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.

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.

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.

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.

Estimating alcohol and tobacco consumption of university students and urban population in Ho Chi Minh City by wastewater analysis.

The quantitative measurement of urinary biomarkers in wastewater has emerged as a robust tool for estimating alcohol and tobacco consumption in populations. In this study, we applied the wastewater-based epidemiology (WBE) approach to compare alcohol and tobacco use between university students and urban inhabitants in Ho Chi Minh City, Vietnam. Ethyl sulfate and cotinine serve as markers for alcohol and tobacco use, respectively. Our findings reveal that urban inhabitants aged 15 and above consume 1.56 ± 0.23 mL of pure ethanol and 2.8 ± 0.33 mg of nicotine per day, while university students consume 0.69 ± 0.13 mL of pure alcohol and 1.2 ± 0.2 mg of nicotine per day. This indicates that, on average, students consume less alcohol and tobacco compared with urban adults. A Monte Carlo simulation indicated that, on average, university students in our study smoke 1.5 cigarettes per day, while urban residents aged 15 and above smoke 4.3 cigarettes per day. Considering the smoking prevalence, a student smoker in this study consumes 6.5 cigarettes per day, a level high enough to establish addiction. On the other hand, alcohol use estimation is significantly lower than previous survey-based reports, likely due to degradation within on-site septic tanks. Future research should aim to extend the sampling period to capture seasonal variations and improve the understanding of tobacco and alcohol consumption patterns. The results from this study are crucial for decision-makers in Ho Chi Minh City to develop effective public health strategies and interventions. PRACTITIONER POINTS: Wastewater-based approach is applicable to estimate the tobacco consumption in Ho Chi Minh City. Each current smoker in the urban area of Ho Chi Minh City smokes nearly a package a day. The estimated consumption for student smokers in U-town is 6.5 cigarettes per day, a level high enough to establish addiction. The existence of septic tanks within Vietnam's drainage systems prevents reliable estimation of alcohol consumption for the entire population.

A decomposition analysis of sociodemographic factors and non-cigarette tobacco use as contributors to the change in smoking rates in South Africa between 2017/18 and 2021.

BACKGROUND: Trends data up to 2018 suggest that tobacco smoking was increasing in South Africa (SA), but only limited information is available on the impact of the COVID-19 pandemic on the current pattern of use of tobacco and nicotine products (TNPs). OBJECTIVES: To assess trends in sociodemographic patterns in the use of TNPs and the extent to which sociodemographic factors and non-cigarette tobacco use may explain possible changes in rates of TNP use between 2017/18 and 2021. METHODS: Data from three waves (2017, 2018 and 2021) of the South African Social Attitudes Survey (total N=8 140) were analysed. The sociodemographic correlates of current daily and non-daily use of factory-manufactured cigarettes (FMCs), roll-your-own (RYO) cigarettes, waterpipe/hubbly, electronic cigarettes (ECigs), snuff (a smokeless tobacco) and any combination of FMCs, RYO cigarettes and waterpipe/hubbly ('current smoking') in 2017/18 (pre-pandemic) were compared with those for 2021 (during the pandemic). Chi-square analyses and generalised linear models were used to compare the prevalence of TNP use between the two periods. A Blinda-Oaxaca decomposition analysis was also used to explore the roles of various sociodemographic factors, including any differences in the use of TNPs, that may explain any observed differences in smoking rates between 2017/18 and 2021. RESULTS: Current smoking increased significantly from 22.4% (95% confidence interval (CI) 20.4 - 24.5) in 2017/18 to 27.6% (95% CI 24.3 - 31.1) in 2021 (p=0.009). Smoking of FMCs did not change significantly overall between these two periods (20.1% v. 22.1%; p=0.240), except for a significant increase among those who self-identified as black African and a decrease among those who self-identified as coloured and those currently employed. However, the use of waterpipe/hubbly, ECigs, RYO cigarettes and snuff increased significantly. Women, individuals aged <35 years and black Africans had the largest increase in waterpipe/hubbly and ECig use. A decomposition analysis showed that increased waterpipe/hubbly and RYO use explained 52% and 15%, respectively, of the increase in smoking rates, while lower employment during 2021 compared with 2017/18 explained 15% of the increase in smoking rates during 2021. CONCLUSION: The use of all TNPs continued to increase in SA, particularly among women and unemployed people. These findings have policy and practice implications for addressing socioeconomic disparities in tobacco-related diseases.

