Research digest August 2020

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

 Research period: 01/08 - 28/08

Research Trawl 22^th – 28^th August

Cigarette-like cigarillo introduced to bypass taxation, standardised packaging, minimum pack sizes, and menthol ban in the UK

Published: 25/08/2020, Tobacco Control

Excerpt: The UK has stringent tobacco control legislation, which has been extended most recently to include standardised packaging with minimum pack sizes, and from 20 May 2020, a ban on menthol. However, this legislation applies only to cigarettes and roll-your-own (RYO) tobacco.

In January 2020, Japan Tobacco International (JTI) launched a new product onto the market that bypasses these laws. Sterling Dual Capsule Leaf Wrapped  are officially being sold as cigarillos, which are defined by law as a cigar (a roll of tobacco with an outer wrapper of tobacco) with a maximum weight of 3 g.  These new ‘cigarillos’ are clearly aimed at cigarette smokers, and closely resemble cigarettes.

Organizational Characteristics and Readiness for Tobacco-Free Workplace Program Implementation Moderates Changes in Clinician’s Delivery of Smoking Interventions within Behavioral Health Treatment Clinics 

Published: 25/08/2020, Nicotine and Tobacco Research

Conclusions: Youth who use cannabis are more likely to report cigarette and e-cigarette use and cannabis use is associated with increased risk of initiation of cigarette and e-cigarette use over one year. Continued success in tobacco control—specifically toward reducing smoking among adolescents—may require focusing on vaping, cannabis, and cigarette use in public health education, outreach, and intervention efforts.

The Economic Cost of Smoking in South Africa, 2016 

Published: 24/08/2020, Nicotine and Tobacco Control

Results: We estimate that 25 708 deaths among persons aged 35–74 in 2016 are smoking-attributable. The economic cost of smoking was R42 billion (US$2.88 billion) of which R14.48 billion was for healthcare costs (hospitalization and outpatient department visits). The economic cost of smoking amounted to 0.97% of the South African GDP in 2016, while the healthcare cost of smoking-related diseases was 4.1% of total South African health expenditure. The costs are lower for women because of their lower smoking prevalence.

Evidence for a Causal Relationship Between Academic Achievement and Cigarette Smoking 

Published: 24/08/2020, Nicotine and Tobacco Research

Conclusions: Two different methods produced consistent evidence that higher academic achievements has a causal effect on reducing smoking rates and increasing cessation rates in smoking pregnant females. Improving academic achievement may result in meaningful gains in population health through reduced smoking.

Interventions to prevent periodontal disease in tobacco-, alcohol-, and drug-dependent individuals.

Published: Oct/2020, Peridontology 2000

Outline: The purpose of this review is to examine the biologic mechanisms underlying their role in disease causation, to understand the pharmacologic and behavioral basis for their habituation, and to investigate the efficacy of population-based and personalized interventions in prevention of periodontal disease.

Interactive Effects of Omega-3 Polyunsaturated Fatty Acids and Secondhand Smoke in Mice and Human Subjects.

Published: 25/08/2020, Cardiovascular Toxicology

Study Outline: Active smoking is associated with reduced levels of omega-3 polyunsaturated fatty acids (n-3 PUFA) and studies show that n-3 PUFA supplementation can improve smoking-induced vascular dysfunction. However, the relationship between n-3 PUFA and SHS exposure has not been studied. Conclusion: Thus, SHS exposure is associated with lower levels of n-3 PUFA in mice and humans; however, an omega-3 index of ~ 8% in mice has vasoprotective and antioxidant properties.

The Vaping Teenager: Understanding the Psychographics and Interests of Adolescent Vape Users to Inform Health Communication Campaigns.

Published: 30/07/2020, Tobacco Use Insights

Methods: We analyzed the 2017-2018 weighted cross-sectional online survey data from Virginia high school students (N = 1594) to identify and describe subgroups of adolescents who vaped. Participants reported 30-day vape use, identification with 5 peer crowds (Alternative, Country, Hip Hop, Mainstream, Popular)… Results: Any current vaping was the highest among those with Hip Hop peer crowd identification (25.4%), then Popular (21.3%). Stronger peer crowd identification was associated with increased odds of any current vaping

The influence of smoking on asthma in the real-life.

