Tobacco, nicotine, and cannabis use and exposure in an Australian Indigenous population during pregnancy: A protocol to measure parental and foetal exposure and outcomes.

BACKGROUND: The Australian National Perinatal Data Collection collates all live and stillbirths from States and Territories in Australia. In that database, maternal cigarette smoking is noted twice (smoking <20 weeks gestation; smoking >20 weeks gestation). Cannabis use and other forms of nicotine use, for example vaping and nicotine replacement therapy, are nor reported. The 2021 report shows the rate of smoking for Australian Indigenous mothers was 42% compared with 11% for Australian non-Indigenous mothers. Evidence shows that Indigenous babies exposed to maternal smoking have a higher rate of adverse outcomes compared to non-Indigenous babies exposed to maternal smoking (S1 File). OBJECTIVES: The reasons for the differences in health outcome between Indigenous and non-Indigenous pregnancies exposed to tobacco and nicotine is unknown but will be explored in this project through a number of activities. Firstly, the patterns of parental and household tobacco, nicotine and cannabis use and exposure will be mapped during pregnancy. Secondly, a range of biological samples will be collected to enable the first determination of Australian Indigenous people's nicotine and cannabis metabolism during pregnancy; this assessment will be informed by pharmacogenomic analysis. Thirdly, the pharmacokinetic and pharmacogenomic findings will be considered against maternal, placental, foetal and neonatal outcomes. Lastly, an assessment of population health literacy and risk perception related to tobacco, nicotine and cannabis products peri-pregnancy will be undertaken. METHODS: This is a community-driven, co-designed, prospective, mixed-method observational study with regional Queensland parents expecting an Australian Indigenous baby and their close house-hold contacts during the peri-gestational period. The research utilises a multi-pronged and multi-disciplinary approach to explore interlinked objectives. RESULTS: A sample of 80 mothers expecting an Australian Indigenous baby will be recruited. This sample size will allow estimation of at least 90% sensitivity and specificity for the screening tool which maps the patterns of tobacco and nicotine use and exposure versus urinary cotinine with 95% CI within ±7% of the point estimate. The sample size required for other aspects of the research is less (pharmacokinetic and genomic n = 50, and the placental aspects n = 40), however from all 80 mothers, all samples will be collected. CONCLUSIONS: Results will be reported using the STROBE guidelines for observational studies. FORWARD: We acknowledge the Traditional Custodians, the Butchulla people, of the lands and waters upon which this research is conducted. We acknowledge their continuing connections to country and pay our respects to Elders past, present and emerging. Notation: In this document, the terms Aboriginal and Torres Strait Islander and Indigenous are used interchangeably for Australia's First Nations People. No disrespect is intended, and we acknowledge the rich cultural diversity of the groups of peoples that are the Traditional Custodians of the land with which they identify and with whom they share a connection and ancestry.

[Tobacco use : guidelines for primary care physicians]. / Aide au sevrage tabagique : recommandations pour les médecins de premier recours.

Tobacco use affects about 25% of the population and is the most important modifiable risk factor for many diseases, namely cancers, cardiovascular and pulmonary diseases. The role of the primary care physician is essential in providing screening and brief intervention to all patients, particularly to those at higher risk. This will help them to quit smoking, or adopt risk reduction strategies, according to their own wish. The main interventions include motivational support, nicotine replacement therapy and other medications. Vaping has been proved to be efficient for tobacco withdrawal and is still studied as a risk reduction tool. At the moment, it is considered by some as twenty times less harmful than smoked tobacco.

La consommation de tabac concerne environ 25 % de la population et est le facteur de risque modifiable le plus important pour de nombreuses pathologies, dont les cancers et les atteintes cardiovasculaires et pulmonaires. Le rôle du médecin de premier recours est primordial dans le dépistage et l'intervention brève chez tous les patients, notamment ceux à plus haut risque, afin d'aider à l'arrêt de la consommation ou à la mise en place de mesures de réduction des risques, selon leur souhait. Les principales stratégies comprennent, en plus de l'accompagnement, les substituts nicotiniques et les approches médicamenteuses. Le vapotage a aujourd'hui démontré son efficacité pour l'arrêt du tabac et, tout en étant encore à l'étude comme moyen de réduction des risques du tabac, il est estimé comme étant jusqu'à vingt fois moins nocif que ce dernier.

