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1.
MMWR Morb Mortal Wkly Rep ; 68(39): 839-844, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581163

RESUMO

The 2009 Family Smoking Prevention and Tobacco Control Act prohibits the inclusion of characterizing flavors (e.g., candy or fruit) other than tobacco and menthol in cigarettes; however, characterizing flavors are not currently prohibited in other tobacco products at the federal level.* Flavored tobacco products can appeal to youths and young adults and influence initiation and establishment of tobacco-use patterns (1). The Food and Drug Administration (FDA) and CDC analyzed data from the 2014-2018 National Youth Tobacco Surveys (NYTS) to determine prevalence of current (past 30-day) use of flavored tobacco products, including electronic cigarettes (e-cigarettes), hookah tobacco, cigars, pipe tobacco, smokeless tobacco, bidis, and menthol cigarettes among U.S. middle school (grades 6-8) and high school (grades 9-12) students. In 2018, an estimated 3.15 million (64.1%) youth tobacco product users currently used one or more flavored tobacco products, compared with 3.26 million (70.0%) in 2014. Despite this overall decrease in use of flavored tobacco products, current use of flavored e-cigarettes increased among high school students during 2014-2018; among middle school students, current use of flavored e-cigarettes increased during 2015-2018, following a decrease during 2014-2015. During 2014-2018, current use of flavored hookah tobacco decreased among middle and high school students; current use of flavored smokeless tobacco, cigars, pipe tobacco, and menthol cigarettes decreased among high school students. Full implementation of comprehensive tobacco prevention and control strategies, coupled with regulation of tobacco products by FDA, can help prevent and reduce use of tobacco products, including flavored tobacco products, among U.S. youths (2,3).


Assuntos
Aromatizantes , Estudantes/psicologia , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Criança , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Prevenção do Hábito de Fumar/legislação & jurisprudência , Estudantes/estatística & dados numéricos , Produtos do Tabaco/legislação & jurisprudência , Uso de Tabaco/legislação & jurisprudência , Uso de Tabaco/prevenção & controle , Tabaco sem Fumaça/estatística & dados numéricos , Estados Unidos/epidemiologia , United States Food and Drug Administration
2.
BMJ ; 366: l5275, 2019 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-31570493

RESUMO

Electronic cigarettes (e-cigarettes) are alternative, non-combustible tobacco products that generate an inhalable aerosol containing nicotine, flavors, propylene glycol, and vegetable glycerin. Vaping is now a multibillion dollar industry that appeals to current smokers, former smokers, and young people who have never smoked. E-cigarettes reached the market without either extensive preclinical toxicology testing or long term safety trials that would be required of conventional therapeutics or medical devices. Their effectiveness as a smoking cessation intervention, their impact at a population level, and whether they are less harmful than combustible tobacco products are highly controversial. Here, we review the evidence on the effects of e-cigarettes on respiratory health. Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco/efeitos adversos , Humanos
3.
BMC Public Health ; 19(Suppl 4): 579, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196055

RESUMO

BACKGROUND: This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status. METHODS: The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status. RESULTS: Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking. CONCLUSIONS: Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.


Assuntos
Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Adolescente , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Fumar/etnologia , Classe Social , Fatores Socioeconômicos , Inquéritos e Questionários
4.
Environ Pollut ; 251: 970-974, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31234264

RESUMO

Data from National Health and Nutrition Examination Survey for 2013-2016 were used to compare observed levels of cadmium, lead, and total mercury in blood among US residents aged ≥12 years who were users of cigars, cigarettes, cigars and cigarettes, e-cigarettes and dual users of cigarettes and e-cigarettes. Total sample size available for analysis was 1139. Adjusted geometric means (AGM) among cigarette, cigar, e-cigarette, cigarette and cigar, and cigarette-e-cigarette users were comparable for blood cadmium lead, and total mercury. Cigar only users had lower AGM than cigar and cigarette users for total mercury (0.56 vs. 0.97 µg/L, p = 0.03). There is no evidence yet that can show concentrations of blood and urine cadmium, lead, and mercury among e-cigarette users are any different than among cigarette and/or dual users of cigarettes and e-cigarettes.


