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1.
Drug Alcohol Depend ; 219: 108497, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33421797

RESUMEN

BACKGROUND: Adolescent e-cigarette use has increased recently; however, little is known about trends in use of specific devices by youth. This study aims to 1) compare rates of e-cigarette device use over time, 2) examine changes in frequency of device use, and 3) identify predictors of device use. METHODS: Cross-sectional surveys were distributed school-wide across 4 diverse Connecticut high-schools in 2017, 2018, 2019 and assessed current (i.e., past-30-day) use of various e-cigarette devices: disposables/cig-a-likes, vape pens, mods, JUULs, and other rechargeable pod devices (added in 2018 and 2019). Analyses compared rates of device use and frequency (i.e., number of days used in past 30) over time. Multivariable logistic regression models examined demographic and tobacco use characteristics (e.g., age first trying e-cigarettes) as predictors of current use of each device type in 2019. RESULTS: From 2017-2019, rates of using JUUL, disposables/cig-a-likes, and vape pens increased significantly, while use of mods and other pod devices decreased (ps<.001). Over 59 % of youth reported using more than one e-cigarette device in 2019. Over time, more youth were frequent users (using ≥20 out of 30 days) of disposable/cig-a-likes (32 % to >46 %) and JUUL (28 % to >35 %) devices. In multivariable models, first trying e-cigarettes at a younger age was associated with current use of disposable/cig-a-like, vape pens, mods, and other rechargeable pod devices. CONCLUSIONS: From 2017-2019, JUUL, disposable/cig-a-like, and vape pens increased in popularity and were used frequently. Tobacco regulations designed to reduce youth use should consider various device types.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Vapeo/tendencias , Adolescente , Connecticut , Estudios Transversales , Femenino , Humanos , Masculino , Instituciones Académicas , Tabaco , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco
2.
Drug Alcohol Depend ; 219: 108476, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33360854

RESUMEN

BACKGROUND: This study examines the association between exposure to e-cigarette use on school campus and e-cigarette use behaviors among adolescents in the United States. METHODS: Data were obtained from the 2019 National Youth Tobacco Survey. First, two multivariate logistic regression models examined the association between in-school exposure to e-cigarette use and ever and past 30-day (i.e., current) e-cigarette use. Next, a multivariate logistic regression model to examine the relationship between in-school exposure to e-cigarette use and susceptibility to use was conducted among a subsample (n = 11,958) of never e-cigarette users. Covariates included grade, race/ethnicity, marketing exposure, and ever use of other tobacco products. RESULTS: Approximately 64.3 % of adolescents reported seeing someone use an e-cigarette on school campus; the most common locations being in the bathroom/locker room (34.4 %) and parking lot (34.0 %). In-school exposure to e-cigarette use was associated with greater odds of ever (Adj OR: 2.06; 95 % CI: 1.82-2.33) and current (Adj OR: 1.70; 95 % CI: 1.46-1.98) e-cigarette use among adolescents as well as greater odds of susceptibility to use (Adj OR: 2.00; 95 % CI: 1.82-2.20) among never e-cigarette users. CONCLUSIONS: Observing e-cigarette use on school campus was associated with greater odds of e-cigarette use and susceptibility. It is plausible that observing e-cigarette use on campus reinforces the social acceptability of adolescent e-cigarette use. Findings inform on the prevalence of e-cigarettes use on-campus as well as how this phenomenon may influence e-cigarette use/susceptibility among youth. The observed relationship highlights the role of schools in the efforts to reduce adolescent e-cigarette use.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Vapeo/epidemiología , Adolescente , Femenino , Humanos , Masculino , Mercadotecnía , Grupo Paritario , Prevalencia , Instituciones Académicas , Estudiantes/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco , Estados Unidos
3.
PLoS One ; 15(12): e0244218, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33347476

RESUMEN

OBJECTIVE: To determine the penetration of heated tobacco products (HTPs) into the youth market in Taiwan, with a particular focus on the correlation between IQOS use and the usage of other tobacco products. METHODS: Data from the 2018 Global Youth Tobacco Survey were used to assess previous experience with and current use (within 30 days prior to survey completion) of IQOS products by Taiwanese students aged 12-18 years. Independent variables included the usage patterns of conventional cigarettes and e-cigarettes. The control variables included background information (gender, grade, monthly income/allowance, household educational level, smoking status at home and among close friends), access to free cigarettes, as well as exposure to cigarette advertisements and anti-tobacco courses. Logistic regression was used to identify tobacco usage patterns correlated with IQOS use. RESULTS: In 2018, 2.33% of Taiwan's adolescents were currently using IQOS and 4.17% had tried IQOS. The use of conventional cigarettes and e-cigarettes (individually and together) were associated with an elevated risk of the ever use and current use of IQOS. CONCLUSION: Despite the fact that HTP products are not sold legally in Taiwan, the use of IQOS products by young people is far from negligible. We recommend amending the "Tobacco Hazards Prevention Act" to include regulations pertaining to the sale and marketing of HTPs.


