Medicine › Physiology

Smoking Behavior and Cessation

Works Count: 78224

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Description

This cluster of papers focuses on smoking cessation, the health effects of tobacco use, nicotine addiction, and the impact of public health campaigns. It covers topics such as the efficacy of smoking cessation therapies, the association between smoking and various health conditions, the use of e-cigarettes as a smoking cessation aid, and the effects of secondhand smoke on public health.

Keywords

Smoking Cessation; Tobacco Use; Nicotine Addiction; Health Consequences; E-Cigarettes; Public Health Campaigns; Secondhand Smoke; Nicotine Metabolism; Psychiatric Disorders; Cancer Risk

How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General

2010-01-01

Office on Smoking

In 1964, the Surgeon General released a landmark report on the dangers of smoking. During the intervening 45 years, 29 Surgeon General’s reports have documented the overwhelming and conclusive biologic, … In 1964, the Surgeon General released a landmark report on the dangers of smoking. During the intervening 45 years, 29 Surgeon General’s reports have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. Our newest report, How Tobacco Smoke Causes Disease, is a comprehensive, scientific discussion of how mainstream and secondhand smoke exposures damage the human body. Decades of research have enabled scientists to identify the specific mechanisms of smoking-related diseases and to characterize them in great detail. Those biologic processes of cigarette smoke and disease are the focus of this report.

Physician advice for smoking cessation

2013-05-28

Lindsay F Stead , Diana Buitrago , Nataly Preciado +3 more

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Pharmacological interventions for smoking cessation: an overview and network meta-analysis

2013-05-28

Kate Cahill , Sarah Stevens , Rafael Perera +1 more

Socioeconomic status and smoking: a review

2011-11-17

Rosemary Hiscock , Linda Bauld , Amanda Amos +2 more

Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and … Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and quit attempts are less likely to be successful. Studies have suggested that this may be the result of reduced social support for quitting, low motivation to quit, stronger addiction to tobacco, increased likelihood of not completing courses of pharmacotherapy or behavioral support sessions, psychological differences such as lack of self‐efficacy, and tobacco industry marketing. Evidence of interventions that work among lower socioeconomic groups is sparse. Raising the price of tobacco products appears to be the tobacco control intervention with the most potential to reduce health inequalities from tobacco. Targeted cessation programs and mass media interventions can also contribute to reducing inequalities. To tackle the high prevalence of smoking among disadvantaged groups, a combination of tobacco control measures is required, and these should be delivered in conjunction with wider attempts to address inequalities in health.

Nicotine replacement therapy for smoking cessation

2012-11-08

Lindsay F Stead , Rafael Perera , Chris Bullen +4 more

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ASSOCIATION OF SPECIFIC OVERT BEHAVIOR PATTERN WITH BLOOD AND CARDIOVASCULAR FINDINGS

1959-03-21

Meyer Friedman

Three groups of men, selected solely according to the behavior pattern which they habitually manifested in their work, were compared with respect to their serum cholesterol levels, clotting times, presence … Three groups of men, selected solely according to the behavior pattern which they habitually manifested in their work, were compared with respect to their serum cholesterol levels, clotting times, presence of clinical coronary disease, and presence of arcus senilis. A group (A) of 83 men were chosen as manifesting an intense, sustained drive for achievement and as being continually involved in competition and deadlines, both at work and in their avocations. In this group the serum cholesterol level, the frequency of arcus senilis, and the incidence of coronary artery disease were much higher than in a group (B) of 83 men who manifested the opposite sort of behavior pattern and a group (C) of 46 unemployed blind men selected as manifesting a chronic state of insecurity and anxiety. Clinical coronary artery disease was seven times more frequent in group A than in group B or group C. Analysis of factors other than the overt behavior pattern described indicated that this pattern per se was largely responsible for the striking differences found.

Smoking, Smoking Cessation, and Major Depression

1990-09-26

Alexander H. Glassman

A relationship between cigarette smoking and major depressive disorder was suggested in previous work involving nonrandomly selected samples. We conducted a test of this association, employing population-based data (n = … A relationship between cigarette smoking and major depressive disorder was suggested in previous work involving nonrandomly selected samples. We conducted a test of this association, employing population-based data (n = 3213) collected between 1980 and 1983 in the St Louis Epidemiologic Catchment Area Survey of the National Institute of Mental Health. A history of regular smoking was observed more frequently among individuals who had experienced major depressive disorder at some time in their lives than among individuals who had never experienced major depression or among individuals with no psychiatric diagnosis. Smokers with major depression were also less successful at their attempts to quit than were either of the comparison groups. Gender differences in rates of smoking and of smoking cessation observed in the larger population were not evident among the depressed group. Furthermore, the association between cigarette smoking and major depression was not ubiquitous across all psychiatric diagnoses. Other data are cited indicating that when individuals with a history of depression stop smoking, depressive symptoms and, in some cases, serious major depression may ensue. (<i>JAMA</i>. 1990;264:1546-1549)

The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change.

1991-01-01

Carlo C. DiClemente , James O. Prochaska , Scott Fairhurst +3 more

Traditionally smoking cessation studies use smoker and nonsmoker categories almost exclusively to represent individuals quitting smoking. This study tested the transtheoretical model of change that posits a series of stages … Traditionally smoking cessation studies use smoker and nonsmoker categories almost exclusively to represent individuals quitting smoking. This study tested the transtheoretical model of change that posits a series of stages through which smokers move as they successfully change the smoking habit. Subjects in precontemplation (n = 166), contemplation (n = 794), and preparation (n = 506) stages of change were compared on smoking history, 10 processes of change, pretest self-efficacy, and decisional balance, as well as 1-month and 6-month cessation activity. Results strongly support the stages of change model. All groups were similar on smoking history but differed dramatically on current cessation activity. Stage differences predicted attempts to quit smoking and cessation success at 1- and 6-month follow-up. Implications for recruitment, intervention, and research are discussed.

Measuring the Heaviness of Smoking: using self‐reported time to the first cigarette of the day and number of cigarettes smoked per day

1989-07-01

Todd F. Heatherton , Lynn T. Kozlowski , Richard C. Frecker +2 more

Summary Two simple self‐report measures have been used to assess the heaviness of smoking,‘number of cigarettes per day’(CPD) and‘time to the first cigarette of the day’(TTF). Little attention, however, has … Summary Two simple self‐report measures have been used to assess the heaviness of smoking,‘number of cigarettes per day’(CPD) and‘time to the first cigarette of the day’(TTF). Little attention, however, has been given to the precise method of scoring this information. Using biochemical indicators of heaviness of smoking (alveolar carbon monoxide and cotinine), we explore the optimum data transformations for regression analysis and categorical analysis. We suggest a four category scoring scheme for both time to the first cigarette of the day (5, 6–30, 31–60 and 61 + mm) and average daily consumption of cigarettes (1–10, 11–20, 21–30, 31 + cigarettes) as the most powerful and practical categorical scoring of these variables. Due to possible ceiling effects on biochemical measures, we suggest using logarithmic transformations of CPD or TTF for regression or correlation analyses.

Smoking and Mental Illness

2000-11-22

Karen E. Lasser , J. Wesley Boyd , Steffie Woolhandler +3 more

THE LEADING PREventable cause of death in the United States. 1 In an effort to target public health interventions, recent studies have focused on smoking in distinct populations, such as … THE LEADING PREventable cause of death in the United States. 1 In an effort to target public health interventions, recent studies have focused on smoking in distinct populations, such as pregnant women 2 and adolescents. 3e believe those with mental illness are another group that merits special attention.Previous studies have found high smoking rates among selected populations of persons with mental illness, such as psychiatric outpatients 4 and patients in a state mental hospital. 5][8][9][10][11] Persons with mental illness may encounter greater difficulty with tobacco cessation. 4,12,13However, no recent study has analyzed rates of smoking and quit rates across the spectrum of psychiatric diagnoses in a nationally representative sample.We hypothesized that persons with mental illness smoke at higher rates than persons without mental illness, have lower quit rates, and comprise a large proportion of the US tobacco market.We used population-based data from the National Comorbidity Survey 14 (NCS) to examine the association between type and severity of mental illness and the likelihood of smoking and subsequent cessation.The NCS differed from previous studies because it was the first to administer a structured psychiatric interview to a nationally representative sample. 15Furthermore, the NCS was specifically designed to examine both substance-use and nonsubstance-use psychiatric disorders. METHODS Data SourcesThe NCS was a congressionally mandated study of the prevalence of psychiatric disorders in the United States. 15dministered between September 1990 and February 1992, the survey used a stratified, multistage probability sample of persons aged 15 to 54 years in the noninstitutionalized civilian population.The data were released for public use in 1998.The study design allowed for estimation of the national prevalence of mental illness as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R).

Active Smoking and the Risk of Type 2 Diabetes

2007-12-11

Carole Clair , Patrick Bodenmann , William A. Ghali +2 more

Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes.To conduct a systematic review with meta-analysis of studies assessing the association between active smoking … Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes.To conduct a systematic review with meta-analysis of studies assessing the association between active smoking and incidence of type 2 diabetes.A search of MEDLINE (1966 to May 2007) and EMBASE (1980 to May 2007) databases was supplemented by manual searches of bibliographies of key retrieved articles, reviews of abstracts from scientific meetings, and contact with experts.Studies were included if they reported risk of impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes in relationship to smoking status at baseline; had a cohort design; and excluded persons with diabetes at baseline.Two authors independently extracted the data, including the presence or absence of active smoking at baseline, the risk of diabetes, methods used to detect diabetes, and key criteria of study quality. Relative risks (RRs) were pooled using a random-effects model. Associations were tested in subgroups representing different patient characteristics and study quality criteria.The search yielded 25 prospective cohort studies (N = 1.2 million participants) that reported 45 844 incident cases of diabetes during a study follow-up period ranging from 5 to 30 years. Of the 25 studies, 24 reported adjusted RRs greater than 1 (range for all studies, 0.82-3.74). The pooled adjusted RR was 1.44 (95% confidence interval [CI], 1.31-1.58). Results were consistent and statistically significant in all subgroups. The risk of diabetes was greater for heavy smokers (> or =20 cigarettes/day; RR, 1.61; 95% CI, 1.43-1.80) than for lighter smokers (RR,1.29; 95% CI, 1.13-1.48) and lower for former smokers (RR, 1.23; 95% CI, 1.14-1.33) compared with active smokers, consistent with a dose-response phenomenon.Active smoking is associated with an increased risk of type 2 diabetes. Future research should attempt to establish whether this association is causal and to clarify its mechanisms.

The validity of self-reported smoking: a review and meta-analysis.

1994-07-01

Donald L. Patrick , Allen Cheadle , D. C. Thompson +3 more

OBJECTIVES. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was … OBJECTIVES. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation in validity estimates. METHODS. Literature searches and personal inquiries identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and specificity of self-reports of smoking were calculated for each study as measures of accuracy. RESULTS. Sensitivity ranged from 6% to 100% (mean = 87.5%), and specificity ranged from 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, reports by adults, and biochemical validation with cotinine plasma were associated with higher estimates of sensitivity and specificity. CONCLUSIONS. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, preferably with cotinine plasma, should be considered in intervention studies and student populations.

Measuring nicotine dependence: A review of the Fagerstrom Tolerance Questionnaire

1989-04-01

Karl Fagerström , Nina Schneider

Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature

2003-11-21

Nancy D. Brener , John O. G. Billy , William R. Grady

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Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012

2014-01-08

Marie Ng , Michael K Freeman , Thomas Fleming +7 more

<h3>Importance</h3> Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress. <h3>Objective</h3> To estimate the … <h3>Importance</h3> Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress. <h3>Objective</h3> To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012. <h3>Design</h3> Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38 315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day. <h3>Main Outcomes and Measures</h3> Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year. <h3>Results</h3> Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%;<i>P</i> < .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%;<i>P</i> < .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%;<i>P</i> = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million–742 million) in 1980 to 967 million (95% UI, 944 million–989 million;<i>P</i> < .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence. <h3>Conclusions and Relevance</h3> Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world’s population, intensified efforts to control its use are needed.

Health warning messages on tobacco products: a review

2011-05-23

David Hammond

Objective To review evidence on the impact of health warning messages on tobacco packages. Data sources Articles were identified through electronic databases of published articles, as well as relevant ‘grey’ … Objective To review evidence on the impact of health warning messages on tobacco packages. Data sources Articles were identified through electronic databases of published articles, as well as relevant ‘grey’ literature using the following keywords: health warning, health message, health communication, label and labelling in conjunction with at least one of the following terms: smoking, tobacco, cigarette, product, package and pack. Study selection and data extraction : Relevant articles available prior to January 2011 were screened for six methodological criteria. A total of 94 original original articles met inclusion criteria, including 72 quantitative studies, 16 qualitative studies, 5 studies with both qualitative and qualitative components, and 1 review paper: Canada (n=35), USA (n=29) Australia (n=16), UK (n=13), The Netherlands (n=3), France (n=3), New Zealand (n=3), Mexico (n=3), Brazil (n=2), Belgium (n=1), other European countries (n=10), Norway (n=1), Malaysia (n=1) and China (n=1). Results The evidence indicates that the impact of health warnings depends upon their size and design: whereas obscure text-only warnings appear to have little impact, prominent health warnings on the face of packages serve as a prominent source of health information for smokers and non-smokers, can increase health knowledge and perceptions of risk and can promote smoking cessation. The evidence also indicates that comprehensive warnings are effective among youth and may help to prevent smoking initiation. Pictorial health warnings that elicit strong emotional reactions are significantly more effective. Conclusions Health warnings on packages are among the most direct and prominent means of communicating with smokers. Larger warnings with pictures are significantly more effective than smaller, text-only messages.

