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1.
Addict Behav ; 114: 106747, 2020 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-33307406

RESUMEN

INTRODUCTION: Smoking cigarettes under the influence of alcohol or cannabis is associated with perceived pleasure. However, it is unclear whether these changes in perceived reward impact the extent of concurrent use of cigarettes with alcohol or cannabis. The current study investigated if self-reported changes in perceived reward from concurrent use of cigarettes with alcohol or cannabis are related to the extent of concurrent use in real-world contexts using a smartphone-based Ecological Momentary Assessment (EMA) study. METHODS: The sample included 126 diverse young adult smokers in the San Francisco Bay Area who reported current alcohol or cannabis use at baseline (M = 22.8 years, 50.8% male, 40.5% sexual minority, 39.7% Non-Hispanic White). Participants completed an online baseline survey and 30 days of smartphone-based daily EMA surveys of cigarette, alcohol, and cannabis use. The baseline assessed self-reported changes in perceived pleasure of smoking cigarettes while using alcohol or cannabis separately. EMA surveys included detailed questions about concurrent use (i.e., the extent of smoking while using another substance) covering the previous day. A total of 2,600 daily assessments were analyzed using mixed models. RESULTS: Higher perceived pleasure from smoking cigarettes while drinking alcohol or using cannabis at baseline were both associated with a greater extent of concurrent use of cigarettes with alcohol (b = 0.140; SE = 0.066; t = 2.1; p = .035) and cannabis (b = 0.136; SE = 0.058; t = 2.4; p = .019) on a given day. CONCLUSIONS: Results suggest that perceived reward from concurrently using cigarettes with alcohol or cannabis is associated with the extent of concurrent use. Findings can inform tailored smoking cessation interventions.

2.
Artículo en Inglés | MEDLINE | ID: mdl-33153143

RESUMEN

The heated tobacco product (HTP) IQOS was authorized for sale in the US in 2019. We investigated how young adults with experience using multiple tobacco products reacted to, perceived, and developed interest in IQOS, informing policies that might prevent HTPs from becoming ubiquitous. We used a novel qualitative method in which 33 young adult tobacco users in California (fall 2019) "unboxed" an IQOS device, tobacco sticks, and marketing materials and narrated their impressions and opinions. We conducted content and thematic analyses of participants' reactions, sensory experiences, and interest. Multiple attributes influenced appeal for participants, including sleek electronic design, novel technology, perceived harmfulness, complexity, and high cost. The "no smoke" claim and heating technology suggested that smoking IQOS was safer than smoking cigarettes. Public health programs should closely monitor HTP marketing and uptake, particularly as "reduced exposure" claims were authorized in July 2020. Evidence-based regulations (e.g., requiring plain packaging for tobacco sticks), actions addressing IQOS' unique attributes (e.g., regulating device packaging to reduce high-tech appeal), and public education might help to counter the appeal generated by potentially misleading IQOS marketing tactics.

3.
Artículo en Inglés | MEDLINE | ID: mdl-33092106

RESUMEN

Given the emerging tobacco landscape, dual use of cigarettes and e-cigarettes has increased among young adults, but little is known about its associated factors. Peer crowds, defined as macro-level connections between individuals with similar core values (e.g., "Hip Hop" describing a group that prefers hip hop music and values strength, honor, and respect), are a promising way to understand tobacco use patterns. We examined associations between peer crowds and tobacco use patterns by using data from a cross sectional survey of 1340 young adults in the San Francisco Bay Area in 2014. Outcomes were the past 30-day use of: neither cigarettes nor e-cigarettes; cigarettes but not e-cigarettes; e-cigarettes but not cigarettes; and both cigarettes and e-cigarettes. Peer crowds included Hipster, Hip Hop, Country, Partier, Homebody, and Young Professional. Multinomial regression analysis indicated that peer crowds were significantly associated with different tobacco use patterns. Compared to Young Professionals, Hip Hop and Hipster crowds were more likely to dual use; Hipsters were more likely to use e-cigarettes only, and Country participants were more likely to smoke cigarettes only. These findings suggest that tobacco control campaigns and cessation interventions should be tailored to different young adult peer crowds and address poly-tobacco use.