Asunto(s)
Conducta del Adolescente , Productos de Tabaco/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adolescente , Niño , Femenino , Humanos , Masculino , Factores Socioeconómicos , Taiwán , Productos de Tabaco/clasificación , Productos de Tabaco/economía , Fumar Tabaco/psicología
4.
MMWR Morb Mortal Wkly Rep ; 69(50): 1881-1888, 2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332300

RESUMEN

Tobacco use is the leading cause of preventable disease and death in the United States; nearly all tobacco product use begins during youth and young adulthood (1,2). CDC and the Food and Drug Administration (FDA) analyzed data from the 2019 and 2020 National Youth Tobacco Surveys (NYTS) to determine changes in the current (past 30-day) use of seven tobacco products among U.S. middle (grades 6-8) and high (grades 9-12) school students. In 2020, current use of any tobacco product was reported by 16.2% (4.47 million) of all students, including 23.6% (3.65 million) of high school and 6.7% (800,000) of middle school students. Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school (19.6%; 3.02 million) and middle school (4.7%; 550,000) students. From 2019 to 2020, decreases in current use of any tobacco product, any combustible tobacco product, multiple tobacco products, e-cigarettes, cigars, and smokeless tobacco occurred among high school and middle school students; these declines resulted in an estimated 1.73 million fewer current youth tobacco product users in 2020 than in 2019 (6.20 million) (3). From 2019 to 2020, no significant change occurred in the use of cigarettes, hookahs, pipe tobacco, or heated tobacco products. The comprehensive and sustained implementation of evidence-based tobacco control strategies at the national, state, and local levels, combined with tobacco product regulation by FDA, is warranted to help sustain this progress and to prevent and reduce all forms of tobacco product use among U.S. youths (1,2).


Asunto(s)
Estudiantes/psicología , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/epidemiología , Adolescente , Niño , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados Unidos/epidemiología
5.
MMWR Morb Mortal Wkly Rep ; 69(46): 1736-1742, 2020 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-33211681

RESUMEN

Cigarette smoking remains the leading cause of preventable disease and death in the United States (1). The prevalence of current cigarette smoking among U.S. adults has declined over the past several decades, with a prevalence of 13.7% in 2018 (2). However, a variety of combustible, noncombustible, and electronic tobacco products are available in the United States (1,3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC analyzed data from the 2019 National Health Interview Survey (NHIS). In 2019, an estimated 50.6 million U.S. adults (20.8%) reported currently using any tobacco product, including cigarettes (14.0%), e-cigarettes (4.5%), cigars (3.6%), smokeless tobacco (2.4%), and pipes* (1.0%).† Most current tobacco product users (80.5%) reported using combustible products (cigarettes, cigars, or pipes), and 18.6% reported using two or more tobacco products.§ The prevalence of any current tobacco product use was higher among males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Native (AI/AN) adults; those whose highest level of educational attainment was a General Educational Development (GED) certificate; those with an annual household income <$35,000; lesbian, gay, or bisexual (LGB) adults; uninsured adults and those with Medicaid; those with a disability; or those with mild, moderate, or severe generalized anxiety disorder. E-cigarette use was highest among adults aged 18-24 years (9.3%), with over half (56.0%) of these young adults reporting that they had never smoked cigarettes. Implementing comprehensive, evidence-based, population level interventions (e.g., tobacco price increases, comprehensive smoke-free policies, high-impact antitobacco media campaigns, and barrier-free cessation coverage), in coordination with regulation of the manufacturing, marketing, and sale of all tobacco products, can reduce tobacco-related disease and death in the United States (1,4). As part of a comprehensive approach, targeted interventions are also warranted to reach subpopulations with the highest prevalence of use, which might vary by tobacco product type.


Asunto(s)
Productos de Tabaco/estadística & datos numéricos , Tabaquismo/epidemiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
6.
Lancet Glob Health ; 8(10): e1282-e1294, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32971051