Factors Influencing the Use of Tobacco Among Youth in Low-Income, Lower-Middle-Income, and Upper-Middle-Income Countries: A Systematic Review.

BACKGROUND: The use of tobacco is a significant global public health issue. According to the World Health Organization, tobacco use is a considerable risk factor for many diseases and causes more than 8 million deaths per year, with a disproportionate impact on low- and middle-income countries. Therefore, this systematic review was conducted to identify the factors influencing tobacco use among youth in low-income, lower-middle-income, and upper-middle-income countries. Study Design: A system review. METHODS: The review followed the PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42023430552). Several data sources were utilized, including PubMed, Scopus, ScienceDirect, MEDLINE, CINAHL, and ProQuest, and cross-sectional data from participants aged 15‒24 underwent investigation. Original full-text articles have been published between 2015 and 2023. Out of the 2892 studies, 20 were included in this review after two reviewers confirmed the eligibility criteria. RESULTS: The average age of the participants was (mean±standard deviation: 19.45±1.686). Most studies were conducted in lower-middle and upper-middle-income countries. Frequently reported influences were at the individual and social levels, including demographic, economic, and psychological parameters, attitude and knowledge, individual behavioral factors, parental education, family member tobacco use, stressful life events, and social networks. At the environmental level, factors included secondhand smoke exposure, community context, media channels, and access to tobacco. CONCLUSION: The findings demonstrated a significant association between youth tobacco use and individual-, social-, and environmental-level factors. Consequently, specific interventions targeting these factors should be deployed to mitigate youth tobacco use in various socioeconomic settings.

Predictors of tobacco use among pregnant women: a large-scale, retrospective study.

OBJECTIVE: To investigate the predictors of smoking among pregnant women in Iran, focusing on health literacy and associated socioeconomic factors. METHODS: This retrospective cohort study included 103,042 pregnant women aged 18-45 years who attended healthcare centers affiliated with Mashhad University of Medical Sciences for routine prenatal and postnatal checkups between 2017 and 2020. Data were collected from the Sina Electronic Health Record System (SinaEHR®), which recorded sociodemographic characteristics, medical history, and lifestyle behaviors, including tobacco use. RESULTS: Smoking prevalence was 0.9%. Women with undergraduate or higher education had significantly lower odds of smoking (OR = 0.36; 95% CI = 0.28-0.47) compared to those with primary education or less. Maternal age was marginally associated with increased smoking risk (OR = 1.01; 95% CI = 1.00-1.03). While unemployment showed an increased crude risk for smoking, this was not significant after adjustment (adjusted OR = 1.02; 95% CI = 0.86-1.21). Strong associations were found between tobacco use and alcohol consumption (OR = 46.3; 95% CI = 24.8-83.4) and opium addiction (OR = 23.4; 95% CI = 14.5-36.3). Chronic disease history also increased smoking odds (OR = 1.51; 95% CI = 1.17-1.92). CONCLUSION: Lower education, substance use, and chronic disease are significant predictors of smoking among pregnant women in Iran. Targeted interventions to improve health literacy and address these factors are essential to reduce tobacco use during pregnancy.

Association of physical activity and sitting time with tobacco and alcohol use in 222,495 adolescents from 66 countries.

BACKGROUND: The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. METHODS: This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. RESULTS: The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83-0.89), alcohol use (OR: 0.74, 95%CI: 0.72-0.76), binge drinking (OR: 0.66, 95%CI: 0.62-0.69), and drunkenness (OR: 0.85, 95%CI: 0.83-0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80-0.85), alcohol use (OR: 0.77, 95%CI: 0.75-0.79), binge drinking (OR: 0.91, 95%CI: 0.87-0.96), and drunkenness (OR: 0.88, 95%CI: 0.85-0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95-0.99), alcohol use (OR: 0.94, 95%CI: 0.92-0.96), and binge drinking (OR: 0.78, 95%CI: 0.75-0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45-1.52), use alcohol (OR: 1.68, 95%CI: 1.64-1.72), binge drink (OR: 1.68, 95%CI: 1.62-1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62-1.69) compared to those with excessive sitting time. CONCLUSION: Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.