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Mortality in relation to smoking: 40 years' observations on male British doctors

1994-10-08

Richard Doll , Richard Peto , Keith Wheatley +2 more

To assess the hazards associated with long term use of tobacco.Prospective study of mortality in relation to smoking habits assessed in 1951 and again from time to time thereafter, with … To assess the hazards associated with long term use of tobacco.Prospective study of mortality in relation to smoking habits assessed in 1951 and again from time to time thereafter, with causes sought of deaths over 40 years (to 1991). Continuation of a study that was last reported after 20 years' follow up (1951-71).34,439 British male doctors who replied to a postal questionnaire in 1951, of whom 10,000 had died during the first 20 years and another 10,000 have died during the second 20 years.Excess mortality associated with smoking was about twice as extreme during the second half of the study as it had been during the first half. The death rate ratios during 1971-91 (comparing continuing cigarette smokers with life-long non-smokers) were approximately threefold at ages 45-64 and twofold at ages 65-84. The excess mortality was chiefly from diseases that can be caused by smoking. Positive associations with smoking were confirmed for death from cancers of the mouth, oesophagus, pharynx, larynx, lung, pancreas, and bladder; from chronic obstructive pulmonary disease and other respiratory diseases; from vascular diseases; from peptic ulcer; and (perhaps because of confounding by personality and alcohol use) from cirrhosis, suicide, and poisoning. A negative association was confirmed with death from Parkinson's disease. Those who stopped smoking before middle age subsequently avoided almost all of the excess risk that they would otherwise have suffered, but even those who stopped smoking in middle age were subsequently at substantially less risk than those who continued to smoke.Results from the first 20 years of this study, and of other studies at that time, substantially underestimated the hazards of long term use of tobacco. It now seems that about half of all regular cigarette smokers will eventually be killed by their habit.

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Varenicline, an α4β2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Sustained-Release Bupropion and Placebo for Smoking Cessation<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>

2006-07-05

David Gonzales , Stephen I. Rennard , Mitchell Nides +7 more

ALTHOUGH NEARLY 41% OF smokers try to quit smoking each year, relapse is common, and only about 10% achieve and maintain abstinence. 1 The negative effects of nicotine withdrawal account, … ALTHOUGH NEARLY 41% OF smokers try to quit smoking each year, relapse is common, and only about 10% achieve and maintain abstinence. 1 The negative effects of nicotine withdrawal account, in part, for low success rates. 2,3Approved pharmacotherapies to treat nicotine dependence (eg, nicotine replacement therapy and bupropion) have had important, albeit moderate, efficacy, with reported rates of quitting generally twice those of placebo. 4Thus, additional and more efficacious therapies are needed.6][7][8] It See also pp 56, 64, and 94.

Signs and Symptoms of Tobacco Withdrawal

1986-03-01

John R. Hughes , Dorothy Hatsukami

• To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by<i>DSM-III</i>, both observed and reported signs and symptoms were measured in 50 … • To test the validity, magnitude, and clinical significance of the signs and symptoms of tobacco withdrawal defined by<i>DSM-III</i>, both observed and reported signs and symptoms were measured in 50 smokers during two days of ad lib smoking and then during the first four days of abstinence. Observer and subject ratings of the<i>DSM-III</i>symptoms of craving for tobacco, irritability, anxiety, difficulty concentrating, and restlessness increased after cessation. In addition, bradycardia, impatience, somatic complaints, insomnia, increased hunger, and increased eating occurred after cessation. The frequency and intensity of these symptoms varied across subjects; however, the average distress from tobacco withdrawal was similar to that observed in psychiatric outpatients. Subjects who had more withdrawal discomfort were more tolerant to the cardiovascular effects of nicotine. Subjects who had more withdrawal discomfort did not have a lower rate of smoking cessation.

A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors

2005-04-09

José de León , Francisco J. Díaz

The Collective Dynamics of Smoking in a Large Social Network

2008-05-21

Nicholas A. Christakis , James H. Fowler

The prevalence of smoking has decreased substantially in the United States over the past 30 years. We examined the extent of the person-to-person spread of smoking behavior and the extent … The prevalence of smoking has decreased substantially in the United States over the past 30 years. We examined the extent of the person-to-person spread of smoking behavior and the extent to which groups of widely connected people quit together.

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Nicotine Chemistry, Metabolism, Kinetics and Biomarkers

2009-01-01

Neal L. Benowitz , Janne Hukkanen , Peyton Jacob

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The Fagerström Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire

1991-09-01

Todd F. Heatherton , Lynn T. Kozlowski , Richard C. Frecker +1 more

We examine and refine the Fagerström Tolerance Questionnaire (FTQ: Fagerström, 1978). The relation between each FTQ item and biochemical measures of heaviness of smoking was examined in 254 smokers. We … We examine and refine the Fagerström Tolerance Questionnaire (FTQ: Fagerström, 1978). The relation between each FTQ item and biochemical measures of heaviness of smoking was examined in 254 smokers. We found that the nicotine rating item and the inhalation item were unrelated to any of our biochemical measures and these two items were primary contributors to psychometric deficiencies in the FTQ. We also found that a revised scoring of time to the first cigarette of the day (TTF) and number of cigarettes smoked per day (CPD) improved the scale. We present a revision of the FTQ: the Fagerström Test for Nicotine Dependence (FTND).

Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries

2010-11-27

Mattias Öberg , Maritta S. Jaakkola , Alistair Woodward +2 more

Effect of smoke-free workplaces on smoking behaviour: systematic review

2002-07-27

Caroline Fichtenberg

To quantify the effects of smoke-free workplaces on smoking in employees and compare these effects to those achieved through tax increases.Systematic review with a random effects meta-analysis.26 studies on the … To quantify the effects of smoke-free workplaces on smoking in employees and compare these effects to those achieved through tax increases.Systematic review with a random effects meta-analysis.26 studies on the effects of smoke-free workplaces.Workplaces in the United States, Australia, Canada, and Germany.Employees in unrestricted and totally smoke-free workplaces.Daily cigarette consumption (per smoker and per employee) and smoking prevalence.Totally smoke-free workplaces are associated with reductions in prevalence of smoking of 3.8% (95% confidence interval 2.8% to 4.7%) and 3.1 (2.4 to 3.8) fewer cigarettes smoked per day per continuing smoker. Combination of the effects of reduced prevalence and lower consumption per continuing smoker yields a mean reduction of 1.3 cigarettes per day per employee, which corresponds to a relative reduction of 29%. To achieve similar reductions the tax on a pack of cigarettes would have to increase from $0.76 to $3.05 (0.78 euro to 3.14 euro) in the United States and from 3.44 pounds sterling to 6.59 pounds sterling (5.32 euro to 10.20 euro) in the United Kingdom. If all workplaces became smoke-free, consumption per capita in the entire population would drop by 4.5% in the United States and 7.6% in the United Kingdom, costing the tobacco industry $1.7 billion and 310 million pounds sterling annually in lost sales. To achieve similar reductions tax per pack would have to increase to $1.11 and 4.26 pounds sterling.Smoke-free workplaces not only protect non-smokers from the dangers of passive smoking, they also encourage smokers to quit or to reduce consumption.

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Levels of selected carcinogens and toxicants in vapour from electronic cigarettes

2013-03-06

Maciej Ł. Goniewicz , Jakub Knysak , Michał Gawron +7 more

<h3>Significance</h3> Electronic cigarettes, also known as e-cigarettes, are devices designed to imitate regular cigarettes and deliver nicotine via inhalation without combusting tobacco. They are purported to deliver nicotine without other … <h3>Significance</h3> Electronic cigarettes, also known as e-cigarettes, are devices designed to imitate regular cigarettes and deliver nicotine via inhalation without combusting tobacco. They are purported to deliver nicotine without other toxicants and to be a safer alternative to regular cigarettes. However, little toxicity testing has been performed to evaluate the chemical nature of vapour generated from e–cigarettes. The aim of this study was to screen e-cigarette vapours for content of four groups of potentially toxic and carcinogenic compounds: carbonyls, volatile organic compounds, nitrosamines and heavy metals. <h3>Materials and methods</h3> Vapours were generated from 12 brands of e-cigarettes and the reference product, the medicinal nicotine inhaler, in controlled conditions using a modified smoking machine. The selected toxic compounds were extracted from vapours into a solid or liquid phase and analysed with chromatographic and spectroscopy methods. <h3>Results</h3> We found that the e-cigarette vapours contained some toxic substances. The levels of the toxicants were 9–450 times lower than in cigarette smoke and were, in many cases, comparable with trace amounts found in the reference product. <h3>Conclusions</h3> Our findings are consistent with the idea that substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants. E-cigarettes as a harm reduction strategy among smokers unwilling to quit, warrants further study. (To view this abstract in Polish and German, please see the supplementary files online.)

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Nicotine Dependence and Psychiatric Disorders in the United States

2004-11-01

Bridget F. Grant , Deborah S. Hasin , S. Patricia Chou +2 more

No information is available on the co-occurrence of DSM-IV nicotine dependence and Axis I and II psychiatric disorders in the US population. No information is available on the co-occurrence of DSM-IV nicotine dependence and Axis I and II psychiatric disorders in the US population.

Outcome criteria in smoking cessation trials: proposal for a common standard

2005-02-25

Robert West , Peter Hájek , Lindsay F Stead +1 more

Smoking cessation treatment is now integrated into many health-care systems and a major research effort is under way to improve current success rates. Until now results from randomized clinical trials … Smoking cessation treatment is now integrated into many health-care systems and a major research effort is under way to improve current success rates. Until now results from randomized clinical trials have been reported in many different ways, leading to problems of interpretation. We propose six standard criteria comprising the 'Russell Standard' (RS). These criteria are applicable to trials of cessation aids where participants have a defined target quit date and there is face-to-face contact with researchers or clinic staff, as follows. (1) Follow-up for 6 months (RS6) or 12 months (RS12) from the target quit date or the end of a predefined 'grace period'; (2) self-report of smoking abstinence over the whole follow-up period allowing up to five cigarettes in total; (3) biochemical verification of abstinence at least at the 6-month or 12-month follow-up point; (4) use of an 'intention-to-treat' approach in which data from all randomized smokers are included in the analysis unless they have died or moved to an untraceable address (participants who are included in the analysis are counted as smokers if their smoking status at the final follow-up cannot be determined); (5) following-up 'protocol violators' and using their true smoking status in the analysis; and (6) collecting follow-up data blind to smokers' allocation to trial group. We believe that these criteria provide the best compromise between practicability and surrogacy for long-term cessation and will enable meaningful comparison between studies. There may be good reasons why other outcome criteria would also be reported, and studies that involve interventions with special groups or where there is no designated target quit date or face to face contact would need to adapt these criteria accordingly.

Adverse Childhood Experiences and Smoking During Adolescence and Adulthood

1999-11-03

Robert F. Anda

ContextIn recent years, smoking among adolescents has increased and the decline of adult smoking has slowed to nearly a halt; new insights into tobacco dependency are needed to correct this … ContextIn recent years, smoking among adolescents has increased and the decline of adult smoking has slowed to nearly a halt; new insights into tobacco dependency are needed to correct this situation. Long-term use of nicotine has been linked with self-medicating efforts to cope with negative emotional, neurobiological, and social effects of adverse childhood experiences.ObjectiveTo assess the relationship between adverse childhood experiences and 5 smoking behaviors.DesignThe ACE Study, a retrospective cohort survey including smoking and exposure to 8 categories of adverse childhood experiences (emotional, physical, and sexual abuse; a battered mother; parental separation or divorce; and growing up with a substance-abusing, mentally ill, or incarcerated household member), conducted from August to November 1995 and January to March 1996.SettingA primary care clinic for adult members of a large health maintenance organization in San Diego, Calif.ParticipantsA total of 9215 adults (4958 women and 4257 men with mean [SD] ages of 55.3 [15.7] and 58.1 [14.5] years, respectively) who responded to a survey questionnaire, which was mailed to all patients 1 week after a clinic visit.Main Outcome MeasuresSmoking initiation by age 14 years or after age 18 years, and status as ever, current, or heavy smoker.ResultsAt least 1 of 8 categories of adverse childhood experiences was reported by 63% of respondents. After adjusting for age, sex, race, and education, each category showed an increased risk for each smoking behavior, and these risks were comparable for each category of adverse childhood experiences. Compared with those reporting no adverse childhood experiences, persons reporting 5 or more categories had substantially higher risks of early smoking initiation (odds ratio [OR], 5.4; 95% confidence interval [CI], 4.1-7.1), ever smoking (OR, 3.1; 95% CI, 2.6-3.8), current smoking (OR, 2.1; 95% CI, 1.6-2.7), and heavy smoking (OR, 2.8; 95% CI, 1.9-4.2). Each relationship between smoking behavior and the number of adverse childhood experiences was strong and graded (P<.001). For any given number of adverse childhood experiences, recent problems with depressed affect were more common among smokers than among nonsmokers.ConclusionsSmoking was strongly associated with adverse childhood experiences. Primary prevention of adverse childhood experiences and improved treatment of exposed children could reduce smoking among both adolescents and adults.

