Oral Nicotine Gum Discussions on Twitter: Content Analysis.

BACKGROUND: Oral nicotine gum such as LUCY, which comes in colorful packaging, mimicking traditional chewing gum, is becoming popular. Many brands of gum have not been approved by the FDA for smoking cessation. This study examined public discourse about, including sentiment toward, oral nicotine gum on Twitter. METHODS: We used Twitter's Streaming Application Programming Interface to collect data from January 1, 2021, to December 21, 2021, using "nicotine gum" and/or "#nicotinegum" search terms (N = 19 171 unique tweets were collected). We used an inductive approach to become familiar with the data, generated a codebook, and conducted a content analysis on (n = 2152) tweets. RESULTS: Cessation (n = 716, 33.3%), personal experience (n = 370, 17.2%), and addiction to gum (n = 135, 6.3%) were the most prevalent themes. Cessation tweets primarily discussed cigarette smoking cessation (n = 418, 58.4% of cessation tweets) and successful cessation experiences (n = 155, 21.6%). Other identified themes pertained to using nicotine gum for cognitive enhancement or catching a "buzz" (n = 102, 4.7%), marketing (n = 98, 4.6%), using nicotine gum with other substances (n = 90, 4.2%), and adverse effects (n = 63, 2.9%). Sentiment analysis results revealed that 675 (44.2%) tweets were categorized as neutral, 605 (39.6%) tweets were classified as positive, and 248 tweets (16.2%) were negative. CONCLUSIONS: About one-third of tweets in our corpus mentioned nicotine gum in the context of smoking cessation. Most nicotine gum-related posts conveyed positive and neutral sentiments. Future studies should consider adding novel nicotine gum-specific search terms as well as exploring other social media platforms to gain more insights about these products. IMPLICATIONS: Our findings suggest that Twitter has the potential to track and facilitate conversations between those seeking cigarette cessation advice and those who have successfully quit tobacco by using nicotine gum. Monitoring of promotional content from nicotine gum companies is needed to ensure these products are not appealing to youth and nonusers of tobacco.

Characterizing Opioid Withdrawal Experiences and Consequences Among a Community Sample of People Who Use Opioids.

BACKGROUND: Opioid withdrawal symptoms are a highly salient and consequential health condition experienced by people who use opioids (PWUO). This study utilized qualitative interviews to explore opioid withdrawal experiences and consequences among PWUO in Los Angeles County, USA. METHODS: Semi-structured qualitative interviews were conducted with 22 PWUO (aged 27-63 years) between May 2021 and May 2022. Participants self-reported opioid and injection drug use in the last 30 days. We employed an inductive thematic approach to systematically code and synthesize textual interview data. RESULTS: Participants experienced withdrawal symptoms frequently, with many going to great lengths to avoid them. Withdrawal pain was described as incapacitating and interfered with PWUO's ability to sustain regular employment and ensure stable housing. Avoiding withdrawal was described as influential in driving decisions to continue using opioids. Mechanisms for managing withdrawal included using other substances to the point of sedation. PWUO who transitioned from heroin to fentanyl use revealed more frequent, painful, and faster onset of withdrawal symptoms. Adverse withdrawal experiences and fear of precipitated withdrawal from buprenorphine were barriers to treatment initiation and continuation. CONCLUSION: Withdrawal symptoms among PWUO increase health risk. Improved strategies to treat opioid withdrawal are urgently needed. Solutions such as safe supply and intentional opioid withdrawal interventions (educational trainings, withdrawal comfort kits) are needed to improve withdrawal management and reduce opioid-related harm.

Racial/ethnic minority females smoke more cigarettes after social interaction with others who smoke.

The present study investigated the effects of social interaction with others who smoke on daily cigarette use among diverse females via ecological momentary assessment methods. Ninety-eight premenopausal females (29.6% White, 70.4% racial/ethnic minority) who smoke daily reported their social interactions and cigarette use over 35-days. Greater than usual levels of social interaction with others who smoke was associated with increased cigarette use that day among racial/ethnic minority females. Future smoking cessation interventions targeting racial/ethnic minority females should consider the impact of social environments on smoking behaviors, such as the frequency of peer interactions with others who smoke.

