The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes' risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. ...Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public-including most smokers-now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers' use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay's authors, encourage the health community, media, and policymakers to more carefully weigh vaping's potential to reduce adult smoking-attributable mortality. We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation.
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The rate of nicotine metabolism is hypothesized to be a determinant of how much a person smokes. That is, rapid metabolizers would be expected to need more nicotine and, therefore, smoke more than ...slow metabolizers. Nicotine is metabolized extensively by the liver enzyme CYP2A6, primarily to cotinine. Cotinine is itself metabolized by CYP2A6 to 3'-hydroxycotinine (3-HC). The ratio of metabolite to parent (i.e., 3-HC:cotinine) would be expected to reflect CYP2A6 activity. We measured the ratio of 3-HC:cotinine in the urine of 72 smokers. This ratio was significantly correlated with the number of cigarettes smoked per day (r = .33, p = .005), though not with the Fagerström Test for Nicotine Dependence. This finding supports the hypothesis that the rate of nicotine metabolism is a determinant of the level of cigarette consumption and supports the use of the 3-HC:cotinine ratio as a noninvasive marker of nicotine metabolism.
The Society for Research on Nicotine and Tobacco began in the United States as a scientific organization "to stimulate the generation and dissemination of new knowledge concerning nicotine and ...tobacco in all its manifestations." Now in its 30th year, the Society is taking on new challenges in tobacco control, nicotine vaping, product regulation, and public policy.
This Review describes the formative years of the Society from the perspective of researchers who were in leadership positions during that time, documenting how biobehavioral and clinical research in the first 10 years was a continuation of the scientific mission of the 1988 United States Surgeon General's Report on Nicotine Addiction and summarizing organizational innovations during each president's term of office.
The Society's promotion of scientific research served as a catalyst for funding, policy, and regulation, setting the stage for its influence and credibility.
This Commentary provides context and an overview of the scientific research and the organizational innovations that occurred during the early years of the Society for Research on Nicotine and Tobacco using publications and available documentation. The Society was able to thrive because biobehavioral research on nicotine addiction provided the scientific underpinnings for the tobacco control enterprise as a whole. The objective of this Commentary is to describe formative events in the Society's history based on the accomplishments of its early leaders.
Initial trials of web-based smoking-cessation programs have generally been promising. The active components of these programs, however, are not well understood. This study aimed to (1) identify ...active psychosocial and communication components of a web-based smoking-cessation intervention and (2) examine the impact of increasing the tailoring depth on smoking cessation.
Randomized fractional factorial design.
Two HMOs: Group Health in Washington State and Henry Ford Health System in Michigan.
1866 smokers.
A web-based smoking-cessation program plus nicotine patch. Five components of the intervention were randomized using a fractional factorial design: high- versus low-depth tailored success story, outcome expectation, and efficacy expectation messages; high- versus low-personalized source; and multiple versus single exposure to the intervention components.
Primary outcome was 7 day point-prevalence abstinence at the 6-month follow-up.
Abstinence was most influenced by high-depth tailored success stories and a high-personalized message source. The cumulative assignment of the three tailoring depth factors also resulted in increasing the rates of 6-month cessation, demonstrating an effect of tailoring depth.
The study identified relevant components of smoking-cessation interventions that should be generalizable to other cessation interventions. The study also demonstrated the importance of higher-depth tailoring in smoking-cessation programs. Finally, the use of a novel fractional factorial design allowed efficient examination of the study aims. The rapidly changing interfaces, software, and capabilities of eHealth are likely to require such dynamic experimental approaches to intervention discovery.