Assuntos
Cádmio/sangue , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Chumbo/sangue , Mercúrio/sangue , Fumantes/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Criança , Humanos , Masculino , Inquéritos Nutricionais
5.
BMJ ; 365: l2036, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31076461

RESUMO

The studyHajek P, Phillips-Waller A, Przulj D, et al. A randomised trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med 2019;380:629-37.This trial was funded by the NIHR Health Technology Assessment Programme (12/167/135) and by Cancer Research UK.To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000757/e-cigarettes-helped-more-smokers-quit-than-nicotine-replacement-therapy.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Nicotina/uso terapêutico , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco/estatística & dados numéricos , Análise Custo-Benefício , Humanos , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-30970567

RESUMO

Electronic nicotine product use is increasing in the U.S., but few studies have addressed its effects on oral health. The goal of this work was to determine the association between electronic nicotine product use and periodontal disease. Population Assessment of Tobacco and Health adult survey data from 2013⁻2016 (waves 1, 2 and 3) was used for the analysis. Longitudinal electronic nicotine product users used electronic nicotine products regularly every day or somedays in all three waves. Participants with new cases of gum disease reported no history of gum disease in wave 1 but reported being diagnosed with gum disease in waves 2 or 3. Odds ratios (OR) were calculated to determine the association between electronic nicotine product use and new cases of gum disease after controlling for potential cofounders. Compared to never users, longitudinal electronic nicotine product users had increased odds of being diagnosed with gum disease (OR 1.76, 95% Confidence Interval (CI) 1.12⁻2.76) and bone loss around teeth (OR 1.67, 95% CI 1.06⁻2.63). These odds were higher for participants with a history of marijuana and a history of illicit or non-prescribed drug use. Our findings show that e-cigarettes may be harmful to oral health.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Inquéritos Epidemiológicos , Doenças Periodontais/etiologia , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/estatística & dados numéricos , Tabagismo/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Doenças Periodontais/epidemiologia , Autorrelato , Tabagismo/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
8.
Prev Chronic Dis ; 16: E42, 2019 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-30950787

RESUMO

INTRODUCTION: Youth exposure to secondhand smoke (SHS) and secondhand aerosol from e-cigarettes (SHA) may contribute to the renormalization of tobacco product use behaviors. Our study assessed self-reported SHS or SHA exposures in indoor or outdoor public places among US students. METHODS: Data came from the 2015 and 2017 National Youth Tobacco Survey, a school-based survey of US students in grades 6 through 12. Past 30-day exposure to SHS and SHA in indoor and outdoor public places was assessed. The prevalence of exposure was assessed overall and by covariates for each year. We used adjusted prevalence ratios (aPRs) to assess determinants of exposure. RESULTS: We observed no significant change from 2015 through 2017 in exposure to SHS (52.6% to 50.5%), SHA (25.2% to 25.6%), or either SHS or SHA (56.7% to 55.1%). Following multivariable adjustment, in 2017, exposure to either SHS or SHA in public was higher among female students versus male students (aPR = 1.29), high school students versus middle school students (aPR = 1.15), current e-cigarette users versus nonusers (aPR = 2.89), and current users of other tobacco product versus nonusers (aPR = 1.21). Exposure was higher for students who reported that a household member used tobacco products. CONCLUSION: In 2017, more than half (55.1%, 14.3 million) of US middle and high school students reported exposure to secondhand tobacco product emissions in indoor or outdoor public places. E-cigarette use may complicate the enforcement of existing smoke-free policies and contribute to the renormalization of tobacco use behaviors. Continued efforts are warranted to reduce the social acceptability of tobacco product use and protect bystanders from all tobacco product emissions.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Autorrelato , Política Antifumo/legislação & jurisprudência , Política Antifumo/tendências , Fumar/epidemiologia , Estudantes , Vaping/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-30935027

