Research Digest April 2021

This page provides a non-exhaustive list of tobacco-related research articles identified weekly from PubMed by the ASH Scotland Information Service. 

Search period: 27/03 - 30/04

Research Trawl  24 April - 30 April

Smoking behavior in 18–20 year-olds after tobacco 21 policy implementation in California: A difference-in-differences analysis with other states

Published: 29/04/2021, Preventative Medicine

Findings: Before California's T21 policy, there was an 11% annual decrease in the odds of ever smoking among 18–20 year-olds in California and a 6% decrease in the referent states. After the policy, these trends did not change significantly. Results for current smoking were similar. For daily smoking, there was an 8% annual decrease before the policy and a 26% annual decrease after the policy among 18–20 year-olds in California; D-I-D estimates were 0.80 (95% CI: 0.57, 1.14) using referent states as the comparison and 0.62 (95% CI: 0.41, 0.95) using 21–23 year-olds in California as the comparison. There was an association between California's T21 policy and a decrease in daily smoking among 18–20 year-olds, compared with 21–23 year-olds, more than three years post-implementation.

Cigarette Smoking and Longitudinal Associations With Blood Pressure: The CARDIA Study

Published: 27/04/2021, Journal of the American Heart Association

Conclusions Although the associations of cigarette smoking with alterations in BP are small, the greater PP observed in consistent smokers may contribute in part to the higher cardiovascular disease risk observed in this group because PP is a strong predictor of cardiovascular disease risk after middle age.

Early-life environmental exposure determinants of child behavior in Europe: A longitudinal, population-based study

Published: 29/04/2021, Environmental International

Conclusions: Our systematic exposome approach identified several environmental contaminants and healthy lifestyle habits that may influence behavioral problems in children. Modifying environmental exposures early in life may limit lifetime mental health risk.

Second hand smoke exposure and oral cancer risk: a systematic review and meta-analysis

Published: 26/04/2021, Tobacco Control

Conclusions: This systematic review and meta-analysis supports a causal association between SHS exposure and oral cancer. Our results could provide guidance to public health professionals, researchers, and policymakers to further support effective SHS exposure prevention programs worldwide.

The ‘filter fraud’ persists: the tobacco industry is still using filters to suggest lower health risks while destroying the environment

Published: 26/04/2021, Tobacco Control

[Industry Watch] Except: The overwhelming majority of independent research shows that filters do not reduce the harms associated with smoking—a fact understood by tobacco industry scientists in the 1960s. In fact, filters may increase the harms caused by smoking by enabling smokers to inhale smoke more deeply into their lungs. Furthermore, toxic fibres shed from the cut end of the filter are inhaled and ingested by smokers. A recent research letter reporting a study with contradictory findings has been criticised for a non-representative sample and failing to take into account confounding factors such as socioeconomic status.

Paying lip service to publication ethics: scientific publishing practices and the Foundation for a Smoke-Free World

Published: 28/04/2021, Tobacco Control

[Special Communication] Abstract: Litigation forced the dissolution of three major tobacco industry-funded organisations because of their egregious role in spreading scientific misinformation. Yet in 2017, a new scientific organisation—the Foundation for a Smoke-Free World (FSFW)—was launched, funded entirely by tobacco corporation Philip Morris International (PMI). Experts fear FSFW similarly serves to benefit its funder’s scientific and political agenda. We present three case studies of FSFW’s publishing practices to explore: whether FSFW and its affiliates are acting with scientific integrity in their attempts to publish research; how conflicts of interest (COI) are governed in the journals FSFW targets; whether scientific publishing needs to be better protected from the tobacco industry in light of this, and if so, how.

Under the influence

Published: 28/04/2021, Tobacco Control

[Commentary] Excerpt: The tobacco industry has a long and well-documented history of influencing, exploiting and misleading public health and research communities.1–4 Starting with the 1953 ‘Tobacco Industry Research Committee’5, stakeholders affiliated with the tobacco industry have strategically promoted industry interests through the funding of research programmes and public health initiatives, in order to influence research agendas, manipulate the design, methods and conduct of research, affect interpretation of findings and selectively disseminate information through publications, conferences, forums and panels.1–4 These activities have enabled the tobacco industry to promote its versions of ‘sound science’ and ‘good epidemiology’ which have been designed to weaken consensus about the harms of tobacco use and second-hand smoke exposure.

