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1.
Nicotine Tob Res ; 25(1): 86-93, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35792868

RESUMO

INTRODUCTION: There has been little investigation of whether the clinical effectiveness of smoking cessation treatments translates into differences in healthcare costs, using real-world cost data, to determine whether anticipated benefits of smoking cessation treatment are being realized. AIMS AND METHODS: We sought to determine the association between smoking cessation treatment and healthcare costs using linked administrative healthcare data. In total, 4752 patients who accessed a smoking cessation program in Ontario, Canada between July 2011 and December 2012 (treatment cohort) were each matched to a smoker who did not access these services (control cohort). The primary outcome was total healthcare costs in Canadian dollars, and secondary outcomes were sector-specific costs, from one year prior to the index date until December 31, 2017, or death. Costs were partitioned into four phases: pretreatment, treatment, posttreatment, and end-of-life for those who died. RESULTS: Among females, total healthcare costs were similar between cohorts in pretreatment and posttreatment phases, but higher for the treatment cohort during the treatment phase ($4,554 vs. $3,237, p < .001). Among males, total healthcare costs were higher in the treatment cohort during pretreatment ($3,911 vs. $2,784, p < .001), treatment ($4,533 vs. $3,105, p < .001) and posttreatment ($5,065 vs. $3,922, p = .001) phases. End-of-life costs did not differ. Healthcare sector-specific costs followed a similar pattern. CONCLUSIONS: Five-year healthcare costs were similar between females who participated in a treatment program versus those that did not, with a transient increase during the treatment phase only. Among males, treatment was associated with persistently higher healthcare costs. Further study is needed to address the implications with respect to long-term costs. IMPLICATIONS: The clinical effectiveness of pharmacological and behavioral smoking cessation treatments is well established, but whether such treatments are associated with healthcare costs, using real-world data, has received limited attention. Our findings suggest that the use of a smoking cessation treatment offered by their health system is associated with persistent higher healthcare costs among males but a transient increase among females. Given increasing access to evidence-based smoking cessation treatments is an important component in national tobacco control strategies, these data highlight the need for further exploration of the relations between smoking cessation treatment engagement and healthcare costs.


Assuntos
Abandono do Hábito de Fumar , Tabagismo , Masculino , Feminino , Humanos , Abandono do Hábito de Fumar/métodos , Tabagismo/tratamento farmacológico , Custos de Cuidados de Saúde , Morte , Ontário , Análise Custo-Benefício
2.
Addict Behav ; 137: 107537, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36332518

RESUMO

INTRODUCTION: Previous studies have indicated that youth who use tobacco products, including cigarettes, cigars, and smokeless tobacco, demonstrate dependence symptoms. However, the tobacco marketplace has expanded dramatically in recent years, and few studies have examined dependence symptoms among youth who use novel products. This study combined 2019-2020 National Youth Tobacco Survey data to report the prevalence and determinants of tobacco dependence symptoms among U.S. middle and high school current (past 30-day) tobacco users. METHODS: Prevalence estimates were calculated to examine dependence outcomes and other covariates by user groups (single product users and multiple product users). Multivariable logistic regression analyses were used to identify independent predictors of tobacco dependence among current users of cigarettes, cigars (regular cigars, cigarillos, and little cigars), e-cigarettes, heated tobacco products, hookah, pipe tobacco, bidis, and smokeless tobacco products (chew, snuff, dip, snus, and dissolvables). RESULTS: Among current tobacco users, 15.7 % (95 % CI: 14.2-17.3) reported wanting to use tobacco within 30 min of waking and 28.3 % (95 % CI: 26.3-30.5) reported strong cravings for tobacco in the past 30 days. Nearly-two-thirds of current users were single product users, of which 80.5 % reported using e-cigarettes. Reporting of dependence symptoms was generally associated with multiple product use, higher frequency of use, earlier initiation age, and use of flavored products. CONCLUSIONS: Among U.S. adolescents, a considerable amount of current tobacco product users, even infrequent users, reported symptoms of dependence. These findings highlight the continued importance of prevention strategies for youth tobacco experimentation and progression to regular use.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Tabagismo , Tabaco sem Fumaça , Adolescente , Humanos , Estados Unidos/epidemiologia , Tabagismo/epidemiologia , Tabaco , Uso de Tabaco/epidemiologia , Instituições Acadêmicas
3.
Addict Behav ; 137: 107506, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36244244

