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1.
AIDS Educ Prev ; 33(2): 158-168, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33821680

RESUMO

Cigarette smoking remains disproportionately prevalent and is increasingly a cause of death and disability among people with HIV (PWH). Many PWH are interested in quitting, but interest in and uptake of first-line smoking cessation pharmacotherapies are varied in this population. To provide current data regarding experiences with and perceptions of smoking cessation and cessation aids among PWH living in Durham, North Carolina, the authors conducted five focus group interviews (total n = 24; 96% African American) using semistructured interviews. Interviews were recorded, transcribed, coded, and thematically analyzed. Major themes included ambivalence and/or lack of interest in cessation; presence of cessation barriers; perceived perceptions of ineffectiveness of cessation aids; perceived medication side effects; and conflation of the harms resulting from use of tobacco products and nicotine replacement therapy. Innovative and effective interventions must account for the aforementioned multiple barriers to cessation as well as prior experiences with and misperceptions regarding cessation aids.


Assuntos
Infecções por HIV/complicações , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Dispositivos para o Abandono do Uso de Tabaco/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos , Idoso , Feminino , Grupos Focais , Comportamentos Relacionados com a Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , North Carolina , Pesquisa Qualitativa , Abandono do Hábito de Fumar/métodos
2.
JMIR Mhealth Uhealth ; 9(4): e23989, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33792551

RESUMO

BACKGROUND: Smoking rates are significantly higher among young people experiencing homelessness than in the general population. Despite a willingness to quit, homeless youth have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. Homeless youth generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. OBJECTIVE: This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI) as an adjunct to group-based cessation counseling and provision of nicotine patches to help homeless youth quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. METHODS: Homeless youth smokers aged 18 to 25 years who were interested in quitting (n=77) were recruited from drop-in centers serving homeless youth in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches, with 52% (40/77) randomly assigned to receive 6 weeks of text messages to provide additional support for their quit attempt. Participants received text messages on their own phone rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow-up survey data as well as back-end data from the messaging platform to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. RESULTS: Participants had widespread (smart)phone ownership-16.4% (36/219) were ineligible for study participation because they did not have a phone that could receive text messages. Participants experienced interruptions in their phone use (eg, 44% [16/36] changed phone numbers during the follow-up period) but reported being able to receive the majority of messages. These survey results were corroborated by back-end data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Qualitative feedback indicated that participants enjoyed the group counseling session that preceded the TMI and suggested including more such group elements into the intervention. CONCLUSIONS: The TMI was well accepted and feasible to support smoking cessation among homeless youth. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support homeless youth, a population urgently in need of effective smoking cessation interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT03874585; https://clinicaltrials.gov/ct2/show/NCT03874585. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13722-020-00187-6.


Assuntos
Pessoas em Situação de Rua/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/efeitos adversos , Envio de Mensagens de Texto , Adolescente , Adulto , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Avaliação de Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Fumar/epidemiologia , Apoio Social , Adulto Jovem
3.
Health Psychol ; 40(3): 207-216, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33630642

RESUMO

OBJECTIVE: Research has shown a beneficial influence of partner support on smoking cessation. Previous studies mainly focused on support and neglected negative behaviors. Less is known about differences in support perceptions between partners. This study aimed to examine how supportive as well as negative control behaviors relate to smoking and relationship satisfaction in single-smoking couples during a quit attempt. METHOD: Smokers and their nonsmoking partners (n = 170 cohabiting couples) participated in an intensive longitudinal study over 21 days with end-of-day diaries. A dyadic score model was used, emphasizing couple levels and differences for the explanatory variables (i.e., support and negative control) and the outcome variables (smoking [for smokers only]; relationship satisfaction). RESULTS: Smokers whose partner showed more supportive and less negative control behavior had a lower probability of smoking, and both partners had higher relationship satisfaction. On days with more supportive and less negative control behavior than usual, smokers had a lower probability of smoking and both partners had higher relationship satisfaction. For smokers who reported more support than their partner reported providing, the couples' relationship satisfaction was higher and the smokers' relationship satisfaction was higher than their partners'. Differences between received and provided support/control at the between-couple and daily level were unrelated to smoking. CONCLUSIONS: Support seems important during a quit attempt as it was related to a lower probability of smoking and higher relationship satisfaction in couples, while negative control behaviors should be avoided as they were associated with higher probability of smoking and lower relationship satisfaction. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/psicologia , Cônjuges/psicologia , Adolescente , Adulto , Idoso , Características da Família , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Método Simples-Cego , Apoio Social , Fumar Tabaco , Adulto Jovem
4.
Drug Alcohol Depend ; 221: 108590, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33631546