Smoking and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

Published: 23/04/2021, Nicotine and Tobacco Research

Conclusions: This study showed that smoking may not be associated with an increased risk of SARS-CoV-2 infection. Smoking tends to lower the risk of SARS-CoV-2 infection; however, these findings should be interpreted with caution

Nicotine induces maternal and fetal inflammatory responses which predispose intrauterine infection risk in a rat model

Published: 24/04/2021, Nicotine and Tobacco Research

Conclusion: The 1 mg/kg/d nicotine dose decreased risk of intrauterine infection, with increased MIR and FIR. The 3 mg/kg/d nicotine dose inhibited FIR, and increased risk for intrauterine infection. Nicotine alterations of the intrauterine environment were markedly dose-dependent.

The effect of maternal smoking on offspring smoking is unrelated to heritable personality traits or initial subjective experiences

Published: 29/04/2021, Nicotine and Tobacco Research

Conclusions: None of the heritable traits examined in this model explained the effect of maternal smoking measures on adolescence or young adulthood offspring smoking. Further research is needed to elucidate the mechanism by which PTE and maternal smoking are linked to offspring smoking.

A comparison of quit outcomes for men and women in a smoking cessation program offering personalized nicotine replacement therapy and counselling in primary care clinics

Published: 29/04/2021, Nicotine and Tobacco Research

Conclusions: Women were slightly less likely to quit than men, despite receiving similar treatment. There was no evidence that women benefitted more or less from variations in dose, type or duration of NRT supply.

Gender Differences in the Interrelations Among Social Support, Stressful Life Events, and Smoking Cessation in People With Severe Mental Illnesses

Published: 30/04/2021, Journal of the American Psychiatric Nurses Association

Results: Total, appraisal, and tangible support among females exerted indirect effects on smoking cessation via decreasing SLE scores. Among males, only belonging support exerted an indirect effect on smoking cessation via an increased SLE score. Conclusions: Findings suggest that interventions focusing on improving social support should be a priority for those working with smokers with SMI.

Lung Damage Caused by Heated Tobacco Products and Electronic Nicotine Delivery Systems: A Systematic Review

Published: 13/04/2021, International Journal for Environmental Research and Public Health

Conclusion: We found that the damage produced by using these devices is involved in pathways related to pulmonary diseases, involving mechanisms previously reported in conventional cigarettes as well as new mechanisms particular to these devices, which challenges that the tobacco industry's claims. The present study provides significant evidence to suggest that these devices are an emerging public health problem and that they should be regulated or avoided.

E-Cigarette Flavors and Frequency of E-Cigarette Use among Adult Dual Users Who Attempt to Quit Cigarette Smoking in the United States: Longitudinal Findings from the PATH Study 2015/16-2016/17

Published: 20/04/2021, International Journal for Environmental Research and Public Health

Findings: Dual users who attempted to quit smoking had greater odds of frequent e-cigarette use at follow-up when they used only non-tobacco, non-menthol/mint flavor than when they used only tobacco flavor as their regular/last e-cigarette flavor (OR = 1.9, 95% CI: 1.1-3.4); findings were no longer significant when adjusted for factors including e-cigarette device type (AOR = 1.4, 95% CI: 0.7-2.8). Past 30-day e-cigarette flavor use results were generally similar, although frequent e-cigarette use at follow-up was highest among those who used any combination of tobacco, menthol/mint, or other flavors. Findings indicate that e-cigarette flavor use among dual users who attempt to quit smoking may be related to e-cigarette use frequency overall, which may indicate a mechanism underlying findings for e-cigarette use and smoking cessation. Further longitudinal research may help to disentangle how e-cigarette characteristics uniquely impact e-cigarette use frequency and smoking cessation/sustained use.

The Impact of Lifetime Alcohol and Cigarette Smoking Loads on Amyotrophic Lateral Sclerosis Progression: A Cross-Sectional Study

Published: 17/04/2021, Life (Basel)

Conclusions: This cross-sectional multicenter study suggested a possible minor role for smoking in worsening disease progression. A possible interaction with alcohol drinking was suggested.

