Taking action on smoking and health
Research period 28/01 - 27/02
Published: 26/02/2020, Tobacco Control
For essentially the entire history of tobacco product regulation in the USA, the tobacco industry has been manipulating its products to exploit regulatory loopholes. From the invention of so-called ‘light’ cigarettes to fool government smoking machines, to the addition of sepiolite (a clay found in cat litter) to increase the weight of cigars in order to receive favourable federal taxation, manufacturers have been finding ways to skirt effective regulation….
In the USA, legal definitions of cigarettes and cigars are critical to tobacco control policy because federal, state and local laws typically tax and regulate cigarettes more strictly than cigars. In 2016, near the end of the Obama Administration, the US Food and Drug Administration (FDA) sent warning letters to four filtered ‘little cigar’ manufacturers stating that their so-called ‘cigars’ were cigarettes and, therefore, subject to more stringent public health restrictions.…
Published: 22/02/2020, Academic Paediatrics
Conclusions: Parental strategies to decrease TSE did not result in lower cotinine levels. Many measures are not evidence-based and do not protect children. Parent's clothing and homes may create a reservoir for nicotine. Education should focus on exposure elimination and cessation rather than protective measures.
Published: 21/02/2020, International Journal of Research and Public Health
The results of stratified analyses suggested a harmful effect of passive smoking exposure on cognitive function in non-smokers, but not in smokers. Therefore, passive smoking exposure increased the risk of cognitive impairment in older adults, especially non-smokers.
Published: 21/02/2020, Archivos Bronceoneumologia
Conclusions: One in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of smoking attributable mortality clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.
Published: 24/02/2020, European Respiratory Journal
…In our view, the recent European Respiratory Journal, Tobacco Control Committee statement on tobacco harm reduction , though well-intentioned, appears to be based on a number of false premises and draws its conclusions from a partial account of available data. It also presents a false dichotomy between the provision of “conventional” tobacco control and harm reduction approaches. We therefore respond, in turn, to the seven arguments presented against the adoption of harm reduction in the Committee's statement…
Published: 24/02/2020, Journal of Addiction Medicine
... Over the past decade, the corrective measures being taken by the FDA for cigarette and e-cigarette regulations also should focus on nicotine exposure levels. Before it is too late to prevent youth from lifetime addiction to nicotine, it is important to address the issues of nicotine concentration, nicotine flux and the e-cigarette device regulations while offering adults with smoking disorder less harmful alternatives to cigarettes.
Published: 24/02/2020, Diabetologia
Conclusions/interpretation: Our best estimate from the study is that maternal smoking in pregnancy was associated with 16% lower childhood type 1 diabetes incidence, and some of this effect was due to residual confounding.
Published: 25/02/2020, American journal of Health Promotion
Conclusions: Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.
Published: 26/02/2020, iScience
Here we show the dysbiotic oral microbial ecology in e-cigarette users influencing the local host immune environment compared with non-smoker controls and cigarette smokers. Our findings for the first time demonstrate that e-cigarette users are more prone to infection.
Published: Feb/2020, BMJ Open Respiratory Research
Conclusions: This study is the first to investigate biomarkers of potential harm and effect in electronic cigarette users and to show a linkage to metal exposure. The biomarker levels in electronic cigarette users were similar to (and not lower than) cigarette smokers. In electronic cigarette users, there was a link to elevated total metal exposure and oxidative DNA damage.
Published: 21/02/2020, Tobacco Control
Results Disposable (nicotinve vapour products) NVP price was higher than the price of a comparable unit for combustible cigarettes in England (EN), USA and Canada (CA). Prefilled cartridge price was higher than the price of a comparable unit of cigarettes in USA and CA, but lower in EN and Australia. E-liquid price was consistently lower than the price of a comparable unit of cigarettes across four countries. For start-up costs, price of a rechargeable device is approximately 3–5 times higher than a pack of cigarettes in four countries.