Regional insights on tobacco-related tweets: unveiling user opinions and usage patterns.

Introduction: Tobacco consumption and its impact on health remain high worldwide. Additionally, it is a contentious issue generating significant controversy. Twitter has proven to be a useful platform for evaluating public health topics related to population health behaviors, and tobacco consumption. Objective: The objective of this study is to analyze the content of tweets related to tobacco. Moreover, geolocation data will be considered to understand regional differences. Methods: Tweets published between 2018 and 2022, in both English and Spanish, containing the keyword "tobacco," were analyzed. A total of 56,926 tweets were obtained. The tweets were classified into different categories. 550 tweets were manually analyzed, and an automated and computerized classification was performed for the remaining and largest subset of tweets. Results: The analysis yielded 30,812 classifiable tweets. Healthcare professionals were the most frequent contributors to the topic (50.2%), with the most common theme being general information about the toxic effects of tobacco. 57.9% of the tweets discussed the harmful effects of tobacco on health, with fear being the predominant emotion. The largest number of tweets were located in America. Conclusions: Our study revealed a substantial number of tweets highlighting the health risks and negative perceptions of tobacco consumption. Africa showed the lowest percentage of tweets discussing the health risks associated with tobacco, coinciding with the continent having the least developed anti-tobacco policies. Healthcare professionals emerged as the most prominent users discussing the topic, which is encouraging as they play a crucial role in disseminating accurate and scientific health information.

Exploring the impacts of risk factors on mortality patterns of global Alzheimer's disease and related dementias from 1990 to 2021.

Alzheimer's Disease and Related Dementias (ADRD) affect millions of people worldwide, with mortality rates influenced by several risk factors and exhibiting significant heterogeneity across geographical regions. This study aimed to investigate the impact of risk factors on global ADRD mortality patterns from 1990 to 2021, utilizing clustering and modeling techniques. Data on ADRD mortality rates, cardiovascular disease, and diabetes prevalence were obtained for 204 countries from the GBD platform. Additional variables such as HDI, life expectancy, alcohol consumption, and tobacco use prevalence were sourced from the UNDP and WHO. All the data were extracted for men, women, and the overall population. Longitudinal k-means clustering and generalized estimating equations were applied for data analysis. The findings revealed that cardiovascular disease had significant positive effects of 1.84, 3.94, and 4.70 on men, women, and the overall ADRD mortality rates, respectively. Tobacco showed positive effects of 0.92, 0.13, and 0.39, while alcohol consumption had negative effects of - 0.59, - 9.92, and - 2.32, on men, women, and the overall ADRD mortality rates, respectively. The countries were classified into five distinct subgroups. Overall, cardiovascular disease and tobacco use were associated with increased ADRD mortality rates, while moderate alcohol consumption exhibited a protective effect. Notably, tobacco use showed a protective effect in cluster A, as did alcohol consumption in cluster B. The effects of risk factors on ADRD mortality rates varied among the clusters, highlighting the need for further investigation into the underlying causal factors.

A Complex Interplay: Navigating the Crossroads of Tobacco Use, Cardiovascular Disease, and the COVID-19 Pandemic: A WHF Policy Brief.