Ice Flavor-Related Discussions on Twitter: Content Analysis.

BACKGROUND: The US Food and Drug Administration (FDA) recently restricted characterizing flavors in tobacco products. As a result, ice hybrid-flavored e-cigarettes, which combine a cooling flavor with fruit or other flavors (eg, banana ice), emerged on the market. Like menthol, ice-flavored e-cigarettes produce a cooling sensory experience. It is unclear if ice hybrid-flavored e-cigarettes should be considered characterizing flavors or menthol, limiting regulatory action. Monitoring the public's conversations about ice-flavored e-cigarettes on Twitter may help inform the tobacco control community about these products and contribute to the US FDA policy targets in the future. OBJECTIVE: This study documented the themes pertaining to vaping and ice flavor-related conversations on Twitter. Our goal was to identify key conversation trends and ascertain users' recent experiences with ice-flavored e-cigarette products. METHODS: Posts containing vaping-related (eg, "vape," "ecig," "e-juice," or "e-cigarette") and ice-related (ie, "Ice," "Cool," "Frost," and "Arctic") terms were collected from Twitter's streaming application programming interface from January 1 to July 21, 2021. After removing retweets, a random sample of posts (N=2001) was selected, with 590 posts included in the content analysis. Themes were developed through an inductive approach. Theme co-occurrence was also examined. RESULTS: Many of the 590 posts were marked as (or consisted of) marketing material (n=306, 51.9%), contained positive personal testimonials (n=180, 30.5%), and mentioned disposable pods (n=117, 19.8%). Other themes had relatively low prevalence in the sample: neutral personal testimonials (n=45, 7.6%), cannabidiol products (n=41, 7%), negative personal testimonials (n=41, 7%), "official" flavor description (n=37, 6.3%), ice-flavored JUUL (n=19, 3.2%), information seeking (n=14, 2.4%), and comparison to combustible tobacco (n=10, 1.7%). The most common co-occurring themes in a single tweet were related to marketing and disposable pods (n=73, 12.4%). CONCLUSIONS: Our findings offer insight into the public's experience with and understanding of ice-flavored e-cigarette products. Ice-flavored e-cigarette products are actively marketed on Twitter, and the messages about them are positive. Public health education campaigns on the harms of flavored e-cigarettes may help to reduce positive social norms about ice-flavored products. Future studies should evaluate the relationship between exposure to personal testimonials of ice-flavored vaping products and curiosity, harm perceptions, and experimentation with these products among priority populations.

#FlavorsSaveLives: An Analysis of Twitter Posts Opposing Flavored E-cigarette Bans.

BACKGROUND: Starting in 2019 policies restricting the availability of flavored e-cigarette products were proposed or implemented in the United States to curb vaping by youth. People took to Twitter to voice their opposition, referencing the phrase "Flavors Save Lives." This study documented the emerging themes pertaining to "Flavors Saves Lives" over a 12-month period. METHODS: The study period was from May 1, 2019, to May 1, 2020. A stratified sampling procedure supplied 2500 tweets for analysis. Posts were classified by one or more of the following themes: (1) Political Referendum; (2) Institutional Distrust; (3) Individual Rights; (4) Misinformation; (5) THC Vaping is the Real Problem; (6) Smoking Cessation; (7) Adult Use; and (8) Not a Bot. The temporal pattern of tweets over the year was examined. RESULTS: Political Referendum (76.5%) and Institutional Distrust (31.3%) were the most prominent themes, followed by Not a Bot (11.0%), Individual Rights (10.4%), Adult Use (8.0%), Smoking Cessation (6.6%), Misinformation (5.9%), and THC Vaping is the Real Problem (3.5%). Total tweet frequencies increased in September 2019 and peaked in November 2019 before returning to relatively low numbers. Political Referendum and Institutional Distrust were consistently the most prevalent themes over time. CONCLUSION: Twitter posts with the phrase "Flavors Save Lives" commonly discussed voting against political incumbents and mentioned distrust of government representatives. Findings demonstrated the possibility of near real-time Twitter monitoring of public opposition to flavor bans. These data may be valuable for designing tobacco control information campaigns in the future. IMPLICATIONS: (a) Starting in 2019 policies restricting the availability of flavored e-cigarette products were proposed or implemented in the United States to curb vaping by youth. (b) This study content analyzed Twitter posts with the phrase "Flavors Save Lives" from a 12-month period to understand opposition to flavor restrictions. (c) Twitter posts commonly discussed voting against political incumbents and mentioned distrust of government representatives. (d) Findings demonstrated the possibility of near real-time Twitter monitoring of public opposition to flavor bans, and contribute to a more comprehensive assessment of different sub-population's responses to current and proposed tobacco control information policies.

