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1.
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
2.
Am J Public Health ; 110(4): 547-553, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32078358

RESUMEN

Objectives. To evaluate changes in licensed tobacco retailers and retailer density 5 years before and 3 years after novel tobacco retailer licensing regulations were implemented in a large, urban area.Methods. We used administrative tobacco license data (n = 23 806 licenses, 2012-2019) to calculate (1) annual retailer density by district (n = 18), (2) density by district and school income status, and (3) retailers within 500 feet of schools (n = 673) before and after regulations.Results. Observed tobacco retailer density declined by 20.3% (from 1.97 to 1.57 per 1000 daytime residents) 3 years after regulation implementation. Regression results showed a decline in the trend of retailers per 1000 daytime population (b = -0.19; 95% confidence interval[CI] = -0.23, -0.14) that was modestly but significantly greater in low-income districts (interaction b = -0.18; 95% CI = -0.25, -0.11) and a 12% decline in the rates of retailers near schools (rate ratio = 0.88; 95% CI = 0.85, 0.92) following implementation of the regulations. We did not observe similar density changes in comparable cities.Conclusions. Tobacco retailer licensing strategies can be an effective policy approach to reduce the availability of tobacco and tobacco marketing, lessen socioeconomic disparities in tobacco retailer density, and decrease the number of tobacco outlets near schools.


Asunto(s)
Comercio/legislación & jurisprudencia , Concesión de Licencias/legislación & jurisprudencia , Productos de Tabaco/legislación & jurisprudencia , Comercio/estadística & datos numéricos , Philadelphia , Instituciones Académicas , Factores Socioeconómicos , Productos de Tabaco/estadística & datos numéricos
3.
Artículo en Inglés | MEDLINE | ID: mdl-31816848

RESUMEN

Although heated tobacco products (HTPs) have become increasingly popular in Japan, little is known about whether these emerging tobacco products are being used within indoor public spaces. Nationally representative data were obtained prior to implementation of a comprehensive smoke-free law in Japan as part of Wave 1 of the International Tobacco Control Japan Survey (February-March 2018). We estimated the weighted prevalence of HTP use within indoor public spaces among tobacco users and compared these to estimates for combustible cigarettes (CCs). Overall, 15.6% of current tobacco users in Japan declared that they used HTPs within indoor public spaces. Any HTP use within indoor public spaces was significantly lower than any CC use (80.1% vs. 96.7%). Dual HTP + CC users reported using CCs more frequently than using HTPs within indoor public spaces (97.7% vs. 76.0%). In conclusion, HTP use is less common than CC use within indoor public spaces. Findings of this study can inform the development of targeted smoke-free policies to benefit public health.


Asunto(s)
Contaminación del Aire Interior/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos , Contaminación por Humo de Tabaco/estadística & datos numéricos , Calor , Humanos , Japón
4.
MMWR Surveill Summ ; 68(12): 1-22, 2019 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-31805035