4.
Nicotine Tob Res ; 2020 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-33031497

RESUMEN

INTRODUCTION: The assessment of electronic nicotine delivery systems (ENDS) use poses unique challenges that go beyond established assessment methods for tobacco cigarettes. Recent studies have proposed using Ecological Momentary Assessment (EMA), a method to collect self-reported data on mobile devices, or data passively collected by "smart" Bluetooth enabled ENDS to assess use. The current study sought to compare ENDS use data using EMA and puff counts collected from a smart device. METHODS: We recruited 18 young adult ENDS users (age M=23.33; 44.4% female) from the San Francisco Bay Area. For a total of 30 days, participants completed daily diaries by EMA and used a second-generation smart Bluetooth enabled ENDS that collected puff data. Repeated measures correlations, multilevel regressions, and paired T-tests assessed concordance of EMA reports and ENDS data. A subset of 4 highly compliant participants were selected for sensitivity analyses. RESULTS: Among all 18 participants, completion of EMA daily diaries was high (77.4%). The ENDS device collected approximately twice as many puffs per day as participants reported. Compared to self-reported number of sessions and amount of e-liquid used, self-reported puff counts had the highest correlation with device collected puff counts (rrm = 0.49; p < .001). Correlations between self-reported and device collected puff counts improved among the subset of 4 highly compliant participants (rrm = 0.59; p < .001). CONCLUSION: Self-reports potentially underestimate use of ENDS. Puff counts appear to be the best self-reported measure to assess ENDS use compared to number of sessions or liquid volume. IMPLICATIONS: The comparison of EMA self-reports and passively collected ENDS device data can inform future efforts to assess ENDS use. Self-reported puff counts are preferable over number of sessions or amount of liquid used, but compared to objective usage data, self-reported puff counts may still underestimate actual use. ENDS use behavior is likely higher than users estimate and report. Future research on improved measures of ENDS use is needed.

5.
Psychol Addict Behav ; 2020 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-32804517

RESUMEN

OBJECTIVE: Sexual minority (SM) young adults have higher rates of substance use than heterosexuals, but little is known about daily use of multiple substances, which confer numerous health risks for this population. Using daily diary data from a smartphone-based study, we examined the associations between sexual identity (i.e., SM vs. heterosexual) and patterns of same-day multiple substance use (i.e., cigarettes and alcohol, cigarettes and cannabis, alcohol and cannabis, and all 3 substances). METHOD: Young adult smokers (N = 147, aged 18-26, 51.7% female, 41.5% SM, 40.8% White) reported consecutive daily assessments on substance use over 30 days. We used generalized estimating equations to examine associations between sexual identity and patterns of same-day multiple substance use, controlling for demographic factors and psychological distress. RESULTS: Of 2,891 daily assessments, 16.7% reported same-day use of cigarettes and alcohol, 18.1% cigarettes and cannabis, 1.5% alcohol and cannabis, and 15.0% use of all 3 substances. SM participants (vs. heterosexuals) had significantly greater odds of reporting days with use of cigarettes and cannabis [Adjusted Odds Ratio (AOR) = 2.05, 95% Confidence Interval (CI) [1.04, 4.01]] and use of all three substances (AOR = 2.79, 95% CI [1.51, 5.14]) than days with single substance use or no use. CONCLUSIONS: These findings warrant tailored interventions addressing multiple substance use among SM young adults and temporally accurate measures of multiple substance use patterns. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

6.
Subst Abuse ; 14: 1178221820926545, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32547048

RESUMEN

Background and aims: Studies assessing the cognitive performance effects of nicotine show inconsistent results and tobacco industry funding has been correlated with study outcomes. We conducted a systematic review of the primary literature assessing the cognitive performance effects of nicotine and assessed potential associations between tobacco and pharmaceutical industry affiliation and reported study conclusions. Methods: We searched PubMed, EMBASE, PsycINFO, BIOSIS, and Web of Science for peer-reviewed journal articles published between 2009 and 2016 that: (1) were randomized controlled trials; (2) investigated the effects of nicotine on cognitive performance in a laboratory setting; (3) administered nicotine to healthy adults (18-60 years); and (4) included participants were nonsmokers or minimally deprived smokers (⩽2 hours of abstaining from smoking). Study disclosures and tobacco industry documents were reviewed to determine industry funding. Results: Searches yielded 3,771 abstracts; 32 studies were included in the review. The majority of studies investigated the effects of nicotine on attention (n = 22). Nicotine had a non-uniform effect on attention: studies reported positive (41%; n = 9), mixed (41%; n = 9), and no effect (18%; n = 4). The majority of study authors had received prior tobacco industry funding (59%; n = 19), however over half of tobacco-industry funded authors did not report this (53%; n = 10). Conclusions: Nicotine does not appear to be associated with consistent cognitive performance effects. Although no association was found between reported outcomes and tobacco or pharmaceutical industry funding, findings likely underestimate the influence of industry funding due to strict inclusion criteria and incomplete data on pharmaceutical industry funding. Clinical trial registration: Not applicable.