Research Trawl  17 April - 23 April

‘It brings light to what you really put into your body’: a focus group study of reactions to messages about nicotine reduction in cigarettes

Published: 16/04/2021, Tobacco Control

Conclusions: Messages communicating about nicotine reduction in cigarettes might help to motivate smokers to quit and can correct the misperceptions that VLNCs are less harmful. The FDA should consider specific target audiences and use different messages that complement each other in communicating about this regulation.

Smoking cessation, weight gain, cardiovascular risk, and all-cause mortality: a meta-analysis

Published: 20/04/2021, Nicotine and Tobacco Control

Conclusions: Smoking cessation was associated with a significantly lower risk of CVD and all-cause mortality, regardless of post-cessation weight gain. A greater risk reduction among quitters with weight gain than those without merits further investigations.

Association of heated tobacco product use with tobacco use cessation in a Japanese workplace: a prospective study

Published: 19/04/2021, Thorax

Abstract: We investigated how use of heated tobacco products (HTPs) affects tobacco cessation in a Japanese workplace. We offered cessation programmes for 158 tobacco. Successful quitting was defined as stopping use of all kinds of nicotine-containing tobacco products. A Poisson regression analysis adjusted with inverse probability weighting showed that HTP users (either exclusive HTP users or dual users) were less likely than exclusive cigarette users to quit tobacco (risk ratio, 0.77; 95% CIs 0.61 to 0.97, p=0.024). The use of HTPs should not be recommended to assist in smoking cessation.

Impact of chronic use of heat-not-burn cigarettes on oxidative stress, endothelial dysfunction and platelet activation: the SUR-VAPES Chronic Study

Published: 19/04/2021, Thorax

Abstract: Tobacco habit still represents the leading preventable cause of morbidity and mortality worldwide. Heat-not-burn cigarettes (HNBCs) are considered as an alternative to traditional combustion cigarettes (TCCs) due to the lack of combustion and the absence of combustion-related specific toxicants. The aim of this observational study was to assess the effect of HNBC on endothelial function, oxidative stress and platelet activation in chronic adult TCC smokers and HNBC users. The results showed that both HNBC and TCC display an adverse phenotype in terms of endothelial function, oxidative stress and platelet activation. Future randomised studies are strongly warranted to confirm these data.

Investigating smoking and nicotine dependence among people with severe mental illness during the COVID-19 pandemic: analysis of linked data from a UK Closing the Gap cohort

Published: 23/04/2021, British Journal of Psychology Open

Abstract: Smoking rates are higher for people who use mental health services, which contributes substantially to health inequalities. Smoking can lead to worse COVID-19 outcomes, yet it remains unclear whether smoking has changed for people who use mental health services. We examined smoking patterns in a large clinical cohort of people with severe mental illness, before and during the pandemic. We found high levels of nicotine dependence and heavier patterns of smoking. Although some people had reported quitting, it is likely that smoking inequalities have become further entrenched. Mental health services should seek to mitigate this modifiable risk and source of poor health.

Estimation of risk of neuropsychiatric adverse events from varenicline, bupropion and nicotine patch versus placebo: secondary analysis of results from the EAGLES trial using Bayes factors

Published: 22/04/2021, Addiction

Conclusions: Secondary analysis of the Evaluating Adverse Events in a Global Smoking Cessation Study trial using Bayes factors provides moderate to strong evidence that use of varenicline, bupropion or nicotine patches for smoking cessation does not increase the risk of neuropsychiatric adverse events relative to use of placebo in smokers without a history of psychiatric disorder. For smokers with a history of psychiatric disorder the evidence also points to no increased risk but with less confidence.

Investigating the effects of chronic perinatal alcohol and combined nicotine and alcohol exposure on dopaminergic and non-dopaminergic neurons in the VTA

Published: 23/04/2021, Scientific Reports

Conclusion: These results depicted that chronic nicotine and alcohol exposures during pregnancy differentially affect both miRNA and gene expression profiles more in DA than the non-DA neurons in the VTA. Understanding how the expression signatures representing specific neuronal subpopulations become enriched in the VTA after addictive substance administration helps us to identify how neuronal functions may be altered in the brain.