RESUMEN

PROBLEM/CONDITION: Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Most tobacco product use begins during adolescence. In recent years, tobacco products have evolved to include various smoked, smokeless, and electronic products. PERIOD COVERED: 2019. DESCRIPTION OF SYSTEM: The National Youth Tobacco Survey (NYTS) is an annual, cross-sectional, school-based, self-administered survey of U.S. middle school (grades 6-8) and high school (grades 9-12) students. A three-stage cluster sampling procedure is used to generate a nationally representative sample of U.S. students attending public and private schools. NYTS is the only nationally representative survey of U.S. middle and high school students that focuses exclusively on tobacco use patterns and associated factors. NYTS is designed to provide national data on tobacco product use and has been conducted periodically during 1999-2009 and annually since 2011. Data from NYTS are used to support the design, implementation, and evaluation of comprehensive tobacco use prevention and control programs and to inform tobacco regulatory activities. Since its inception in 1999 through 2018, NYTS had been conducted via paper and pencil questionnaires. In 2019, NYTS for the first time was administered in schools using electronic data collection methods. CDC's Office on Smoking and Health, in collaboration with the U.S. Food and Drug Administration's (FDA's) Center for Tobacco Products, analyzed data from the 2019 NYTS to assess tobacco product use patterns and associated factors among U.S. middle and high school students. Overall, 19,018 questionnaires were completed and weighted to represent approximately 27.0 million students. On the basis of self-reported grade level, this included 8,837 middle school questionnaires (11.9 million students) and 10,097 high school questionnaires (15.0 million students); 84 questionnaires with missing information on grade level were excluded from school-level analyses. RESULTS: In 2019, an estimated 53.3% of high school students (8.0 million) and 24.3% of middle school students (2.9 million) reported having ever tried a tobacco product. Current (past 30-day) use of a tobacco product (i.e., electronic cigarettes [e-cigarettes], cigarettes, cigars, smokeless tobacco, hookahs, pipe tobacco, and bidis [small brown cigarettes wrapped in a leaf]) was reported by 31.2% of high school students (4.7 million) and 12.5% of middle school students (1.5 million). E-cigarettes were the most commonly cited tobacco product currently used by 27.5% of high school students (4.1 million) and 10.5% of middle school students (1.2 million), followed in order by cigars, cigarettes, smokeless tobacco, hookahs, and pipe tobacco. Tobacco product use also varied by sex and race/ethnicity. Among current users of each tobacco product, the prevalence of frequent tobacco product use (on ≥20 days of the preceding 30 days) ranged from 16.8% of cigar smokers to 34.1% of smokeless tobacco product users. Among current users of each individual tobacco product, e-cigarettes were the most commonly used flavored tobacco product (68.8% of current e-cigarette users). Among students who reported ever having tried e-cigarettes, the three most commonly selected reasons for use were "I was curious about them" (55.3%), "friend or family member used them" (30.8%), and "they are available in flavors, such as mint, candy, fruit, or chocolate" (22.4%). Among never users of each individual tobacco product, curiosity and susceptibility (a construct that can help to identify future tobacco product experimentation or use) was highest for e-cigarettes (39.1% and 45.0%, respectively) and cigarettes (37.0% and 45.9%, respectively). Overall, 86.3% of students who reported contact with an assessed potential source of tobacco product advertisements or promotions (going to a convenience store, supermarket, or gas station; using the Internet; watching television or streaming services or going to the movies; or reading newspapers or magazines) reported exposure to marketing for any tobacco product; 69.3% reported exposure to e-cigarette marketing and 81.7% reported exposure to marketing for cigarettes or other tobacco products. Among all students, perceiving no harm or little harm from intermittent tobacco product use (use on some days but not every day) was 28.2% for e-cigarettes, 16.4% for hookahs, 11.5% for smokeless tobacco products, and 9.5% for cigarettes. Among current users of any tobacco product, 24.7% reported experiencing cravings to use tobacco products during the past 30 days and 13.7% reported wanting to use a tobacco product within 30 minutes of waking. Moreover, 57.8% of current tobacco product users reported they were seriously thinking about quitting the use of all tobacco products and 57.5% reported they had stopped using all tobacco products for ≥1 day because they were trying to quit. INTERPRETATION: In 2019, approximately one in four youths (23.0%) had used a tobacco product during the past 30 days. By school level, this represented approximately three in 10 high school students (31.2%) and approximately one in eight middle school students (12.5%). Since 2014, e-cigarettes have been the most commonly used tobacco product among youths. Importantly, more than half of current youth tobacco product users reported seriously thinking about quitting all tobacco products in 2019. However, established factors of use and initiation, including the availability of flavors, exposure to tobacco product marketing, curiosity and susceptibility, and misperceptions about harm from tobacco product use, remained prevalent in 2019 and continue to promote tobacco product use among youths. PUBLIC HEALTH ACTION: The continued monitoring of all forms of youth tobacco product use and associated factors through surveillance efforts including NYTS is important to the development of public health policy and action at national, state, and community levels. Everyone, including public health professionals, health care providers, policymakers, educators, parents, and others who influence youths, can help protect youths from the harms of all tobacco products. In addition, the comprehensive and sustained implementation of evidence-based tobacco control strategies, combined with FDA's regulation of tobacco products, is important for reducing all forms of tobacco product use among U.S. youths.