7.
Health Promot Pract ; : 1524839920910372, 2020 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-32111139

RESUMEN

Purpose. Peer crowd-targeted campaigns are a novel approach to engage high-risk young adults in tobacco use prevention and cessation. We elicited the perspectives of young adult key informants to understand how and why two social branding interventions were effective: (1) "COMMUNE," designed for "Hipsters" as a movement of artists and musicians against Big Tobacco, and (2) "HAVOC," designed for "Partiers" as an exclusive, smoke-free clubbing experience. Design. Qualitative study (27 semistructured qualitative phone interviews). Setting. Intervention events held in bars in multiple U.S. cities. Participants: Twenty-seven key informants involved in COMMUNE or HAVOC as organizers (e.g., musicians, event coordinators) or event attendees. Measures. We conducted semistructured, in-depth interviews. Participants described intervention events and features that worked or did not work well. Analysis. We used an inductive-deductive approach to thematically code interview transcripts, integrating concepts from intervention design literature and emergent themes. Results: Participants emphasized the importance of fun, interactive, social environments that encouraged a sense of belonging. Anti-tobacco messaging was subtle and nonjudgmental and resonated with their interests, values, and aesthetics. Young adults who represented the intervention were admired and influential among peers, and intervention promotional materials encouraged brand recognition and social status. Conclusion. Anti-tobacco interventions for high-risk young adults should encourage fun experiences; resonate with their interests, values, and aesthetics; and use subtle, nonjudgmental messaging.

8.
Spat Spatiotemporal Epidemiol ; 32: 100307, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32007281

RESUMEN

Neighborhood characteristics and the built environment are important determinants in shaping health inequalities. We evaluate the role of a retail density ordinance in reducing concentration of tobacco stores based on neighborhood characteristics and land use pattern in San Francisco. The study evaluated the spatial distribution of tobacco retailers before and after the ordinance to identify geographic pockets where the most significant reduction had occurred. A generalized additive model was applied to assess the association between the location of the closure of tobacco retailer and socio-demographic characteristics and land use pattern. We did not find a meaningful change in the overall concentration of retailers based on neighborhood income and ethnicity but found a significant association based on patterns of land use. Our findings suggest that future polices must account for the differential distribution of retailers based on land use mix to lower concentration in areas where it is needed the most.

9.
Am J Health Promot ; 34(7): 754-761, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32077305

RESUMEN

PURPOSE: To evaluate the impact of a Social Branding intervention in bars and nightclubs on smoking behavior. DESIGN: Quasi-experimental controlled study. SETTING: Bars and nightclubs in San Diego and San Francisco (intervention) and Los Angeles (control). PARTICIPANTS: "Hipster" young adults (age 18-26) attending bars and nightclubs. INTERVENTION: Anti-tobacco messages delivered through monthly anti-tobacco music/social events, opinion leaders, original art, direct mail, promotional activities, and online media. MEASURES: A total of 7240 surveys were collected in 3 cities using randomized time location sampling at baseline (2012-2013) and follow-up (2015-2016); data were analyzed in 2018. The primary outcome was current smoking. ANALYSIS: Multivariable logistic regression assessed correlates of smoking, adjusting for covariates including electronic cigarette use; differences between cities were evaluated using location-by-time interactions. RESULTS: Smoking in San Francisco decreased at a significantly faster rate (51.1%-44.1%) than Los Angeles (45.2%-44.5%) (P = .034). Smoking in San Diego (mean: 39.6%) was significantly lower than Los Angeles (44.8%, P < .001) at both time points with no difference in rate of change. Brand recall was not associated with smoking behavior, but recall was associated with anti-tobacco attitudes that were associated with smoking. CONCLUSION: This is the first controlled study of Social Branding interventions. Intervention implementation was accompanied by decreases in smoking (San Francisco) and sustained lower smoking (San Diego) among young adult bar patrons over 3 years.