RESUMO

A growing literature indicates that electronic cigarette use increases the risk of subsequent initiation of conventional smoking among cigarette-naïve adolescents in several Western countries. This research assesses the same relationship in an Asian country, Taiwan. The Taiwan Adolescent to Adult Longitudinal Study is a school-based survey that was carried out in two waves in 2014 (baseline) and in 2016 (follow-up). It employs probability sampling to create nationally representative samples of students in junior high school (mean age 13, 7th grade at baseline) and in senior high school (mean age 16, 10th grade at baseline). Data from this survey were analyzed via logistic regression to estimate the association between ever use of e-cigarettes at baseline and smoking initiation at follow-up, accounting for susceptibility to smoking, socio-demographic profile, depression status, and peer support. Among the 12,954 cigarette-naïve students surveyed, those with e-cigarette experience at baseline exhibited higher odds of smoking initiation at follow-up (Odds Ratio = 2.14, 95% CI (1.66, 2.75), p < 0.001). For the first time, we confirmed, through a longitudinal survey, a prospective association between ever use of e-cigarettes and smoking initiation in an Asian adolescent population. The restrictive policy on e-cigarettes currently in force in Taiwan is justified to prevent both e-cigarette and cigarette use among adolescents.


Assuntos
Comportamento do Adolescente , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Instituições Acadêmicas , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Taiwan/epidemiologia , Produtos do Tabaco/estatística & dados numéricos
10.
Public Health Rep ; 134(3): 282-292, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30857471

RESUMO

OBJECTIVES: The use of flavored electronic cigarettes (e-cigarettes) is common among e-cigarette users, but little is known about the potential harms of flavorings, the extent to which the concurrent use of multiple flavor types occurs, and the correlates of flavor type use. The objective of this study was to assess the types of e-cigarette flavors used by adolescent (aged 12-17), young adult (aged 18-24), and older adult (aged ≥25) e-cigarette users. METHODS: We assessed the prevalence of flavored e-cigarette use within the past month by flavor types and concurrent use of multiple flavor types among past-month e-cigarette users sampled during Wave 2 (2014-2015) of the Population Assessment for Tobacco and Health Study among 414 adolescents, 961 young adults, and 1711 older adults. We used weighted logistic regression models for the use of fruit-, candy-, mint/menthol-, tobacco-, or other-flavored e-cigarettes and concurrent use of multiple flavor types. Covariates included demographic characteristics, e-cigarette use frequency, cigarette smoking status, current use of other tobacco products, and reasons for e-cigarette use. RESULTS: The leading e-cigarette flavor types among adolescents were fruit, candy, and other flavors; among young adults were fruit, candy, and mint/menthol; and among older adults were tobacco or other flavors, fruit, and mint/menthol. Compared with older adults, adolescents and young adults were more likely to use fruit-flavored e-cigarettes (adjusted odds ratio [aOR] = 3.35; 95% confidence interval [CI], 2.56-4.38; and aOR = 2.31; 95% CI, 1.77-3.01, respectively) and candy-flavored e-cigarettes (aOR = 3.81; 95% CI, 2.74-5.28; and aOR = 2.95; 95% CI, 2.29-3.80, respectively) and concurrently use multiple flavor types (aOR = 4.58; 95% CI, 3.39-6.17; and aOR = 2.28; 95% CI, 1.78-2.91, respectively). CONCLUSIONS: Regulation of sweet e-cigarette flavors (eg, fruit and candy) may help reduce the use of e-cigarettes among young persons without substantially burdening adult e-cigarette users.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Aromatizantes , Produtos do Tabaco/estatística & dados numéricos , Vaping/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Vaping/etnologia , Vaping/psicologia , Adulto Jovem
11.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30858346