Tobacco use is a leading contributor to disability and death worldwide, and genetic factors contribute in part to the development of nicotine dependence. To identify novel genes for which natural ...variation contributes to the development of nicotine dependence, we performed a comprehensive genome wide association study using nicotine dependent smokers as cases and non-dependent smokers as controls. To allow the efficient, rapid, and cost effective screen of the genome, the study was carried out using a two-stage design. In the first stage, genotyping of over 2.4 million single nucleotide polymorphisms (SNPs) was completed in case and control pools. In the second stage, we selected SNPs for individual genotyping based on the most significant allele frequency differences between cases and controls from the pooled results. Individual genotyping was performed in 1050 cases and 879 controls using 31 960 selected SNPs. The primary analysis, a logistic regression model with covariates of age, gender, genotype and gender by genotype interaction, identified 35 SNPs with P-values less than 10−4 (minimum P-value 1.53 × 10−6). Although none of the individual findings is statistically significant after correcting for multiple tests, additional statistical analyses support the existence of true findings in this group. Our study nominates several novel genes, such as Neurexin 1 (NRXN1), in the development of nicotine dependence while also identifying a known candidate gene, the β3 nicotinic cholinergic receptor. This work anticipates the future directions of large-scale genome wide association studies with state-of-the-art methodological approaches and sharing of data with the scientific community.
Balfour et al. Respond Balfour, David J K; Benowitz, Neal L; Colby, Suzanne M ...
American journal of public health (1971),
01/2022, Volume:
112, Issue:
1
Journal Article
Peer reviewed
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7.
Balfour et al. Respond Balfour, David J K; Benowitz, Neal L; Colby, Suzanne M ...
American journal of public health (1971),
01/2022, Volume:
112, Issue:
1
Journal Article
Peer reviewed
Stanton Glantz writes that "the key conclusion" in his and his colleagues' meta-analysis was that "among all e-cigarette users, there was no significant association between e-cigarette consumer ...product use and quitting smoking."1 This finding derives from the authors combining daily e-cigarette users, who show significantly increased smoking cessation rates, with nondaily users, who have significantly lower quit rates. We consider it illogical to merge the two. In our article,2 we say that the difference in quit rates could reflect self-selection: daily e-cigarette users may be more motivated to quit smoking, whereas some infrequent vapers may use e-cigarettes as a temporary nicotine source where smoking is prohibited. The point is that people who want to quit smoking and use e-cigarettes frequently exhibit a statistically significantly ncreased odds of quitting, just as with daily versus infrequent adherence to nicotine replacement therapy.3 We suggest that regular vaping may help a subset of smokers-not all smokers-to quit. We see e-cigarettes, properly regulated, as representing a potentially important addition to the armamentarium of smoking cessation treatments and policies.On the basis of their key conclusion, Glantz and his colleagues drew a second "principal conclusion," namely, that "E-cigarettes should not be approved as consumer products."1 (pe1) We disagree. First, as noted, the key conclusion on which this second conclusion rests nappropriately merges the experiences of daily e-cigarette users with those of nondaily users. Second, approval of e-cigarettes as consumer products should derive from review of all the evidence. In our article, we enumerate four distinct types of evidence that, combined, resulted in our conclusion that e-cigarettes likely increase smoking cessation. We considerthe evidence strong, if not definitive (as stated in the article). One of those types of evidence is randomized clinical trials, which, Glantz acknowledges, find e-cigarettes more effective for quitting smoking than Food and Drug Administration-approved nicotine replacement therapy products. However, Glantz considers RCTs not relevant to the use of e-cigarettes as consumer products. We disagree. Although not sufficient on their own, randomized clinical trials can provide valuable evidence regarding product safety, use patterns, and the impact on other tobacco product use, among other things.
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ABSTRACT
Aims To extend the previously identified association between a single nucleotide polymorphism (SNP) in neuronal acetylcholine receptor subunit alpha‐5 (CHRNA5) and nicotine dependence to ...current smoking and initial smoking‐experience phenotypes.
Design, setting, participants Case–control association study with a community‐based sample, comprising 363 Caucasians and 72 African Americans (203 cases, 232 controls).
Measurements Cases had smoked ≥ five cigarettes/day for ≥ 5 years and had smoked at their current rate for the past 6 months. Controls had smoked between one and 100 cigarettes in their life‐time, but never regularly. Participants also rated, retrospectively, pleasurable and displeasurable sensations experienced when they first smoked. We tested for associations between smoking phenotypes and the top 25 SNPs tested for association with nicotine dependence in a previous study.
Findings A non‐synonymous coding SNP in CHRNA5, rs16969968, was associated with case status odds ratio (OR) = 1.5, P = 0.01 and, in Caucasians, with experiencing a pleasurable rush or buzz during the first cigarette (OR = 1.6, P = 0.01); these sensations were associated highly with current smoking (OR = 8.2, P = 0.0001).