Development of a Risk Behavior Diagnosis Scale for E-cigarette Use

Published: 01/03/2021, American Journal of Health Behaviour

Conclusions: The measure demonstrates strong preliminary reliability and validity for a developmental sample of adolescents.

Vaping in the Workplace: Awareness and Support for E-cigarette Workplace Policies

Published: 01/03/2021, American Journal of Health Behaviour

Conclusions: E-cigarette-free workplace policies have high levels of support among employees, including both current and former e-cigarette users. Policies restricting workplace vaping can improve the health of all employees.

Clarifying the Genetic Influences on Nicotine Dependence and Quantity of Use in Cigarette Smokers

Published: 22/04/2021, Behavioural Genetics

The fact that the Maintenance-cigarettes-per-day feedback model fits the data best implies that there are at least two biological pathways that lead from rs16969968 to smoking behaviors. The model is consistent with a supply and demand system, which allows individuals to achieve a homeostatic equilibrium for their nicotine concentration.

Prenatal exposure to paternal smoking and likelihood for autism spectrum disorder

Published: 20/04/2021, Autism

Implications for practice, research, or policy: Smoking prevention, especially in pregnancy planning, may decrease autism spectrum disorder risk in offspring.

Rural-Urban Differences in Changes and Effects of Tobacco 21 in Youth E-cigarette Use

Published: 19/04/2021, Paediatrics

Conclusions: In this study, we reported marked disparities in the increase of youth e-cigarette use, with a larger recent increase in rural than in urban areas. T21 policies appear to mitigate these increases in both rural and urban youth.

Research Trawl  10 April - 16 April

Effects of advertising features on smokers’ and non-smokers’ perceptions of a reduced nicotine cigarette modified risk tobacco product

Published: 15/04/2021, Tobacco Control

Conclusions: Disclaimer content may effectively inform consumers about addiction risk of a new reduced nicotine content cigarette modified risk tobacco product, and further inform non-smokers about health risks. This element, however, had little effect on perceived health risks among smokers, among whom the Moonlight product name was associated with health risk misperceptions similar to the banned ‘light’ descriptor.

Sources of flavoured e-cigarettes among California youth and young adults: associations with local flavoured tobacco sales restrictions

Published: 13/04/2021, Tobacco Control

Conclusion: Although local laws may reduce access to flavoured e-cigarettes from retail sources, more comprehensive state or federal restrictions are recommended to close the loopholes for online sources. Dedicated efforts to curtail access from social sources are needed.

Critical challenges and creative solutions for quantifying nicotine vaping: qualitative reports from young adults

Published: 13/04/2021, Nicotine and Tobacco Research

Conclusion: Existing vaping behavior survey measures may not accurately capture quantity of vaping as they differ from how (or if) participants track their own vaping consumption patterns. While continued research is needed to optimally refine survey measures on vaping consumption, future measures may better align with vapers’ self-monitoring by including questions on device-type and replenishment frequency.

The relationship between trauma exposure and adult tobacco use: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions (III)

Published: 13/04/2021, Nicotine and Tobacco Research

Conclusion: Trauma exposure, PTSD, and experiences of violence/abuse, are associated with current tobacco use. BH conditions may also play a role in current and former tobacco use. Recognizing and addressing trauma exposure and behaviour health conditions (mood, anxiety, substance use, personality disorders) among tobacco users may improve cessation rates in these populations.

Pilot Randomized Clinical Trial of a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness

Published: 14/04/2021, Nicotine and Tobacco Research

Conclusions: Adding a 6-week text messaging intervention (TMI) support to a brief group counseling and pharmacotherapy protocol holds promise for smoking reduction and abstinence among young people experiencing homelessness smokers. Results indicate that further development and evaluation of the TMI in this population is warranted.

National Estimates of Prevalence, Time-Trend, and Correlates of Smoking in US People Living with HIV (NHANES 1999–2016)

Published: 14/04/2021, Nicotine and Tobacco Research

Cigarette smoking among people living with HIV (PLWH) is a major public health problem in the United States. Targeted and tailored smoking cessation interventions that incorporate assessment and treatment of depression and co-occurring substance use are critical for PLWH, especially among those who are disproportionately affected by smoking and HIV (sexual minority).

