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1.
N Z Med J ; 134(1543): 90-102, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34695080

RESUMO

AIM: To estimate prevalence and patterns of smoking and vaping, and associations between smoking and vaping, among university students in New Zealand when access to nicotine-containing e-cigarettes was restricted (ie, time point 1 or T1) and 12-months after restrictions were relaxed (ie, time point 2 or T2). METHOD: Cross-sectional surveys of university students across all eight universities: T1, March 2018 (n=1,932), and T2, March 2019 (n=2,004). Chi-squared tests compared responses between T1 and T2 and logistic regression examined associations between smoking and vaping with student characteristics. RESULTS: The patterns of smoking (T1 vs T2): current (10.6% vs 12.1%, p=0.716), daily (5.0% vs 4.6%, p=0.121), and cigarettes/day, time to first cigarette, and avoidance of smoking in smoke-free spaces were not significantly different. In contrast, vaping: current (6.8% vs 13.5%, p<0.001), daily (2.7% vs 5.4%, p<0.001), and possibly vaping in smoke-free spaces, were significantly higher at T2. At both periods, males had higher odds of smoking, vaping and dual use; students aged 25-34 and long-term residents had higher odds of vaping. Asian and Other students had lower odds of smoking at T1, and Other students had higher odds of vaping at T2. CONCLUSION: Vaping was significantly more prevalent at T2 than T1, without their being a corresponding decrease in smoking. Age, sex, student type and ethnicity predicted smoking and vaping.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Grupos Étnicos/estatística & dados numéricos , Vaping/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Nova Zelândia/epidemiologia , Estudantes , Inquéritos e Questionários , Tabaco , Universidades , Adulto Jovem
3.
Pediatr Clin North Am ; 68(5): 977-990, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34538307

RESUMO

Studies have yielded mixed findings regarding changes in adolescent substance use during the COVID-19 pandemic; some report increased alcohol and cannabis use, others show less binge drinking and vaping behaviors, and others no change. In 2019, only 8.3% of the 1.1 million adolescents with a substance use disorder received specialized treatment. Treatment rates for 2020 have not yet been published. Stay-at-home orders and social distancing guidelines put into place in March 2020 caused the partial closure of many outpatient substance use clinics. The implications of this treatment suspension and special considerations for working with adolescents during stay-at-home orders are discussed.


Assuntos
Comportamento do Adolescente/psicologia , COVID-19/psicologia , Isolamento Social/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Alcoolismo/epidemiologia , COVID-19/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Vaping/epidemiologia
4.
PLoS One ; 16(9): e0256844, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469460

RESUMO

INTRODUCTION: E-liquid flavor is typically presented by flavor category (e.g. menthol, mint, fruit, dessert). Cooling sensations produced by flavor additives such as menthol enhance appeal of e-cigarettes among youth, but not all e-liquids that produce cooling sensations are labeled as menthol. Sensory experiences produced by flavors may allow for a new way to capture e-cigarette flavor use. This study aims to examine use of flavors that produce cooling sensations among youth and its association with e-cigarette use behaviors. METHODS: A 2019 survey of high school students (n = 4875) examined use of e-cigarette flavors that produced cooling sensations (cooling flavors) among past 30-day e-cigarette users. E-cigarette use behaviors (flavor use, nicotine use, frequency of use) were examined between those who did and did not use cooling flavors. A binary logistic regression was used to examine associations between vaping frequency, nicotine (vs. non-nicotine) use, and vaping cooling flavors while controlling for demographics, number of flavors vaped in the past month, and vaping age of onset. RESULTS: 51.6% (n = 473/916) of the analytic sample endorsed vaping cooling flavors. There were no demographic differences by vaping cooling flavors. Vaping cooling flavors was associated with vaping more frequently (AOR:1.04,95% CI:1.03,1.05) and vaping nicotine (AOR:2.37,95% CI:1.53,3.67). CONCLUSION: Vaping cooling flavors was associated with greater nicotine vaping and frequency of e-cigarette use. Assessing sensory experience, such as cooling, in addition to flavor category may more fully capture e-cigarette flavor use and its impacts on youth e-cigarette use behaviors.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Aromatizantes/administração & dosagem , Mentol/administração & dosagem , Paladar/efeitos dos fármacos , Vaping/epidemiologia , Adolescente , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Vaping/psicologia , Adulto Jovem
6.
Am J Health Behav ; 45(4): 635-641, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34340731

