Taking action on smoking and health
Search period: 30/10 - 27/11
Tobacco control: far from the finish line
Published: 26/11/2021, Tobacco Control
Editiorial: excerpt: In their pursuit of tobacco control, governments and practitioners worldwide can draw lessons from the UK example. This month Action on Smoking and Health (ASH), the prominent UK anti-smoking organisation, marks its 50th anniversary. When the charity was established by the Royal College of Physicians in 1971, two-thirds of men and four in ten women in the UK smoked. In 2021, just one in six people were cigarette smokers. The UK has achieved this reduction by…
Is Adolescent E-Cigarette Use Associated with Subsequent Smoking? A New Look
Published: 20/11/2021, Nicotine and Tobacco Research
Conclusions: Among adolescent never cigarette smokers, those who had ever used e-cigarettes at baseline, compared with never e-cigarette users, exhibited modest or non-significant increases in subsequent past 12-month or past 30-day smoking when adjusting for behavioral risk factors.
Urinary Nicotine Metabolites and Self-Reported Tobacco Use Among Adults in the Population Assessment of Tobacco and Health (PATH) Study, 2013–2014
Published: 20/12/2021, Nicotine and Tobacco Research
Results: Among daily users, the highest geometric mean (GM) concentrations of nicotine, cotinine were found in exclusive smokeless tobacco users, and the lowest in exclusive e-cigarette users. Exclusive combustible product users had intermediate concentrations, similar to those found in users of multiple products (polyusers). Concentrations increased with age within the categories of tobacco users, and differences associated with gender, race/ethnicity and educational attainment were also noted among user categories. Recent (past 12 months) former users had GM cotinine concentrations that were more than threefold greater than never users.
Associations Between Nicotine Knowledge and Smoking Cessation Behaviors among U.S. Adults Who Smoke
Published: 25/11/2021, Nicotine and Tobacco Research
Conclusion: Harm reduction efforts may be impeded by misperceptions about nicotine. Further work should evaluate the effects of correcting such misperceptions through public education.
Demand for Factory-Made Cigarettes and Roll-Your-Own Tobacco and Differences Between Age and Socioeconomic Groups: Findings From the International Tobacco Control Netherlands Survey
Published: 23/11/2021, Nicotine and Tobacco Control
Conclusions: Individuals who smoke RYO tobacco indicated higher price sensitivity than those smoking FM cigarettes, supporting the need to harmonize tobacco taxation. Taxation may be especially beneficial to reducing consumption among individuals with a low income or smoke RYO tobacco. Substantially higher prices are needed in the Netherlands to achieve the desired results.
Peer-delivery of a gender-specific smoking cessation intervention for women living in disadvantaged communities in Ireland We Can Quit2 (WCQ2) – a pilot cluster randomized controlled trial
Published: 20/11/2021, Nicotine and Tobacco Control
Conclusions: The We Can Quit2 pilot was feasible to deliver by trained facilitators and indicated a positive direction in abstinence rates. Low literacy will need to be addressed in a future trial design.
PMI New Zealand conflates IQOS heated tobacco products with electronic nicotine delivery systems
Published: 19/11/2021, Tobacco Control
Industry watch: excerpt: according to the survey data presented, among smokers who have seen, read or heard something about ‘smoke-free’ products in the past 6 months, nearly half (47%) report receiving conflicting or unclear information. PMI appears to imply others are responsible for this conflicting information, even though its own advertising, which has conflated heated tobacco products (HTPs) with electronic nicotine delivery systems (ENDS), may foster confusion.
Switching people who smoke to unfiltered cigarettes: perceptions, addiction and behavioural effects in a cross-over randomised controlled trial
Conclusion: People who smoke perceived unfiltered cigarettes as having greater nicotine effects and less desirable sensory effects than filtered cigarettes, and they smoked fewer of these during the trial. Although cotinine, dependence and intention to quit were similar for smoking unfiltered and filtered cigarettes in this small trial, results suggest that banning the sale of filtered cigarettes might make smoking less attractive overall to people who smoke.