RESUMEN

BACKGROUND: Worldwide, smoking tobacco causes 7 million deaths annually, and this toll is expected to increase, especially in low-income and middle-income countries. In Latin America, smoking is a leading risk factor for death and disability, contributes to poverty, and imposes an economic burden on health systems. Despite being one of the most effective measures to reduce smoking, tobacco taxation is underused and cigarettes are more affordable in Latin America than in other regions. Our aim was to estimate the tobacco-attributable burden on mortality, disease incidence, quality of life lost, and medical costs in 12 Latin American countries, and the expected health and economic effects of increasing tobacco taxes. METHODS: In this modelling study, we developed a Markov probabilistic microsimulation economic model of the natural history, medical costs, and quality-of-life losses associated with the most common tobacco-related diseases in 12 countries in Latin America. Data inputs were obtained through a literature review, vital statistics, and hospital databases from each country: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Paraguay, Peru, and Uruguay. The main outcomes of the model are life-years, quality-adjusted life-years, disease events, hospitalisations, disease incidence, disease cost, and healthy years of life lost. We estimated direct medical costs for each tobacco-related disease included in the model using a common costing methodology for each country. The disease burden was estimated as the difference in disease events, deaths, and associated costs between the results predicted by the model for current smoking prevalence and a hypothetical cohort of people in each country who had never smoked. The model estimates the health and financial effects of a price increase of cigarettes through taxes, in terms of disease and health-care costs averted, and increased tax revenues. FINDINGS: In the 12 Latin American countries analysed, we estimated that smoking is responsible for approximately 345 000 (12%) of the total 2 860 921 adult deaths, 2·21 million disease events, 8·77 million healthy years of life lost, and $26·9 billion in direct medical costs annually. Health-care costs attributable to smoking were estimated to represent 6·9% of the health budgets of these countries, equivalent to 0·6% of their gross domestic product. Tax revenues from cigarette sales cover 36·0% of the estimated health expenditures caused by smoking. We estimated that a 50% increase in cigarette price through taxation would avert more than 300 000 deaths, 1·3 million disease events, gain 9 million healthy life-years, and save $26·7 billion in health-care costs in the next 10 years, with a total economic benefit of $43·7 billion. INTERPRETATION: Smoking represents a substantial health and economic burden in these 12 countries of Latin America. Tobacco tax increases could successfully avert deaths and disability, reduce health-care spending, and increase tax revenues, resulting in large net economic benefits. FUNDING: International Development Research Centre (IDRC), Canada.


Asunto(s)
Costo de Enfermedad , Costos de la Atención en Salud/estadística & datos numéricos , Fumar/economía , Fumar/epidemiología , Impuestos/economía , Productos de Tabaco/economía , Humanos , América Latina/epidemiología , Cadenas de Markov , Modelos Económicos , Impuestos/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos
7.
PLoS One ; 15(8): e0237513, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32790798

RESUMEN

INTRODUCTION: The tobacco industry (TI) has used small cigarette pack sizes to encourage brand-switching and consumption, and to mitigate the impacts of tobacco tax increases. Since 2016, the European Union (EU) Tobacco Products Directive (TPD) specifies a minimum pack size of 20 cigarettes. We examined cigarette pack sizes in the EU and whether pack size composition differed between cheap and expensive price segments, as well as the impact of the revised TPD. METHODS: We conducted a longitudinal analysis of pricing data from 23 EU countries between 2006-2017. We examined pack sizes over time to assess the impact of the TPD, differences in pack size composition between cheap and expensive price segments, and compared gaps in median prices between products using actual and 'expected' prices (price if all packs contained 20 sticks). RESULTS: Cigarette pack sizes changed over time, across the EU. The distribution of pack sizes varied between price segments, with small pack sizes especially frequent in the cheap segment of the cigarette market, but this varied over time and across countries. Packs of <20 cigarettes almost disappeared from the data samples after implementation of the TPD. CONCLUSION: Implementation of the TPD appears to have virtually eliminated packs with <20 cigarettes, restricting their use by the TI. Our analysis suggests pack sizes have been used differentially across the EU. Country-level analyses on the industry's use of pack sizes, consumer responses, and evaluations of restricting certain pack sizes are needed to confirm our findings and strengthen policy.


Asunto(s)
Comercio/estadística & datos numéricos , Embalaje de Productos/métodos , Industria del Tabaco/métodos , Productos de Tabaco/estadística & datos numéricos , Unión Europea , Humanos , Estudios Longitudinales , Productos de Tabaco/economía , Productos de Tabaco/provisión & distribución
8.
Public Health ; 185: 332-337, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32721771

RESUMEN

OBJECTIVES: In 2017, one in four French 17-year-olds was a daily smoker, even though France prohibited the sale of tobacco to under-18 minors in 2009. This research aims to evaluate the retail violation rate for sale to minors (RVRms) and the associated factors. STUDY DESIGN: The study design used is observational mystery shopping study. METHODS: We conducted a mystery shopping study enlisting 12-year-old and 17-year-old youths in a representative sample of 527 tobacco outlets during three weeks in spring 2019. Multinomial Logit and Probit regressions were estimated on the data collected. RESULTS: The law is not respected. Two of three sellers (65.2%) were willing to make an illegal sale to a 17-year-old minor, and almost one in 12 (8.1%) were willing to sell to a 12-year-old child attempting to buy tobacco. Illegal sales were more likely to be made by male sellers, retailing in big cities, when there were no in-shop queues, and to 17-year-old females. The absence of the mandatory enforcement poster flagging up the ban on the sale of tobacco to minors appears to be a strong factor associated with RVRm. CONCLUSIONS: These findings show that progress needs to be made to better enforce tobacco control legislation to help decrease underage smoking in France. Rate of compliance with the law could be improved by stronger enforcement measures and tougher sanctions, but also by training and the provision of age-verification tools for sellers, as demonstrated by experiments in other countries.