E-cigarette advertising in the UK: a content analysis of traditional and social media advertising to observe compliance with current regulations

Published: 15/04/2021, Nicotine and Tobacco Research

Conclusions: We found overall good compliance for advertising in traditional channels, but assessed all of our social media advertising sample was in breach of regulations. Current guidance on e-cigarette advertising could be improved to facilitate e-cigarette advertising assessment and regulation. It would be beneficial to bring consumer perspectives into the assessment of regulation compliance.

Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco-related toxicant exposure: a four-arm, parallel-group, randomised, controlled trial

Published: 13/04/2021, The Lancet, Respiratory Medicine

Interpretation: Use of an ENDS with cigarette-like nicotine delivery can reduce exposure to a major pulmonary carcinogen, NNAL, even with concurrent smoking. Future ENDS trials should involve products with well characterised nicotine delivery, including those with nicotine delivery approaching that of a cigarette.

Vaping, Smoking Cessation, and Harm Reduction? Look Before You Leap

Published: 07/04/2021, Canadian Journal of Cardiology

[editorial] Tobacco addiction, arguably the most significant and deadly of the modifiable cardiovascular risk factors - and the most neglected—has long been a challenge for the cardiovascular specialist  […] Smoking cessation is not easy […] The suggestion, therefore, that the introduction of vaping devices, or electronic nicotine delivery systems (ENDS), would facilitate cessation and mitigate the harms of smoking warrants careful consideration.

Effectiveness of multimodal interventions focused on smoking cessation in patients with schizophrenia: A systematic review

Published: 12/04/2021, Schizophrenia Research

Conclusion: [Review] Evidence suggests that multimodal smoking cessation interventions for individuals diagnosed with schizophrenia should be recommended by clinicians, as they showed to be effective in reducing smoking without worsening psychiatric symptoms. Further studies are needed to understand how interventions can become more effective in helping patients achieve long-term smoking abstinence.

E-Cigarette Use Among Youths and Young Adults During the COVID-19 Pandemic: United States, 2020

Published: 15/04/2021, American Journal of Public Health

Results: Odds of current e-cigarette use were significantly lower during the COVID-19 pandemic compared with the pre‒COVID-19 period among youths aged 15 to 17 years (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.96) and young adults aged 18 to 20 years (OR = 0.65; 95% CI = 0.52, 0.81). E-cigarette users with reduced access to retail environments had higher odds of reporting reduced e-cigarette use (OR = 1.51)

Accurate and sufficient measurement of cannabis and tobacco co‐use: agreement, consensus and the path forward

Published: 14/04/2021, Addiction

[Commentary] Hindocha & McClure argued for better measurement of cannabis and tobacco co‐use at multiple levels of investigation (e.g. clinical studies, clinical care, surveillance), as there may be unknown harms associated with co‐use. We appreciate the insightful responses generated from experts in the field and feel that, collectively, this Debate series supports the need to develop a path forward for co‐use measurement consensus and implementation.

Tobacco Use Status as a Function of Transgender Identity: The Mediating Role of Psychological Distress

Published: 30/03/2021, Tobacco Use Insight

Discussion: This is the first study of our knowledge to examine the association between psychological symptoms and smoking and vaping products with transgender identity. The results of this study support previous findings that transgender individuals are at risk for elevated substance use and extend the literature by demonstrating this this risk is associated with elevated psychological distress.

Harm Perceptions of Tobacco/Nicotine Products and Child Exposure: Differences between Non-Users, Cigarette-Exclusive, and Electronic Cigarette-Exclusive Users

Published: 30/03/2021, Tobacco Use Insights

Discussion: In this sample, caregivers who used e-cigarettes perceived them as less harmful, reported using them more frequently at home and in the car, even when their children were present, compared to cigarette users. As a result, children appear to be exposed to nicotine at levels similar to children living with cigarette users. Future caregiver prevention and intervention efforts should target education around the potential harms of secondhand e-cigarette aerosol to children.

Research Trawl  3 April - 9 April

A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation

Published: 07/04/2021, Addictive Behaviours

Conclusion: Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies.