Tobacco use, secondhand exposure and knowledge of secondhand and third-hand smoke among medical college students in Western Nepal: a cross-sectional study.

OBJECTIVES: This study was conducted to assess the prevalence of tobacco use, secondhand smoke (SHS) exposure and knowledge about SHS and third-hand smoke (THS) exposure among students in a medical college in Western Nepal. DESIGN: This is a cross-sectional study. SETTING: Data collection was done from 8 July 2023 to 8 August 2023 in a medical college in Nepal. PARTICIPANTS: This study was conducted on undergraduate students studying in a medical college in Western Nepal using a census (whole population) sampling technique. MAIN OUTCOME MEASURES: Prevalence of tobacco use was assessed by asking a question, 'Did you use tobacco products within the last 30 days?'. Secondhand smoke exposure and knowledge about SHS and THS exposure were assessed by using structured questionnaires. The χ2 test was used to compare the group exposed and non-exposed to tobacco, SHS and THS by sociodemographic variables (sex, residence, year of study and academic stream). RESULTS: The response rate was 96.43% (n=595/617). The overall prevalence of tobacco use was found to be 16.30%. A total of 88.83% of students from clinical years knew about SHS which was more than preclinical students (p <0.001). The Bachelor of Medicine and Bachelor of Surgery students have higher knowledge of SHS as compared with others (p =0.003). More than 95% of students favoured banning smoking in public places. Nearly half of the participants (45.45%) experienced SHS exposure in the last 7 days. More than half proportion of the clinical students knew about THS, which was higher than preclinical students and interns (p <0.001). CONCLUSIONS: Tobacco use prevalence among the participants was found to be lower in comparison to other studies including medical students in several Asian countries. Despite more than three-fourths of students knowing the harmful effects of SHS exposure, almost one-half of them were exposed to SHS. The proportion of students who knew about THS exposure was comparably lower.

An Analysis of Tobacco and Marijuana Use by Middle School and High School Bisexual and Homosexual Students Surveyed by the National Youth Tobacco Survey From 2020 to 2022.

OBJECTIVES: This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors. METHODS: Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups. RESULTS: Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students. CONCLUSIONS: The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

Associations of tobacco and alcohol use with sexual behaviors among adolescents in 59 countries: a population-based study.

BACKGROUND: Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide. METHODS: Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12-17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1-2, 3-5, 6-9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors. RESULTS: Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47-2.81] to 3.98[2.63-6.03]; risky: 2.43[1.75-3.38] to 4.21[3.26-5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12-14 years (vs. aged 15-17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas). CONCLUSIONS: Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.

Prevalence and association between alcohol, tobacco, and COVID-19: a study from a tribal predominant district in eastern India.

Introduction: Alcohol and tobacco use has been proposed to significantly affect COVID-19 outcomes. The study aimed to estimate the prevalence of alcohol and tobacco use among COVID-19-positive patients and compare it with the general population prevalence rates. It also aimed to assess and determine the association between the severity of COVID-19 illness and the complications with alcohol and tobacco use. Method: For this, a cross-sectional, retrospective, telephone-based study was conducted using a structured questionnaire among COVID-19 diagnosed patients in the district of Deoghar of the Indian state of Jharkhand. A multinomial logistic regression is done to determine the association. Results: Among 1,425 patients interviewed, tobacco and alcohol were used by 22.31 and 9.96%, significantly more than the prevalence of tobacco (Z = 4.9485, p < 0.00001) and alcohol use (Z = 7.118, p < 0.00001), respectively, in the district (tobacco-11.7% and alcohol-4.8%).In a regression model, patients with co-morbidity had higher odds of severe [3.34 (1.99-5.62)] and moderate [2.95 (1.97-4.41)] COVID-19. Young [0.12 (0.04-0.38)] and middle-aged individuals [0.23 (0.13-0.4)], people below the poverty line 0.28 (0.11-0.69) are at lower odds of severe COVID-19. Tobacco users [1.58 (1.16-2.14)], alcohol users [1.53 (1.03-2.28)], incomplete vaccination [3.24 (1.49-7.01)], and patients with comorbidity [3.6 (2.79-4.68)] were found to have higher odds of post-COVID-19 complications. Discussion: People with COVID-19 in our study population had significantly higher tobacco and alcohol use compared to the general population. Tobacco and alcohol use significantly increases the risk of post-COVID-19 complications. The study highlights the need for addiction treatment services to prevent complications during future pandemics.

