Research Digest July 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: 03/07 - 30/07

Research Trawl 24 - 30 July

Was the implementation of standardised tobacco packaging legislation in England associated with changes in smoking prevalence? A segmented regression analysis between 2006 and 2019

Published: 29/07/2021, Tobacco Control

Findings: The implementation of standardised packaging was associated with a significant step reduction in the odds of being a smoker after May 2017 (OR: 0.93; 95% CI 0.87 to 0.99). The magnitude of the association was similar when modelling the step change in May 2016 at the start of the 1-year policy implementation period

Smoking Cessation and Preterm Birth in Second Pregnancy Among Women who Smoked in Their First

Published: 23/07/2021, Nicotine and Tobacco Research

Results: Approximately 34% (N = 21 540) of women who smoked during their first pregnancy did not smoke in the second pregnancy. Smoking cessation among women who smoked at first pregnancy was associated with a 26% (95% CI: 21%, 31%) decrease in risk of preterm birth at a second pregnancy.

Vaping on TikTok: a systematic thematic analysis

Published: 26/07/2021, Tobacco control

Conclusion: Our findings illustrated that positively framed e-cigarette and vaping-related postings available without age restrictions on TikTok—a rising video-sharing platform that is popular among adolescents—have been viewed many times. Effective age restrictions are needed to reduce adolescents’ potential exposure to videos that portray vaping positively.

Over-Time Risk of Lung Cancer Is Largely Owing to Continuing Smoking Exposition: A Good Reason to Quit

Published: August/2021, Journal of Thoracic Oncology

Letter to the Editor: … We previously documented an enhanced risk of additional lung cancers over time in resected early-stage patients who were disease-free after 5 years. Today, we are aware of the reasons for such a situation, which is largely attributable to continuing activity of risk factors [Smoking]. Therefore, smoking cessation advice or counseling should be intensively pursued in both screening programs and clinical practice.

Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality : A Prospective Cohort Study

Published: 27/07/2021, Annals of Internal Medicine

Conclusion: Smoking cessation after diagnosis materially improved overall and progression-free survival among current smokers with early-stage lung cancer.

Tobacco smoking and severity of COVID-19: Experience from a hospital-based prospective cohort study in Lyon-France

Published: 27/07/2021, Journal of Medical Virology

Discussion: The results suggest that past-smoking is associated with enhanced risk of progressing towards severe COVID-19 disease in hospitalized patients.

Adolescent Use of and Susceptibility to Heated Tobacco Products

Published: 26/07/2021, Pediatrics

Conclusions: The awareness of HTPs among adolescents was remarkable given the low availability of products at the time of survey. Only a small percentage of adolescents experimented with HTPs. However, almost a third of those who had experimented with HTPs continued to use them. This high ratio and the fact that almost 1 out of 5 never users were susceptible to future HTP use should put the public health community on high alert as more HTP products are coming into the market, with promotion of these products likely to increase.

Genetic mechanisms of COVID-19 and its association with smoking and alcohol consumption

Published: 26/07/2021, Briefings in Bioinformatics

Conclusion: Our study revealed some novel COVID-19 related genes and suggested that genetic liability to smoking may quantitatively contribute to an increased risk for a severe course of COVID-19.

Anxiety Sensitivity and Emotion Dysregulation in Dual and Exclusive E-Cigarette Users

Published: 26/07/2021, Substance Use and Misuse

Conclusion: The current data suggest that dual users are an at-risk group in terms of emotional processes. Dual users would likely benefit from targeted intervention efforts focused on reducing anxiety sensitivity and improving emotion regulation in order to reduce nicotine consumption and/or promote cessation.

Mobile Delivery of Mindfulness-Based Smoking Cessation Treatment Among Low-Income Adults During the COVID-19 Pandemic: Pilot Randomized Controlled Trial

Published: 23/07/2021, JMIR Formative Research 

Conclusions: This study supports the promise of text messaging and the use of teleconferencing to provide mindfulness and smoking cessation services to underserved populations during a pandemic.

Research Trawl 17 - 23 July

Open letter to the prime minister and secretary of state on the second anniversary of England’s announcement that it would be smoke-free by 2030

Published: 21/07/2021, BMJ

Excerpt: Two years ago today the government announced its ambition to make England smoke-free by 2030.12 This includes making smoked tobacco obsolete, with smokers quitting or moving to reduced risk products like e-cigarettes. Despite acknowledging that it would be “extremely challenging,” there is still no sign to date of the “bold action” the government promised to deliver this crucial public health objective.