Published: Aug-Sept/2020, Respiratory Medicine

Results: The heavy smokers with asthma were more frequently older, male, overweight, and non-allergic than other asthmatics. Heavy smokers had more severe obstructive impairments than light and never smokers with similar ICS dose, showing a steroid insensitivity, but displayed less allergy with low FeNO and blood eosinophil count, thus being a definite phenotype.

Nicotine forms: Why and how do they matter in nicotine delivery from electronic cigarettes?

Published: 26/08/2020, Expert Opinion in Drug Delivery

[Review] Areas covered: Current review aims to emphasize on the possible mechanism behind different absorption profiles of nicotine forms considering their physical states (droplet and vapor phase) and the aerosol particle size, their analysis in e-cigarette research and the regulatory attention warranted by them to combat nicotine addiction in the population due to e-cigarettes.

Maternal Prenatal Smoking and Autism Spectrum Disorder in Offspring: a California Statewide Cohort and Sibling Study.

Published: 24/08/2020, American Journal of Epidemiology

Our findings are consistent with an increased risk for ASD in offspring of mothers who smoked 20+ cigarettes/day during pregnancy; associations with lighter smoking were weaker.

Smokers with insomnia symptoms are less likely to stop smoking

Published: Aug-Sept/2020, Respiratory Medicine

Conclusions: Insomnia symptoms and excessive daytime sleepiness negatively predict smoking cessation. Smoking is a risk factor for the development of difficulty initiating sleep. Treatment for sleep disturbances should be included in smoking-cessation programs.

Research Trawl 15^th – 21^st August

COVID-19, smoking and inequalities: a study of 53 002 adults in the UK 

Published: 21/08/2020, Tobacco Control

Results Compared with never smokers (0.26% (95% CI 0.21% to 0.33%)), prevalence of confirmed COVID-19 was higher among current (0.56% (0.41% to 0.75%)) but not ex-smokers (0.19% (0.13% to 0.28%)). Associations were similar before (current: OR=2.14 (1.49–3.08); ex-smokers: OR=0.73 (0.47–1.14)) and after (current: OR=1.79 (1.22–2.62); ex-smokers: OR=0.85 (0.54–1.33)) adjustment. For current smokers, this was moderated by socio-economic position, with higher rates only seen in those without post-16 qualifications (OR=3.53 (2.04–6.10)). After including suspected cases, prevalence was higher among current smokers (11.2% (10.6% to 11.9%), OR=1.11 (1.03–1.20)) and ex-smokers (10.9% (10.4% to 11.5%), OR=1.07 (1.01–1.15)) than never smokers (10.2% (9.9% to 10.6%)), but remained higher only among ex-smokers after adjustment (OR=1.21 (1.13–1.29)). Current and ex-smokers had higher odds than never smokers of reporting significant stress about becoming seriously ill from COVID-19 (current: OR=1.34 (1.27–1.43); ex-smokers: OR=1.22 (1.16–1.28)). Adherence to recommendations to prevent spread of COVID-19 was high (96.3% (96.1% to 96.4%)), but lower among current than never smokers (OR=0.70 (0.62–0.78)).

Conclusions In a population sample, current smoking was independently associated with self-reported confirmed COVID-19 infection. There were socio-economic disparities, with the association only apparent among those without post-16 qualifications. Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.

A magic bullet? The potential impact of e-cigarettes on the toll of cigarette smoking 

Published: 21/08/2020, Nicotine and Tobacco Research

Methods: [Using data from the US] We employ a dynamic population simulation model that tracks individuals from ages 0-110, differentiated by gender and smoking status…. Conclusions Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not “the” answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures.

Pharmacological interventions for smoking cessation among people with schizophrenia spectrum disorders: a systematic review, meta-analysis, and network meta-analysis

Published: Sept/2020, Lancet Psychiatry

Interpretation: We found evidence to support use of pharmacological agents for smoking cessation for people with psychosis. Varenicline might be superior to bupropion; however, additional direct testing and combination trials of pharmacological agents for smoking cessation are required to inform clinical decision making for people with psychosis.

Reactions to, and trial intentions for, three dissuasive cigarette designs: a cross-sectional survey of adolescents in Scotland

Published: 19/08/2020, Tobacco Control

Results More participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared with the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs older adolescents), never-smokers (vs ever smokers) and non-susceptible never-smokers (vs susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84%–91%).