RESUMO

Insomnia is a common sleep disorder associated with poor health outcomes. Individuals from racially underrepresented groups as well as women tend to report more severe insomnia symptoms, and frequent experiences of discrimination have been found to drive such disparities. Smokers commonly experience sleep problems since nicotine can alter the sleep-wake cycle. Discrimination is associated with increased nicotine dependence, and such discrimination may also intensify tobacco withdrawal, specifically mood and cognitive-related aspects of withdrawal. The potential impact of discrimination on withdrawal symptoms and related mood symptoms like depression may lead to increases in insomnia symptoms. However, no studies to date have evaluated the indirect association of discrimination with insomnia severity through nicotine withdrawal and depressive symptoms. Therefore, this cross-sectional survey of n = 110 non-Hispanic Black and White current smokers (48.2 % Black, 69.1 % women) investigated these associations through a serial mediation model. Controlling for race, gender, nicotine dependence levels, and income, multivariate analyses supported a significant indirect effect of discrimination on insomnia severity through depressive symptoms. Analyses supported the hypothesized serial mediation model whereby discrimination is positively associated with depressive symptoms, which in turn are linked to more severe nicotine withdrawal, leading to greater insomnia severity. Smokers encountering frequent experiences of discrimination might be at increased risk of suffering insomnia as a result of their increased depressive and withdrawal symptoms. Future work is necessary to understand the role of depressive symptoms in these associations as well as possible implications for smoking relapse and success of smoking cessation programs.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Síndrome de Abstinência a Substâncias , Tabagismo , Feminino , Humanos , Masculino , Nicotina/efeitos adversos , Tabagismo/complicações , Fumantes , Depressão , Estudos Transversais , Síndrome de Abstinência a Substâncias/etiologia
5.
Braz. j. oral sci ; 22: e239237, Jan.-Dec. 2023. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1399762

RESUMO

Aim: To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods: The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results: The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36­2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36­0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41­0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21­20.29). Conclusion: Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation


Assuntos
Humanos , Masculino , Feminino , Adolescente , Estudantes de Odontologia , Tabagismo , Saúde Mental , Depressão/epidemiologia , Desempenho Acadêmico
6.
Behav Brain Res ; 437: 114120, 2023 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-36181947

RESUMO

INTRODUCTION: Models of addiction have identified deficits in inhibitory control, or the ability to inhibit inappropriate or unwanted behaviors, as one factor in the development and maintenance of addictive behaviors. Current literature supports disruption of the prefrontal circuits that mediate reactive inhibitory control processes (i.e., inhibition in response to sudden, unplanned changes in environmental demands) in substance use disorders. However, the relationship between disorders of addiction, such as nicotine dependence, and planned inhibitory processes (i.e., inhibition that occurs after advance warning) is unclear. The goal of the present study was to examine the extent to which reactive and planned inhibitory processes are differentially disrupted in nicotine dependent individuals. METHOD: We employed an internet-based novel stop signal task wherein participants were instructed to stop a continuous movement at either a predictable or unpredictable time. This task explicitly separated planned and reactive inhibitory processes and assessed group differences in task performance between smokers (N = 281) and non-smokers (N = 164). The smoker group was defined as any participant that identified as a smoker and reported an average daily nicotine consumption of at least 2 mg. The non-smoker group was defined as any participant that identified as a non-smoker and had not been a former smoker that quit within the last year. The smoker group also completed a questionnaire regarding smoking behaviors which included the Fägerstrom Test of Nicotine Dependence (FTND). We used these data to assess the continuous relation between planned stopping, unplanned stopping, and smoking behaviors. RESULTS: We found significant differences in stop times for both reactive and planned stopping between groups as well as within the smoker group. Additionally, in the smoker group, dependence as measured by the FTND was associated with longer stop times on planned stop trials. Surprisingly, greater daily average consumption of nicotine was related to faster stopping for both trial types. CONCLUSION: These results indicate the relevance of measuring both reactive and planned inhibitory processes for elucidating the relationship between nicotine addiction and mechanisms of inhibitory control.