Published: 11/02/2020, Redox Biology
[Review] Highlights: 1) Waterpipe tobacco smoking is growing in popularity globally, since it is thought to be a safer alternative to cigarette smoking. 2) The amount of harmful substances produced from one waterpipe smoking session are greater than found in a standard cigarette. 3) Waterpipe smoking can cause oxidative stress and inflammation, which precede and exacerbate multiple pathological conditions.
Published: 21/02/2020, American Journal Physiology Lung Cell and Molecular Physiology
Conclusion: Thus, our data indicate that maternal vaping impairs pregnancy outcomes, alters fetal lung structure, and dysregulates the Wnt signaling. This study provides experimental evidence for future regulations of e-cig products for pregnant women and developmentally vulnerable populations.
Published: 21/02/2020, Annual of Behavioural Medicine
Results: Lower SES scores were associated with a higher likelihood of smoking lapse. Decomposition of the path from SES to smoking lapse into indirect effects showed significant paths through exposure to places where smoking is allowed and cigarette availability. Additionally, significant serial indirect paths from SES through both exposure to other smokers and places where smoking was allowed, in turn, through cigarette availability, and, ultimately, to smoking lapse were noted.
Published: 21/02/2020, Nicotine and Tobacco Research
Results [U.S. Virginia] After introduction of a federally mandated smoke free housing policy there was a 27% reduction in indoor PM2.5 and a 32% reduction in airborne nicotine in the first month after SFH adoption, compared to the month prior to adoption. However, there was a 33% increase in PM2.5 and a 25% increase in airborne nicotine after 12 months.
Published: 21/02/2020, European Child and Adolescent Psychiatry
Abstract: Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.
Published: 19/02/2020, Addiction
Conclusion: Varenicline compared with nicotine replacement therapy does not appear to be associated with an increased risk of cardiovascular or neuropsychiatric hospitalizations. Bupropion appears to be associated with a lower risk of cardiovascular hospitalization and a higher risk of neuropsychiatric hospitalization, compared with nicotine replacement therapy.
Using Social Media for Smoking Cessation Interventions: A Systematic Review
Published: 20/02/2020, Perspectives in Public Health
Conclusions: This review highlights the effectiveness of social media-based smoking cessation intervention studies. Due to the widespread use of social media, as well as its low cost, we suggest embedding smoking cessation interventions within existing popular social media platforms.
Published: 20/02/2020, American Journal of Public Health
Conclusions: Tobacco retailer licensing strategies can be an effective policy approach to reduce the availability of tobacco and tobacco marketing, lessen socioeconomic disparities in tobacco retailer density, and decrease the number of tobacco outlets near schools.
Published: 14/02/2020, Tobacco Control
Conclusions Flavours play a major role in vaping initiation for current smokers, former smokers and vaping-susceptible non-smokers, and remain important to those who continue vaping. Our findings highlight the need for regulation that allows some flavour diversity without the extravagant marketing currently used to promote vaping and e-liquids.
Published: 13/02/2020, Tobacco Control
Conclusions: Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for smokeless tobacco use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished
Published: 12/02/2020, Tobacco Control
Background: Cigarette pack inserts are small cards inside the pack that provide information on the benefits of quitting and advice on how to quit. Introduced in 2000, the original Canadian inserts featured textual messages about the benefits of quitting. Research found that Canadian smokers who read the inserts at least a few times reported greater confidence in their ability to quit, more quit attempts and more quit attempts lasting 30 days or longer. Pack inserts are inexpensive, with costs borne by the tobacco industry, and the positive and supportive information complements the motivating. Building on Australia’s successful comprehensive approach….
Published: 13/02/2020, Nicotine and Tobacco Research
Conclusions: E-cigarettes continue to be a newsworthy topic, with coverage both reflecting numerous changes and events over time, and providing repeated opportunities for informing the public and policymakers about these novel products. Future research should continue to track how discourse changes over time and assess its potential influence on e-cigarette perceptions and policy changes.