The Coronavirus Disease 2019, commonly referred to as COVID-19, is responsible for one of the deadliest pandemics in human history. The direct, indirect and lasting repercussions of the COVID-19 pandemic on individuals and public health, as well as health systems can still be observed, even today. In the midst of the initial chaos, the role of tobacco as a prognostic factor for unfavourable COVID-19 outcomes was largely neglected. As of 2023, numerous studies have confirmed that use of tobacco, a leading risk factor for cardiovascular and other diseases, is strongly associated with increased risks of severe COVID-19 complications (e.g., hospitalisation, ICU admission, need for mechanical ventilation, long COVID, etc.) and deaths from COVID-19. In addition, evidence suggests that COVID-19 directly affects multiple organs beyond the respiratory system, disproportionately impacting individuals with comorbidities. Notably, people living with cardiovascular disease are more prone to experiencing worse outcomes, as COVID-19 often inherently manifests as thrombotic cardiovascular complications. As such, the triad of tobacco, COVID-19 and cardiovascular disease constitutes a dangerous cocktail. The lockdowns and social distancing measures imposed by governments have also had adverse effects on our lifestyles (e.g., shifts in diets, physical activity, tobacco consumption patterns, etc.) and mental well-being, all of which affect cardiovascular health. In particular, vulnerable populations are especially susceptible to tobacco use, cardiovascular disease and the psychological fallout from the pandemic. Therefore, national pandemic responses need to consider health equity as well as the social determinants of health. The pandemic has also had catastrophic impacts on many health systems, bringing some to the brink of collapse. As a result, many health services, such as services for cardiovascular disease or tobacco cessation, were severely disrupted due to fears of transmission and redirection of resources for COVID-19 care. Unfortunately, the return to pre-pandemic levels of cardiovascular disease care activity has stagnated. Nevertheless, digital solutions, such as telemedicine and apps, have flourished, and may help reduce the gaps. Advancing tobacco control was especially challenging due to interference from the tobacco industry. The industry exploited lingering uncertainties to propagate misleading information on tobacco and COVID-19 in order to promote its products. Regrettably, the links between tobacco use and risk of SARS-CoV-2 infection remain inconclusive. However, a robust body of evidence has, since then, demonstrated that tobacco use is associated with more severe COVID-19 illness and complications. Additionally, the tobacco industry also repeatedly attempted to forge partnerships with governments under the guise of corporate social responsibility. The implementation of the WHO Framework Convention on Tobacco Control could address many of the aforementioned challenges and alleviate the burden of tobacco, COVID-19, and cardiovascular disease. In particular, the implementation of Article 5.3 could protect public health policies from the vested interests of the industry. The world can learn from the COVID-19 pandemic to better prepare for future health emergencies of international concern. In light of the impact of tobacco on the COVID-19 pandemic, it is imperative that tobacco control remains a central component in pandemic preparedness and response plans.

Tobacco use and its associated factors among students of medical college at tertiary care center of Eastern Nepal.

BACKGROUND: Despite declining smoking prevalence globally, South Asia faces a rising burden. In Nepal, existing tobacco control laws haven't curbed use, with 28.9% of young adults engaging in tobacco use. This study investigates tobacco use and associated factors among medical, dental, and nursing students at a Nepalese tertiary care center. OBJECTIVE: We aimed to assess tobacco use prevalence and identify factors associated with it among future healthcare professionals, considering their distinct roles in tobacco control. Medical students can contribute through clinical counseling and public health advocacy, dental students through oral health education, and nursing students through patient education and community outreach. METHODS: A cross-sectional study involving 427 medical, dental, and nursing students was conducted. Data was collected using online questionnaires distributed via email and social media. Descriptive statistics and Chi-square tests were used for analysis. RESULTS: The study found that 45% of participants were aged 22-25, with females comprising the majority (53.2%). Nearly half (49.2%) belonged to the medical faculty, and 24.4% were in their first year. Furthermore, among those who smoke, 53% reported smoking less than 5 cigarettes daily. The analysis revealed significant associations between smoking with age (p = 0.01), year of study (p = 0.001), parental smoking history (p = 0.001), and having friends who smoke (p = 0.001). CONCLUSION: Our findings highlight the moderate prevalence of cigarette smoking among medical students, with family and friends emerging as major influences. Stress relief was a common reason, particularly among young females and first-year students. These results emphasize the urgent need for comprehensive tobacco control programs within medical institutions to equip future healthcare professionals to effectively address smoking issues.

