Current Use of Cigarettes in the United States: The Joint Role of Race/Ethnicity and Health Insurance Coverage.

The goal of this study was to assess the joint role of race/ethnicity and a health insurance coverage type (private, Medicare, Medicaid) in current cigarette use among adults in the U.S. Data from the 2019 Tobacco Use Supplement and the 2019 Annual Social and Economic Supplement of the Current Population Survey were merged (n = 39,882). Bivariate associations between each coverage type and smoking prevalence were examined within each of six racial/ethnic groups. A multiple logistic regression model (for the odds of current cigarette use) was estimated to explore the interactions between race/ethnicity and an indicator of each type of coverage among Hispanic, non-Hispanic (NH) Black/African American, and NH White adults. All analyses included survey weights. Results of bivariate analyses indicated that private and Medicare coverage were associated with significantly lower smoking prevalence (compared to no such coverage), while Medicaid coverage was associated with significantly higher smoking prevalence (all p ≤ 0.05). Some of these associations were significant among NH Black/African American and NH White adults (all p ≤ 0.05). The model indicated that the interaction between race/ethnicity and the indicator of private coverage was significant (p = 0.044): private coverage was significantly associated with lower prevalence among NH White adults only (AOR = 0.59, 98.3%, CI = 0.46:0.76). In addition, Medicaid coverage was significantly associated with higher smoking prevalence (overall). The study points to possible racial/ethnic disparities in the quality of smoking-related health care that people with the same type of coverage receive and possible underutilization of health care services even among adults with health insurance coverage, especially among communities of color and Medicaid enrollees.

Negative impact of chronic pandemic-specific financial stress on food security among college students.

Since the pandemic started, food insecurity has become a more serious issue for U.S. college students. The study goals were to evaluate whether pandemic-specific stress contributes to current food insecurity (as of February-March of 2022) and to determine which student characteristics are associated with food insecurity. We used the 2022 Spring American College Health Association-National College Health Assessment data (n = 620) collected at a public university. We estimated two multiple logistic regression models. The odds of having very low food security (OR = 8.65, 95% CI = 4.84:15.43) and low food security (OR = 2.87, 95% CI = 1.66:4.96) were significantly higher among students whose financial situation had become a lot more stressful as a result of the pandemic (relative to the other students). Sexual and gender minority, relationship, and current tobacco use statuses were associated with very low food security. There is a need for continued efforts to decrease the negative impact of the pandemic on students' food security.

Financial stress caused by the pandemic was significantly associated with food insecurityVery low food security (VLFS) was more common among sexual and gender minority (SGM) relative to non-SGM studentsVLFS was more common among current users of tobacco relative to non-usersAbout 50% of students could not afford balanced meals occasionally or often in the last 30 days (L30D)Almost a quarter of students ever were hungry but didn't eat in the L30D because there wasn't enough money.

Correlates of COVID-19 vaccine uptake among U.S. College students.

Hesitance toward COVID-19 vaccination has greatly decreased over the course of the pandemic in the U.S. However, some populations have lower vaccination rates than the general population. This study was conducted to identify correlates of being fully vaccinated (i.e., having received all doses required to be fully vaccinated) among college students using students' responses to the 2022 Spring American College Health Association-National College Health Assessment. The surveys were administered in March of 2022. The sample (n = 617) included 18-to-30-year-old students. Firth logistic regression models were performed that controlled for age, sex assigned at birth, and food security (at a 5% significance level). The model-assisted results indicated that being a member of sexual and gender minority communities, being a graduate student, and being concerned about someone close getting COVID-19 were positively associated with being fully vaccinated, while current use of any tobacco product and current use of e-cigarettes were negatively associated with being fully vaccinated (all p-values < 0.05). In addition, the percentage of fully vaccinated students was higher among transgender/gender non-binary students (95%) than among cisgender men and women (85-87%), and among sexual minority groups (93-97%) than among heterosexual/straight students (82%). Among the racial/ethnic groups considered, the percentage of fully vaccinated students was lowest among non-Hispanic Black/African American students (77%), but the racial/ethnic differences were not statistically significant (at 5% level). The study points to a critical need for development and implementation of tailored vaccination campaigns to help students from diverse communities, including tobacco users, make informed decisions and become fully vaccinated.