RESUMO

AIMS: To explore i) associations between vaping and self-reported diagnosed/suspected Covid-19; ii) changes in vaping since Covid-19 and factors associated with these changes; iii) whether Covid-19 motivated current or recent ex-vapers to quit. METHODS: Cross-sectional online survey of 2791 UK adults recruited 30/04/2020-14/06/2020. Participants self-reported data on sociodemographic characteristics, diagnosed/suspected Covid-19, vaping status, changes in vaping and motivation to quit vaping since Covid-19. RESULTS: There were no differences in diagnosed/suspected Covid-19 between never, current and ex-vapers. Bayes factors indicated there was sufficient evidence to rule out small negative (protective) associations between vaping status and diagnosed/suspected Covid-19. Among current vapers (n = 397), 9.7 % (95 % CI 6.8-12.6 %) self-reported vaping less than usual since Covid-19, 42.0 % (37.2-46.9 %) self-reported vaping more, and 48.3 % (43.4-53.2 %) self-reported no change. In adjusted analyses, vaping less was associated with being female (aOR = 3.40, 95 % CI 1.73-6.71), not living with children (aOR = 4.93, 1.15-21.08) and concurrent smoking (aOR = 8.77, 3.04-25.64), while vaping more was associated with being younger (aOR = 5.26, 1.37-20.0), living alone (aOR = 2.08, 1.14-3.85), and diagnosed/suspected Covid-19 (aOR = 4.72, 2.60-8.62). Of current vapers, 32.2 % (95 % CI 27.5-36.8 %) were motivated to quit vaping since Covid-19, partly motivated by Covid-19, and 21.0 %, (10.5-31.4 %) of recent ex-vapers quit vaping due to Covid-19. CONCLUSIONS: Among UK adults, self-reported diagnosed/suspected Covid-19 was not associated with vaping status. Half of current vapers changed their vaping consumption since Covid-19, with the majority reporting an increase, and a minority was motivated to quit due to Covid-19. REGISTRATION: The analysis plan was pre-registered, and it is available at https://osf.io/6j8z3/.


Assuntos
/psicologia , Motivação , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Vaping/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Fumantes/estatística & dados numéricos , Reino Unido/epidemiologia , Vaping/epidemiologia , Adulto Jovem
5.
Aust N Z J Public Health ; 45(1): 34-38, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33522685

RESUMO

OBJECTIVE: To examine the supply of smoking cessation medicines to Aboriginal and Torres Strait Islander smokers compared to non-Indigenous smokers across Australia. METHODS: We analysed the total number of smoking cessation prescriptions dispensed over three years through the Pharmaceutical Benefits Scheme (PBS) compared to those supplied nationally through the Closing the Gap (CTG) measure and also in the Northern Territory through the Remote Area Aboriginal Health Service (RAAHS) program. RESULTS: Aboriginal and Torres Strait Islander smokers were supplied with fewer smoking cessation medicines per smoker under the CTG measure compared to non-Indigenous smokers under general PBS benefits. Supply of medicines though the RAAHS program complicated the use of CTG data where higher proportions of Aboriginal and Torres Strait Islander people live in remote areas and use of the CTG measure is lower. CONCLUSIONS: Fewer smoking cessation medicines are being prescribed and then dispensed to Aboriginal and Torres Strait Islander smokers than to non-Indigenous smokers. Implications for public health: CTG and RAAHS data may be useful to monitor and evaluate the effectiveness of interventions to improve the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers. However, there are limitations and current obstacles to accessing RAAHS data would need to be removed.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde do Indígena/organização & administração , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/efeitos adversos , Adulto , Idoso , Austrália/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Northern Territory/epidemiologia , Grupo com Ancestrais Oceânicos , Estudos Prospectivos , Fumantes/psicologia , Fumar/epidemiologia , Fumar/etnologia , Abandono do Hábito de Fumar/etnologia
6.
JAMA Netw Open ; 4(1): e2032757, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33433597