Cigarette Smoking Reduction and Health Risks: A Systematic Review and Meta-Analysis

Published: 17/08/2020, Nicotine and Tobacco Control

IMPLICATIONS: This meta-analysis helps clarify our understanding of various smoking reduction levels on some health risks. While smoking reduction may decrease risks of lung cancer, the relationships between smoking reduction and other endpoints, including all-cause mortality and cardiovascular disease, remain unclear. Although smoking reduction may decrease lung cancer risks, the magnitude of lung cancer risk remain high. Among smokers, complete cessation remains the most effective approach for cancer and CVD prevention

Economic Costs of Diseases and Deaths Attributable to Tobacco use in India, 2017-18

Published: 17/08/2020, Nicotine and Tobacco Research

Results Total economic costs attributable to tobacco use from all diseases and deaths in India in the year 2017-18 for persons 35 years or older amount to USD 27.5 billion, of which 22% is direct and 78% is indirect cost. Men bear 91% of the total costs. Smoking contributed 74% and smokeless tobacco use contributed 26% of the costs.

Exclusive e-cigarette users report lower levels of respiratory symptoms relative to dual e-cigarette and cigarette users

Published: 18/08/2020, Nicotine and Tobacco Research

Results There was a significant mean difference in ATSQ score [respiratory questionnaire] across smoking status, with greater ATSQ scores for vapers who also smoked cigarettes than for exclusive vapers. In the final model, of the predictors of interest, only cigarette smoking status predicted significantly greater ATSQ scores (overall F = 2.51, p = .006; R2 = .26; smoking status β=.39, p < .0001).

Do lifestyle factors including smoking, alcohol, and exercise impact your risk of developing kidney stone disease? Outcomes of a systematic review

Published: 18/08/2020, Journal of Endourology

Results: …On the other hand, four studies found a significant association between smoking and renal stone formation.

On providing smoking cessation services in alcohol and other drug treatment settings: Results from a U.S. national survey of attitudes among recovering persons

Published: Oct/2020, Journal of Substance Abuse Treatment

Conclusions: About half of those sampled were either against Smoking Cessation Services (SCS) inclusion , or were in favor of making it "available" only, but not in offering it or integrating it. This oppositional pattern was accentuated particularly among those with primary alcohol problem histories and those participating in mutual-help organizations.

Prepregnancy smoking and the risk of gestational diabetes requiring insulin therapy

Published: 17/08/2020, Scientific Reports

In conclusion, women who smoke have a significantly higher risk of GDM requiring insulin therapy, which may be proportional to the cumulative exposure to smoking.

Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births

Published: 18/08/2020, PLoS Medicine

Conclusions: We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy.

Maternal cigarette smoking before and during pregnancy and the risk of preterm birth: A dose-response analysis of 25 million mother-infant pairs

Published: 18/08/2020, PLoS Medicine

Conclusions: In this study, we observed that low-intensity cigarette consumption during either the first or second trimester of pregnancy, even as low as 1-2 cigarettes per day, was associated with an increased risk of preterm birth. These findings suggest that there is no safe level or safe trimester for maternal smoking during pregnancy.

Research Trawl 8^st – 14^th August

Co-optation of harm reduction by Big Tobacco

Published: 12/08/2020, Tobacco Control

Harm reduction is a respected public health strategy for managing addictive behaviours that pose severe health risks. Such an approach recognises that for people unable to abstain from a certain risky behaviour, public health interventions can be used to mitigate the potential dangers and health risks. For tobacco harm reduction, the curious involvement and role of the industry prove to be contentious. Multinational tobacco companies, such as British American Tobacco (BAT) and Philip Morris International (PMI), have adopted harm reduction in their public relations initiatives and marketing communication, which provides them an opportunity to showcase their engagement in new product development of self-styled ‘next-generation products’.

Smoking epidemic in Europe in the 21st century

Published: 07/08/2020, Tobacco Control

Objective To estimate smoking-attributable mortality in the long-term future in 29 European countries using a novel data-driven forecasting approach that integrates the wave pattern of the smoking epidemic and the cohort dimension. Results smoking attributable mortality fraction (SAMF) among men are projected to decline from, on average, 25% in 2014 to 11% in 2040 (range: 6.3%–15.4%), 7% in 2065 (range: 5.9%–9.4%) and 6% in 2100. SAMF among women in 21 non-Eastern European countries, currently at an average of 16%, are projected to reach peak levels in 2013 (Northern Europe), 2019 (Western Europe), 2027 (Greece, Italy) and 2022 (Central Europe), with maximum levels of, on average, 17%, (and to decline to 10% in 2040 (range: 4%–20%), 5% in 2065 (range: 3.5%–7.6%) and 4% in 2100. For women, a short-term shift in the peak of the inverse U-shaped age pattern to higher ages is projected, and crossovers between the age-specific trends.