Effects of hypobaric hypoxia during a simulated ultra-long-haul flight on inflammation and regeneration after muscle trauma and muscle trauma-hemorrhagic shock.

INTRODUCTION/AIMS: Because wounded warfighters or trauma victims may receive en route care to the closest medical facility via airplane transport, we investigated the effects of extended mild hypobaric hypoxia (HB), the environmental milieu of most airplanes, on inflammation and regeneration after muscle trauma or monotrauma (MT) and muscle trauma-hemorrhagic shock or polytrauma (PT). METHODS: Male C57BL/6N mice were assigned to one of six groups pertaining to injury (control/uninjured, MT, and PT) and atmospheric pressure exposure (HB and normobaric normoxia, NB). Body mass, blood and muscle leukocyte number by flow cytometry, immunohistochemistry, or both, and the muscle relative mRNA level of selected genes involved in inflammation and muscle regeneration were examined at ~1.7, 4, 8, and 14 days post trauma (dpt). At 14 dpt, the proportion of smaller- and larger-sized myofibers at the regenerating site of MT mice was determined. RESULTS: Greater body mass loss, an increased number of blood and muscle leukocytes, and differential muscle relative mRNA levels were observed in MT and PT groups compared to controls. The MT+HB or PT+HB mice demonstrated more body mass loss and altered relative mRNA level than the corresponding NB mice. Additionally, a subgroup of MT+HB mice demonstrated a greater proportion of smaller myofibers (250 to 500 µm2 ) than MT+NB mice at 14 dpt. DISCUSSION: HB exposure after muscle trauma alone may prolong regeneration. Following HB exposure, therapies that promote oxygenation may be needed during this muscle recovery.

Mild hypobaric hypoxia influences splenic proliferation during the later phase of stress erythropoiesis.

Tissue trauma and hemorrhagic shock are common battlefield injuries that can induce hypoxia, inflammation, and/or anemia. Inflammation and hypoxia can initiate adaptive mechanisms, such as stress erythropoiesis in the spleen, to produce red blood cells and restore the oxygen supply. In a military context, mild hypobaric hypoxia-part of the environmental milieu during aeromedical evacuation or en route care-may influence adaptive mechanisms, such as stress erythropoiesis, and host defense. In the present study, healthy (control), muscle trauma, and polytrauma (muscle trauma and hemorrhagic shock) mice were exposed to normobaric normoxia or hypobaric hypoxia for ∼17.5 h to test the hypothesis that hypobaric hypoxia exposure influences splenic erythropoiesis and splenic inflammation after polytrauma. This hypothesis was partially supported. The polytrauma + hypobaric hypoxia group exhibited more splenic neutrophils, fewer total spleen cells, and fewer splenic proliferating cells than the polytrauma+normobaric normoxia group; however, no splenic erythroid cell differences were detected between the two polytrauma groups. We also compared splenic erythropoiesis and myeloid cell numbers among control, muscle trauma, and polytrauma groups. More reticulocytes at 1.7 days (40 h) post-trauma (dpt) and neutrophils at 4 dpt were produced in the muscle trauma mice than corresponding control mice. In contrast to muscle trauma, polytrauma led to a reduced red blood cell count and elevated serum erythropoietin levels at 1.7 dpt. There were more erythroid subsets and apoptotic reticulocytes in the polytrauma mice than muscle trauma mice at 4 and 8 dpt. At 14 dpt, the red blood cell count of the polytrauma + normobaric normoxia mice was 12% lower than that of the control + normobaric normoxia mice; however, no difference was observed between polytrauma + hypobaric hypoxia and control + hypobaric hypoxia mice. Our findings suggest muscle trauma alone induces stress erythropoiesis; in a polytrauma model, hypobaric hypoxia exposure may result in the dysregulation of splenic cells, requiring a treatment plan to ensure adequate immune functioning.

LncRNA PAINT is associated with aggressive prostate cancer and dysregulation of cancer hallmark genes.