Topics of Nicotine-Related Discussions on Twitter: Infoveillance Study.

BACKGROUND: Cultural trends in the United States, the nicotine consumer marketplace, and tobacco policies are changing. OBJECTIVE: The goal of this study was to identify and describe nicotine-related topics of conversation authored by the public and social bots on Twitter, including any misinformation or misconceptions that health education campaigns could potentially correct. METHODS: Twitter posts containing the term "nicotine" were obtained from September 30, 2018 to October 1, 2019. Methods were used to distinguish between posts from social bots and nonbots. Text classifiers were used to identify topics in posts (n=300,360). RESULTS: Prevalent topics of posts included vaping, smoking, addiction, withdrawal, nicotine health risks, and quit nicotine, with mentions of going "cold turkey" and needing help in quitting. Cessation was a common topic, with mentions of quitting and stopping smoking. Social bots discussed unsubstantiated health claims including how hypnotherapy, acupuncture, magnets worn on the ears, and time spent in the sauna can help in smoking cessation. CONCLUSIONS: Health education efforts are needed to correct unsubstantiated health claims on Twitter and ultimately direct individuals who want to quit smoking to evidence-based cessation strategies. Future interventions could be designed to follow these topics of discussions on Twitter and engage with members of the public about evidence-based cessation methods in near real time when people are contemplating cessation.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents.

Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

Return of cartoon to market e-cigarette-related products.

INTRODUCTION: The tobacco industry's use of cartoons to market products has been shown to be effective at increasing awareness and appeal of combustible cigarettes among youth. While the Master Settlement Agreement placed restrictions on the use of cartoons for major cigarette and smokeless (chew) tobacco brands in the USA, no such restrictions exist for electronic cigarettes (e-cigarettes). Research has shown that e-cigarette manufacturers are using cartoons to market products, but limited data exist on the extent of these practices. This study examined the extent of the use of cartoons to market e-liquids on Instagram. METHODS: Instagram posts with the hashtag #ejuice or #eliquid were collected from 3 November 2017 to 17 November 2017. Rules were established to identify Cartoon (the post contained a cartoon), Logo (the post was labelled a cartoon due to the logo) and Promo (the image of the post or accompanying text indicated it was a promotion) in the data (n=3481). RESULTS: Among all posts, 723 (20.77%) contained a Cartoon, and 479 (13.76%) were coded as a cartoon because of the Logo. In other words, 479/723 or (66.25%) of Cartoon were coded as cartoons due to the vendor's or manufacture's logo. Among all posts, 2360 (67.80%) were Promo. CONCLUSION: Findings indicate that e-cigarette companies are using cartoons to market their products and many of these companies' logos are cartoons. Empirical data are needed to determine whether cartoon marketing strategies impact perceived risk and benefits, product appeal, the intention to use and actual use of e-cigarettes.

Validation of a behavioral economic purchase task for assessing drug abuse liability.