RESUMO

OBJECTIVES: To determine how smoke-free and vape-free home and car policies differ for parents who are dual users of cigarettes and electronic cigarettes (e-cigarettes), who only smoke cigarettes, or who only use e-cigarettes. To identify factors associated with not having smoke-free or vape-free policies and how often smoke-free advice is offered at pediatric offices. METHODS: Secondary analysis of 2017 parental interview data collected after their children's visit in 5 control practices participating in the Clinical Effort Against Secondhand Smoke Exposure trial. RESULTS: Most dual users had smoke-free home policies, yet fewer had a vape-free home policies (63.8% vs 26.3%; P < .01). Dual users were less likely than cigarette users to have smoke-free car (P < .01), vape-free home (P < .001), or vape-free car (P < .001) policies. Inside cars, dual users were more likely than cigarette users to report smoking (P < .001), e-cigarette use (P < .001), and e-cigarette use with children present (P < .001). Parental characteristics associated with not having smoke-free or vape-free home and car policies include smoking ≥10 cigarettes per day, using e-cigarettes, and having a youngest child >10 years old. Smoke-free home and car advice was infrequently delivered. CONCLUSIONS: Parents may perceive e-cigarette aerosol as safe for children. Dual users more often had smoke-free policies than vape-free policies for the home. Dual users were less likely than cigarette-only smokers to report various child-protective measures inside homes and cars. These findings reveal important opportunities for intervention with parents about smoking and vaping in homes and cars.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Pais , Política Antifumo , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Adulto , Automóveis , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Entrevistas como Assunto , Modelos Logísticos , Masculino , Análise Multivariada , Medição de Risco , Prevenção do Hábito de Fumar , Estados Unidos
12.
BMC Public Health ; 19(1): 302, 2019 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-30866897

RESUMO

BACKGROUND: Knowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly). METHODS: A cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use. RESULTS: Dual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females. CONCLUSIONS: The majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.


Assuntos
Autoavaliação Diagnóstica , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumantes/psicologia , Produtos do Tabaco/estatística & dados numéricos , Vaping/efeitos adversos , Adulto , Estudos Transversais , Feminino , Humanos , Hungria , Internet , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Inquéritos e Questionários
13.
Artigo em Inglês | MEDLINE | ID: mdl-30889838

RESUMO

The awareness and use of the recently introduced heated product in the global tobacco market is rapidly increasing. Few studies have investigated the association of this product's use with health-related factors. To examine the association of the heated tobacco product (HTP)'s use with perceived stress, physical activity, and internet use, we analyzed data from the Korea Youth Risk Behavior Survey using multinomial logistic regression models. The participants included 60,040 students from middle school and high school. There were significant associations between high perceived stress and cigarette use only, dual use of cigarette and e-cigarette, triple use of cigarette, e-cigarette, and HTP; a negative association between HTP's use and perceived stress; positive association between physical activity and tobacco use; and not using the internet significantly increased the odds of use of all types of tobacco products. A smoking prevention program, tailored to meet the needs of different types of tobacco product users, is recommended. A program aimed at not only increasing awareness of perceived risk but also decreasing perceived benefits of risky behaviors, should also be considered. Further research using a longitudinal design to test the causal relationship of tobacco product use with perceived stress, physical activity, and internet use is warranted.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Exercício , Internet , Fumar , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco , Adolescente , Feminino , Humanos , Masculino , Percepção , República da Coreia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
14.
J Health Care Poor Underserved ; 30(1): 249-264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30827981

RESUMO

OBJECTIVE: To examine alternative tobacco product (ATP) use and associated factors among middle school students in Appalachian Tennessee. METHOD: Data (2015-2016; N=573) from school-based tobacco surveys in 11 middle schools in Appalachian Tennessee were analyzed. Multiple logistic regression model described factors associated with ATP use. RESULTS: More than one-tenth (13.2%) of participants have ever used ATPs. Approximately 9%, 7%, 6%, and 2% of participants have ever used e-cigarettes, cigarettes, smokeless tobacco, and little cigars or cigarillos, respectively. The following were significantly associated with ever use of ATPs: believing tobacco users have more friends, owning tobacco-branded item(s), living with a tobacco user, having ever smoked cigarettes, and living in homes where smoking is allowed. CONCLUSION: More than one in 10 of participants have ever used at least one ATP, and association with desirable objects and situations may promote ATP use. Interventions should seek to reduce these positive images and make all tobacco products unappealing.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Estudantes/psicologia , Produtos do Tabaco/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Adolescente , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Risco , Estudantes/estatística & dados numéricos , Tennessee/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-30862006

