E-cigarette use and change in plans to quit cigarette smoking among adult smokers in the United States: Longitudinal findings from the PATH Study 2014-2019.

INTRODUCTION: Much of the population-based e-cigarette use and cigarette cessation literature is restricted to smokers who have expressed intention to quit smoking, though experimental studies suggest e-cigarette use might motivate some smokers to change their quit intentions. We used U.S. nationally representative data to evaluate whether e-cigarette use by smokers initially not planning to ever quit is associated with change in plans to quit. METHODS: Longitudinal Population Assessment of Tobacco and Health (PATH) Study data collected between 2014 and 2019 were analyzed. Main analyses were conducted among adult daily cigarette smokers not currently using e-cigarettes with no plans to ever quit smoking (n = 2366 observations from n = 1532 individuals). Generalized estimating equations were used to evaluate the association between change in e-cigarette use and change in plans to quit smoking within the next six months, over three assessment pairs. RESULTS: Daily cigarette smokers with no plans to quit had a higher rate of change to plan to quit if at follow-up they used e-cigarettes daily (41.4%, 95% CI: 27.1-57.3%) versus not at all (12.4%, 95% CI: 10.6-14.5%; aOR = 5.7, 95% CI: 2.9-11.2). Rate of change to plan to quit did not statistically differ between those who at follow-up used e-cigarettes some days versus not at all. CONCLUSIONS: Among adult daily cigarette smokers initially not planning to ever quit, subsequent daily e-cigarette use is associated with subsequent plans to quit smoking. Population-level research on e-cigarette use that is focused on smokers already motivated to quit may limit a complete evaluation of the smoker population.

Network-based recruitment of people who inject drugs for hepatitis C testing and linkage to care.

Although oral direct-acting agent (DAA) therapies have the potential to reduce the burden of hepatitis C virus (HCV) infection, treatment uptake remains low, particularly among people who inject drugs (PWID). This study examined the feasibility of an innovative peer-based recruitment strategy to engage PWID in HCV testing and treatment. We interviewed an initial set of HCV antibody-positive PWID as 'primary indexes' to gather demographic, drug use, health information and drug network characteristics. Primary indexes were then briefly educated on HCV and its treatment and encouraged to recruit their injection drug 'network members' for HCV testing and linkage to care. Eligible network members were enrolled as 'secondary indexes' and completed the same index study procedures. In sum, 17 of 36 primary indexes initiated the recruitment of 64 network members who were HCV antibody positive and eligible to become indexes. In multivariable analysis, successful recruitment of at least one network member was positively associated with prior HCV treatment (OR 2.80; CI [1.01, 7.72]), daily or more injection drug use (OR 2.38; CI [1.04, 5.47]), and a higher number of injection drug network members (OR 1.20; CI [1.01, 1.42]). Among the 69 participants with chronic HCV not previously linked to HCV care at enrolment, 91% (n = 63) completed a linkage to HCV care appointment, 45% (n = 31) scheduled an appointment with an HCV provider, and 20% (n = 14) initiated HCV therapy. These findings suggest a potential benefit for peer-driven, network-based interventions focused on HCV treatment-experienced PWID as a mechanism to increase HCV linkage to care.

Coding communications across time: Documenting changes in interaction patterns across adopter categories.

GLOBALink, a large online network of tobacco control professionals, was active in the promotion of the World Health Organization's Framework Convention on Tobacco Control treaty, an international treaty aimed at reducing the global burden of tobacco-related death and disease. We examined and compared the roles that different countries served in the GLOBALink community during FCTC negotiation and ratification. Previous studies of FCTC ratification found the process adhered to a diffusion of innovation model (Valente et al., 2015). We followed that work by conducting content analyses of discussion messages posted by GLOBALink members representing different countries. Based on the time when they ratified the FCTC, each country was labeled by one of the four adoption stages of the diffusion model and we investigated the amount of shared word use between the different stages. A goodness-of-fit chi-squared test indicated that content was not shared in an expected manner between stages (χ 2 = 11,856.45, N = 51,447, p < 0.001). A deeper look at the specific words shared between countries within and between adoption stages provided insight into how interactions between certain countries might have served to support the ratification process.

