Research digest May 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: 02/05 - 29/05

Research Trawl 23^th – 29^th May

Identification of volatile constituents released from IQOS heat-not-burn tobacco HeatSticks using a direct sampling method

Published: 26/02/2020, Tobacco Control

Results The temperature profile of the IQOS device revealed a non-combustive process employed in generating the tobacco aerosol. Real-time qualitative analysis revealed 62 compounds encompassing a broad spectrum of chemicals such as carbonyls, furans and phthalates, which are highly toxic.

Will 5.6 million current American youth eventually die from smoking? The anatomy of a commonly accepted tobacco control measure

Published: 23/05/2020, Tobacco Control

Findings Based on 2012 data, the estimated number of youth alive in 2012 who will die prematurely from smoking is 5.31 million. With lower young adult smoking prevalence in 2018, the future smoking-related mortality estimate is 3.66 million. For 2024, the estimate is 2.54 million.

Future smoking prevalence by socioeconomic status in England: a computational modelling study

Published: 23/05/2020, Tobacco Control

Conclusions If the current trends continue, smoking prevalence in England is projected to decline in the future, but with substantial differences across socioeconomic groups. Absolute inequalities in smoking are likely to decline and relative inequalities in smoking are likely to increase in future. The achievement of England’s Tobacco Free Ambition will require the reduction of both absolute and relative inequalities in smoking by socioeconomic status.

Exposure to JUUL use: cue reactivity effects in young adult current and former smokers

Published: 23/05/2020, Tobacco Control

Conclusions The use of JUUL affects the user and elicits responses in observers; this study is the first to demonstrate that exposure to JUUL use may act as a smoking cue and exposure to JUUL use may affect tobacco control efforts.

The association of e-cigarette flavors with satisfaction, enjoyment, and trying to quit or stay abstinent from smoking among regular adult vapers from Canada and the United States: Findings from the 2018 ITC Four Country Smoking and Vaping Survey

Published: 25/05/2020

Conclusions A majority of regular vapers in Canada and the US use non-tobacco flavors. Greater satisfaction and enjoyment with vaping is higher among fruit and candy flavor users. While it does not appear that certain flavors are associated with a greater propensity to attempt to quit smoking among concurrent users, non-tobacco flavors are popular among former smokers who are exclusively vaping. Future research should determine the likely impact of flavor bans on those who are vaping to quit smoking or to stay quit.

Initial views and experiences of vaping in prison: a qualitative study with people in custody preparing for the imminent implementation of Scotland’s prison smokefree policy

Published: 24/05/2020, Nicotine and Tobacco Research

Conclusion Our findings suggest possible benefits of e-cigarettes as one means of supporting smokefree policy in a population with many smokers. They also point to potential challenges posed by vaping in prisons and smokefree settings caring for similar populations. There is a need for ongoing measures to maximise the health benefits of smokefree settings, and for further research on vaping in situations of enforced abstinence.

Severity of Negative Mood and Anxiety Symptoms Occurring During Acute Abstinence From Tobacco: A Systematic Review and Meta-Analysis

Published: 23/05/2020, Neuroscience Biobehaviour Reviews

Results indicated that female smokers may experience worse mood symptoms compared to male smokers and that these symptoms may emerge within 3 hrs post-quit. Smoking cessation programs should implement sex-tailored interventions in order to improve their effectiveness, while future research should focus on alternative methods of nicotine administration.

Advancing Our Understanding of Tobacco Use in Vulnerable Populations

Published: June/2020, Nicotine and Tobacco Research

[Editorial]

Is the e‐cigarette harmless among asthmatic patients?

Published: 26/05/2020, Respirology

Excerpt: Even if exposure to e‐cigarette is less harmful than tobacco smoking among patients with asthma, e‐cigarette may be a harmful smoking cessation tool compared to other nicotine replacement therapies.