Genetic overlap and causal associations between smoking behaviours and mental health

Published: 21/07/2021, Scientific Reports

In conclusion, smoking and psychiatric disorders share genetic influences that cannot be attributed to covariates such as risk-taking, insomnia or other substance use. As such, there may be some common genetic pathways underlying smoking and psychiatric disorders. In addition, smoking may play a causal role in vulnerability for mental illness.

Reappraising Choice in Addiction: Novel Conceptualizations and Treatments for Tobacco Use Disorder

Published: 22/07/2021, Nicotine and Tobacco Control

Implications: Given the advent of novel, alternative tobacco products, Tobacco Use Disorder must be conceptualized within a contemporary framework that includes harm reduction and alternative outcomes. The unique contributions of nicotine pharmacology, non-pharmacologic reinforcers, and consequences of use can be used to inform treatments for TUD with the ultimate goal of improving the health of individuals who use tobacco.

Further Consideration of the Impact of Tobacco Control Policies on Young Adult Smoking in Light of the Liberalization of Cannabis Policies

Published: 17/07/2021, Nicotine and Tobacco Research

Conclusions: This paper provides evidence that the liberalization of cannabis laws has not adversely affected the efficacy of tobacco control efforts.

The “organic” descriptor and its association with commercial cigarette health risk expectancies, subjective effects, and smoking topography: a pilot human laboratory study

Published: 21/07/2021, Tobacco Control

Conclusions: Findings support that smokers associate the “organic” descriptor with health and reduced harm. This descriptor may differentially impact puffing behavior by gender.

Impact of standardised packaging in the UK on warning salience, appeal, harm perceptions and cessation-related behaviours: a longitudinal online survey

Published: 16/07/2021, Tobacco Control

Introduction: In the UK, since 20 May 2017, tobacco companies must sell cigarettes and rolling tobacco in standardised packs. Results: Compared with wave 1 (2016), the proportions noticing warnings first on packs, and rating cigarettes/rolling tobacco less appealing and worse value than a year ago, were higher at W2 (2017) and W3 (2019). Disagreeing that some brands contain more harmful substances was higher at W2. Interactions between social grade and survey wave for warning salience, and each appeal and harm outcome, were non-significant. Smokers switching from not noticing warnings first at W1 to noticing warnings first at W2, or who had a lower composite appeal score at W2, were more likely to plan to quit and to have made a quit attempt at W2. Smokers who switched to disagreeing that some brands contain more harmful substances at W2, after giving a different response at W1, were more likely to quit at W3.

Evolving chemical landscape of e-cigarettes, 2021

Published: 21/07/2021, Tobacco Control

Except:…Recently, disposable e-cigarettes, such as Puff Bar and Puff Plus, skyrocketed in popularity following the Food and Drug Administration’s (FDA) restrictions on flavoured, cartridge-based products, such as JUUL. While the ban on flavoured, cartridge-based e-cigarettes was intended to reduce the appeal of e-cigarettes to youth, in reality, youth simply switched to disposable products that were not included in the flavour ban. This notion is supported by data from the 2020 National Youth Tobacco Survey, which indicates that between 2019 and 2020, the percentage of high school e-cigarette users who used disposable…

Biomarkers of Inflammation and Oxidative Stress Among Adult Former Smoker, Current E-Cigarette Users Results from Wave 1 PATH Study

Published: 21/07/2021, Cancer Epidemiology,Biomarkers and Prevention

Conclusions: Dual users have greater concentration of F2-isoprostane than smokers. Exclusive e-cigarette users have biomarker concentrations that are similar to those of former smokers who do not currently use tobacco, and lower than those of exclusive cigarette smokers.

Preliminary assessment of the subjective effects of electronic-cigarettes in young-adult low-dose electronic-cigarette users: Effects of nicotine dose and e-liquid flavour

Published: 20/07/2021, Journal of American College Health

Conclusions: Flavored e-liquids contribute to the reinforcing properties of nicotine by enhancing the subjective effects, which may lead to continued ECIG use.

Adolescent Electronic Cigarette Use and Tobacco Smoking in the Millennium Cohort Study

Published: 19/07/2021, Addiction

Conclusions: E-cigarette use by age 14 is associated with increased odds of tobacco cigarette initiation and frequent smoking at age 17 among British youth. Similarly, tobacco smoking at age 14 is associated with increased odds of both e-cigarette initiation and frequent use at age 17.

Potentially toxic elements leachates from cigarette butts into different types of water: A threat for aquatic environments and ecosystems?

Published: 17/06/2021, Environmental Research

Abstract: Trillions of cigarette butts (CBs) are released into the environment and the leached potentially toxic elements (PTEs) from CBs may contaminate the environments. In this study, the leaching of PTEs including both heavy metals and metalloids (metal(loid)s) from CBs into deionized water (DW), tap water (TW), and seawater (SW) was checked during the different contact times (from 60 min to 60 days). According to the results, PTEs were leached from CBs into different water samples. The levels of leached PTEs exceeded the standards of surface freshwater to maintain aquatic life.