RESUMO

Objectives: This study investigated the smoking behavior and its association with the availability of tobacco products purchases among Korean adolescents. Methods: The data of the 2019 Korea Youth Risk Behavior Survey were used (N =57,303). This study assessed 3 tobacco products: cigarettes, e-cigarettes, and heated tobacco products. Smoking behavior including lifetime, current, daily, heavy smoking, and attempting to quit and its association with the availability of tobacco products for purchase was assessed. Results: Overall, 92.9% did not try to purchase tobacco products during the past 30 days, 2.2% found it impossible to purchase, 0.8% could buy with a lot of effort, 1.7% could buy with little effort, and 2.3% could buy easily without any effort. Lifetime smokers were 13.8% (12.7% for cigarettes, 7.4% for e-cigarettes, and 4.9% for heated tobacco products). Among lifetime smokers, the current smoking rates for cigarettes, e-cigarettes, and heated tobacco products were 48.5%, 22.9%, and 19.0%, and the rates were lower in adolescents who responded that it was impossible to buy tobacco products. Among current smokers, the daily smoking rates were lower in adolescents who were found it impossible to buy tobacco products. Conclusions: The ease of access to tobacco products was associated with higher use of cigarettes, e-cigarettes, and heated tobacco products and lower attempts to quit smoking in Korean adolescents.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Fumar , Produtos do Tabaco , Vaping/epidemiologia , Adolescente , Humanos , República da Coreia/epidemiologia , Fumantes , Fumar/epidemiologia , Produtos do Tabaco/economia
7.
Pediatrics ; 148(3)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34408091

RESUMO

Electronic nicotine delivery system use contributes to the epidemic of youth vaping. Regulations to curtail or prohibit the sale of flavored nicotine products aim to disrupt initiation of child nicotine use by reducing access to enticing nicotine flavorings. A total of 6 states and >300 localities have restricted or banned flavored nicotine product sales. In this case study, we outline the use of a localized town-based strategy, which offered 2 potential bills to incrementally restrict or prohibit sale of flavored vape products when county or state legislation was not politically feasible. Over the course of 18 months, these bills reduced the number of municipalities where these products could be sold or advertised until county, city, and statewide bans were effectively in place, ultimately making the passage of a bill in the statehouse palatable. Strong partnerships with officials who had expertise in local town government, local American Academy of Pediatrics chapter physician champions, and a diverse coalition were instrumental in motivating smaller governments, which often pass legislation faster than larger legislatures, to create child-protective tobacco policies.


Assuntos
Produtos do Tabaco/legislação & jurisprudência , Vaping , Adolescente , Comércio/legislação & jurisprudência , Sistemas Eletrônicos de Liberação de Nicotina , Aromatizantes , Humanos , Governo Local , Marketing , Nicotina , Política Pública , Estados Unidos , Vaping/epidemiologia
8.
BMC Pulm Med ; 21(1): 231, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256746