Dose-Dependent association of cumulative tobacco consumption with the presence of carotid atherosclerosis in individuals with type 1 diabetes.

AIMS: Evaluate the association between cumulative tobacco consumption (CTC; packs-year) and atherosclerosis in type 1 diabetes (T1D), and study whether the inclusion of CTC in the Steno T1 Risk Engine (ST1RE) equation improves the identification of plaques. METHODS: Cross-sectional study in T1D patients without cardiovascular disease (CVD), with ≥ 1 of the following: ≥40 years-old, diabetic kidney disease, and/or T1D duration ≥ 10 years + cardiovascular risk factors.Preclinical atherosclerosis was evaluated by carotid ultrasonography. RESULTS: N = 584 patients were included (46.1 % women, age 48.7 ± 10.5 years, T1D duration 27.3 ± 10.8 years, 26.2 % active smokers). The overall plaque prevalence was 40.9 %. In models adjusted for age, sex, lipids, blood pressure, kidney function, statin use, microvascular complications and HbA1c, CTC was dose-dependently associated with the number of plaques (none, 1-2, ≥3) overall and in both active and former smokers (p < 0.001). This association remained after adjusting for ST1RE (OR 1.11 [1.02-1.19]). Although the inclusion of CTC in the ST1RE did not improve plaque identification overall (p = 0.180), it did so when analyzing active smokers separately (AUC 0.738 vs. 0.768; p < 0.01). CONCLUSIONS: In T1D patients, CTC is dose-dependently associated with atherosclerosis. Further prospective studies are needed to determine if CTC could identify T1D individuals more prone to accelerated atherosclerosis.

A commercial tobacco and alcohol use intervention for urban Native American youth.

OBJECTIVE: Westernized alcohol and commercial tobacco use prevention approaches for Native Americans have not been effective, or sustainable. The overall objective of this study examined the effect of the culturally based Urban Talking Circle (UTC) intervention versus standard education (SE) program for the prevention of alcohol and commercial tobacco use among urban Native American youth. DESIGN: The study employed a 2-condition quasi-experimental design and utilized convenience and snowball sampling methods for recruiting 100 urban Native American youth participants in two urban Native American community program locations in Florida. Study participants were randomized by their urban Native American community program location to one of the 2-conditions. These included the standard education (SE) program used within United States school systems (drug abuse resistance education) and the Urban Talking Circle (UTC) intervention, culturally tailored and developed for urban Native American youth from the culturally based Talking Circle Intervention for rural Native American Youth. The Native American Alcohol Measure for Youth (NAAMY) and Native Reliance Questionnaire were utilized to collect participants' data. Participants' data was analyzed using multivariate analysis of variance to determine differences between the scores on all measures at pre/post-intervention for the 2-conditions. RESULTS: Study findings indicate that a culturally based intervention was more effective for the reduction of commercial tobacco and alcohol use than a non-culturally based intervention for urban Native American youth. CONCLUSION: The study findings emphasized that the utilization of the culturally tailored UTC intervention reduced involvement associated with alcohol and commercial tobacco use.

Reasons for multiple tobacco product and cannabis co-use among Texas young adults.