Asunto(s)
Comercio/legislación & jurisprudencia , Menores/legislación & jurisprudencia , Productos de Tabaco/legislación & jurisprudencia , Adolescente , Conducta del Adolescente , Niño , Comercio/estadística & datos numéricos , Femenino , Francia/epidemiología , Humanos , Masculino , Mercadotecnía , Menores/estadística & datos numéricos , Fumar/epidemiología , Fumar/legislación & jurisprudencia , Tabaco , Productos de Tabaco/economía , Productos de Tabaco/estadística & datos numéricos
9.
Public Health ; 185: 275-282, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32707470

RESUMEN

OBJECTIVES: Extensive empirical and theoretical studies have been devoted to analyzing the relationship between tobacco and income. The price and income elasticities of demand for cigarette consumption are the main focus of studies in this body of literature. However, few empirical studies exist that analyze how economic growth affects the cigarette market, and no one has studied the effects of economic expansions and recessions. Spain, as in the other countries of the European Union, has suffered a strong recession since 2008. Therefore, this article aims to detect if income elasticity takes different values in economic growth and recession and, in addition, to check whether price elasticity in Spain is consistent with previous studies. STUDY DESIGN: This is an observational epidemiological study. METHODS: In this article, the price and income elasticities of demand for cigarette consumption are measured for the Spanish cigarette market using time series data from 1957 to 2016 and by applying a non-linear autoregressive dynamics lag model. The novel specification proposed in this study is the determination of the possible effects of asymmetries in the economic shocks on cigarette consumption. RESULTS: Our results reveal that cigarette consumption maintains a notable asymmetric relationship. In particular, our results show that in expansion shocks, cigarette consumption increases (a 10% economic growth is associated with a 4.05% increase in cigarette consumption), whereas in recession shocks, cigarette consumption decreases dramatically, with a more pronounced pattern in recession phases than in expansion phases (a 10% economic decline is associated with a 58.16% decrease in cigarette consumption). On the other hand, price elasticity maintains the same behavior shown in the previous literature (a 10% price increase is associated with a 2% decrease in cigarette consumption). CONCLUSIONS: Higher cigarette prices are associated with decreased smoking. In addition, the economic recession helps in decreasing cigarette consumption. Therefore, it is strongly recommended that tax authorities have our results in mind before establishing health policies. If the authorities do not, it is possible that they will not obtain the expected results in terms of decreased tobacco consumption.


Asunto(s)
Comercio/estadística & datos numéricos , Renta/estadística & datos numéricos , Fumar/economía , Fumar/epidemiología , Productos de Tabaco/economía , Comercio/economía , Desarrollo Económico , Recesión Económica , Unión Europea , Política de Salud , Humanos , España , Impuestos/economía , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco
10.
BMC Public Health ; 20(1): 986, 2020 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-32594907

RESUMEN

Altering the availability of products (e.g. food, alcohol or tobacco products) is one potential intervention to change behaviours to help reduce preventable premature deaths worldwide. However, research on these interventions lacks consistent conceptualisation, hindering clear reporting and cumulative synthesis. This paper proposes a conceptual framework - categorising intervention types and summarising constituent components - with which interventions can be reliably described and evidence synthesised. Three principal distinctions are proposed: interventions altering: (i) Absolute Availability (changing the overall number of options, while keeping the proportions comprised by any subsets of options constant); (ii) Relative Availability (changing the proportion comprised by a subset of options, yet keeping the overall number of options constant); (iii) Absolute and Relative Availability (changing both the overall number of options and the proportions comprised by subsets of options). These are subdivided into those targeting (a) a product or (b) a category of products. Mechanisms that might underlie each of these intervention types are discussed, and implications for future research highlighted. The proposed framework aims to facilitate study of a set of interventions that could contribute significantly to healthier behaviour across populations.


