IntroductionThis paper reports a study done to estimate the reliability and validity of answers to the Youth and Adult questionnaires of the Population Assessment of Tobacco and Health (PATH) ...Study.Methods407 adults and 117 youth respondents completed the wave 4 (2016–2017) PATH Study interview twice, 6–24 days apart. The reinterview data were used to estimate the reliability of answers to the questionnaire. Kappa statistics, gross discrepancy rates and correlations between answers to the initial interview and the reinterview were used to measure reliability. We examined every item in the questionnaire for which there were at least 100 observations. After the reinterview, most respondents provided a saliva sample that allowed us to assess the accuracy of their answers to the tobacco use questions.ResultsThere was generally a very high level of agreement between answers in the interview and reinterview. On the key current tobacco use items, the average kappa (the agreement rate adjusted for chance agreement) was 0.79 for adult respondents (age 18 or older). Youth respondents exhibited equally high levels of agreement across interviews. The items on current tobacco use also exhibited high levels of agreement with saliva test results (kappa=0.72). Rating scale items showed lower levels of exact agreement across interviews but the answers were generally within one scale point or category.ConclusionsThe PATH Study questions were developed using a careful protocol and the results indicate the answers provide reliable and valid information about tobacco use.
Introduction The 2009 Family Smoking Prevention and Tobacco Control Act banned characterizing flavors other than menthol in cigarettes but did not restrict their use in other forms of tobacco (e.g., ...smokeless, cigars, hookah, e-cigarettes). Methods A cross-sectional analysis of Wave 1 data from 45,971 U.S. adults and youth, aged ≥12 years in the Population Assessment of Tobacco and Health (PATH) Study collected in 2013–2014, was conducted in 2016. This study examined (1) the prevalence and reasons for use of flavored tobacco products; (2) the proportion of ever tobacco users reporting that their first product was flavored; and (3) correlates of current flavored tobacco product use. Results Current flavored (including menthol) tobacco product use was highest in youth (80%, aged 12–17 years); and young adult tobacco users (73%, aged 18–24 years); and lowest in older adult tobacco users aged ≥65 years (29%). Flavor was a primary reason for using a given tobacco product, particularly among youth. Eighty-one percent of youth and 86% of young adult ever tobacco users reported that their first product was flavored versus 54% of adults aged ≥25 years. In multivariable models, reporting that one’s first tobacco product was flavored was associated with a 13% higher prevalence of current tobacco use among youth ever tobacco users and a 32% higher prevalence of current tobacco use among adult ever users. Conclusions These results add to the evidence base that flavored tobacco products may attract young users and serve as starter products to regular tobacco use.
This study was a secondary analysis of baseline data from a clinical trial of an intensive group-based smoking cessation treatment for people with HIV (PWH) who smoke. It examined the cross-sectional ...relationship between perceived ethnic discrimination (PED) and cigarette smoking variables (i.e., nicotine dependence, motivation to quit smoking, self-efficacy to quit smoking) among PWH and explored whether depressive symptoms mediated the relationship between PED and smoking variables. Participants (N = 442;
M
age
= 50.6; 52.8% Male; 56.3% Black, non-Hispanic; 6.3% White, non-Hispanic; 13.3% Hispanic; 87.7% unemployed; 81.6% single) completed measures of demographics, cigarette smoking, depressive symptoms, and PED. Greater PED was related to lower self-efficacy to quit smoking, greater perceived stress, and greater depressive symptoms. In addition, depressive symptoms mediated the relationship between PED and two cigarette smoking variables (i.e., nicotine dependence, self-efficacy to quit smoking). Findings highlight the need for smoking interventions to target PED, self-efficacy, and depressive symptoms to improve smoking cessation variables among PWH.
Monitoring use of tobacco products among pregnant women is a public health priority, yet few studies in U.S. national samples have been reported on this topic. We examined prevalence and correlates ...of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of pregnant women. Data were obtained from all pregnant women (≥18 years) in the first wave of the Population Assessment of Tobacco and Health (PATH, 2013–2014) Study (N=388). Prevalence of current and prior use of tobacco/nicotine products was examined overall and among current cigarette smokers. Multiple logistic regression was used to examine correlates of use of cigarettes, e-cigarettes, hookah and cigars. Overall prevalence was highest for cigarettes (13.8%), followed by e-cigarettes (4.9%), hookah (2.5%) and cigars (2.3%), and below 1% for all other products. Prevalence of using other tobacco products is much higher among current smokers than the general population, with e-cigarettes (28.5%) most prevalent followed by cigars (14.0%), hookah (12.4%), smokeless (4.7%), snus (4.6%), and pipes (2.1%). Sociodemographic characteristics (poverty, low educational attainment, White race) and past-year externalizing psychiatric symptoms were correlated with current cigarette smoking. In turn, current cigarette smoking and past year illicit drug use were correlated with using e-cigarettes, hookah, and cigars. These results underscore that tobacco/nicotine use during pregnancy extends beyond cigarettes. The results also suggest that use of these other products should be included in routine clinical screening on tobacco use, and the need for more intensive tobacco control and regulatory strategies targeting pregnant women.
•Investigation of prevalence of tobacco use in a U.S. national sample of pregnant women.•Compared tobacco use among current, former, and never tobacco cigarette smokers.•Overall prevalence was highest for tobacco cigarettes (13.8%) and e-cigarettes (4.9%).•Prevalence of use across all products was higher among smokers vs. overall prevalence.•Cigarette smoking and illicit drug use predicted use of e-cigarettes, hookah, and cigars.
Use of electronic cigarettes (e-cigarettes) is increasing. Measures of exposure to known tobacco-related toxicants among e-cigarette users will inform potential health risks to individual product ...users.