Assuntos
Tabagismo , Humanos , não Fumantes , Nicotina/farmacologia , Inibição Reativa , Fumantes
7.
BMJ Open ; 12(11): e067694, 2022 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-36410805

RESUMO

INTRODUCTION: The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than non-menthol VLNCs, this would indicate that some aspect of menthol may maintain smoking even in the absence of nicotine and FDA's regulatory authority to ban or restrict the sale of menthol cigarettes should apply to reduced nicotine content of cigarettes. In April 2022, the FDA announced proposed rulemaking to prohibit menthol cigarettes, however it is unclear if a menthol prohibition would apply to VLNCs. METHODS AND ANALYSIS: This study will recruit 172 young adult menthol smokers (with a specific subsample of n=40 sexual and gender minority young adults) and measure appeal for smoking experimental menthol and non-menthol VLNCs, and the impact of proposed product standards on tobacco product purchasing behaviour using an Experimental Tobacco Marketplace. Appeal across product standards will be assessed in a controlled laboratory and using ecological momentary assessment. ETHICS AND DISSEMINATION: The protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#11865). Findings will examine the effects of a reduced nicotine standard and a menthol ban on young adult smoking and will be disseminated through peer-reviewed journal articles and presentations at scientific conferences. TRIAL REGISTRATION NUMBER: NCT04340947.


Assuntos
Produtos do Tabaco , Tabagismo , Humanos , Adulto Jovem , Mentol , Nicotina , Fumantes
8.
Cancer Control ; 29: 10732748221138713, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36373741

RESUMO

Tobacco use accounts for 30% of all cancer-related deaths worldwide and 20% in the US, despite effective, evidence-based interventions for reducing tobacco use and tobacco-related cancers and deaths. In 2012, to reduce the burden of tobacco-related cancer and associated population-level risks across Texas, The University of Texas MD Anderson Cancer Center initiated the EndTobacco® program to promote statewide cancer control activities. We created evidence-based initiatives, established selection criteria, and implemented actions involving policy, education, and tobacco treatment services. As a result, EndTobacco has supported, educated, and convened local and state coalitions in policymaking; provided tobacco treatment education to health professionals; implemented Texas' only certified tobacco treatment training program; and led an initiative to enhance the tobacco-free culture of the state's publicly funded university system. Supported by commitments from MD Anderson, we developed and implemented evidence-based actions for tobacco control tailored to the center's mission, values, expertise, resources, and partnerships. By 2021, the adult smoking rate in Texas dropped from 19.2% (2014) to 13.2%. Contributors to this drop include state tobacco control policies, programs and services from multiple agencies and associations, and EndTobacco activities that complement the statewide effort to prevent youth smoking initiation and increase quit attempts among youth and adults.


Assuntos
Neoplasias , Tabagismo , Adulto , Adolescente , Estados Unidos/epidemiologia , Humanos , National Cancer Institute (U.S.) , Tabagismo/prevenção & controle , Fumar , Tabaco , Atenção à Saúde , Neoplasias/epidemiologia , Neoplasias/prevenção & controle
9.
Artigo em Inglês | MEDLINE | ID: mdl-36429968

RESUMO

INTRODUCTION: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). METHODS: Data come from the baseline C'RILLOS study, a U.S. nationally representative sample of young adults aged 18-34 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents' modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). RESULTS: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. DISCUSSION: The tobacco use field currently classifies 'tobacco users' based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered 'discontinued use' and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.


Assuntos
Cannabis , Produtos do Tabaco , Tabagismo , Adulto Jovem , Humanos , Tabaco , Fumar/epidemiologia , Uso de Tabaco/epidemiologia
10.
Sci Rep ; 12(1): 19787, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396945

RESUMO

Deficits in impulse control belong to the core profile of nicotine dependence. Smokers might thus benefit from voluntarily self-restricting their access to the immediate temptation of nicotine products (precommitment) in order to avoid impulse control failures. However, little is known about how smokers' willingness to engage in voluntary self-restrictions is determined by metacognitive insight into their general preferences for immediate over delayed rewards. Here, with a series of monetary intertemporal choice tasks, we provide empirical evidence for reduced metacognitive accuracy in smokers relative to non-smokers and show that smokers overestimate the subjective value of delayed rewards relative to their revealed preferences. In line with the metacognitive deficits, smokers were also less sensitive to the risk of preference reversals when deciding whether or not to restrict their access to short-term financial rewards. Taken together, the current findings suggest that deficits not only in impulse control but also in metacognition may hamper smokers' resistance to immediate rewards and capacity to pursue long-term goals.