Asunto(s)
Bebidas Alcohólicas/estadística & datos numéricos , Ambiente , Abastecimiento de Alimentos/estadística & datos numéricos , Conductas Relacionadas con la Salud , Productos de Tabaco/estadística & datos numéricos , Abastecimiento de Alimentos/métodos , Humanos
11.
PLoS One ; 15(6): e0235496, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32598379

RESUMEN

INTRODUCTION: Over 120 US jurisdictions have implemented policies mandating minimum cigar pack quantities, yet little empirical research exists on the relationship between pack quantity and use. We examined whether cigar use was associated with purchasing cigars by the box/pack or as singles, purchase quantity, and price paid per cigar. METHODS: Data are from Waves 1-3 (2013-2016) of the Population Assessment of Tobacco and Health (PATH) Study, analyzed in 2019. The sample included adults who reported current use of any type of cigars (cigarillos [N = 3,051], traditional cigars [N = 2,586], and filtered cigars [N = 1,295], including with marijuana) at Wave 1. For each cigar type, a generalized estimating equation model was used to examine the population-averaged effects of purchasing behavior on cigar use. RESULTS: Cigar users of each type who purchased by the box or pack smoked more per day than users who purchased singles (cigarillos: ß = 1.02, p<0.0001; traditional cigars: ß = 1.40, p<0.0001; filtered cigars: ß = 2.55, p<0.01). Cigar users who purchased larger quantities smoked more per day (cigarillos: ß = 0.16, p<0.0001; traditional cigars: ß = 0.04, p<0.0001; filtered cigars: ß = 0.24, p<0.0001). Higher price per cigar was significantly associated with smoking fewer traditional cigars (ß = -0.12, p<0.01) and filtered cigars (ß = -0.86, p = 0.02), but not cigarillos (ß = 0.08, p = 0.62). CONCLUSIONS: Smaller pack quantities and higher price per cigar were associated with smoking fewer cigars per day. Given the authority of the Food and Drug Administration and local jurisdictions over cigar pack quantity, this study provides data pertinent to potential minimum and maximum package quantity regulations and policies.


Asunto(s)
Comportamiento del Consumidor/economía , Vigilancia de la Población , Fumar/epidemiología , Fumar/psicología , Productos de Tabaco/economía , Adolescente , Adulto , Anciano , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Fumar/economía , Productos de Tabaco/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
12.
JAMA Netw Open ; 3(6): e204813, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32501492

RESUMEN

Importance: Relapse to smoking among former smokers is a serious clinical concern, and use of electronic nicotine delivery systems (ENDS) has been proposed as a new risk factor for relapse. Understanding the specificity of this risk can help guide clinical practice and lead to improved health outcomes. Objective: To assess the associations of ENDS use with cigarette smoking relapse among adult former cigarette smokers. Design, Setting, and Participants: This cohort study examined data from the Population Assessment of Tobacco and Health Study, waves 1 to 4 (2013-2018). Cox proportional hazards models were developed. This is an ongoing, nationally representative, longitudinal cohort study in the US. Participants included adult (≥18 years) former cigarette smokers who reported no tobacco product use at wave 1 (unweighted n = 2273), separated into recent former cigarette smokers (last smoked ≤12 months previously) and long-term former smokers (last smoked >12 months previously). Data analysis was conducted from July to August 2019. Exposures: Self-reported use of cigarettes, ENDS, and other tobacco products (ie, cigars, pipe tobacco, hookah, snus tobacco, other smokeless tobacco, and dissolvable tobacco) was assessed. Main Outcomes and Measures: Self-reported current (every day or some days) use of cigarettes at follow-up interviews. Results: Of 2273 adult former cigarette smokers, 51.8% (95% CI, 49.7%-53.8%) were women, 65.0% (95% CI, 62.6%-67.4%) were older than 50 years, and 79.5% (95% CI, 77.8%-81.2%) were non-Hispanic white participants. Use of ENDS was associated with significant risk of cigarette smoking relapse among recent former smokers (adjusted hazard ratio [AHR], 1.63; 95% CI, 1.04-2.53; unweighted n = 304) and among long-term former smokers (AHR, 3.79; 95% CI, 1.75-8.20; unweighted n = 1554). Use of other tobacco products was also associated with significant risk for cigarette smoking relapse among recent former smokers (AHR, 1.97; 95% CI, 1.27-3.05) and among long-term former smokers (AHR, 3.82; 95% CI, 1.91-7.66). Conclusions and Relevance: In this study, use of ENDS and other tobacco products was associated with increased risk of cigarette smoking relapse among former cigarette smokers who did not use any tobacco product at wave 1 of the PATH Study. For clinicians treating former smokers who have successfully quit all nicotine products, the implications are that use of ENDS products should be discouraged, just as use of all other tobacco products is discouraged.