Transitions in Smoking and Nicotine Use From 2016 to 2017 Among a UK Cohort of Adult Smokers and Ex-Smokers

Published: 26/05/2020, Drug and Alcohol Review

Discussion and conclusions: Nearly half of the participants continued smoking without having tried to reduce harm or quit. Of smokers who transitioned, the majority quit smoking and abstained from nicotine altogether. Use of alternative nicotine products alongside smoking was associated with higher probabilities of becoming an ex-smoker.

Cancer Mortality Risk, Fine Particulate Air Pollution, and Smoking in a Large, Representative Cohort of US Adults

Published: 27/05/2020, Cancer Causes Control

Conclusions: Exposure to PM2.5 air pollution contributes to lung cancer mortality and may be a risk factor for other cancer types. Cigarette smoking has a larger impact on cancer mortality than PM2.5 , but is associated with similar cancer types.

Impact of Tobacco Control Policies on Smoking-Related Cancer Incidence in Germany 2020 to 2050 - A Simulation Study

Published: 26/05/2020, Cancer Epidemiology, Biomarkers and Prevention

Results: Over a 30-year horizon, an estimated 13.3% (men 14.0%, women 12.2%) of smoking-related cancer cases could be prevented if a combination of different tobacco control policies were to be implemented in Germany, with repeated price increases being the most effective single policy (men 8.5%, women 7.3%). Extensive sensitivity analyses indicated that the model is fairly robust

Research Trawl  16^th – 22^th May

Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK

Published: 17/05/2020, Tobacco Control

[Industry Watch] … excerpt: In addition to flavouring, it has local anaesthetic properties that can conceal the negative sensations of smoking, due to desensitising receptors. Menthol cigarettes increase overall smoke intake, but mask early respiratory disease symptoms, reducing the chance of quitting. Smoking menthol cigarettes also may raise nicotine intake, promoting nicotine dependence and the establishment of smoking in youth. Thus, banning menthol should reduce smoking prevalence. Furthermore, menthol cigarettes are likely to contribute to health inequalities as sociodemographic groups more likely to be of low income

Global review of tobacco product flavour policies

Published: 15/05/2020, Tobacco Control

Results Countries with a tobacco product flavour policy include the USA, Canada, Brazil, Ethiopia, Uganda, Senegal, Niger, Mauritania, EU (28 Member States), Moldova, Turkey and Singapore. Most of the countries’ policies provide a rationale of dissuading youth from taking up tobacco use.

Reducing second-hand smoke exposure among non-smoking pregnant women: a systematic review

Published: 19/05/2020, Nicotine and Tobacco Research

Results: Educational interventions were primarily targeted at the pregnant woman to change her or others’ behaviour, with only two studies involving the partner who smoked. Intervention delivery was mixed, spanning brief discussions through to more involving sessions with role play. The effective interventions involved multiple follow-ups.

Calling out companies responsible for putting cartoons on e-juice labels

Published: 20/05/2020, Nicotine and Tobacco Research

Excerpt: …which e-cigarette companies are using cartoons? What is more, which e-cigarette companies are using cartoons as their logos, helping them to establish their brand identity? In the face of growing public concern over the appeal of ecigarettes among youth, it is important to identify the companies whose promotional practices may drive youth e-cigarette use. 5 To further this conversation, this letter reports on data from original research investigating the promotional practices of e-cigarette companies.

Intensive longitudinal study of the relationship between cigalike e-cigarette use and cigarette smoking among adult cigarette smokers without immediate plans to quit smoking

Published: 18/05/2020, Nicotine and Tobacco Research

Conclusions Giving e-cigarettes to smokers who did not intend to quit reduced their cigarette smoking on days when they used e-cigarette more frequently, but this relationship did not hold for menthol smokers. Satisfaction with e-cigarette use was predictive of continued use 30 days later.

The Harm-Reduction Quandary of Reducing Adult Smoking While Dissuading Youth Initiation

Published: June/2020, American Journal of Public Health

Are e-cigarettes a danger to youth or cessation tool for adults? Both have to be considered.