Tobacco use and khat chewing among adolescents in Yemen: a large-scale school-based cross-sectional study.

OBJECTIVE: The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. METHODS: This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. RESULTS: A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p < 0.001), shisha use (20.3% vs. 17.2%, p < 0.01), and cigarette smoking (8.8% vs. 2.6%, p < 0.001). Male gender, older age, poor knowledge, khat chewing, parents' low education level, and parents' and peers' smoking habits were significant determinants of adolescents' cigarette smoking status. Private education, male gender, older age, poor knowledge, parents' low education level, and parents' and peers' khat chewing habits were significant determinants of adolescents' khat chewing status. The participant's knowledge of and attitudes toward tobacco use and khat chewing were inadequate. CONCLUSION: The prevalence of khat chewing, shisha use, and to lesser extent cigarette smoking among Yemeni adolescents is high that needs immediate intervention. The results highlight the urgent need to implement prevention strategies to tackle these habits among the youth in Yemen.

Longitudinal associations between exclusive, dual and polytobacco use and respiratory illness among youth.

BACKGROUND: The health consequences of polytobacco use are not well understood. We evaluated prospective associations between exclusive, dual, and polytobacco use and diagnosed bronchitis, pneumonia, or chronic cough among US youth. METHODS: Data came from Waves 1-5 of the Population Assessment of Tobacco and Health Study. We categorized time-varying past 30-day tobacco use into seven categories: (1) non-current use; exclusive use of 2) cigarettes, 3) e-cigarettes, and 4) other combustible products (OC; pipes, hookah, and cigars); dual use of 5) e-cigarettes + cigarettes or e-cigarettes + OC, and 6) cigarettes + OC; and 7) polyuse of all three products. The outcome was parent-reported diagnosis of bronchitis, pneumonia, or chronic cough among youth. We conducted weighted multilevel Poisson models (person n = 17,517, 43,290 observations) to examine the longitudinal exposure-outcome relationship, adjusting for covariates: sex, age, race and ethnicity, parental education, body mass index, secondhand smoke exposure, and household use of combustible products. RESULTS: Compared to nonuse, exclusive cigarette use (Risk Ratio (RR) = 1.83, 95% CI 1.25-2.68), exclusive e-cigarette use (RR = 1.53, 95% CI 1.08-2.15), combustible product + e-cigarette dual use (RR = 1.90, 95% CI 1.18-3.04), cigarettes + OC dual use (RR = 1.96, 95% CI 1.11-3.48), and polytobacco use (RR = 3.06 95% CI 1.67-5.63) were associated with a higher risk of bronchitis, pneumonia, or chronic cough. In additional analyses, we found that the risk ratio for polytobacco use was higher compared to exclusive e-cigarette use (RR 2.01 CI 95% 1.02-3.95), but not higher compared to exclusive cigarette use (RR 1.67 CI 95% 0.85-3.28). CONCLUSION: We found that exclusive, dual, and poly tobacco use were all associated with higher risk of bronchitis, pneumonia, or chronic cough compared to non-current use.

Experiences of smoking and tobacco use during pregnancy: A qualitative study protocol.

