Rassegna Stampa Scientifica Ottobre 2021       Prenatal Tobacco Exposure and the Risk of Tobacco Smoking and Dependence in Offspring: a Systematic Review and Meta-Analysis Drug Alcohol Depend. 2021 Aug 27;227:108993. Online ahead of print. Bereket Duko, Gavin Pereira, Robert J Tait, Sylvester Dodzi Nyadanu, Kim Betts, Rosa Alati https://www.sciencedirect.com/science/article/abs/pii/S0376871621004889   "The web of this chronic disease, whether it be defined as tobacco use disorder or nicotine dependence, intermingles itself among almost every other disease state, both acute and chronic. It is one of the single most important diagnoses because successful treatment leads to less of a need for treatment of other illnesses such as stroke, peripheral artery disease, coronary disease, and many more. However, we continue to put these and other diagnoses above tobacco use disorder on the problem list, and despite the best efforts of select policy makers and electronic medical record designers, it is subsequently overlooked, ignored, and improperly managed."   Letter to the Editor Changing the Culture of Tobacco Dependence Treatment Among Not Only Patients, But Also Prescribers Mayo Clin Proc. 2021 Sep;96(9):2494-2495. Adam Edward Lang https://www.mayoclinicproceedings.org/article/S0025-6196(21)00550-4/fulltext   Authors' Reply:   In Reply: Changing the Culture of Tobacco Dependence Treatment Among Not Only Patients, But Also Prescribers https://www.mayoclinicproceedings.org/article/S0025-6196(21)00556-5/fulltext Note: Open Access.   "We conducted a random effects meta-analysis and examined heterogeneity across 27 studies through subgroup analyses and meta-regression. Tobacco retailer density (RRR=2.55, 95% CI 1.91 to 3.19, k=155) and proximity (RRR=2.38, 95% CI 1.39 to 3.37, k=100) were associated with tobacco use behaviours. Pooled results including both density and proximity found an estimated 2.48% reduction in risk of tobacco use from reductions in tobacco retailer density and proximity (RRR=2.48, 95% CI 1.95 to 3.02, k=255)… Conclusions: Across studies, lower levels of tobacco retailer density and decreased proximity are associated with lower tobacco use. Reducing tobacco supply by limiting retailer density and proximity may lead to reductions in tobacco use."   Associations of tobacco retailer density and proximity with adult tobacco use behaviours and health outcomes: a meta-analysis Tobacco Control Published Online First: 03 September 2021. Joseph G L Lee, Amanda Y Kong, Kerry B Sewell, Shelley D Golden, Todd B Combs, Kurt M Ribisl, Lisa Henriksen https://tobaccocontrol.bmj.com/content/early/2021/09/03/tobaccocontrol-2021-056717   Also:   Call for emergency action to limit global temperature increases, restore biodiversity and protect health https://tobaccocontrol.bmj.com/content/early/2021/09/02/tobaccocontrol-2021-056997 Note: Open Access.   "An increase in the percent of a county's population covered by smoke-free air laws yielded a significant decline of 2.4% (RR: 0.976, 95%CI: 0.954, 0.997) in acute cerebrovascular disease hospitalizations among older adults. Moreover, significant declines of 2.0% (RR: 0.980, 95%CI: 0.967, 0.994) and 2.8% (RR: 0.972, 95%CI:0.949, 0.996) in acute cerebrovascular disease were observed among older adults in the first year and subsequent years after smoke-free air legislation was implemented, respectively. Conventional cigarette taxes did not yield a significant change in acute cerebrovascular disease hospitalizations, nor did either tobacco control policy lead to a significant decline in acute myocardial infarction hospitalizations."   The impact of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations Nicotine Tob Res. 2021 Sep 4;ntab158. Online ahead of print. Jon F Oliver https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab158/6364115   Analysis of Wholesale Cigarette Sales in Canada After Menthol Cigarette Bans JAMA Netw Open. 2021;4(11):e2133673. November 9, 2021 Michael Chaiton, Robert Schwartz, Anasua Kundu, Christopher Houston, Robert Nugent https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785881   Note: Open Access.   Related coverage:   Study: Ban on menthol cigarettes in Canada had more people quit smoking https://www.upi.com/Health_News/2021/11/10/canada-cigarettes-menthol-ban-more-quitters/4981636581934/ In Canada, Ban on Menthol Cigarettes Had More Smokers Quitting https://www.usnews.com/news/health-news/articles/2021-11-10/in-canada-ban-on-menthol-cigarettes-had-more-smokers-quitting   "A total of 1466 respondents (52.8%) — including 145 of 457 current smokers (31.7%), 367 of 682 adults under 30 years of age (53.8%), and 599 of 1122 adults aged 50 or more (53.4%) — thought it would be good were selling cigarettes in retail outlets phased out; 533 (19.2%), including 181 smokers (39.6%), thought it would be bad. A total of 1779 respondents (64.2%) thought it fair to implement the phase‐out within the next ten years… Support for phasing out sales and for doing so within five years was greatest among never smokers and lowest among smokers; age group did not influence support for phasing out sales, but affirming that doing so within five years was fair was higher among respondents aged 30 years or more."   Public support for phasing out the sale of cigarettes in Australia Med J Aust 2021; 215 (10): 471-472. Published online: 30 August 2021 Emily Brennan, Sarah Durkin, Michelle M Scollo, Maurice Swanson and Melanie Wakefield https://www.mja.com.au/journal/2021/215/10/public-support-phasing-out-sale-cigarettes-australia   Related MJA Perspective & coverage:   It is time for governments to support retailers in the transition to a smoke‐free society https://www.mja.com.au/journal/2021/215/10/it-time-governments-support-retailers-transition-smoke-free-society Australian governments urged to set a date to ban cigarette retail sales https://www.theguardian.com/australia-news/2021/nov/15/australian-governments-urged-to-set-a-date-to-ban-cigarette-retail-sales   "Wanting and planning to quit were significantly positively associated with making quit attempts, but negatively associated with smoking abstinence. A significant interaction between the Heaviness of Smoking Index and age warranted an age-stratified analysis for both abstinence outcomes. Lower HSI predicted abstinence in only the younger smokers. Motivation and plans to quit were positively associated with abstinence in younger smokers, but surprisingly were negatively associated with abstinence in older smokers."

 

 

Rassegna Stampa Scientifica Giugno 2022

 

 

Orticaria indotta da citisina: un caso clinico durante un trattamento per smettere di fumare

La notizia è relativa al recente articolo pubblicato sulla rivista Acta Biomedica (Acta Biomed 2022; Vol. 93, Supplement 1: e2022073) accessibile attraverso il link: https://pubmed.ncbi.nlm.nih.gov/35731167/ 

La citisina il più antico farmaco per smettere di fumare, utilizzata da oltre 50 anni nell’Europa dell’est e in Asia, è generalmente ben tollerata ed efficace. Gli eventi avversi riportati negli studi sono in genere disturbi gastrointestinali e del sonno, non gravi e autolimitanti. E’ stato recentemente pubblicato per la prima volta un caso sospetto di orticaria, in una donna di 48 anni in cura per tabagismo presso l'Unità di Medicina delle Dipendenze, Dipartimento di Medicina Interna, Azienda Ospedaliera di Verona, Italia¹. Il protocollo terapeutico utilizzato per la cessazione dal fumo era quello standard che prevede l’aumento gradualmente delle capsule di citisina assunte giornalmente. La paziente ha sospeso la citisina, è stata trattata per i primi tre giorni con betametasone (1 mg/die) e ha mostrato segni di guarigione dopo una settimana.

 

Brain lesions disrupting addiction map to a common human brain circuit

Nature Medicine (2022)

Published: 13 June 2022

Juho Joutsa, Khaled Moussawi, Shan H. Siddiqi, Amir Abdolahi, William Drew, Alexander L. Cohen, Thomas J. Ross, Harshawardhan U. Deshpande, Henry Z. Wang, Joel Bruss, Elliot A. Stein, Nora D. Volkow, Jordan H. Grafman, Edwin van Wijngaarden, Aaron D. Boes & Michael D. Fox

https://www.nature.com/articles/s41591-022-01834-y

https://www.nature.com/articles/s41591-022-01834-y.pdf

 

 

A smoke-free generation: New Zealand's tobacco ban

The Lancet

VOLUME 399, ISSUE 10339, P1930-1931, MAY 21, 2022

Chris McCall

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00925-4/fulltext

https://www.thelancet.com/action/showPdf?pii=S0140-6736%2822%2900925-4

 

Note: Open Access upon registration.

 

"Despite the current no-tobacco advertising policies, both PMI’s [Philip Morris International's] and Altria’s corporate image campaigns have run extensively in major news outlets (in both physical and digital formats), including the New York Times and Washington Post… They feature high-ranking corporate executives advocating for company-sponsored research coupled with claims that these companies are aligned with public health objectives. Message placement in prominent news outlets suggests a deliberate attempt to position their sponsored content alongside news reporting while helping to ensure message exposure among an influential audience… The extent to which these ‘corporate promotion’ ads have infiltrated major news outlets is concerning, raising questions about how objective media outlets should treat sponsored industry content."

 

Ad watch

Tobacco industry advertising: efforts to shift public perception of big tobacco with paid media in the USA

Tobacco Control Published Online First: 16 May 2022.

Robin Koval, Nicole Dorrler, Barbara Schillo

https://tobaccocontrol.bmj.com/content/early/2022/05/08/tobaccocontrol-2021-057189

 

"Our study demonstrates majority support for regulations controlling e-cigarettes in Australia. Parents generally favoured wide-ranging restrictions that could reduce adolescent e-cigarette use. Almost all parents support a ban on marketing and advertising of e-cigarettes to teenagers thus recognising the reach and influence of product appeal, placement and price on this age group. Australian governments have an opportunity to help prevent more widespread e-cigarette use and protect the health of adolescents by limiting their exposure to e-cigarette promotions."

 

Parents support strong restrictions controlling e-cigarette use in Australia: findings from a national survey

Tobacco Control Published Online First: 17 May 2022.

Mary-Anne Measey, Vikram Palit, Monsurul Hoq, Moya Vandeleur, Anthea Rhodes

https://tobaccocontrol.bmj.com/content/early/2022/05/16/tobaccocontrol-2021-057074

 

Also:

 

Analysis of mainstream emissions, secondhand emissions and the environmental impact of IQOS waste: a systematic review on IQOS that accounts for data source

https://tobaccocontrol.bmj.com/content/early/2022/05/12/tobaccocontrol-2021-056986

Place-based inequities in cigarette smoking across the USA

https://tobaccocontrol.bmj.com/content/early/2022/05/17/tobaccocontrol-2022-057293

 

"Due to the low return of saliva samples, validated prolonged abstinence rates in the intention-to-treat analysis were low (39 of 571 (6.8%) versus 25 of 569 (4.4%) in the e-cigarette and NRT [nicotine replacement therapy] arms, respectively) and did not differ significantly between the two study arms… In summary, in the unadjusted primary analysis there was insufficient evidence to confidently demonstrate that e-cigarettes are more effective than NRT in helping pregnant women to stop smoking. The effects of e-cigarettes appear to have been masked by e-cigarette use in the NRT arm. When abstinent participants using non-allocated products were excluded, e-cigarettes were markedly more effective than patches in all abstinence outcomes. "

 

Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial

Nature Medicine (2022)

Published: 16 May 2022

Peter Hajek, Dunja Przulj, Francesca Pesola, Chris Griffiths, Robert Walton, Hayden McRobbie, Tim Coleman, Sarah Lewis, Rachel Whitemore, Miranda Clark, Michael Ussher, Lesley Sinclair, Emily Seager, Sue Cooper, Linda Bauld, Felix Naughton, Peter Sasieni, Isaac Manyonda & Katie Myers Smith

https://www.nature.com/articles/s41591-022-01808-0

https://www.nature.com/articles/s41591-022-01808-0.pdf

 

Note: Open Access.

 

Related coverage:

 

E-cigarettes ‘as safe as nicotine patches’ for pregnant smokers trying to quit

https://www.theguardian.com/society/2022/may/16/e-cigarettes-as-safe-as-nicotine-patches-for-pregnant-smokers-trying-to-quit

Vaping may be an effective way to quit smoking during pregnancy

https://www.newscientist.com/article/2320515-vaping-may-be-an-effective-way-to-quit-smoking-during-pregnancy/

 

"We did not find a significant difference in the cardiovascular risk of exclusive e-cigarette use compared with nonuse of cigarettes and e-cigarettes, although analyses were limited by a small number of CVD [cardiovascular disease] events in e-cigarette users. Dual use of cigarettes and e-cigarettes was associated with a significantly increased risk of CVD compared with nonuse. The cardiovascular risk of dual use did not differ from the risk among those exclusively smoking cigarettes."