Asunto(s)
Fumar/epidemiología , Estudiantes/psicología , Productos de Tabaco/estadística & datos numéricos , Adolescente , Niño , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados Unidos/epidemiología
5.
BMC Public Health ; 19(1): 1684, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31842834

RESUMEN

BACKGROUND: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. METHODS: Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. RESULTS: Almost half of the participants reported ever smoking (44.0%; CI: 40.1-47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2-29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9-30.9) and 19.1% (CI: 16.2-22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8-45.3) were moderately/highly dependent on nicotine. Current 'any tobacco product users' (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5-49.3) while 1.0% (CI: 0.4-2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27-0.41), current smokers (RRR = 0.18; CI: 0.12-0.25), and ATPU (RRR = 0.75; CI: 0.63-0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31-8.25), or current snuff use (RRR = 26.19; CI: 8.32-82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03-1.70), current snuff users (RRR = 1.40; CI: 1.03-1.89) and ATPU (RRR = 1.27; CI: 1.07-1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. CONCLUSION: There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Infecciones por VIH/epidemiología , Tabaquismo/epidemiología , Adolescente , Adulto , Anciano , Antirretrovirales/uso terapéutico , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sudáfrica/epidemiología , Productos de Tabaco/estadística & datos numéricos , Tabaco sin Humo/estadística & datos numéricos , Adulto Joven
6.
Nicotine Tob Res ; 21(Suppl 1): S56-S62, 2019 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-31867646

RESUMEN

INTRODUCTION: Minimal research exists on adolescent smokers' perceptions of very low-nicotine-content (VLNC) cigarettes. As approximately half of adolescent smokers prefer menthol cigarettes, it is important to consider the influence of menthol preference on VLNC cigarette perceptions and to what extent menthol preference may affect VLNC smoking behavior. This study examined the effects of cigarette nicotine content and menthol preference or menthol smoking on health risk perceptions, subjective ratings, and carbon monoxide (CO) boost in adolescent smokers. METHODS: Across two counterbalanced sessions, adolescent smokers sampled VLNC and normal nicotine content (NNC) research cigarettes following overnight abstinence. Cigarettes were mentholated or non-mentholated consistent with participants' usual brand. In each session, participants smoked the research cigarette and then completed the Perceived Health Risk Scale and Cigarette Evaluation Scale. Breath CO readings were obtained pre- and post-smoking. Mixed-factor ANOVA tests compared outcomes with cigarette type (VLNC vs. NNC) as the within-subjects factor and menthol preference as the between-subjects factor. RESULTS: Participants (N = 50) were M = 17.7 years old, smoked M = 8.2 cigarettes/day, and 56% typically smoked menthol cigarettes. Participants reported lower risk of developing lung cancer, other cancers, emphysema, bronchitis, and heart disease (ps ≤ .05) when smoking VLNC cigarettes relative to NNC cigarettes. Perceived risk of addiction and stroke did not differ by nicotine content. Menthol preference or menthol smoking did not moderate risk perceptions, subjective ratings, or CO boost. CONCLUSIONS: Adolescents may incorrectly perceive that VLNC cigarettes are less harmful products. Health communication campaigns could help to correct VLNC misperceptions and potentially minimize unintended consequences of a nicotine reduction policy.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Nicotina , Fumadores , Productos de Tabaco/estadística & datos numéricos , Adolescente , Monóxido de Carbono , Humanos , Mentol , Riesgo , Fumadores/psicología , Fumadores/estadística & datos numéricos
7.
MMWR Morb Mortal Wkly Rep ; 68(45): 1013-1019, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31725711