RESUMO

BACKGROUND: The association between the dual use of electronic cigarette (e-cigarette) and conventional cigarettes (c-cigarette) and spirometry-defined chronic obstructive pulmonary disease (COPD) has not been studied thoroughly. METHODS: A total of 47,217 participants were identified in the 2013-2018 Korea National Health and Nutrition Examination Survey; of them, 12,919 participants aged ≥ 40 who underwent spirometry and had no missing data were enrolled. Pulmonary function testing, urinary cotinine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels were compared between dual users, current smokers, former smokers, and non-users using complex sample linear regression analysis. The odds ratio (OR) for COPD was calculated using a complex sample logistic regression model after adjusting for covariates. RESULTS: Among current e-cigarette users, approximately 85% of the participants used c-cigarette concurrently, and 1.3% of all the participants were dual users (2.3% in males and 0.1% in females). Both dual users and current smokers showed higher levels of urine cotinine and NNAL than non-users and former smokers. The weighted prevalence of COPD was the highest in dual users (13.8% for all participants and 14.1% for males). The multivariate-adjusted OR of COPD for male dual users, compared to non-users, was 3.46 (Ptrend < 0.001). The OR for COPD was 3.10 (Ptrend < 0.001) in middle-aged (40-64 years) and 3.70 (Ptrend < 0.001) in older (≥ 65 years) men. In females, the association was not observed and could not be precisely measured because of the small proportion of the smoking population. CONCLUSIONS: Dual use of e-cigarette and c-cigarette is associated with COPD in males.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Vaping/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia
9.
Carcinogenesis ; 42(8): 1009-1022, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34223886

RESUMO

This review highlights the convergence of three global health challenges at a crossroad where the pandemic of coronavirus disease 2019 (COVID-19) meets the tobacco epidemic and vaping. It begins with an overview of the current knowledge on the biology, pathophysiology and epidemiology of COVID-19. It then presents the state of smoking and vaping during the pandemic by summarizing the published data on prevalence, use patterns, product availability/accessibility, sales records and motivation to quit before and after the start of the pandemic. It highlights the state of evidence on the association of tobacco product use with COVID-19 infection and transmission rates, symptom severity and clinical outcomes. Also discussed are proposed biological mechanisms and behavioral factors that may modulate COVID-19 risk in tobacco product users. Furthermore, competing hypotheses on the protective effect of nicotine against COVID-19 as well as the claimed 'smokers' paradox' are discussed. Considerations and challenges of COVID-19 vaccination in tobacco product users are underscored. Collectively, the present data show an 'incomplete' but rapidly shaping picture on the association of tobacco product use and COVID-19 infection, disease course and clinical outcomes. Evidence is also growing on the mechanisms by which tobacco product use may contribute to COVID-19 pathophysiology. Although we await definitive conclusions on the relative risk of COVID-19 infection in tobacco product users, compelling data confirm that many comorbidities associated with/caused by smoking predispose to COVID-19 infection, severe disease and poor prognosis. Additionally, it is becoming increasing clear that should smokers get the disease, they are more likely to have serious health consequences.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2/isolamento & purificação , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , COVID-19/complicações , COVID-19/patologia , COVID-19/virologia , Saúde Global , Humanos , Fumar Tabaco/patologia , Vaping/patologia
10.
Obstet Gynecol ; 138(1): 85-94, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34259468

RESUMO

OBJECTIVE: To evaluate the risk of adverse birth outcomes among adults who use electronic cigarettes (e-cigarettes) before and during pregnancy. METHODS: Data from the 2016-2018 PRAMS (Pregnancy Risk Assessment Monitoring System) were used to assess the association between e-cigarette use during the 3 months before and last 3 months of pregnancy among 79,176 individuals with a recent live birth and the following birth outcomes: preterm birth, small for gestational age, and low birth weight (LBW). Adjusted prevalence ratios were generated using average marginal predictions from multivariable logistic regression models. Models were stratified by prenatal combustible cigarette smoking and frequency of e-cigarette use (daily or less than daily use). RESULTS: In the 3 months before pregnancy, 2.7% (95% CI 2.6-2.9%) of respondents used e-cigarettes; 1.1% (95% CI 1.0-1.2%) used e-cigarettes during the last 3 months of pregnancy. Electronic cigarette use before pregnancy was not associated with adverse birth outcomes. Electronic cigarette use during pregnancy was associated with increased prevalence of LBW compared with nonuse (8.1% vs 6.1%; adjusted prevalence ratio 1.33; 95% CI 1.06-1.66). Among respondents who did not also smoke combustible cigarettes during pregnancy (n=72,256), e-cigarette use was associated with higher prevalence of LBW (10.6%; adjusted prevalence ratio 1.88; 95% CI 1.38-2.57) and preterm birth (12.4%; adjusted prevalence ratio 1.69; 95% CI 1.20-2.39). When further stratified by frequency of e-cigarette use, associations were seen only for daily users. CONCLUSION: E-cigarette use during pregnancy, particularly when used daily by individuals who do not also smoke combustible cigarettes, is associated with adverse birth outcomes.