 

Letter

E-cigarette Use and Risk of Cardiovascular Disease: A Longitudinal Analysis of the PATH Study, 2013-2019

Circulation. 2022;0

Originally published 6 May 2022

Jonathan B. Berlowitz, Wubin Xie, Alyssa F. Harlow, Naomi M. Hamburg, Michael J. Blaha, Aruni Bhatnagar, Emelia J. Benjamin and Andrew C. Stokes

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057369  

https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.121.057369

 

Note: Open Access.

 

"We analyzed Global Adult Tobacco Survey data in Bangladesh, China, Costa Rica, Ethiopia, India, Kazakhstan, Mexico, Philippines, Romania, Russia, Senegal, Ukraine, Turkey, Uruguay, and Viet Nam during 2014–2018… EC [E-cigarette] use was low in most countries. “Dual use” was common among current smokers and the quit ratio was higher among ECs users… Nevertheless, comprehensive EC regulatory policies should be implemented to prevent the escalation of EC use by targeting population subgroups such as young adults, educated and wealthier individuals."

 

Awareness About and E-Cigarette Use Among Adults in 15 Low- and Middle-Income Countries, 2014–2018 Estimates From Global Adult Tobacco Surveys

Nicotine & Tobacco Research, ntab269.

Published: 21 May 2022

Chandrashekhar T Sreeramareddy, Anusha Manoharan

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab269/6590320

 

"Following JUUL’s removal of mint in November 2019, JUUL’s market share dropped from over 66% in Florida and the United States to 37.1% (Florida) and 55.1% (United States). In January 2020, the second leading brands were Puff Bar (15.0%) in Florida and Vuse (18.1%) in the United States. Mint market share decreased and share of all other flavor categories increased, particularly menthol and concept. Total ENDS sales increased in Florida but decreased in the United States. Average prices of ENDS devices decreased. Conclusions: While JUUL’s actions led to a decline in its sales, Puff Bar emerged and menthol and concept flavors experienced growth."

 

JUUL’s 2019 Removal of Mint-Flavored Pods and Changes to the Retail Environment of Electronic Nicotine Delivery Systems in Florida and the United States

Nicotine & Tobacco Research, ntac128.

Published: 15 May 2022

Jennifer Gaber, Doris G Gammon, Youn Ok Lee, James Nonnemaker, Brittany Young, Annice Kim, Lauren Porter

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac128/6586051

 

Also:

Adolescents’ understanding of smoking and vaping risk language: Cognitive interviews to inform scale development

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac127/6585952

Secondhand tobacco smoke and functional impairments in older adults living in the community

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac131/6586052

A randomized pilot of a tailored smoking cessation quitline intervention for individuals who smoke and vape

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac129/6586250

 

"How we define “current use” of tobacco and nicotine delivery products changes our estimates of how individuals transition to, between, and from different patterns of use. We show that the robustness of transition estimates to whether or not non-established users are included as current users and to different frequency-of-use threshold depends in part on whether low-frequency users are categorized as non-current users or as a distinct category. Our results emphasize the importance of intentional definitions of product use that reflect the larger goals of public health and tobacco control."

 

The impact of current tobacco product use definitions on estimates of transitions between cigarette and ENDS use

Nicotine & Tobacco Research, ntac132.

Published: 19 May 2022

Andrew F Brouwer, David T Levy, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Luz María Sanchez-Romero, Ritesh Mistry, Rafael Meza

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac132/6589520

 

Also:

 

The unhealthy association between smoking, vaping, and other drug use

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac130/6588418

 

Note: Open Access.

 

"The hardening hypothesis suggests that tobacco control activities influence an individual’s ability to quit, and those who find it challenging to quit are those who remain smokers. Reviews and papers have attempted to demystify this hypothesis, and the debate continues. Adding to the continuing discussions, a recently-published umbrella and systematic review by Harris et al. (2022) strongly opposed the existence of the hardening hypothesis, after conducting a wide-ranging qualitative synthesis of the evidence pertinent to various hardening constructs and indicators. However, several key methodological issues may have ushered a deficient—or worse, unqualified—interpretation of the evidence base."

 

Correspondence

The Hardening Hypothesis – Further Testing is Still Required

Nicotine & Tobacco Research, ntac125.

Published: 13 May 2022

Isabella Steffensen, Red Thaddeus D Miguel, Julien Carlone

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac125/6585632

 

Referenced N&TR study:

 

Smokers increasingly motivated and able to quit as smoking prevalence falls: umbrella and systematic review of evidence relevant to the 'hardening hypothesis', considering transcendence of manufactured doubt

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac055/6542043

 

Note: Open Access.

 

"Ever/current [Hungarian] HTP [heated tobacco product] users presented misperceptions about the harms of HTPs, e-cigarettes, and NRT. They underestimated the potential health benefits of NRT and had distorted harm perceptions about HTPs and e-cigarettes. Public education about the relative harms of different nicotine and tobacco products is urgently needed."

 

Perceived harm of heated tobacco products, e-cigarettes, and nicotine replacement therapy compared with conventional cigarettes among ever and current heated tobacco users

Addict Behav Rep. 2022 May 16;15:100432. eCollection 2022 Jun.

Melinda Pénzes, Tamás Joó, Róbert Urbán

https://www.sciencedirect.com/science/article/pii/S235285322200027X

 

Note: Open Access.

 

"We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas… Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. Conclusions: These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions."

 

Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors

Tob Prev Cessat. 2022 May 6;8:18. eCollection 2022.

Breesa Bennett, Katelyn F Romm, Carla J Berg

http://www.tobaccopreventioncessation.com/Changes-in-cigarette-and-e-cigarette-use-among-US-young-nadults-from-before-to-during,148245,0,2.html

 

Note: Open Access.

 

"In 2020, the prevalence of middle and high school students reporting “no” or “little” harm (vs. “some” or “a lot”) was 20.1% for e-cigarettes, 17.4% for hookahs, 14.6% for cigars, 13.5% for smokeless tobacco, and 11.0% for cigarettes. During 2016–2020, perceptions of “no” or “little” harm decreased for e-cigarettes, increased for cigarettes and smokeless tobacco, and exhibited nonlinear changes for hookahs. Discussion: Most youth are aware of tobacco product harms, but opportunities exist to educate youth about the harms of nondaily tobacco product use."

 

Tobacco Product Harm Perceptions Among US Middle and High School Students, 2016-2020

J Adolesc Health. 2022 May 19;S1054-139X(22)00386-X. Online ahead of print.

Emily Glidden, Nikki A Hawkins, Ahmed Jamal, Teresa W Wang

https://www.jahonline.org/article/S1054-139X(22)00386-X/fulltext

 

"The implementation of CEASE [Clinical effort against secondhand smoke exposure] in practices was influenced by the adaptability and complexity of the intervention, the needs of patients and their families, the resources available to practices to support the implementation of CEASE, other competing priorities at the practices, the cultures of practices, and clinicians' and office staffs' knowledge and beliefs about family-centered tobacco control."

 

A Qualitative Study of Factors Influencing Implementation of Tobacco Control in Pediatric Practices

J Smok Cessat. 2022 May 5;2022:4156982. eCollection 2022.

Emara Nabi-Burza, Jonathan P Winickoff, Jeremy E Drehmer, Maurice P Zeegers, Bethany Hipple Walters

https://www.hindawi.com/journals/josc/2022/4156982/

https://downloads.hindawi.com/journals/josc/2022/4156982.pdf

 

Note: Open Access.

 

"In the French context, the new plain packaging of tobacco products probably had an impact on smokers’ perception of tobacco by increasing the embarrassment they felt when they took out their pack of cigarettes in plain sight. It also influenced the motivation to quit smoking, and more generally, it could contribute to the denormalization of tobacco."

 

Plain packaging on tobacco products in France: Effectiveness on smokers’ attitudes one year after implementation

Tob. Induc. Dis. 2022;20(April):35

Anne Pasquereau, Romain Guignard, Raphaël Andler, Karine Gallopel-Morvan, Viêt Nguyen-Thanh

http://www.tobaccoinduceddiseases.org/Plain-packaging-on-tobacco-products-in-France-Effectiveness-non-smokers-attitudes,146600,0,2.html

http://www.tobaccoinduceddiseases.org/pdf-146600-74381?filename=Plain%20packaging%20on.pdf

 

Note: Open Access.

 

 

Rassegna Stampa Scientifica Maggio 2022

 

 

Impact of Canada’s menthol cigarette ban on quitting among menthol smokers: pooled analysis of pre–post evaluation from the ITC Project and the Ontario Menthol Ban Study and projections of impact in the USA

Tobacco Control Published Online First: 28 April 2022.

Geoffrey T Fong, Janet Chung-Hall, Gang Meng, Lorraine V Craig, Mary E Thompson, Anne C K Quah, K Michael Cummings, Andrew Hyland, Richard J O'Connor, David T Levy, Cristine D Delnevo, Ollie Ganz, Thomas Eissenberg, Eric K Soule, Robert Schwartz, Joanna E Cohen, Michael O Chaiton

https://tobaccocontrol.bmj.com/content/early/2022/04/27/tobaccocontrol-2021-057227

 

Also:

 

Vaping and anime: a growing area of concern

https://tobaccocontrol.bmj.com/content/early/2022/04/25/tobaccocontrol-2021-057195

 

Note: Open Access.

 

"In conclusion, this review indicates that e-cigarette products with ice hybrid flavours or synthetic coolants may be appealing, widely marketed, preferred among young people and possess possible toxicological concerns. To inform regulation of e-cigarettes with ice flavours and non-menthol coolants, research is needed to address evidence gaps on the epidemiology, toxicology, health effects, addiction potential and influence on smoking cessation of the evolving product class."

 

Ice flavours and non-menthol synthetic cooling agents in e-cigarette products: a review

Tobacco Control Published Online First: 28 April 2022.

Adam M Leventhal, Alayna P Tackett, Lauren Whitted, Sven Eric Jordt, Sairam V Jabba

https://tobaccocontrol.bmj.com/content/early/2022/04/27/tobaccocontrol-2021-057073

 

Related BMJ Open report:

 

Measuring young adult appeal for menthol and non-menthol cigarettes: protocol of a clinical trial using both laboratory and intensive longitudinal methods (PRISM)

https://bmjopen.bmj.com/content/12/4/e058823.long

 

Note: Open Access.

 

"Of the sampled 558 960 adults, 41.4% (unweighted) were aged 18 to 25 years, 29.8% (unweighted) were aged 26 to 49 years, and 53.4% (unweighted) were women. From 2006 to 2019, the past-month self-reported cigarette smoking prevalence declined significantly among adults with MDE from 37.3% to 24.2% for an average annual percent change of −3.2 (95% CI, −3.5 to −2.8; P < .001)… In this exploratory, serial, cross-sectional study, there were significant reductions in the prevalence of self-reported cigarette smoking among US adults with major depressive episode, substance use disorder, or both, between 2006 and 2019."

 

Trends in Prevalence of Cigarette Smoking Among US Adults With Major Depression or Substance Use Disorders, 2006-2019

JAMA. 2022;327(16):1566-1576.

April 26, 2022

Beth Han, Nora D. Volkow, Carlos Blanco, Douglas Tipperman, Emily B. Einstein, Wilson M. Compton

https://jamanetwork.com/journals/jama/fullarticle/2791406

 

Related coverage:

 

Smoking rates fall among Americans with depression, substance use disorders

https://www.upi.com/Health_News/2022/04/27/smoking-depression-substance-use/2241651068404/

 

"Approximately 1% of pregnant women reported past 30-day exclusive e-cigarette use and 3.2% used e-cigarettes and one other tobacco product. Compared to no tobacco use, past 30-day e-cigarette use (exclusive or use with another tobacco product) during pregnancy was not associated with increased odds of an adverse pregnancy or birth outcome in bivariate or multivariable models… Conclusions: E-cigarette use during pregnancy is rare. Understanding the positive and negative impacts of pre-natal e-cigarette use on women’s health may guide public health messaging campaigns."

 

Birth Outcomes Associated with E-Cigarette and Non-E-Cigarette Tobacco Product Use During Pregnancy: An Examination of PATH Data Waves 1 – 5

Nicotine & Tobacco Research, ntac111.

Published: 26 April 2022

Amy Cohn, Hoda Elmasry, Robert C Wild, Amanda L Johnson, Haneen Abudayyeh, Allison Kurti, Victoria H Coleman-Cowger

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac111/6574582

 

"Results from this study provide initial insights into the extent to which required nicotine warning statements appear in ENDS [electronic nicotine delivery systems] ads in the study sample across traditional (e.g., magazines, television, radio) and digital (e.g., online/mobile ads) advertising mediums. Following the August 10, 2018 effective date, we observed a substantial increase in the presence of the required FDA warning statement on the ENDS ads in this sample. However, a notable number of ads in the study lacked the required warning and warnings did not always include the required formatting displays."