Long noncoding RNAs (lncRNAs) play regulatory role in cellular processes and their aberrant expression may drive cancer progression. Here we report the function of a lncRNA PAINT (prostate cancer associated intergenic noncoding transcript) in promoting prostate cancer (PCa) progression. Upregulation of PAINT was noted in advanced stage and metastatic PCa. Inhibition of PAINT decreased cell proliferation, S-phase progression, increased expression of apoptotic markers, and improved sensitivity to docetaxel and Aurora kinase inhibitor VX-680. Inhibition of PAINT decreased cell migration and reduced expression of Slug and Vimentin. Ectopic expression of PAINT suppressed E-cadherin, increased S-phase progression and cell migration. PAINT expression in PCa cells induced larger colony formation, increased tumor growth and higher expression of mesenchymal markers. Transcriptome analysis followed by qRT-PCR validation showed differentially expressed genes involved in epithelial mesenchymal transition (EMT), apoptosis and drug resistance in PAINT-expressing cells. Our study establishes an oncogenic function of PAINT in PCa.

Design-based single-mediator approach for complex survey data.

We discuss a two-step approach to test for a mediated effect using data gathered via complex sampling. The approach incorporates design-based multiple linear regressions and a generalized Sobel's method to test for significance of a mediated effect. We illustrate the applications to a study of nicotine dependence, race/ethnicity and cigarette purchase price among daily smokers in the U.S. The study goal was to assess significance of cigarette purchase price as a mediator in the association between race/ethnicity (non-Hispanic Black/African American, non-Hispanic White) and nicotine dependence measured in terms of the average number of cigarettes smoked per day. The single-mediator model incorporated 18 covariates as control factors. The results indicated a significant mediated effect of cigarette purchase price on the association. However, the relative effect size of 5% indicated low practical significance of the cigarette purchase price as a mediator in the association between race/ethnicity and nicotine dependence. The approach can be modified to studies where data are gathered via other types of complex sampling.

Smokers' reports on receiving a doctor's advice to quit smoking; receiving the advice is more prevalent among smokers with Crohn's Disease relative to smokers with Ulcerative Colitis.

Receiving a doctor's advice to quit smoking is an important predictor for improving smokers' intentions to quit smoking and successful smoking cessation. We examined reports of smokers with Crohn's Disease (CD) and Ulcerative Colitis (UC) regarding receiving a doctor's advice to quit smoking in the past 12 months, and evaluated the differences in the rates of receiving the advice between the CD and UC patients. The data were retrospectively reported by CD and UC patients (n = 453) who self-identified as current smokers in online assessments conducted by IBD Partners in the period from 2011 to 2014 in the USA. Statistical methods included chi-square tests and a multiple logistic regression model for the logit of the probability of receiving the advice as a function of patient's characteristics and assessment year. Overall, about 77% of smokers reported receiving a doctor's advice to quit smoking. The percentage was significantly (p < 0.001) higher among smokers with CD (80%) than it was among smokers with UC (63%). While the specific differences by CD/UC depended on smoking initiation age, the overall effect of disease type on the odds of receiving the advice remained significant: the odds of receiving the advice were higher for smokers with CD relative to smokers with UC (OR = 3.6, p < 0.001). Although the majority of CD and UC patients report receiving a doctor's advice to quit smoking, the encountered difference associated with the disease type is concerning. Because long-term smoking increases cancer and mortality risks, doctors should address smoking cessation with all patients who smoke.

Mild Hypobaric Hypoxia Effects on Murine Skeletal Muscle Morphology and Macrophages and Well-Being.

BACKGROUND: In the last 10 yr, the number of ultra-haul flights-defined as flights greater than 12 h of flying time-has increased. While the medical complications of these flights are well-known, the underlying cellular effects are less clear. The primary objective of this study was to test the effects of extended mild hypobaric hypoxia on overall well-being and skeletal muscle morphology and macrophage populations.METHODS: A total of 22 male C57BL/6 mice were assigned to a normobaric (NB) or hypobaric (HB) chamber for 14-17 h. Overall mouse well-being and the general morphology and resident macrophage number in hindlimb muscles were compared between the two pressure conditions.RESULTS: During mild hypobaric hypoxia, the mice behaved normally and no changes were observed in general muscle morphology. Regarding resident macrophages, the mean antigen area of CD206 in the hindlimb muscles, lateral gastrocnemius (LG, 33.8 ± 2.0 vs. 35.3 ± 1.6), medial gastrocnemius (MG, 32.4 ± 1.6 vs. 32.6 ± 1.5), and quadriceps femoris (QF, 36.3 ± 1.2 vs. 34.3 ± 1.1) were similar between NB and HB conditions, and the number of CD68-positive cells in the LG and QF were similar between the two conditions. Significantly fewer CD206-positive cells were counted in the LG muscle under the HB condition.CONCLUSION: Our findings indicate that extended exposure to mild hypobaric hypoxia, similar to that of an ultra-long-haul flight, does not adversely affect healthy skeletal muscle.Zhang L, Soulakova J, St. Pierre Schneider B. Mild hypobaric hypoxia effects on murine skeletal muscle morphology and macrophages and well-being. Aerosp Med Hum Perform. 2019; 90(12):1050-1054.