Why Tasmanian retailers stop selling tobacco and implications for tobacco control

Published: 07/08/2020, Tobacco Control

Conclusions This study provides insights into factors that make tobacco sales unattractive or unfeasible for low-volume outlets and may inform supply-focused tobacco control policy. A campaign that emphasises the possible business benefits of ending tobacco sales in favour of other higher-margin products may support retailers to transition away from tobacco sales. The regulatory obligations of selling tobacco are disincentives and create a less favourable retail environment.

British American Tobacco’s ‘Glo Sens’ promotion with K-pop (Korea)

Published: 07/08/2020, Tobacco Control

Except: [‘Glo Sens’ is a heat-not-burn device owned by BAT.] In addition to a music video, [allow due to a loophole in legislation] BAT Korea is also engaged in aggressive marketing tactics through Glo Sens official website, such as providing discount coupons and selling limited-edition devices that have been engraved with special designs. Despite strong government regulations, tobacco companies continue to find innovative ways to market products to teenagers and young people. There is a need to reinforce existing tobacco control policies; particularly, restrictions should be placed on the entry of new tobacco products into the market and marketing should be monitored and regulated to protect youth from gaining access to and using these new tobacco products.

One-year efficacy and incremental cost-effectiveness of contingency management for cigarette smokers with depression

Published: 09/08/2020, Nicotine and Tobacco Control

Conclusions Behavioral treatments addressing both smoking and depression are efficacious for sustaining high quit rates at one year. Adding contingency management  to CBT+behavioural activation for smoking cessation is highly cost-effective, with an estimated net benefit of €4,704 (US$5,344.80).

A Meta-Analysis of Cue Reactivity in Tobacco Cigarette Smokers

Published: 09/08/2020, Nicotine and Tobacco Research

Implications A core feature of addiction is that drug-related cues can have a major impact on motivational responses across multiple substance use disorders, including tobacco cigarettes. This paper describes a meta-analysis updating and synthesizing cue reactivity research with tobacco cigarette smokers over the last 20 years, a time of rapid growth for this literature. The study leads to a better understanding of the cue reactivity paradigm across different self-report and physiological variables, and identifies factors that may modulate addictive motivation for tobacco cigarettes.

Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries

Published: 12/08/2020, BMC Medicine

Conclusions: Smokeless-tobacco (ST) is used across the globe and poses a major public health threat predominantly in South and Southeast Asia. While our disease risk estimates are based on a limited evidence of modest quality, the likely ST-related disease burden is substantial. In high-burden countries, ST use needs to be regulated through comprehensive implementation of the World Health Organization Framework Convention for Tobacco Control.

Current E-Cigarette Research in the Context of Asthma

Published: 08/08/2020, Current Allergy and Asthma Reports

[Review] Recent findings: Human, rodent, and cell culture studies show that key cellular functions of epithelial cells, macrophages, and neutrophils are altered by e-cigarette exposure. Because respiratory immunity is already dysregulated in asthma, further alteration of cellular function by e-cigarettes could impact asthma development, severity, and/or exacerbations. Future research is needed to more directly investigate this relationship using controlled human exposure studies and exposure of cell culture or animal models of asthma to e-cigarettes.

Will the tobacco industry ultimately triumph in the midst of COVID-19 pandemic?: A call for nurses’ action in tobacco control

Published: 25/07/2020, International Journal of Nursing Studies

Excerpt: Three international Big Tobacco companies of Philip Morris International (2020), Altria Group (2020), and Japan Tobacco International (2020) reported overall increased net revenues by 6.0%, 13.6% and 2.8% respectively in Q1 2020. These increases are striking as duty-free shops, a main source of tobacco sales, faced closures due to global travel restrictions in the COVID-19 pandemic. Increased sales volumes were reported also in East Asia and Australia (2.4%) and Europe (European Union: 8.4%; South and West Europe [e.g., Italy and Spain]: 6.7%) (Japan Tobacco International, 2020; Philip Morris International, 2020), coinciding with the rapid spread of COVID-19 in these regions between February and March 2020.