10.
BMC Public Health ; 20(1): 32, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31969114

RESUMEN

BACKGROUND: Cigarette lifestyle marketing with psychographic targeting has been well documented, but few studies address non-cigarette tobacco products. This study examined how young adults respond to e-cigarette advertisements featuring diverse peer crowds - peer groups with shared identities and lifestyles - to inform tobacco counter-marketing design. METHODS: Fifty-nine young adult tobacco users in California participated in interviews and viewed four to five e-cigarette advertisements that featured characters from various peer crowd groups. For each participant, half of the advertisements they viewed showed characters from the same peer crowd as their own, and the other half of the advertisements featured characters from a different peer crowd. Advertisements were presented in random order. Questions probed what types of cues are noticed in the advertisements, and whether and how much participants liked or disliked the advertisements. RESULTS: Results suggest that participants liked and provided richer descriptions of characters and social situations in the advertisements featuring their own peer crowd more than the advertisements featuring a different peer crowd. Mismatching age or device type was also noted: participants reported advertisements showing older adults were not intended for them. Participants who used larger vaporizers tended to dislike cigalike advertisements even if they featured a matching peer crowd. CONCLUSION: Peer crowd and lifestyle cues, age and device type are all salient features of e-cigarette advertising for young adults. Similarly, educational campaigns about e-cigarettes should employ peer crowd-based targeting to engage young adults, though messages should be carefully tested to ensure authentic and realistic portrayals.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/economía , Mercadotecnía/métodos , Grupo Paritario , Adolescente , Adulto , Publicidad , Factores de Edad , California , Femenino , Educación en Salud , Humanos , Estilo de Vida , Masculino , Investigación Cualitativa , Medio Social , Adulto Joven
11.
J Community Health ; 45(2): 319-328, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31535264

RESUMEN

This study evaluated young adults' exposure to drifting secondhand smoke in San Francisco County housing units using the 2014 Bay Area Young Adult Health Survey (N = 1363). Logistic and geographically weighted regression models were used to determine whether residing in multiunit housing or in areas with greater neighborhood disorder were risk factors for exposure, and how drifting smoke exposure varied spatially within San Francisco County. Residing in buildings with five or more units significantly increased the odds of reporting drifting smoke exposure [OR (3.5 1.3, 9.9)], but neighborhood disorder did not have a significant association in the fully adjusted logistic regression model. At the local level, however, neighborhood disorder was significantly associated with exposure in lower income residential and downtown areas. Multiunit housing was significantly associated with exposure across all neighborhoods.

12.
Nicotine Tob Res ; 22(9): 1560-1568, 2020 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-31807784

RESUMEN

INTRODUCTION: Young adults have high combustible cigarette and e-cigarette use rates, and low utilization of evidence-based smoking cessation strategies compared to older adults. It is unknown whether young adults who try to quit smoking without assistance, with evidence-based strategies, or with e-cigarettes, are equally successful compared to older adults. AIMS AND METHODS: This analysis used a population-based sample from the Population Assessment of Tobacco and Health study of young adult (aged 18-24, n = 745) and older adult (aged 25-64, n = 2057) established cigarette smokers at Wave 1 (2013-2014) who reported having made a quit attempt at Wave 2 (2014-2015). Cessation strategies were: behavioral therapy, pharmacotherapy, product substitution, 2+ strategies, and unassisted. Logistic regression estimated associations between cessation strategy and short-term cessation status at Wave 2 (quit, no quit); multinomial logistic regression predicted long-term cessation patterns at Waves 2 and 3 (sustained quit, temporary quit, delayed quit, no quit). RESULTS: No cessation strategy (ref: unassisted) significantly predicted short-term cessation. No cessation strategy (ref: unassisted) significantly predicted long-term cessation patterns for young adults. Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day (adjusted odds ratio [AOR]: 1.70; 95% confidence interval: 1.08, 2.67) but did not predict long-term cessation patterns. CONCLUSIONS: Despite differences in cessation strategy use between young and older adult smokers, strategy effectiveness largely did not differ by age group. No strategy examined, including e-cigarettes, was significantly associated with successful cessation for young adults. More work is needed to identify effective interventions that help young adult smokers quit. IMPLICATIONS: (1) Neither behavioral support, pharmacotherapy, nor product substitution was associated with short-term cessation for young or older adults compared to quitting unassisted. (2) Neither behavioral support, pharmacotherapy, nor product substitution was associated with longer-term cessation for young or older adults compared to quitting unassisted. (3) Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day but was not associated with longer-term cessation.