FDA’s reduced exposure marketing order for IQOS: why it is not a reliable global model

Published: 02/04/2021, Tobacco Control

Under US law, FDA’s IQOS orders are problematic because FDA disregarded valid scientific evidence that IQOS increases exposure to other dangerous toxins and that Philip Morris Products S.A. failed to demonstrate that consumers understand the difference between reduced-exposure and reduced-harm claims. Unfortunately, both ‘reduced-exposure’ and ‘reduced-harm’ are classified as ‘modified risk tobacco products’ under US law. Exploiting this confusion, Philip Morris International used the FDA decision as the basis for marketing and public relations campaigns outside the USA to press governments to reverse policies that ban or regulate the sales and marketing of HTPs, including IQOS. Parties to the WHO Framework Convention on Tobacco Control should reject tobacco companies’ unsubstantiated explicit or implied claims of reduced harm associated with HTPs and resist Philip Morris International’s and other companies’ calls to relax HTP regulations based on the FDA’s actions.

Impact Of Cyp2a6 Activity On Nicotine Reinforcement And Cue-Reactivity In Daily Smokers

Published: 05/04/2021, Nicotine and Tobacco Control

Implications: CYP2A6 activity is a key determinant of smoking behaviour and outcomes. Therefore, these findings support the targeting of CYP2A6 activity, either therapeutically or as a clinically relevant biomarker in a precision medicine approach, for tobacco use disorder treatment.

Tobacco mythbusting—tobacco is not a major driver of foot traffic in low socio-economic small retail stores

Published: 8/04/2021, Tobacco Control

Results: Purchasing tobacco was the primary motivation for store visits for only 3% of consumers. The vast majority of products purchased (92%) were not tobacco, with hot food, groceries and lottery tickets most frequent. Only 8% of consumers purchased tobacco. When unplanned purchasing patterns were compared, consumers’ who purchased tobacco were no more likely to buy other products.

Exenatide Adjunct to Nicotine Patch Facilitates Smoking Cessation and May Reduce Post-Cessation Weight Gain: a Pilot Randomized Controlled Trial

Published: 08/04/2021, Nicotine and Tobacco Control

Implications: Despite considerable progress in tobacco control, cigarette smoking remains the leading cause of preventable disease, disability, and death. In this pilot study, we showed that extended-release exenatide, a glucagon-like peptide-1 receptor agonist, added to the nicotine patch, improved abstinence and mitigated post-cessation body weight gain compared to patch alone. Further research is needed to confirm these initial positive results.

The Effect Of Pulmonary Rehabılıtatıon On Smokıng And Health Outcomes In Copd Patıents

Published: 08/04/2021, The Clinical Respiratory Journal

Conclusion: Smoker COPD patients were benefited from the PR program at least as much as the patients who are not smoking. Furthermore, nicotine dependence and amount of cigarette decreased in smoker patients. Therefore COPD patients who are smoking should be referred to the PR programs.

Smoking Cessation and Hospitalized Patients: A Missed Opportunity to Avoid Premature Deaths

Published: 08/04/2021, Ochsner

Editorial: In this paper, we discuss effective and safe counseling and drug therapies that have the potential to prevent numerous premature deaths in the United States caused by cigarettes in hospitalized smokers.

Multidimensional Intersection of Nicotine, Gene Expression, and Behavior

Published: 22/03/2021, Frontiers in Behavioural Neuroscience

Aim: [Review] In this review, we provide an overview of the actions of nicotine that lead to changes in gene expression and further highlight evidence supporting how these changes can often be bidirectional, thereby inducing subsequent changes in behaviors associated with further drug intake. 

Smoking-attributable mortality in South America: A systematic review

Published: 27/03/2021, Journal of Global Health

Conclusions: Regardless of the country and point in time covered by the estimate, the highest figures were recorded for men in all cases. The burden of attributable vs observed mortality varied among countries, reaching a figure of 20.3% in Argentina in 1986. The highest SAM burden was registered for the group of cardiovascular diseases. However, smoking attributable mortality estimates are available for all South American countries the respective study periods differ and the frequency of the estimates is unclear. For 4 countries, the only estimates available are drawn from reports, something that does not allow for a detailed assessment of the estimates obtained.

'Money up in smoke': The financial benefits of smoking cessation may be more motivating to people who are homeless than potential health gains

Published: 07/04/2021, Drug and Alcohol Review

Discussion and conclusions: Smoking cessation campaigns promoting the financial savings of cessation may be more salient than health-focused campaigns among relatively young men who smoke and experience homelessness. There is a clear need for innovative, targeted strategies promoting smoking cessation among this population.