Tobacco use during pregnancy is the main avoidable cause of morbidity and mortality both for pregnant women and their offspring. Between 12 and 22% of pregnant women in industrialized countries smoke during pregnancy, and 13% are unable to stop smoking. Pregnancy is considered an ideal opportunity to intervene and control tobacco use among smokers and their families. However, pregnant women experience barriers to quitting smoking, including social stigma and fear of being judged. Thus, it is necessary to develop interventions for smoking cessation adapted for pregnant women. This paper presents a qualitative study protocol to assess the barriers and facilitators of smoking cessation during pregnancy that female smokers encounter or perceive. It consists of a series of focus groups and individual interviews with female smokers who have been pregnant within the last five years. Participants will be recruited from the Sexual and Reproductive Health Care Services of the Camp de Tarragona. A group of 5-10 women who have been pregnant and tried to quit smoking over the last 5 years will be selected. The data will be collected by means of semistructured interviews. All interviews will be transcribed verbatim, coded and synthesized into categories and main themes. Thematic analysis will be conducted employing an iterative and reflexive approach. The results of this study will offer new perspectives on smoking interventions for pregnant women and enhance our comprehension of the main barriers to and facilitators of smoking cessation during pregnancy. This will contribute to the adaptation of the Tobbstop app, originally designed for the general public, to suit the needs of pregnant women. Consequently, the creation of targeted interventions will positively influence the health outcomes of both pregnant women and newborns. Trial registration: Clinicaltrials.gov ID: NCT05222958. The trial was registered 3 February 2022, at https://clinicaltrials.gov/ct2/show/NCT05222958.

End TB strategy: Role of tobacco control.

Tobacco use and Tuberculosis (TB) presents a huge public health challenge globally. Tobacco and TB have consistent and strong epidemiological evidence with smokers having higher odds of TB infection, disease, mortality, delayed diagnosis etc. Overall, limited evidence exists about the extent of TB-tobacco integration. The aim of the current short communication is to highlight comprehensive strategy for addressing TB-tobacco comorbidities.

Associations of alcohol and tobacco use with psychotic, depressive and developmental disorders revealed via multimodal neuroimaging.

People affected by psychotic, depressive and developmental disorders are at a higher risk for alcohol and tobacco use. However, the further associations between alcohol/tobacco use and symptoms/cognition in these disorders remain unexplored. We identified multimodal brain networks involving alcohol use (n = 707) and tobacco use (n = 281) via supervised multimodal fusion and evaluated if these networks affected symptoms and cognition in people with psychotic (schizophrenia/schizoaffective disorder/bipolar, n = 178/134/143), depressive (major depressive disorder, n = 260) and developmental (autism spectrum disorder/attention deficit hyperactivity disorder, n = 421/346) disorders. Alcohol and tobacco use scores were used as references to guide functional and structural imaging fusion to identify alcohol/tobacco use associated multimodal patterns. Correlation analyses between the extracted brain features and symptoms or cognition were performed to evaluate the relationships between alcohol/tobacco use with symptoms/cognition in 6 psychiatric disorders. Results showed that (1) the default mode network (DMN) and salience network (SN) were associated with alcohol use, whereas the DMN and fronto-limbic network (FLN) were associated with tobacco use; (2) the DMN and fronto-basal ganglia (FBG) related to alcohol/tobacco use were correlated with symptom and cognition in psychosis; (3) the middle temporal cortex related to alcohol/tobacco use was associated with cognition in depression; (4) the DMN related to alcohol/tobacco use was related to symptom, whereas the SN and limbic system (LB) were related to cognition in developmental disorders. In summary, alcohol and tobacco use were associated with structural and functional abnormalities in DMN, SN and FLN and had significant associations with cognition and symptoms in psychotic, depressive and developmental disorders likely via different brain networks. Further understanding of these relationships may assist clinicians in the development of future approaches to improve symptoms and cognition among psychotic, depressive and developmental disorders.

Changes in tobacco use and associated factors among Brazilian adolescents: National Student Health Survey. / Mudanças no uso do tabaco entre adolescentes brasileiros e fatores associados: Pesquisa Nacional de Saúde do Escolar.

This cross-sectional study used data from Brazil's National Student Health Survey (PeNSE), from 2015 and 2019, to compare consumption of tobacco products among adolescent students in Brazil and identify associated factors. The study variables were current cigarette smoking, use of other tobacco products and use of any tobacco product. Pearson's Chi-square test was used to ascertain associations between the variables; bivariate and multivariate analyses were performed using logistic regression. Cigarette smoking remained stable between 2015 (6.6%) and 2019 (6.8%), but use of any tobacco product increased (from 10.6% in 2015 to 14.8% in 2019), involving particularly hookahs (7.8%) and e-cigarettes (2.8%). Cigarette smoking was greater among adolescents aged 16 and 17, whose skin colour was black or brown, who missed classes without permission, who reported having no friends, displayed other risk factors, such as drinking alcoholic beverages, or who were passive smokers. The prevalence of smoking has increased over the years and is associated with sociodemographic aspects and other health risk behaviour, highlighting the need for lifelong health promotion actions.