 

Presence of nicotine warning statement on US electronic nicotine delivery systems (ENDS) advertisements six months before and after the August 10, 2018 effective date

Nicotine & Tobacco Research, ntac104.

Published: 29 April 2022

Lauren Czaplicki, Kristy Marynak, Dannielle Kelley, Meghan Moran, Sarah Trigger, Ryan David Kennedy

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac104/6576195

 

"We found high rates of e-cigarette ever use (29%) and current use (13%) among study participants. There was high exposure to e-cigarette advertising and promotion in social media, with a majority of participants (84%) reported ever seeing e-cigarette adverts or promotions on Facebook, Instagram, YouTube, and others. Both high rates of e-cigarette use and exposure to social media advertising are associated. Participants reported ever seeing adverts and promotions were 2.91 times and 2.82 times more likely ever to use and currently use e-cigarettes, respectively, after controlling for socioeconomic factors, region, and cigarette smoking status."

 

Is Exposure to Social Media Advertising and Promotion Associated with E-cigarette Use? Evidence from Indonesia

Asian Pac J Cancer Prev. 2022 Apr 1;23(4):1257-1262.

Widya Ratna Wulan, Dian Kusuma, Nurjanah Nurjanah, Aprianti Aprianti, Abdillah Ahsan

http://journal.waocp.org/article_90059.html

http://journal.waocp.org/article_90059_b62d9e1456dba0b0bc46e82651231ea0.pdf

 

Also:

 

Cigarette Consumption and Nutrient Intake in Indonesia: Study of Cigarette-Consuming Households

http://journal.waocp.org/article_90066.html

http://journal.waocp.org/article_90066_1a899637ec3d23e9f65ab845147af2d9.pdf

 

Note: Open Access.

 

"The annual cessation rate increased 29% using NHIS [National Health Interview Survey] data (from 4.2% in 2008-2013 to 5.4% in 2014-2019) and 33% with NSDUH [National Survey on Drug Use and Health] data (4.2% to 5.6%). The cessation rate increase accounts for 60% of a smoking prevalence decline in the most recent period exceeding the 1990-2013 predicted trend. The remaining 40% owes to declining smoking initiation. With current initiation and cessation rates, smoking prevalence should fall to 8.3% in 2030 and eventually reach a steady state of 3.53%... This [cessation rate] increase suggests that the Healthy People 2030 goal of 5% adult smoking prevalence, while ambitious, is attainable."

 

Monitoring the Increase in the U.S. Smoking Cessation Rate and its Implication for Future Smoking Prevalence

Nicotine & Tobacco Research, ntac115.

Published: 29 April 2022

David Méndez, Thuy T T Le, Kenneth E Warner

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac115/6576151

 

Note: Open Access.

 

Also:

 

A Daily Assessment Study of Smoking Cessation After a Head and Neck Cancer Diagnosis

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac114/6576149

 

"We analysed the 2020 Eurobarometer survey, which collected data in 28 European countries… 51.1% of current tobacco smokers and 27.1% of exclusive EC [e-cigarette] or HTP [heated tobacco product] users reported having ever made a quit attempt. The majority of former and current smokers (75.8%) who made a quit attempt did so unassisted, with 28.8% reporting at least one attempt using a cessation aid. The most popular cessation aids were nicotine replacement therapy or other medication (13.4%) and ECs (11.3%)… Cessation support services should take into consideration the increasing numbers of users of EC and HTP who may be trying to quit."

 

How do Europeans quit using tobacco, e-cigarettes and heated tobacco products? A cross-sectional analysis in 28 European countries

BMJ Open. 2022 Apr 29;12(4):e059068.

Marie Line El Asmar, Anthony A Laverty, Constantine I Vardavas, Filippos T Filippidis

https://bmjopen.bmj.com/content/12/4/e059068

 

Also:

 

Cross-sectional survey on cigarette smoking in Chinese high-income areas

https://bmjopen.bmj.com/content/12/4/e056209

 

Note: Open Access.

 

"After adjustment for secular trends, there was a significant increase from the pre-pandemic to pandemic period in the prevalence of use of traditional remote support by past-year smokers in a quit attempt (odds ratio[OR]=2.18[95% confidence interval 1.42-3.33]); specifically telephone support (OR=7.16[2.19-23.45]) and websites (OR=2.39[1.41-4.08]). There was also an increase in the prevalence of use of prescription medication (OR=1.47[1.08-2.00]); specifically varenicline (OR=1.66[1.09-2.52]). There were no significant changes in prevalence of use of other cessation aids after adjustment for secular trends."

 

Prevalence of use and real-world effectiveness of smoking cessation aids during the Covid-19 pandemic: a representative study of smokers in England

Addiction. 2022 May 2. Online ahead of print.

Sarah E Jackson, Sharon Cox, Lion Shahab, Jamie Brown

https://onlinelibrary.wiley.com/doi/10.1111/add.15903

 

Also:

 

Identifying Prospective Subpopulations of Combustible and Electronic Cigarette Dual Users in the United States via Finite Mixture Modeling

https://onlinelibrary.wiley.com/doi/10.1111/add.15906

 

"The results indicate that higher cigarette prices and taxes were associated with a decrease in smoking prevalence and an increased likelihood of quitting smoking. Cigarette tax and price increases produced the most powerful impact on the smoking prevalence of 18- to 24-year-olds. The estimates also show that males tended to be more price-sensitive than females… Cigarette price and tax changes were likely to have a smaller effect on individuals with annual income under $25,000 relative to individuals with higher income levels."

 

The association between smoking behaviors and prices and taxes per cigarette pack in the United States from 2000 through 2019

BMC Public Health. 2022 Apr 28;22(1):856.

Thuy T T Le, Mohammed A Jaffri

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13242-5

https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-022-13242-5.pdf

 

Note: Open Access.

 

"Considering the average PAAS [primary aromatic amines] content and estimated CBs [cigarette butts] littered worldwide every year, freshly smoked CBs can theoretically emit 2.9 tons of ∑PAAs into the environment annually. Considering other chemicals that may also be released into the environment via CBs (beside PAAs), we can consider CBs as a critical source of toxic compounds into the environment and water bodies."

 

Aromatic amines contents of cigarette butts: Fresh and aged cigarette butts vs unsmoked cigarette

Chemosphere. 2022 Apr 27;134735. Online ahead of print.

Sina Dobaradaran, Xenia A M Mutke, Torsten C Schmidt, Philipp Swiderski, Gabriel E De-la-Torre, Maik A Jochmann

 

 

E-cigarette Use and Risk of Cardiovascular Disease: A Longitudinal Analysis of the PATH Study, 2013-2019

Circulation

Originally published 6 May 2022

Jonathan B. Berlowitz, Wubin Xie, Alyssa F. Harlow, Naomi M. Hamburg, Michael J. Blaha, Aruni Bhatnagar, Emelia J. Benjamin and Andrew C. Stokes

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057369

https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.121.057369

 

Note: Open Access.

 

Related PR:

 

No health benefits among adults who used both e-cigarettes and traditional cigarettes

https://newsroom.heart.org/news/no-health-benefits-among-adults-who-used-both-e-cigarettes-and-traditional-cigarettes

 

"3830 English videos were included in the supervised machine learning. The most common video theme was ‘product review’ (48.9%), followed by ‘instruction’ (eg, ‘how to’ use/modify e-cigarettes; 17.3%); diverse e-cigarette products were featured; ‘vape enthusiasts’ most frequently posted e-cigarette videos (54.0%), followed by retailers (20.3%); 43.2% of videos had discount/sales of e-cigarettes; and the most common sales strategy was external links for purchasing (34.1%). ‘Vape trick’ was the least common theme but had the highest engagement (eg, >2 million views)… Discussion Our findings indicate that on YouTube videos accessible to youth, a variety of e-cigarette products are featured through diverse videos themes, with discount/sales. The findings highlight the need to regulate the promotion of e-cigarettes on social media platforms."

 

Understanding e-cigarette content and promotion on YouTube through machine learning

Tobacco Control Published Online First: 03 May 2022.

Grace Kong, Alex Sebastian Schott, Juhan Lee, Hassan Dashtian, Dhiraj Murthy

https://tobaccocontrol.bmj.com/content/early/2022/05/02/tobaccocontrol-2021-057243

 

"Significant lung disease (EVALI) has occurred in adolescents and not all cases are linked to vitamin E acetate. Finally, extrapolating research on adults to adolescents raises the possibility that e-cigarette use is linked to pre-symptomatic cardiovascular dysfunction and may have a significant health impact during adulthood. The combination of this evidence, from pre-clinical to population-based longitudinal studies, conclusively demonstrates that e-cigarettes are not safe for youth."

 

Health effects of electronic cigarettes

Curr Probl Pediatr Adolesc Health Care. 2022 May 4;101202. Online ahead of print.

Judith Groner

https://www.sciencedirect.com/science/article/abs/pii/S1538544222000712

 

Also:

 

E-cigarette disparities: Who are the targets?

https://www.sciencedirect.com/science/article/abs/pii/S1538544222000700

 

"Participants [young adults aged 18-25 years old in Los Angeles, California] reported pairing nicotine vaping with caffeinated beverages like coffee, pop/soda, tea, and after every meal (like patterns of combustible cigarette use). Participants also reported vaping nicotine as a tool to avoid binge eating and increase concentration while studying. Reports of vaping effecting (sic) appetite and eating behaviors also emerged. Vaping nicotine to suppress appetite and/or achieve weight loss was often reported in conjunction with an eating disorder. Participants reported learning about weight-motivated vaping from peers or deducing from cigarette effects and their own experiences with nicotine. Others mentioned controlling food cravings by vaping a similar e-liquid flavor."

 

A chocolate cake or a chocolate vape? Young adults describe their relationship with food and weight in the context of nicotine vaping

Appetite. 2022 May 5;175:106075. Online ahead of print.

Afton Kechter, Rachel Carmen Ceasar, Kelsey A Simpson, Sara J Schiff, Genevieve F Dunton, Ricky N Bluthenthal, Jessica L Barrington-Trimis

https://www.sciencedirect.com/science/article/abs/pii/S0195666322001660

 

"After the introduction of new plain packaging [in France], the proportion of smokers who felt embarrassed taking out their pack of cigarettes in plain sight because of its appearance doubled in 2017 (11.9%, 95% CI: 10.2-13.9 vs 5.9%, 95% CI: 4.4-7.8 in 2016, p<0.001) and continued to increase in 2018 (15.5%, 95% CI: 13.7-17.5, p<0.01). In 2018, women were more embarrassed than men (OR=2.0; 95% CI: 1.5-2.6, p<0.001). In 2018, 26.8% (95% CI: 24.6-29.1) of smokers said the appearance of a pack of cigarettes motivated them to quit, and 22.5% (95% CI: 18.3-27.2) ex-smokers cited it as having motivated them to quit. Smokers who were embarrassed by displaying their pack were more likely to be motivated to quit because of the pack's appearance."

 

Plain packaging on tobacco products in France: Effectiveness on smokers' attitudes one year after implementation

Tob Induc Dis. 2022 Apr 7;20:35. eCollection 2022.

Anne Pasquereau, Romain Guignard, Raphaël Andler, Karine Gallopel-Morvan, Viêt Nguyen-Thanh

http://www.tobaccoinduceddiseases.org/Plain-packaging-on-tobacco-products-in-France-Effectiveness-non-smokers-attitudes,146600,0,2.html

http://www.tobaccoinduceddiseases.org/pdf-146600-74381?filename=Plain%20packaging%20on.pdf

 

Also:

 

Stigmatizing attitudes about lung cancer among individuals who smoke cigarettes

http://www.tobaccoinduceddiseases.org/Stigmatizing-attitudes-about-lung-cancer-among-individuals-nwho-smoke-cigarettes,146907,0,2.html

http://www.tobaccoinduceddiseases.org/pdf-146907-75360?filename=Stigmatizing%20attitudes.pdf

Content and trend analysis of user-generated nicotine sickness tweets: A retrospective infoveillance study

http://www.tobaccoinduceddiseases.org/Content-and-trend-analysis-of-user-generated-nicotine-nsickness-tweets-A-retrospective,145941,0,2.html

http://www.tobaccoinduceddiseases.org/pdf-145941-73102?filename=Content%20and%20trend.pdf

 

Note: Open Access.

 

"Almost two-thirds of [1874] respondents thought it would be ‘a good thing’ if there came a time when it was no longer legal to sell cigarettes in shops in Australia and only 16.7% thought it would be ‘a bad thing’. After the concept of a phase-out was defined as removing a product from the Australian market over a set period, such as 5 years, but still allowing purchases online from overseas companies, 50.7% indicated support for such a phase-out and 61.8% thought it should happen within 10 years. Support was greater for specific measures such as licensing tobacco retailers (75.3%) and restricting sales to places children cannot enter (76.3%)."