Assuntos
Metacognição , Tabagismo , Humanos , Tabagismo/psicologia , Recompensa , Nicotina/efeitos adversos , Motivação
11.
Zhongguo Zhen Jiu ; 42(11): 1235-9, 2022 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-36397220

RESUMO

OBJECTIVE: To compare the clinical efficacy between auricular point sticking combined with transcutaneous electrical acupoint stimulation (TEAS) and nicotine patch for smoking cessation. METHODS: Two hundred patients who voluntarily quit smoking were randomly divided into a combination group and a nicotine patch group, 100 cases in each group. In the combination group, auricular point sticking (Shenmen [TF4], Neifenmi [CO18], Pizhixia [AT4], Jiaogan [AH6a], etc., once every other day) combined with TEAS(Lieque [LU 7] and Zusanli [ST 36], with continuous wave, 20 Hz in frequency, 1 mA in current intensity, 30 min each time, once a day) were applied. In the nicotine patch group, nicotine patch was applied. Both groups were treated for 8 weeks. The immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and in follow-up of 16 weeks after treatment in the two groups were compared; before treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the degree of nicotine dependence was evaluated by using Fagerström test for nicotine dependence (FTND); 1 week into treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the withdrawal symptoms and smoking craving were evaluated by using Minnesota nicotine withdrawal scale (MNWS); the safety and compliance (dropped off rate and treatment completeness) were evaluated in the two groups. RESULTS: There was no statistical significance of the differences in the immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and during follow-up between the two groups (P>0.05). The FTND scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those before treatment (P<0.01); the FTND score during follow-up in the combination group was lower than the nicotine patch group (P<0.05). The MNWS scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those 1 week into treatment (P<0.05); the changes of MNWS scores 8 weeks into treatment and during follow-up in the combination group were greater than the nicotine patch group (P<0.05, P<0.01). There were no serious adverse reactions in either group. Eight weeks into treatment and during follow-up, the dropped off rates were all 16.0% (16/100) in the combination group, which were 20.0% (20/100) and 23.0% (23/100) in the nicotine patch group, there was no statistical significance of the differences in the two groups (P>0.05). There was no significant difference in treatment completeness between the two groups (P>0.05). CONCLUSION: Auricular point sticking combined with TEAS could effective decrease the degree of nicotine dependence, improve withdrawal symptoms in smokers, its effect is superior to nicotine patch.


Assuntos
Abandono do Hábito de Fumar , Síndrome de Abstinência a Substâncias , Tabagismo , Humanos , Pontos de Acupuntura , Administração Cutânea , Nicotina , Síndrome de Abstinência a Substâncias/tratamento farmacológico
12.
Clín. investig. arterioscler. (Ed. impr.) ; 34(6): 330-338, Nov-Dic. 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-VR-379

RESUMO

El tabaquismo sigue siendo la principal causa de morbimortalidad a nivel mundial. Por su clara influencia en las enfermedades cardiovasculares y respiratorias, es un factor importante en la consulta de medicina interna. Aunque la tasa de abandono del hábito tabáquico está ascendiendo en los últimos años, existe un porcentaje de pacientes que continúan fumando porque no pueden o no quieren cesar el hábito, a pesar de haber probado las terapias farmacológicas y no farmacológicas existentes. Para este grupo de paciente existen unas estrategias que se basan en intervenciones destinadas a reducir los efectos negativos del tabaco sin la necesidad de extinguir por completo su consumo. En esta revisión se contempla como gracias a la ausencia de combustión de la materia orgánica que se da en el cigarrillo convencional, en snus, cigarrillo electrónico y productos de tabaco calentado se genera un nivel significativamente inferior de sustancias tóxicas.(AU)


Smoking remains the leading cause of morbidity and mortality worldwide. Because of its clear influence on cardiovascular and respiratory diseases, it is an important factor in internal medicine consultations. Although the rate of smoking cessation has been increasing in recent years, there is a percentage of patients who continue to smoke because they are unable or unwilling to quit, despite having tried existing pharmacological and non-pharmacological therapies. For this group of patients there are strategies based on interventions aimed at reducing the negative effects of smoking without the need for complete cessation. In this review it is shown that due to the absence of combustion of organic matter in conventional cigarettes, snus, e-cigarettes and heated tobacco products generate significantly lower levels of toxic substances.(AU)