An Appraisal of Social Network Theory and Analysis as Applied to Public Health: Challenges and Opportunities.

The use of social network theory and analysis methods as applied to public health has expanded greatly in the past decade, yielding a significant academic literature that spans almost every conceivable health issue. This review identifies several important theoretical challenges that confront the field but also provides opportunities for new research. These challenges include (a) measuring network influences, (b) identifying appropriate influence mechanisms, (c) the impact of social media and computerized communications, (d) the role of networks in evaluating public health interventions, and (e) ethics. Next steps for the field are outlined and the need for funding is emphasized. Recently developed network analysis techniques, technological innovations in communication, and changes in theoretical perspectives to include a focus on social and environmental behavioral influences have created opportunities for new theory and ever broader application of social networks to public health topics.

Associations of functional and dysfunctional impulsivity to smoking characteristics.

OBJECTIVES: Although the relation between impulsivity and smoking is well-documented, one model of impulsivity that has received little attention in the addiction literature separates impulsivity into 2 dimensions: functional impulsivity (tendency to make quick effective decisions) and dysfunctional impulsivity (tendency to make quick ineffective decisions). METHODS: This cross-sectional study examined relations of functional and dysfunctional impulsivity to smoking characteristics in 212 non-treatment-seeking daily smokers (M = 15 cigarettes per day, M age = 24 years, 53% women). RESULTS: Dysfunctional impulsivity exhibited small- to medium-sized positive associations with difficulty refraining from smoking in forbidden places, craving, and smoking without awareness. Functional impulsivity was inversely associated with a measure of cigarette craving. Other suggestive associations were found; however, these were not statistically significant after type I error correction. CONCLUSIONS: Although the overall predictive validity of these impulsivity constructs for explaining variance in smoking characteristics was relatively modest, the results suggest that conceptualizing impulsivity as a unitary construct indicative of a tendency to make quick decisions may mask heterogeneity within the impulsivity-smoking relationship. These findings suggest that high-dysfunctional impulsivity smokers may perhaps require more intensive interventions to dampen motivation to smoke. They also highlight the possibility that certain manifestations of impulsivity are not related with increased smoking behavior and may actually associate with reduced drive to smoke.

Associations between posttraumatic stress disorder symptom clusters and cigarette smoking.

Understanding the relationship between Posttraumatic stress disorder (PTSD) and cigarette smoking has been difficult because of PTSD's symptomatic heterogeneity. This study examined common and unique lifetime cross-sectional relationships between PTSD symptom clusters [Re-experiencing (intrusive thoughts and nightmares about the trauma), Avoidance (avoidance of trauma-associated memories or stimuli), Emotional Numbing (loss of interest, interpersonal detachment, restricted positive affect), and Hyperarousal (irritability, difficulty concentrating, hypervigilance, insomnia)] and three indicators of smoking behavior: (1) smoking status; (2) cigarettes per day; and (3) nicotine dependence. Participants were adult respondents in the National Epidemiologic Survey of Alcohol and Related Conditions with a trauma history (n = 23,635). All four symptom clusters associated with each smoking outcome in single-predictor models (ps <. 0001). In multivariate models including all of the symptom clusters as simultaneous predictors, Emotional Numbing was the only cluster to retain a significant association with lifetime smoking over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.30, p < .01). While Avoidance uniquely associated with smoking status and nicotine dependence in multivariate models, these relations fell below significance after adjusting for demographics and comorbidity. No clusters uniquely associated with cigarettes per day. Hyperarousal uniquely related with nicotine dependence over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.51, p < .001). These results suggest the following: (a) common variance across PTSD symptom clusters contribute to PTSD's linkage with smoking in the American population; and (b) certain PTSD symptom clusters may uniquely associate with particular indicators of smoking behavior. These findings may clarify the underpinnings of PTSD-smoking comorbidity and inform smoking interventions for trauma-exposed individuals.