Associations of childhood executive control with adolescent cigarette and E-cigarette use: Tests of moderation by poverty level

Published: 26/03/2021, Addictive Behaviour

Results: Cigarette onset was higher in the poverty group (17%) than in the non-poverty (8%) group, but e-cigarette onset did not differ by poverty level (36% poverty versus 38% non-poverty). Multiple group structural equation modeling revealed a statistically significant group difference such that EC ability was a significant negative predictor of e-cigarette onset for poverty but not for non-poverty youth. A similar group difference was evident as a trend for cigarette onset

Changes in smoking and alcohol consumption during COVID-19-related lockdown: A cross-sectional study in France

Published: 07/04/2021, European Journal for Public Health

Conclusion: The national lockdown implemented in France during the COVID-19 pandemic influenced tobacco and alcohol consumption in different ways according to sociodemographic group and mental health.

The effectiveness of technology-based interventions for smoking cessation: An umbrella review and quality assessment of systematic reviews

Published: 06/04/2021, Drug and Alcohol Reviews

Implications: Policymakers are recommended to develop strategies that enable health professionals to integrate these approaches with face-to-face smoking cessation support. Health professionals are recommended to be trained and equipped for online and mobile-based interventions.

Conclusion: Adding technology-based intervention to face-to-face smoking cessation support improves smoking cessation. Further research is needed to evaluate stand-alone web-based and mobile phone-based interventions.

Research Trawl  27 March - 2 April

Understanding commercial actors’ engagement in policy debates on proposed e-cigarette regulation in Scotland

Published: 26/03/2021, Tobacco Control

Results: The results show that commercial actors’ positions on e-cigarette regulation aligned with business interests. Transnational tobacco corporations’ (TTCs), independent e-cigarette manufacturers and other non-licensed commercial actors were opposed to most aspects of potential e-cigarette regulation (except for age of sale restrictions), whereas licensed commercial actors, including pharmaceutical companies, supported more stringent regulation. While collaboration was viewed as strategically important to gain policy influence, distinct commercial interests and concerns about TTC credibility led to strategic distancing and to collaboration being largely confined to sector boundaries. In addition to reiterating arguments employed by TTCs in previous regulatory debates, commercial actors focused on highlighting the technical complexity and harm reduction potential of e-cigarettes.

Impact of COVID-19 lockdown on smoking consumption in a large representative sample of Italian adults

Published: 29/03/2021, Tobacco Control

Results: During the lockdown, 5.5% of the overall sample quit or reduced smoking, but 9.0% of the sample started, relapsed smoking or increased their smoking intensity. In total, the lockdown increased cigarette consumption by 9.1%. An improvement in smoking habits was associated with younger age, occasional smoking and unemployment, whereas a worsening was mainly associated with mental distress. In particular, an increase in cigarette consumption during lockdown was more frequently reported among those with worsening quality of life, reduction in sleep quantity, and increased anxiety, and depressive symptoms.

Budgetary impact from multiple perspectives of sustained antitobacco national media campaigns to reduce the harms of cigarette smoking

Published: 29/03/2021, Tobacco Control

Conclusions: 1, 5 and 10-year antitobacco media campaigns all yield net savings within 10 years from all perspectives. Multiyear campaigns yield substantially higher savings than a 1-year campaign.

Age as a predictor of quit attempts and quit success in smoking cessation: findings from the International Tobacco Control Four‐Country survey (2002–14)

Published: 02/03/2021, Addiction

Conclusions: An international cohort study indicates that young smokers are more likely to attempt to quit and appear to have similar levels of success in abstaining from smoking compared with older smokers when controlling for dependence. Quit success in all ages is most predicted by lower levels of nicotine dependence.

Delayed Reward Discounting as a Prognostic Factor for Smoking Cessation Treatment Outcome: A Systematic Review

Published: 27/03/2021, Nicotine and Tobacco Research

Conclusions This review revealed consistent low-bias evidence for impulsive DRD as a negative prognostic predictor smoking cessation treatment outcome in adults. However, methodological heterogeneity was high, precluding meta-analysis and formal tests of small study bias. The prospects of targeting impulsive DRD as a potentially modifiable risk factor or providing targeted treatment for smokers exhibiting high levels of discounting are discussed.

