out for additional help following relapse. This study examined whether the timing, method, and content of an offer for further assistance influenced re-engagement rates for a vulnerable population of smokers—Medicaid beneficiaries. Relapsing smokers are responsive to re-engagement offers as early as three months, but there is a closing window of opportunity to reach them.
PubDate: Sat, 22 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac246
Issue No: Vol. 25, No. 4 (2022)
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- Facebook Intervention to Connect Alaska Native People With Resources and
Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial-
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Pages: 803 - 813
Abstract: AbstractIntroductionThere is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults.Aims and MethodsRecruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence.ResultsOf intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97).ConclusionsWhile additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence.ImplicationsThis study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.
PubDate: Tue, 20 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac221
Issue No: Vol. 25, No. 4 (2022)
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- A Phase I, Double-blind, Randomized, Placebo-controlled, Single
Dose-escalation Study to Evaluate the Tolerability, and Safety of
Cytisinicline in Adult Smokers-
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Pages: 814 - 820
Abstract: AbstractIntroductionCytisinicline is a nicotinic acetylcholine receptor partial agonist marketed historically as oral tablets in Central and Eastern Europe as an aid to smoking cessation. Dosing and scheduled regimen for cytisinicline treatment is currently being redeveloped for market approval in the United States and elsewhere.Aims and Methods A phase 1, double-blind, randomized, placebo-controlled, single-ascending dose clinical trial was conducted under fasting conditions in healthy adults who were current daily (>10 cigarettes) smokers. Safety parameters for the identification of a maximum tolerated dose (MTD) and limited supportive pharmacokinetic assessments were evaluated. Ascending single oral doses of cytisinicline or placebo were administered to 9 cohorts, each comprised of eight unique participants (randomization: 6 cytisinicline; 2 placebo). Dose escalation to the next cohort was dependent upon the safety review of preceding cohorts. Dose levels tested were 6, 9, 12, 15, 18, 21, 24, 27, and 30 mg. Treatment-emergent adverse events (TEAEs) and clinically relevant changes in laboratory blood tests, vital signs, and 12-lead electrocardiograms were evaluated.ResultsSeventy-two participants completed the study (54 cytisinicline; 18 placebo). Nausea was the most common TEAE (10 participants [19%]). The MTD was defined as cytisinicline 30 mg based on gastrointestinal symptoms, predominantly vomiting (2 of 6 subjects, 33%). Maximum plasma concentration (observed Cmax) values appeared to plateau at higher dose levels (beyond 24 mg).ConclusionsSingle cytisinicline doses up to 30 mg were well tolerated and raised no new safety concerns in fasting adult smokers. An increased frequency of gastrointestinal symptoms defined the MTD at 30 mg.ImplicationsThe cytisinicline therapeutic dose being evaluated in phase 3 clinical trials is 3 mg, which is a 10-fold lower dose than the 30 mg MTD level for cytisinicline, resulting in an excellent safety margin.
PubDate: Wed, 05 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac233
Issue No: Vol. 25, No. 4 (2022)
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- Knowledge, Beliefs, and Behaviors Related to Secondhand Smoke and Smoking
in the Home: A Qualitative Study With Men in Malaysia-
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Pages: 821 - 827
Abstract: AbstractIntroductionDespite the health risks associated with secondhand smoke (SHS) exposure, smoking in the home is common in Malaysia, and almost exclusively a male behavior.Aims and MethodsThis study explored male smokers’ knowledge, beliefs, and behaviors related to SHS exposure and smoking in the home, to guide future intervention development. Twenty-four men who smoked and lived in Klang Valley, Kuantan, or Kuala Terengganu took part in semi-structured interviews which explored knowledge and beliefs regarding SHS in the home, and associated home-smoking behaviors. Data were managed and analyzed using the framework approach.ResultsThere was limited knowledge regarding the health risks associated with SHS: the smell of SHS in the home was a more prominent concern in most cases. Many had no rules in place restricting home smoking, and some suggested that smoking in specific rooms and/or near windows meant SHS was not “shared” with other household members. A few fathers had created but not maintained a smoke-free home prior to and/or after their children were born. Desire to smoke in the home conflicted with men’s sense of responsibility as the head of the household to protect others and set a good example for their children.ConclusionsMen’s home-smoking behaviors are shaped by a lack of understanding of the health risks associated with SHS exposure. Gaining a broader understanding of the factors that shape men’s decisions to create a smoke-free home is important to facilitate the development of culturally appropriate interventions that address their responsibility to protect other household members from SHS exposure.ImplicationsOur findings highlight the need for public information campaigns in Malaysia to educate men who smoke regarding the health harms associated with SHS in the home and the ways in which SHS travels and lingers in household air. This is important given men’s concerns about SHS often focus on the smell of cigarette smoke in the home. Our findings suggest a number of potential avenues for future intervention development, including household and community-level initiatives that could build on men’s sense of responsibility as the head of the household and/or their general desire to protect their families.