 

Public support for policies to phase out the retail sale of cigarettes in Australia: results from a nationally representative survey

Tobacco Control Published Online First: 03 May 2022.

Emily Brennan, Elizaveta Ilchenko, Michelle Scollo, Sarah J Durkin, Melanie A Wakefield

https://tobaccocontrol.bmj.com/content/early/2022/05/02/tobaccocontrol-2021-057122

 

Also:

 

Ex ante evaluation of the impact of tobacco control policy measures aimed at the point of sale in the Netherlands

https://tobaccocontrol.bmj.com/content/early/2022/05/04/tobaccocontrol-2021-057205

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2022/05/04/tobaccocontrol-2021-057205.full.pdf

 

Note: Netherlands paper Open Access.

 

"Key themes from the employer interviews included: the local environment played an important role in implementation of tobacco control EBIs [evidence-based interventions]; tobacco control was perceived as important but not a priority; and tobacco control decisions were driven by worksite culture. Key themes from the employee focus groups included: perceived employer support for tobacco cessation was limited although there was interest from employees; employees who currently used tobacco were stigmatized for their behavior; and incentives and coaching were considered ideal tobacco control EBIs."

 

Worksite tobacco control - a qualitative study on perspectives from employers and employees at small worksites

BMC Public Health. 2022 May 6;22(1):904.

Christine M Kava, Raymond A Ruiz, Jeffrey R Harris, Peggy A Hannon

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13346-y

https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-022-13346-y.pdf

 

Note: Open Access.

 

"Data from a 4-year cohort of the Population Assessment of Tobacco and Health (PATH) study was used, including 7,512 smokers at Wave 1 who had smoking status data at Wave 4… Older smokers were more likely to report 12-month cigarette and tobacco abstinence and the effect of age on abstinence differed by smoking frequency/intensity. Smoking cessation interventions need to be age-specific and consider smoking frequency… Younger smokers may need more targeted cessation interventions to successfully quit."

 

Short and Long-Term Cigarette and Tobacco Abstinence among Daily and Non-Daily Older Smokers

Nicotine & Tobacco Research, ntac116.

Published: 03 May 2022

Jaqueline C Avila, Carla J Berg, Jason Robinson, Jasjit S Ahluwalia

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac116/6578513

 

Also:

 

Measuring nicotine dependence among adolescent and young adult cigarillo users

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac117/6581064

 

"Average mouth-level nicotine estimates from cigarettes smoked during the hotel stays indicate participants puffed VLNC [very low nicotine content] cigarettes with greater intensity than NNC [normal nicotine content] cigarettes in each respective 24-hour period. However, this effect diminished over time (p<0.001). Specifically, VLNC puffing intensity was 40.0% (95% CI: 29.9, 53.0) greater than NNC puffing intensity in the first period, and 16.1% (95% CI: 6.9, 26.0) greater in the fourth period. Conclusion: Average puffing intensity per cigarette was elevated with exclusive VLNC cigarette use, but the extent of this effect declined across four days."

 

Early Changes in Puffing Intensity When Exclusively Using Open-Label Very Low Nicotine Content Cigarettes

Nicotine & Tobacco Research, ntac118.

Published: 07 May 2022

Cassidy M White, Clifford Watson, Roberto Bravo Cardenas, Phuong Ngac, Liza Valentin-Blasini, Benjamin C Blount, Joseph S Koopmeiners, Rachel L Denlinger-Apte, Lauren R Pacek, Neal L Benowitz, Dorothy K Hatsukami, Eric C Donny, Matthew J Carpenter, Tracy T Smith

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac118/6582320

 

"The prevalence of current use across all TNP [tobacco and/or nicotine-containing products] in the general adult population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for IQOS use. With regard to the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7-22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers."

 

Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( IQOS ®): a cross-sectional study

F1000Res. 2021 Jun 25;10:504. eCollection 2021.

Esther F Afolalu, Peter Langer, Karina Fischer, Steve Roulet, Pierpaolo Magnani

Competing interests: All authors are/were employees of Philip Morris International. Philip Morris International is the sole source of funding and sponsor of this research. IQOS is manufactured by Philip Morris Products S.A.

https://f1000research.com/articles/10-504/v2

 

Note: Open Access tobacco industry research.

 

"The COVID-19 pandemic was not associated with an increase in the number of women attending smoking cessation clinics, (2020-2021 n=46 [40.8%] of 110); compared to (2019-2020 n=44 [30.9%] of 142 referred pregnant women pre-pandemic) p=0.061. Eighty-two women utilised NRT [nicotine replacement therapy] to help them stop smoking and the frequency of NRT use did not change during the pandemic (2019-2020 n=39, 2020-2021 n=43; p=0.420)."

 

The impact of COVID-19 on smoking cessation in pregnancy

J Perinat Med. 2022 May 10. Online ahead of print.

Nadja Bednarczuk, Emma E Williams, Gareth Absalom, Judith Olaitan-Salami, Anne Greenough

https://www.degruyter.com/document/doi/10.1515/jpm-2022-0178/html

https://www.degruyter.com/document/doi/10.1515/jpm-2022-0178/pdf

 

Note: Open Access.

 

"Androgenetic alopecia is thought to be caused by twin factors of heredity and androgens. Other factors such as environmental factors are also regarded as important, and smoking is believed to be one of them. This review shows that smoking may have a significant role to play in androgenetic alopecia. There is also some evidence to support a relation between amount of smoking and severity of baldness and also age of onset of AGA. There are a number of plausible mechanisms through which smoking could affect hair loss. The dermatologist should therefore advise patients of AGA to stop smoking."

 

Role of Smoking in Androgenetic Alopecia: A Systematic Review

Int J Trichology. Mar-Apr 2022;14(2):41-48. Epub 2022 Apr 4.

Yatra Kavadya, Venkataram Mysore

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069908/

 

Note: Open Access.

 

Tobacco industry is “talking trash” on environmental harms of production, say WHO and watchdog

BMJ 2022;377:o1211 (Published 13 May 2022)

Luke Taylor

https://www.bmj.com/content/377/bmj.o1211  

 

"Cigarette filters are composed of more than 15,000 fibres strands which can be detached in a MF [microfiber] size range or eventually get fragmented into lower sizes. This MF can be introduced to the trophic chain and can be easily ingested by a wide range of organism including human. Therefore, a new form of pollution from cigarettes is added to the environment with proven damage to ecosystems and therefore to humans. This pollution cannot be ignored and should be treated by the scientific and social communities as an important MP [microplastics] source that harms our planet and its biodiversity."

 

Tobacco as a Source of Microplastics. Tobacco and Environment: World No Tobacco Day 2022

Arch Bronconeumol. 2022 May 2;S0300-2896(22)00327-1. Online ahead of print.

José Ignacio de Granda-Orive, Segismundo Solano-Reina, Carlos A Jiménez-Ruiz

https://www.sciencedirect.com/science/article/pii/S0300289622003271

 

Note: Open Access.

 

"Addiction, chemicals, negative health symptoms and effects, and cigarette comparison themes were associated with higher PME [perceived message effectiveness], as were graphic images and warning symbols. Industry targeting, environmental impact, flavour themes, images of food and people’s faces were associated with lower PME, as were hashtags, statistics and first-person language or the word ‘teen’. Most elements were not associated with appeal, but ads with a flavour theme were associated with increased vaping appeal."

 

Perceived effectiveness of objective elements of vaping prevention messages among adolescents

Tobacco Control Published Online First: 09 May 2022.

Marcella H Boynton, Nora Sanzo, Whitney Brothers, Alex Kresovich, Erin L Sutfin, Paschal Sheeran, Seth M Noar

https://tobaccocontrol.bmj.com/content/early/2022/05/08/tobaccocontrol-2021-057151

 

Note: Open Access.

 

Related PR:

 

Effective anti-vaping advertisements can have the greatest impact on teens

https://www.news-medical.net/news/20220510/Effective-anti-vaping-advertisements-can-have-the-greatest-impact-on-teens.aspx

 

"In 47 lower-middle, upper-middle and high-income countries from 2015 to 2018, ~1 in 12 (8.6%) adolescents reported vaping in the past 30 days, but prevalence of frequent vaping was low (1 in 60; 1.7%). A higher tobacco tax was associated with higher adolescent vaping."

 

Association between the implementation of tobacco control policies and adolescent vaping in 44 lower-middle, upper-middle, and high-income countries

Addiction

First published: 11 May 2022

Gary C. K. Chan,Coral Gartner,Carmen Lim,Tianze Sun,Wayne Hall,Jason Connor,Daniel Stjepanović, Janni Leung

https://onlinelibrary.wiley.com/doi/10.1111/add.15892

 

Related PR:

 

New study finds global adolescent vaping is low

https://medicalxpress.com/news/2022-05-global-adolescent-vaping.html

 

"Younger adolescents 12-15 years had lower tobacco use compared to 16-17 year olds and less stable classes. In the 16-17 year group, there were five unique trajectories of cigarette smoking, including a Persistent High Frequency class. Four e-cigarette use trajectories were identified; but not a persistent use class. Shared predictors of class membership for cigarettes and e-cigarettes included mental health problems, other tobacco use, marijuana use, and poorer academic achievement… Conclusions: There was no evidence that initiation with e-cigarettes as the first product tried was associated with cigarette progression (nor cigarettes as first product and e-cigarette progression)."

 

Predictors of e-cigarette and cigarette use trajectory classes from early adolescence to emerging adulthood across four years (2013-2017) of the PATH Study

Nicotine & Tobacco Research, ntac119.

Published: 11 May 2022

Cassandra A Stanton, Zhiqun Tang, Eva Sharma, Elizabeth Seaman, Lisa D Gardner, Marushka L Silveira, Dorothy Hatsukami, Hannah R Day, K Michael Cummings, Maciej L Goniewicz, Jean Limpert, Colm Everard, Maansi Bansal-Travers, Bridget Ambrose, Heather L Kimmel, Nicolette Borek, Wilson M Compton, Andrew J Hyland, Jennifer L Pearson

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac119/6584494

 

Note: Open Access.

 

"Before instituting a ban on all non-tobacco e-cigarette flavors (which might have unintended consequences) or a cap on nicotine concentration or limiting ease of access to e-cigarettes for adult smokers, we believe that alternative approaches should be carefully considered to avoid negative ramifications of policy decisions, especially if e-cigarettes have the potential to reduce cigarette related mortality."

 

Correspondence

Response to: Appropriate policy implications of the fact that high content and flavored e-cigarettes have higher abuse liability

Nicotine & Tobacco Research, ntac120.

Published: 10 May 2022

Mari S Gades, BA, Dorothy K Hatsukami

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac120/6583153

 

Related N&TR Correspondence & Referenced Study:

 

Appropriate Policy Implications of the Fact That High Content and Flavored E-Cigarettes Have Higher Abuse Liability

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac089/6562583

The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac073/6550857

 

Note: Correspondence Open Access, study available upon request.

 

"This study used ITS [interrupted time series] analysis to examine the impact of vaping introduction on smoking in six high-income jurisdictions [in four Canadian provinces, United Kingdom and Australia] that have adopted varied regulatory approaches to vaping. Our findings showed that in most, but not all, settings where policies enable substitution of cigarettes with e-cigarettes, vaping introduction has accelerated the rate of decline in smoking, whereas in settings that restrict the uptake of e-cigarettes or do not permit the use of nicotine in e-cigarettes, vaping introduction has slowed the secular rate of decline in smoking."

 

Impact of vaping introduction on cigarette smoking in six jurisdictions with varied regulatory approaches to vaping: an interrupted time series analysis

BMJ Open 2022;12:e058324.

Online issue publication May 02, 2022

Daphne C Wu, Beverley M Essue, Prabhat Jha

https://bmjopen.bmj.com/content/12/5/e058324

https://bmjopen.bmj.com/content/bmjopen/12/5/e058324.full.pdf

 

Note: Open Access.

 

"In the UK, the regulatory authorities, the Royal Colleges, and learned societies (with the exception of the Royal College of Paediatrics and Child Health), are immobilised. They are ignoring the tactics of a resurgent industry that seems to be targeting children and younger people, increasing their exposure to nicotine (nicotine alone has significant toxicity, including to the fetus) and several other inhalants of unknown toxicity. The tobacco industry has a record of duplicitous suppression of data; yet, with their promotion of ENDS [electronic nicotine delivery systems] they are regaining ground they previously lost with tobacco cigarettes. At the least, ENDS should be subject to the same legislation as tobacco, and those who supply them to under-age children should be subject to stringent penalties."