RESUMEN

Cigarette smoking is the leading cause of preventable disease and death in the United States (1). The prevalence of adult cigarette smoking has declined in recent years to 14.0% in 2017 (2). However, an array of new tobacco products, including e-cigarettes, has entered the U.S. market (3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed data from the 2018 National Health Interview Survey (NHIS). In 2018, an estimated 49.1 million U.S. adults (19.7%) reported currently using any tobacco product, including cigarettes (13.7%), cigars (3.9%), e-cigarettes (3.2%), smokeless tobacco (2.4%), and pipes* (1.0%). Most tobacco product users (83.8%) reported using combustible products (cigarettes, cigars, or pipes), and 18.8% reported using two or more tobacco products. The prevalence of any current tobacco product use was higher in males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Natives; those with a General Educational Development certificate (GED); those with an annual household income <$35,000; lesbian, gay, or bisexual adults; uninsured adults; those with a disability or limitation; and those with serious psychological distress. The prevalence of e-cigarette and smokeless tobacco use increased during 2017-2018. During 2009-2018, there were significant increases in all three cigarette cessation indicators (quit attempts, recent cessation, and quit ratio). Implementing comprehensive population-based interventions in coordination with regulation of the manufacturing, marketing, and distribution of all tobacco products can reduce tobacco-related disease and death in the United States (1,4).


Asunto(s)
Cese del Hábito de Fumar/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos , Tabaquismo/epidemiología , Adolescente , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Tabaquismo/etnología , Estados Unidos/epidemiología , Adulto Joven
8.
Artículo en Inglés | MEDLINE | ID: mdl-31694236

RESUMEN

This study sought to assess the effectiveness of religious cigarette health warning labels (HWLs) in Indonesia, a country with a high public health burden from tobacco use. The study tested different religious and nonreligious messages related to suicide, secondhand smoke (SHS) and gangrene. Participants were smokers and non-smokers from Surabaya, Indonesia (n = 817). Participants rated each HWL for its effectiveness on a scale of 1 to 10 (1 = "not at all", 10 = "extremely") with respect to 10 items. Nonreligious HWLs were marginally superior for SHS and suicide while religious HWLs were marginally superior for gangrene. Given the close rating scores between religious and nonreligious HWLs, they were functionally equal in effectiveness. With proper assessment of potential unintended consequences, the implementation of religious HWLs could be considered for a proportion of HWLs.


Asunto(s)
Etiquetado de Productos/métodos , Religión y Medicina , Productos de Tabaco/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Indonesia , Masculino , Persona de Mediana Edad , Etiquetado de Productos/estadística & datos numéricos , Cese del Hábito de Fumar/psicología , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-31766232

RESUMEN

Socioeconomic inequalities in conventional cigarette smoking are well established in developed countries. The aim of this study was to investigate socioeconomic inequalities in e-cigarette use in Korea, in comparison with inequalities in conventional cigarette use. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Community Health Survey (KCHS) were analyzed. The years of data collected were 2013 to 2016 for the KNHANES and 2014 to 2016 for the KCHS, respectively. The age-adjusted prevalence of ever and current e-cigarette use and conventional cigarette use was calculated according to socioeconomic status indicators, including education, occupation, and income. The prevalence of ever e-cigarette use in men increased from 12.1% in 2013 to 19.2% in 2016 in the KNHANES, and from 13.4% in 2014 to 17.9% in 2016 in the KCHS. Ever and current e-cigarette use was concentrated among current smokers and was much more prevalent among men and also more common among younger age groups in men and women. There was higher prevalences of conventional cigarette use among men and women with less education, manual occupational class and lower income, with the differences more pronounced for women. There was higher ever and current use of e-cigarettes among women with less education, manual occupational class and lower income, but among men there was much less difference in e-cigarette use by these indicators of socio-economic status.


Asunto(s)
Fumar Cigarrillos/epidemiología , Factores Socioeconómicos , Vapeo/epidemiología , Adulto , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Prevalencia , República de Corea/epidemiología , Encuestas y Cuestionarios , Productos de Tabaco/estadística & datos numéricos , Adulto Joven
10.
Artículo en Inglés | MEDLINE | ID: mdl-31766776