Assuntos
Exposição Materna/efeitos adversos , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Vaping/efeitos adversos , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Nascimento Prematuro/etiologia , Prevalência , Inquéritos e Questionários , Estados Unidos/epidemiologia , Vaping/epidemiologia , Adulto Jovem
11.
PLoS One ; 16(6): e0253322, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34166402

RESUMO

BACKGROUND: Studies have produced inconsistent results on prevalence trends in asthma and allergic rhinitis (AR). We surveyed young adults about asthma in 2008 and 2016 and examined the impact of gender, AR and smoking. METHODS: Thirty-thousand randomly selected subjects aged 16-75 years in Western Sweden received postal questionnaires in 2008 and 50,000 in 2016. This study is based on responders aged 16-25 years, 2,143 in 2008 and 2,484 in 2016. RESULTS: From 2008-2016 current asthma increased from 9.3% to 11.5% (p = 0.014) and was significant in males without AR (aOR 1.83, 95% CI 1.09-3.07) and male smokers (aOR 3.02, 95% CI 1.12-8.13). In both years the risk of current asthma was reduced by growing up on a farm (aOR 0.26, 95% CI 0.81-0.84 and aOR 0.47, 95% CI 0.23-0.996), independent of a family history of asthma or allergy. AR did not differ significantly from 2008-2016 (22.5% vs 24.4%, p = 0.144). Current smoking decreased from 20.3% to 15.2% (p<0.001), especially in females (23.5% to 16.2%, p<0.001). Female smokers started smoking later and smoked fewer cigarettes in 2016 than 2008. In 2016, 4.8% of the cohort reported using electronic cigarettes. Of those, 60.7% also smoked tobacco and more than two-thirds who used both (67.2%) were heavy smokers. CONCLUSION: Current asthma increased in respondents aged 16-25 from 2008-2016, mainly among males without AR and male smokers. Current AR levelled off in this young population, while current smoking decreased among females.


Assuntos
Asma/epidemiologia , Rinite Alérgica/epidemiologia , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adolescente , Adulto , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Suécia , Adulto Jovem
12.
J Pediatr Orthop ; 41(Suppl 1): S64-S69, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34096540

RESUMO

INTRODUCTION: Adolescents undergoing pediatric orthopaedic surgery typically experience an uncomplicated postoperative course. However, adolescence represents a unique transition period from pediatric to adult physiology. As a result, the astute pediatric orthopaedic surgeon will be aware of unique medical and social scenarios which are relevant to adolescents during the perioperative course including the risk of venous thromboembolism (VTE), prevalence of mental health conditions, and rising use of electronic cigarettes or "vaping" to consume nicotine and cannibas. DISCUSSION: Adolescents are at a greater risk of VTE after pediatric orthopaedic surgery. In particular, adolescent females with a family history of blood clotting disorders and those with a change in mobility after surgery should be considered for prophylaxis. The prevalence of adolescent mental health conditions including anxiety, depression, and behavioral issues is increasing in the United States. Higher levels of preoperative anxiety and the presence of mental health pathology are associated with slower recovery, higher levels of postoperative pain, and the increased likelihood for chronic pain. Several quick screening instruments are available to assess adolescents for preoperative anxiety risk, including the Visual Analogue Scale for Anxiety or the Amsterdam Perioperative Anxiety Information Scale. Unfortunately, electronic cigarettes have become increasingly popular for the consumption of nicotine and cannabis among adolescents. Preoperative use of combustive cigarettes (nicotine/cannabis) represents perioperative risks for induction/anesthesia, postoperative pain, and analgesia requirements and issues with delayed wound and fracture healing. CONCLUSIONS: VTE, underlying mental health conditions, and usage of nicotine and cannabis are clear detriments to the recovery and healing of adolescent patients following orthopaedic surgery. Therefore, standardized screening for adolescents before orthopaedic surgery is indicated to identify perioperative risk factors which have negative impacts on functional outcomes.