Published: March 2020, American Journal of Health and Behaviour
Conclusions: Method of menthol delivery did not impact cessation, nicotine dependence, and quit attempts.
Published: 01/03/2020, American Journal of Health Behaviour
Conclusions: Tobacco education and public health messages should encourage youth to evaluate the tobacco industry messages they receive, as counterarguing is associated with higher risk perceptions. Furthermore, fostering increased awareness of the risks associated with e-cigarette use by youth can reduce intentions to use them.
Published: 08/02/2020, Journal of Environmental Sciences
We report here determination of arsenic species in e-liquids and aerosols generated from vaping the e-liquid. Aerosols condensed from vaping the e-liquids were analyzed and compared for arsenic species. Six arsenic species were detected
Published: March 2020, Clinics in Chest Medicine
In this review, the authors describe the current state of tobacco dependence treatment focusing on new paradigms and approaches and their particular relevance for persons at risk or on treatment for lung cancer.
Published: 05/02/2020, Drug Alcohol Dependence
Conclusions: ECIG dependence has similarities to cigarette smoking dependence, but dependence indicators appear to be unique to ECIG use. Health professionals and the public should be aware of ECIG dependence risk and indicators.
Published: 08/02/2020, Research in Social and Administrative Pharmacy
…This commentary summarises the current evidence surrounding the safety and efficacy of NVPs, the Australian regulatory landscape, and provides a guide for pharmacy staff to use in discussions with customers regarding NVPs. Evidence strongly points to NVPs being considerably less harmful than smoking tobacco cigarettes and that they can be effective for smoking cessation.
Published: Journal of Perinatal Medicine
Conclusion Young, mixed-race women were most likely to be both smoking and using cannabis during pregnancy and should be targeted for cessation programmes.
Compared with individuals who had never smoked, current smokers showed a higher risk of dementia. Among ex-smokers, the risk for those who had stopped smoking for ≤ 2 years was still high, however, quitting smoking for 3 years or longer mitigated the increased risk incurred by smokers. Our study suggests that the risk of incident dementia among ex-smokers becomes the same level as that of never smokers if they maintain abstinence from smoking for at least 3 years.
Published: 12/02/2020, American Journal of Preventative Medicine
Conclusions: There was a positive association between secondhand smoking and depressive symptoms among in-school adolescents from low- and middle-income countries. Further research should investigate causality and assess whether prevention of exposure to secondhand smoke can have a positive effect on the mental well-being of adolescents.
Published: 10/02/2020, Tobacco Control
Conclusions Among smokers, JUUL and IQOS delivered less nicotine than cigarettes. Also, in this sample, IQOS and OB reduced abstinence symptoms more effectively than JUUL. Additional work with experienced JUUL and IQOS users is needed, as their nicotine delivery profiles and subjective experiences may differ.
Conclusions Information from manufacturers can be used to identify frequently used and category-specific flavourings. Qualitative and quantitative ingredient information can be used to successfully predict an e-liquid’s flavour category, serving as an example for regulators that have similar datasets available.
Conclusion Tobacco companies are continuing to market tobacco and influence sales through provision of incentives and benefits to retailers. Laws that ban the supply of benefits to consumers should be extended to also prohibit the provision of benefits to tobacco retailers.
Published: 11/02/2020, Tobacco Control
Conclusions: In the absence of trusted information, participants used sensory heuristics to rationalise their ENDS practices. Policy-makers face the challenge of correcting misperceptions about SHA without deterring full transition from smoking to ENDS use. They could consider including vaping in current smoke-free area policies; this measure would signal that SHA is not harmless, and could protect clean-air settings and reduce potential normalisation of vaping among non-smokers.
Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for smokeless tobacco use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished.
Conclusions: Poly-substance use is highly prevalent among adolescents who use e-cigarettes. Therefore, e-cigarette screening should include assessment of other substances, especially alcohol. Early and comprehensive prevention efforts to reduce e-cigarette and other substance use could have a substantial beneficial impact on population health over time.