Asthma and early smoking associated with high risk of panic disorder in adolescents and young adults

Published: 19/07/2021, Social Psychiatry and Psychiatric Epidimiology

Conclusions: Patients newly diagnosed with asthma had a 1.7-times higher risk of developing panic disorder. Smoking during late childhood or adolescence increased the risk for developing the panic disorder in patients with asthma.

Research Trawl 10 - 16 July

Associations between smoke-free vehicle legislation and childhood admissions to hospital for asthma in Scotland: an interrupted time-series analysis of whole-population data

Published: 15/07/2021, The Lancet Public Health

Interpretation: Although legislation banning smoking in vehicles did not affect hospital admissions for severe asthma among children overall or in the older age group, this legislation was associated with a reduction in severe asthma exacerbations requiring hospital admission among preschool children, over and above the underlying trend and previous interventions designed to reduce exposure to second-hand smoke. Similar legislation prohibiting smoking in vehicles that contain children should be adopted in other countries.

An empirical perspective on cigarette use in substance use recovery

Published: 15/07/2021, Psychological Medicine

Abstract: This paper explores why tobacco is not considered a ‘substance’ akin to alcohol and illicit substances in the SUD treatment setting and examines whether this differential consideration may influence SUD treatment outcomes and long-term recovery. To our knowledge, overlooking tobacco as a substance of addiction when considering polysubstance use and disorder is a historical artifact rather than an evidence-based decision. We will provide a historical context for the exclusion of tobacco from the SUD treatment paradigm and systematically examine the prevalence, associated harms, and standard SUD treatment guidelines for alcohol and tobacco co-use v. alcohol and cocaine co-use to assess the empirical basis for the disparate approach toward tobacco v. other substances.

History and Correlates of Smoking Cessation Behaviors among Individuals with Current or Past Major Depressive Disorder Enrolled in a Smoking Cessation Trial

Published: 14/07/2021, Nicotine and Tobacco Research

Conclusions: These data indicate that smokers with current or past major depressive disorder are highly motivated to quit smoking and have a history of engaging in efforts to quit. Interventions to promote smoking cessation behaviors should address younger and lighter smokers, who may perceive less risk from tobacco use, and efforts to promote smoking cessation medications and counseling should address minority smokers who are engaging in complementary reinforcers.

Effects of Reduced Nicotine Content Cigarettes on Fractional Exhaled Nitric Oxide (FeNO) and Self-Reported Respiratory Health Outcomes among Smokers with Psychiatric Conditions or Socioeconomic Disadvantage

Published: 13/07/2021, Nicotine and Tobacco Research

Conclusion: Use of reduced nicotine content cigarettes across a 12-week period attenuates smoking-related reductions in FeNO levels in smokers with affective disorders and socioeconomic disadvantage although not those with OUD. FeNO changes were not accompanied by changes in respiratory-health ratings.

Cigarette Smoking and the Role of Menthol in Tobacco Use Inequalities for Sexual Minorities

Published: 13/07/2021, Nicotine and Tobacco Research

Conclusions: Our study found that menthol preference was disproportionately high among sexual minorities who smoke—bisexual and gay/lesbian females who smoke in particular. Research is needed to understand why menthol use is common among sexual minorities who smoke.

A clinical trial comparing smoking cessation interventions at two levels of intensity in stroke patients, stratified by the presence of insular cortex lesions

Published: 15/07/2021, Nicotine and Tobacco Control

Conclusions: A high percentage of patients gave up smoking in both intervention groups with no significant differences between the two. The effect of the insular lesion on smoking cessation, which is early and continued after two years, is particularly notable.

Use of heated tobacco products where their use is prohibited

Published: 13/07/2021, Tobacco Control

Conclusion: Stealth use was prevalent among current HTP users, especially among the poly-users of tobacco products. Considering the positive relationship between an agreement with allowing indoor use of HTPs and stealth use, a campaign to promote change in attitudes of HTP users about their indoor use may be warranted to protect non-users.

"Do You Smoke?" Physician-Patient Conversations About Smoking and Lung Cancer

Published: 15/07/2021, Journal of Cancer Education

Abstract: This study examined how physicians initiated and navigated conversations about smoking with patients with lung cancer. While there are numerous health benefits associated with smoking cessation in patients with advanced lung cancer, conversations about smoking cessation are infrequent and often lack tangible cessation support. We conducted a qualitative inductive content analysis on transcripts of 58 conversations.