Assuntos
Procedimentos Ortopédicos , Complicações Pós-Operatórias , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Vaping/epidemiologia , Tromboembolia Venosa , Adolescente , Humanos , Saúde Mental , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/psicologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Prevalência , Risco Ajustado , Fatores de Risco , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle
13.
PLoS One ; 16(6): e0252427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086706

RESUMO

INTRODUCTION: COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. METHODS: This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. RESULTS: Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. CONCLUSIONS: Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries.


Assuntos
COVID-19/epidemiologia , Cognição , Comportamentos Relacionados com a Saúde , SARS-CoV-2 , Fumantes , Abandono do Hábito de Fumar , Inquéritos e Questionários , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adolescente , Adulto , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar Tabaco/psicologia , Vaping/psicologia
14.
Sci Rep ; 11(1): 13508, 2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34188127

RESUMO

Although pregnant smokers may perceive electronic cigarettes (e-cigarettes) as safe alternatives to smoking combustible cigarettes, few studies have evaluated perinatal e-cigarette use and its associated health effects. We analyzed data from the Pregnancy Risk Assessment Monitoring System (PRAMS, 2016-2018) for 16,022 women who recently gave birth and reported smoking combustible cigarettes prior to pregnancy. Using average marginal predictive values from multivariable logistic regression to produce adjusted prevalence ratios (aPRs), we estimated the prevalence of combustible cigarette smoking during pregnancy and adverse birth outcomes associated with e-cigarette use. In total, 14.8% of smoking women reported using e-cigarettes prior to pregnancy. There was no association between e-cigarette use prior to pregnancy and combustible cigarette smoking during pregnancy (aPR 0.95; 95% CI 0.88, 1.02); however, e-cigarette use during pregnancy was associated with higher prevalence of combustible cigarette smoking during pregnancy (aPR 1.65; 95% CI 1.52, 1.80). In this sample, we did not observe evidence to support reduced risk of preterm birth, small-for-gestational age and low birthweight compared to combustible cigarette smoking during pregnancy. The prevalence of LBW was higher for those who used e-cigarettes, even exclusively, compared to women who quit smoking cigarettes entirely. These results suggest that e-cigarettes should not be considered a safe alternative to combustible cigarette smoking during pregnancy.


Assuntos
Fumar Cigarros , Sistemas Eletrônicos de Liberação de Nicotina , Recém-Nascido de Baixo Peso , Recém-Nascido Pequeno para a Idade Gestacional , Nascimento Prematuro , Produtos do Tabaco , Vaping , Adulto , Fumar Cigarros/efeitos adversos , Fumar Cigarros/epidemiologia , Feminino , Humanos , Recém-Nascido , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Prevalência , Medição de Risco , Vaping/efeitos adversos , Vaping/epidemiologia
15.
J Am Heart Assoc ; 10(12): e021118, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34102851