Behavioral economic purchase tasks quantify drug demand (i.e. reinforcing value of a drug) and have been used extensively to assess the value of various drugs among current users. However, purchase tasks have been rarely used with unfamiliar drugs to address a compound's abuse liability, and the current study sought to validate the paradigm in this capacity. Using a double-blind placebo-controlled within-subjects drug challenge design, the study evaluated differential drug demand on an experimental drug purchase task for a 20 mg dose of oral D-amphetamine (versus placebo), a prototypic psychostimulant, in 98 stimulant-naïve participants. Compared with placebo, amphetamine significantly increased intensity, breakpoint and Omax , and significantly decreased elasticity. Mechanistic analyses revealed that Omax and breakpoint mediated the relationship between subjective drug effects and 'willingness to take again', a putative indicator of liability via motivation for future drug-seeking behavior. These findings validate the purchase task paradigm for quantifying the reinforcing value and, in turn, abuse liability of unfamiliar compounds, providing a foundation for a variety of future applications.

Monitoring Tobacco Brand Websites to Understand Marketing Strategies Aimed at Tobacco Product Users and Potential Users.

Introduction: Limited information exists about strategies and methods used on brand marketing websites to transmit pro-tobacco messages to tobacco users and potential users. This study compared age verification methods, themes, interactive activities and links to social media across tobacco brand websites. Methods: This study examined 12 tobacco brand websites representing four tobacco product categories: cigarettes, cigar/cigarillos, smokeless tobacco, and e-cigarettes. Website content was analyzed by tobacco product category and data from all website visits (n = 699) were analyzed. Adult smokers (n = 32) coded websites during a one-year period, indicating whether or not they observed any of 53 marketing themes, seven interactive activities, or five external links to social media sites. Results: Most (58%) websites required online registration before entering, however e-cigarette websites used click-through age verification. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature themes related to "party" lifestyle, and e-cigarette websites were much more likely to feature themes related to harm reduction. Cigarette sites featured greater levels of interactive content compared to other tobacco products. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature activities related to events and music. Compared to cigarette sites, both cigar and e-cigarette sites were more likely to direct visitors to external social media sites. Conclusion: Marketing methods and strategies normalize tobacco use by providing website visitors with positive themes combined with interactive content, and is an area of future research. Moreover, all tobacco products under federal regulatory authority should be required to use more stringent age verification gates. Implications: Findings indicate that the Food and Drug Administration (FDA) should require brand websites of all tobacco products under its regulatory authority use more stringent age verification gates by requiring all visitors be at least 18 years of age and register online prior to entry. This is important given that marketing strategies may encourage experimentation with tobacco or deter quit attempts among website visitors. Future research should examine the use of interactive activities and social media on a wide variety of tobacco brand websites as interactive content is associated with more active information processing.

Anhedonia and Abstinence as Predictors of the Subjective Pleasantness of Positive, Negative, and Smoking-Related Pictures.

INTRODUCTION: Anhedonia-diminished interest or pleasure in response to rewards-is a dimension implicated in several psychiatric disorders linked to smoking. This laboratory study sought to identify motivational mechanisms linking anhedonia and tobacco addiction by testing the hypothesis that anhedonia, abstinence, and their interaction would predict excesses and deficits in the perceived pleasantness of smoking-related and positive pictures, respectively. We assessed the pleasantness of negative pictures as a secondary outcome. METHODS: After a baseline session involving self-report measures of anhedonia and other factors, 125 regular smokers attended two counterbalanced experimental sessions (overnight abstinent and non-abstinent) at which they rated the pleasantness of positive, smoking-related, negative, and neutral (control) pictures presented via computer. The difference in pleasantness ratings of positive, smoking-related, and negative pictures relative to neutral pictures served as the index of participants' appraisal of the motivational salience of nondrug reward, drug reward, and aversive signals, respectively. RESULTS: With and without adjusting for sex and depressive symptoms, greater anhedonia significantly or marginally predicted greater pleasantness of smoking (vs. neutral), lower pleasantness of positive (vs. neutral), less unpleasantness of negative (vs. neutral) pictures (|ßs| = 0.18 to 0.35, ps = .007 to .07). Anhedonia by abstinence interaction effects on pleasantness ratings of each stimulus category (vs. neutral) were not significant (|ßs| ≤ 0.02, ps ≥ .36). CONCLUSIONS: Anhedonia and abstinence additively increase the salience of smoking-related cues in anhedonic smokers. Smoking cessation efforts that attenuate sensitization to smoking stimuli may benefit anhedonic smokers early in quit attempts. IMPLICATIONS: Taken together, these findings provide tentative evidence that anhedonia is associated with a relative imbalance in the motivational salience of drug relative to nondrug rewards and may be associated with a generalized hypo-reactivity to both positive and negative stimuli. Though some prior smoking research has evidenced this relative imbalance in anhedonia with self-report or a smoking-choice task, we additionally show that this pattern may extend to hyper-affective reactivity to smoking-related stimuli being coincident with hypo-affective reactivity to nondrug-related positive stimuli (ie, may extend to greater pleasantness ratings of smoking pictures being accompanied by lower pleasantness ratings of positive pictures).