Investigating the association between smoking, environmental tobacco smoke exposure and reward-related brain activity in adolescent experimental smokers

Published: 14/07/2021, Addiction Biology

Results: The results converged in revealing no significant relationships between monthly smoking, ETS exposure and reward-related brain activation across the brain or in the (ventral) striatum specifically. However, Bayesian statistics showed only anecdotal evidence for the null hypothesis in the VS, providing limited insight into the (non-)existence of the hypothesized relationship

Co-administering cannabis with tobacco and persistent tobacco smoking after 4½ years in young adults who use stimulants: A prospective population-based study

Published: 13/07/2021, Journal of Psychoactive Drugs

Conclusions: Always co-administering cannabis with tobacco was associated with more frequent and persistent tobacco smoking at 4½ years (Odds Ratio (OR): 1.98), independently of factors including baseline frequency of cannabis and tobacco use. Young adults who use cannabis should be advised not to co-administrate cannabis with tobacco, and comprise an important target group for tobacco smoking cessation interventions.

Research Trawl 3 - 9 July

Effects of menthol use and transitions in use on short-term and long-term cessation from cigarettes among US smokers

Published: 06/07/2021, Tobacco Control

Conclusion: These results demonstrate that menthol impaired menthol smokers’ attempts to quit smoking but switching from menthol improved success. This suggests that removing menthol may improve menthol smokers’ success during quit attempts.

Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

Published: 05/07/2021, Tobacco Control

Findings: Consistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups). Conclusion Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.

COVID-19 and a temporary ban on tobacco sales in South Africa: impact on smoking cessation

Published: 05/07/2021, Tobacco Control

Conclusions: Cigarette smoking in SA dropped during the 2020 COVID-19 lockdown, but the estimates were inconsistent, probably because of survey design. There was evidence that the lockdown achieved the fastest rate of decline in smoking prevalence in the country’s history. The true extent of the fall though is uncertain. Prevalence studies post lockdown, using probability sampling, may more accurately show how many people quit smoking.

Assessment of IQOS Marketing Strategies at Points-of-Sale in Israel at a Time of Regulatory Transition

Published: 03/70/2021, Nicotine and Tobacco Research

Conclusion: The relatively limited IQOS/HEETS marketing at POS suggests that, with regulatory changes, online or other forms of marketing might be prioritized. IQOS may be promoted to higher SES populations, as indicated by pricing and POS neighbourhood characteristics. Access near schools and placement near youth-oriented merchandise are potential concerns necessitating further research.

Exercise as a smoking cessation treatment for women: a randomized controlled trial

Published: 07/07/2021, Journal of Behavioural Medicine

Conclusion: There was no effect of exercise on smoking cessation. The present study adds to the literature suggesting null effects of exercise as a smoking cessation adjunctive treatment despite promising findings in short-term laboratory based studies.

Effects of tobacco smoking on recurrent hospitalisation with pneumonia: a population-based cohort study

Published: 07/07/2021, Thorax

Abstract: The incidence of and risk factors for recurrent hospitalisation for pneumonia were investigated using data from Hospital Episode Statistics, linked to a UK primary care database. Within 90 days and 1 year of follow-up, 1733 (3.1%) and 5064 (9.0%), developed recurrent pneumonia respectively. Smoking status at the time of hospitalisation with index pneumonia was associated with the risk of readmission with recurrent pneumonia within a year of discharge: current versus never smokers: adjusted subhazard ratio (sHR) 1.42, and ex smokers versus never smokers: adjusted sHR 1.24.

The Effects of Pharmacological Interventions on Smoking Cessation in People with Alcohol Dependence: A Systematic Review and Meta-analysis of Nine Randomized Controlled Trials

Published: 06/07/2021, International Journal of Clinical Practice

Conclusion: Varenicline may promote smoking cessation in people with alcohol dependence. However, Naltrexone, Topiramate, and Bupropion have no clear effect on increasing smoking abstinence among drinkers. The small number of studies and the low certainty of evidence indicate that the results should be interpreted cautiously.

Adverse Birth Outcomes Associated With Prepregnancy and Prenatal Electronic Cigarette Use

Published: July 2021, Obstetrics and Gynecology

Conclusion: E-cigarette use during pregnancy, particularly when used daily by individuals who do not also smoke combustible cigarettes, is associated with adverse birth outcomes.

Tobacco sales prohibition and teen smoking

Published: 05/07/2021, Journal of Economic behaviour and Organisation

Highlights: We evaluate the staggered banning of tobacco sales to teens across Swiss regions. - The tobacco sales bans did not statistically significantly reduce teen smoking. - Teens circumvent the sales bans by getting cigarettes from peers instead of stores. - Tobacco sales bans can change attitudes: they make smokers appear less cool. - Sales bans do not statistically significantly affect the perceived danger of smoking.