Conclusions We replicated the observation that the minor allele of rs16969968 affects smoking behavior, and extended these findings to sensitivity to smoking effects upon experimentation. While the ability to test genetic associations was limited by sample size, the polymorphism in the CHRNA5 subunit was shown to be associated significantly with enhanced pleasurable responses to initial cigarettes in regular smokers in an a priori test. The findings suggest that phenotypes related to subjective experiences upon smoking experimentation may mediate the development of nicotine dependence.
The direct physiological effects that promote nicotine dependence (ND) are mediated by nicotinic acetylcholine receptors (nAChRs). In line with the genetic and pharmacological basis of addiction, ...many previous studies have revealed significant associations between variants in the nAChR subunit genes and various measures of ND in different ethnic samples. In this study, we first examined the association of variants in nAChR subunits α2 (
CHRNA2
) and α6 (
CHRNA6
) genes on chromosome 8 with ND using a family sample consisting of 1,730 European Americans (EAs) from 495 families and 1,892 African Americans (AAs) from 424 families (defined as the discovery family sample). ND was assessed by two standard quantitative measures: smoking quantity (SQ) and the Fagerström Test for ND (FTND). We found nominal associations for all seven tested SNPs of the genes with at least one ND measure in the EA sample and for two SNPs in
CHRNA2
in the AA sample. Of these, associations of SNPs rs3735757 with FTND (
P
= 0.0068) and rs2472553 with both ND measures (with a
P
value of 0.0043 and 0.00086 for SQ and FTND, respectively) continued to be significant in the EA sample even after correction for multiple tests. Further, we found several haplotypes that were significantly associated with ND in the EA sample in
CHRNA6
and in the both EA and AA samples in
CHRNA2
. To confirm the associations of the two genes with ND, we conducted a replication study with an independent case–control sample from the SAGE study, which showed a significant association of the two genes with ND, although the significantly associated SNPs were not always the same in the two samples. Together, these findings indicate that both
CHRNA2
and
CHRNA6
play a significant role in the etiology of ND in AA and EA smokers. Further replication in additional independent samples is warranted.
Abstract To investigate race differences in retrospectively-reported early smoking experiences, we studied African-American ( n = 48) and Caucasian ( n = 155) current smokers who participated in a ...study designed to identify phenotypic and genotypic factors associated with smoking. Compared with Caucasian smokers, African-American smokers were less educated (mean ± s.e.m.: 13.3 ± 0.25 vs. 14.3 ± 0.16; p < .01), had higher BMI (28.9 ± 1.06 vs. 26.7 ± 0.52; p < .05), and smoked significantly fewer cigarettes/day (14.1 ± 1.00 vs. 18.4 ± 0.74; p < .01). Ninety percent of African-American smokers consumed menthol cigarettes, as opposed to 25% of Caucasian smokers. African-American smokers were significantly older than Caucasian smokers upon initial smoking experimentation (17.4 ± 1.1 vs. 14.7 ± 0.3; p < .05) and onset of regular smoking (19.7 ± 0.9 vs. 17.4 ± 0.4; p < .05). African-American smokers were significantly more likely than Caucasian smokers to endorse global pleasurable sensations (48% vs. 30%; p < .05), “pleasurable rush or buzz” (62% vs. 43%; p < .05), and “relaxing” (45% vs. 27%; p < .05) as early experiences with smoking, whereas Caucasian smokers were marginally more likely to report dizziness and difficulty inhaling (61% vs. 45%; p < .10 and 48% vs. 31%; p < .10, respectively). Caucasian smokers were significantly more likely to endorse friends (6.9 ± 0.2 vs. 4.8 ± 0.4; p < .0001) and “perk me up” (4.2 ± 0.3 vs. 3.1 ± 0.4; p < .05) and marginally more likely to endorse buzz (4.2 ± 0.2 vs. 3.4 ± 0.5; p < .10) as reasons for starting to smoke. Further research is needed to determine the relative contributions of genetic, developmental, and socio-cultural factors to these findings.
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