Widespread use of flavored e-cigarettes and hookah tobacco in the United States.

In 2009, the U.S. Food and Drug Administration banned the sale of flavored cigarettes (excluding menthol) in the U.S. However, the sale of flavored e-cigarettes (FE) and flavored hookah tobacco (FHT) is still legal. In this study (conducted in the US in the period from October 2018 to February 2019), we estimated the prevalence of use of FE and FHT across users' sociodemographic characteristics (e.g., age, sex, race/ethnicity) and identified the key characteristics of tobacco users associated with use of FE and FHT. We analyzed the 2014-2015 Tobacco Use Supplement to the Current Population Survey data for current e-cigarette (n = 3691) and hookah tobacco (n = 658) users. Among e-cigarette users, 65.5% used FE; and among hookah tobacco users, 87.3% used FHT. Among e-cigarette users, the prevalence of use of FE was significantly higher for 18-24 year-old than 45+ year-old adults; women than men; Southern than Northeastern residents; and never smokers of regular cigarettes than current smokers of regular cigarettes (all adjusted p's < 0.05). Among hookah tobacco users, the rates of FHT use were significantly higher for women than men, and never smokers of regular cigarettes than current smokers (all adjusted p's < 0.05). Because availability and accessibility of flavored tobacco products may promote tobacco use, revising regulatory guidelines concerning manufacturing and distribution of FE and FHT may help reduce the popularity of emerging tobacco products. IMPLICATIONS: Among users of emerging tobacco products such as e-cigarettes and hookah tobacco, use of flavored products is very common. Among e-cigarette users, 66% consumed flavored e-cigarettes; and among users of hookah tobacco, 87% consumed flavored hookah tobacco. Use of flavored products was especially common among users who were young adults, women, or never and former smokers of regular cigarettes. Availability of emerging tobacco products in many different flavors could be a reason for tobacco use initiation and continued use of tobacco after cessation of regular-cigarette smoking.

Preclinical assessment of MEK1/2 inhibitors for neurofibromatosis type 2-associated schwannomas reveals differences in efficacy and drug resistance development.

BACKGROUND: Neurofibromatosis type 2 (NF2) is a genetic tumor-predisposition disorder caused by NF2/merlin tumor suppressor gene inactivation. The hallmark of NF2 is formation of bilateral vestibular schwannomas (VS). Because merlin modulates activity of the Ras/Raf/mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) pathway, we investigated repurposing drugs targeting MEK1 and/or MEK2 as a treatment for NF2-associated schwannomas. METHODS: Mouse and human merlin-deficient Schwann cell lines (MD-MSC/HSC) were screened against 6 MEK1/2 inhibitors. Efficacious drugs were tested in orthotopic allograft and NF2 transgenic mouse models. Pathway and proteome analyses were conducted. Drug efficacy was examined in primary human VS cells with NF2 mutations and correlated with DNA methylation patterns. RESULTS: Trametinib, PD0325901, and cobimetinib were most effective in reducing MD-MSC/HSC viability. Each decreased phosphorylated pERK1/2 and cyclin D1, increased p27, and induced caspase-3 cleavage in MD-MSCs. Proteomic analysis confirmed cell cycle arrest and activation of pro-apoptotic pathways in trametinib-treated MD-MSCs. The 3 inhibitors slowed allograft growth; however, decreased pERK1/2, cyclin D1, and Ki-67 levels were observed only in PD0325901 and cobimetinib-treated grafts. Tumor burden and average tumor size were reduced in trametinib-treated NF2 transgenic mice; however, tumors did not exhibit reduced pERK1/2 levels. Trametinib and PD0325901 modestly reduced viability of several primary human VS cell cultures with NF2 mutations. DNA methylation analysis of PD0325901-resistant versus -susceptible VS identified genes that could contribute to drug resistance. CONCLUSION: MEK inhibitors exhibited differences in antitumor efficacy resistance in schwannoma models with possible emergence of trametinib resistance. The results support further investigation of MEK inhibitors in combination with other targeted drugs for NF2 schwannomas.