 

Comment

E-cigarette company tactics in sports advertising

The Lancet Respiratory Medicine

Published: May 11, 2022

Stephen Fowler, Jayesh Bhatt, Sarah Brown, Louise Fleming, Sarah Mayell, Ian Sinha, Andrew Bush

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00166-7/fulltext

 

"Perceived stress predicted e-cigarette progression and continuation among current users among a diverse cohort of youth and young adults in Texas; perceived stress did not predict e-cigarette initiation among never users. Two study hypotheses (i.e., progression; continuation) were supported while one hypothesis (i.e., initiation) was not supported."

 

Perceived stress and E-cigarette use during emerging adulthood: A longitudinal examination of initiation, progression, and continuation

Prev Med. 2022 May 11;107080. Online ahead of print.

Dale S Mantey, Stephanie I Clendennen, Aslesha Sumbe, Anna V Wilkinson, Melissa B Harrell

https://www.sciencedirect.com/science/article/abs/pii/S0091743522001281

 

"The ecological data underscore that menthol in cigarettes continues to stall progress in reducing cigarette smoking, and menthol capsules have likely played a role in overall usage trends. Given its documented public health harms and high rates of use among marginalised populations,10 eliminating menthol as a characterising flavour from the cigarette market remains a priority. Moreover, menthol bans must also address innovative delivery methods, such as flavour capsules."

 

Letter

Impact of menthol capsule cigarettes on menthol and non-menthol cigarette consumption in the USA, 2008–2020

Tobacco Control Published Online First: 10 May 2022.

Cristine D Delnevo, Daniel P Giovenco, Andrea C Villanti

https://tobaccocontrol.bmj.com/content/early/2022/05/10/tobaccocontrol-2022-057422

 

"The 2000 Canadian GWL [graphic warning label] policy reduced smoking prevalence overall, with similar reductions for males and females and across education levels. The impact of the Canadian GWLs in reducing smoking prevalence did not reduce differences by sex or education. Although beneficial for all smokers, GWLs may not serve to decrease existing disparities, especially those by socioeconomic status… Our findings confirm existing studies that the 2000 implementation of GWLs in Canada was significantly associated with an overall reduction in smoking prevalence in Canada compared to the US."

 

The differential impact of the 2000 Canadian Graphic Warning Label policy on smoking prevalence by sex and education: A Difference-In-Difference-In-Difference Model

Nicotine & Tobacco Research, ntac122.

Published: 10 May 2022

Bukola Usidame, Gang Meng, James F Thrasher, Mary E Thompson, Geoffrey T Fong, Nancy L Fleischer

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac122/6583382

 

Also:

 

Gender Differences in Reasons for Using Electronic Cigarettes: A Systematic Review

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac108/6584717

Characterization of salivary progesterone in female smokers

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac121/6582861

 

"A recent Lancet Editorial about the slow pace of tobacco control around the world singled out the UK as a leader in reducing the number of smokers. It has accomplished this feat, the Editorial stated, through measures such as increased tobacco taxes, comprehensive smoke-free laws in public spaces, and health warnings on product packages. Yet, there was no mention of alternative nicotine delivery devices, such as e-cigarettes and heated tobacco products… From September, 2017 to October, 2021, I was President and CEO of the Foundation for a Smoke-Free World, a non-profit entity funded by Philip Morris International, with a mandate to support scientific research and development in the battle against smoking."

 

Correspondence

Tobacco harm reduction matters

The Lancet

VOLUME 399, ISSUE 10338, P1864-1865, MAY 14, 2022

Published: May 14, 2022

Darek (sic) Yach

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00834-0/fulltext

 

Also:

 

Tobacco control: getting to the finish line

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00835-2/fulltext

 

Referenced Lancet Editorial:

 

Tobacco control: far from the finish line

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02650-7/fulltext

 

Note: Open Access.

 

"Smokers are at higher risk of uro-oncological cancers, infertility, erectile dysfunction, reduced urinary tract function, postoperative complications, and side effects during systemic therapy. Most patients are aware of the link between smoking and lung cancer, yet many urology patients are unaware of the link between smoking and urological illness and postoperative complications. Education initiatives by urologists could address this knowledge gap.. In summary, we hope that the European Association of Urology and other organizations will implement a strong recommendation in urology guidelines to include counseling on smoking cessation as a standard of care. Smoking cessation is one of the most effective interventions urologists can offer patients."

 

Editorial

Why and How Smoking Cessation Must Be Implemented in Urology Clinics as a Standard of Care

Eur Urol. 2022 May 4;S0302-2838(22)02263-1. Online ahead of print.

Andres Affentranger, Richard S Matulewicz, Christian D Fankhauser

https://www.sciencedirect.com/science/article/abs/pii/S0302283822022631

 

"The results of this cohort study suggest that a significant proportion of patients with HNSCC [head and neck squamous cell carcinoma] who are daily smokers at the time of diagnosis continue to smoke after treatment. Smokers with HNSCC who successfully quit smoking were most likely to do so in the first 6 months after treatment, which could potentially serve as a preferred window for smoking cessation interventions. These data highlight the need for inclusion of aggressive smoking cessation intervention in head and neck cancer care pathways."

 

Persistent Tobacco Use After Treatment for Head and Neck Cancer

JAMA Otolaryngol Head Neck Surg.

Published online May 12, 2022.

Tyler Van Heest, Nathan Rubin, Samir S. Khariwala https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2792443

 

Related coverage:

 

Three-fifths of smokers diagnosed with head and neck cancer STILL used cigarettes two years after treatment, study finds

https://www.dailymail.co.uk/health/article-10809917/Most-smokers-head-neck-cancer-puffed-cigarettes-two-years-treatment.html

 

 

A smoke-free generation: New Zealand's tobacco ban

The Lancet

VOLUME 399, ISSUE 10339, P1930-1931, MAY 21, 2022

Chris McCall

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00925-4/fulltext

https://www.thelancet.com/action/showPdf?pii=S0140-6736%2822%2900925-4

 

Note: Open Access upon registration.

 

"Despite the current no-tobacco advertising policies, both PMI’s [Philip Morris International's] and Altria’s corporate image campaigns have run extensively in major news outlets (in both physical and digital formats), including the New York Times and Washington Post… They feature high-ranking corporate executives advocating for company-sponsored research coupled with claims that these companies are aligned with public health objectives. Message placement in prominent news outlets suggests a deliberate attempt to position their sponsored content alongside news reporting while helping to ensure message exposure among an influential audience… The extent to which these ‘corporate promotion’ ads have infiltrated major news outlets is concerning, raising questions about how objective media outlets should treat sponsored industry content."

 

Ad watch

Tobacco industry advertising: efforts to shift public perception of big tobacco with paid media in the USA

Tobacco Control Published Online First: 16 May 2022.

Robin Koval, Nicole Dorrler, Barbara Schillo

https://tobaccocontrol.bmj.com/content/early/2022/05/08/tobaccocontrol-2021-057189

 

"Our study demonstrates majority support for regulations controlling e-cigarettes in Australia. Parents generally favoured wide-ranging restrictions that could reduce adolescent e-cigarette use. Almost all parents support a ban on marketing and advertising of e-cigarettes to teenagers thus recognising the reach and influence of product appeal, placement and price on this age group. Australian governments have an opportunity to help prevent more widespread e-cigarette use and protect the health of adolescents by limiting their exposure to e-cigarette promotions."

 

Parents support strong restrictions controlling e-cigarette use in Australia: findings from a national survey

Tobacco Control Published Online First: 17 May 2022.

Mary-Anne Measey, Vikram Palit, Monsurul Hoq, Moya Vandeleur, Anthea Rhodes

https://tobaccocontrol.bmj.com/content/early/2022/05/16/tobaccocontrol-2021-057074

 

Also:

 

Analysis of mainstream emissions, secondhand emissions and the environmental impact of IQOS waste: a systematic review on IQOS that accounts for data source

https://tobaccocontrol.bmj.com/content/early/2022/05/12/tobaccocontrol-2021-056986

Place-based inequities in cigarette smoking across the USA

https://tobaccocontrol.bmj.com/content/early/2022/05/17/tobaccocontrol-2022-057293

 

"Due to the low return of saliva samples, validated prolonged abstinence rates in the intention-to-treat analysis were low (39 of 571 (6.8%) versus 25 of 569 (4.4%) in the e-cigarette and NRT [nicotine replacement therapy] arms, respectively) and did not differ significantly between the two study arms… In summary, in the unadjusted primary analysis there was insufficient evidence to confidently demonstrate that e-cigarettes are more effective than NRT in helping pregnant women to stop smoking. The effects of e-cigarettes appear to have been masked by e-cigarette use in the NRT arm. When abstinent participants using non-allocated products were excluded, e-cigarettes were markedly more effective than patches in all abstinence outcomes. "

 

Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial

Nature Medicine (2022)

Published: 16 May 2022

Peter Hajek, Dunja Przulj, Francesca Pesola, Chris Griffiths, Robert Walton, Hayden McRobbie, Tim Coleman, Sarah Lewis, Rachel Whitemore, Miranda Clark, Michael Ussher, Lesley Sinclair, Emily Seager, Sue Cooper, Linda Bauld, Felix Naughton, Peter Sasieni, Isaac Manyonda & Katie Myers Smith

https://www.nature.com/articles/s41591-022-01808-0

https://www.nature.com/articles/s41591-022-01808-0.pdf

 

Note: Open Access.

 

Related coverage:

 

E-cigarettes ‘as safe as nicotine patches’ for pregnant smokers trying to quit

https://www.theguardian.com/society/2022/may/16/e-cigarettes-as-safe-as-nicotine-patches-for-pregnant-smokers-trying-to-quit

Vaping may be an effective way to quit smoking during pregnancy

https://www.newscientist.com/article/2320515-vaping-may-be-an-effective-way-to-quit-smoking-during-pregnancy/

 

"We did not find a significant difference in the cardiovascular risk of exclusive e-cigarette use compared with nonuse of cigarettes and e-cigarettes, although analyses were limited by a small number of CVD [cardiovascular disease] events in e-cigarette users. Dual use of cigarettes and e-cigarettes was associated with a significantly increased risk of CVD compared with nonuse. The cardiovascular risk of dual use did not differ from the risk among those exclusively smoking cigarettes."

 

Letter

E-cigarette Use and Risk of Cardiovascular Disease: A Longitudinal Analysis of the PATH Study, 2013-2019

Circulation. 2022;0

Originally published 6 May 2022

Jonathan B. Berlowitz, Wubin Xie, Alyssa F. Harlow, Naomi M. Hamburg, Michael J. Blaha, Aruni Bhatnagar, Emelia J. Benjamin and Andrew C. Stokes

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057369  

https://www.ahajournals.org/doi/epdf/10.1161/CIRCULATIONAHA.121.057369

 

Note: Open Access.

 

"We analyzed Global Adult Tobacco Survey data in Bangladesh, China, Costa Rica, Ethiopia, India, Kazakhstan, Mexico, Philippines, Romania, Russia, Senegal, Ukraine, Turkey, Uruguay, and Viet Nam during 2014–2018… EC [E-cigarette] use was low in most countries. “Dual use” was common among current smokers and the quit ratio was higher among ECs users… Nevertheless, comprehensive EC regulatory policies should be implemented to prevent the escalation of EC use by targeting population subgroups such as young adults, educated and wealthier individuals."

 

Awareness About and E-Cigarette Use Among Adults in 15 Low- and Middle-Income Countries, 2014–2018 Estimates From Global Adult Tobacco Surveys

Nicotine & Tobacco Research, ntab269.

Published: 21 May 2022

Chandrashekhar T Sreeramareddy, Anusha Manoharan

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab269/6590320

 

"Following JUUL’s removal of mint in November 2019, JUUL’s market share dropped from over 66% in Florida and the United States to 37.1% (Florida) and 55.1% (United States). In January 2020, the second leading brands were Puff Bar (15.0%) in Florida and Vuse (18.1%) in the United States. Mint market share decreased and share of all other flavor categories increased, particularly menthol and concept. Total ENDS sales increased in Florida but decreased in the United States. Average prices of ENDS devices decreased. Conclusions: While JUUL’s actions led to a decline in its sales, Puff Bar emerged and menthol and concept flavors experienced growth."

 

JUUL’s 2019 Removal of Mint-Flavored Pods and Changes to the Retail Environment of Electronic Nicotine Delivery Systems in Florida and the United States

Nicotine & Tobacco Research, ntac128.

Published: 15 May 2022

Jennifer Gaber, Doris G Gammon, Youn Ok Lee, James Nonnemaker, Brittany Young, Annice Kim, Lauren Porter

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac128/6586051

 

Also:

Adolescents’ understanding of smoking and vaping risk language: Cognitive interviews to inform scale development

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac127/6585952

Secondhand tobacco smoke and functional impairments in older adults living in the community

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac131/6586052

A randomized pilot of a tailored smoking cessation quitline intervention for individuals who smoke and vape

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac129/6586250

 

"How we define “current use” of tobacco and nicotine delivery products changes our estimates of how individuals transition to, between, and from different patterns of use. We show that the robustness of transition estimates to whether or not non-established users are included as current users and to different frequency-of-use threshold depends in part on whether low-frequency users are categorized as non-current users or as a distinct category. Our results emphasize the importance of intentional definitions of product use that reflect the larger goals of public health and tobacco control."