Islam and Motivation to Quit Smoking: Public Health Policy Implications

Published: 06/2020, Journal of Religion and Health

…This paper concludes that there is an insufficient evidence base on which to adopt a religiously inspired approach. All of civil society, including religious Muslim authorities, should rather supplement the efforts of health professionals to encourage smoking cessation.

Factors Influencing the Uptake and Use of Nicotine Replacement Therapy and E-Cigarettes in Pregnant Women Who Smoke: A Qualitative Evidence Synthesis

Published: 22/05/2020, Cochrane Database Systematic Review

Authors' conclusions: Consistent messages from health professionals, based on high-quality evidence and clearly explaining the safety of NRT and e-cigarettes compared to smoking in pregnancy, could help women use NRT and e-cigarettes more consistently/as recommended. This may improve their attitudes towards NRT or e-cigarettes, increase their willingness to use these in their attempt to quit, and subsequently encourage them to stay smoke-free

The Association Between Exposure to Second-Hand Smoke and Sleep Disturbances: A Systematic Review and Meta-Analysis

Published: 20/05/2020, Sleep Health

Conclusion: This study is the first systematic review and meta-analysis to examine the association between SHS exposure and sleep outcomes. Self-reported exposure to SHS is positively associated with SSD, EDS, and PSQ, although the effects are modest. Further studies with robust methodology to ascertain exposure information are warranted to further elucidate the relationship between SHS exposure and sleep disturbances.

Changes in Tobacco Product Advertising at Point of Sale: 2015-2018

Published: 21/05/2020, Pediatrics

Conclusions: [US data] The longitudinal changes observed for each product's advertising reflect national youth use rates of the corresponding products. The point-of-sale environment around schools may be influencing youth tobacco use and must be monitored and regulated.

Research Trawl  9^th – 15^th May

Smoking is Associated with COVID-19 Progression: A Meta-Analysis

Published: 13/05/2020, Nicotine and Tobacco Research

Conclusions: Smoking is a risk factor for progression of COVID-19, with smokers having higher odds of COVID-19 progression than never smokers.

Beyond Smoking Cessation: Investigating Medicinal Nicotine to Prevent and Treat COVID-19

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

[Letter]  On the potential of Nicotine as a treatment for Covid-19

Has the time come to focus on (young adult) smoking uptake prevention?

Published: 11/05/2020, Nicotine and Tobacco Research

[Editorial Commentary] What are the arguments for greater focus on smoking uptake prevention? There is a strong moral and ethical case for societies to prioritise measures to protect minors and young people from becoming addicted to a product that will kill over half of its long-term users prematurely. In this issue, several articles address youth and young adult smoking and its prevention, highlighting Tobacco 21 legislation in particular

Prospective and Daily Effects of Cannabis Use on Smoking Outcomes during a Self-Guided Quit Attempt

Published: 12/05/2020, Nicotine and Tobacco Research

Conclusions This study produced evidence to support daily Quitter and Partner cannabis use as a risk factor for poor smoking outcomes. Smoking cessation programs might benefit from targeting cannabis use as well as taking a couples-oriented approach to treatment.

Roll-your-own smokers’ reactions to cessation-efficacy messaging integrated into tobacco packaging design: a sequential mixed-methods study

Published: 13/05/2020, Tobacco Control

Conclusions Integrating cessation-related messaging within tobacco packaging could be a high reach, just-in-time micro-intervention at the point of decision-making. Enhanced efficacy messages could complement and enhance PWLs, and support quitting among groups where smoking prevalence is especially high.