Effects of acute doses of prosocial drugs methamphetamine and alcohol on plasma oxytocin levels.

Many drugs, including alcohol and stimulants, demonstrably increase sociability and verbal interaction and are recreationally consumed in social settings. One drug, 3,4-methylenedioxymethamphetamine (MDMA, ecstasy), seems to produce its prosocial effects by increasing plasma oxytocin levels, and the oxytocin system has been implicated in responses to several other drugs of abuse. Here, we sought to investigate the effects of 2 other "social" drugs on plasma oxytocin levels--methamphetamine and alcohol. Based on their shared capacity to enhance sociability, we hypothesized that both methamphetamine and alcohol would increase plasma oxytocin levels. In study 1, 11 healthy adult volunteers attended 3 sessions during which they received methamphetamine (10 mg or 20 mg) or placebo under double-blind conditions. Subjective drug effects, cardiovascular effects, and plasma oxytocin levels were measured at regular intervals throughout the sessions. In study 2, 8 healthy adult volunteers attended a single session during which they received 1 beverage containing placebo, and then a beverage containing alcohol (0.8 g/kg). Subjective effects, breath alcohol levels, and plasma oxytocin levels were measured at regular intervals. Both methamphetamine and alcohol produced their expected physiological and subjective effects, but neither of these drugs increased plasma oxytocin levels. The neurobiological mechanisms mediating the prosocial effects of drugs such as alcohol and methamphetamine remain to be identified.

Examination of anxiety sensitivity and distress tolerance as transdiagnostic mechanisms linking multiple anxiety pathologies to alcohol use problems in adolescents.

BACKGROUND: Multiple forms of anxiety psychopathology are associated with alcohol use problems in adolescents. Yet, the mechanisms underlying this association are unclear. Anxiety sensitivity (AS) and distress tolerance (DT) represent 2 distinct, conceptually relevant transdiagnostic constructs implicated in multiple manifestations of anxiety that may also underlie alcohol use problems and thereby explain why people with anxiety are more likely to have alcohol problems. METHODS: The current cross-sectional study examined whether AS and DT accounted for (i.e., statistically mediated) the relationship between manifest indicators of the 3 common anxiety phenotypes (generalized anxiety, social anxiety, and panic disorders) and alcohol problems in a sample of 534 high school students (14 to 15 years old). RESULTS: Multiple manifestations of anxiety were associated with greater alcohol use problems. AS statistically mediated multiple anxiety-alcohol associations, but DT did not. CONCLUSIONS: These findings provide preliminary evidence suggesting AS may be an important transdiagnostic target for alcohol prevention programs for those in early adolescence that experience elevated anxiety symptoms.

Diminished Alternative Reinforcement as a Mechanism Underlying Socioeconomic Disparities in Adolescent Substance Use.