Multimediation Method With Balanced Repeated Replications For Analysis Of Complex Surveys.

We propose a method suitable for analysis of cross-sectional studies with complex sampling and continuous variables. The method consists of R+4 steps, where R denotes the number of replications. In the first R+1 steps, the main and R replicate weights are used (one at a time) to estimate the product of coefficients for all mediation effects using a structural equation model. In step R+2, the standard errors of these estimates are computed via balanced repeated replications. In step R+3, the raw p-values corresponding to mediation effects are computed based on the generalized Sobel's tests. In the final step, R+4, the p-values are adjusted for multiplicity and statistical inferences regarding mediation effects are drawn. To illustrate the approach we examined significance of attitudes toward smoking bans as mediators in the association between smoking restrictions at work and nicotine dependence among male daily smokers.

Workplace smoking restrictions and support for smoking cessation in the USA: state, region, and overall trends from 2010-11 to 2014-15.

We discuss the most recent changes in smoking policies and support for smoking cessation offered to smokers at US workplaces. We used reports of employed adults (n = 112,008) regarding smoking restrictions and support for smoking cessation offered at their indoor workplaces from the 2010-11 and 2014-15 Tobacco Use Supplement-Current Population Survey. The percentage of adults who reported having workplace smoking restrictions was 94% in 2010-11 and 93% in 2014-15 (P = 0.001). There was a decrease in the Northeastern region (P < 0.001) and no significant changes in the other three US regions. The percentages decreased in Hawaii, New York, Oregon, Pennsylvania, and Tennessee and increased in Indiana, Nebraska, and Wyoming. The percentage of employees who reported having workplace support for smoking cessation increased from 24% to 29% (P < 0.001), which was uniform across all US regions but differed across the US states. The percentages decreased in Hawaii and increased in the majority of states. Analysis of smokers' reports (versus all reports) resulted in lower percentages of workplaces with smoking restrictions and support for smoking cessation. It is essential to further enhance support for smoking cessation offered to smokers at US workplaces.

Patterns and correlates of purchasing cigarettes on Indian reservations among daily smokers in the United States.

INTRODUCTION: We described the population of daily smokers purchasing cigarettes on Indian reservations (IRs), estimated the rates of cigarette purchasing on IRs for diverse populations of daily smokers in the U.S., and assessed the trends in the period from 2010-11 to 2014-15. METHODS: We used the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey data for adult daily smokers as well as additional information, e.g., state excise tax on tobacco (n = 33,871). RESULTS: Daily smokers who purchased cigarettes on IRs were primarily 45+ years old, non-Hispanic (NH) White, resided in a state with an IR, paid less than $4.50 per pack, and purchased cigarettes in the state of their residency. The majority of purchases on IRs were made in New York (28%), Oklahoma (14%), Washington (10%), Arizona (9%), and Florida (6%). The rate of purchasing cigarettes on IRs decreased from 4% in 2010-11 to 3% in 2014-15 (p = 0.012). The rates were higher for females than males (OR = 1.23, CI = 1.09:1.40) and heavy than non-heavy smokers (OR = 1.35, CI = 1.17:1.55). Higher state excise tax on tobacco, on average, was associated with purchasing cigarettes on IRs. CONCLUSIONS: The rate of purchasing cigarettes on IRs is relatively low and has decreased in recent years. However, the rates differ across sociodemographic factors of daily smokers, including the state of residency and purchase. Purchasing cigarettes on IRs at lower prices can affect smokers' intentions to quit and can reduce federal and state efforts toward a tobacco-free nation.

Retrospective reports of former smokers: Receiving doctor's advice to quit smoking and using behavioral interventions for smoking cessation in the United States.