 

The impact of current tobacco product use definitions on estimates of transitions between cigarette and ENDS use

Nicotine & Tobacco Research, ntac132.

Published: 19 May 2022

Andrew F Brouwer, David T Levy, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Luz María Sanchez-Romero, Ritesh Mistry, Rafael Meza

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac132/6589520

 

Also:

 

The unhealthy association between smoking, vaping, and other drug use

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac130/6588418

 

Note: Open Access.

 

"The hardening hypothesis suggests that tobacco control activities influence an individual’s ability to quit, and those who find it challenging to quit are those who remain smokers. Reviews and papers have attempted to demystify this hypothesis, and the debate continues. Adding to the continuing discussions, a recently-published umbrella and systematic review by Harris et al. (2022) strongly opposed the existence of the hardening hypothesis, after conducting a wide-ranging qualitative synthesis of the evidence pertinent to various hardening constructs and indicators. However, several key methodological issues may have ushered a deficient—or worse, unqualified—interpretation of the evidence base."

 

Correspondence

The Hardening Hypothesis – Further Testing is Still Required

Nicotine & Tobacco Research, ntac125.

Published: 13 May 2022

Isabella Steffensen, Red Thaddeus D Miguel, Julien Carlone

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac125/6585632

 

Referenced N&TR study:

 

Smokers increasingly motivated and able to quit as smoking prevalence falls: umbrella and systematic review of evidence relevant to the 'hardening hypothesis', considering transcendence of manufactured doubt

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac055/6542043

 

Note: Open Access.

 

"Ever/current [Hungarian] HTP [heated tobacco product] users presented misperceptions about the harms of HTPs, e-cigarettes, and NRT. They underestimated the potential health benefits of NRT and had distorted harm perceptions about HTPs and e-cigarettes. Public education about the relative harms of different nicotine and tobacco products is urgently needed."

 

Perceived harm of heated tobacco products, e-cigarettes, and nicotine replacement therapy compared with conventional cigarettes among ever and current heated tobacco users

Addict Behav Rep. 2022 May 16;15:100432. eCollection 2022 Jun.

Melinda Pénzes, Tamás Joó, Róbert Urbán

https://www.sciencedirect.com/science/article/pii/S235285322200027X

 

Note: Open Access.

 

"We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas… Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. Conclusions: These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions."

 

Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors

Tob Prev Cessat. 2022 May 6;8:18. eCollection 2022.

Breesa Bennett, Katelyn F Romm, Carla J Berg

http://www.tobaccopreventioncessation.com/Changes-in-cigarette-and-e-cigarette-use-among-US-young-nadults-from-before-to-during,148245,0,2.html

 

Note: Open Access.

 

"In 2020, the prevalence of middle and high school students reporting “no” or “little” harm (vs. “some” or “a lot”) was 20.1% for e-cigarettes, 17.4% for hookahs, 14.6% for cigars, 13.5% for smokeless tobacco, and 11.0% for cigarettes. During 2016–2020, perceptions of “no” or “little” harm decreased for e-cigarettes, increased for cigarettes and smokeless tobacco, and exhibited nonlinear changes for hookahs. Discussion: Most youth are aware of tobacco product harms, but opportunities exist to educate youth about the harms of nondaily tobacco product use."

 

Tobacco Product Harm Perceptions Among US Middle and High School Students, 2016-2020

J Adolesc Health. 2022 May 19;S1054-139X(22)00386-X. Online ahead of print.

Emily Glidden, Nikki A Hawkins, Ahmed Jamal, Teresa W Wang

https://www.jahonline.org/article/S1054-139X(22)00386-X/fulltext

 

"The implementation of CEASE [Clinical effort against secondhand smoke exposure] in practices was influenced by the adaptability and complexity of the intervention, the needs of patients and their families, the resources available to practices to support the implementation of CEASE, other competing priorities at the practices, the cultures of practices, and clinicians' and office staffs' knowledge and beliefs about family-centered tobacco control."

 

A Qualitative Study of Factors Influencing Implementation of Tobacco Control in Pediatric Practices

J Smok Cessat. 2022 May 5;2022:4156982. eCollection 2022.

Emara Nabi-Burza, Jonathan P Winickoff, Jeremy E Drehmer, Maurice P Zeegers, Bethany Hipple Walters

https://www.hindawi.com/journals/josc/2022/4156982/

https://downloads.hindawi.com/journals/josc/2022/4156982.pdf

 

Note: Open Access.

 

"In the French context, the new plain packaging of tobacco products probably had an impact on smokers’ perception of tobacco by increasing the embarrassment they felt when they took out their pack of cigarettes in plain sight. It also influenced the motivation to quit smoking, and more generally, it could contribute to the denormalization of tobacco."

 

Plain packaging on tobacco products in France: Effectiveness on smokers’ attitudes one year after implementation

Tob. Induc. Dis. 2022;20(April):35

Anne Pasquereau, Romain Guignard, Raphaël Andler, Karine Gallopel-Morvan, Viêt Nguyen-Thanh

http://www.tobaccoinduceddiseases.org/Plain-packaging-on-tobacco-products-in-France-Effectiveness-non-smokers-attitudes,146600,0,2.html

http://www.tobaccoinduceddiseases.org/pdf-146600-74381?filename=Plain%20packaging%20on.pdf

 

Note: Open Access.

 

From smoking to vaping: a new environmental threat?

Lancet Respir Med

Published: May 23, 2022

Jérémie Pourchez, Clément Mercier, Valérie Forest

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00187-4/fulltext

https://www.thelancet.com/action/showPdf?pii=S2213-2600%2822%2900187-4

 

Note: Open Access.

 

“Globally, in 2019 there were an estimated 2.5 million cancer-related deaths (95% UI: 2.3 to 2.7) and 56.4 million DALYs [disability-adjusted life years] (51.3 to 61.7) attributable to smoking. The global age-standardized death and DALY rates of cancers attributable to smoking per 100,000 decreased by 23.0% (-29.5 to -15.8) and 28.6% (-35.1 to -21.5), respectively, over the period 1990-2019. Central Europe (50.4 [44.4 to 57.6]) and Western Sub-Saharan Africa (6.7 [5.7 to 8.0]) had the highest and lowest age-standardized death rates, respectively, for cancers attributable to smoking. In 2019, the age-standardized DALY rate of cancers attributable to smoking was highest in Greenland (2224.0 [1804.5 to 2678.8]) and lowest in Ethiopia (72.2 [51.2 to 98.0]). Also in 2019, the global number of DALYs was highest in the 65-69 age group and there was a positive association between SDI and the age-standardized DALY rate. Conclusions: The results of this study clearly illustrate that renewed efforts are required to increase utilization of evidence-based smoking cessation support in order to reduce the burden of smoking-related diseases.”

 

Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990-2019

Cancer Med. 2022 May 27. Online ahead of print.

Saeid Safiri, Seyed Aria Nejadghaderi, Morteza Abdollahi, Kristin Carson-Chahhoud, Jay S Kaufman, Nicola Luigi Bragazzi, Maziar Moradi-Lakeh, Mohammad Ali Mansournia, Mark J M Sullman, Amir Almasi-Hashiani, Ali Taghizadieh, Gary S Collins, Ali-Asghar Kolahi

https://onlinelibrary.wiley.com/doi/10.1002/cam4.4647

https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.4647

 

Note: Open Access.

 

"This cross-sectional study of 6131 US residents aged 13 to 40 years found that 25.9% had ever used a nonnicotine e-cigarette, 16.7% had used one in the past 30 days, and 12.4% had used one in the past 7 days; 18.8% had ever co-used nonnicotine and nicotine e-cigarettes. The most-used flavors were sweet, dessert, or candy flavors; fruit flavors; and mint or menthol flavors; most common ingredients were tetrahydrocannabinol, cannabidiol, melatonin, caffeine, and essential oils. Meaning: These findings suggest that a significant proportion of US residents are using nonnicotine flavored e-cigarettes marketed with unsupported health claims."

 

Use Patterns, Flavors, Brands, and Ingredients of Nonnicotine e-Cigarettes Among Adolescents, Young Adults, and Adults in the United States

JAMA Netw Open. 2022;5(5):e2216194.

May 25, 2022

Shivani Mathur Gaiha, Crystal Lin, Lauren Kass Lempert, Bonnie Halpern-Felsher

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2792671

 

Note: Open Access.

 

“In August 2020, 78.7% of vapers in the United States reported using a flavor prohibited in cartridges or pods, versus 86.3% in Canada (adjusted odds ratio [AOR] = 1.73; 95% CI = 1.25, 1.40) and 79.8% in England (AOR = 1.10; 95% CI = 0.78, 1.55). Disposable e-cigarettes (exempt from flavor restrictions) increased to a greater extent among vapers in the United States (13.2% to 36.8%) versus Canada (7.7% to 14.2%; AOR = 2.01; 95% CI = 1.33, 3.04) and England (10.8% to 16.4%; AOR = 2.33; 95% CI = 1.52, 3.57). Puff Bar (disposable) emerged as the most popular brand in the United States.”

 

E-Cigarette Flavors, Devices, and Brands Used by Youths Before and After Partial Flavor Restrictions in the United States: Canada, England, and the United States, 2017-2020

Am J Public Health. 2022 May 27;e1-e11. Online ahead of print.

David Hammond, Jessica L Reid, Robin Burkhalter, Maansi Bansal Travers, Shannon Gravelly, Andy Hyland, Karin Kasza, Ann McNeill

https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2022.306780

 

Related AJPH Editorials:

 

E-Cigarette Flavors, Devices, and Brand Preferences Among Youths in Canada, England, and the United States: The Value and Challenges of Comparing International Survey Data

https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2022.306903

The Food and Drug Administration's e-Cigarette Flavor Restrictions Have Not Gone Far Enough to Curb the Youth e-Cigarette Use Epidemic

https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2022.306822

 

"Current exclusive and dual/poly e-cigarette use, with 0.2% and 3.5% prevalence in 2015–2018 [National Health Interview Survey data], were associated with higher odds of reporting poor health status than never tobacco users. Poor health status was associated with higher odds of using the four healthcare services and a greater number of ER [Emergency Room] and doctor visits. Annual healthcare expenditures attributable to all current e-cigarette use was $15.1 billion ($2024 per user) in 2018, including $1.3 billion attributable to exclusive e-cigarette use ($1796 per user) and $13.8 billion attributable to dual/poly e-cigarette use ($2050 per user). Conclusion: Adult current e-cigarette use was associated with substantial excess healthcare utilisation and expenditures."

 

Healthcare utilisation and expenditures attributable to current e-cigarette use among US adults

Tobacco Control Published Online First: 23 May 2022.

Yingning Wang, Hai-Yen Sung, James Lightwood, Tingting Yao, Wendy B Max

https://tobaccocontrol.bmj.com/content/early/2022/05/04/tobaccocontrol-2021-057058

 

Note: Open Access.

 

Related PR:

 

Using e-cigarettes may lead to higher use of and spending on health services

https://medicalxpress.com/news/2022-05-e-cigarettes-higher-health.html

 

“This review highlights how mitochondrial damage caused by inhaled intoxicants increases ROS [reactive oxygen species] production, apoptosis, reduces respiration, alters mitochondrial membrane potential, and destroys the equilibrium of fission/fusion effects. These detrimental changes contribute to aggravated inflammatory pathways and various disease pathogeneses… The intimate connection between mitochondrial morphological changes and dysfunction impairs multiple pathways and alters downstream signaling. Interestingly, these toxic changes vary based on the chemical composition of different e-liquids.”

 

Alterations of Mitochondrial Network by Cigarette Smoking and E-Cigarette Vaping

Cells. 2022 May 19;11(10):1688.

Manasa Kanithi, Sunil Junapudi, Syed Islamuddin Shah, Alavala Matta Reddy, Ghanim Ullah, Bojjibabu Chidipi

https://www.mdpi.com/2073-4409/11/10/1688/htm

 

Note: Open Access.

 

“About 17.1% of participants reported ever e-cigarette use. Of never users, 17.5% were susceptible to e-cigarette use. E-cigarette advertising exposure was mainly through online sources (31.5%). Most participants (59.4%) perceived e-cigarettes as equally or more harmful than cigarettes… Regulatory actions are needed to address e-cigarette marketing, particularly on the Internet.”

 

The Mediating Effect of E-Cigarette Harm Perception in the Relationship between E-Cigarette Advertising Exposure and E-Cigarette Use

Int J Environ Res Public Health. 2022 May 20;19(10):6215.