13.
Nicotine Tob Res ; 22(5): 638-646, 2020 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-30590749

RESUMEN

INTRODUCTION: Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. We investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18-24) and compared patterns with those of older adults (age 25-64). METHODS: We used a population-based sample from the Population Assessment of Tobacco and Health (PATH) study of young adult (n = 1,881) and older adult (n = 6,366) established smokers of conventional cigarettes at Wave 1 (2013-2014), who were surveyed at Wave 2 (2014-2015). Simple regression analysis compared intentions to quit between age groups. Among Wave 1 smokers who reported a Wave 2 quit attempt (young adults [YA] n = 748; older adults [OA] n = 2,068), bivariate and multinomial logistic regression estimated differences in use of behavioral support, pharmacotherapy, product substitution, and unassisted quit attempts. Interaction terms estimated age-group differences in relationships between predictors and cessation strategy use. RESULTS: Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared with older adults. Young adults were significantly less likely to use pharmacotherapy (adjusted odds ratio: 0.15; confidence interval: 0.09, 0.24; reference: quitting unassisted). Both groups reported using product substitution (YA: 31.6%; OA: 28.5%), primarily with e-cigarettes, more than any evidence-based cessation strategy. Socioeconomic predictors of cessation strategy use did not differ between age groups. CONCLUSIONS: More research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance. IMPLICATIONS: Young adulthood is a key transition time for tobacco use, and early cessation substantially reduces the risk of morbidity and mortality from smoking. In the context of high e-cigarette and polytobacco use, this study finds young adults have significantly less intention to quit than older adults and are less likely to use evidence-based cessation strategies to help quit. Innovative methods are needed to increase young adult intentions to quit and use of evidence-based cessation assistance.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Conductas Relacionadas con la Salud , Fumadores/psicología , Cese del Hábito de Fumar/métodos , Prevención del Hábito de Fumar/estadística & datos numéricos , Fumar/psicología , Vapeo/psicología , Adolescente , Adulto , Femenino , Humanos , Intención , Masculino , Persona de Mediana Edad , San Francisco/epidemiología , Fumar/epidemiología , Cese del Hábito de Fumar/psicología , Encuestas y Cuestionarios , Vapeo/prevención & control , Adulto Joven
14.
J Adolesc Health ; 66(4): 423-430, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31784411

RESUMEN

PURPOSE: The rise of noncigarette, alternative tobacco product (ATP) use among adolescents may be due in part to an increase in retail availability of ATPs. We examined whether proximity and density of tobacco retailers near students' homes are associated with a higher likelihood of initiating ATP use over time. METHODS: Using data from 728 adolescents (aged 13-19 years at baseline) residing in 191 different neighborhoods and attending 10 different California high schools, longitudinal multilevel and cross-classified random effect models evaluated individual-level, neighborhood-level, and school-level risk factors for ATP initiation after 1 year. Covariates were obtained from the American Community Survey and the California Department of Education. RESULTS: The sample was predominantly female (63.5%) and was racially and ethnically diverse. Approximately one third of participants (32.5%) reported ever ATP use at baseline, with 106 (14.5%) initiating ATP use within 1 year. The mean number of tobacco retailers per square mile within a tract was 5.66 (standard deviation = 6.3), and the average distance from each participant's residence to the nearest tobacco retailer was .61 miles (standard deviation = .4). Living in neighborhoods with greater tobacco retailer density at baseline was associated with higher odds of ATP initiation (odds ratio = 1.22, 95% confidence interval = 1.07-2.12), controlling for individual and school factors. CONCLUSIONS: Tobacco retailers clustered in students' home neighborhood may be an environmental influence on adolescents' ATP use. Policy efforts to reduce adolescent ATP use should aim to reduce the density of tobacco retailers and limit the proximity of tobacco retailers near adolescents' homes and schools.