Smoking and drinking in relation to oral and pharyngeal cancer.

1988-06-01

William J. Blot , Joseph K. McLaughlin , Deborah M. Winn +7 more

A case-control study of oral and pharyngeal cancer conducted in four areas of the United States provided information on the tobacco and alcohol use of 1114 patients and 1268 population-based … A case-control study of oral and pharyngeal cancer conducted in four areas of the United States provided information on the tobacco and alcohol use of 1114 patients and 1268 population-based controls. Because of the large study size, it could be shown that the risks of these cancers among nondrinkers increased with amount smoked, and conversely that the risks among nonsmokers increased with the level of alcohol intake. Among consumers of both products, risks of oropharyngeal cancer tended to combine more in a multiplicative than additive fashion and were increased more than 35-fold among those who consumed two or more packs of cigarettes and more than four alcoholic drinks/day. Cigarette, cigar, and pipe smoking were separately implicated, although it was shown for the first time that risk was not as high among male lifelong filter cigarette smokers. Cessation of smoking was associated with a sharply reduced risk of this cancer, with no excess detected among those having quit for 10 or more years, suggesting that smoking affects primarily a late stage in the process of oropharyngeal carcinogenesis. The risks varied by type of alcoholic beverage, being higher among those consuming hard liquor or beer than wine. The relative risk patterns were generally similar among whites and blacks, and among males and females, and showed little difference when oral and pharyngeal cancers were analyzed separately. From calculations of attributable risk, we estimate that tobacco smoking and alcohol drinking combine to account for approximately three-fourths of all oral and pharyngeal cancers in the United States.

A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update

2008-07-09

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Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings

2001-02-01

Lisa Sanderson Cox , Stephen T. Tiffany , Arden G. Christen

A brief, 10-item version of the Questionnaire of Smoking Urges (QSU; Tiffany & Drobes, British Journal of Addiction 86:1467-1476, 1991) was administered to 221 active cigarette smokers in a laboratory … A brief, 10-item version of the Questionnaire of Smoking Urges (QSU; Tiffany & Drobes, British Journal of Addiction 86:1467-1476, 1991) was administered to 221 active cigarette smokers in a laboratory setting (Study 1) and to 112 smokers enrolled in a comprehensive smoking cessation program (Study 2). In the laboratory setting, craving to smoke was evaluated in response to neutral and smoking-related stimuli. In the clinical setting, craving was assessed prior to cessation and again during treatment. Factor analyses revealed that a two-factor solution best described the item structure of the QSU-Brief across conditions. Factor 1 items reflected a strong desire and intention to smoke, with smoking perceived as rewarding for active smokers. Factor 2 items represented an anticipation of relief from negative affect with an urgent desire to smoke. The findings were consistent with the expressions of craving found in the 32-item version of the QSU (Tiffany & Drobes, 1991). Regression analyses demonstrated stronger baseline mood intensity and self-reported tendency to smoke to achieve pleasurable effects and to experience the desire to smoke when cigarettes are unavailable were predictive of general levels of craving report in active smokers in the laboratory and clinical setting. The findings supported a multidimensional conceptualization of craving to smoke and demonstrated the utility of a brief multidimensional measure of craving.

The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes

2004-04-01

Sven Cnattingius

The prevalence of smoking during pregnancy varies markedly across countries. In many industrialized countries, prevalence rates appear to have peaked and begun to decline, whereas in other countries smoking is … The prevalence of smoking during pregnancy varies markedly across countries. In many industrialized countries, prevalence rates appear to have peaked and begun to decline, whereas in other countries smoking is becoming increasingly common among young women. Randomized controlled trials have shown that smoking interventions during pregnancy have had limited success. Smoking during pregnancy is in many countries recognized as the most important preventable risk factor for an unsuccessful pregnancy outcome. Smoking is causally associated with fetal growth restriction, and increasing evidence also suggests that smoking may cause stillbirth, preterm birth, placental abruption, and possibly also sudden infant death syndrome. Smoking during pregnancy also is generally associated with increased risks of spontaneous abortions, ectopic pregnancies, and placenta previa and may increase risks of behavioral disorders in childhood. Smoking during pregnancy will continue to be an important risk factor for maternal and fetal outcomes during pregnancy.

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A descriptive model of the cigarette epidemic in developed countries

1994-09-01

Alan D López , Neil Collishaw , T Piha

It has been estimated that cigarettes are the cause of the deaths of one in two of their persistent users, and that approxi mately half a billion people currently alive-8% … It has been estimated that cigarettes are the cause of the deaths of one in two of their persistent users, and that approxi mately half a billion people currently alive-8% of the world's population could eventually be killed by tobacco if current smoking patterns persist. De spite this pandemic, tobacco consump tion continues and is increasing in many countries, especially in Asia and in Southern and Eastern Europe. A major factor affecting public awareness of the substantial health hazards of tobacco use is the three- to four-decade lag between the peak in smoking prevalence and the subsequent peak in smoking-related mortality. Based on nearly 100 years of observations in countries with the longest history of widespread cigarette use, a four-stage model of cigarette consump tion and subsequent mortality among men and women is proposed. From the model it is clear that, during certain periods of evolution of this epidemic, it is to be expected that smoking-attributable mortality will rise at the same time that smoking prevalence might be decreasing. This is because current mortality is most closely related to previous, not current, levels of cigarette consumption. Broad geographic classifications of regions are given, according to the stage of the epidemic that they are currently ex periencing. Tobacco control policy im plications for countries at each of the four stages of the cigarette epidemic are also discussed.

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Efficacy of Varenicline, an α4β2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Placebo or Sustained-Release Bupropion for Smoking Cessation<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>

2006-07-05

Douglas E. Jorenby

ContextVarenicline, a partial agonist at the α4β2 nicotinic acetylcholine receptor, has the potential to aid smoking cessation by relieving nicotine withdrawal symptoms and reducing the rewarding properties of nicotine.ObjectiveTo determine … ContextVarenicline, a partial agonist at the α4β2 nicotinic acetylcholine receptor, has the potential to aid smoking cessation by relieving nicotine withdrawal symptoms and reducing the rewarding properties of nicotine.ObjectiveTo determine the efficacy and safety of varenicline for smoking cessation compared with placebo or sustained-release bupropion (bupropion SR).Design, Setting, and ParticipantsA randomized, double-blind, placebo-controlled trial conducted between June 2003 and March 2005 at 14 research centers with a 12-week treatment period and follow-up of smoking status to week 52. Of 1413 adult smokers who volunteered for the study, 1027 were enrolled; 65% of randomized participants completed the study.InterventionVarenicline titrated to 1 mg twice daily (n = 344) or bupropion SR titrated to 150 mg twice daily (n = 342) or placebo (n = 341) for 12 weeks, plus weekly brief smoking cessation counseling.Main Outcome MeasuresContinuous abstinence from smoking during the last 4 weeks of treatment (weeks 9-12; primary end point) and through the follow-up period (weeks 9-24 and 9-52).ResultsDuring the last 4 weeks of treatment (weeks 9-12), 43.9% of participants in the varenicline group were continuously abstinent from smoking compared with 17.6% in the placebo group (odds ratio [OR], 3.85; 95% confidence interval [CI], 2.69-5.50; P<.001) and 29.8% in the bupropion SR group (OR, 1.90; 95% CI, 1.38-2.62; P<.001). For weeks 9 through 24, 29.7% of participants in the varenicline group were continuously abstinent compared with 13.2% in the placebo group (OR, 2.83; 95% CI, 1.91-4.19; P<.001) and 20.2% in the bupropion group (OR, 1.69; 95% CI, 1.19-2.42; P = .003). For weeks 9 through 52, 23% of participants in the varenicline group were continuously abstinent compared with 10.3% in the placebo group (OR, 2.66; 95% CI, 1.72-4.11; P<.001) and 14.6% in the bupropion SR group (OR, 1.77; 95% CI, 1.19-2.63; P = .004). Treatment was discontinued due to adverse events by 10.5% of participants in the varenicline group, 12.6% in the bupropion SR group, and 7.3% in the placebo group. The most common adverse event with varenicline was nausea, which occurred in 101 participants (29.4%).ConclusionsVarenicline is an efficacious, safe, and well-tolerated smoking cessation pharmacotherapy. Varenicline's short-term and long-term efficacy exceeded that of both placebo and bupropion SR.Trial Registrationclinicaltrials.gov Identifier: NCT00143364

E-Cigarettes

2014-05-12

Rachel Grana , Neal L. Benowitz , Stanton A. Glantz

chemicals delivered to users and the air pollution generated by the exhaled aerosol. 19-liquids are flavored, including tobacco, menthol, coffee, fruit, candy, and alcohol flavors, as well as unusual flavors … chemicals delivered to users and the air pollution generated by the exhaled aerosol. 19-liquids are flavored, including tobacco, menthol, coffee, fruit, candy, and alcohol flavors, as well as unusual flavors such as cola and Belgian waffle. 3Flavored (conventional) tobacco products are used disproportionately by youth and initiators

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21st-Century Hazards of Smoking and Benefits of Cessation in the United States

2013-01-23

Prabhat Jha , Chinthanie Ramasundarahettige , Victoria Landsman +5 more

Extrapolation from studies in the 1980s suggests that smoking causes 25% of deaths among women and men 35 to 69 years of age in the United States. Nationally representative measurements … Extrapolation from studies in the 1980s suggests that smoking causes 25% of deaths among women and men 35 to 69 years of age in the United States. Nationally representative measurements of the current risks of smoking and the benefits of cessation at various ages are unavailable.

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Shape of the relapse curve and long‐term abstinence among untreated smokers

2003-12-17

John R. Hughes , Josue Keely , Shelly Naud

To describe the relapse curve and rate of long-term prolonged abstinence among smokers who try to quit without treatment.Systematic literature review.Cochrane Reviews, Dissertation Abstracts, Excerpt Medica, Medline, Psych Abstracts and … To describe the relapse curve and rate of long-term prolonged abstinence among smokers who try to quit without treatment.Systematic literature review.Cochrane Reviews, Dissertation Abstracts, Excerpt Medica, Medline, Psych Abstracts and US Center for Disease Control databases plus bibliographies of articles and requests of scientists.Prospective studies of self-quitters or studies that included a no-treatment control group.Two reviewers independently extracted data in a non-blind manner.The number of studies was too small and the data too heterogeneous for meta-analysis or other statistical techniques.There is a paucity of studies reporting relapse curves of self-quitters. The existing eight relapse curves from two studies of self-quitters and five no-treatment control groups indicate most relapse occurs in the first 8 days. These relapse curves were heterogeneous even when the final outcome was made similar. In terms of prolonged abstinence rates, a prior summary of 10 self-quitting studies, two other studies of self-quitters and three no-treatment control groups indicate 3-5% of self-quitters achieve prolonged abstinence for 6-12 month after a given quit attempt.More reports of relapse curves of self-quitters are needed. Smoking cessation interventions should focus on the first week of abstinence. Interventions that produce abstinence rates of 5-10% may be effective. Cessation studies should report relapse curves.

Biochemical verification of tobacco use and cessation

2002-05-01

Neal L. Benowitz , Peyton Jacob , Karen Ahijevych +7 more

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A Controlled Trial of Sustained-Release Bupropion, a Nicotine Patch, or Both for Smoking Cessation

1999-03-04

Douglas E. Jorenby , Scott J. Leischow , Mitchell Nides +7 more

Use of nicotine-replacement therapies and the antidepressant bupropion helps people stop smoking. We conducted a double-blind, placebo-controlled comparison of sustained-release bupropion (244 subjects), a nicotine patch (244 subjects), bupropion and … Use of nicotine-replacement therapies and the antidepressant bupropion helps people stop smoking. We conducted a double-blind, placebo-controlled comparison of sustained-release bupropion (244 subjects), a nicotine patch (244 subjects), bupropion and a nicotine patch (245 subjects), and placebo (160 subjects) for smoking cessation. Smokers with clinical depression were excluded. Treatment consisted of nine weeks of bupropion (150 mg a day for the first three days, and then 150 mg twice daily) or placebo, as well as eight weeks of nicotine-patch therapy (21 mg per day during weeks 2 through 7, 14 mg per day during week 8, and 7 mg per day during week 9) or placebo. The target day for quitting smoking was usually day 8.