RESUMO

Importance: Alkaline free-base nicotine is bitter and a respiratory irritant. High-nicotine electronic cigarette (e-cigarette) products contain acid additives that change nicotine from a free-base to a protonated salt chemical form, which could improve the sensory experience of vaping, particularly among never smokers unaccustomed to inhaling free-base nicotine. Objective: To determine whether exposure to e-cigarettes with salt vs free-base nicotine formulations improves the appeal and sensory experience of vaping e-cigarettes and whether nicotine formulation effects differ by e-cigarette flavor and ever combustible cigarette smoking status. Design, Setting, and Participants: Single-visit double-blind within-participant randomized clinical trial was conducted in an academic medical center outpatient clinical research facility in Southern California. Participants were 119 individuals with past 30-day e-cigarette or combustible cigarette use aged 21 years or older recruited from November 2019 to March 2020. Interventions: Participants self-administered standardized puffs of each 10 differently flavored e-cigarette solutions using a pod-style device. Each flavor was administered in salt (benzoic acid added) and free-base (no benzoic acid) nicotine formulations with commensurate nicotine concentrations (mean, 23.6 mg/mL). The 20 solutions were administered in randomly assigned sequences. Immediately after puffing each solution, participants rated appeal and sensory attributes. Main Outcomes and Measures: Self-reported appeal (mean of like, dislike [reverse-scored], and willingness to use again ratings) and 4 sensory attributes (sweetness, smoothness, bitterness, and harshness; analyzed individually) on visual analog scales with not at all and extremely anchors (range, 0-100). Results: Of the 119 participants; 39 (32.8%) were female. The mean (SD) age was 42.1 (14.4) years; 105 (88.2%) were ever combustible cigarette smokers, and 66 (55.5%) were current e-cigarette users. Salt vs free-base nicotine formulations produced higher ratings of appeal (salt vs free-base mean difference effect estimate: b = 12.0; 95% CI, 9.9-14.1; P < .001), sweetness (b = 9.3; 95% CI, 7.1-11.4; P < .001), and smoothness (b = 17.4; 95% CI, 15.2-19.6; P < .001) and lower ratings of bitterness (b = -13.3; 95% CI, -15.4 to -11.2; P < .001) and harshness (b = -21.0; 95% CI, -23.2 to -18.7; P < .001). Nicotine formulation effects largely generalized across different flavors and the smoothness-enhancing and harshness-reducing effects of nicotine salt were stronger in never vs ever cigarette smokers. Conclusions and Relevance: In this randomized clinical trial of adult current nicotine or tobacco product users, controlled exposure to e-cigarette puffs with salt vs free-base nicotine formulations appeared to increase product appeal and improve the sensory experience of vaping, particularly among never smokers. Regulatory policies limiting acid additives in e-cigarettes might reduce the appeal of high-nicotine e-cigarettes among populations deterred from vaping e-cigarettes that emit harsh aerosol. Trial Registration: ClinicalTrials.gov Identifier: NCT04399031.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Nicotina/administração & dosagem , Nicotina/química , Fumantes/psicologia , Vaping , Adulto , Idoso , California , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensação
7.
JMIR Public Health Surveill ; 7(1): e24859, 2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33347422

RESUMO

BACKGROUND: Previous studies have shown that electronic cigarette (e-cigarette) users might be more vulnerable to COVID-19 infection and could develop more severe symptoms if they contract the disease owing to their impaired immune responses to viral infections. Social media platforms such as Twitter have been widely used by individuals worldwide to express their responses to the current COVID-19 pandemic. OBJECTIVE: In this study, we aimed to examine the longitudinal changes in the attitudes of Twitter users who used e-cigarettes toward the COVID-19 pandemic, as well as compare differences in attitudes between e-cigarette users and nonusers based on Twitter data. METHODS: The study dataset containing COVID-19-related Twitter posts (tweets) posted between March 5 and April 3, 2020, was collected using a Twitter streaming application programming interface with COVID-19-related keywords. Twitter users were classified into two groups: Ecig group, including users who did not have commercial accounts but posted e-cigarette-related tweets between May 2019 and August 2019, and non-Ecig group, including users who did not post any e-cigarette-related tweets. Sentiment analysis was performed to compare sentiment scores towards the COVID-19 pandemic between both groups and determine whether the sentiment expressed was positive, negative, or neutral. Topic modeling was performed to compare the main topics discussed between the groups. RESULTS: The US COVID-19 dataset consisted of 4,500,248 COVID-19-related tweets collected from 187,399 unique Twitter users in the Ecig group and 11,479,773 COVID-19-related tweets collected from 2,511,659 unique Twitter users in the non-Ecig group. Sentiment analysis showed that Ecig group users had more negative sentiment scores than non-Ecig group users. Results from topic modeling indicated that Ecig group users had more concerns about deaths due to COVID-19, whereas non-Ecig group users cared more about the government's responses to the COVID-19 pandemic. CONCLUSIONS: Our findings show that Twitter users who tweeted about e-cigarettes had more concerns about the COVID-19 pandemic. These findings can inform public health practitioners to use social media platforms such as Twitter for timely monitoring of public responses to the COVID-19 pandemic and educating and encouraging current e-cigarette users to quit vaping to minimize the risks associated with COVID-19.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/normas , Pandemias , Percepção , Fumantes/psicologia , Mídias Sociais/instrumentação , /complicações , /transmissão , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Humanos , Mídias Sociais/tendências
8.
Nicotine Tob Res ; 22(Suppl 1): S45-S53, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320252