Asunto(s)
Fumar Cigarrillos/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Ex-Fumadores/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Estimación de Kaplan-Meier , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Recurrencia , Factores de Riesgo , Autoinforme , Productos de Tabaco/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
13.
BMC Public Health ; 20(1): 748, 2020 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-32448193

RESUMEN

BACKGROUND: Graphic health warning labels (GHWLs) on tobacco products are more effective than text warnings for communicating the risk of smoking. The implementation of GHWLs can prevent adolescents from initiating smoking. Therefore, this study examined the association between GHWLs newly implemented on December 23, 2016, in South Korea and attitudes toward smoking among adolescents. METHODS: This post-implementation cross-sectional analysis examined the responses of 62,276 students (31,624 boys and 30,652 girls) who participated in the 2017 Web-based Korean Youth Risk Behavior Survey, which was completed anonymously as a self-administered questionnaire by middle and high school students. Multinomial logistic regression was applied to explore the attitudes toward smoking among the youth (13-18 years old) who have been exposed to GHWLs in order to identify relationship of exposure to the GHWLs with smoking initiation and awareness of the danger of smoking. RESULTS: Six months after implementation, 69.4% of adolescents reported having been exposed to GHWLs in the previous 30 days. Among those exposed to GHWLs both boys and girls in grade 7 were significantly more likely than grade 12 high school students to decide not to start smoking (boys: AOR = 3.96, 95% CI 3.31-4.75, p < 0.001; girls: AOR = 2.76, 95% CI 2.32-3.30, p < 0.001) and to think that smoking was dangerous to their health (boys: AOR = 3.01, 95% CI 2.52-3.58, p < 0.001; girls: AOR = 2.42, 95% CI 2.03-3.88, p < 0.001) after seeing GHWLs. These associations were greater for adolescents who had experienced smoking-prevention education or had been exposed to anti-tobacco advertisements. However, those who smoked, used e-cigarettes, or experienced secondhand smoking were significantly less likely to decide not to smoke and to view smoking as dangerous. CONCLUSIONS: To maintain the perception of the harm of tobacco from childhood through adolescence, the government should implement both comprehensive tobacco controls, including smoking-prevention education in schools, and measures to encourage a smoke-free environment in homes.


Asunto(s)
Actitud Frente a la Salud , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Etiquetado de Productos , Prevención del Hábito de Fumar/métodos , Estudiantes/psicología , Productos de Tabaco/estadística & datos numéricos , Fumar Tabaco/psicología , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , República de Corea , Instituciones Académicas , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Contaminación por Humo de Tabaco/prevención & control
14.
Womens Health Issues ; 30(3): 221-229, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32376187

RESUMEN

INTRODUCTION: Smoking during pregnancy is a primary risk factor for adverse perinatal outcomes. Although electronic cigarette (e-cigarette) use has increased, reasons for and behaviors of use are not fully understood. The purpose of this study, composed exclusively of pregnant current smokers, was to describe perceptions of health risks associated with e-cigarette use among pregnant women, describe the use patterns of pregnant dual users (defined as those who simultaneously use conventional/combustible cigarettes and e-cigarettes), and examine smoking-related behaviors between conventional-only (defined as those smoking combustible cigarettes but not e-cigarettes) and dual users. METHODS: Cross-sectional data from a larger study of pregnant conventional-only and dual users were analyzed. A brief survey measured perceptions of prenatal e-cigarette use and smoking behaviors. Analysis included descriptive statistics, bivariate analysis, and logistic and linear regression analysis. RESULTS: Among 176 pregnant smokers (38% dual users), more than one-half of participants believed e-cigarettes were harmful to women (56%) and posed harm to the fetus (53%). Among dual users, 41% used their e-cigarette daily, on average eight times per day. Eleven percent of dual users smoked a pack of cigarettes per day, compared with 5% of conventional-only smokers, and dual users scored significantly higher (p = .026) on the Penn State Cigarette Dependence Index. The most common e-cigarette liquid flavor was fruit (64%), and the most frequently reported e-cigarette nicotine concentration was 1-6 mg. CONCLUSIONS: Characterizing perceptions and behaviors of e-cigarette use during pregnancy is foundational for future research to explore the association between product use and maternal and infant outcomes.


Asunto(s)
Fumar Cigarrillos/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Fumadores/psicología , Productos de Tabaco/estadística & datos numéricos , Vapeo/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Nicotina , Embarazo/estadística & datos numéricos , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
15.
BMC Public Health ; 20(1): 741, 2020 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-32434517