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Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial

2016-04-29

Robert M. Anthenelli , Neal L. Benowitz , Robert West +7 more

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Quitting Smoking Among Adults — United States, 2000–2015

2017-01-05

Stephen Babb , Ann Malarcher , Gillian L. Schauer +2 more

Quitting cigarette smoking benefits smokers at any age (1). Individual, group, and telephone counseling and seven Food and Drug Administration-approved medications increase quit rates (1-3). To assess progress toward the … Quitting cigarette smoking benefits smokers at any age (1). Individual, group, and telephone counseling and seven Food and Drug Administration-approved medications increase quit rates (1-3). To assess progress toward the Healthy People 2020 objectives of increasing the proportion of U.S. adults who attempt to quit smoking cigarettes to ≥80.0% (TU-4.1), and increasing recent smoking cessation success to ≥8.0% (TU-5.1),* CDC assessed national estimates of cessation behaviors among adults aged ≥18 years using data from the 2000, 2005, 2010, and 2015 National Health Interview Surveys (NHIS). During 2015, 68.0% of adult smokers wanted to stop smoking, 55.4% made a past-year quit attempt, 7.4% recently quit smoking, 57.2% had been advised by a health professional to quit, and 31.2% used cessation counseling and/or medication when trying to quit. During 2000-2015, increases occurred in the proportion of smokers who reported a past-year quit attempt, recently quit smoking, were advised to quit by a health professional, and used cessation counseling and/or medication (p<0.05). Throughout this period, fewer than one third of persons used evidence-based cessation methods when trying to quit smoking. As of 2015, 59.1% of adults who had ever smoked had quit. To further increase cessation, health care providers can consistently identify smokers, advise them to quit, and offer them cessation treatments (2-4). In addition, health insurers can increase cessation by covering and promoting evidence-based cessation treatments and removing barriers to treatment access (2,4-6).

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Protecting Adolescents From Harm

1997-09-10

Michael D. Resnick

<h3>Context.</h3> —The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. <h3>Objective.</h3> —To identify risk and protective factors … <h3>Context.</h3> —The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. <h3>Objective.</h3> —To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. <h3>Design.</h3> —Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. <h3>Participants.</h3> —A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. <h3>Setting.</h3> —The interview was completed in the subject's home. <h3>Main Outcome Measures.</h3> —Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. <h3>Results.</h3> —Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12:<i>P</i><.001) and violence (grades 7-8:<i>P</i><.001; grades 9-12:<i>P</i><.001). Access to substances in the home was associated with use of cigarettes (<i>P</i><.001), alcohol (<i>P</i><.001), and marijuana (<i>P</i><.001) among all students. Working 20 or more hours a week was associated with emotional distress of high school students (<i>P</i><.01), cigarette use (<i>P</i><.001), alcohol use (<i>P</i><.001), and marijuana use (<i>P</i><.001). Appearing "older than most" in class was associated with emotional distress and suicidal thoughts and behaviors among high school students (<i>P</i><.001); it was also associated with substance use and an earlier age of sexual debut among both junior and senior high students. Repeating a grade in school was associated with emotional distress among students in junior high (<i>P</i><.001) and high school (<i>P</i><.01) and with tobacco use among junior high students (<i>P</i><.001). On the other hand, parental expectations regarding school achievement were associated with lower levels of health risk behaviors; parental disapproval of early sexual debut was associated with a later age of onset of intercourse (<i>P</i><.001). <h3>Conclusions.</h3> —Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy

2019-01-30

Peter Hájek , Anna Phillips‐Waller , Dunja Przulj +7 more

E-cigarettes are commonly used in attempts to stop smoking, but evidence is limited regarding their effectiveness as compared with that of nicotine products approved as smoking-cessation treatments. E-cigarettes are commonly used in attempts to stop smoking, but evidence is limited regarding their effectiveness as compared with that of nicotine products approved as smoking-cessation treatments.

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Summary health statistics for U.S. adults: national health interview survey, 2012.

2014-02-01

Debra L. Blackwell , Jacqueline W Lucas , Tainya C. Clarke

This report presents detailed tables from the 2012 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, education, current employment … This report presents detailed tables from the 2012 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, education, current employment status, family income, poverty status, health insurance coverage, marital status, and place and region of residence. Estimates (frequencies and percentages) are presented for selected chronic conditions and mental health characteristics, functional limitations, health status, health behaviors, health care access and utilization, and human immunodeficiency virus testing. Percentages and percent distributions are presented in both age-adjusted and unadjusted versions.NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2012, data were collected on 34,525 adults in the Sample Adult questionnaire. The conditional response rate was 79.7%, and the final response rate was 61.2%. The health information for adults in this report was obtained from one randomly selected adult per family.In 2012, 61% of adults aged 18 and over had excellent or very good health. Eleven percent of adults had been told by a doctor or other health professional that they had heart disease, 24% had been told on two or more visits that they had hypertension, 9% had been told that they had diabetes, and 21% had been told that they had some for of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. Eighteen percent of adults were current smokers and 21% were former smokers. Based on estimates of body mass index, 35% of adults were overweight and 28% were obese.

Cigarette Smoking Among Adults--United States, 2003

2005-07-12

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

2021-05-27

Marissa B Reitsma , Parkes Kendrick , Emad Ababneh +7 more

<h2>Summary</h2><h3>Background</h3> Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed … <h2>Summary</h2><h3>Background</h3> Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. <h3>Methods</h3> We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. <h3>Findings</h3> Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. <h3>Interpretation</h3> In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. <h3>Funding</h3> Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.

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Antidepressants for smoking cessation

2020-04-22

Seth Howes , Jamie Hartmann‐Boyce , Jonathan Livingstone‐Banks +2 more

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Current Cigarette Smoking Among Adults — United States, 2005–2014

2015-11-10

Ahmed Jamal , David M. Homa , Erin L. O’Connor +5 more

Tobacco smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 480,000 premature deaths and more than $300 billion in direct health care … Tobacco smoking is the leading cause of preventable disease and death in the United States, resulting in approximately 480,000 premature deaths and more than $300 billion in direct health care expenditures and productivity losses each year (1). To assess progress toward achieving the Healthy People 2020 objective of reducing the percentage of U.S. adults who smoke cigarettes to ≤12.0%,* CDC assessed the most recent national estimates of smoking prevalence among adults aged ≥18 years using data from the 2014 National Health Interview Survey (NHIS). The percentage of U.S. adults who smoke cigarettes declined from 20.9% in 2005 to 16.8% in 2014. Among daily cigarette smokers, declines were observed in the percentage who smoked 20–29 cigarettes per day (from 34.9% to 27.4%) or ≥30 cigarettes per day (from 12.7% to 6.9%). In 2014, prevalence of cigarette smoking was higher among males, adults aged 25–44 years, multiracial persons and American Indian/Alaska Natives, persons who have a General Education Development certificate, live below the federal poverty level, live in the Midwest, are insured through Medicaid or are uninsured, have a disability or limitation, or are lesbian, gay, or bisexual. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, high impact mass media campaigns, and barrier-free access to quitting assistance, are critical to reduce cigarette smoking and smoking-related disease and death among U.S. adults.

PREDICTORS OF INTENTION TO QUIT TOBACCO AND BARRIERS TO QUIT TOBACCO IN ADULTS AMONG RESIDENTS OF RAIPUR CITY, CHHATTISGARH

2025-06-25

S Yogesh , Verma Nirmal , Agrawal Shailendra +4 more | International Journal of Advanced Research

Background: Tobacco claims the lives of half of its users who fail to quit. Tobacco usage in any form leads to the death and illness of millions annually. The tobacco … Background: Tobacco claims the lives of half of its users who fail to quit. Tobacco usage in any form leads to the death and illness of millions annually. The tobacco epidemic represents one of the most significant public health challenges. Aims/Objectives: To assess the predictors of intention to quit tobacco and barriers to quit tobacco in adults among residents of Raipur city, Chhattisgarh. Methodology:Cross-sectional, community-based observational study.Pre-designed, pre-tested semi-structured questionnaire of socio-demographic information and the use of any kind of tobacco, quitting attempts was put to each subject to assess their intention to quit, barriers to quit, smoking practices, smoking history, knowledge about smoking-related damage and perceived health status. Results: Among the 410 study participants, a majority (224 or 54.6%) reported having the intention to quit tobacco use. 45.4% (186) were identified as having barriers preventing them from quitting tobacco. Conclusions: The prevalence of the intention to quit tobacco among study participants is high, similar to national levels, with significant barriers to quitting. Family pressure and improve in own health was strong predictors of intention to quit tobacco.

In adults, is varenicline more effective than nicotine replacement monotherapy for smoking cessation?

2025-06-25

A. Bryant , Enrique Chávez León | Evidence-Based Practice

Best practice for tobacco smoking policies within an acute substance use disorder care facility: considerations from a withdrawal management setting in British Columbia, Canada

2025-06-24

Natasha Caton , Mark Lysyshyn , Nicole Cowan +1 more | Tobacco Control

Smoking-related illness has historically been a major cause of death in persons with substance use disorders. Smoking cessation has the potential to support improved substance use disorder outcomes, as well … Smoking-related illness has historically been a major cause of death in persons with substance use disorders. Smoking cessation has the potential to support improved substance use disorder outcomes, as well as improved physical and mental health outcomes in persons receiving other substance use disorder treatment. However, tobacco abstinence-oriented policies within substance use disorder care settings may create barriers to clients who are uninterested in quitting smoking being able to access other potentially lifesaving substance use disorder treatment. In British Columbia, where the drug toxicity crisis has become the leading cause of unnatural death, reducing barriers to accessing substance use disorder treatment is a key public health priority. We present a reflection on considerations from a withdrawal management setting of a smoking policy change within that facility and review the potential benefits and harms of permissive smoking policies within substance use disorder care environments. Benefits include the elimination of a barrier to accessing other substance use treatment, patient autonomy over participation in smoking cessation treatment and the potential for less covert smoking and associated risks. Risks include ongoing physical and mental health harms of smoking, potentially poorer other substance use treatment outcomes, risks of tobacco relapse to other clients and secondhand smoke exposure to staff and other clients. Further research will be needed to explore the impacts of this policy change and evaluate the potential role for other smoking cessation innovations, including expansion of nicotine replacement options such as provision of nicotine electronic cigarette devices.

Cas complexe et tabac

2025-06-24

Pierre-Boris Mathern , Aslem Kheireddine , Phuc Nguyen | Psychotropes

En tabacologie, le cas complexe peut revêtir plusieurs formes et dans différentes spécialités, avec une nomenclature officielle inexistante. En psychiatrie, notamment chez le patient atteint de schizophrénie, on note l’importance … En tabacologie, le cas complexe peut revêtir plusieurs formes et dans différentes spécialités, avec une nomenclature officielle inexistante. En psychiatrie, notamment chez le patient atteint de schizophrénie, on note l’importance des interactions entre les traitements médicamenteux, le tabagisme et l’état clinique. Devant un échec d’objectif de sevrage tabagique, l’alternative sera d’opter pour une réduction des risques et des dommages. Face à cette complexité multifactorielle, l’approche motivationnelle et l’alliance patient/soignant restent des éléments phares de la prise en charge. Le cas clinique présenté illustre l’interaction qu’il peut y avoir entre le sevrage tabagique et le traitement médicamenteux d’un patient sous Clozapine, il rappelle la nécessité d’une surveillance régulière clinique et pharmacologique liée au cytochrome p450.

E-Cigarette and Cannabis Social Media Posts and Adolescent Substance Use

2025-06-24

Julia Vassey , Junhan Cho , Erin A. Vogel +3 more | JAMA Network Open

Adolescents are exposed to e-cigarette and cannabis content on social media. Understanding associations of these exposures with use and dual use of these products can guide regulations. To assess whether … Adolescents are exposed to e-cigarette and cannabis content on social media. Understanding associations of these exposures with use and dual use of these products can guide regulations. To assess whether adolescent exposure to e-cigarette and/or cannabis content on social media, including posts by various content creators, is associated with e-cigarette, cannabis, and dual use. Two surveys, one longitudinal (study 1, baseline in 2021 to 2022) and one cross-sectional (study 2, fall 2023), were conducted among California high school students who completed questionnaires on computers in classrooms. In study 1, the baseline was frequent exposure (weekly or more vs less frequent or none) to e-cigarette and/or cannabis social media posts. In study 2, the exposure (yes vs no) was to e-cigarette and/or cannabis posts from specific sources (friends, celebrities, microinfluencers, e-cigarette and/or cannabis brands, or unknown sources). For study 1, the primary outcome was solo e-cigarette, solo cannabis, or dual use initiation at 1-year follow-up among baseline never-users of e-cigarettes and cannabis. For study 2, the primary outcome was past-month use of e-cigarettes, cannabis, and dual use. Generalized estimating equations models adjusted for sociodemographic characteristics, mental health, other tobacco product use, social media use, and social environment. In study 1, of 4232 adolescents (mean [SD] age, 17.0 [0.6] years; 2205 female [52.1%]), 968 (22.9%) reported frequent baseline exposure to e-cigarette posts and 507 (12.0%) reported exposure to cannabis posts on social media, broadly; 567 (13.4%) were frequently exposed to e-cigarette posts specifically on TikTok. Frequent exposure to cannabis social media posts was associated with solo e-cigarette use (adjusted odds ratio [AOR], 1.83; 95% CI, 1.11-3.01), solo cannabis use (AOR, 1.60; 95% CI, 1.07-2.38), and dual use (AOR, 1.71; 95% CI, 1.11-2.63) initiation at 1-year follow-up. Frequent exposure to e-cigarette posts on TikTok was associated with solo cannabis use (AOR, 1.74; 95% CI, 1.17-2.58) and dual use (e-cigarette and cannabis) initiation (AOR, 1.78; 95% CI, 1.19-2.66). In study 2, of 3380 adolescents (mean [SD] age, 17.0 [0.6] years; 1840 female [54.4%]), 195 (5.8%) were exposed to microinfluencer e-cigarette posts, and 152 (4.5%) were exposed to microinfluencer cannabis posts; 151 (4.5%) were exposed to friends' e-cigarette posts, and 161 (4.8%) were exposed to friends' cannabis posts. Exposure to e-cigarette (AOR, 2.67; 95% CI, 1.55-4.59) and cannabis (AOR, 2.14; 95% CI, 1.15-4.00) microinfluencer posts was associated with past-month cannabis use. Exposure to friends' e-cigarette posts was associated with past-month dual use (AOR, 2.53; 95% CI, 1.24-5.19), whereas exposure to friends' cannabis posts was associated with past-month cannabis use (AOR, 3.35; 95% CI, 1.94-5.78) and dual use (AOR, 2.46; 95% CI, 1.28-4.71). In this survey study of California adolescents, exposure to e-cigarette or cannabis posts was associated with adolescent e-cigarette, cannabis, or dual use. Improvement of social media community guidelines and greater policy attention to co-use and marketing of e-cigarettes and cannabis may help prevent youth substance use.