The Potential Effectiveness of COVID-Related Smoking Cessation Messages in Three Countries

Published: 30/03/2021, Nicotine and Tobacco Research

Conclusions: Smokers in Australia, New Zealand, and the United Kingdom appear likely to be receptive to messages about their COVID-related risk. Such messages have the potential to increase quit intentions and prompt information-seeking behaviors.

Perceptions of tobacco product-specific COVID-19 risk and changes in tobacco use behaviors among smokers, e-cigarette users, and dual users

Published: 30/03/2021, Nicotine and Tobacco Research

Results: A majority of those who used cigarettes (63.7%) and e-cigarettes (56.1%) felt that the risk of COVID-19 was greater for users of their tobacco product than for non-users. Twenty-four percent of smokers had increased their cigarette use since the start of the pandemic and 28.0% had decreased. Similarly, 27.3% of e-cigarette users had increased their e-cigarette use since the start of the pandemic and 23.8% had decreased. Higher risk perceptions for COVID-19 were associated with reductions in tobacco use since the pandemic began for exclusive e-cigarette users and dual users.

Psychiatric co-morbidity and multi-morbidity in the EAGLES trial: Descriptive correlates and associations with neuropsychiatric adverse events, treatment adherence, and smoking cessation

Published: 31/03/2021, Nicotine and Tobacco Research

Conclusions: While having multiple psychiatric diagnoses increased risk of developing moderate-to-severe neuropsychiatric adverse events during a quit attempt, neither co- nor multi-morbidity were associated with treatment adherence or odds of quitting. These findings reassure providers to advise smokers with multiple stable psychiatric conditions to consider using FDA-approved medications when trying to quit.

Naming racism, not race, as a determinant of tobacco-related health disparities

Published: 02/04/2021, Nicotine and Tobacco Research

This editorial discussed a number of research papers which “highlight how, as people engaged in nicotine and tobacco research, we can improve how we engage stakeholders and conceptualize, conduct, and report research exploring racial/ethnic disparities.”

Heated tobacco product awareness, use, and perceptions in a sample of young adults in the U.S

Published: 02/04/2021, Nicotine and Tobacco Research

Conclusions: The relatively positive perceptions of HTPs and access via various channels underscores potential penetration of HTPs among US young adults.

Measures of both perceived general and specific risks and benefits differentially predict adolescent and young adult tobacco and marijuana use: findings from a Prospective Cohort Study

Published: 29/03/2021, Nature - Humanities and Social Sciences Communications

Results: These findings indicate that measures of specific perceived social and health outcomes can be useful to discern nuanced differences in motivation for using different substances. Study implications are important for survey dimension-reduction and assessing relationships among perceptions, motivations, and use of tobacco and marijuana products.

Sex differences in mortality: results from a population-based study of 12 longitudinal cohorts

Published: 15/03/2021, Canadian Medical Association

Results: The study included 179 044 individuals. Men had 60% higher mortality risk than women after adjustment for age (pooled hazard ratio [HR] 1.6; 95% confidence interval 1.5–1.7), yet the effect sizes varied across countries (I2 = 71.5%, HR range 1.1–2.4). Only smoking and cardiovascular diseases substantially attenuated the effect size (by about 22%).

Differential mechanisms of change in motivational interviewing versus health education for smoking cessation induction

Published: 01/03/2021 Psychology and Addictive Behaviour

Conclusions: Motivational interviewing (MI) and health education (HE were both efficacious via different pathways to change, confirming the utility of MI in this RCT as well as highlighting the potential of HE based on the "5R's" for smoking cessation. These findings emphasize the value of exploring theorized mechanisms of action of interventions evaluated in RCTs.

Executive Functions in Tobacco Use Disorder: New Challenges and Opportunities

Published: 15/03/2021, Frontiers Psychiatry

Abstract: this study was designed to determine the relationship between years of smoking addiction and several variables of executive functions. Years of smoking and heavy smoking indicated worse performance than light smoking on updating tasks. These findings report the ability of working memory to predict years of smoking and suggest that cigarette packaging warning may experience a loss of effectiveness in heavy smokers.