Assuntos
Humanos , Uso de Tabaco , Tabagismo , Doenças Cardiovasculares , Sistemas Eletrônicos de Liberação de Nicotina , Tabaco sem Fumaça , Arteriosclerose , Doenças Respiratórias , Pesquisa
13.
Tijdschr Psychiatr ; 64(9): 604-607, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-36349857

RESUMO

BACKGROUND: In 2018 Jellinek became a smoke free institution. By implementing ‘Jellinek Smoke free’ in all locations (15), a policy has been implemented to facilitate smoking cessation in clients with a comorbid tobacco use disorder seeking treatment for substance use disorders at Jellinek. AIM: To investigate whether the implementation of the new policy impacted smoking behaviour of clients in treatment for substance use disorders at Jellinek. METHOD: Based on data from anonymized client files, changes in smoking behaviour (cessation or reduction) were analysed for clients with other addictions who started treatment in 2016 versus clients who started in 2019 - after the implementation of the new smoke free policy. Comparative analyses were conducted on the population as a whole, per type of treatment (outpatient care, residential care, Minnesota, outreaching care) as well as per type of smoker (light, moderate, heavy). RESULTS: In the client population as a whole, significantly more people stopped smoking in 2019 (22%) in comparison to 2016 (16%) and there was a trend toward statistical significance with regard to reduction. When a cessation period was part of treatment, significantly more clients stopped and decreased the number of cigarettes a day. Moreover, light and moderate smokers (≤ 20 cigarettes a day) stopped and reduced significantly more in 2019 (32%) than in 2016 (23%). In outpatient care, outreaching care and with heavy smokers (> 20 cigarettes a day), there was no significant difference in percentage of cessation and reduction between 2016 and 2019. CONCLUSION: After implementing Jellinek Smoke free, significant changes in smoking behaviour occurred in the client population as a whole with a comorbid tobacco use disorder, in treatments where a cessation period was part of treatment as well as with light and moderate smokers.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar , Transtornos Relacionados ao Uso de Substâncias , Tabagismo , Humanos , Tabagismo/epidemiologia , Tabagismo/terapia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Fumar/epidemiologia , Fumar/terapia
15.
Medicine (Baltimore) ; 101(43): e31456, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36316847

RESUMO

BACKGROUND: Smoking negatively impacts public health. There are several treatments to quit smoking, and nicotine replacement treatment (NRT) reportedly doubles the smoking cessation rate, with some limitations. Acupuncture is an alternative option with proven effects on smoking cessation. However, there has been no definite report that indicates the efficacy and safety of auricular acupuncture (AA) combined with NRT on smoking cessation. METHODS: This is a randomized, assessor-blind, and pragmatic pilot study. We will recruit 40 participants who want to stop smoking and randomly allocate them into an NRT group and an NRT + AA group with a 1:1 ratio. Participants will receive NRT for 4 weeks and the NRT + AA group will receive additional AA treatment with 5 AA points (Shenmen (TF4), lung (CO14), throat (TF3), inner nose (TG4), and endocrine (CO18)) twice a week for 4 weeks. Follow-up will be conducted 1 and 3 months after intervention completion. The primary outcome will be tobacco consumption and abstinence rate determined by calculating the rate of change in cigarette use and a urine test. Secondary outcomes will be the quality of life (EuroQol-5D and visual analogue scale), nicotine dependence (Fagerstrom test for nicotine dependence), nicotine withdrawal (Minnesota nicotine withdrawal scale), physical effects, satisfaction, and safety measurement (adverse events). RESULTS: We will investigate the efficacy and safety of AA combined with NRT treatment for smoking cessation. CONCLUSION: Our study will provide additional clinical evidence for AA as an adjuvant treatment for smoking cessation. TRIAL REGISTRATION NUMBER: Clinical Research Information Service (registration number: KCT0007212).