Smoking increases the risk of infectious diseases: A narrative review

Published: July/2020, Tobacco Induced diseases

Abstract excerpt: The mechanisms of susceptibility to infection in smokers may include alteration of the structural, functional and immunologic host defences. Smoking is one of the main risk factors for infections in the respiratory tract, digestive tract, reproductive tract, and other systems in humans, increasing the prevalence of HIV, tuberculosis, SARS-CoV, and the current SARS-CoV-2. Smoking cessation can reduce the risk of infection.

Nicotine Use and DSM-IV Nicotine Dependence in the United States, 2001-2002 and 2012-2013

Published: 14/08/2020, American Journal of Psychiatry

Objective:…the "hardening hypothesis," which proposes that declines in nicotine use resulting from population-level control measures leave a growing proportion of highly dependent users… Results: …are findings that support the hardening hypothesis. Vulnerable subgroups of the population in terms of hardening were identified who would benefit from targeted nicotine dependence intervention programs to help them in overcoming dependence and quitting nicotine use.

What Does It Meme? A Qualitative Analysis of Adolescents' Perceptions of Tobacco and Marijuana Messaging

Published: 13/08/2020, Public Health Reports

Conclusion: These findings suggest the need for increased regulation of social media messaging and marketing of tobacco and marijuana, with a particular focus on regulating social media, paid influencers, and marketing that appeals to adolescents and young adults. The findings also suggest the importance of prevention programs addressing the role of social media in influencing the use of tobacco and marijuana.

Cigarette smoking and cognitive function among older adults living in the community

Published: 12/08/2020, Ageing, Neuropsychology and Cognition

Results: Cigarette smoking can have a long-term impact on both executive function and memory. However, current smoking can increase the risk of executive function impairment compared to former smokers. Lung disease and current smoking can have a synergic effect of impairment in executive function.

Research Trawl 1^st – 7^th August

Changing the language of how we measure and report smoking status: Implications for reducing stigma, restoring dignity, and improving the precision of scientific communication

Published: 05/08/2020, Nicotine and Tobacco Research

Except: In this commentary, we make an appeal for researchers and clinicians to use personfirst language (e.g., “people who smoke”) rather than commonly used labels (e.g., “smokers”) in written (e.g., in scholarly reports) and verbal communication (e.g., clinical case presentations ) to promote greater respect and convey dignity for people who smoke. We assert that the use of precise and bias-free language to describe people who smoke has the potential to reduce smoking-related stigma and may enhance the precision of scientific communication.

Tobacco control in the United States: Failure to protect the right to health

Published: 06/08/2020, Tobacco Prevention and Cessation

Introduction: 1. Tobacco is often viewed as a problem that has been solved, particularly in the United States. However, tobacco kills more than 0.48 million Americans per year1. About 1 in 5 deaths in the United States is due to tobacco.

2. Tobacco is a human rights issue and should be considered as part of the government’s human rights obligations. Tobacco, and the actions of the tobacco industry, prevents citizens of the United States from enjoying the highest attainable standard of health and disproportionately impacts people of certain races and socioeconomic condition.

Unraveling the role of cigarette use in neural cannabis cue reactivity in heavy cannabis users

Published: 05/08/2020, Addiction Biology

These findings and the high prevalence of cannabis and cigarette co-use underscore the importance of considering cigarette smoking status when investigating the role of cue reactivity in heavy cannabis use.

Smoking history and cessation discussions in cancer patients receiving definitive radiotherapy: Do we treat all patients equally?

Published: 22/05/2020, Tobacco Prevention and Cessation

Conclusions: We document smoking history less frequently for prostate cancer patients than H&N, lung or breast cancer patients. Breast and prostate cancer patients have lower rates of current smoking than H&N and lung cancer patients. We document smoking cessation discussions less frequently in current smoking breast and prostate cancer patients than current smoking H&N and lung cancer patients. As all of these patients have been shown to experience poorer outcomes when smoking during radiotherapy, all should be asked about their smoking history.