15.
Tob Regul Sci ; 5(2): 94-104, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31840040

RESUMEN

Objectives: E-cigarettes are not FDA-approved smoking cessation aids. Nevertheless, content analyses have shown that e-cigarette companies make claims about cessation efficacy. Some advertisements are explicit (directly mentioning their product can help smokers quit or stop smoking), while others are implicit (not containing cessation-related language, but implying cessation efficacy through subtle wording and imagery). This is the first study to examine directly how adolescents and young adults (AYAs) perceived these ads, and specifically whether they identify the cessation claims in e-cigarette advertisements. Methods: 248 AYAs in California viewed 4 e-cigarette advertisements with cessation claims, then selected claims made by each advertisement. Descriptive statistics and multi-level logistic regression models were used to examine the relationship between the type of claims and perception. Results: The claim "helps me quit smoking" was most frequently selected after viewing advertisements with explicit cessation claims, but not after viewing implicit claims. No significant effect of tobacco use and age on claim selection was observed. Conclusions: E-cigarette manufacturers make claims about cessation efficacy, and AYAs can identify such claims in advertisements, especially the explicit ones. FDA should regulate these advertisements as making therapeutic claims.

16.
Am J Public Health ; 109(7): e1-e8, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31095414

RESUMEN

Background. Tobacco companies have actively promoted the substitution of cigarettes with purportedly safer tobacco products (e.g., smokeless tobacco, e-cigarettes) as tobacco harm reduction (THR). Given the tobacco, e-cigarette, and pharmaceutical industries' substantial financial interests, we quantified industry influence on support for THR. Objectives. To analyze a comprehensive set of articles published in peer-reviewed journals assessing funding sources and support for or opposition to substitution of tobacco or nicotine products as harm reduction. Search Methods. We searched PubMed, Embase, Web of Science, and PsycINFO with a comprehensive search string including all articles, comments, and editorials published between January 1, 1992, and July 26, 2016. Selection Criteria. We included English-language publications published in peer-reviewed journals addressing THR in humans and excluded studies on modified cigarettes, on South Asian smokeless tobacco variants, on pregnant women, on animals, not mentioning a tobacco or nicotine product, on US Food and Drug Administration-approved nicotine replacement therapies, and on nicotine vaccines. Data Collection and Analysis. We double-coded all articles for article type; primary product type (e.g., snus, e-cigarettes); themes for and against THR; stance on THR; THR concepts; funding or affiliation with tobacco, e-cigarette, pharmaceutical industry, or multiple industries; and each author's country. We fit exact logistic regression models with stance on THR as the outcome (pro- vs anti-THR) and source of funding or industry affiliation as the predictor taking into account sparse data. Additional models included article type as the outcome (nonempirical or empirical) and industry funding or affiliation as predictor, and stratified analyses for empirical and nonempirical studies with stance on THR as outcome and funding source as predictor. Main Results. Searches retrieved 826 articles, including nonempirical articles (21%), letters or commentaries (34%), editorials (5%), cross-sectional studies (15%), systematic reviews and meta-analyses (3%), and randomized controlled trials (2%). Overall, 23.9% disclosed support by industry; 49% of articles endorsed THR, 42% opposed it, and 9% took neutral or mixed positions. Support from the e-cigarette industry (odds ratio [OR] = 20.9; 95% confidence interval [CI] = 5.3, 180.7), tobacco industry (OR = 59.4; 95% CI = 10.1, +infinity), or pharmaceutical industry (OR = 2.18; 95% CI = 1.3, 3.7) was significantly associated with supportive stance on THR in analyses accounting for sparse data. Authors' Conclusions. Non-industry-funded articles were evenly divided in stance, while industry-funded articles favored THR. Because of their quantity, letters and comments may influence perceptions of THR when empirical studies lack consensus. Public Health Implications. Public health practitioners and researchers need to account for industry funding when interpreting the evidence in THR debates.