RESUMO

INTRODUCTION: Electronic cigarettes (ECIGs) expose users to an aerosol containing chemicals, which could affect the respiratory system negatively. This study examined negative respiratory symptoms associated with ECIG use. METHODS: In 2019, adult current ECIG users from 24 US states who reported experiencing negative respiratory symptoms from ECIG use (n = 49; 44.9% women; mean age = 35.2, SD = 11.5) completed an online survey and brainstormed statements that completed the prompt: "A specific negative effect or symptom related to my breathing, nose, mouth, throat, or lungs that I have experienced from vaping/using my e-cigarette is..." Participants sorted the final list of 56 statements into groups of similar content and rated statements on how true they were for them. Multidimensional scaling analysis identified thematic clusters. RESULTS: Eight ECIG use respiratory symptom clusters identified in analysis included Mucus and Congestion, Fatigue, Throat Symptoms, Breathing Problems, Mouth Symptoms, Chest Symptoms, Illness Symptoms, and Nose and Sinus Symptoms. Highly rated (ie, most common) symptoms included dry throat or mouth, fatigue during physical activity, coughing, shortness of breath, excessive phlegm, and bad taste in mouth. Mean cluster ratings did not differ based on lifetime cigarette smoking status (100 lifetime cigarettes smoked), but current cigarette smokers (ie, dual users) rated the Fatigue, Breathing Problems, Mucus and Congestion, and Nose and Sinus Symptoms clusters higher than noncurrent cigarette smokers. CONCLUSIONS: Participant-identified respiratory symptoms perceived to be ECIG related, many similar to cigarette smoking symptoms. Future research should assess if these symptoms are associated with other negative health outcomes. IMPLICATIONS: ECIG use exposes users to chemicals that may have negative health impacts on the respiratory system. Limited research has examined the broad range of negative respiratory symptoms associated with e-cigarette use. This study identified that ECIG-cigarette users perceive their ECIG use to be associated with negative respiratory symptoms. Many e-cigarette user-reported negative respiratory symptoms are similar to those associated with cigarette smoking, though some appear unique to e-cigarette use. Future research should continue to monitor respiratory symptoms reported by ECIG users and whether these are associated with health outcomes over time.


Assuntos
Fumar Cigarros/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumantes/psicologia , Vaping/efeitos adversos , Vaping/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
9.
Nicotine Tob Res ; 22(Suppl 1): S61-S69, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320254

RESUMO

BACKGROUND: The link between e-cigarette use and subsequent development of respiratory diseases remains an open question. AIMS AND METHODS: A subset of a probability sample of U.S. adults from the Population Assessment of Tobacco and Health Study Waves 1 and 2 were selected for biospecimen analysis (n = 4614). Subjects were divided into three mutually exclusive groups at baseline: nonusers (n = 2849), exclusive e-cigarette users (n = 222), and poly e-cigarette/tobacco users (n = 1,543). Geometric mean concentrations of baseline biomarkers from five classes of harmful and potentially harmful constituents were reported. Multivariable linear regressions were conducted to examine the relationship between baseline biomarkers and subsequent respiratory symptoms among user groups. RESULTS: Baseline exclusive e-cigarette users (33.6%[confidence interval, CI: 26.7% to 41.4%]) and poly e-cigarette/tobacco users (50.8%[CI: 47.4% to 54.2%]) had higher prevalence of subsequent respiratory symptoms than nonusers (21.7%[19.2% to 24.4%]). As compared with nonusers, poly e-cigarette/tobacco users had higher concentrations in clinically relevant biomarkers at baseline than exclusive e-cigarette users. Among poly e-cigarette/tobacco users, baseline nicotine metabolites (TNE2, cotinine), tobacco-specific nitrosamine (NNAL), PAH (1-NAP, 3-FLU), and volatile organic compound (N-Acetyl-S-(2-carboxyethyl)-l-cysteine, N-acetyl-S-(2-cyanoethyl)-l-cysteine) were significantly higher among those reporting subsequent respiratory symptoms than those who did not. Among exclusive e-cigarette users, baseline NNAL was significantly higher among those reporting subsequent respiratory symptoms than those who did not. Within subjects with subsequent respiratory symptoms, NNAL was 2.5 times higher in exclusive e-cigarette users (10.7[6.5 to 17.5]) and 63.4 times higher in poly e-cigarette/tobacco users (199.6[176.7 to 225.4]) than nonusers (3.1[2.4 to 3.9]). CONCLUSIONS: E-cigarette use is associated with higher concentrations of known tobacco-related toxicants and risks of subsequent respiratory symptoms than nonusers. Poly e-cigarette/tobacco users exhibit higher risk than exclusive e-cigarette users. IMPLICATIONS: This longitudinal study identified positive associations between baseline urinary biomarkers of exposure to tobacco-related toxicants and increased risks of subsequent respiratory symptoms across varying e-cigarette use groups. E-cigarette use is associated with increased exposure to known tobacco-related toxicants, and certain toxicant exposure increases the risk of respiratory symptoms.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Fumantes/psicologia , Vaping/epidemiologia , Compostos Orgânicos Voláteis/efeitos adversos , Adolescente , Adulto , Idoso , Fumar Cigarros/psicologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças Respiratórias/induzido quimicamente , Fumantes/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Vaping/psicologia , Adulto Jovem
11.
J Med Internet Res ; 22(10): e21743, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33001829