Differences in flavourant levels and synthetic coolant use between USA, EU and Canadian Juul products

Published: 13/05/2020, Tobacco Control

Conclusions Tested US/Canadian Juul e-liquids contained higher flavour concentrations than EU products, likely reflecting adaptation to user preferences. In EU, ‘Mint’ e-liquid, menthol is partially substituted with the synthetic coolant WS-3 that elicits a cooling effect like menthol but lacks its distinct ‘minty’ odour. The inhalational safety of WS-3 is unknown. The use of an emulsifier in US/Canadian ‘Mango’ Juul e-liquid may be necessary to keep the product homogeneous. Similar power specifications of devices between countries suggest that nicotine aerosol delivery is likely proportional to the e-liquid nicotine content.

ESTIMATING AND FORECASTING THE SMOKING-ATTRIBUTABLE MORTALITY FRACTION FOR BOTH GENDERS JOINTLY IN OVER 60 COUNTRIES

Published: 04/2020, The Annals of Applied Statistics

Here we use the same method to estimate the all-age SAF (Smoking Attributable Factor) for both genders for over 60 countries. We document a strong and cross-nationally consistent pattern of the evolution of the SAF over time.

Bullying Victimization and e-Cigarette Use Among Middle and High School Students

Published: 13/05/2020, The Journal of School and Health,

Conclusions: Bullying victims were significantly more likely to use an e-cigarette, and findings appeared to vary by sex. Female bullying victims had a higher likelihood of e-cigarette use.

Changing Exposure Perceptions: A Randomized Controlled Trial of an Intervention With Smoking Parents

Published: 12/05/2020, International Journal of Environmental Research and Public Health

..By making parents more aware of exposure and the circumstances in which it occurs, we can help parents change their smoking behaviour and better protect their children.

Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity

Published: 12/05/2020, JAMA Network

Conclusions and Relevance: These findings suggest that even low levels of prenatal alcohol exposure or prenatal tobacco exposure are associated with changes in offspring brain development.

The Use of Tobacco in Online Trailers of Top-Grossing Movies

Published: July/2020, Tobacco Prevention and Cessation

Conclusions: A considerable number of online movie trailers contain incidents of tobacco use, with a noteworthy exposure to those incidents. As such, tobacco use in movie trailers should be monitored to the same extent as full-length movies, and public health professionals should advocate for age-verification restrictions to movie trailers that contain tobacco incidents and that anti-smoking advertisements be shown before trailers containing any incidents.

Recommendations on How to Achieve Tobacco-Free Nations in Europe

Published: July/2020, Tobacco Prevention and Cessation

[Editorial] This paper considers various ways how EU and national policy makers may accomplish this (Article 20 and 22 of WHO FCTC). We conclude that progress in three areas is needed: 1) generation of more scientific evidence relevant for each country; 2) facilitation of policy learning between countries; and 3) building capacity and collaborations between researchers and tobacco-control advocates to bridge the gap from research to policy, especially in countries with weak tobacco-control infrastructures.

Gaps and Challenges: WHO Treatment Recommendations for Tobacco Cessation and Management of Substance Use Disorders in People With Severe Mental Illness

Published: 14/05/2020, BMC Psychiatry

Conclusions: These guidelines mark an important step towards addressing premature mortality in people with SMD. The dearth of high-quality evidence and evidence from LMIC settings must inform the future research agenda.

Research Trawl  2^nd – 8^th May

Smoking Cessation During the COVID-19 Epidemic

Published: 04/05/2020, Nicotine and Tobacco Research

[Letter]

Smoking links to the severity of Covid‐19: An update of a meta‐analysis

Published: 05/05/2020, Journal of Medical Virology

The updated meta-analysis: The pooled OR of the fixed effect model was 2.16 (95% CI: 1.45-3.22). The heterogeneity was smaller than that of the original analysis (I2: 39% vs. 44%). The sensitivity analysis excluding the study from W. Guan revealed a pooled OR of 1.89 (95% CI: 1.10-3.24).