RESUMO

Background: Most studies on perceived risks of smokeless tobacco products (SLT) have been conducted in the U.S., and the vast majority conclude that perceptions of the relative harmfulness of SLT versus cigarettes in the population are inconsistent with epidemiologically-based risk estimates, and typically conflated to that of cigarettes. We tested whether such inaccuracies also existed in Norway, where SLT-products are less toxic (Swedish snus) and SLT use is more prevalent than in the U.S. Methods: Over a 16 years period (2003⁻2018), 13,381 respondents (aged 16⁻79 years) answered questions about risk perceptions in Statistics Norway's nationally representative survey of tobacco behavior. We applied an indirect measure of comparative harm where risk beliefs for eight nicotine products were assessed independently of other products and then compared the answers. The wording of the question was: "We will now mention a variety of nicotine products and ask you how harmful you think daily use of these are. Use a scale from 1 to 7, where 1 is slightly harmful and 7 is very harmful". Mean scores with 95% confidence intervals were calculated. Results: The overall risk score for cigarettes was 6.48. The risk score for snus was 5.14⁻79.3% of the risk score of cigarettes. The relative risk scores for e-cigarettes (3.78) and NRT products (3.39) was 58.4% and 52.3% when compared to cigarettes. Perceptions of risk were stable over time. A strong association was observed between perceived risk of snus and having used snus in attempts to quit smoking. Conclusion: Perceptions of relative risk between snus and cigarettes is inconsistent with estimates from medical expert committees, which assess the overall health risk from use of Swedish snus to be minor when compared to the risk from smoking. Like the situation in the US, incorrect beliefs about SLT risks seem to be prevalent also in the snus-prevalent Norwegian setting. Accurate information on differential harms needs to be communicated. Future research should try to identify reasons why health authorities in the US and Scandinavia allow these well-documented misconceptions to persist.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar/epidemiologia , Produtos do Tabaco , Tabaco sem Fumaça/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicotina , Noruega/epidemiologia , Percepção , Prevalência , Risco , Países Escandinavos e Nórdicos , Abandono do Hábito de Fumar , Fumar Tabaco , Adulto Jovem
16.
MMWR Morb Mortal Wkly Rep ; 68(8): 189-194, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30817748

RESUMO

Electronic vapor products (EVPs) comprise a diverse group of devices, including electronic cigarettes (e-cigarettes). EVP users inhale an aerosol that typically contains nicotine, flavorings, and other additives (1). Nicotine is a developmental toxicant that adversely affects pregnancy and infant outcomes (2). Data from the 2015 Pregnancy Risk Assessment Monitoring System (PRAMS) for Oklahoma and Texas were analyzed to estimate population-based EVP use among women with a recent live birth. EVP use before pregnancy (defined as >3 months before pregnancy) and around the time of pregnancy (defined as any time during the 3 months before pregnancy, the last 3 months of pregnancy, or 2-6 months after delivery), reasons for EVP use, and dual use of EVPs and cigarettes were assessed. Prevalence of EVP use was 10.4% before pregnancy and 7.0% around the time of pregnancy, including 1.4% during the last 3 months of pregnancy. Among women using EVPs during the last 3 months of pregnancy, 38.4% reported use of EVPs containing nicotine, and 26.4% were unsure of nicotine content. Among women who had used EVPs and cigarettes, dual use prevalence was 38.0% in the 3 months before pregnancy, 7.7% during the last 3 months of pregnancy, and 11.8% in the 2-6 months after delivery. The most frequently reported reasons for EVP use around the time of pregnancy were curiosity (54.0%), the perception that EVPs might help with quitting or reducing cigarette smoking (45.2%), and the perception of reduced harm to the mother, when compared with cigarette smoking (45.2%). Clear messages that EVP use is not safe during pregnancy are needed, and broad, barrier-free access to evidence-based tobacco cessation strategies need to be made available.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Gestantes/psicologia , Fumar/epidemiologia , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Nascimento Vivo , Oklahoma/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Medição de Risco , Fumar/efeitos adversos , Texas/epidemiologia , Fatores de Tempo
17.
Drug Alcohol Depend ; 197: 37-41, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30769264