O estudo objetiva comparar o consumo de diferentes produtos do tabaco entre os escolares adolescentes no Brasil em 2015 e 2019 e identificar os fatores associados ao seu uso. Estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e 2019. Variáveis: uso atual de cigarro, uso de outros produtos do tabaco e uso de qualquer produto do tabaco. Foi usado o teste do Qui-quadrado de Pearson para verificar associação entre as variáveis, realizada análise bivariada e a multivariada por meio da regressão logística. O uso de cigarros se manteve estável entre 2015 (6,6%) e 2019 (6,8%). Mas houve aumento do uso de qualquer produto do tabaco (de 10,6% em 2015 para 14,8% em 2019), sendo o narguilé o mais frequente (7,8%) seguido do cigarro eletrônico (2,8%). O uso de cigarro foi mais elevado entre os adolescentes de 16 e 17 anos, com cor da pele preta e parda, que faltaram as aulas sem autorização, entre aqueles que relataram não ter amigos, que apresentavam outros fatores de risco como consumir bebidas alcoólicas e que eram fumantes passivos. A prevalência de tabagismo aumentou ao longo dos anos e foi associada com aspectos sociodemográficos e a outros comportamentos de risco à saúde, o que alerta para a necessidade de ações de promoção da saúde ao longo do ciclo de vida.

Use of tobacco during COVID-19: A qualitative study among medically underserved individuals.

The COVID-19 pandemic produced stress for people around the world. The perception that tobacco can be a coping tool for stress relief suggests that the conditions during the COVID-19 pandemic can provide insight into the relationship between stress and tobacco use patterns, particularly among those most at risk for severe COVID-19 disease. The goal was to identify the impacts of the COVID-19 pandemic on tobacco use and preparedness for smoking cessation among individuals who smoke and are older and medically underserved. We conducted in-depth interviews with 39 patients to learn about individuals' smoking behavior during the COVID-19 pandemic. We used a modified grounded theory approach to code and analyze all qualitative data. We conducted thematic analysis to identify key factors associated with smoking behaviors during COVID-19. Our results indicated that increases in perceived stress and social isolation may have been associated with increased tobacco use during the COVID-19 pandemic. Pandemic-related social isolation contributed to increases in smoking, despite respondents being concerned about the severity of COVID-19. While many respondents felt that smoking relieved their stress from the pandemic, they appeared unaware of the stress-inducing properties of tobacco use. Our findings indicate that pandemic-related stress impacted smoking behavior among older, medically underserved smokers. Results may assist clinicians in addressing the role of tobacco use in response to highly stressful events. Smoking cessation strategies should consider the implications of stress on smoking behavior, including smoking relapse in response to highly stressful events-particularly for medically underserved populations.

Coupon Redemption in a National Sample of Individuals Who Use Tobacco and Nicotine Products.

This cross-sectional study investigates coupon redemption in a national sample of US adults who used tobacco and nicotine in the past 30 days.

Trends in cannabis and tobacco co-use in the United States, 2002-2021.