To estimate concentrations of tobacco-related toxicants among e-cigarette users and compare these biomarker concentrations with those observed in combustible cigarette users, dual users, and never tobacco users.
A population-based, longitudinal cohort study was conducted in the United States in 2013-2014. Cross-sectional analysis was performed between November 4, 2016, and October 5, 2017, of biomarkers of exposure to tobacco-related toxicants collected by the Population Assessment of Tobacco and Health Study. Participants included adults who provided a urine sample and data on tobacco use (N = 5105).
The primary exposure was tobacco use, including current exclusive e-cigarette users (n = 247), current exclusive cigarette smokers (n = 2411), and users of both products (dual users) (n = 792) compared with never tobacco users (n = 1655).
Geometric mean concentrations of 50 individual biomarkers from 5 major classes of tobacco product constituents were measured: nicotine, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs).
Of the 5105 participants, most were aged 35 to 54 years (weighted percentage, 38%; 95% CI, 35%-40%), women (60%; 95% CI, 59%-62%), and non-Hispanic white (61%; 95% CI, 58%-64%). Compared with exclusive e-cigarette users, never users had 19% to 81% significantly lower concentrations of biomarkers of exposure to nicotine, TSNAs, some metals (eg, cadmium and lead), and some VOCs (including acrylonitrile). Exclusive e-cigarette users showed 10% to 98% significantly lower concentrations of biomarkers of exposure, including TSNAs, PAHs, most VOCs, and nicotine, compared with exclusive cigarette smokers; concentrations were comparable for metals and 3 VOCs. Exclusive cigarette users showed 10% to 36% lower concentrations of several biomarkers than dual users. Frequency of cigarette use among dual users was positively correlated with nicotine and toxicant exposure.
Exclusive use of e-cigarettes appears to result in measurable exposure to known tobacco-related toxicants, generally at lower levels than cigarette smoking. Toxicant exposure is greatest among dual users, and frequency of combustible cigarette use is positively correlated with tobacco toxicant concentration. These findings provide evidence that using combusted tobacco cigarettes alone or in combination with e-cigarettes is associated with higher concentrations of potentially harmful tobacco constituents in comparison with using e-cigarettes alone.
In December 2021, FDA CTP issued the first marketing denial orders for e-cigarettes after determining that the applications for about 55 000 flavoured e-cigarette products lacked sufficient evidence ...for a benefit to adult smokers adequate to overcome the public health threat posed by empirical evidence of ‘alarming levels’ of youth use of these products.6 In May 2022, FDA CTP announced a proposed rule under consideration that would prohibit characterising non-tobacco flavours, such as fruit flavours, in all cigars and their components to reduce their appeal, particularly to youth and young adults.7 The goal of this special issue is to bring together timely multidisciplinary research findings on how restricting characterising flavours in non-cigarette tobacco products (including but not limited to e-cigarettes, cigarillos and little cigars) impacts product appeal (especially to youth), user behaviour (including initiation of tobacco use among non-users and transitions between tobacco products among current users), chemistry and toxicity of flavoured products and short/long-term health outcomes to inform tobacco product standards and policies. Additionally, this issue includes timely empirical studies, reports and commentaries examining how tobacco product composition and marketing strategies have been modified by manufacturers, distributors and sellers in response to flavour restrictions. ...regulations specific to components that could be used to modify tobacco products by manufacturers13–16 or DIY products17 by users are an area that needs attention. Illegal Experimental Tobacco Marketplace II: effects of vaping product bans — findings from the 2020 International Tobacco Control Project.
As cigarette smoking rates decline, an important policy question is whether increasing cigarette taxes will continue to encourage smoking cessation. We tested this question following recent tobacco ...tax increases. Data were from the Minnesota Adult Tobacco Survey, a serial cross-sectional telephone survey conducted statewide, and was limited to past-year cigarette smokers in 2010 (n = 1029) and 2014 (n = 1382). Weighted estimates were calculated of the prevalence of past year smokers, smokers who attempted to quit smoking, and those who successfully quit by demographics, tobacco use, use of evidence-based cessation assistance to quit, and smoker perceptions of the tax increases. Among past year smokers, almost 60% reported a quit attempt in both years, 12.8% successfully quit in 2010 and 15.6% in 2014. Although older age, daily smoking, mean cigarettes per day, and more days of e-cigarette use, were associated with quit attempts in unadjusted models, only the perceived tax increase effect (AOR = 8.9; 95% CI 6.3–12.5) and low nicotine dependence (AOR = 1.9, 95% CI 1.3–2.7) were associated with making a quit attempt in adjusted models. Successful 12-month quits were predicted by college education (AOR = 3.2, 95% CI 1.3–7.8), the use of cessation support (AOR = 2.1, 95% CI 1.3–3.6), and reporting the tax increase helped maintain a quit (AOR = 12.3, 95% CI 7.5–20.1). These findings suggest that a large tax increase is effective in promoting quitting even in the presence of strong tobacco control measures such as indoor smoking bans and other smoking restrictions, mass media campaigns, and universal access to cessation support.
•In 2013, Minnesota cigarette excise tax increased $1.75.•60% of past year smokers made a quit attempt and 15% successfully quit.•Higher education and use of cessation aids predicted quit success.•Perception of the tax as helpful strongly predicted quitting.•Cigarette tax revenue should be directed to assist smoking cessation.
U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly ...concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15-44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007-2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ2(1) = 579.33, p < .0001) and among non-pregnant (χ2(1) = 578.0, p < .0001) and pregnant (χ2(1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, .53 -.63) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, .62 -.92), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ2(2) = 790.42, p < .0001) and among non-pregnant (χ2(2) = 790.58, p < .0001) and pregnant women examined separately (χ2(2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012–2013 data from the National Survey on Drug ...Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants’ residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities.
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