Assuntos
Acupuntura Auricular , Abandono do Hábito de Fumar , Tabagismo , Humanos , Abandono do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco , Nicotina/efeitos adversos , Projetos Piloto , Qualidade de Vida , Agonistas Nicotínicos , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Tob Control ; 31(Suppl 3): s206-s213, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36328462

RESUMO

SIGNIFICANCE: The purpose of this research was to measure flavour loyalty and identify how current cigarillo users may respond to a hypothetical flavour ban in the USA. METHODS: Cigarillo users aged 21-28 (n=531) were recruited between October 2020 and April 2021 to participate in an online survey. Respondents categorised their preferred, usual and current cigarillo flavours. Individuals who preferred tobacco flavours were compared with individuals who preferred any other flavours. Strength of preferences, or flavour loyalty, was defined when an individual's preferred flavour matched what they use both usually and currently creating a spectrum of individuals with a strong tobacco preference (n=34), weak tobacco preference (n=20), weak flavour preference (n=162) and strong flavour preference (n=315). Those preferring tobacco were aggregated into any tobacco preference (n=54). RESULTS: Individuals who preferred any flavour scored higher on a scale of nicotine dependence. There was a dose-response relationship in those who said they would discontinue cigarillos if flavoured options were not available: 11.4% of individuals with any tobacco flavour preference, 27.8% of those with a weak flavour preference and 38.1% of those with a strong flavour preference. A similar trend was noted among those who would switch to another product: 19.2% of those with tobacco flavour preference, 34.3% of those with a weak flavour preference and 43.2% of those with a strong flavour preference. CONCLUSION: Individuals who display strong flavour preferences were more likely to say they would discontinue use or seek out alternative flavoured products following a ban on flavoured cigarillos.


Assuntos
Produtos do Tabaco , Tabagismo , Adulto Jovem , Humanos , Aromatizantes , Uso de Tabaco , Paladar , Tabaco
17.
Artigo em Inglês | MEDLINE | ID: mdl-36429485

RESUMO

BACKGROUND: Previous studies have shown that socializing with other smokers is an essential trigger for social smoking among smokers with a low nicotine dependence. This study further explored the mediating effects of the belief of smoking rationalization and smoker identity on the relationship between socializing with smokers and social smoking behavior. METHODS: A cross-sectional design was conducted. A total of 696 low-nicotine-dependent smokers in China completed questionnaires that assessed socializing with smokers, social smoking behavior, smoker identity, and the belief of smoking rationalization. The mediating roles of the belief of smoking rationalization and smoker identity on the relationship between socializing with smokers and social smoking behavior were assessed by using SPSS 23 and AMOS 23. RESULTS: The belief of smoking rationalization, smoker identity, socializing with smokers, and social smoking behavior were significantly and positively correlated with each other. In addition, this study found an independently mediated role for smoker identity in the relationship with smoker socialization and social smoking behavior, and a sequentially mediated role for smoking rationalization and smoker identity in this relationship. CONCLUSION: Reducing the belief of smoking rationalization and smoker identity may be conducive to reducing social smoking behavior for low-nicotine-dependent smokers when socializing with other smokers.


Assuntos
Abandono do Hábito de Fumar , Tabagismo , Masculino , Humanos , Fumantes , Racionalização , Estudos Transversais , Nicotina , Fumar/epidemiologia
18.
JAMA Netw Open ; 5(11): e2240671, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36342713

RESUMO

Importance: As e-cigarettes have become more effective at delivering the addictive drug nicotine, they have become the dominant form of tobacco use by US adolescents. Objective: To measure intensity of use of e-cigarettes, cigarettes, and other tobacco products among US adolescents and their dependence level over time. Design, Setting, and Participants: This survey study analyzed the cross-sectional National Youth Tobacco Surveys from 2014 to 2021. Confirmatory analysis was conducted using Youth Behavioral Risk Factor Surveillance System from 2015 to 2019. The surveys were administered to national probability samples of US students in grades 6 to 12. Exposures: Use of e-cigarettes and other tobacco products before and after the introduction of e-cigarettes delivering high levels of nicotine. Main Outcomes and Measures: First tobacco product used, age at initiation of use, intensity of use (days per month), and nicotine addiction (measured as time after waking to first use of any tobacco product). Results: A total of 151 573 respondents were included in the analysis (51.1% male and 48.9% female; mean [SEM] age, 14.57 [0.03] years). Prevalence of e-cigarette use peaked in 2019 and then declined. Between 2014 and 2021, the age at initiation of e-cigarette use decreased, and intensity of use and addiction increased. By 2017, e-cigarettes became the most common first product used (77.0%). Age at initiation of use did not change for cigarettes or other tobacco products, and changes in intensity of use were minimal. By 2019, more e-cigarette users were using their first tobacco product within 5 minutes of waking than for cigarettes and all other products combined. Median e-cigarette use also increased from 3 to 5 d/mo in 2014 to 2018 to 6 to 9 d/mo in 2019 to 2020 and 10 to 19 d/mo in 2021. Conclusions and Relevance: The changes detected in this survey study may reflect the higher levels of nicotine delivery and addiction liability of modern e-cigarettes that use protonated nicotine to make nicotine easier to inhale. The increasing intensity of use of modern e-cigarettes highlights the clinical need to address youth addiction to these new high-nicotine products over the course of many clinical encounters. In addition, stronger regulation, including comprehensive bans on the sale of flavored tobacco products, should be implemented.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Tabagismo , Vaping , Adolescente , Masculino , Feminino , Humanos , Vaping/epidemiologia , Tabagismo/epidemiologia , Nicotina , Estudos Transversais
19.
Tob Control ; 31(Suppl 3): s161-s166, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36328470