BACKGROUND: Co-use of cannabis and tobacco poses greater risks than use of either substance individually and may be becoming more prevalent with increasing cannabis medicalization and legalization. We aimed to assess trends in the prevalence of cannabis and tobacco co-use between 2002-2019 and identify the updated prevalence and correlates of co-use in 2021 among US adults. METHODS: This study used data from the 2002-2021 National Survey on Drug Use and Health, a nationally-representative, cross-sectional survey in the US. We assessed prevalence trends in past 30-day cannabis and tobacco co-use, exclusive cannabis use, and exclusive tobacco use overall and by sociodemographic group using joinpoint regression. Additionally, multinomial models identified correlates of co-use in 2021. RESULTS: In 2021, the weighted prevalence of cannabis and tobacco co-use was 6.38 %, the weighted prevalence of exclusive cannabis use was 7.28 %, and the weighted prevalence of exclusive tobacco use was 15.01 %. From 2002 to 2019, the prevalence of past 30-day co-use of cannabis and tobacco increased significantly (annual percentage change [APC]: 1.9 [1.4-2.4], P<0.05) among the overall US population. All subgroups of sex, race/ethnicity, and age also saw significant increases in co-use, other than young adults ages 18-25, for whom co-use was stagnant between 2002-2014 and then decreased significantly between 2014-2019. CONCLUSION: This study identified increasing cannabis and tobacco co-use overall and among most sociodemographic strata in the US. As cannabis policy changes rapidly, co-use requires closer surveillance, clinical screening, and dedicated research.

Association of conventional cigarette smoking, heated tobacco product use and dual use with hypertension.

BACKGROUND: Heated tobacco products (HTPs) have emerged as alternatives to conventional cigarettes. However, their health effects remain largely unknown. This study aimed to prospectively explore the association between the use of cigarettes and HTPs and the risk of hypertension. METHODS: This cohort study analysed data from 30 152 workers (82.0% men, mean age 42.9 ± 11.0 years) who were initially free of hypertension, participating in the Japan Epidemiology Collaboration on Occupational Health Study. Participants were categorized into five groups based on their self-reported tobacco product use: never smokers, past smokers, exclusive cigarette smokers, exclusive HTP users and dual users of cigarettes and HTPs. Hypertension cases were identified using three data points from annual health checkup data collected between 2019 and 2021. Cox proportional hazards regression models were used to investigate the association between tobacco product use and hypertension. RESULTS: During a mean follow-up of 2.6 years (range: 0.1-4.0 years), 3656 new cases of hypertension were identified. Compared with never smokers, the risk of hypertension was higher among exclusive cigarette smokers [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.13-1.41] and exclusive HTP users (HR 1.19, 95% CI 1.06-1.34). There was also a suggestion of increased risk of hypertension among dual users (HR 1.16, 95% CI 0.98-1.38). Furthermore, the risk of hypertension increased with the intensity of cigarette/HTP use in all tobacco product users. CONCLUSIONS: Similarly, both cigarette smoking and HTP use elevate the risk of hypertension. HTPs should not be regarded as less harmful alternatives to traditional cigarettes for preventing hypertension.

Are Anti-Tobacco Messages Delivered through Different Mass-Media Channels Effective in India? Results from GATS-II Survey.

BACKGROUND: Anti-tobacco mass-media campaigns are an integral part of tobacco control. There is still a need to understand which mode of mass-media channels aids in promoting tobacco cessation. This study aimed to examine if exposure to anti-tobacco messages delivered through different media channels is associated with tobacco user's thoughts and attempts to quit. METHODS: We selected a sample of tobacco users (N=21857) from the Global Adult Tobacco Survey (GATS-2), and assessed the association of noticing the anti-tobacco information through different media channels with tobacco user's thoughts and attempts to quit. RESULTS: Males reported noticing anti-tobacco information more than females in almost all modes of media channels. Among males, the odds were significant and were highest with exposure to radio (1.78 (1.4-2.27)), and internet (1.68 (1.12-2.52)) for thoughts to quit smoking and to radio (2.17 (1.63-2.89) and newspaper (1.46 (1.2-1.79) for thoughts to quitting smokeless tobacco (SLT). The attempt to quit smoking and SLT use among males was significant for exposure through public transportation (1.22 (1.03-1.44)), public walls (1.44 (1.21-1.71), internet (1.68 (1.06-2.66)), and radio (1.44 (1.1-1.87)). Exposure to more than two media resulted in a higher likelihood of thoughts of quitting tobacco, and those exposed to more than one media attempted to quit tobacco among males. Females reported no influence from the media exposure. CONCLUSION: The study underscores the importance of targeted and combination of different mass-media channels to maximize the quit behaviors among male tobacco users. The current study also highlights the need for future studies to identify effective ways to communicate anti-tobacco information to women and all socio-economic groups in the country.