Effects of oral nicotine pouches on cigarette smoking behaviour and tobacco harm exposure: a randomised pilot trial in adults

2025-06-23

Lisa M. Fucito , Stephen R. Baldassarri , Ran Wu +5 more | Tobacco Control

Oral nicotine pouches may have potential for smoking cessation, but scientific evidence on the effects of pouches and their constituents on smoking behaviour is limited. This study was a 4-week, … Oral nicotine pouches may have potential for smoking cessation, but scientific evidence on the effects of pouches and their constituents on smoking behaviour is limited. This study was a 4-week, open-label, randomised pilot trial of nicotine pouches in 3 mg (low) or 6 mg (high) nicotine strength. US outpatient research clinic with non-treatment seeking adults who smoke cigarettes (N=30). Participants selected two flavours and were instructed to switch to using nicotine pouches in place of cigarettes. We compared groups on cigarettes smoked per day, pouch use and urinary levels of a tobacco-specific carcinogen (NNAL) over 4 weeks, biochemically verified 7-day point prevalence smoking abstinence at week 4, and willingness to continue pouch use. Nearly all participants completed the trial (29/30). Participants in both groups significantly reduced their cigarettes smoked per day (log-transformed) over time (F3, 74.4=3.8, p=0.01). The 6 mg group reported numerically greater, but non-significant, reductions in smoking than the 3 mg group (least-square mean difference (LSMD) at week 1=0.008; 95% CI -0.42-0.44; LSMD at week 4=0.38; 95% CI -0.06-0.81). The 6 mg group also reported numerically higher, but non-significant, likelihood of complete smoking abstinence (13% vs 0%) and willingness to continue pouch use (67% vs 40%). There were no differences by group or time for NNAL. Results provide preliminary support for nicotine pouches for cigarette substitution. Compared with lower nicotine strength pouches, higher nicotine strength pouches may have a greater impact on smoking behaviour and adults who smoke may be more willing to use them. NCT04250727.

Assessment of the prevalence, regional differences and determinants of tobacco use among men and women of reproductive age in Nigeria

2025-06-23

Adams Victor Eseoghen , Obinna Princewill Anyatonwu , Owen Adams +3 more | Deleted Journal

Remediated marketing: leveraging computer vision and rule-based classification models to detect e-cigarette warning labels across social media

2025-06-22

Kellen Sharp , Marzieh Babaeianjelodar , Dhiraj Murthy +5 more | Information Communication & Society

Global Youth Tobacco Survey (2001-2022) in Saudi Arabia: An Analysis of Forecasting and Insights Pertaining to Dental Public Health and Tobacco Cessation Counseling

2025-06-22

Bugude Shiva Shankar | Cureus

Tobacco use among youth is a critical public health concern, particularly in Saudi Arabia, where a significant youth demographic and evolving tobacco control policies shape usage patterns. The Global Youth … Tobacco use among youth is a critical public health concern, particularly in Saudi Arabia, where a significant youth demographic and evolving tobacco control policies shape usage patterns. The Global Youth Tobacco Survey (GYTS) provides standardized data to monitor these trends, offering insights for dental public health and tobacco cessation counseling. This study analyzes GYTS data from 2001 to 2022 to evaluate trends in youth tobacco use, their association with tobacco control policy implementation, and implications for oral health interventions. Data from the GYTS conducted in Saudi Arabia (2001, 2007, 2010, and 2022) among youth aged 13-15 years (n = 1,830-4,526) were analyzed. Key indicators included current cigarette smoking, environmental tobacco smoke exposure, cessation attempts, and knowledge/attitudes toward smoking. Descriptive statistics, percent change calculations, linear and joinpoint regression analyses, and gender-specific comparisons assessed trends and policy impacts. Prediction models forecast the prevalence to 2030. Statistical analyses were performed using Python (version 3.10; Python Software Foundation, Wilmington, DE) and the Joinpoint Regression Program (version 4.9.1.0; National Cancer Institute, Bethesda, MD). Current cigarette smoking increased from 4.7% (2001) to 8.9% (2010) before declining to 2.9% (2022), a 38.3% relative decrease. Joinpoint analysis identified a significant trend reversal after 2010, coinciding with comprehensive MPOWER policy implementation (p < 0.001). Boys exhibited higher smoking prevalence than girls, but the gender gap narrowed from 4.0 to 1.3 percentage points (2001-2022). Environmental tobacco smoke exposure and living with smokers decreased by 28.8% and 33.0%, respectively. Cessation indicators showed declines in desire (74.0%-64.9%) and attempts to quit (69.3%-58.7%). Support for smoking bans rose by 14.6%. Predictions suggest smoking prevalence may approach 1.0%-2.0% by 2030 if trends persist. Comprehensive tobacco control policies after 2010 significantly reduced youth tobacco use in Saudi Arabia, with notable declines in smoking prevalence and environmental exposure. However, declining cessation indicators highlight the need for targeted interventions. Dental professionals can leverage these trends to integrate cessation counseling into routine care, enhancing oral health outcomes. Sustained policy enforcement and gender-sensitive strategies are crucial to further reduce youth tobacco use by 2030.

Rising trend of E-cigarettes among adolescents of Pakistan and cardiovascular implications of electronic nicotine delivery systems

2025-06-20

Abdul W. Basit , Sarmad Javed , Qasim Mehmood +3 more | World Journal of Cardiology

It is a common misconception that e-cigarettes are safer than tobacco smoking, given their adverse cardiopulmonary effects, habituation, and the fact that it is only a fashion based manifestation to … It is a common misconception that e-cigarettes are safer than tobacco smoking, given their adverse cardiopulmonary effects, habituation, and the fact that it is only a fashion based manifestation to sell and use them. Therefore, the use of e cigarettes should not be encouraged as an alternative and pragmatic measure should be taken to profess this agenda.

Smoking cessation: A guide for the oral healthcare team

2025-06-20

Ismail Mohammed Farook , Manàs Dave , Paul Coulthard | BDJ Team

The impact of electronic cigarettes on pregnancy and childhood health outcomes: the ECHO study—a protocol for a multicentre, prospective, observational, cohort

2025-06-20

Eibhlín F. Healy , Abigail O’Connell , Marah Shaikh Yousef +7 more | Archives of Gynecology and Obstetrics

Abstract Background Stopping cigarette smoking in pregnancy positively impacts on the incidence of preterm birth, intrauterine growth restriction, and stillbirth. Electronic cigarettes (E-cigarettes) are viewed by some women as a … Abstract Background Stopping cigarette smoking in pregnancy positively impacts on the incidence of preterm birth, intrauterine growth restriction, and stillbirth. Electronic cigarettes (E-cigarettes) are viewed by some women as a lower risk alternative to tobacco smoking during pregnancy and are cautiously endorsed in some parts of the UK to support smoking cessation(1), however, robust, high-quality data on the impact of E-cigarettes on pregnancy and childhood health outcomes are lacking. Objective The objective of the ECHO study is to investigate the impact of maternal E-cigarette use during pregnancy on obstetric, neonatal, and infant outcomes. Methods Pregnant women attending three, large, standalone, urban, university, maternity units in Dublin, Ireland, will be invited to take part in this prospective, multicentre, observational cohort. Smoking and vaping patterns will be assessed using digital patient questionnaires. Objective assessment of breath carbon monoxide and urine cotinine levels will accurately determine exposure status at pre-specified timepoints. A third trimester ultrasound will assess growth and fetal dopplers across all groups. Postnatally, infants will undergo anthropometric measurements and developmental checks. A subgroup of 150 randomly selected infants will be assessed with the Bayley’s Scales of Infant and Toddler Development. Discussion Nicotine-containing E-cigarettes are addictive and their long-term impact on pulmonary, cardiovascular, and neurological function on developing humans is undetermined. This study is ambitious as it aims to longitudinally assess the outcomes of the mother/baby dyad, examining the impact of vaping on pregnancy, neonatal and infant health, growth and neurocognitive outcomes. Trial registration ClincialTrials.gov NCT06297005

Should medical professionals focus more on e-cigarette user among young people in Poland?

2025-06-20

Paulina Kurdyś , Leon Kośmider , Wojciech Bykowski +2 more | Pediatria i Medycyna Rodzinna

Introduction and objective: The initial surge in the popularity of e-cigarettes among adults was largely driven by their perceived potential to aid in quitting traditional cigarettes. Anti-smoking prevention is a … Introduction and objective: The initial surge in the popularity of e-cigarettes among adults was largely driven by their perceived potential to aid in quitting traditional cigarettes. Anti-smoking prevention is a crucial aspect of public health aimed at reducing the morbidity and mortality associated with tobacco-related diseases. Materials and methods: This study aimed to evaluate tobacco prevention among youths in Poland by surveying a sample of 10,388 individuals aged 12–18 through an online questionnaire. Findings revealed that 32.2% (3,347) of respondents had smoked cigarettes, 37.8% (3,924) had used e-cigarettes, and 10.4% (1,078) had tried heated tobacco products. Results: The highest smoking prevalence was observed in rural areas (50.4%) and small towns (26.22%). Only 26.7% (1,165) of adolescents reported being asked about smoking by a doctor, and just 5.7% (249) were offered counselling. Gender analysis showed that doctors discussed smoking more frequently with boys (28.66%) than with girls (25.02%; OR = 1.20; CI = 0.95). Urban children were more likely to be asked about tobacco use than their rural peers (OR = 1.26; CI = 0.95). Among those who had used cigarettes or e-cigarettes in the past 30 days, only 6.45% (139) received support to quit from a doctor. Conclusions: The findings highlight a need to enhance healthcare communication regarding smoking among paediatric patients, as a significant number of youths who have tried tobacco or marijuana products have not engaged in discussions about smoking with their doctors, nor have they received assistance in quitting.

Co-Use of Nicotine Products and Cannabis and Its Association with ENDS Dependence Among U.S. adults Frequently Using ENDS

2025-06-20

Qinghua Nian , Jeffrey J Hardesty , Elizabeth Crespi +2 more | Substance Use & Misuse

Background: People who use electronic nicotine delivery systems (ENDS) often also use other nicotine products and cannabis. This study explores the co-use of these substances among adults frequently using ENDS … Background: People who use electronic nicotine delivery systems (ENDS) often also use other nicotine products and cannabis. This study explores the co-use of these substances among adults frequently using ENDS and examines its association with ENDS dependence. Objectives: Data came from wave 5 (February-April 2023) of a longitudinal study. A subsample of 1,290 U.S. adults (21+) who self-reported using ENDS 5+ days/week and uploaded photos of their most used ENDS devices and liquids, reported their use of nicotine products and cannabis in the past 30 days, days per week they used these substances, and ENDS dependence. Co-use patterns were categorized as: (1) exclusive ENDS use, (2) ENDS-other nicotine product(s) co-use, (3) ENDS-cannabis co-use, (4) ENDS-other nicotine product(s)-cannabis co-use. We examined the association between co-use and dependence, measuring co-use as the use of nicotine products and cannabis in the past 30 days and on 5+ days/week. ANCOVAs and multiple linear regression analyses were conducted. Results: After controlling for sociodemographic and device and liquid characteristics, participants co-using ENDS-cannabis (n = 344, 26.6%) reported significantly higher ENDS dependence (e-cigarette dependence scale [EDS, range 0-4, 4 being most dependent] = 2.5) compared to those co-using ENDS-other nicotine product(s)-cannabis (n = 81, 6.2%, EDS = 2.3, p < 0.05), and co-using ENDS-other nicotine product(s) (n = 127, 9.8%, EDS = 2.2, p < 0.05). Conclusions: Co-use of ENDS-cannabis is common among adults frequently using ENDS and is associated with greater ENDS dependence compared to other co-use patterns. Further research is needed to explore impacts of frequent co-use beyond dependence and to inform prevention efforts.