The study investigated the over-time changes and racial/ethnic disparities in the quality of health care services for cigarette smoking cessation in the U.S. from 2007 to 2015. The primary measures included receiving a doctor's advice to quit smoking in the year before smoking cessation and using behavioral interventions for smoking cessation (telephone helplines and web-based interventions) while trying to quit smoking. The study was conducted from January to July 2018. We used merged data from the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey. The sample sizes were 7011 and 12,025, respectively, for the analyses corresponding to two primary measures. The rate of receiving a doctor's advice to quit increased significantly from 66% (SE = 2%) in 2007 to 73% (SE = 4%) in 2015. The rate of usage of telephone helplines or web-based interventions for smoking cessation increased only from 3% (SE = 1%) in 2007 to 5% (SE = 1%) in 2015. These positive trends remained even after adjusting for several important factors. For both measures, the rates were consistently lower among Hispanic smokers than Non-Hispanic Black/African American and White smokers. Despite the availability of states' behavioral interventions for cessation of tobacco use, utilization of these interventions remains very low, indicating that smokers may not be aware of these free resources, may have misconceptions about these interventions being evidence-based, or there are barriers for using these interventions.

Frontline Science: RIP2 promotes house dust mite-induced allergic airway inflammation.

House dust mites (HDMs) are one of the most significant environmental allergens in the establishment of the so-called "Atopic March." It is known that the immune response to HDM is Th2 dominant, but the innate mechanisms leading to HDM-induced type 2 responses are still not completely understood. A number of innate immune receptors have been implicated in the response to HDM including toll-like receptors, C-type lectin receptors, and protease activated receptors. NOD2 is a member of the NOD-like receptor family, which has been reported to be involved in the establishment of type 2 immunity and in blocking respiratory tolerance. NOD2 mediates its effects through its downstream effector kinase, receptor interacting protein (RIP2). It has not been shown if RIP2 is involved in the innate response to HDM and in the resulting generation of type 2 immunity. Furthermore, the role of RIP2 in modulating allergic airway inflammation has been controversial. In this study, we show that RIP2 is activated in airway epithelial cells in response to HDM and is important for the production of CCL2. Using a murine HDM asthma model, we demonstrate that lung pathology, local airway inflammation, inflammatory cytokines, HDM-specific IgG1 antibody production, and HDM-specific Th2 responses are all reduced in RIP2 knockout mice compared to WT animals. These data illustrate that RIP2 can be activated by a relevant allergic stimulus and that such activation can contribute to allergic airway inflammation. These findings also suggest that RIP2 inhibitors might have some efficacy in down-regulating the inflammatory response in type 2 dominated diseases.

Survey Mode and Rates of Smoke-free Homes and Support for Smoking Bans Among Single Parents in the United States in 2010-2011 and 2014-2015.

National surveys are commonly used to monitor the rates of smoke-free homes and public attitudes toward smoking bans. The study explored the difference in the estimates corresponding to two survey modes-personal interviews and phone interviews-among single-parent households. Data from the Tobacco Use Supplement to the Current Population Survey administered in 2010-11 and 2014-15 were used in a stratified fashion. The rate of smoke-free homes was lower for personal interviews (79% in 2010-11 and 82% in 2014-15) than for phone interviews (85% in 2010-11 and 90% in 2014-15). Even after controlling for several factors, personal interviews corresponded to lower odds of having a smoke-free home relative to phone interviews (OR=0.7, CI=0.6:0.9 in 2010-11; OR=0.5, CI = 0.4:0.6 in 2014-15). The survey mode should be included in the analyses when estimating the rates of smoke-free homes and other smoking-related attitudes, because different survey modes could be associated with different response bias.

Prevalence and factors associated with use of hookah tobacco among young adults in the U.S.