RESUMEN

BACKGROUND: From among the global public health concerns, smoking remains one of the most crucial challenges. Especially for adolescents, the increase in the use of electronic cigarettes is controversial, as its use may lead to established smoking. In Japan, where a unique tobacco regulation system exists, the heat-not-burn tobacco market has been growing. However, the prevalence and association of combustible cigarettes and new tobacco-related products have not yet been closely investigated among Japanese adolescents. This study aimed to clarify the prevalence of smoking among adolescents, including new types of tobacco-related products, and to compare the characteristics of their users. METHODS: The 2017 Lifestyle Survey of Adolescents is a nationally-representative survey collected in Japan. From the national school directory, 98 junior high schools and 86 high schools were randomly sampled throughout Japan. The students completed an anonymous questionnaire at school. We calculated the prevalence of use for each type of tobacco product. Then, the use of a combination of products and the characteristics of different types of products were examined. RESULTS: In total, 64,152 students from 48 junior high schools and 55 high schools were included the analysis (school response rate = 56%, Mage = 15.7 years, 53.9% boys). The age-adjusted rate of ever (current) use of electronic cigarettes was 2.1% (0.7%) in junior high school and 3.5% (1.0%) in high school; that of combustible cigarettes was 2.6% (0.6%) in junior high school and 5.1% (1.5%) in high school. The rate of heat-not-burn tobacco use was lower relative to other products: 1.1% (0.5%) in junior high school and 2.2% (0.9%) in high school. An examination of the combined use of the three products identified a high number of dual users. Comparisons between different types of users indicated different backgrounds for combustible cigarette users and new product users. CONCLUSIONS: The prevalence of new tobacco-alternative products is growing in popularity among Japanese adolescents. Dual use is common, and many adolescents use new products only. Moreover, e-cigarettes might attract a broader range of groups to smoking. Continuous monitoring and research are needed to investigate their influence as a possible gateway to tobacco smoking.


Asunto(s)
Conducta del Adolescente , Sistemas Electrónicos de Liberación de Nicotina , Productos de Tabaco , Fumar Tabaco/epidemiología , Vapeo/epidemiología , Adolescente , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Calor , Humanos , Japón/epidemiología , Estilo de Vida , Estudios Longitudinales , Masculino , Prevalencia , Instituciones Académicas , Fumar/epidemiología , Estudiantes , Encuestas y Cuestionarios , Tabaco , Productos de Tabaco/clasificación , Productos de Tabaco/estadística & datos numéricos
16.
Am J Public Health ; 110(7): 1002-1005, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32437272

RESUMEN

Objectives. To estimate the combined effect of California's Tobacco 21 law (enacted June 2016) and $2-per-pack cigarette excise tax increase (enacted April 2017) on cigarette prices and sales, compared with matched comparator states.Methods. We used synthetic control methods to compare cigarette prices and sales after the policies were enacted, relative to what we would have expected without the policy reforms. To estimate the counterfactual, we matched pre-reform covariate and outcome trends between California and control states to construct a "synthetic" California.Results. Compared with the synthetic control in 2018, cigarette prices in California were $1.89 higher ($7.86 vs $5.97; P < .001), and cigarette sales were 16.6% lower (19.9 vs 16.6 packs per capita; P < .001). This reduction in sales equates to 153.9 million fewer packs being sold between 2017 and 2018.Conclusions. California's new cigarette tax was largely passed on to consumers. The new cigarette tax, combined with the Tobacco 21 law, have contributed to a rapid and substantial reduction in cigarette consumption in California.


Asunto(s)
Comercio/estadística & datos numéricos , Política Pública , Impuestos , Productos de Tabaco/economía , California , Comportamiento del Consumidor/economía , Humanos , Fumar/economía , Gobierno Estatal , Industria del Tabaco/economía , Productos de Tabaco/estadística & datos numéricos
17.
Pneumologie ; 74(7): 448-455, 2020 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-32323286

RESUMEN

AIM: Description of adolescent e-cigarette use over time. METHOD: In 2017 and 2019, 261 adolescents from North Rhine-Westphalia who had used e-cigarettes at least once a month (mean age: 14.9 years; 33.5 % female) took part in a questionnaire study. RESULTS: In 2017, 84 adolescents (32.2 %) reported exclusive e-cigarette use (single users), 177 adolescents were classified as dual users (67.8 %) because they consumed a tobacco product (conventional cigarette and/or hookah) in addition to e-cigarettes. During the observation period of 18 months, 83 adolescents (31.8 %) quit nicotine products altogether. Dual users quit nicotine less often than single users (N = 39 or 22.0 % vs. N = 44 or 52.4 %, p < 0.001). Seven single users (8.3 %) did not change their behavior, 11 began to use tobacco exclusively (13.1 %), another 22 (26.2 %) started dual use. Seventy-eight dual users (44.1 %) did not change their behavior, 57 (32.1 %) switched to tobacco use only, 3 dual users (1.7 %) stopped tobacco use, but continued to use e-cigarettes. Taken together, at the end of the study, 10 (5.6 %) of the remaining 178 adolescents consumed only e-cigarettes, while 168 (94.4 %) smoked tobacco or were dual-users. CONCLUSIONS: More than two thirds of all young e-cigarette users and more than three quarters of dual users also used nicotine products 18 months later. The remaining consumers showed a less frequent stay or switch to single use, instead a more frequent use of tobacco or dual use.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Nicotina/administración & dosificación , Fumar/epidemiología , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/epidemiología , Tabaco sin Humo/estadística & datos numéricos , Vapeo/epidemiología , Adolescente , Estudios de Cohortes , Femenino , Humanos , Masculino , Fumar/efectos adversos
18.
Am J Physiol Lung Cell Mol Physiol ; 318(5): L1004-L1007, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-32233791
19.
JAMA Netw Open ; 3(3): e201177, 2020 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-32181828