Effect of a Brief Sensitization Session on Tobacco Control Awareness Among Healthcare Professionals Across India: A Pre– and Post-intervention Evaluation

2025-06-20

Saurabh Varshney , G. Jahnavi , Bijit Biswas +7 more | Cureus

The Impact of Maternal/In Utero Exposure of Novel Tobacco Products on the Offspring Cardiovascular Health

2025-06-20

Shelby S. Umphres , Precious Badejo , Fadi T. Khasawneh +1 more | Cardiovascular Toxicology

Abstract Novel tobacco products (NTPs) have recently been on the rise appealing to a variety of users, including pregnant women and women of childbearing age, who deem these products to … Abstract Novel tobacco products (NTPs) have recently been on the rise appealing to a variety of users, including pregnant women and women of childbearing age, who deem these products to be a safe/safer alternative to traditional smoking. To this end, several studies have made advances toward proving the invalidity of these claims, especially in the context of cardiovascular disease. However, an area that has yet to be extensively explored is maternal/in utero exposure to these devices and the cardiovascular health outcomes on the offspring into their adult life. Herein, our aim is to critically assess the literature to identify and discuss the cardiovascular health risks that the offspring exhibits as a result of in utero exposure to NTPs. These studies have been summarized as a comprehensive review.

Harmful health effects of e-cigarettes (vapes) and other non-tobacco oral nicotine products, trends in their use, and interventions: living protocol for a living evidence map and linked research digests

2025-06-20

Gareth J. Hollands , Ian Shemilt , Katy Sutcliffe +3 more | F1000Research

<ns3:p>There is a recognised need to further understand potential harms from the use of e-cigarettes and other non-tobacco oral nicotine products (ONPs), particularly among children and young people. This protocol … <ns3:p>There is a recognised need to further understand potential harms from the use of e-cigarettes and other non-tobacco oral nicotine products (ONPs), particularly among children and young people. This protocol describes a programme of work that aims to continually identify and classify the evolving international evidence base on the effects of these products on human health, trends in their use, and related interventions. In terms of its methods, we will produce and maintain a living evidence map, available in an online interactive format, and updated continually over the planned duration of the project (~5 years from registration). A wide range of electronic databases will be searched, with eligible articles including a focus on the use of e-cigarettes or ONPs in humans. Should satisfactory levels of machine performance be reached (by reference to human performance benchmarks), we intend to automate the bulk screening of articles for inclusion using Large Language Model (LLM) decisions. A similar approach will be applied to the automated coding of a range of characteristics of included articles, including their type of research, and the nature of harms and products being examined. In conjunction with the production of the living evidence map, we will produce regular descriptive surveillance reports (research digests) that will summarise the current contents of the map. Ongoing production and maintenance of this living evidence map and linked outputs will enable potential users – including across research, policy, and charitable sectors – to more efficiently establish an overview of the landscape of relevant research and surveil key developments.</ns3:p>

Predictors of smoking abstinence among diabetic smokers: Evidence from the French national smoking cessation registry CDTnet

2025-06-20

Ingrid Allagbé , David Baudoin , Bastien Rance +1 more | PLoS ONE

Evidence suggests that diabetic smokers are less likely to quit smoking when compared to non-diabetic smokers. This study aimed to determine predictors of abstinence among diabetic smokers attending smoking cessation … Evidence suggests that diabetic smokers are less likely to quit smoking when compared to non-diabetic smokers. This study aimed to determine predictors of abstinence among diabetic smokers attending smoking cessation services (SCSs) across France. We analysed data from 94,827 adult smokers registered in the French national smoking cessation registry (CDTnet) between 2007 and 2016. Participants attended ≥2 SCS visits, and one-month continued abstinence was confirmed by carbon monoxide measurement. Among 6,405 diabetic smokers, 33% achieved one-month continued abstinence, versus 38% among 88,422 non-diabetic smokers (p < 0.001). Positive predictors of abstinence among diabetic smokers included employment (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.37-1.89), ≥ 3 prior quit attempts (OR, 1.61; 95% CI, 1.36-1.91), low nicotine dependence (OR, 1.42; 95% CI, 1.13-1.78), prescription of combined nicotine replacement therapy (NRT) (OR, 1.43; 95% CI, 1.19-1.72) or varenicline (OR, 1.64; 95% CI, 1.20-2.25), and ≥7 SCS consultations (OR, 4.47; 95% CI, 3.40-5.84). Conversely, negative predictors included history of myocardial infarction/angina (OR, 0.82; 95% CI, 0.70-0.96), chronic bronchitis/chronic obstructive pulmonary disease (OR, 0.79; 95% CI, 0.69-0.91), anxiety (OR, 0.82; 95% CI, 0.71-0.94), recent cannabis use (OR, 0.67; 95% CI, 0.50-0.90), and exclusive oral NRT use (OR, 0.70; 95% CI, 0.56-0.88). Overall, tailored cessation programs are crucial for enhancing cessation outcomes among diabetic smokers.

Identifying Key Predictors of Smoking Cessation Success: Text-Based Feature Selection Using a Large Language Model

2025-06-20

Thuy T. T. Le , Jack Yang , Zhihe Zhao +3 more | medRxiv (Cold Spring Harbor Laboratory)

Abstract Background The most effective way to reduce mortality and morbidity among current smokers is to quit smoking. Although about half of smokers attempted to quit, only one-tenth succeeded in … Abstract Background The most effective way to reduce mortality and morbidity among current smokers is to quit smoking. Although about half of smokers attempted to quit, only one-tenth succeeded in 2022. Objective To identify key predictors of smoking cessation success to inform cessation interventions and increase quitting rates. Methods We analyzed data from waves 5 and 6 of the Population Assessment of Tobacco and Health (PATH) study (December 2018 to November 2021). Using OpenAI’s GPT-4.1, we identified the top 45 variables from wave 5 that are highly predictive of 12-month smoking abstinence in wave 6, based on descriptions of survey variables. We then validated the predictive power of the GPT-4.1-selected variables by comparing the performance of eXtreme Gradient Boosting (XGBoost) trained on different sets of variables. Finally, we derived insights into the top 10 variables, ranked according to their SHapley Additive exPlanations values. Results The performance of XGBoost trained with all possible wave 5 variables and the 45 selected variables was almost identical (AUC:0.749 vs AUC:0.752). The top 10 variables included past 30-day smoking frequency, minutes from waking up to smoking first cigarette, important people’s views on tobacco use, prevalence of tobacco use among close associates, daily electronic nicotine product use, emotional dependence, and health harm concerns. Conclusion This study demonstrates the ability of OpenAI’s GPT-4.1 to identify the top 45 PATH wave 5 variables associated with 12-month smoking abstinence using only their descriptions. This approach could help researchers design more effective survey questionnaires and improve efficiency of data collection. What is already known on this topic Generative artificial intelligence models have recently been applied to assess their potential in addressing various tobacco-related issues, such as detecting tobacco products in social media videos and promoting vaping cessation. However, their application in identifying the most significant predictors of tobacco use behavior, based on survey data, remains unexplored. What this study adds GPT-4.1 successfully assigned high-quality importance scores to survey variables for predicting 12-month smoking abstinence over two years among current established smokers. It accomplished this using only the textual descriptions of the survey variables, without accessing the actual survey data. Based on these importance scores, GPT-4.1 can aid in identifying the most crucial variables for predicting smoking cessation success. How this study might affect research, practice or policy This study demonstrates the capacity of GPT-4.1 to perform feature selection, paving the way for future exploration of this innovative approach to address other tobacco-related issues.

Nicotine Dependence in a Banned Market: Biomarker Evidence from E-Cigarette Users in São Paulo, Brazil

2025-06-19

Jaqueline Schölz Issa , Elaine Cristine D’Amico , Juliana Takitane +7 more | International Journal of Environmental Research and Public Health

Although electronic cigarettes have been banned in Brazil since 2009, their use is increasing, particularly among youth. We conducted a biomarker-based study to profile exclusive e-cigarette users in São Paulo … Although electronic cigarettes have been banned in Brazil since 2009, their use is increasing, particularly among youth. We conducted a biomarker-based study to profile exclusive e-cigarette users in São Paulo and to examine the associations of e-cigarette use with salivary nicotine and cotinine levels. A population-based, cross-sectional study was conducted between April and September 2024 in six municipalities in São Paulo, Brazil. Randomly selected participants who reported exclusive use of electronic cigarettes completed a questionnaire and provided oral fluid samples for the determination of their nicotine and cotinine concentrations using LC-MS/MS. The cohort consisted of N = 417 participants. Significant associations were found between nicotine and cotinine concentrations and variables such as knowledge of nicotine content and product type. Addiction status significantly influenced the nicotine and cotinine concentrations, as well as smoking history, last consumption, recharge/purchase frequency, and consumption duration (all p < 0.001). Participants who perceived themselves to have a moderate or severe addiction exhibited higher nicotine and cotinine concentrations compared with those who did not perceive that they had an addiction (p < 0.001). Most participants were young, predominantly White, and highly educated and earned higher incomes. The findings reveal a correlation between perceived nicotine dependence and salivary nicotine and cotinine concentrations, underscoring the physiological and behavioral markers of electronic cigarette addiction. High salivary concentrations of nicotine appear to be independent of duration of e-cigarette use, smoking history, and age. These findings underscore the urgent need for surveillance and public health interventions, even in jurisdictions where these products remain illegal. The study limitations include its cross-sectional design and potential selection bias due to convenience sampling.

Evaluation of Nicotine Transdermal Patches Available on the Domestic Market

2025-06-19

| Glasnik hemicara i tehnologa Bosne i Hercegovine

The use of transdermal patches with nicotine is a better way to quit smoking because it ensures a similar concentration of nicotine in the blood as when smoking and reduces … The use of transdermal patches with nicotine is a better way to quit smoking because it ensures a similar concentration of nicotine in the blood as when smoking and reduces the morning desire for a cigarette. The aim of this work was to analyze the behavior of the matrix with the active substance under conditions that are close to skin conditions. A total of 3 samples were collected from local market. The analysis was performed after 0.5, 1, 4, 10, 16 and 24 hours for each sample. The concentration of released nicotine for samples at 50 RPM ranged in the following range: sample 1 43.87 %-115.23 %; sample 2 40.56 %-114.70 %; sample 3 43.53 %-117.13 %. The concentration of released nicotine for the samples at 100 RPM ranged in the following range: sample 1 45.14 %-120.82 %; sample 2 49.05 %-120.79 %; sample 3 44.73 %-118.51 %. It was determined that most of the nicotine is released already after 4 hours. The samples also show very similar concentration results after 10 hours, and for all three samples the result was 0.096 mg/ml.

‘E-cigarette smoking’ is a misleading term: a critical review of its use in academic literature

2025-06-18

Yusuff Adebayo Adebisi , Nafisat Dasola Jimoh , Chimwemwe Ngoma | Internal and Emergency Medicine

Abstract The terminology used to describe e-cigarette-related behaviours in academic literature is critical for accurate communication and interpretation. Despite fundamental differences between e-cigarette use (vaping) and tobacco smoking, terms such … Abstract The terminology used to describe e-cigarette-related behaviours in academic literature is critical for accurate communication and interpretation. Despite fundamental differences between e-cigarette use (vaping) and tobacco smoking, terms such as “e-cigarette smoking” have been used to refer to vaping, potentially conflating the two behaviours. This study aims to assess the use of the term “e-cigarette smoking” and its variants in peer-reviewed literature and discuss the implications of their usage. A review of academic literature published between 2015 and 2024 was conducted using Embase, Scopus, Web of Science, ScienceDirect, and ProQuest databases. Searches included terms such as “e-cigarette smoking” and related variants, with database-specific filters applied to exclude irrelevant document types. A supplementary search in Google Scholar was performed to capture broader usage, including grey literature. The search identified 613 articles in Embase, 462 in Web of Science, 407 in ScienceDirect, 282 in Scopus and 121 in ProQuest, highlighting the widespread use of “e-cigarette smoking” and related terms. The Google Scholar search returned approximately 4680 results, reflecting the widespread and informal use of “e-cigarette smoking” across diverse publication types, including grey literature. The term has also appeared in highly cited and recent studies in ways that conflate e-cigarette use with smoking, obscuring the fundamental differences between these distinct behaviours. The use of “e-cigarette smoking” and its variants in academic literature has notable implications for research integrity, addiction science, public health, and policy. Misleading terminology can contribute to distorted understandings of nicotine dependence, complicate harm reduction strategies, and risk shaping restrictive policies that fail to differentiate e-cigarette use from smoking. Standardising terminology in academic literature is essential to ensure accurate communication, support evidence-based policymaking, and enhance public health initiatives.

Trends of cotinine and secondhand smoke exposure rates in children and adolescent aged 6–19 years: Impact of race and socioeconomic factors over two decades

2025-06-18

Junwen Wang , Jun Ma , Teng Hu +7 more | Addictive Behaviors

Smoking cessation treatment outcomes before and during the covid-19 pandemic in people with and without mental health disorders

2025-06-18

Gemma Nieva , Núria Sisternas , Sílvia Mondón +7 more | Journal of Studies on Alcohol and Drugs

The COVID-19 pandemic likely heightened stress in smokers undergoing cessation treatment, while healthcare services faced challenges in maintaining interventions during the pre-vaccination phase. This study compares smoking cessation outcomes before … The COVID-19 pandemic likely heightened stress in smokers undergoing cessation treatment, while healthcare services faced challenges in maintaining interventions during the pre-vaccination phase. This study compares smoking cessation outcomes before and during the pandemic in individuals with and without mental health disorders and identifies variables associated with abstinence. A naturalistic longitudinal design with a one-year follow-up was used. Smoking quit rates and time to relapse in participants who received a multicomponent cessation intervention before the lockdown (2019 group, n=147) were compared with those during the pandemic (2020 group, n=120). The sample was 53.6% female, mean age of 58.2, and 79.4% had a comorbid mental disorder. One-year quit rates and time to relapse were similar between the 2019 and 2020 groups (51% vs. 50.8%; 225.3 vs. 221.6 days, respectively). A mental health history did not affect outcomes. Smokers aged 55 or older had higher quit rates during the pandemic than younger smokers (61% vs. 41%) and no differences were found between in-person and telematic interventions. Smoking cessation rates were similar before and during the pandemic, regardless of mental health status, and the increased use of telematic visits could be considered after the pandemic era. Older age was only associated with abstinence during the pandemic; highlighting the need for research on improving outcomes in younger populations undergoing treatment during stressful times. Identifying modifiable variables associated with abstinence can help smoking cessation services implement strategies to prevent relapse.