Asunto(s)
Conflicto de Intereses , Cese del Hábito de Fumar/economía , Prevención del Hábito de Fumar/economía , Dispositivos para Dejar de Fumar Tabaco/economía , Sistemas Electrónicos de Liberación de Nicotina/economía , Reducción del Daño , Humanos , Cese del Hábito de Fumar/métodos , Industria del Tabaco/economía , Productos de Tabaco/economía
17.
JAMA Netw Open ; 2(5): e194006, 2019 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-31099874

RESUMEN

Importance: Use of alternative tobacco products (ATPs) such as electronic cigarettes, chewing tobacco, pipes, cigars, cigarillos, little cigars, and hookah is rapidly increasing. Although marketing restrictions exist for cigarettes, marketing of ATPs is not yet fully regulated, and studies have not assessed the association between ownership of ATP promotional materials and subsequent ATP or cigarette initiation among adolescents and young adults. Objective: To estimate the association between marketing receptivity measured at baseline and ATP and any tobacco initiation 1 year later, including cigarettes, among adolescents and young adults. Design, Setting, and Participants: Longitudinal cohort study of adolescents and young adults aged 13 to 19 years recruited at high schools in California from July 2014 to October 2015, with follow-up 1 year later. Data were analyzed from January to March 2018. Exposures: Ownership of ATP-specific promotional material and ownership of any tobacco promotional materials (eg, samples, coupons, branded caps, t-shirts, or posters) assessed in wave 1. Main Outcomes and Measures: Outcomes were (1) ATP initiation and (2) either ATP or cigarette initiation in wave 2. Results: Of 757 participants (mean [SD] age at wave 1, 16.1 [1.1] years; 481 [63.5%] female; 166 [21.9%] Asian or Pacific Islander, 202 [26.7%] white, and 276 [36.4%] Latino), 129 (17.0%) initiated ATP use and 141 (18.6%) initiated ATP or cigarette use 1 year later. In unadjusted models, wave 2 ATP initiation was found to be significantly associated with wave 1 ownership of ATP promotional materials (odds ratio, 2.23; 95% CI, 1.26-3.97). After adjustment for wave 1 demographic covariates, the association between ownership of ATP promotional material and ATP initiation 1 year later yielded similar results (odds ratio, 2.13; 95% CI, 1.16-3.91). Results of models assessing a combined outcome variable of either ATP or cigarette ever use were not statistically significant. Conclusions and Relevance: Ownership of ATP promotional materials was associated with subsequent initiation of ATPs. The results of this study are consistent with the suggestion that current marketing restrictions for cigarettes, including restrictions of the distribution of samples, coupons, and other promotional material, should extend to ATPs.


Asunto(s)
Publicidad/estadística & datos numéricos , Uso de Tabaco/epidemiología , Adolescente , Conducta del Adolescente , Publicidad/métodos , California/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Estudios Prospectivos , Encuestas y Cuestionarios , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/psicología , Adulto Joven
18.
BMJ Open ; 9(4): e026306, 2019 04 04.
Artículo en Inglés | MEDLINE | ID: mdl-30948599

RESUMEN

OBJECTIVE: Electronic cigarettes (e-cigarettes) which utilise prefilled 'pods' (pod devices) entered the US market in 2015. One brand, JUUL, captured more than half the e-cigarette market in early 2018, and the US Food and Drug Administration recently warned its manufacturer about adolescent uptake. This is the first qualitative study to describe distinct features of pod devices that appear to contribute to their popularity among young people. DESIGN: Qualitative interview study of young adults who had used pod devices. Participants were recruited from Facebook, other social media, street recruitment and via snowball sampling. SETTING: Participants were from California, with most from the San Francisco Bay Area. PARTICIPANTS: Young adults (aged 18-29 years) using multiple tobacco products (cigarettes, e-cigarettes and/or smokeless tobacco) were recruited. Of the sample of 60 participants, 24 were included in this analysis: 10 who reported experience with pod devices and 14 who used other non-pod e-cigarette devices. RESULTS: Ten participants had used a pod device in the past year. Of the pod device users, seven still used a pod device at the time of the interview and five did so daily. Nearly all (n=9) pod device users smoked cigarettes in the past month; none were daily smokers. The 14 participants who used non-pod devices provided a point of comparison. Participants highlighted some distinct aspects of pod devices that facilitated use, including their aesthetic similarity to personal electronics, high levels of nicotine delivery with distinct psychoactive effects, more discreet and shorter duration use sessions, and greater social acceptability than more ostentatious non-pod e-cigarettes. CONCLUSIONS: Pod devices' unique characteristics likely encourage pod device uptake among young people. Limitations on advertising in youth channels, flavours and distribution, and education about nicotine addiction may decrease initiation among young people and non-smokers.