Smoking Cessation as a Public Health Measure to Limit the Coronavirus Disease 2019 Pandemic

Published: 23/04/2020, European Cardiology 

Tobacco Use and Orofacial Pain: A Meta-analysis

Published: 06/05/2020, Nicotine and Tobacco Research

Conclusions: The odds of experiencing orofacial pain among patients with oral diseases increase for patients who are also smokers. The findings could help dentists and other health specialists more effectively manage patients with orofacial pain who are tobacco consumers

Public health perspectives of smokeless tobacco and areca nut use in the COVID-19 era

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

[Letter]

American Public Health Association [Journal] June issue

APHA June issue: A dossier on youth e-cigarette use and FDA's multifaceted approach

This issue features a special dossier on the FDA's response to increased e-cigarette usage among young consumers, as well as perspectives on vaping as harm reduction and international responses to growth in e-cigarette popularity. The issue also includes research on tobacco tax's impact on smoking behaviour.

- Experimental Forum 1: The 2020 Food and Drug Administration Guidance on E-Cigarettes

- Youth E-Cigarette Use and the Food and Drug Administration’s Multifaceted Approach

- Flavors Are a Major Driver of the Youth E-Cigarette Epidemic

- A List of Permissible Electronic Nicotine Delivery Systems Ingredients Would Be More Effective

- The Food and Drug Administration as Gatekeeper and the Menthol Exemption

- Restricting Flavors in ENDS Could Have Repercussions Beyond Youths’ Use

- The Food and Drug Administration Is Not Positioned to Deter Adolescent E-Cigarette Use

- Placing the Legal Vape Market in the Hands of Big Tobacco

- Will E-Cigarette Regulation Evolve in Pace With New Products?

- The Australian Approach to Tobacco Harm Reduction Is Even More Misguided Than the US Approach

- Flavored E-Cigarette Sales in the United States Under Self-Regulation From January 2015 Through October 2019

- The Harm-Reduction Quandary of Reducing Adult Smoking While Dissuading Youth Initiation

- Smoking Behavior in Low- and High-Income Adults Immediately Following California Proposition 56 Tobacco Tax Increase

Association Between Changes in Harm Perceptions and E-Cigarette Use Among Current Tobacco Smokers in England: A Time Series Analysis

Published: 05/05/2020, BMC Medicine

Conclusions: Between 2014 and 2019 in England, at the population level, monthly changes in the prevalence of accurate harm perceptions among current tobacco smokers were strongly associated with changes in e-cigarette use.

Smoking and SARS-CoV-2 Disease (COVID-19): Dangerous Liaisons or Confusing Relationships?

Published: 02/05/2020, Journal of Clinical Medicine

On the mechanism of SARS-Cov-2, ACE-2 receptor and smoking

Cost-benefit Analysis of Funding Smoking Cessation Before Surgery

Published: 05/05/2020, The  British Journal of Surgery

Conclusion: From the perspective of the Spanish NHS, the benefit of funding smoking cessation before surgery, in terms of healthcare cost savings, appears to greatly outweigh the costs.

Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children-An Overview in Research Insights of the Last Few Years

Published: 05/05/2020, International Journal of Environmental Research and Public Health

Prenatal Tobacco Smoke (PTS) and Second Hand Smoke (SHS) exposure are major elicitors of mechanisms of oxidative stress. Genetic predisposition can compound the health effects of PTS and SHS exposure. Epigenetic effects might influence in utero gene expression and disease susceptibility. Hence, the limitation of domestic and public exposure to SHS as well as PTS exposure has to be in the focus of policymakers and the public in order to save the health of children at an early age. Global substantial smoke-free policies, health communication campaigns, and behavioural interventions are useful and should be mandatory.

Smoking Associated Interstitial Lung Disease: Update and Review

Published: 07/05/2020, Expert Review of Respiratory Medicine

[Review] Expert opinion: Cigarette smoking is associated with a variety of pathologic conditions that affect the airways and lungs. E-cigarette use and vaping present new challenges to the clinician. Consensus between the clinical, radiographic, and pathologic findings are important in identifying and differentiating between the various entities to properly diagnose smoking-related interstitial lung diseases discussed in this review.