Changes in seeking smoking cessation therapy among Japanese employees and their families: a possible role for the dissemination of heated tobacco products (HTPs)

2025-06-18

Chie Taniguchi , Isao Oze , Akihiko Narisada +4 more | Tobacco Control

Introduction The adoption of heated tobacco products (HTPs) has grown as smokers transition away from conventional cigarettes for harm reduction. However, the impact of HTP use on smoking behaviours remains … Introduction The adoption of heated tobacco products (HTPs) has grown as smokers transition away from conventional cigarettes for harm reduction. However, the impact of HTP use on smoking behaviours remains unclear. Methods We analysed data from 8890 records of smokers seeking smoking cessation therapy (SCT) between 2014 and 2019 using the Japan Medical Data Center claims database. September 2015, when the HTP ‘IQOS’ was launched in 12 major prefectures in Japan, marked the first dissemination phase of HTP. April 2016, when IQOS became available nationwide, marked the second phase. Interrupted time series analysis was applied to evaluate changes in SCT uptake rates across these phases. Results Following the first dissemination phase, there was a significant immediate decrease in SCT uptake (−0.21%, 95% CI: −0.41% to −0.16%, p=0.035), followed by a further significant reduction after the second phase (−0.26%, 95% CI: −0.48% to −0.10%, p=0.008). Additionally, the slope of SCT uptakes was significantly decreased after the second phase (−0.007% per month, 95% CI: −0.012 to −0.02, p=0.008). Conclusions Our study showed that SCT uptake decreased sharply when HTPs were disseminated to all prefectures in Japan, and this downward trend continued thereafter. These findings are considered to result from the widespread adoption of HTP in the Japanese market, as these products were perceived to be less harmful than traditional cigarettes. Therefore, it is worrying that the widespread availability of HTP resulted in reduced smoking cessation behaviour among cigarette users.

Long‐Term Effectiveness of Tobacco Smoking Cessation Interventions in Adults: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

2025-06-18

Dadang Saadulloh , Rohman Rohman , Fitrian Rayasari +3 more | Journal of Nursing Scholarship

ABSTRACT Background Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although … ABSTRACT Background Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation have been implemented, their effectiveness remains unclear. This study aimed to assess the long‐term effectiveness of various smoking cessation interventions in adults. Design We conducted a systematic review and meta‐analysis of randomized controlled trials reporting long‐term outcomes. Methods Evidence searches were conducted in the Cochrane Library, Embase, Medline‐OVID, PubMed, Web of Science, and Clinicaltrials.gov . Two researchers searched until August 2023 without restrictions on country, language, or year of publication. The risk ratio (RR) for continuous abstinence was obtained through biochemical verification at measurements ≥ 6 months post‐intervention. Data were extracted and assessed for quality using Risk of Bias 2. Meta‐analysis was carried out using a random effects model. Subgroup analyses and meta‐regression were performed to explore moderator variables. Sensitivity and publication bias analyses were also performed. Results Twenty‐two effect sizes from 13 studies showed that tobacco smoking cessation interventions increased continuous abstinence by 2.5 times (RR 3.52; 95% CI; 2.19–5.65). The highest ratio was in the behavioral intervention (RR 7.83) with more than 6 months of therapy (RR 10.57). The tobacco smoking cessation intervention worked better in 55–64 years (RR 7.29), especially in Asia (RR 10.08). The intervention was more effective for female respondents (RR 4.21) and combination therapy format (RR 3.82). However, meta‐regression showed that differences in gender and therapy format did not significantly influence the effectiveness of tobacco smoking cessation interventions in adults ( p values 0.2748 and 0.8769). Sensitivity analysis ( p ‐value 0.0025) further strengthens the evidence of the conclusions and credibility of the findings. Conclusion Behavioral therapy lasting more than 6 months was the most successful tobacco smoking cessation intervention in respondents aged 55–64 years, especially when implemented in Asia. Although not significant, therapies delivered in combination formats, especially in women, have the potential to increase continuous abstinence for adults. These findings provide important evidence for developing effective prevention and treatment strategies for long‐term smoking cessation concerning the type, format, and total of therapy.

Restricting Online Sales and Reclassifying E-Cigarettes as Prescription-Only: A Public Health Policy Perspective

2025-06-17

Taiwo Opeyemi Aremu , Fredrick M Ogugua | Cureus

Patterns of tobacco retailer counts by zoning designations and sociodemographic characteristics in Oklahoma City and Tulsa, Oklahoma

2025-06-17

Lily Herbert , Daniel P Giovenco , Isabel Cuéllar‐Flores +5 more | Health & Place

Living in a neighborhood with a high count of tobacco retailers (i.e., tobacco retailer availability, TRA) is associated with youth and adult tobacco use behaviors. As such, policies that reduce … Living in a neighborhood with a high count of tobacco retailers (i.e., tobacco retailer availability, TRA) is associated with youth and adult tobacco use behaviors. As such, policies that reduce TRA have been identified as an important intervention for reducing tobacco use and achieving an equitable tobacco endgame. Zoning regulations could be leveraged as an innovative policy tool to reduce inequities in TRA, especially in states that may preempt local tobacco retail licensing. This study analyzed TRA inequities by zoning designations and sociodemographic characteristics in Oklahoma City and Tulsa (Oklahoma, USA) in 2023. We obtained locations of all licensed tobacco retailers in OKC and Tulsa and downloaded spatial zoning files containing all zoning designations (e.g., C-3, Community Commercial). We created quintiles of 2019-2023 American Community Survey census tract ethnic, racial, and socioeconomic characteristics. We spatially joined these data and calculated the total count of tobacco retailers within zoning designations and across all census tracts. To identify zoning-based inequities, we fit linear regression models examining associations between sociodemographic quintiles of census tracts and the total count of tobacco retailers in each zoning designation in a tract. Across both cities, tobacco retailer counts were generally higher in neighborhoods with greater percentages of Black and Hispanic or Latine residents, lower percentages of White residents, higher income inequality, lower median household income, and higher percentages of residents living below the federal poverty line. Among tracts with commercial zones near residential areas, tracts with the highest (vs. lowest) percentage of residents living below the federal poverty line had 1.4 more retailers (SE, 0.3, p < 0.001) in OKC. This pattern was similar in Tulsa though not significant. In contrast, TRA in tracts with commercial zoning near residential areas was lower in tracts with the highest (vs. lowest) percentage of White residents (OKC: B = -1.1; SE, 0.3, p < 0.01; Tulsa: B = -3.0; SE, 0.8, p < 0.001) and highest (vs. lowest) median household income (OKC: B = -1.4; SE, 0.3, p < 0.001; Tulsa: B = -1.9; SE, 0.8, p < 0.05). For places that are prohibited from implementing licensing-based policies to reduce TRA, zoning laws may be the only viable policy approach to reducing TRA, which may also reduce inequities in tobacco use, promoting health equity.

Barriers and Facilitators to Smoking Cessation Among University Students: A Scoping Review

2025-06-17

Farhan Alanazi , Walid Jumma Mohamed Mohamed , Stathis Konstantinidis +1 more | International Journal of Environmental Research and Public Health

University students are a vulnerable population for smoking initiation and continuation, often facing unique challenges in accessing cessation support. This scoping review aimed to map the existing literature on the … University students are a vulnerable population for smoking initiation and continuation, often facing unique challenges in accessing cessation support. This scoping review aimed to map the existing literature on the barriers and facilitators to smoking cessation among university students using the Theoretical Domains Framework (TDF). Following the JBI methodology, six studies conducted in the United States, Jordan, and Qatar were included, employing both qualitative and quantitative designs. A total of 22 barriers and 20 facilitators were identified and mapped across relevant TDF domains. Key barriers included time constraints, financial limitations, low self-efficacy, and social smoking norms. Facilitators included access to flexible, low-cost interventions, peer support, and previous quit attempts. Digital interventions were preferred by students. The findings suggest that smoking cessation strategies targeting university students should be flexible, affordable, and embedded within campus health systems. Interventions that combine behavioral support, peer involvement, and accessible technology show strong potential in addressing the multifaceted barriers faced by this population. This review provides a theory-informed foundation for the development of tailored smoking cessation interventions and identifies key directions for future research.

Fumar y trabajar: percepciones y riesgos del tabaquismo en estudiantes y profesionales

2025-06-17

Mario García-Suárez , Juan Gómez‐Salgado , Daniel Fernández-García | Atención Primaria

The case of the Hermann J. Muller’s unpublished manuscript entitled: does smoking lengthen life?

2025-06-17

Edward J. Calabrese | Archives of Toxicology

When meta-analysis misleads: the need for methodological integrity in e-cigarette research

2025-06-17

Riccardo Polosa , Giulio Geraci , Yusuff Adebayo Adebisi | Internal and Emergency Medicine

Tobacco cessation among dual users: analysis of two rounds of Global Adult Tobacco Survey, India

2025-06-16

Shailendra Kumar , Nilesh Gawde , GK Mini | Journal of Public Health

Abstract Objective The tobacco epidemic in India involves extensive use of smoking and smokeless tobacco products, with nearly 24 million dual users (using both forms) in 2016–17. Tobacco cessation among … Abstract Objective The tobacco epidemic in India involves extensive use of smoking and smokeless tobacco products, with nearly 24 million dual users (using both forms) in 2016–17. Tobacco cessation among dual users remains underexplored. This study examines the pattern and determinants of tobacco cessation among dual users using the transtheoretical model. Methods Data from two rounds of the Global Adult Tobacco Survey, India (2009–10 and 2016–17) were used (pooled sample of 6956 current dual users) to estimate the prevalence of tobacco cessation stages (precontemplation, contemplation, preparation, and relapse). We modelled association with cessation stages using multinomial logistic regression. Results About 43% of dual users were in precontemplation, 10% in contemplation, 23% in preparation, and 24% in relapse in 2009–10. These proportions shifted to 48%, 8%, 17%, and 27%, respectively, in 2016–17. The regression model indicated significant temporal influence, with dual users in 2016–17 more likely to be in precontemplation [relative risk ratio (RRR): 1.59], contemplation (RRR: 1.37), and relapse (RRR: 1.88) than in 2009–10. Age, gender, wealth quintile, region, and exposure to tobacco-related health warnings were significant predictors. Conclusion Addressing dual tobacco use requires targeted cessation interventions that consider regional and contextual factors to support users through the stages of readiness to quit.

Author Correction: A cross-national analysis of demographic variation in daily smoking across 22 countries

2025-06-16

Sung Joon Jang , Pedro Antonio de la Rosa , R. Noah Padgett +3 more | Scientific Reports

Simultaneous analysis of cotinine and 8-OHdG in urine: A biomarker approach for smoking exposure and oxidative stress

2025-06-16

Na-Youn Park , Hyeon‐Sook Koo , Jung Hoan Kim +4 more | Environmental Analysis Health and Toxicology

This study developed and validated a simultaneous LC-MS/MS method to quantify cotinine and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urine, biomarkers for smoking exposure and oxidative DNA damage. The method demonstrated high specificity, … This study developed and validated a simultaneous LC-MS/MS method to quantify cotinine and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urine, biomarkers for smoking exposure and oxidative DNA damage. The method demonstrated high specificity, sensitivity, and reproducibility, with detection limits of 0.23 ng/mL for cotinine and 0.5 ng/mL for 8-OHdG. Cross-laboratory validation showed strong agreement between institutions, with Pearson correlation coefficients and intraclass correlation coefficients exceeding 0.9. Analysis of urine samples from children and adults revealed that cotinine and 8-OHdG levels were significantly higher in smokers, and also influenced by age, gender, and alcohol consumption. The findings underscore the potential of these biomarkers for assessing smoking-related oxidative stress and health risks.

Electronic Cigarette Regulation Around the World: A Scoping Review on Public Health Challenges, Regulatory Approaches, and Policy Strategies

2025-06-16

Victoria Borges Spinola , Megan E. Roberts , Celso Zilbovícius +2 more | Journal of Science Policy & Governance

Regulatory policies on electronic cigarettes vary significantly across different continents, reflecting regional differences in how the risks and benefits of e-cigarettes are perceived and prioritized. We recommend ongoing analysis of … Regulatory policies on electronic cigarettes vary significantly across different continents, reflecting regional differences in how the risks and benefits of e-cigarettes are perceived and prioritized. We recommend ongoing analysis of emerging evidence from all sources and the adoption of standardized practices that implement proven effective measures to achieve positive outcomes.