INTRODUCTION: Among young adults, use of hookah tobacco (HT) is an emerging health-risk behavior. The goals were to demonstrate that (1) the prevalence of ever-use and current use of HT increased among U.S. young adults (18-30 years old) in the period from 2010 to 2015 and (2) the patterns of HT use differed across diverse demographic subpopulations of young adults. METHODS: We merged and analyzed data from the 2010-2011 and 2014-2015 Tobacco Use Supplement to the Current Population Survey. The sample (n = 55,352) was representative of the young adult population in the U.S. Two binary measures were the ever and current use of HT. The significance level was 5%. RESULTS: The rate of current use of HT increased from 1% in 2010-11 to 2% in 2014-15 (CI = 0.6%:1.1%). The rate of ever-use increased from 7% to 12% (CI = 4.2%:5.6%). The over-time increase was not uniform: the increase was most rapid among 26-30 year-old adults, non-Hispanic Black and African American adults, and in Northeastern and Midwestern U.S. regions. HT ever-use, overall, was associated (all p's < 0.001) with many sociodemographic factors and current tobacco-use behaviors. The rate of HT ever-use was 16% for daily and 23% for occasional cigarette smokers, 23% for users of smokeless tobacco products, 37% for cigar smokers, and 55% for smokers of regular pipe (filled with tobacco). DISCUSSION/CONCLUSION: HT use is becoming increasingly more popular among young adults in the U.S. Methods should target not only cessation of cigarette smoking but use of all tobacco products.

Smoke-free homes among single-parent families: Differences associated with parental race/ethnicity and smoking behaviors.

We assessed differences in the rates of smoke-free homes among single-parent households with regard to parental race/ethnicity and smoking status. We identified two cohorts representative of the U.S. single-parent households with underage children (children under the age of 18) based on the Tobacco Use Supplement to the Current Population Survey: 2010-11 (n = 6474) and 2014-15 (n = 6114). The interviews were conducted by phone and in-person. Statistical analysis was performed in 2017. The overall rate of smoke-free homes was 82% in 2010-11 and 86% in 2014-15. The rate of a smoke-free home was highest for Non-Hispanic (NH) Asian (94%) and Hispanic (92%) parents and lowest for NH Multiracial (77% in 2010-11 and 82% in 2014-15) in both survey periods. However, 2014-15 model-based comparisons relative to NH Whites indicated only one significant difference: the rate was lower for NH Blacks (OR = 0.46, 99% CI = 0.32:0.66). The smoke-free homes were least prevalent among daily smokers, followed by occasional smokers, followed by former smokers, and most prevalent among never smokers in each survey period. The 2010-11 and 2014-15 rates were 45% and 54% for daily, 64% and 72% for occasional, 89% and 91% for former, and 93% and 94% for never smokers. The gap in the rates of smoke-free homes for diverse parental racial/ethnic groups observed in 2010-11 decreased by 2014-15. While smoke-free homes became more prevalent in 2014-15, the rates remain drastically different among families with different parental smoking behaviors. Exposure to secondhand smoke at home remains common among single-parent households where the parent smokes.

Level of Cigarette Consumption and Duration of Smoking Abstinence During Failed Quit Attempts Among Long-Term Daily Smokers: the Role of Race/Ethnicity and Cessation Aids.

The goal of this study was to determine whether race/ethnicity and use of smoking cessation aids are associated with the duration of the last serious quit attempt and reductions in cigarette consumption among long-term daily smokers who tried, and failed, to quit smoking during the preceding year. Data came from the 2010-2011 Tobacco Use Supplement survey conducted in the USA, and analyses included 6672 reports of long-term daily smokers (i.e., smokers who smoked daily for 1 year or longer) who made at least one serious quit attempt in the past 12 months. About 39% of these smokers used at least one smoking cessation aid during their last quit attempt. Use of aids was significantly lower for non-Hispanic Black (NHB, 29%) and Hispanic (HISP, 29%) smokers than for non-Hispanic White (NHW, 42%) smokers, possibly due to differences in socioeconomic status and access to healthcare for smoking cessation. The effect of using any aids on mean cigarette reduction and duration of the last long quit attempt (i.e., one that lasted a day or more) was similar across race/ethnicity. Using any aids did not substantially influence mean cigarette reduction but was positively associated with duration of the quit attempt: the duration was 6 days longer (CI = 3:10), on average, when aids were used than when smokers attempted to quit unassisted. Race/ethnicity was significantly associated with mean cigarette reduction (p = 0.023); non-Hispanic American Indian and Alaska Native smokers had the highest mean reduction (of 3 cigarettes, CI = 1:5) among the racial/ethnic groups considered. Use of aids may help increase duration of quit attempts and thus, may increase likelihood of quitting successfully in the near future.