Longitudinal association between environmental tobacco smoke exposure and behavioral problems in children from ages 5 to 9

Published: 29/07/2020, The Science of the Total Environment

The results of this longitudinal cohort study provide evidence regarding the negative effects of ETS exposure in early childhood and their behavioral problems over time. This study supports the strengthening of anti-smoking policies used in educational interventions for parents, in order to reduce early ETS exposure in children.

Secondhand smoke exposure and other signs of tobacco consumption at outdoor entrances of primary schools in 11 European countries

Published: July/2020, The Science of the Total Environment

Results: There were detectable levels of nicotine in 45.9% of the outdoor entrances, in 29.1% smell of smoke, in 43.2% people smoking, in 75.0% discarded butts, and in 14.6% ashtrays. Median nicotine concentration was below the laboratory's limit of quantification <0.06 μg/m3 (Interquartile range:<0.06-0.119). We found higher SHS levels in countries with lower Total Control Scale (TCS) scores, higher national smoking prevalence, and in the Southern and Eastern European regions. People smoking were more common in schools from lower area-level socio-economic status and in countries with lower TCS scores (p<0.05).

Advances in smoking cessation pharmacotherapy: Non-nicotinic approaches in animal models

Published: 03/08/2020, Neuropharmacology

The present review focuses on such pharmacological approaches, including nicotine vaccines, anti-nicotine antibodies, nicotine-degrading enzymes, cannabinoids, and metformin.

Smoking cessation and survival among people diagnosed with non-metastatic cancer

Published: 05/08/2020, BMC Cancer

Conclusions: Our point estimates suggest longer 3-year survival, but the results are compatible with 1.5 month shorter or 5.1 longer 3-year overall survival after smoking cessation within 6 months of cancer diagnosis. Future studies with larger sample sizes that test the comparative effectiveness of different smoking cessation strategies are needed for more detailed evidence to inform decision-making about the effect of smoking cessation on survival among cancer patients

Smoking, Vaping, and Tobacco Industry During COVID-19 Pandemic: Twitter Data Analysis

Published: 30/70/2020, Cyberpsychology, Behaviour and Social Networking

We analyzed n = 33,890 tweets on COVID-19 and smoking. The sentiment of tweets was negative, hitting a nadir in mid-March, but became less negative in April when preprints suggesting benefits from smoking on COVID-19 were released. We found 58 messages from the tobacco industry concerning COVID-19.

Smoking and COVID-19: Similar bronchial ACE2 and TMPRSS2 expression and higher TMPRSS4 expression in current versus never smokers

Published: 05/08/2020, Drug Development Research 

…In contrast, the expression levels of TMPRSS4, coding for a protease that primes SARS-CoV-2 for cell entry similarly to TMPRSS2, were elevated in bronchial epithelial cells from current smokers compared with never smokers, suggesting that higher bronchial TMPRSS4 levels in smokers might put them at higher SARS-Cov-2 infection risk. The effects of smoking on COVID-19 severity need clarification with larger studies. Additionally, the postulated protective effects of nicotine and nitric oxide, which may presumably reduce the risk of a "cytokine storm" in infected individuals, deserve assessment by controlled clinical trials.

Association of cigarette smoking with cognitive impairment in male patients with chronic schizophrenia

Published: 05/08/2020, Psychopharmacology

Conclusions: Our findings show that smoking patients with chronic schizophrenia exhibit more severe cognitive impairment than nonsmoking patients, especially in working memory and executive function.

Replacing smoking with vaping during pregnancy: impacts on metabolic health in mice

Published: 01/08/2020, Reproduction Toxicology

Results: In the Smoke-exposed (SE) mothers, plasma insulin levels were reduced, leading to downstream increases in hepatic gluconeogenesis and plasma non-esterified fatty acids (NEFA). In the e-vapour replacement mothers, these changes were not as significant. In the SE offspring, there was impaired glucose tolerance, and increased plasma NEFA and liver triglyceride concentrations. E-vapour replacement restored lipid homeostasis but did not improve glucose tolerance. Therefore, in a murine model, low dose e-cigarette replacement during pregnancy is less toxic than cigarette smoke.

E-cigarette use and cigarette smoking initiation among Australian women who have never smoke

Published: 04/08/2020, Drug and Alcohol Review

Discussion and conclusions: This study identified a strong association between e-cigarette use and subsequent initiation of smoking. Enforcing the existing restriction of sale and supply of e-liquid containing nicotine is essential to prevent never smokers from nicotine addiction via e-cigarettes.