RESUMO

BACKGROUND: The COVID-19 outbreak was designated a global pandemic on March 11, 2020. The relationship between vaping and contracting COVID-19 is unclear, and information on the internet is conflicting. There is some scientific evidence that vaping cannabidiol (CBD), an active ingredient in cannabis that is obtained from the hemp plant, or other substances is associated with more severe manifestations of COVID-19. However, there is also inaccurate information that vaping can aid COVID-19 treatment, as well as expert opinion that CBD, possibly administered through vaping, can mitigate COVID-19 symptoms. Thus, it is necessary to study the spread of inaccurate information to better understand how to promote scientific knowledge and curb inaccurate information, which is critical to the health of vapers. Inaccurate information about vaping and COVID-19 may affect COVID-19 treatment outcomes. OBJECTIVE: Using structural topic modeling, we aimed to map temporal trends in the web-based vaping narrative (a large data set comprising web-based vaping chatter from several sources) to indicate how the narrative changed from before to during the COVID-19 pandemic. METHODS: We obtained data using a textual query that scanned a data pool of approximately 200,000 different domains (4,027,172 documents and 361,100,284 words) such as public internet forums, blogs, and social media, from August 1, 2019, to April 21, 2020. We then used structural topic modeling to understand changes in word prevalence and semantic structures within topics around vaping before and after December 31, 2019, when COVID-19 was reported to the World Health Organization. RESULTS: Broadly, the web-based vaping narrative can be organized into the following groups or archetypes: harms from vaping; Vaping Regulation; Vaping as Harm Reduction or Treatment; and Vaping Lifestyle. Three archetypes were observed prior to the emergence of COVID-19; however, four archetypes were identified post-COVID-19 (Vaping as Harm Reduction or Treatment was the additional archetype). A topic related to CBD product preference emerged after COVID-19 was first reported, which may be related to the use of CBD by vapers as a COVID-19 treatment. CONCLUSIONS: Our main finding is the emergence of a vape-administered CBD treatment narrative around COVID-19 when comparing the web-based vaping narratives before and during the COVID-19 pandemic. These results are key to understanding how vapers respond to inaccurate information about COVID-19, optimizing treatment of vapers who contract COVID-19, and possibly minimizing instances of inaccurate information. The findings have implications for the management of COVID-19 among vapers and the monitoring of web-based content pertinent to tobacco to develop targeted interventions to manage COVID-19 among vapers.


Assuntos
Canabidiol/administração & dosagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etiologia , Internet/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Vaping/efeitos adversos , Vaping/epidemiologia , Canabidiol/efeitos adversos , Canabidiol/farmacologia , Canabidiol/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Humanos , Pandemias , Pneumonia Viral/terapia , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Mídias Sociais , Produtos do Tabaco
12.
BMJ ; 371: m3797, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33055176