RESUMEN

Appealing product characteristics, such as flavors, may stimulate e-cigarette use. While switching to e-cigarettes may reduce harm for smokers, concerns exist about e-cigarette use among never-smokers. The role of flavors in the decision to switch to or refrain from vaping is unclear. This study used a bottom-up approach to investigate the relation between flavor preferences and individual factors related to vaping between various user groups. A cross-sectional survey was conducted among never-users (n = 407), smokers (n = 138), dual users (n = 122), and exclusive vapers (n = 61) in the Netherlands. Demographics, attractiveness of product characteristics, flavor preferences, and individual factors related to vaping (knowledge, trust, perceived susceptibility, attitude, social influence, deliberation, and intention) were assessed. The availability of different flavors was the most attractive characteristic of e-cigarettes. Dual users and exclusive vapers had most often used tobacco and menthol/mint flavors when they first started vaping. Compared to dual users, exclusive vapers currently used more fruit and sweet flavors. Never-users who were interested in trying an e-liquid flavor had more knowledge about and a more positive attitude towards e-cigarettes. Smokers who were interested in trying a flavor had a more positive attitude towards e-cigarettes and experienced the social influence towards not using e-cigarettes as less strong than those who did not want to try any flavor. Hence, individual factors related to vaping differed depending on whether never-users and smokers wanted to try an e-liquid flavor. This means that flavors may moderate differences found in individual factors related to vaping, or vice versa.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Aromatizantes , Fumadores , Vapeo , Adulto , Actitud , Estudios Transversales , Grupos Étnicos , Femenino , Humanos , Intención , Masculino , Países Bajos , Encuestas y Cuestionarios , Gusto , Productos de Tabaco/estadística & datos numéricos
11.
MMWR Morb Mortal Wkly Rep ; 68(39): 839-844, 2019 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-31581163

RESUMEN

The 2009 Family Smoking Prevention and Tobacco Control Act prohibits the inclusion of characterizing flavors (e.g., candy or fruit) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products at the federal level.* Flavored tobacco products can appeal to youths and young adults and influence initiation and establishment of tobacco-use patterns (1). The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014. Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015. During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students. Full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths (2,3).


Asunto(s)
Aromatizantes , Estudiantes/psicología , Productos de Tabaco/estadística & datos numéricos , Uso de Tabaco/epidemiología , Adolescente , Niño , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Instituciones Académicas/estadística & datos numéricos , Prevención del Hábito de Fumar/legislación & jurisprudencia , Estudiantes/estadística & datos numéricos , Productos de Tabaco/legislación & jurisprudencia , Uso de Tabaco/legislación & jurisprudencia , Uso de Tabaco/prevención & control , Tabaco sin Humo/estadística & datos numéricos , Estados Unidos/epidemiología , United States Food and Drug Administration
12.
Artículo en Inglés | MEDLINE | ID: mdl-31623202

RESUMEN

The use of electronic cigarettes (e-cigarettes) has increased in the US, but little is known about the effects of these products on lung health. The main purpose of this study was to examine the association between e-cigarette use and a participant's report of being diagnosed with chronic obstructive pulmonary disease (COPD) in a nationally representative sample of adults. Methods: The first wave of the Population Assessment of Tobacco and Health (PATH) survey adult data was used (N = 32,320). Potential confounders between e-cigarette users and non-users were balanced using propensity score matching. Odds ratios (OR) were calculated to examine the association between e-cigarette use and COPD in the propensity-matched sample, the entire sample, different age groups, and in nonsmokers. Replicate weights and balanced repeated replication methods were utilized to account for the complex survey design. Results: Of the 3642 participants who met the criteria for e-cigarette use, 2727 were propensity matched with 2727 non e-cigarette users. In the propensity-matched sample, e-cigarette users were more likely to report being diagnosed with COPD (OR 1.43, 95% confidence interval [CI] 1.12-1.85) than non-e-cigarette users after adjusting for confounders. The result was similar in the entire sample and in the different age subgroups. Among nonsmokers, the odds of reporting a COPD diagnosis were even greater among e-cigarette users (OR 2.94, 95% CI 1.73-4.99) compared to non-e-cigarette users. Conclusion: Our findings demonstrate that e-cigarette use was associated with a reported diagnosis of COPD among adults in the US. Further research is necessary to characterize the nature of this association and on the long-term effects of using e-cigarettes.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Enfermedad Pulmonar Obstructiva Crónica/etiología , Vapeo/efectos adversos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Autoinforme , Productos de Tabaco/estadística & datos numéricos , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-31487796