PubDate: Fri, 14 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac239
Issue No: Vol. 25, No. 4 (2022)
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- Secondhand Smoke Exposure Inside the Home Among Adults in Eight Countries
in Sub-Saharan Africa: Global Adult Tobacco Survey, 2012–2018-
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Pages: 828 - 837
Abstract: AbstractIntroductionSecondhand tobacco smoke (SHS) exposure causes diseases and death in adults and children. Evidence indicates that most SHS exposures occur at home and in the workplace. Therefore, home is a major place where adults and children can be effectively protected from SHS. This study examined the magnitude of SHS exposure at home and associated factors in eight sub-Saharan African countries.Aims and MethodsWe analyzed 2012–2018 Global Adult Tobacco Survey data for Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda. We computed prevalence estimates of self-reported monthly SHS exposure at home reported as anyone smoking inside their home daily, weekly, or monthly. We calculated SHS exposure at home prevalence and applied multivariable logistic regression models to identify related factors.ResultsOverall median prevalence of SHS exposure at home was 13.8% in the eight countries; ranging from 6.6% (95% CI: 5.7%, 7.6%) in Nigeria to 21.6% (95% CI: 19.4%, 24.0%) in Senegal. In multivariable analysis across the countries, SHS exposure at home was associated with living with a smoker, ranging from an adjusted odds ratio (AOR) of 4.6 (95% CI: 3.6, 5.8) in Botswana to 27.6 (95% CI: 20.1, 37.8) in Nigeria. SHS exposure at home was significantly associated with lower education attainment (Kenya and Ethiopia), and lower wealth index (Uganda, Senegal, and Botswana).ConclusionsSHS exposure in homes was associated with the presence of a smoker in the home and lower socioeconomic status.
PubDate: Sat, 22 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac247
Issue No: Vol. 25, No. 4 (2022)
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- Sugars and Sweeteners in Tobacco and Nicotine Products: Food and Drug
Administration’s Regulatory Implications-
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Pages: 838 - 840
Abstract: National Institute of HealthNational Heart, Lung, and Blood Institute10.13039/1000000501R01HL152435-01A1University of California10.13039/100005595T30IP1013U54DA036151Tobacco-Related Disease Research Program10.13039/100005188T30IP1013U54DA036151Yale Tobacco Center of Regulatory ScienceNational Institute on Drug Abuse10.13039/100000026FDA Center for Tobacco Products
PubDate: Fri, 23 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac222
Issue No: Vol. 25, No. 4 (2022)
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- The Role of Communication Research to Support Policy Change: The US
Menthol Ban-
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Pages: 841 - 843
Abstract: Center for Tobacco Products10.13039/100010628K01CA253234NIH10.13039/100000002K01CA253234
PubDate: Wed, 02 Nov 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac249
Issue No: Vol. 25, No. 4 (2022)
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- Furthering the Validation of Passive Detection of Cigarette Smoking
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Pages: 844 - 845
Abstract: Cancer Research UK10.13039/501100000289C18281/A29019UK Medical Research Council10.13039/501100000265University of Bristol10.13039/501100000883MC_UU_00011/6
PubDate: Fri, 28 Oct 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac251
Issue No: Vol. 25, No. 4 (2022)
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- Correction to: Tobacco Retail Outlets, Neighborhood Deprivation and the
Risk of Prenatal Smoke Exposure-
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Pages: 846 - 846
Abstract: This is a correction to: David C Wheeler, PhD, MPH, Joseph Boyle, BS, D Jeremy Barsell, MS, Rachel L Maguire, MS, Junfeng (Jim) Zhang, PhD, Jason A Oliver, PhD, Shawn Jones, BA, Bassam Dahman, PhD, Susan K Murphy, PhD, Cathrine Hoyo, PhD, Chris D Baggett, PhD, Joseph McClernon, PhD, Bernard F Fuemmeler, PhD, MPH, Tobacco Retail Outlets, Neighborhood Deprivation and the Risk of Prenatal Smoke Exposure, Nicotine & Tobacco Research, 2022; ntac164, https://doi.org/10.1093/ntr/ntac164
PubDate: Sat, 24 Sep 2022 00:00:00 GMT
DOI: 10.1093/ntr/ntac217
Issue No: Vol. 25, No. 4 (2022)
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