RESUMO

OBJECTIVE: To compare several monetary incentive programmes for promoting smoking abstinence among employees who smoke at workplaces in a middle income country. DESIGN: Parallel group, open label, assessor blinded, cluster randomized controlled trial. SETTING: Large industrial workplaces in metropolitan Bangkok, Thailand. PARTICIPANTS: Employees who smoked cigarettes and planned to quit within six months recruited from 101 worksite clusters (84 different companies). INTERVENTIONS: Worksites were digitally cluster randomized by an independent investigator to usual care or usual care plus one of eight types of incentive programmes. Usual care consisted of one time group counseling and cessation support through a 28 day text messaging programme. The incentive programmes depended on abstinence at three months and varied on three intervention components: refundable deposits, assignment to a teammate, and bonus size ($20 (£15; €17) or $40). MAIN OUTCOME MEASURES: The primary outcome was biochemically verified seven day point prevalence smoking abstinence at 12 months. Secondary outcomes were programme acceptance at enrollment and smoking abstinence at three months (end of intervention) and at six months. All randomized participants who had complete baseline information were included in intention-to-treat analyses; participants with missing outcomes were coded as continuing smokers. RESULTS: Between April 2015 and August 2016, the trial enrolled 4190 participants. Eighteen were omitted because of missing baseline covariates and death before the primary endpoint, therefore 4172 participants were included in the intention-to-treat analyses. Programme acceptance was relatively high across all groups: 58.7% (2451/4172) overall and 61.3% (271/442) in the usual care group. Abstinence rates at 12 months did not differ among deposit programmes (336/2253, 14.9%) and non-deposit programmes (280/1919, 14.6%; adjusted difference 0.8 points, 95% confidence interval -2.7 to 4.3, P=0.65), but were somewhat lower for team based programmes (176/1348, 13.1%) than individual based programmes (440/2824, 15.6%; -3.2 points, -6.6 to -0.2, P=0.07), and higher for $40 bonus programmes (322/1954, 16.5%) than programmes with no bonus (148/1198, 12.4%; 5.9 points, 2.1 to 9.7, P=0.002). The $40 individual bonus was the most efficacious randomization group at all endpoints. Intervention components did not strongly interact with each other. CONCLUSIONS: Acceptance of monetary incentive programmes for promoting smoking abstinence was high across all groups. The $40 individual bonus programmes increased long term smoking abstinence compared with usual care, although several other incentive designs did not, such as team based programmes and deposit programmes. Incentive design in workplace wellness programmes might influence their effectiveness at reducing smoking rates in low resource settings. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02421224).


Assuntos
Fumar Cigarros/terapia , Motivação , Serviços de Saúde do Trabalhador/métodos , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Adulto , Fumar Cigarros/psicologia , Análise por Conglomerados , Aconselhamento , Feminino , Humanos , Masculino , Recompensa , Método Simples-Cego , Abandono do Hábito de Fumar/psicologia , Envio de Mensagens de Texto , Tailândia , Resultado do Tratamento , Local de Trabalho/psicologia
13.
Ann Epidemiol ; 49: 61-67, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32951805

RESUMO

PURPOSE: Nondaily smoking is increasing in the United States and common among Hispanic/Latino smokers. We characterized factors related to longitudinal smoking transitions in Hispanic/Latino nondaily smokers. METHODS: The Hispanic Community Health Study/Study of Latinos is a population-based cohort study of Hispanics/Latinos aged 18-74 years. Multinomial logistic regression assessed the baseline factors (2008-2011) associated with follow-up smoking status (2014-2017) in nondaily smokers (n = 573), accounting for complex survey design. RESULTS: After ∼6 years, 41% of nondaily smokers became former smokers, 22% became daily smokers, and 37% remained nondaily smokers. Factors related to follow-up smoking status were number of days smoked in the previous month, household smokers, education, income, and insurance. Those smoking 16 or more of the last 30 days had increased risk of becoming a daily smoker [vs. < 4 days; relative risk ratio (RRR) = 5.65, 95% confidence interval (95% CI) = 1.96-16.33]. Greater education was inversely associated with transitioning to daily smoking [>high school vs.

Assuntos
Hispano-Americanos/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar Tabaco/etnologia , Tabagismo/psicologia , Aculturação , Adolescente , Adulto , Distribuição por Idade , Idoso , Ansiedade , Depressão , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fumantes/psicologia , Fumar Tabaco/psicologia , Tabagismo/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
14.
PLoS One ; 15(9): e0238377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870924

RESUMO

INTRODUCTION: Given JUUL e-cigarettes' potential for smoking cessation and its drastically increased sales in the U.S., more evidence is needed to understand the antecedents of JUUL use among adult cigarette smokers. This study assessed the relationships between awareness sources, perceptions about using JUUL, and JUUL use behavior. METHODS: In an online study with adult smokers who were aware of JUUL e-cigarettes (n = 341), respondents reported their sources for learning about JUUL, perceptions of using JUUL versus Vuse (a competitor brand), and ever and past-30-day (current) JUUL use. Multivariable logistic regressions were used to examine the associations between awareness sources, perceptions, and JUUL use, adjusting for covariates. RESULTS: Learning about JUUL through internet ads was associated with positive perceptions about JUUL compared to Vuse, including JUUL was more fun to use (AOR = 2.04, 95% CI = 1.21, 3.42) and tastier (AOR = 1.96, 95% CI = 1.19, 3.22). Perceiving JUUL as being tastier (AOR = 2.07, 95% CI = 1.23, 3.49), more helpful for quitting smoking (AOR = 2.07, 95% CI = 1.22, 3.53), and cooler (AOR = 2.07, 95% CI = 1.21, 3.56) than Vuse was associated with ever using JUUL. Only perceiving JUUL as being tastier (AOR = 1.98, 95% CI = 1.10, 3.59) than Vuse was associated with current use of JUUL. DISCUSSION: Adult smokers may be more likely to focus on the sensory and social experience of using JUUL rather than JUUL's smoking cessation benefits. These positive perceptions are likely to be influenced by internet ads in general instead of JUUL's official marketing outlets. They are also more likely to sustain JUUL use than JUUL's perceived smoking cessation benefits.