RESUMEN

Flavored cigar use is common among cigar smokers, particularly those at younger ages. Several US localities have implemented policies restricting the sale of flavored tobacco products, including cigars. We estimated the population health benefits of removal of flavored cigars throughout the US in terms of reductions in cigar smoking-attributable mortality due to increased cessation and reductions in cigar smoking prevalence due to decreased initiation and continuing use. Monte Carlo simulation was used to estimate possible ranges for these values. We used published estimates of cigar use and attributable mortality in the US, as well as prior study conclusions on the effect of local and national flavor restriction policies. We estimated that removal of flavored cigars would result in approximately 800 (90% prediction interval = 400-1200) fewer cigar smoking-attributable deaths in the US each year and 112,000 fewer cigar smokers (90% prediction interval = 76,000-139,000) in each cohort of 18 year olds. The removal of characterizing flavors in cigars sold in the US is thus projected to have substantial public health benefits over time.


Asunto(s)
Fumar Puros/mortalidad , Aromatizantes/análisis , Salud Pública , Productos de Tabaco/estadística & datos numéricos , Fumar Puros/tendencias , Humanos , Estados Unidos/epidemiología
14.
Artículo en Inglés | MEDLINE | ID: mdl-31547374

RESUMEN

Cigarette pack graphic warning labels (GWLs) are associated with increased knowledge of tobacco-related harms; scant research has evaluated their effects on behavior among vulnerable populations. We used a behavioral economic approach to measure the effects of GWLs and price on hypothetical cigarette purchasing behavior among HIV-positive smokers. Participants (n = 222) completed a cigarette valuation task by making hypothetical choices between GWL cigarette packs at a fixed price ($7.00) and text-only warning label cigarette packs at increasing prices ($3.50 to $14.00; $0.25 increments). More than one-quarter (28.8%) of participants paid more to avoid GWLs. The remaining participants' purchasing decisions appear to have been driven by price: 69.8% of participants chose the cheaper pack. Across all participants, overall monetary choice value observed for GWL cigarette packs (mean = $7.75) was greater than if choice was driven exclusively by price ($7.00). Most (87.4%) preferred the text-only warning label when GWL and text-only cigarette packs were equally priced. Correlation analysis indicated GWL pack preference was associated with agreement with statements that GWLs would stop individuals from having a cigarette or facilitate thoughts about quitting. These data suggest that GWLs may influence some HIV-positive smokers in such a way that they are willing to pay more to avoid seeing GWLs.


Asunto(s)
Infecciones por VIH/psicología , Etiquetado de Productos/estadística & datos numéricos , Fumadores/psicología , Productos de Tabaco/economía , Poblaciones Vulnerables/estadística & datos numéricos , Adulto , Comportamiento del Consumidor/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumadores/estadística & datos numéricos , Envío de Mensajes de Texto/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos , Estados Unidos , Poblaciones Vulnerables/psicología , Adulto Joven
15.
BMC Public Health ; 19(1): 1249, 2019 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-31510968

RESUMEN

BACKGROUND: The consumption of tobacco products has evolved to include more complex combinations of different products. We investigated the tobacco habits of a representative population of young Finnish male conscripts in order to evaluate the prevalence of dual use of cigarettes and snus as well as the transition from one tobacco product to another. In addition, we evaluated the correlation between the level of education and the use of cigarettes and snus. METHODS: A questionnaire-based survey was carried out in three out of 17 garrisons among conscripts during their first week of service in 2014. A total of 1971 male conscripts were selected by simple random sampling of the 9013 males in the selected garrisons. Of them 1916 participated and filled in the questionnaire. The response rate was 97.2%. The questionnaire consisted of 25 questions including age, gender, basic education, use of tobacco products as well as questions assessing nicotine dependency. RESULTS: The amount of dual users of cigarettes and snus was 21%. There was a higher probability of dual use of cigarettes and snus among smokers compared to snus users (p < 0.001). One third (35%) of former smokers reported daily snus use and over 40% of the former snus users smoked daily. One third (34%) of the participants reported snus usage and 14% of the study subjects used snus daily. 40% of the study population were smokers and over 25% smoked daily. Of the participants with basic educational background 57% smoked daily (p < 0.001), however, no association between snus and level of education was found (p = 0.69). CONCLUSIONS: This study provides better understanding of the complex tobacco habits of young adult males. The simultaneous usage of multiple tobacco products as well as the high tendency to transition from one tobacco product to another should be taken into consideration when planning cessation interventions in health care settings and tobacco control policies at societal levels.