OBJECTIVE: This study examined socioeconomic disparities in adolescent substance use utilizing a behavioral economic theoretical framework. We tested the hypothesis that teens of lower (vs. higher) socioeconomic status (SES) are vulnerable to substance use because they engage in fewer pleasurable substance-free activities that provide reinforcement and may deter substance use. METHOD: In a cross-sectional correlational design, 9th grade students (N=2839; mean age=14.1years) in Los Angeles, California, USA completed surveys in Fall 2013 measuring SES (i.e., parental education), alternative reinforcement (engagement in pleasurable substance-free activities, e.g., hobbies), substance use susceptibility, initiation, and frequency, and other factors. RESULTS: For multi-substance composite outcomes, lower parental education was associated with greater likelihood of substance use initiation in the overall sample, frequency of use among lifetime substance users, and susceptibility to substance use in never users. Substance-specific analyses revealed that lower parental education was associated with higher likelihood of initiating cigarettes, alcohol, and marijuana use as well as greater susceptibility to use cigarettes in never smokers. Each inverse association between parental education and substance-related outcomes was statistically mediated by diminished alternative reinforcement; lower parental education was associated with lower engagement in alternative reinforcers, which, in turn, was associated with greater substance use susceptibility, initiation, and frequency. CONCLUSION: These results point to a behavioral economic interpretation for socioeconomic disparities in adolescent substance use. Replication and extension of these findings would suggest that prevention programs that increase access to and engagement in healthy and fun activities may reduce youth socioeconomic health disparities related to substance use.

Pharmacological, sensorimotor, and expectancy effects on tobacco withdrawal: a preliminary study.

OBJECTIVE: Research designs for parsing the mechanisms underlying tobacco withdrawal are scant. This study introduced a novel research design that simultaneously manipulated three tobacco withdrawal mechanisms: pharmacological (nicotine dissipation), sensorimotor (elimination of the smoking ritual), and expectancy (activation of beliefs regarding the effects of nicotine deprivation), permitting examination of the effects of each mechanism while holding the other two mechanisms constant. METHODS: Following overnight abstinence, 32 regular cigarette smokers were randomized in a 2 (expectancy: told patch contains nicotine versus told placebo patch) × 2 (drug: receive 21-mg transdermal nicotine patch versus receive placebo patch) × 2 (sensorimotor: smoke very low nicotine content cigarettes versus no smoking) full factorial between-subjects design. Participants repeatedly completed measures of craving, affect, and anticipated pleasure from and desire for rewarding experiences, followed by a smoking lapse analog task. RESULTS: Receiving nicotine (versus placebo) increased positive affect and anticipated pleasure from and desire for reward. Expecting nicotine (versus placebo) reduced negative affect and increased smoking delay. Sensorimotor stimulation from smoking (versus no smoking) reduced smoking urge and behavior. CONCLUSION: Results provided initial validation of this novel three-mechanism design. This design can be used in the future to advance understanding and treatment of tobacco withdrawal.

Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence.

IMPORTANCE: Exposure to nicotine in electronic cigarettes (e-cigarettes) is becoming increasingly common among adolescents who report never having smoked combustible tobacco. OBJECTIVE: To evaluate whether e-cigarette use among 14-year-old adolescents who have never tried combustible tobacco is associated with risk of initiating use of 3 combustible tobacco products (ie, cigarettes, cigars, and hookah). DESIGN, SETTING, AND PARTICIPANTS: Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, mean age = 14.1 years) and at a 6-month follow-up (spring 2014, 9th grade) and a 12-month follow-up (fall 2014, 10th grade). Ten public high schools in Los Angeles, California, were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and completed follow-up assessments at 6 or 12 months (N = 2530). At each time point, students completed self-report surveys during in-classroom data collections. EXPOSURE: Student self-report of whether he or she ever used e-cigarettes (yes or no) at baseline. MAIN OUTCOMES AND MEASURES: Six- and 12-month follow-up reports on use of any of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes or no); (2) combustible cigarettes (yes or no), (3) cigars (yes or no); (4) hookah (yes or no); and (5) number of combustible tobacco products (range: 0-3). RESULTS: Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever users (n = 222) than never users (n = 2308) at the 6-month follow-up (30.7% vs 8.1%, respectively; difference between groups in prevalence rates, 22.7% [95% CI, 16.4%-28.9%]) and at the 12-month follow-up (25.2% vs 9.3%, respectively; difference between groups, 15.9% [95% CI, 10.0%-21.8%]). Baseline e-cigarette use was associated with greater likelihood of use of any combustible tobacco product averaged across the 2 follow-up periods in the unadjusted analyses (odds ratio [OR], 4.27 [95% CI, 3.19-5.71]) and in the analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR, 2.73 [95% CI, 2.00-3.73]). Product-specific analyses showed that baseline e-cigarette use was positively associated with combustible cigarette (OR, 2.65 [95% CI, 1.73-4.05]), cigar (OR, 4.85 [95% CI, 3.38-6.96]), and hookah (OR, 3.25 [95% CI, 2.29-4.62]) use and with the number of different combustible products used (OR, 4.26 [95% CI, 3.16-5.74]) averaged across the 2 follow-up periods. CONCLUSIONS AND RELEVANCE: Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal.