Assuntos
Conscientização , Percepção , Fumantes/psicologia , Vaping , Adolescente , Adulto , Feminino , Humanos , Internet , Modelos Logísticos , Masculino , Razão de Chances , Abandono do Hábito de Fumar , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-32872132

RESUMO

The European Tobacco Products Directive (TPD) was introduced in 2016 in an effort to decrease prevalence of smoking and increase cessation in the European Union (EU). This study aimed to explore quitting behaviours, motivation, reasons and perceptions about quitting, as well as predictors (reported before the TPD implementation) associated with post-TPD quit status. A cohort study was conducted involving adult smokers from six EU countries (n = 3195). Data collection occurred pre-(Wave 1; 2016) and post-(Wave 2; 2018) TPD implementation. Bivariate and logistic regression analyses of weighted data were conducted. Within this cohort sample, 415 (13.0%) respondents reported quitting at Wave 2. Predictors of quitting were moderate or high education, fewer cigarettes smoked per day at baseline, a past quit attempt, lower level of perceived addiction, plans for quitting and the presence of a smoking-related comorbidity. Health concerns, price of cigarettes and being a good example for children were among the most important reasons that predicted being a quitter at Wave 2. Our findings show that the factors influencing decisions about quitting may be shared among European countries. European policy and the revised version of TPD could emphasise these factors through health warnings and/or campaigns and other policies.


Assuntos
Motivação , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Adolescente , Adulto , Estudos de Coortes , Europa (Continente) , Feminino , Inquéritos Epidemiológicos , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
BMC Public Health ; 20(1): 1237, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795286

RESUMO

BACKGROUND: Tobacco control strategies have engendered overall declines in smoking; however, a large gap remains between people with and without mental health problems, causing substantial health inequalities. Population-level information on barriers and opportunities for improvements is scarce. We aimed to assess mental health status of cigarette smokers and recent ex-smokers ('past-year smokers') in England, and smoking and harm reduction behaviour and quit attempts by mental health status. METHODS: Data were collected from 5637 current and 434 recent ex-smokers in 2016/17 in household surveys of representative samples of adults. We calculated weighted prevalence of different indicators of mental health problem: a) ever diagnosis, b) none, moderate, serious past-month distress, c) past-year treatment. We compared weighted smoking status, cigarette type, dependence, motivation to stop smoking, cutting down, use of nicotine replacement therapy or e-cigarettes, short-term abstinence, and quit attempts according to mental health status. RESULTS: Among past-year smokers: 35.9% ever had a diagnosis; 24.3% had experienced moderate, an additional 9.7% serious, past-month distress; 21.9% had had past-year treatment. Those with an indication of a mental health problem were more highly dependent and more likely to smoke roll-your-own cigarettes but also more likely to be motivated to stop smoking, to cut down, use nicotine replacement therapy or e-cigarettes and to have attempted to quit in the past year. CONCLUSIONS: About a third of cigarette smokers in England have mental health problems. Interventions should address their increased dependence and leverage higher prevalence of harm reduction behaviours, motivation to stop and attempts to stop smoking.


Assuntos
Redução do Dano , Transtornos Mentais/epidemiologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/epidemiologia , Adolescente , Adulto , Idoso , Inglaterra/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Adulto Jovem
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1058-1062, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741170

RESUMO

Objective: To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures. Methods: Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors. Results: Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ(2)=14.211, P=0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ(2)=51.977, P<0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ(2)=85.865, P<0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant (Z=5.612, P<0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant (Z=-3.734, P<0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ(2)=62.277, P=0.005). Multiple logistic regression analysis results showed people with general awareness (OR=0.61, 95%CI: 0.39-0.94) and poor awareness (OR=0.67, 95%CI: 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness (OR=0.64, 95%CI: 0.53-0.76) and poor awareness (OR=0.87, 95%CI: 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions: Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Intenção , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Adolescente , Adulto , Idoso , Pequim/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
18.
PLoS One ; 15(7): e0235709, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32650339