Asunto(s)
Fumar Cigarrillos/epidemiología , Conductas Relacionadas con la Salud , Cese del Hábito de Fumar/estadística & datos numéricos , Tabaquismo/epidemiología , Tabaco sin Humo/estadística & datos numéricos , Adolescente , Finlandia/epidemiología , Humanos , Masculino , Productos de Tabaco/estadística & datos numéricos , Adulto Joven
16.
PLoS One ; 14(7): e0220241, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31365564

RESUMEN

BACKGROUND: The tobacco industry has aggressively introduced new and diverse products in the market, including electronic cigarettes (e-cigarettes) and heat-not-burn (HNB) tobacco products, to which adolescents are readily susceptible. Conventional cigarettes have a well-established relationship with adolescent risky behaviors such as alcohol and drug use; however, no studies exist on the association between alcohol consumption and use of e-cigarettes or HNB tobacco products among Korean adolescents. This study evaluated alcohol-related behaviors and drug use in relation to whether a Korean nationally representative adolescent sample had ever used e-cigarettes and HNB tobacco products. METHODS: Data from the 2018 Korean Youth Risk Behavior Web-based Survey were analyzed. The final study sample comprised 60,040 adolescents. Chi-square and logistic regression were used to examine whether the ever having used e-cigarettes and HNB tobacco products was associated with alcohol-related behaviors and drug use. P-values for trends were calculated to examine the dose-response relationship for each variable. RESULTS: Respondents with higher drinking frequency, drinking quantity, alcohol intoxication, alcohol availability, and drug use were more likely to report having used e-cigarettes and HNB tobacco products, thus implying a significant relationship between substance use and novel tobacco product (P < .001). CONCLUSIONS: Our findings suggest that at-risk adolescents who are engaged in other forms of risk-taking behaviors are prone to attract the experimentation with e-cigarettes or HNB tobacco products. Thus, smoking cessation programs related to substance use should be implemented, and there is an urgent need to monitor and regulate these products effectively.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Productos de Tabaco/estadística & datos numéricos , Adolescente , Conducta del Adolescente , Femenino , Humanos , Internet , Masculino , República de Corea/epidemiología , Fumar , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/patología , Encuestas y Cuestionarios
17.
Curr Opin Pediatr ; 31(5): 670-674, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31389807

RESUMEN

PURPOSE OF REVIEW: The purpose of this review is to highlight the emerging smoking behaviors and varied tobacco products elevating public health concerns related to the exposure of these potentially harmful substances in the adolescent population. RECENT FINDINGS: Although adolescent smoking of traditional cigarettes has declined in the last 40 years, the inhalation of other nicotine-containing products using alternative methods and devices, such as smoking electronic cigarettes, using hookahs, vaping, and JUULing are dramatically on the rise in the adolescent population. Regardless of the novel delivery devices or methods, use of nicotine-containing products in any form is hazardous and unsafe. SUMMARY: If adolescent smoking trends continue at the current rate in the United States, 5.6 million of today's American youth under the age of 18 will die early from a smoking-related illness. With the emerging high-risk smoking behaviors resulting in detrimental exposure to nicotine and other harmful substances available to adolescents, pediatric healthcare providers will have an increasing responsibility to screen, to manage, and to educate patients and families to combat this imminent threat to the public health of our next generation.


Asunto(s)
Fumar/epidemiología , Adolescente , Humanos , Fumar/psicología , Productos de Tabaco/efectos adversos , Productos de Tabaco/estadística & datos numéricos , Estados Unidos/epidemiología
18.
Artículo en Ruso | MEDLINE | ID: mdl-31465647

RESUMEN

The article presents an assessment of the economic damage associated with smoking for the period of 2009-2016. The obtained data on the prevalence of tobacco dependence for 2009-2016 showed, on the one hand, a decrease in tobacco dependence among the population surveyed, and on the other hand, an increase in the share of consumer spending on tobacco products and of an index of the physical volume of retail sales of tobacco products. The study included an analysis of the incidence of diseases associated with smoking, as well as an analysis of the attendance of medical care for patients with tobacco-related diseases.