Published: 12/02/2020, Nicotine and Tobacco Research
Conclusions: Awareness and use of Heated Tobacco Products (HTP) [Heat-Not-Burn] among young adults were associated with greater use of tobacco products and other substances and, among current smokers, with greater cigarette dependence (but not cessation-related factors). As these products become increasingly available in the United States, additional surveillance and monitoring activities are needed to better understand use patterns, consequences, and reasons for using HTPs
Results: In fully-adjusted models, compared to never smokers, residents of areas with a higher density of tobacco retail were more likely to 1) be characterized as established smokers, 2) have experienced repeated changes in smoking status (being “switchers”) during the 4-year study period, and 3) be former smokers.
Published: 29/01/2020, Nature
…Thus, tobacco smoking increases mutational burden, cell-to-cell heterogeneity and driver mutations, but quitting promotes replenishment of the bronchial epithelium from mitotically quiescent cells that have avoided tobacco mutagenesis.
Published: 05/02/2020, JAMA network Open
Conclusions and relevance: This study found that prevalence of current and frequent e-cigarette use among adolescents was higher when inclusive of JUUL use, and JUUL was by far the most common e-cigarette brand used, providing support for inclusion of brand-specific questions when assessing e-cigarette use. The results also identify characteristics of adolescents who may be more likely to use e-cigarettes
Published: 10/02/2020, Revista Brasileira de enfermagem
Final considerations: The results showed that the users expressed their desire for cessation of tobacco use and that to achieve this goal, family and group support, professional help and changing habits are key factors for this process.
Published: 12/02/2020, Australian and New Zealand Journal of Public Health
Conclusions: The introduction of organisational procedures that include routine cessation care should be of high priority in CSOs to help reduce smoking rates among clients. Staff may also benefit from receiving training in the provision of cessation support and education about the importance and feasibility of addressing smoking concurrently with other issues.
Published: 01/02/2020, American Journal of Ethics
Abstract: Electronic nicotine delivery systems (ENDS) have been widely referred to as "safer," "healthier," and more "effective" smoking cessation aids, but little evidence supports such claims. New concerns about pulmonary injuries associated with ENDS suggest reasons for concern about these products' health risks and potential for nicotine addiction. Nevertheless, multinational tobacco companies heavily market ENDS to retain customers with nicotine addiction, and global progress against tobacco use might slow as a result. The tobacco industry has managed to divide the tobacco control community by offering hope of harm reduction without actual evidence of ENDS' effectiveness or long-term safety. Low- and middle-income countries need this evidence to assess ENDS' value in mitigating tobacco use.
Published: 04/20/2020, Tobacco Inducible Diseases
Results: The probability of e-cigarette use gradually increased over the age of 15 years and then decreased by the age of 17 years for females and after the age of 18 years for males. Significant gender differences were observed between the ages of 17 and 19.5 years. Peer e-cigarette use was associated with higher odds of current e-cigarette use across all ages for females and after the age of 16 years for males. Exposure to e-cigarette commercials increased current use significantly for males between the ages of 16 and 18 years. Household use increased the odds of current use of e-cigarettes between the ages of 17 and 19 years for males and under 16.5 and over 18 years for females.
Published: 11/02/2020, Pediactrics
Published: 01/02/2020, American Journal of Ethics
Abstract…Ongoing challenges include weak implementation and enforcement of some aspects of the WHO Framework Convention on Tobacco Control and a lack of consensus among health professionals on how to address the tobacco industry's health claims related to e-cigarettes and other novel tobacco products. We argue that, despite these challenges, countries must prioritize the implementation and enforcement of restrictions on tobacco and e-cigarette marketing as these products represent not only a serious public health threat but also a violation of children's rights.