RESUMO

BACKGROUND: Although smoking is prevalent among populations with opioid use disorder (OUD), few studies have examined electronic cigarette (EC) use in individuals seeking opioid agonist therapy (OAT). The aim of this study was to evaluate the prevalence and correlates of EC use among individuals seeking OAT. METHODS: 782 patients seeking OAT for OUD completed surveys assessing current and past EC use, reasons for use, current and past cigarette smoking, nicotine dependence, psychiatric distress, trauma, and pain. Bivariate and multivariate models evaluated correlates of daily EC use, past-30-day EC use, and current cigarette smoking. RESULTS: 6% of patients reported daily EC use, 18% reported past-30-day use, 62% reported EC use history, and 85% reported current cigarette smoking. 46% reported using ECs to quit or cut down smoking. In multivariate analyses, daily EC use was associated with higher odds of being a former smoker (OR 21; CI 1.7-273) and lower odds of ever smoking more than 100 cigarettes (OR 0.07; CI 0.01-0.32), while EC use in the past 30 days was associated with lower odds of being Caucasian (OR 0.55; CI 0.34-0.89), ever smoking more than 100 cigarettes (OR 0.13; CI 0.02-0.67), and history of chronic pain (OR 0.59; CI 0.38-0.90), and higher odds of reporting psychiatric distress (OR 1.5; CI 1.1-2.2). CONCLUSIONS: EC use is common among people with OUD who smoke cigarettes. Those with daily use had higher odds of being former smokers than current smokers. Interventions using ECs may be effective to help reduce harms and mortality in OUD.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/psicologia , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adulto , Buprenorfina/uso terapêutico , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Metadona/uso terapêutico , Pessoa de Meia-Idade , Razão de Chances , Tratamento de Substituição de Opiáceos/psicologia , Prevalência , Inquéritos e Questionários , Fumar Tabaco/psicologia , Tabagismo/psicologia , Vaping/psicologia
18.
PLoS One ; 14(2): e0212353, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30811486

RESUMO

BACKGROUND: There is an increased need to understand how e-cigarette flavors may contribute to e-cigarette uptake and use among youth. We examined the relationship between perceived ease of flavored e-cigarette use and e-cigarette use susceptibility and progression among a nationally representative sample of U.S. youth never tobacco users. METHODS: The wave 1 (2013-2014) and wave 2 (2014-2015) surveys of PATH Study were used. Youth never tobacco users (ages 12-17) who reported whether flavored e-cigarettes were easier to use than unflavored e-cigarettes at wave 1 (n = 6,983) were included in the study. Multivariable logistic regressions were used to examine the associations between perceived ease of using flavored e-cigarettes (wave 1) and e-cigarette use outcomes including e-cigarette use susceptibility (wave 1) and e-cigarette initiation and past-30-day use (wave 2). RESULTS: Overall, 21.2% of the sample perceived flavored e-cigarettes easier to use than unflavored e-cigarettes; and 28.9% of the sample were susceptible to using e-cigarettes at wave 1, and 7.5% and 2.0% initiated e-cigarettes and used e-cigarettes in the past 30 days at wave 2, respectively. Among those who perceived flavored e-cigarettes easier to use, 41.0% were susceptible to using e-cigarettes at wave 1, and 10.6% and 3.4% initiated and used e-cigarettes in the past 30 days at wave 2, respectively. Perceiving flavored e-cigarettes as easier to use than unflavored e-cigarettes at wave 1 was positively associated with e-cigarette use susceptibility at wave 1 (AOR = 1.43, CI = 1.21, 1.69), and e-cigarette initiation (AOR = 1.32, CI = 1.12, 1.67) and past-30-day use (AOR = 1.25, CI = 1.10, 2.47) at wave 2. CONCLUSIONS: Perceiving flavored e-cigarettes as easier to use than unflavored e-cigarettes may lead to e-cigarette use progression among youth never tobacco users. Determining the factors (including e-cigarette marketing and specific e-cigarette flavors) that lead to perceived ease of using flavored e-cigarettes would inform efforts to prevent and curb youth e-cigarette use.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Aromatizantes/química , Fumar/psicologia , Vaping/epidemiologia , Vaping/psicologia , Adolescente , Criança , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Fumar/epidemiologia , Inquéritos e Questionários
19.
Prev Chronic Dis ; 16: E17, 2019 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-30730828