Effects of intranasal oxytocin on cigarette withdrawal and smoking in the laboratory: Differences by sex and social functioning traits.

Intranasal oxytocin (INOT) has received attention as a treatment for substance use disorders including tobacco dependence. However, it is unclear whether INOT-related effects differ by sex and social functioning traits. This study examined the influence of sex and two trait social functioning measures (hostility and rejection sensitivity) on INOT effects on abstinence-related subjective measures and smoking lapse. Adults who smoked cigarettes daily (N = 64; 21-40 years; 39% female) completed trait hostility and rejection sensitivity surveys at baseline followed by three experimental sessions following 12-hr smoking abstinence. Each session, participants received a single INOT dose (placebo, 20, 40 international units [IU]) in counterbalanced order, completed withdrawal, smoking urges and affect questionnaires, and a smoking lapse analog task. Interactive effects between INOT and sex, hostility, or rejection sensitivity on all outcomes were analyzed. INOT produced differential effects as a function of sex, trait hostility, and rejection sensitivity. The 20 IU dose worsened abstinence-related subjective effects for individuals with high trait hostility. Both INOT doses decreased smoking urges for high rejection sensitivity, and the 20 IU dose increased smoking urges for low rejection sensitivity. INOT increased withdrawal symptoms, smoking urges, and feelings of anger in females but not males. INOT did not improve withdrawal symptoms during abstinence and did not affect smoking lapse. While INOT produced some beneficial effects for a subset of participants with high rejection sensitivity, it worsened abstinence-related symptoms for others. Our results suggest that sex and social functioning should be considered when examining the therapeutic potential of INOT for smoking cessation in future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of cannabis use on cigarette smoking cessation in LGBTQ+ individuals.

OBJECTIVE: Sexual and gender minority individuals are more likely to use tobacco and cannabis and have lower cigarette cessation. This study examined cannabis use associations with daily cigarettes smoked in sexual and gender minority individuals before and during a quit attempt. METHOD: Participants included dual smoking same-sex/gender couples from California that were willing to make a quit attempt (individual n = 205, 68.3% female sex). Participants reported baseline past 30-day cannabis use and number of cigarettes smoked and cannabis use (yes/no) during 35 nightly surveys. Individuals with current cannabis use reported baseline cannabis use and/or nightly survey cannabis use. Multilevel linear models predicted number of cigarettes smoked by cannabis use. RESULTS: Number of cigarettes decreased from before to during a quit attempt, but this decrease was smaller in individuals with current cannabis use compared to no current cannabis use (p < .001). In individuals with current cannabis use, number of cigarettes smoked was greater on days with cannabis use (p < .001). Furthermore, cannabis use that day increased overall number of cigarettes in those with relatively high overall cannabis use but only during a quit attempt in those with relatively low cannabis use (Within-Subject Cannabis Use × Between-Subject Cannabis Use × Quit Attempt interaction; p < .001). CONCLUSIONS: Sexual and gender minority individuals with cannabis and cigarette use may have a harder time quitting smoking than those who do not use cannabis. For those with cannabis use, guidance on not using cannabis during a quit attempt may improve cigarette cessation outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessing the public discourse on Twitter: Reactions to the JUUL e-cigarettes ban in the United States.