RESUMEN

Importance: The World Health Organization estimates that the 1 billion individuals who smoke worldwide contribute to the 880 000 secondhand smoke (SHS)-related deaths among individuals who do not smoke each year. A better understanding of the scale of harm of SHS to those who do not smoke could increase awareness of the consequences of smoking and help to design measures to protect individuals who do not smoke, especially children. Objective: To calculate the number of individuals who smoke associated with the death of 1 individual who died of SHS exposure both on a global scale and in various World Bank regions. Design, Setting, and Participants: In this cross-sectional epidemiologic assessment, data from Our World in Data were used to tabulate the number of individuals who smoke in each country and number of premature deaths related to SHS in that country from 1990 to 2016. The mean number of cigarettes consumed in all countries was also included in analyses. Data were collected for the following World Bank regions: North America, Latin America and the Caribbean, Europe and Central Asia, the Middle East and North Africa, sub-Saharan Africa, South Asia, and East Asia and the Pacific from 1990 and 2016. Statistical analysis was conducted in July 2019. Exposure: Secondhand smoke. Main Outcomes and Measures: The pack-year index, calculated as the number of pack-years associated with the death of 1 individual who does not smoke but was exposed to SHS, and the SHS index, calculated as the number of individuals who smoked for 24 years (ie, the mean duration of smoking) associated with the death of 1 individual who does not smoke. Results: Globally, the SHS index changed favorably, from 31.3 (95% CI, 30.6-32.0) individuals who smoked associated with the death of 1 individual who did not smoke in 1990 to 52.3 (95% CI, 51.2-53.5) individuals who smoked in 2016. There was a wide regional variation in the 2016 secondhand smoke index, from 42.6 (95% CI, 41.6-43.5) individuals who smoked in the Middle East and North Africa to 85.7 (95% CI, 83.8-87.7) individuals who smoked in North America. Worldwide, the pack-year index also changed favorably from 751.9 (95% CI, 736.3-770.7) pack-years associated with 1 death in 1990 to 1255.9 (95% CI, 1227.2-1284.4) pack-years in 2016. Conclusions and Relevance: In this study, the substantial disparity among regions in both the SHS index and pack-year index reflected large differences in the scale of the harm of SHS on those who do not smoke. This information may help local policy makers implement measures to better protect those who do not smoke and increase public engagement. Although the number of pack-years and the number of individuals who smoke associated with the death of 1 individual who did not smoke favorably changed over the study period, as of 2016, 52.3 individuals who smoked were associated with the death of 1 individual who did not smoke.


Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , Salud Global/estadística & datos numéricos , Mortalidad Prematura/tendencias , Fumar/epidemiología , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Productos de Tabaco/estadística & datos numéricos , Adulto Joven
20.
Am J Public Health ; 110(5): 725-730, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32191512

RESUMEN

Objectives. To assess explicit- (products clearly labeled flavored) and emergent concept- (products implying flavoring but not clearly labeled) flavored tobacco product availability following New York City's flavor restriction.Methods. We examined explicit- and concept-flavored tobacco product availability, with 2017 New York City Retailer Advertising of Tobacco Survey data (n = 1557 retailers). We assessed associations between block group-level demographic characteristics and product availability by using logistic regression.Results. Most retailers sold explicit-flavored (70.9%) or concept-flavored (69.3%) products. The proportion of non-Hispanic Black neighborhood residents predicted explicit- and concept-flavored product availability, as did having a high school within a retailer's block group for concept-flavored products.Conclusions. Explicit- and concept-flavored other tobacco products persisted throughout New York City, despite 2009 legislation restricting sales.Public Health Implications. Making local sales restrictions or federal production bans inclusive of all explicit and concept flavors would reduce retailer and industry evasion opportunities and protect the health of youths and others.


Asunto(s)
Aromatizantes , Productos de Tabaco/legislación & jurisprudencia , Productos de Tabaco/estadística & datos numéricos , Afroamericanos/estadística & datos numéricos , Humanos , Modelos Logísticos , Ciudad de Nueva York , Instituciones Académicas/estadística & datos numéricos , Factores Socioeconómicos
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