Nan Jiang, Shu Xu, Le Li, Omar El-Shahawy, Nicholas Freudenberg, Jenni A Shearston, Scott E Sherman

https://www.mdpi.com/1660-4601/19/10/6215

 

Also:

 

Nicotine Dependence from Different E-Cigarette Devices and Combustible Cigarettes among US Adolescent and Young Adult Users

https://www.mdpi.com/1660-4601/19/10/5846

Do Budget Cigarettes Emit More Particles? An Aerosol Spectrometric Comparison of Particulate Matter Concentrations between Private-Label Cigarettes and More Expensive Brand-Name Cigarettes

https://www.mdpi.com/1660-4601/19/10/5920

Association between Fathers' Use of Heated Tobacco Products and Urinary Cotinine Concentrations in Their Spouses and Children

https://www.mdpi.com/1660-4601/19/10/6275

 

Note: Open Access.

 

“We combined data from two cross-sectional samples of youth and young adult (15-24) participants of a monthly surveillance study (data collected April and June 2021)… Over a third of the sample (37.9%) reported increasing e-cigarette use, while 28.9% reported decreasing use, and 33.1% reported no change… Conclusions: This study provides recent data on how the ongoing and evolving COVID-19 pandemic has impacted youth and young adults’ e-cigarette use. Findings identify subpopulations that may benefit from e-cigarette prevention interventions, as well as insights that may inform the content and delivery of such interventions.”

 

Changes in e-cigarette use among youth and young adults during the COVID-19 pandemic: Insights into risk perceptions and reasons for changing use behavior

Nicotine & Tobacco Research, ntac136.

Published: 26 May 2022

Morgane Bennett, Jessica Speer, Nathaniel Taylor, Tesfa Alexander

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac136/6593856

 

"Smoking increased during the COVID-19 pandemic in this sample of adults from vulnerable populations, even while most adopted protective health measures to prevent infection. Unemployment and anxiety might identify those at greatest risk for increases in tobacco use."

 

The Impact of the Covid-19 Pandemic on Smoking Among Vulnerable Populations

Nicotine & Tobacco Research, ntac135.

Published: 23 May 2022

Rhiannon C Wiley, Anthony C Oliver, Miranda B Snow, Janice Y Bunn, Anthony J Barrows, Jennifer W Tidey, Dustin C Lee, Stacey C Sigmon, Diann E Gaalema, Sarah H Heil, Catherine Markesich, Andrea C Villanti, Stephen T Higgins

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac135/6590894

 

Also:

 

Associations of California’s Tobacco 21 Minimum Sales Age Law with Tobacco Use among Sexual Minority Adolescents: A Trends Analysis

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac134/6590853

Optimum Urine Cotinine and NNAL Levels to Distinguish Smokers from Non-Smokers by the Changes in Tobacco Control Policy in Korea from 2008 to 2018

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntac133/6591481

 

“Across time, NA [negative affect] peaked 1 week post-quit, PA [positive affect] did not change, and craving declined. Less steep rises in NA (indirect effect 95% CI: 0.01 to 0.30) and lower mean craving at 1 week post-quit (CI: 0.06 to 0.50) were mediators of the relationship between varenicline and higher cessation rates at the end of treatment. PA was associated with cessation, but was not a significant mediator. Conclusions: These results partially support the hypothesis that varenicline improves smoking cessation rates by attenuating changes in specific psychological processes and supported negative affect and craving as plausible treatment mechanisms of varenicline.”

 

Evaluating Treatment Mechanisms of Varenicline: Mediation by Affect and Craving

Nicotine & Tobacco Research, ntac138.

Published: 26 May 2022

Sarah S Tonkin, Craig Colder, Martin C Mahoney, Gary E Swan, Paul Cinciripini, Robert Schnoll, Tony P George, Rachel F Tyndale, Larry W Hawk, Jr

https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac138/6593861

 

Note: Open Access.

 

“Findings from our within-subject study suggest that a cigarette displaying the text 'cancer, heart disease, stroke' and a drab dark brown coloured cigarette are most dissuasive for Dutch non-smoking adolescents. Whether dissuasive cigarettes reduce appeal, reduce product trial, or increase perceptions of harm compared to a regular cigarette should be further examined in larger between-subject studies.”

 

Non-smoking adolescents' perceptions of dissuasive cigarettes

Addict Behav Rep. 2022 May 18;15:100433. eCollection 2022 Jun.

Dirk Jan A van Mourik, Gera E Nagelhout, Nikita L Poole, Marc C Willemsen, Math J J M Candel, Crawford Moodie, Bas van den Putte, James F Thrasher, Hein de Vries

https://www.sciencedirect.com/science/article/pii/S2352853222000281

 

Note: Open Access.

 

 

Rassegna Stampa Scientifica Luglio 2022

 

 

The End of the Illusion That Smoking Is a Choice

 

Credit...Illustration by Shoshana Schultz/The New York Times; Photograph by Image Source via Getty

By Sarah Milov

Dr. Milov is an associate professor of history at the University of Virginia and the author of “The Cigarette: A Political History.”

The Food and Drug Administration recently proposed lowering the nicotine content in cigarettes to less addictive levels. If adopted, this regulation would finally test one of the tobacco industry’s favorite claims: that smoking is a choice. Portraying smoking as a willful, personal decision has long allowed tobacco companies to promote cigarettes even while acknowledging their deadly risks. But the paradigm of individual choice has also guided cigarette regulation, ironically strengthening the industry’s key talking point — until now.

Nicotine is the addictive element in a cigarette. By reducing nicotine levels in cigarettes, federal regulations will, for the first time, address the key driver of cigarette consumption, which claims 480,000 American lives each year. Nicotine’s effects are particularly acute in adolescence, which is when most smokers start.

 

Tobacco companies have long understood that physiological dependence on nicotine — or what executives preferred to call nicotine satisfaction — was central to their business. Since the 1960s, the tobacco industry has manipulated ammonia levels in cigarettes to enhance nicotine’s effects. As one cigarette company research director commented in 1954, “It’s fortunate for us that cigarettes are a habit they can’t break.”

 

Publicly, tobacco’s advocates have argued that smoking is a choice of free, responsible adults. As early as 1929, the United States Patent Office granted patents to engineers who had devised processes for denicotinizing tobacco. But as one 1935 American Tobacco Company pamphlet reassured its readers, “The makers of Lucky Strike cigarettes deliberately refrain” from these techniques because “such removal of nicotine produces an emasculated product, shorn of the very qualities which give a cigarette character and appeal.” Selling the cigarette has always involved selling both the illusion of choice and a product designed to preclude it.

 

Ironically, the argument for individual consent was even bolstered by the earliest federal regulations on cigarettes — some of which the industry quietly lauded. After the surgeon general released the landmark 1964 report on smoking and health, policymakers debated how they would heed its call for “appropriate remedial action” to respond to the deadly health threat posed by cigarettes. The Federal Trade Commission’s proposal for cigarette warning labels that explicitly linked cigarette smoking to cancer and death was pre-empted by the warning label proposed by a tobacco-friendly Congress: “Caution: Cigarette smoking may be hazardous to your health.” These labels, which have intensified in urgency with each revision since 1966, appear to put the responsibility for smoking squarely on the shoulders of the smoker. Having been duly warned, it is the smoker’s decision to smoke and bear the consequences.

 

While publicly the industry howled that a warning label was unfair, privately lawyers breathed a sigh of relief. The surgeon general’s report and the warning label could bolster the industry’s defense in the courtroom in any future product liability suits. Indeed, when a wave of product liability suits brought by dying smokers or their families hit the industry in the 1980s, industry lawyers could gloat that “no tobacco company has ever paid one penny in damages” to a plaintiff. The warning label shielded companies as much as it informed smokers.

 

To circumvent the power that the tobacco industry held in Congress and at courthouses, anti-tobacco activists in the 1970s and ’80s pioneered a different strategy. Laws and workplace rules aimed at reducing public smoking — such as the creation of nonsmoking sections and smoking sections, indoor bans and even outdoor bans — were enacted on behalf of nonsmokers. Whatever a smoker may have decided, nonsmokers never agreed to smoke secondhand. One antismoking bumper sticker from the late 1970s playfully satirized the assumption-of-risk paradigm: “Caution: Your smoking may be hazardous to my health.”

 

The nonsmokers’ rights movement catalyzed a sharp decline in smoking rates. But it left the paradigm of individual consent untouched — or even strengthened. For nonsmokers’ rights activists, the smoker can pursue his choice with full knowledge of the deadly consequences as long as his choices don’t affect others. “I would not mind a smoker killing himself privately,” one nonsmoker explained in support of public smoking restrictions in 1978. “I greatly object to his infecting my air.”

 

In more recent decades, age restrictions on smoking have reinforced the idea that smoking is the choice of fully consenting adults. After fighting such laws for decades, cigarette manufacturers supported 2019 legislation that raised the minimum purchase age from 18 to 21. Whereas the industry once feared that such laws would “gut our key young adult market,” in the words of a Philip Morris strategy document, it now embraces them as a way to preserve “adult choice.”

“We can’t defend continued smoking as a ‘free choice’ if the person was ‘addicted,’” a tobacco lobbyist observed more than four decades ago. And yet this is precisely what the industry has done — with the unintended blessing of even anti-tobacco lawmakers, whose rules have granted the validity of the cigarette’s engineering while making it ever more difficult, expensive and stigmatized to be a smoker.

 

The F.D.A.’s nicotine proposal is, at long last, an opportunity to test one of the industry’s core propositions. Only then will we truly see if smoking is a free adult choice rather than the consequence of addiction and skillful product design.

 

The fact is that most smokers want to quit. For all the industry’s insistence that cigarettes are an emblem of individuality, nearly 70 percent of adult smokers would prefer not to. More than half of the nation’s 31 million adult smokers attempt to quit each year, and only 7.5 percent succeed.

 

One study found that lowering nicotine levels could save an estimated 8.5 million lives in the next 80 years — lives of current smokers who will find it easier to quit, as well as lives of would-be smokers who never get hooked. It will save many millions more from tobacco-related heart and lung disease and from the unquantifiable grief that attends watching loved ones suffer prolonged and preventable illness. Such a stunning victory for public health is possible only with the kind of regulation that rightfully targets not individual smokers but the cigarette itself.

 

https://www.nytimes.com/2022/07/06/opinion/nicotine-smoking-cigarettes.html

 

There's a new status symbol for Britain's teenagers – and it's toxic

Billed as a suitable alternative to tobacco and filling Britain’s high streets, can the nation’s youth resist the allure of e-cigarettes?

 

By Charlotte Lytton 14 July 2022 • 6:00am

 

 ‘If we’re just replacing one bad with another bad, are we really tackling the issue?’

 

You don’t have to look far in modern Britain to find a group of teenagers exhaling clouds of coloured, scented, flavoured vapour, insouciantly sucking on plastic tubes. Close by, you will probably find clusters of alarmed parents, worrying about their children’s new habit – vaping – but unsure what to do.

For while, in the UK, it is illegal for under-18s to buy e-cigarettes, the market is being flooded with unsafe, dessert-flavoured disposable devices aimed at children, according to Trading Standards in England and Wales, who say they are currently receiving hundreds of complaints per month. Last week, a YouGov survey for Action on Smoking and Health (ASH) found that a quarter of the products purchased did not meet the standards required to be sold on UK shelves.

And the trade seems unstoppable. Vaping has almost doubled among 11 to 17-year-olds to seven per cent, with use of disposable e-cigarettes rising in popularity sevenfold.

While the NHS recommends vaping as a suitable alternative to smoking tobacco cigarettes, what of those who balk at the idea of a ciggie, but have been lured in by the endless shops featuring brightly coloured nicotine pens for a couple of pounds a pop?

The average cigarette contains around 12mg of nicotine. Elf Bars – among the most commonly used in the UK – contain 20mg of nicotine per 2ml of liquid, equating to around 40-50 cigarettes’ worth in fewer than 600 puffs. The amount consumed by vapers is hard to calculate, as cartridges come in different sizes and many users begin inhaling at the outset of the day, and don’t stop.

UK restrictions on what is now a £15 billion industry limit vape cartridge capacity to no more than 2ml, and the volume and strength of nicotine-containing liquid to 10ml and 20mg/ml respectively. These guidelines are among the more relaxed globally: in Australia, vapes can only be purchased by over-18s with a prescription, while they are banned from sale in San Francisco (rules vary state-to-state across the US). In countries from Japan to Brazil, India to Hong Kong, it is illegal to sell e-cigarettes. 