RESUMO

Background Although tobacco product use and transitions have been characterized in the general population, few studies have focused on individuals with established cardiovascular disease (CVD) in a population-based sample. Methods and Results We examined tobacco use prevalence and longitudinal patterns of tobacco product transitions in adults (≥18 years) of the nationally representative PATH (Population Assessment of Tobacco and Health) study, from 2013 to 2014 (Wave 1) through 2016 to 2018 (Wave 4). Prevalent CVD was classified through self-report of having had a heart attack, heart failure, stroke, or other heart condition. Factors associated with tobacco product use and transitions were investigated using survey logistic regression. We examined 2615 participants with self-reported CVD at Wave 1. Overall, 28.9% reported current tobacco use, equating to ≈6.2 million adults in the United States with prevalent CVD and current tobacco use. Among adults with CVD who are current tobacco users, the most commonly used product was cigarettes (82.8%), followed by any type of cigar (23.7%), and e-cigarette use (23.3%). E-cigarette use without concurrent cigarette use among participants with prevalent CVD was uncommon (1.1%). Factors associated with tobacco use were younger age, male sex, had lower education level, and lack of knowledge about the association between smoking and CVD. Men with prevalent CVD were less likely to use e-cigarettes compared with women (odds ratio [OR], 0.7; 95% CI, 0.5-0.9). Among cigarette users with CVD, transition rates between Waves 1 and 4 demonstrated <5% decrease in cigarette, with a 0.5% increase in e-cigarette use. Only ≈10% were in formal tobacco cessation programs. Conclusions Despite known harmful cardiovascular effects, over one fourth of adults with prevalent CVD use tobacco products and few quit smoking over the 4 waves of the PATH data set.


Assuntos
Doenças Cardiovasculares/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Fumantes , Abandono do Hábito de Fumar , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Fumar/epidemiologia , Fatores de Tempo , Estados Unidos/epidemiologia , Vaping/efeitos adversos , Vaping/epidemiologia , Adulto Jovem
17.
Am J Drug Alcohol Abuse ; 47(4): 414-421, 2021 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-34187262

RESUMO

Background: Initial evidence suggests a role for Google Trends (GT) in monitoring use and interest in Electronic Nicotine Delivery Systems (ENDS).Objective: To examine the validity of GT data for assessing population behavior and interest in ENDS.Methods: GT search, done from the US and India to assess: (a) whether descriptive and statistical trends of specific search words depicting online interest in ENDS were similar to the published reports on actual use of these products in the US; (b) correlations between state-wise relative search volumes (RSV) of these words and prevalence of ENDS use; (c) the change in the online interest of ENDS after change in its regulatory policy.Results: Locally weighted scatter plot analysis showed "electronic cigarette," "vaping," and "cigarette" trends mirrored the use trend reported by the US-based National Youth Tobacco Survey (2019). Online interest in "Juul pods" followed the trends of its use. Geo-spatial RSVs of "electronic cigarette" (r=0.74, p<0.0001) and "vaping" (r=0.55, p<0.0001) correlated positively with state-wise prevalence of switch to ENDS in adults. Complete ENDS use prohibition in India was associated with a decrease in the online interest in "electronic cigarettes" (t=3.18, p=0.01) and "vaping" (t=2.3, p=0.04). Regulation of use in New Mexico (USA) was associated with a reduction in "electronic cigarettes" (t=4.09, p=0.0005) but not in "vaping."Conclusion: GT may be used to validate existing information and assess the potential effect of ENDS regulations. Its role can also be extended for monitoring interest and use of other drugs and alcohol.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Ferramenta de Busca/normas , Humanos , Índia/epidemiologia , Prevalência , Uso de Tabaco/epidemiologia , Estados Unidos/epidemiologia , Vaping/epidemiologia
18.
LGBT Health ; 8(6): 433-438, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129400

RESUMO

Purpose: Sexual and gender minority (SGM) young adults report disproportionately higher rates of tobacco and nicotine product use. This study assessed the role of adverse childhood experiences (ACEs) in nicotine and tobacco product use among SGM young adults. Methods: A cross-sectional survey was administered to 11,694 college students (ages 18-29 years) between 2017 and 2018 in California, Minnesota, and Texas. Results: For every additional ACE reported, the odds of cigarette, e-cigarette, and dual use increased for all students, with significantly higher past 30-day cigarette use among ACE-exposed SGM students. Conclusion: ACEs are an important contributing factor to tobacco-related disparities facing SGM groups.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Fumar Cigarros/epidemiologia , Minorias Sexuais e de Gênero/psicologia , Estudantes/psicologia , Vaping/epidemiologia , Adolescente , Adulto , California/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Texas/epidemiologia , Universidades , Adulto Jovem
19.
Respir Res ; 22(1): 151, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006276

RESUMO

The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades. In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health. Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19).