Asunto(s)
Productos de Tabaco/economía , Fumar Tabaco/epidemiología , Comercio , Humanos , Prevalencia , Fumar , Productos de Tabaco/estadística & datos numéricos , Fumar Tabaco/economía
19.
Artículo en Inglés | MEDLINE | ID: mdl-31323981

RESUMEN

Cigarette affordability measures the price smokers pay for cigarettes in relation to their incomes. Affordability can be measured using the relative income price of cigarettes (RIP), or the price smokers pay to purchase 100 packs of 20 cigarettes divided by their per capita household income. Using longitudinal data from 7046 smokers participating in the International Tobacco Control (ITC) US Survey, the purpose of this study was to test whether affordability significantly changed following the US federal tax increase implemented on 1 April 2009. This study also estimated temporal trends in affordability from 2003-2015 at state and national levels using small area estimation methods and segmented linear mixed effects regression models. RIP increased slightly during 2003-2008. This was followed by a 30% increase during 2008-2010, indicating cigarettes were less affordable after the federal tax increase. RIP continued to increase during 2010-2013 but decreased during 2013-2015, suggesting cigarettes have recently become more affordable for US smokers. State-level trends in RIP were consistent with overall national trends. Controlling for other factors, a $1 increase in the state excise tax was significantly associated with a 9% increase in RIP, indicating state taxes reduced affordability. Tax-induced price increases must keep pace with underlying economic conditions to ensure cigarettes do not become more affordable over time.


Asunto(s)
Comercio/economía , Comportamiento del Consumidor/economía , Costos y Análisis de Costo/economía , Renta/estadística & datos numéricos , Fumadores/psicología , Impuestos/economía , Productos de Tabaco/economía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Comercio/estadística & datos numéricos , Comportamiento del Consumidor/estadística & datos numéricos , Costos y Análisis de Costo/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumadores/estadística & datos numéricos , Encuestas y Cuestionarios , Impuestos/estadística & datos numéricos , Tabaco , Productos de Tabaco/estadística & datos numéricos , Estados Unidos , Adulto Joven
20.
Asian Pac J Cancer Prev ; 20(7): 2027-2032, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-31350961

RESUMEN

Background: Known is the fact that adult tobacco users mostly had their initiation into the habit during the adolescence period. The current study was conducted to evaluate the impact of awareness programmes among adolescent students in rural Kerala, India, in terms of knowledge enhancement on tobacco hazards. Methods: A total of 10 high schools and higher secondary schools from one educational sub district were selected using multi stage sampling design. Male students in the age group 13-19 years studying in class IX and X (high school category) and class XI and XII (higher secondary school) were included in the study. The effectiveness was assessed using pre and post training evaluation forms based on mean knowledge scores. Results: 1,114 students participated by filling both the forms (mean age 15.6, SD 1.3). The response rate was 92.8%. The prevalence of 'current users' in the study was 4.3% (95% CI 3.11- 5.49). Overall difference in mean knowledge scores among study subjects was evident when pre and post training responses were compared (p<0.001). The difference in knowledge scores was evident among 'never users' of tobacco before and after the awareness programmes (p<0.0001). However, no significant difference in mean scores was observed among 'ever users' of tobacco (p = 0.584), age groups of ever users (p=0.208), students of high schools (p = 0.242) and higher secondary schools (p= 0.994). Comparison of never, ever and current users revealed significant difference between 'never' and 'current' users (p = 0.001). However, no such difference was observed between 'ever' and 'current' users (p =0.138) and 'ever' versus 'never' users (p =0.099). Conclusion: The study was useful to improve knowledge among school students in general. However, newer strategies have to be tested to understand the best possible measures for tobacco awareness training among adolescent tobacco users.


Asunto(s)
Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Productos de Tabaco/estadística & datos numéricos , Fumar Tabaco/prevención & control , Adolescente , Adulto , Estudios Transversales , Estudios de Seguimiento , Humanos , India/epidemiología , Masculino , Prevalencia , Población Rural , Estudiantes/psicología , Encuestas y Cuestionarios , Fumar Tabaco/epidemiología , Adulto Joven
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