RESUMO

SIGNIFICANCE: Reducing youth e-cigarette use is a New York State (NYS) public health priority. In May 2020, a state-wide restriction on flavoured e-cigarettes, except tobacco flavour, was passed. This study examines changes in nicotine product use behaviour among youth around the time of the state-wide vaping flavour restriction. METHODS: NYS data from the US International Tobacco Control Policy Evaluation Project Youth Tobacco and E-cigarette Tobacco and Vaping Survey were analysed cross-sectionally from February 2020 (n=955), August 2020 (n=946), February 2021 (n=1030) and August 2021 (n=753). Online surveys were conducted among youth 16-19 years. Weighted descriptive statistics and regression models were used to describe changes in nicotine product use behaviour. Models were adjusted for age, sex, race/ethnicity and perceived family socioeconomic status. RESULTS: Significant decreases in past 30-day e-cigarette use (20%-11%), cigarette (7%-4%), and dual use of e-cigarettes and cigarettes (5%-2%) were observed over the 2-year period in NYS. Over 95% of vapers still reported using a non-tobacco-flavoured e-cigarette following the restriction, with fruit-flavoured being the most popular at each time point. CONCLUSIONS: Nearly all NYS youth continued to vape flavours that were restricted in NYS. While youth past 30-day vaping prevalence decreased significantly from 2020 to 2021, increased flavour restriction compliance could result in an even greater decrease. Continuous monitoring is important to better understand perceptions, use patterns and access at the individual level, retail level and population level to inform future enforcement and restrictions.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Tabagismo , Vaping , Adolescente , Humanos , Vaping/epidemiologia , New York , Nicotina , Aromatizantes , Tabagismo/epidemiologia , Política Pública
20.
MMWR Morb Mortal Wkly Rep ; 71(45): 1429-1435, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36355596

RESUMO

Tobacco use* is the leading cause of preventable disease, disability, and death among adults in the United States (1). Youth use of tobacco products in any form is unsafe, and nearly all tobacco use begins during youth and young adulthood (2). The Food and Drug Administration (FDA) and CDC analyzed data from the 2022 National Youth Tobacco Survey (NYTS) to estimate current (past 30-day) use of eight tobacco products among U.S. middle (grades 6-8) and high school (grades 9-12) students. In 2022, approximately 11.3% of all students (representing 3.08 million persons) reported currently using any tobacco product, including 16.5% of high school and 4.5% of middle school students (2.51 million and 530,000 persons, respectively). Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school (14.1%; 2.14 million) and middle school (3.3%; 380,000) students. Approximately 3.7% of all students (representing 1 million persons) reported currently smoking any combustible tobacco product. Current use of any tobacco product was higher among certain population groups, including 13.5% of non-Hispanic American Indian or Alaska Native (AI/AN)† students; 16.0% of students identifying as lesbian, gay, or bisexual (LGB); 16.6% of students identifying as transgender; 18.3% of students reporting severe psychological distress; 12.5% of students with low family affluence; and 27.2% of students with low academic achievement. Implementation of comprehensive evidence-based tobacco control strategies, combined with FDA regulation, is important for preventing and reducing youth tobacco product use (1,2).


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Tabagismo , Adolescente , Adulto , Feminino , Humanos , Estados Unidos/epidemiologia , Adulto Jovem , Inquéritos Epidemiológicos , Uso de Tabaco/epidemiologia , Tabagismo/epidemiologia , Estudantes
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