Assuntos
COVID-19/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Aromatizantes/efeitos adversos , Nível de Saúde , Vaping/efeitos adversos , Vaping/epidemiologia , COVID-19/metabolismo , Aromatizantes/metabolismo , Humanos , Vaping/metabolismo
20.
JAMA Pediatr ; 175(7): 715-722, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33938922

RESUMO

Importance: Stay-at-home policies related to the COVID-19 pandemic could disrupt adolescents' substance use and physical activity. Objective: To compare adolescents' substance use and physical activity behaviors before and after stay-at-home restrictions. Design, Setting, and Participants: Ongoing prospective cohort study of tobacco use behaviors among ninth- and tenth-grade students enrolled at 8 public high schools in Northern California from March 2019 to February 2020 and followed up from September 2019 to September 2020. Race/ethnicity was self-classified from investigator-provided categories and collected owing to racial/ethnic differences in tobacco and substance use. Exposures: In California, a COVID-19 statewide stay-at-home order was imposed March 19, 2020. In this study, 521 six-month follow-up responses were completed before the order and 485 were completed after the order. Main Outcomes and Measures: The prevalence of substance use (ie, past 30-day use of e-cigarettes, other tobacco, cannabis, and alcohol) and physical activity (active ≥5 days/week) was compared at baseline and follow-up. A difference-in-difference approach was used to assess whether changes from baseline to 6-month follow-up varied if follow-up occurred after the stay-at-home order, adjusting for baseline behaviors and characteristics. All models were weighted for losses to follow-up using the inverse probability method. Weights were derived from a logistic regression model for having a follow-up response (dependent variable), as predicted by baseline characteristics and behaviors. Results: Of 1423 adolescents enrolled at baseline, 1006 completed 6-month follow-up (623 [62%] were female, and 492 [49%] were non-Hispanic White). e-Cigarette use declined from baseline to 6-month follow-up completed before the stay-at-home order (17.3% [89 of 515] to 11.3% [58 of 515]; McNemar χ2 = 13.54; exact P < .001) and 6-month follow-up completed after the stay-at-home order (19.9% [96 of 482] to 10.8% [52 of 482]; McNemar χ2 = 26.16; exact P < .001), but the extent of decline did not differ statistically between groups responding before vs after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.84; 95% CI, 0.47-1.52; P = .58). In contrast, being physically active was unchanged from baseline if follow-up was before the order (53.7% [279 of 520] to 52.9% [275 of 520]; McNemar χ2 = 0.09; exact P = .82) but declined sharply from baseline if follow-up was after the order (54.0% [261 of 483] to 38.1% [184 of 483]; McNemar χ2 = 30.72; exact P < .001), indicating a pronounced difference in change from baseline after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.49; 95% CI, 0.35-0.69; P < .001). Overall in the cohort, reported use of other tobacco, cannabis, and alcohol did not differ meaningfully before and after the order. Conclusions and Relevance: In this cohort, a reduction in e-cigarette use occurred independently of COVID-19 stay-at-home restrictions, but persistent cannabis and alcohol use suggest continued need for youth substance use prevention and cessation support. Declining physical activity during the pandemic is a health concern.


Assuntos
Comportamento do Adolescente/psicologia , COVID-19/epidemiologia , Usuários de Drogas/psicologia , Exercício Físico/psicologia , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , COVID-19/psicologia , Usuários de Drogas/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Estados Unidos , Vaping/epidemiologia
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