INTRODUCTION: JUUL is a high-nicotine pod-based vaping device that is popular among adolescents and young adults. On 23 June 2022, the US Food and Drug Administration (FDA) denied authorization to market JUUL, and ordered JUUL Labs to remove products from the US market. The next day, a US federal appeals court temporarily suspended the ban. The mixed public discourse surrounding the FDA ban warrants further investigation. METHODS: This study examined Twitter data to describe public reaction to these announcements. Posts containing terms 'JUUL' and/or '#JUUL' (N=97548 unique tweets) were collected from 23 June to 3 July 2022, from Twitter's Streaming Application Programming Interface (API). After removing retweets, we used an inductive approach to become familiar with the data, generated a codebook, and conducted a content analysis on a random sample of n=4000 tweets. RESULTS: A total of 2755 (68.9%) tweets discussed JUUL in the context of the FDA ban. News (n=1425/2755; 51.7%) about the JUUL ban, government distrust (n=588; 21.3%), and individual rights (n=253; 9.2%) were the most prevalent themes. Less commonly discussed themes included inconsistencies between policies (n=174; 6.3%), mentions of switching to other products (n=162; 5.9%), smoking cessation (n=99; 3.6%), and craving for JUUL (n=94; 3.4%). Sentiment analysis of JUUL ban-related posts (n=2755) demonstrated that 1989 (72.2%) tweets were categorized as neutral, while anti-ban posts (n=566; 20.5%) were more prevalent than pro-ban posts (n=200; 7.3%). CONCLUSIONS: Besides straightforward announcements of the JUUL ban and its suspension, Twitter posts discussed government distrust, individual rights, and policy inconsistencies. While most posts conveyed neutral sentiments, anti-ban posts were almost three times more prevalent than pro-ban posts. Our findings suggest that text-based social media platforms like Twitter may be an effective instrument to understand opinions, attitudes, and beliefs regarding the FDA's JUUL ban.

Effect of a mindfulness training app on a cigarette quit attempt: an investigator-blinded, 58-county randomized controlled trial.

BACKGROUND: Cigarette smoking is the leading cause of preventable cancers. A majority of the 34 million people who currently smoke report wanting to quit. Mindfulness training apps offer a guided telehealth intervention to foster individuals' behavioral meditation practice. We present the main outcomes of a parallel-group randomized controlled trial that tested app-based mindfulness training vs attention control on smoking behavior. METHODS: We enrolled adult residents from across California who smoked daily and were willing to make a quit attempt (N = 213). Participants completed daily sessions in 10-minute segments for 14 consecutive days. Participants then started a quit attempt and reported daily smoking for 28 days following the quit date using the timeline follow-back measure. RESULTS: Seven-day point-prevalence abstinence for each week during the 4-week quit period ranged from 21.8% to 27.7% for app-based mindfulness training and 17.9% to 19.6% for controls. The intention-to-treat sample revealed that app-based mindfulness training outperformed controls on the proportion of abstinence days during the quit period (odds ratio = 2.00, 95% confidence interval = 1.03 to 3.87, P = .041). Although the 7-day point prevalence abstinence for week 4 favored app-based mindfulness training, significance was not reached (odds ratio = 1.65, 95% confidence interval = 0.84 to 3.23, P = .148). The mean number of cigarettes smoked per day among smokers was 4.95 for app-based mindfulness training vs 5.69 for controls (odds ratio = 0.81, 95% confidence interval = 0.71 to 0.92, P = .002), suggesting harm reduction in continued smokers. CONCLUSION: A mindfulness training app prescribed for 2 weeks leading up to a quit date showed an advantage over controls for total abstinence days and fewer cigarettes smoked in a diverse sample consisting of urban and rural residents. These findings yield implications for the use of apps to reduce exposure to the carcinogenic properties of cigarette smoke.