RESUMO

BACKGROUND: Since 2005, the Smoking Treatment for Ontario Patients (STOP) program has provided smoking cessation treatment of varying form and intensity to smokers through 11 distinct treatment models, either in-person at partnering healthcare organizations or remotely via web or telephone. We aimed to characterize the patient populations reached by different treatment models. METHODS: We linked self-report data to health administrative databases to describe sociodemographics, physical and mental health comorbidity, healthcare utilization and costs. Our sample consisted of 107,302 patients who enrolled between 18Oct2005 and 31Mar2016, across 11 models operational during different time periods. RESULTS: Patient populations varied on sociodemographics, comorbidity burden, and healthcare usage. Enrollees in the Web-based model were youngest (median age: 39; IQR: 29-49), and enrollees in primary care-based Family Health Teams were oldest (median: 51; IQR: 40-60). Chronic Obstructive Pulmonary Disease and hypertension were the most common physical health comorbidities, twice as prevalent in Family Health Teams (32.3% and 30.8%) than in the direct-to-smoker (Web and Telephone) and Pharmacy models (13.5%-16.7% and 14.7%-17.7%). Depression, the most prevalent mental health diagnosis, was twice as prevalent in the Addiction Agency (52.1%) versus the Telephone model (25.3%). Median healthcare costs in the two years up to enrollment ranged from $1,787 in the Telephone model to $9,393 in the Addiction Agency model. DISCUSSION: While practitioner-mediated models in specialized and primary care settings reached smokers with more complex healthcare needs, alternative settings appear better suited to reach younger smokers before such comorbidities develop. Although Web and Telephone models were expected to have fewer barriers to access, they reached a lower proportion of patients in rural areas and of lower socioeconomic status. Findings suggest that in addition to population-based strategies, embedding smoking cessation treatment into existing healthcare settings that reach patient populations with varying disparities may enhance equitable access to treatment.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Fumantes/psicologia , Adulto , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Depressão/patologia , Feminino , Custos de Cuidados de Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/patologia , Internet , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/patologia , Abandono do Hábito de Fumar , Inquéritos e Questionários , Telefone
19.
Artigo em Inglês | MEDLINE | ID: mdl-32722469

RESUMO

Combustible tobacco users appear to be at greater risk for serious complications from COVID-19. This study examined cigar smokers' perceived risk of COVID-19, quit intentions, and behaviors during the current pandemic. We conducted an online study between 23 April 2020 to 7 May 2020, as part of an ongoing study examining perceptions of different health effects of cigars. All participants used cigars in the past 30 days (n = 777). Three-quarters of the sample (76.0%) perceived they had a higher risk of complications from COVID-19 compared to non-smokers. The majority of participants (70.8%) intended to quit in the next six months due to COVID-19, and almost half of the sample (46.5%) reported making a quit attempt since the start of the COVID-19 pandemic. Far more participants reported increasing their tobacco use since COVID-19 started (40.9%) vs. decreasing their tobacco use (17.8%). Black or African American participants, participants who reported using a quitline, and participants with higher COVID-19 risk perceptions had higher intentions to quit using tobacco due to COVID-19, and higher odds of making a quit attempt since COVID-19 started. More research is needed to understand how tobacco users are perceiving COVID-19 risks and changing their tobacco use behaviors.


Assuntos
Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Fumantes/psicologia , Abandono do Uso de Tabaco/psicologia , Adulto , Afro-Americanos , Betacoronavirus , Fumar Charutos , Infecções por Coronavirus/etnologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/etnologia , Tabaco , Produtos do Tabaco , Uso de Tabaco , Abandono do Uso de Tabaco/etnologia , Estados Unidos
20.
Artigo em Inglês | MEDLINE | ID: mdl-32727019

RESUMO

This longitudinal study investigated the factors that determine the effectiveness of graphic health warnings (GHWs) by comparing 246 South Korean smoker's responses before and after the introduction of the country's new tobacco control policy wherein GHWs were placed on all cigarette packaging. Even though introducing GHWs did not cause immediate changes in smokers' intention to quit smoking or perception of smoking's health risk, GHWs eventually motivated smokers to quit smoking when they experienced negative emotional responses to the newly introduced graphic warnings on cigarette packaging. More importantly, this study found that positive changes in smokers' perceived risk associated with smoking due to the introduction of GHWs mediated a positive relationship between changes in smokers' negative emotions (NE) from text-only warnings to graphic warnings and changes in their intention to quit smoking during the same period. Based on these results, the authors suggest that, for GHW policy to be more effective in motivating smoking cessation, the warnings need to convey images sufficiently unpleasant to induce negative emotional responses among smokers.


Assuntos
Emoções , Rotulagem de Produtos , Fumantes , Produtos do Tabaco , Humanos , Estudos Longitudinais , República da Coreia , Fumantes/psicologia , Prevenção do Hábito de Fumar
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