Cigarrillo electrónico, salud y medio ambiente

2025-06-15

Rodrigo Córdoba-García , Vidal Barchilon Cohen , Cecilia Amato +3 more | Revista Clínica de Medicina de Familia

Los cigarrillos electrónicos (e-cigs) se caracterizan por el calentamiento del líquido que contienen, el cual está compuesto por diversos productos que producen un aerosol. El objetivo de esta revisión fue … Los cigarrillos electrónicos (e-cigs) se caracterizan por el calentamiento del líquido que contienen, el cual está compuesto por diversos productos que producen un aerosol. El objetivo de esta revisión fue describir la relación entre el uso de e-cigs y los efectos en la salud pública y el medio ambiente. El aerosol contiene una combinación de sustancias químicas. Las más habituales son la nicotina, el propilenglicol (PG), el glicerol y los aromas. La mayoría de los líquidos utilizados en los e-cigs contienen una mezcla de PG y glicerol. Los compuestos carbonílicos como el formaldehído, acetaldehído, acroleína y el glioxal, que se han encontrado en los aerosoles de los e-cigs, son potencialmente peligrosos y pueden inducir diversos efectos sobre la salud. Si bien muchos sabores son seguros como aditivos alimenticios, pueden ser dañinos cuando se inhalan. La publicidad de estos productos indica que tiene un 95% menos de riesgo que el cigarrillo convencional, sin embargo, revisiones recientes concluyen que, aunque los e-cigs presentan una morbilidad un 20% menor que los cigarrillos convencionales, su habitual consumo dual la incrementa cerca de un 30%. Los desechos electrónicos son responsables de dos tercios de los metales pesados en los vertederos, y están aumentando, mientras que disminuyen las colillas de cigarrillos. Estos materiales son difíciles de reciclar adecuadamente, por lo que su prohibición es la mejor opción.

Isolating the unique role of transdiagnostic risk factors and perceived barriers for smoking cessation

2025-06-15

Andre Bizier , Jessica Thai , Lorra Garey +2 more | Addiction Research & Theory

Interventions for smokeless tobacco use cessation

2025-06-15

| Kazan medical journal

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Livingstone-Banks J, Vidyasagaran AL, Croucher R, Siddiqui F, Zhu S, Kidwai Z, Parkhouse … This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Livingstone-Banks J, Vidyasagaran AL, Croucher R, Siddiqui F, Zhu S, Kidwai Z, Parkhouse T, Mehrotra R, Siddiqi K. Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews. 2025. Issue 4. Art. No.: CD015314. DOI: 10.1002/14651858.CD015314.pub2

Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims

2025-06-13

Kinsey Pebley , Joni Nelson , Julie L Marshall +1 more | Substance Abuse Treatment Prevention and Policy

Vendor density mapping and compliance assessment with tobacco control laws around schools in Bhubaneswar City—a geo-spatial mapping and observational study

2025-06-13

Nancy Satpathy , Pratap Kumar Jena , Amit Yadav +6 more | Frontiers in Public Health

Background Tobacco use among youth remains a significant public health challenge, particularly in India, where vendor accessibility plays a crucial role in initiation and consumption. This study examines tobacco vendor … Background Tobacco use among youth remains a significant public health challenge, particularly in India, where vendor accessibility plays a crucial role in initiation and consumption. This study examines tobacco vendor density around schools in Bhubaneswar City, Odisha, utilizing advanced geo-spatial mapping techniques to provide evidence for regulatory enforcement. Methods A geo-spatial mapping approach was employed using ArcMap 10.8 and Google Maps to identify tobacco vendors within a 100-yard radius of 15 selected high schools. Data collection was conducted through a structured questionnaire with 53 closed-ended questions via the Epicollect5 platform. The study adopted a probability proportional-to-size sampling method to ensure representative vendor distribution. Results The study identified 107 tobacco vendors surrounding the selected schools, with an average vendor density of approximately seven per school vicinity. Pan vendors and grocery/convenience stores were the most prevalent vendor types. Despite existing regulations, widespread tobacco advertising, brand displays, and promotional activities were observed. Additionally, violations related to smoking near schools and sales to minors indicated gaps in regulatory compliance. Conclusion The high density of tobacco vendors near schools underscores the need for strengthened enforcement mechanisms and policy interventions. Enhancing regulatory compliance through stricter zoning laws, targeted monitoring, and community-driven initiatives is essential to reducing youth exposure to tobacco products and mitigating associated health risks.

Prevalence and knowledge of medical students about the risks of E-cigarette use

2025-06-13

Maria Antonia Souza de Castro , Gisele Fabrino Machado , Mauro Zamboni +2 more | Deleted Journal

Knowledge Attitude and practice about E-cigarettes among University Students: A comparative study between Afghanistan, Netherlands, and Turkey

2025-06-13

Mansoorullah Muradi , Lima Oria , Tariq Aziz Azizi | Research Square (Research Square)

<title>Abstract</title> Background The rise in electronic cigarette (e-cigarette) use among young adults has raised significant public health concerns. Initially introduced as a harm-reduction tool, e-cigarettes have increasingly become a popular … <title>Abstract</title> Background The rise in electronic cigarette (e-cigarette) use among young adults has raised significant public health concerns. Initially introduced as a harm-reduction tool, e-cigarettes have increasingly become a popular alternative to traditional smoking. However, misconceptions about their safety, social acceptability, and long-term health effects persist among university students. Objective The aim of this study was to find out the knowledge, attitude, and practice about E-Cigarettes among University Students in Afghanistan, the Netherlands, and Turkey. Methods This study adopts an analytical cross-sectional design and employs a foundational approach by administering an online questionnaire. The study uses a quantitative methodology to explore universities students’ knowledge, attitudes, and perceptions regarding e-cigarettes. Data collection was facilitated through a survey distributed via Google Forms and statistical analysis was performed using SPSS 26 to identify significant associations. Results The findings revealed that 54.2% of students reported using e-cigarettes, with a higher prevalence among those with close friends or family members who smoked. Knowledge about e-cigarettes was generally low, with 56.2% demonstrating poor understanding, particularly regarding the health risks and regulatory status of e-cigarettes. Attitudes were largely negative, with 73.4% expressing concerns about vaping, though 62.7% believed it was more socially acceptable than traditional smoking. Peer influence was a major factor, as 74.6% of e-cigarette users had close friends who also vaped. A significant association was found between smoking tobacco and e-cigarette use (p = 0.00), indicating a trend of dual-use rather than e-cigarettes serving as a quitting tool. Conclusion The study highlights a critical gap in e-cigarette knowledge and a strong influence of social and environmental factors on vaping behaviors. Despite negative attitudes toward vaping, its perceived social acceptability remains high. Public health interventions should focus on targeted educational campaigns, peer-led awareness programs, and regulatory measures to address misconceptions and reduce e-cigarette use among young adults.

Telephone-based Stop Smoking Service support: experiences, accessibility and health equity implications

2025-06-13

Thomas Mills , Elisa G. Lewis , Charlotte Taylor-Page +7 more | Research Square (Research Square)

<title>Abstract</title> <bold>Background</bold> This evaluation explored the changing provision of Stop Smoking Services (SSS) from face-to-face (F2F) to telephone support (TS) across three Local Authorities in England (Central Bedfordshire, Bedford Borough … <title>Abstract</title> <bold>Background</bold> This evaluation explored the changing provision of Stop Smoking Services (SSS) from face-to-face (F2F) to telephone support (TS) across three Local Authorities in England (Central Bedfordshire, Bedford Borough and Milton Keynes) with a focus on specialist groups (those with a physical or mental health condition or pregnant) and those from the most deprived areas. <bold>Methods</bold> An evaluation, conducted between December 2022 and November 2023, comprised three components. First, analysis of existing i) quarterly return data and ii) individual level data from 8668 episodes, to explore effectiveness and cost-effectiveness. Second, surveys of 311 service-users and 23 providers to explore preferences, acceptability and experiences of TS (vs F2F). Third, qualitative interviews with 18 service-users (sampled from specialist groups and lower quintiles of deprivation) and 7 service providers. <bold>Results</bold> People from specialist groups, or more deprived areas, were less likely to quit smoking and cost more to achieve a successful quit than people not in these situations. We did not find any advantage of F2F support for quit success, and among specialist groups and those living in more deprived areas, no preference for it. Although convenience was seen as a clear advantage of TS, qualitative data highlighted the importance of choice, flexibility, and advisors’ attributes, skills and approaches as more important than mode of delivery. <bold>Conclusions</bold> Our findings suggest that: i) efforts to provide equitable support for specialist groups and those from more deprived areas are warranted; ii) SSS do not need to routinely offer F2F support for these groups; iii) choice and flexibility of delivery method is preferable to service-users and could remove some access barriers experienced by marginalised groups; iv) the skills, attributes and approaches of advisors can enhance satisfaction with SSS and improve chances of quit success. <bold>Clinical trial number:</bold>not applicable

Comment on “Fake smoke, real fire: a retrospective single-center analysis of the underestimated risk of e-cigarette explosions and the typical burn patterns”

2025-06-13

Renu Sah , Ankita Mathur | Wiener klinische Wochenschrift

Smoking patterns among individuals with hypertension in Iran: findings from the nationwide STEPS survey 2021

2025-06-12

Sarmad Salehi , Ali Golestani , Negar Rezaei +5 more | Public Health

Trends of oral nicotine pouch prices and sales by product characteristics in the USA, 2021–2024

2025-06-12

Yanyun He , Zezhong Zhang , Brittney Keller‐Hamilton +4 more | Tobacco Control

Background Oral nicotine pouches (ONPs) have rapidly gained popularity in recent years. While ONPs likely expose users to fewer toxicants than cigarettes, they contain nicotine and may initiate, sustain or … Background Oral nicotine pouches (ONPs) have rapidly gained popularity in recent years. While ONPs likely expose users to fewer toxicants than cigarettes, they contain nicotine and may initiate, sustain or increase nicotine addiction and dependence. Monitoring the ONP marketplace is essential to inform timely regulatory action. Methods We used Nielsen ScanTrack data to analyse ONP sales and prices from 2021 to 2024. Joinpoint regression assessed sales and price trends, and ordinary least squares regression evaluated the association between ONP sales and product characteristics. Results Monthly ONP unit sales increased significantly, from 327 million in July 2021 to 1046 million in May 2024—more than tripling over this period (p<0.001, average monthly per cent change (AMPC)=3.45). Inflation-adjusted prices also rose, from 19 cents/pouch in June 2021 to 22 cents/pouch in May 2024 (p<0.001, AMPC=0.50). The sales of ZYN, On!, Rogue and VELO account for 99.8% of total sales. ONPs with explicit flavour descriptors outsold those with implicit flavour descriptors by more than eight times. The ‘chill’ flavour had also gained notable popularity. ONPs with 6 mg and 3 mg nicotine concentrations made up 68% of total sales. Additionally, ONPs with explicit flavour descriptors and higher nicotine concentrations were associated with increased sales. Conclusions Policy-makers may need to consider the role of major manufacturers, product flavours, and nicotine content in shaping the market. Continued surveillance is warranted to assess trends in use, particularly among youth and non-tobacco users.

Knowledge, attitude and practice (KAP) toward tobacco among university students in Jordan: a cross-sectional study

2025-06-12

Yara Obaidat , Tuqa Ananbeh , Mohammad Al-Qudah +4 more | Journal of Substance Use

What cigarette price would drive Vietnamese people who smoke to quit smoking? Findings from the 2019-2020 ITC Vietnam surveys

2025-06-12

Thi Phuong Thao Tran , Thi Ngoc Phuong Nguyen , Thu Trang Vu +7 more | Tobacco Control

Background Tobacco taxation is the most effective strategy for reducing tobacco consumption, yet it remains underused globally, especially in low- and middle-income countries. This study aimed to investigate the price … Background Tobacco taxation is the most effective strategy for reducing tobacco consumption, yet it remains underused globally, especially in low- and middle-income countries. This study aimed to investigate the price that would lead Vietnamese people who smoke to quit smoking and examine the impact of non-tax tobacco control policies on this price. Methods Cross-sectional data from Waves 2 and 3 of the International Tobacco Control Project in Vietnam were analysed. The price to quit was assessed by a question ‘What price for a pack of cigarettes would make you try to quit smoking?’. Tobit models were used to examine the association between non-tax policies (ie, noticing health warnings, anti-smoking advertising, use of cessation services and workplace smoke-free policies) and the price to quit. Results The weighted median of the price to quit for a cigarette pack was Vietnam dong (VND)20 000 (US$0.86), which doubled the weighted median of the purchased price of VND10 000 (US$0.43). If cigarette prices increased by VND2000 or VND5000, 27.4% and 42.8% of people who smoke would intend to quit smoking, respectively. Price increases that doubled or tripled current prices would lead 70.7% and 82.9% of people who smoke to consider quitting smoking, respectively. Smoke-free policies at workplace were associated with a lower price to quit. Conclusion Given that the current cigarette prices are very low and affordable, substantial price increases are needed to motivate quitting. Adding specific taxes in addition to the existing ad valorem system could enhance the effectiveness of tobacco taxation.