Toward a Comprehensive Measure of Drug-Attributable Harm.

This Viewpoint from authors at the Harvard T.H. Chan School of Public Health summarizes approaches to addressing substance use in the US; challenges posed by metrics such as overdose deaths; and more informative metrics, such as quality-adjusted life-years, to promote health equity and improve length and quality of life and health outcomes at all levels.

The role of positive emotion in harmful health behavior: Implications for theory and public health campaigns.

Meta-analyses have concluded that positive emotions do not reduce appetitive risk behaviors (risky behaviors that fulfill appetitive or craving states, such as smoking and excessive alcohol use). We propose that this conclusion is premature. Drawing on the Appraisal Tendency Framework and related theories of emotion and decision-making, we hypothesized that gratitude (a positive emotion) can decrease cigarette smoking, a leading cause of premature death globally. A series of multimethod studies provided evidence supporting our hypothesis (collective N = 34,222). Using nationally representative US samples and an international sample drawn from 87 countries, Studies 1 and 2 revealed that gratitude was inversely associated with likelihood of smoking, even after accounting for numerous covariates. Other positive emotions (e.g., compassion) lacked such consistent associations, as expected. Study 3, and its replication, provided further support for emotion specificity: Experimental induction of gratitude, unlike compassion or sadness, reduced cigarette craving compared to a neutral state. Study 4, and its replication, showed that inducing gratitude causally increased smoking cessation behavior, as evidenced by enrollment in a web-based cessation intervention. Self-reported gratitude mediated the effects in both experimental studies. Finally, Study 5 found that current antismoking messaging campaigns by the US Centers for Disease Control and Prevention primarily evoked sadness and compassion, but seldom gratitude. Together, our studies advance understanding of positive emotion effects on appetitive risk behaviors; they also offer practical implications for the design of public health campaigns.

Assessment of Epidemiological Data and Surveillance in Korea Substance Use Research: Insights and Future Directions.

OBJECTIVES: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea. METHODS: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments. RESULTS: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets. CONCLUSIONS: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.

Tobacco control interventions for populations living in subsidised, low-income housing: a scoping review.

OBJECTIVES: People living in subsidised low-income housing are more likely to smoke and experience secondhand smoke exposure compared to the general population. While tobacco control interventions have yielded substantial population health benefits, people living in subsidised housing experience a greater burden of tobacco-related harms. We synthesised existing peer-reviewed and grey literature to determine tobacco control interventions that have been implemented in subsidised housing globally, and to understand their impact on smoking and secondhand smoke exposure. METHODS: We searched five databases for peer-reviewed research, and Google Advanced for grey literature. We adhered to the JBI Scoping Review Methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. RESULTS: Fifty-seven sources met the eligibility criteria. The most common type of intervention was mandatory smoking bans covering all indoor spaces (n = 32), followed by cessation-focused interventions (n = 19). Interventions that indirectly addressed smoking were the least common (n = 6). Our findings suggest smoking bans can increase smoking cessation and reduce secondhand smoke exposure, especially if implemented alongside cessation support strategies. CONCLUSION: Tobacco control interventions targeting subsidised housing demonstrate positive effects on tobacco-related outcomes for residents and provide an important opportunity to address health disparities. Future research should examine the long-term impacts of the interventions, including potential unintended consequences, in varied subsidised housing contexts.

Smokers Awareness and Risk Perceptions of Filter Ventilation.

Objectives: The addition of tiny rows of holes in the tipping paper (filter ventilation) of cigarettes allows air to mix with the smoke, which can change risk perceptions. In this study, we examine smokers' knowledge and beliefs about filter ventilation. Methods: Web-based panel surveys conducted in 2016 and 2017 of current adult cigarette smokers (N = 2355) provided data on awareness and understanding of filter vents in their cigarettes, whether they believed blocking the holes would change the taste of their cigarettes, and their perceptions about their future risk of being diagnosed with lung cancer. The most commonly used cigarette brands reported by participants also were characterized on the presence and level of ventilation holes. Results: Approximately 40% of participants (mostly younger and male) reported awareness of the filter ventilation in their cigarettes. Only 30% of the participants were both aware of and understood the function of filter ventilation; they also were significantly more likely to worry about developing lung cancer. Conclusion: Although misleading descriptors associated with filter ventilation are prohibited, most smokers still smoked cigarettes with filter vents, and many are unaware and misunderstand the potential risks of filter ventilation.

Factors Associated with Recent Use of Nicotine Replacement Therapy Among Multiethnic Smokers Residing in Public Housing.

Introduction: Understanding factors associated with increased use of nicotine replacement therapy (NRT) is critical to implementing cessation interventions for low-income individuals yet the factors associated with NRT use among low-income smokers are poorly understood. Aims: Assess factors associated with NRT use among low-income public housing residents. Methods: 'Kick it for Good' was a randomised smoking cessation intervention study conducted among residents of public housing sites in Boston, MA. Secondary, cross-sectional analyses were conducted on smokers from a community-based intervention cessation intervention who reported making a quit attempt and use of NRT in the past 12 months (n = 234). Results: Among smokers who made a quit attempt in the past year, 29% reported using NRT. Black (prevalence ratio,PR = 0.52, 95% CI: 0.38-0.71) and Hispanic (PR = 0.52, 95% CI: 0.31-0.88) participants were less likely to report use of NRT compared with Whites. The prevalence of recent NRT use was greatest among those both asking for and receiving provider advice (PR = 1.90, 95% CI: 0.96-3.78). Conclusions: Minority race and ethnicity and low provider engagement on NRT use were associated with lower NRT use. Providing barrier-free access to NRT and facilitating provider engagement with smokers regarding NRT use can increase NRT use among low-income populations.

Evaluation of modified risk claim advertising formats for Camel Snus.

Objectives: The US Food and Drug Administration (FDA) has regulatory authority for modified risk tobacco product advertising claims. To guide future regulatory efforts, we investigated how variations in modified risk claim advertisements influence consumer perceptions of product risk claims for Camel Snus. Methods: Young people and adults (15-65), including current, never, and former smokers, were randomised to view one of five Camel Snus print advertisements as part of a web-based survey. Four of the advertisements presented information related to nitrosamine content of snus using four formats: (1) text, (2) a bar chart, (3) a text/testimonial and (4) a bar chart/testimonial. The fifth format, used as a control, was a current advertisement for Camel Snus without the explicit claims made about nitrosamine content. After viewing advertisements for all products, participants were asked which product they would be most interested in trying. Results: Participants exposed to advertisements that contained an explicit reduced risk message agreed the advertising claim for that product posed fewer health risks than cigarettes. However, advertisements containing the reduced risk messages were also viewed as containing less truthful information and respondents were more sceptical of the information presented. Advertisement claim format was not associated with selecting snus over the other tobacco products, nor was it associated with purchase intentions. Conclusion: The results of this research indicate that consumers respond to reduced risk messages, though perhaps not in the direct way anticipated. We found no significant differences by advertisement format (numerical, graphical, testimonial).