OBJECTIVE: This study examines differences in reasons for e-cigarette, cigarette, and cannabis use across exclusive, dual, co-, and poly co-users. METHODS: Participants were 645 young adults who reported past 30-day (P30D) use of e-cigarettes, cigarettes, or cannabis at wave 14 (Fall, 2021) of the Texas Adolescent Tobacco Marketing and Surveillance System (TATAMS). Exclusive users reported P30D use of one product, dual users reported P30D use of e-cigarettes and cigarettes, co-users reported use of cannabis and one tobacco product, and poly co-users reported P30D use of all three products. Participants were asked if they agreed with a series of reasons for using their respective products. Multinomial logistic regression analyses were conducted to examine associations between reasons for use and pattern of use, controlling for sex, race/ethnicity, and lifetime product use. RESULTS: 26.36 % of P30D users reported cannabis and tobacco use. Poly co-users were more likely to report using e-cigarettes because their friends do than e-cigarette co-users (aRRR = 2.64; 95 %CI = 1.19-5.83) and dual tobacco users (aRRR = 5.11; 95 %CI = 1.73-15.12). Poly co-users were more likely to smoke cigarettes while drinking alcohol (aRRR = 4.68; 95 %CI = 1.06-20.72) or to experience a pleasurable buzz (aRRR = 5.48; 95 %CI = 1.62-18.57) than exclusive cigarette users. Poly co-users more often reported using cannabis for taste (aRRR = 3.13; 95 %CI = 1.51-6.51), because their friends use it (aRRR = 2.19; 95 %CI = 1.08-4.42), and while drinking alcohol (aRRR = 2.13; 95 %CI = 1.03-4.41) than exclusive cannabis users. CONCLUSIONS: Given that reasons for use differ significantly among types of multiple product users and exclusive users, interventions should be tailored to address the specific tobacco and cannabis use practices of young adults.

The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations.

The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents' exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.

Smokeless Tobacco Use and Quit Behaviour Assessment in a Middle Aged to Elderly Population in a Rural Setting - An Evaluative Study.

INTRODUCTION: Expanding knowledge on tobacco use and quitting outcomes in Chhattisgarh, India, is crucial. Limited data hinder the assessment of tobacco use prevalence and quitting outcomes in the region. This household-based cross-sectional study aimed to assess smokeless tobacco (SLT) use and quit behaviour among village dwellers aged 35-44 and 65-74 years in Jamul, Chhattisgarh. MATERIALS AND METHODS: A survey was conducted among 450 participants, utilising a pretested questionnaire and data analysis using IBM Statistical Package for the Social Sciences (SPSS) v23. RESULTS: The study revealed that among the survey participants, 61.1% were males and 38.9% were females. The prevalence of SLT use was found to be 67.8%, with 59.1% of current SLT users reporting daily use. Middle-aged individuals predominantly chose gutkha, while khaini was more common among the elderly. Tobacco and paan with tobacco were also commonly used forms. Gudakhu, a popular SLT product for oral hygiene and easy defecation, was reported by 71.34% of participants. Television warnings and SLT packages proved to be successful methods for disseminating information about the dangers of SLT use. However, SLT users who attempted to quit independently reported encountering one or more withdrawal symptoms, which posed significant obstacles to quitting SLT. CONCLUSION: Community-based awareness programmes are implemented via regional television (TV) channels, coupled with cessation initiatives, including professional counselling, pharmaceutical interventions and support of peer. Changing attitudes against SLT use and promoting tobacco-free environments are prioritized. These strategies will effectively address SLT use and improve quitting outcomes in Jamul, Chhattisgarh, fostering a healthier community.

Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use.

BACKGROUND: Few studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis. METHOD: Cross-sectional online survey of a national convenience sample of 13-40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13-17-, 18-24-, and 25-40-year-olds. RESULTS: Among 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06-1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28-2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35-1.80; <0.001), cigarettes (aOR = 1.24, 1.04-1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51-2.42; <0.001), and blunts (aOR = 1.22, 1.00-1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %). CONCLUSIONS: Screening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.

Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study.

SIGNIFICANCE: A growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. METHODS: Data came from Waves 4-6 (12/2016-11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. RESULTS: Among US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9-16.4) of females and 23.4% (20.0-26.9) of males were young adults (aged 18-24), 11.7% (9.2-14.2) of females and 14.4% (11.6-17.2) of males had