 

 Stores full of brightly coloured vials of flavoured vape fluid are common on Britain’s high streets CREDIT: Loop Images Ltd / Alamy Stock Photo

 

A big part of the UK’s stance is formed by the Government’s encouragement of vaping as a means to wean people off cigarettes, not to encourage them to vape per se – and its pledge to make Britain smoke-free by 2030 (currently 14.5 per cent of over-16s smoke).

“If we’re just replacing one bad with another bad, are we really tackling the issue?” asks dentist Anna Middleton. She has seen a rise in young patients coming into her Chelsea clinic presenting with bleeding gums – brought on by the nicotine in e-cigarettes, which “is a vasoconstrictor, and therefore affects blood supply. It’s a recipe for gum disease, because the bad bacteria is just thriving in that toxic environment.” Those risks aren’t communicated to would-be vapers, she adds. 

A 2018 report from the National Academies of Science, Engineering and Medicine also found that e-cigarettes “contain and emit numerous potentially toxic substances,” and exacerbated asthma and wheezing among adolescent users.

The Medicines and Healthcare products Regulatory Agency says it seeks to create “an environment that protects children from starting to use these products”. Yet ASH’s research found that almost half of under-18s surveyed bought their e-cigarettes from shops whose purveyors were clearly unbothered by their customers being underage. Though the cost is comparatively small – from £1.99 for a 600-puff Elf Bar, compared with around £12 for a packet of cigarettes – the industry is predicted to grow 30 per cent year-on-year.

One “very concerned” parent of an 18-year-old says her daughter’s friends “order vape juice online with no problem” – and that while they consider cigarette smokers “disgusting”, they “don’t feel vaping is the same”. Others report that they believe vaping can be a gateway to cigarettes themselves.

Josh, an A-level student from Nottingham, had never smoked before being handed an Elf Bar at school last year, aged 17. E-cigarettes then began popping up in social settings so often, he was soon using them frequently – within a few months becoming so used to the nicotine hit, he switched to tobacco cigarettes. “I had no intention of more than one try for fun,” he says. But “with more and more people using them, I felt I needed to own one”; he didn’t want to seem “uncool or boring”.

Vaping is now something of a status symbol for teenagers, adds Josh. “Middle class teens and students opt for Elf Bars, Geek Bars or other smaller disposable vapes.” At festivals, they are often handed out for free by vape companies.

 

Vaping has almost doubled among 11 to 17-year-olds to seven per cent, with use of disposable e-cigarettes rising in popularity sevenfold CREDIT: Phoenixns

 

Image is a huge part of the appeal, says Dr Sandro Demaio, CEO of VicHealth in Australia. “The packaging looks like make-up or products that are very alluring to young people.” While Australia’s e-cigarette laws are far more stringent than the UK’s, he is calling for tighter restrictions on an industry “targeting teenagers, tweens and very young people” who are “breathing highly toxic, highly addictive products deep into their lungs as their bodies, minds and identities are still developing”.

He adds: “We urgently need to do all we can to protect young people to ensure that we don’t end up with another entire generation addicted, for life, to nicotine.”

Dr Demaio says that in the past week, he has met children as young as 10 addicted to vaping – and that a black market for illegal vapes is thriving on the likes of TikTok.

“The glamorous promotion of vaping on social media is completely inappropriate and social media platforms should take responsibility,” agrees Deborah Arnott, chief executive of ASH. The Khan review that produced the 2030 no-smoking benchmark also suggested that £15 million should be invested in enforcement, but “online platforms like TikTok don’t need to wait, they must act now”, Arnott says.

Skirmishes between companies and consumers continue, with little action. In the US, one family sued Juul, another e-cigarette brand, after their 15-year-old became addicted, resulting in seizures. And last month, the company received a ban on sales from the Food and Drug Administration – which was then revoked last week.

Part of the issue for governments considering further restrictions is how useful the devices are as a proxy for tobacco cigarette smokers. “Smoking is still the leading cause of premature death [worldwide],” Arnott points out. “That’s what’s killing people; not vaping.”

The challenge remains the new cohort. “I do believe that vaping products are used as the new cigarette ,” Josh says, adding that it is “now a large part of youth culture and identity in the UK”. There is data to show relative safety, compared with tobacco cigarettes – but nothing that goes beyond around the 15-year mark.

“We have no long-term data on health implications and the concentration of nicotine varies,” the mother of the 18-year-old says. “They think no health problems will pop up in their future.”

Gillian Golden, CEO of the Independent Vape Trade Association, comments: “It is illegal to sell vape products to anyone under 18, so young people should not be able to access them. 

“E-cigarettes are meant for adult smokers who are looking to quit, or looking for a far safer alternative to cigarettes. The IBVTA would like to see more funding for enforcement and stiffer penalties for those who break the law.”

https://www.telegraph.co.uk/health-fitness/body/how-vaping-could-create-new-generation-nicotine-addicts/

 

F.D.A. Orders Juul to Stop Selling E-Cigarettes

The agency ruled against the company’s application to stay on the market, a decisive blow to a once-popular vaping brand that appealed to teenagers.

In its heyday, Juul occupied 75 percent of the market share and employed 4,000 people. Credit...Jeenah Moon for The New York Times

By Matt Richtel and Andrew Jacobs

June 23, 2022, 10:36 a.m. ET

The Food and Drug Administration on Thursday ordered Juul to stop selling e-cigarettes on the U.S. market, a profoundly damaging blow to a once-popular company whose brand was blamed for the teenage vaping crisis.

The order affects all of Juul’s products on the U.S. market, the overwhelming source of the company’s sales. Juul’s sleek vaping cartridges and sweet-flavored pods helped usher in an era of alternative nicotine products among adults as well, and invited intense scrutiny from antismoking groups and regulators who feared they would do more harm to young people than good to former smokers.

“Today’s action is further progress on the F.D.A.’s commitment to ensuring that all e-cigarette and electronic nicotine delivery system products currently being marketed to consumers meet our public health standards,” Dr. Robert M. Califf, the agency commissioner, said in a statement. “The agency has dedicated significant resources to review products from the companies that account for most of the U.S. market. We recognize these make up a significant part of the available products and many have played a disproportionate role in the rise in youth vaping.”

The move by the F.D.A. is part of a wide-ranging effort to remake the rules for smoking and vaping products and to reduce illnesses and deaths caused by inhalable products containing highly addictive nicotine.

On Tuesday, the agency announced plans to slash nicotine levels in traditional cigarettes as a way to discourage use of the most deadly of legal consumer products. In April, the F.D.A. said it would move toward a ban on menthol-flavored cigarettes.

The action against Juul in particular is part of a newer regulatory mission for the agency, which must determine which electronic cigarettes currently for sale, or proposed for sale, will be allowed onto U.S. shelves permanently now that the F.D.A. has authority over e-cigarettes.

But it could take years before these proposals take effect — if they can withstand fierce resistance from the powerful tobacco lobby, antiregulatory groups and the vaping industry.

Juul is expected to appeal the F.D.A.’s decision.

Public health groups hailed the ruling.

“The F.D.A.’s decision to remove all Juul products from the marketplace is both most welcomed and long overdue,” said Erika Sward, national assistant vice president of advocacy for the American Lung Association. “Juul’s campaign to target and hook kids on tobacco has gone on for far too long.”

A statement from the American Vapor Manufacturing Association, an industry trade group, hinted at the fight ahead.

“Measured in lives lost and potential destroyed, F.D.A.’s staggering indifference to ordinary Americans and their right to switch to the vastly safer alternative of vaping will surely rank as one of the greatest episodes of regulatory malpractice in American history,” Amanda Wheeler, the association’s president, said in a statement.

Read More on Smoking and Vaping

• Nicotine Levels: Aiming to reduce the toll of smoking, the Food and Drug Administration is planning to require tobacco companies to slash the amount of nicotine in cigarettes.
• Menthol Ban: The F.D.A. has also proposed a plan to ban sales of menthol cigarettes, a measure experts say may save hundreds of thousands of lives, especially among Black smokers.
• ‘Smoking Is Back’: Cigarettes, still the No. 1 cause of preventable death in the United States, are making a comeback with a younger crowd.
• Vaping Loophole: A crackdown on flavored e-cigarettes was meant to curtail teenage vaping, but sales are rising due to synthetic nicotine.
• The Rise of Juul: A Times documentary traced the e-cigarette maker on its path from fledgling start-up to Silicon Valley juggernaut and, eventually, public health villain.

The agency’s ruling capped a nearly two-year review of data that Juul had submitted to try to win authorization to continue selling its tobacco- and menthol-flavored products in the United States. The application required the company to prove the safety of its devices and whether they were appropriate for the protection of public health.

Juul, in particular, had been the target of regulators, schools and policymakers for years, starting in 2018, when the F.D.A. began an investigation into Juul’s marketing efforts. Before that time, Juul had advertised its product using attractive young models and flavors like cool cucumber and creme brulee that critics said attracted underage users.

 

By April 2018, the F.D.A. announced a crackdown on the sale of such products, including Juul’s, to people under the age of 21.

 

Use among young people had soared. In 2017, 19 percent of 12th graders, 16 percent of 10th graders and 8 percent of eighth graders reported vaping nicotine in the past year, according to Monitoring the Future, an annual survey done for the National Institute on Drug Abuse.

 

For its part, Juul routinely denied that it targeted young people, but it was pursued in lawsuits and by state attorneys general, with some cases resulting in millions of dollars in damages against the company. In one settlement in 2021, Juul agreed to pay $40 million to North Carolina, which represented various parties in the state who asserted the company had helped lure underage users to vaping. More than a dozen other states have lawsuits and investigations that are still pending.

Dr. Scott Gottlieb, the former F.D.A. commissioner, explained his approval of the move against Juul on Wednesday, which was first reported in The Wall Street Journal.

The news is somewhat less weighty for the industry now than it would have been in Juul’s heyday, given the company’s plummeting market share. Once the dominant player with 75 percent of the market, Juul now has a considerably smaller share of the market.

But the news delivers a significant blow to Altria, formerly known as Philip Morris and the maker of Marlboro, which in December 2018 bought 35 percent of Juul for $12.8 billion. Because of smaller market share and regulatory headwinds, Altria said, the value of that stake fell to $1.7 billion by the end of 2021.

At its peak, Juul had more than 4,000 employees. It now has slightly over 1,000, mostly in the United States, but with some in Canada, Britain and other countries. Its revenue has fallen to $1.3 billion in 2021, down from $2 billion in 2019, with about 95 percent in U.S. sales.

Nicotine itself is not the cause of lung cancer and other deadly ills from smoking, but the drug is exceedingly addictive, making it difficult for smokers to quit despite the health risks. The adolescent brain is particularly susceptible to nicotine, which can affect memory, concentration, learning and self-control.

Already, the e-cigarette companies have said they will challenge the decision in court.

E-cigarettes have been sold on the U.S. market for more than a decade without formal F.D.A. authorization, because they did not fall under the agency’s regulatory purview for several years.

In 2019, the F.D.A. issued a warning letter to Juul, saying that the company violated federal regulations because it had not received approval to promote and sell its products as a healthier option to smoking.

The agency has been reviewing all types of vaping products, some in development, for more than a year, and companies awaiting a decision have been allowed to keep selling some products.

The F.D.A. recently said it had so far rejected more than a million applications whose products it considered more of a health risk than a benefit. In October, it authorized R.J. Reynolds to continue marketing Vuse. This was the first time the agency granted approval to a vaping product made by a big cigarette company.

In its review of devices that it compared with traditional cigarettes, the agency said that the devices contained a “significant reduction” in harmful chemicals, although some were still present. The review said the toxins and potential cancer-causing chemicals were far lower in the blood and urine of people using the Vuse device compared with those of smokers.

Still, California law required R.J. Reynolds to warn Vuse buyers about exposure to glycidol, which is “known to the state to cause cancer” based on studies of mice and rats.

In March, the agency authorized several tobacco-flavored products from Logic Technology Development, saying the company was able to show that its products were likely to help adults make the transition from traditional cigarettes while posing a low risk of attracting young, new users.

But the agency disappointed some prominent lawmakers and advocacy groups when it announced recently that it would not be able to finish reviewing all of the e-cigarette marketing applications until June 2023, a year after a court-imposed deadline.

Some tobacco-control experts said the decision to ban Juul from the U.S. market was misguided and ultimately counterproductive.

Clifford Douglas, director of the Tobacco Research Network at the University of Michigan School of Public Health, said that the F.D.A. appeared to punish Juul for its past activity marketing to teenagers, and that many experts had come to see Juul and other e-cigarettes as valuable tools for helping adult smokers quit conventional cigarettes.

“They are so-called off ramps that can provide smokers an alternative to combustibles, which are responsible for virtually every death related to tobacco,” he said. “But now that off ramp is being narrowed and sort of paved over, which is putting millions of adult lives at risk.”

Christina Jewett and Sheila Kaplan contributed reporting.

https://www.nytimes.com/2022/06/23/health/fda-juul-ecigarettes-ban.html