Waterpipe cafés are hazardous to your health: Determination of a waterpipe specific calibration factor.

INTRODUCTION: The use of a waterpipe to smoke tobacco has emerged as a popular trend in the United States. Waterpipe smoking establishments have had an increasing presence in the U.S., despite smoke-free air legislation. Dangers of waterpipe smoking have been documented, but less data has been gathered about the waterpipe café itself. This project sought to determine a waterpipe-specific calibration factor (CF) for measuring waterpipe aerosol, and field-test this CF by conducting surveillance on the existing waterpipe cafés of western and central New York. METHODS: Nine laboratory-controlled experiments were conducted to determine a waterpipe-specific CF. In the lab, two TSI SidePak AM510 Personal Aerosol Monitors and two sampling trains for gravimetric PM2.5 sampling were present during waterpipe smoking sessions (lasting 1-3h). Indoor air quality was assessed in 7 waterpipe cafés in three counties of New York, and real-time measurements of particulate matter (PM2.5) and carbon monoxide (CO) were obtained. RESULTS: Results from the 9 controlled waterpipe experiments determined a calibration factor of 0.38 (SD 0.08), which should be used to convert SidePak measurements to true PM2.5 measurements. When applying the CF to the measurements taken in the 7 public waterpipe venues, the mean PM2.5 concentration was 515µg/m3 micrograms per cubic meter (SD=338.8) while the mean ambient CO was 20.5ppm (SD=18.3). The mean active smoking density was 2.41 waterpipes per 100m3 of air. The PM2.5 levels increased with increasing active smoking density (rho=0.68, p=0.09). CONCLUSIONS: Applying the waterpipe-specific CF for the SidePak, 0.38, allowed for field assessments to be conducted in locations with waterpipe smoke to determine accurate particle exposure concentrations. The concentrations of both particulate matter and carbon monoxide were above established air quality standards and therefore increase the health risks of both patrons and workers of these establishments.

Using Experimental Auctions to Examine Demand for E-Cigarettes.

BACKGROUND: E-cigarettes are the latest in a line of potentially reduced exposure products that have garnered interest among smokers. METHODS: In this paper, we use experimental auctions to estimate smokers' demand for e-cigarettes and to assess the impact of advertisements on willingness to pay. These are actual auctions, with winners and losers, which means hypothetical biases often seen in surveys are minimized. RESULTS: We find smokers have positive demand for e-cigarettes, and that the print advertisements used in our study had greater effectiveness than video ads (b = 2.00, p < .05) in terms of increasing demand for disposable e-cigarettes. Demand was greater for reusable versus disposable e-cigarettes. In multivariate models, demand for e-cigarettes was higher among non-white participants and among smokers willing to pay more for cigarettes. CONCLUSIONS: Our findings suggest that cigarette smokers are interested in e-cigarettes as alternatives to traditional products, particularly for reusable forms, and that this demand can be influenced by messaging/advertising. IMPLICATIONS: Given these reduced harm products are appealing, if smokers are able to switch completely to e-cigarettes, there is a good chance for accrual of significant harm reduction.

Switching between menthol and nonmenthol cigarettes: findings from the U.S. Cohort of the International Tobacco Control Four Country Survey.

INTRODUCTION: This article examines trends in switching between menthol and nonmenthol cigarettes, smoker characteristics associated with switching, and associations among switching, indicators of nicotine dependence, and quitting activity. METHODS: Participants were 5,932 U.S. adult smokers who were interviewed annually as part of the International Tobacco Control Four Country Survey between 2002 and 2011. Generalized estimating equations (GEEs) were used to examine the prevalence of menthol cigarette use and switching between menthol and nonmenthol cigarettes (among 3,118 smokers who participated in at least 2 consecutive surveys). We also evaluated characteristics associated with menthol cigarette use and associations among switching, indicators of nicotine dependence, and quitting activity using GEEs. RESULTS: Across the entire study period, 27% of smokers smoked menthol cigarettes; prevalence was highest among Blacks (79%), young adults (36%), and females (30%). Prevalence of switching between menthol and nonmenthol cigarettes was low (3% switched to menthol and 8% switched to nonmenthol), and switchers tended to revert back to their previous type. Switching types was not associated with indicators of nicotine dependence or quit attempts. However, those who switched cigarette brands within cigarette types were more likely to attempt to quit smoking. CONCLUSIONS: While overall switching rates were low, the percentage who switched from menthol to nonmenthol was significantly higher than the percentage who switched from nonmenthol to menthol. An asymmetry was seen in patterns of switching such that reverting back to menthol was more common than reverting back to nonmenthol, particularly among Black smokers.

Patterns and correlates of polytobacco use in the United States over a decade: NSDUH 2002-2011.

BACKGROUND: Few studies have examined the patterns and correlates of polytobacco use among a large, nationally representative population over an extended period of time. METHODS: This study examined 10years of data from the National Survey on Drug Use and Health (NSDUH) to establish time trends and correlates for exclusive and mixed use of cigarettes, smokeless tobacco (SLT), cigars, and pipes. RESULTS: Results show that rates of polytobacco use were essentially unchanged from 2002 to 2011 (8.7% to 7.4%), though some product combinations, including cigarettes and SLT, cigars and SLT, and use of more than two products have increased. In tobacco users under age 26, the proportion of polytobacco use increased, even as overall tobacco use declined. The factors associated with polytobacco use among tobacco users included sex, income, education, risk taking/seeking behaviors, and outward indicators of 'risk-liability'. CONCLUSIONS: Findings provide a snapshot of trends of single and polytobacco product use as well as trends in combinations of product use. Longitudinal studies are needed to examine the sequence of individual patterns of tobacco product use and to identify whether polytobacco use results in greater nicotine dependence, increased exposure to harmful and potentially harmful constituents and/or greater risk of tobacco related disease.