Published: 05/02/2020, Drug and Alcohol Dependence
Abstract: … Nationally representative data from the years 2006-2015 indicate that the prevalence of perceived great risk of smoking one or more packs of cigarettes per day has declined significantly among the United States general population. These findings have important implications for initiation of cigarette smoking, as well as interest in quitting, quit attempts, and sustained cessation.
Published: 08/10/20, Paediatric International
Conclusions: Obstructive Sleep Apnea Syndrome occurs more often in children exposed to tobacco smoke and these children demonstrate concentration problems, tiredness and irritability/hyperactivity to a greater extent than control group.
Published: 01/02/20, The Lancet: Respiratory Journal
…For the first time since records began, the total number of men using tobacco worldwide is projected to decrease, according to the latest findings in the WHO tobacco prevalence report.
Published: 05/02/20, The Lancet: Respiratory Medicine
Besides reaffirming the superiority of combination smoking cessation therapy over monotherapy, which has already been shown, this study establishes the importance of the use of nicotine in e-cigarettes to optimise smoking cessation success. Although the results presented are significant, the effect size in terms of abstinence is quite modest.
Published: 07/02/20 – Addiction
Conclusions: Among young people in urban California USA, differences in day-to-day exposure to tobacco outlets within activity spaces does not seem to be significantly associated with whether a person smokes a cigarette on a given day, but higher exposure to tobacco outlets appears to be positively associated with the number of cigarettes smoked on that day.
Conclusions: The introduction of standardised tobacco packaging and new larger graphic health warnings in the United Kingdom seems have reduced the perceived attractiveness of cigarette packs among young people in the UK who smoke or are at elevated risk of becoming smokers, disrupting positive brand imagery (the brand heuristic), increasing the salience of health warnings, and contributing to denormalising smoking.
Published: 07/02/20 – Neuropharmacology
…By controlling for important sociodemographic and health confounders, such as alcohol use, this study identifies distinct associations between smoking and brain structure, highlighting potential mechanisms of risk for common neurological sequelae (e.g., dementia).
Published: 31/01/20, Addiction
Conclusions: Single and multi-substance interventions addressing tobacco and/or cannabis have not shown a clear effect on either tobacco or cannabis cessation and reduction amongst co-users. However, dual substance interventions targeting tobacco and cannabis appear feasible.
Published: 31/01/20, British Journal of Cancer
Conclusion: The data suggest that nicotine treatment, by perturbing intracellular redox state and altering p53 function, can create a pro-tumorigenic environment in lung epithelium. The results suggest caution in using nicotine replacement therapies and e-cigarett
Published: 30/01/20, Scientific Reports
Results: We found that daily or almost daily consumption of tobacco and alcohol were both significantly associated with increased relative brain age.
Published: 03/01/20, JAMA
Conclusions and relevance: These findings suggest that several state regulations regarding e-cigarettes may be associated with reduced e-cigarette use among US adults.
Published: 29/01/20, Journal of Medical Imaging and Radiation Sciences
Results: The identified themes were categorized into three topic areas: knowledge (eg, impact of smoking on illness and why they should not smoke); individual decision to quit (eg, motivators), and the social unacceptability of smoking (eg, the public perception of smoking over the last 40 years). HCP-identified themes included identification of smokers, triggers to start a conversation, approach, gaps and barriers to cessation, rationale for cessation, and judgment. Patient-identified themes included knowledge, individual decision to quit, and the social unacceptability of smoking
Published: Feb 2020, Spatial and Spatiotemporal Epidemiology
Abstract: Neighborhood characteristics and the built environment are important determinants in shaping health inequalities. Our findings suggest that future polices must account for the differential distribution of retailers based on land use mix to lower concentration in areas where it is needed the most.
Published: 27/01/20, Regulatory Toxicology and Pharmacology
Conclusion: Comparison of our results to the literature illustrates the need for development of a standardized ENDS testing protocol. Our results further support that device variability must be fully characterized and considered before assessing the impact of e-liquid formulations.
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