RESUMO

INTRODUCTION: State-level monitoring of changes in tobacco product use can help inform tobacco control policy and practice. This study examined state-specific prevalence of cigarette, smokeless tobacco, and e-cigarette use among US adults. METHODS: Data came from the 2016 Behavioral Risk Factor Surveillance System (BRFSS), a state-based telephone survey of US adults aged 18 years or older (N = 477,665). Prevalence estimates for current (every day or some days) cigarette smoking, smokeless tobacco use, and e-cigarette use were calculated for all 50 states and the District of Columbia (DC) and stratified by sex and race/ethnicity. Because the 2016 BRFSS measured e-cigarette use for the first time, estimates of ever e-cigarette use and concurrent use of cigarettes and e-cigarettes were also calculated. We assessed subgroup differences with χ2 tests. RESULTS: In 2016, prevalence of current cigarette smoking among US adults ranged from 8.8% (Utah) to 24.8% (West Virginia), while prevalence of current smokeless tobacco use ranged from 1.3% (DC) to 9.8% (Wyoming). For e-cigarettes, ever use ranged from 16.2% (DC) to 28.4% (Arkansas), and current use ranged from 2.4% (DC) to 6.7% (Oklahoma). Across all states, current e-cigarette use was significantly higher among current cigarette smokers than among former or never cigarette smokers. States with the highest prevalence of cigarette smoking generally had a high prevalence of current e-cigarette use. CONCLUSION: Prevalence of adult cigarette smoking, smokeless tobacco use, and e-cigarette use varies across states. These findings underscore the importance of comprehensive statewide tobacco control and use prevention efforts that address the diverse tobacco products used among adults.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Tabaco sem Fumaça/estatística & dados numéricos , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Estudos Transversais , Feminino , Humanos , Masculino , Vigilância da População , Prevalência
20.
Am J Public Health ; 109(3): 465-471, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30676800

RESUMO

OBJECTIVES: To examine intraindividual change in polytobacco and individual tobacco and nicotine product use across young adulthood. METHOD: Participants were 2711 students from 24 Texas colleges participating in a 6-wave online study, with 6 months between each wave. Participants were aged 18 to 25 years at baseline in fall 2014 or spring 2015 and aged 20 to 28 years at wave 6. We used growth curve modeling for an accelerated longitudinal design to examine change from ages 18 to 28 years in polytobacco use (use of 2 or more products) and in use of 5 individual products (cigarettes, smokeless tobacco or snus, large cigars, cigarillos, or little cigars, hookah, and electronic nicotine delivery systems [ENDS]). RESULTS: There was a statistically significant decline in polytobacco use from ages 18 to 28 years. There were also statistically significant declines in ENDS, hookah, and cigar use but not in smokeless tobacco use, for which use was negligible, or in cigarette use. Importantly, cigarettes were the most used product at virtually all ages. CONCLUSIONS: Young adults may mature out of polytobacco use with increasing age, but they may continue to use some products, most notably cigarettes, potentially the most toxic and addictive tobacco and nicotine product.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Fumar Tabaco/tendências , Tabaco sem Fumaça/estatística & dados numéricos , Universidades/estatística & dados numéricos , Universidades/tendências , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Texas , Adulto Jovem
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