Asunto(s)
Publicidad/métodos , Actitud Frente a la Salud , Sistemas Electrónicos de Liberación de Nicotina/normas , Investigación Cualitativa , Fumar/epidemiología , Medios de Comunicación Sociales , Productos de Tabaco/efectos adversos , Adolescente , Adulto , Femenino , Humanos , Incidencia , Masculino , San Francisco/epidemiología , Encuestas y Cuestionarios , Productos de Tabaco/estadística & datos numéricos , Adulto Joven
19.
Subst Use Misuse ; 54(7): 1106-1114, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30747029

RESUMEN

BACKGROUND: Young adults are at high risk for using flavored tobacco, including menthol and underrepresented populations, such as Latino and African American young adults, are at particular risk. OBJECTIVES: The purpose of this study is to identify sociodemographic correlates of menthol use among young adult smokers and examine the potential role of experienced discrimination in explaining any associations. METHODS: We conducted a probabilistic multimode household survey of young adults (aged 18-26) residing in Alameda and San Francisco Counties in California in 2014 (n = 1,350). We used logistic regression to evaluate associations between menthol cigarette use and experienced discrimination among young adult smokers as well as with respect to sociodemographic, attitudinal, and behavioral predictors. Interactions between experienced discrimination and race/ethnicity, sex and LGB identity were also modeled. RESULTS: Latino and non-Hispanic Black young adult smokers were more likely to report current menthol use than non-Hispanic Whites, while those with college education were less likely to do so. Experienced discrimination mediated the relationship between race and menthol use for Asian/Pacific Islander and Multiracial young adult smokers with odds of use increasing by 32 and 42% respectively for each additional unit on the experienced discrimination scale. Conclusions/Importance: Latino and African American young adult smokers have disproportionately high menthol use rates; however, discrimination only predicted higher use for Asian/Pacific Islander and Multiracial young adult smokers. Limits on the sale of menthol cigarettes may benefit all nonwhite race/ethnic groups as well as those with less education.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Mentol , Racismo/psicología , Fumadores/psicología , Productos de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Aromatizantes , Humanos , Modelos Logísticos , Masculino , San Francisco/epidemiología , Factores Sexuales , Adulto Joven
20.
Am J Health Promot ; 33(6): 876-885, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30754982

RESUMEN

PURPOSE: To compare the relationship between anti-tobacco industry attitudes and intention and attempts to quit smoking across 6 young adult peer crowds. DESIGN: A cross-sectional bar survey in 2015. SETTING: Seven US cities (Albuquerque, Los Angeles, Nashville, Oklahoma City, San Diego, San Francisco, and Tucson). PARTICIPANTS: Two thousand eight hundred seventeen young adult bar patrons who were currently smoking. MEASURES: Intention to quit in the next 6 months and having made a quit attempt in the last 12 months were binary outcomes. Anti-industry attitudes were measured by 3 items indicating support for action against the tobacco industry. Peer crowd affiliation was measured using the I-Base Survey. ANALYSIS: Adjusted multivariable logistic regression models examined the association between anti-industry attitudes and the outcomes for the total sample and for each peer crowd. RESULTS: Overall, anti-industry attitudes were positively associated with both intention to quit (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.24-1.52) and attempt to quit (OR = 1.14, 95% CI = 1.03-1.27). Intriguingly, the relationship between anti-industry attitudes and intention to quit differed by peer crowd affiliation, with significant associations for Homebody, Partier, Hipster, and Hip Hop, but not for Young Professional and Country. CONCLUSIONS: Developing health communication messages that resonate with unique peer crowd values can enhance the relevance of public health campaigns. Tobacco control practitioners should tailor anti-industry messages to promote intention to quit smoking among the highest risk young adults.


Asunto(s)
Intención , Grupo Paritario , Cese del Hábito de Fumar , Fumar/legislación & jurisprudencia , Industria del Tabaco , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Estados Unidos , Adulto Joven
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