Recall of Flavor at First E-cigarette Use and Its Association with E-cigarette Progression: The Mediating Effects of First Sensory Experience.

OBJECTIVE: To test whether the association between flavor at first vape and continued use is mediated through subjective experience at first vape. STUDY DESIGN: In a 2020 cross-sectional survey, 955 young adult ever-vapers recalled their first flavor vaped, subjective experiences at first use, current vaping behavior, nicotine dependence, and quit attempts. A latent class model grouped first-use subjective experiences into classes. Two-part negative binomial hurdle models for each vaping behavior evaluated whether the association of first flavor used with vaping outcomes was mediated by positive experience. RESULTS: Four latent classes (positive, positive and negative, negative, and minimal experience) were further reduced to "any positive experience" (only positive, positive and negative) vs "no positive experience" (negative or minimal). Class membership mediated the association of first flavor used (mint/menthol/ice [ie, "cooling"] or sweet vs other) with each vaping outcome. For example, cooling flavor (vs. other) was associated with positive class membership (OR = 3.5; 95% CI: 1.5, 8.1), which was then associated with any past 30-day vaping (OR = 3.9; 95% CI: 2.7, 5.8) and greater number of vaping days among current vapers (RR = 1.9; 95% CI: 1.3, 2.7) in the two-part hurdle model. Similar results were observed for nicotine dependence and quit attempts, and for sweet (vs other) flavor for any dependence or quit attempts, but not number of dependence symptoms or quit attempts. CONCLUSIONS: Use of a cooling or sweet flavor at first use was associated with having a positive first vaping sensory experience, and then greater likelihood as a young adult of reporting past 30-day vaping, more vaping days, and greater risk for nicotine dependence, suggesting a key mediating role of first use experience.

[Current and emerging issues in tobacco prevention and control]. / Estado actual y desafíos emergentes en la prevención y el control del tabaco.

OBJECTIVE: To review the implementation of the WHO Framework Convention onTobacco Control in theAmericas, describe two national case studies and analyze the evidence on electronic cigarettes from a public health perspective. MATERIALS AND METHODS: Revision of the tobacco control legislation and the scientific evidence regarding electronic cigarettes. RESULTS: Implementation of tobacco control policies is not homogeneous, with important advances in smoke-free environments, pictorial health warnings, and epidemiological surveillance, but challenges that remain for the implementation of a total ban of tobacco advertising, increases in tobacco taxes, and tobacco cessation programs. Tobacco industry interference is one of the main obstacles for advancing and novel products create uncertainty about their regulation. CONCLUSIONS: There is a need for political will for a comprehensive implementation of the Convention, with evidence-based decisions to confront challenges and to defend the achievements from tobacco industry interference.

OBJETIVO: Revisar la aplicación del Convenio Marco de la OMS para el Control del Tabaco en las Américas, describir dos estudios de caso nacionales y analizar la evidencia sobre los cigarrillos electrónicos desde la perspectiva de salud pública. MATERIAL Y MÉTODOS: Revisión de la legislación de control de tabaco y la evidencia científica sobre los cigarrillos electrónicos. RESULTADOS: La aplicación de políticas no es homogénea, con avances importantes en ambientes libres de humo, advertencias sanitarias gráficas y vigilancia epidemiológica, pero desafíos pendientes en la prohibición total de la publicidad, incremento de impuestos y cesación tabáquica.La interferencia de la industria tabacalera es uno de los principales obstáculos para avanzar y los nuevos productos crean incertidumbre sobre su regulación. CONCLUSIONES: Se necesita revitalizar la voluntad política para aplicar integralmente el Convenio, tomando decisiones basadas en evidencia ante los nuevos desafíos y defendiendo los logros de la interferencia de la industria.

Estado actual y desafíos emergentes en la prevención y el control del tabaco / Current and emerging issues in tobacco prevention and control

Resumen: Objetivos: Revisar la aplicación del Convenio Marco de la OMS para el Control del Tabaco en las Américas, describir dos estudios de caso nacionales y analizar la evidencia sobre los cigarrillos electrónicos desde la perspectiva de salud pública. Material y métodos: Revisión de la legislación de control de tabaco y la evidencia científica sobre los cigarrillos electrónicos. Resultados: La aplicación de políticas no es homogénea, con avances importantes en ambientes libres de humo, advertencias sanitarias gráficas y vigilancia epidemiológica, pero desafíos pendientes en la prohibición total de la publicidad, incremento de impuestos y cesación tabáquica. La interferencia de la industria tabacalera es uno de los principales obstáculos para avanzar y los nuevos productos crean incertidumbre sobre su regulación. Conclusiones: Se necesita revitalizar la voluntad política para aplicar integralmente el Convenio, tomando decisiones basadas en evidencia ante los nuevos desafíos y defendiendo los logros de la interferencia de la industria.

Abstract: Objectives: To review the implementation of the WHO Framework Convention on Tobacco Control in the Americas, describe two national case studies and analyze the evidence on electronic cigarettes from a public health perspective. Materials and methods: Revision of the tobacco control legislation and the scientific evidence regarding electronic cigarettes. Results: Implementation of tobacco control policies is not homogeneous, with important advances in smoke-free environments, pictorial health warnings, and epidemiological surveillance, but challenges that remain for the implementation of a total ban of tobacco advertising, increases in tobacco taxes, and tobacco cessation programs. Tobacco industry interference is one of the main obstacles for advancing and novel products create uncertainty about their regulation. Conclusion: There is a need for political will for a comprehensive implementation of the Convention, with evidence-based decisions to confront challenges and to defend the achievements from tobacco industry interference.