Cigarette dependence is more prevalent and increasing among US adolescents and adults who use cannabis, 2002–2019
Published: 23/11/2021, Tobacco Control
Conclusions: US individuals who use both cigarettes and cannabis report a higher prevalence of cigarette dependence relative to individuals who use cigarettes and do not use cannabis at virtually all levels of cigarette consumption. Further, cigarette dependence is increasing in the USA both among those who use and do not use cannabis. Given the increase in cannabis use among those using cigarettes, efforts to elucidate the nature of the association between cannabis and cigarette dependence are needed.
Back health bill amendments to make England smoke free by 2030, medical leaders urge
Published: 19/11/2021, BMJ
Excerpt: More than 650 health experts and activists are calling on the government to back amendments in the forthcoming Health and Care Bill that they say will help England become smoke free by 2030.
Monitoring changes in smoking and quitting behaviours among Australians with and without mental illness over 15 years
Published: 25/11/2021, Aust NZ Journal of Public Health
Conclusion: Since 2004, there have been some encouraging trends in reducing tobacco use among people with mental illness; however, smoking rates remain substantially higher than among those without mental illness. Implications for public health: Findings highlight the importance of routinely identifying smokers with mental illness and improving access and adherence to best practice smoking cessation treatment.
Potential explanations for conflicting findings on abrupt versus gradual smoking cessation: a population study in England
Published: 18/11/2021, Nicotine and Tobacco Research
Conclusions: Among a representative sample of adults who had smoked and made a quit attempt in the past year, there was evidence of an association between abrupt attempts and quit success before and after adjusting for relevant confounders. This suggests that the differences in quit success seen between abrupt and gradual quit attempt types are not completely driven by self-selection in observational data.
Profile of menthol cigarette smokers in the months following the removal of these products from the market: a cross-sectional population survey in England
Published: 17/11/2021, Tobacco Control
Conclusions A substantial minority of current smokers in England reported menthol cigarette smoking between July 2020 and June 2021, despite the ban, possibly reflecting mitigation of restrictions by a variety of licit means, such as legal menthol accessories. The reduction in menthol smoking across April–June 2021 warrants further monitoring.
Youth Use of E-Liquid Flavours – A systematic review exploring patterns of use of e liquid flavours and associations with continued vaping, tobacco smoking uptake, or cessation
Published: 16/11/2021, Addiction
Conclusions: Flavours may be an important motivator for e-cigarette uptake, but the role of flavours in tobacco smoking uptake or cessation is unclear. The quality of the evidence on use of e-cigarette flavours by young people is low overall.
Effects of electronic cigarette e-liquid flavouring on cigarette craving
Conclusions We did not find evidence to suggest that nicotine-containing fruit/sweet-flavoured and unflavoured e-liquids have different effects on cigarette cravings after 1 week of use. Further research is needed to establish if differences emerge over longer periods of exposure and extend to smoking cessation outcomes.
Nicotine Use Disorder in Older Adults
Published: February/2022, Clinical Geriatric Medicine
Abstract excerpt: moking cessation is a difficult task especially in the elderly; therefore, physicians should encourage older patients to quit with every patient-physician encounter by offering counseling and replacement therapy.
Association of Cigarette Smoking with Risk of Chronic Musculoskeletal Pain: A Meta-Analysis
Published: December/2021, Pain Physician
Conclusions: Cigarette smoking was associated with increased risk of chronic musculoskeletal pain CMP. In view of the high prevalence of smoking in many countries and the increasing number of CMP patients worldwide, reducing tobacco use should be an important public health strategy to prevent and control the global epidemic of CMP. Future research should attempt to establish whether this association is causal and clarify its mechanisms.
Cigarette Smoking and Competing Risks for Fatal and Nonfatal Cardiovascular Disease Subtypes Across the Life Course
Published: 17/11/2021, Journal of the American Hearth Association
Conclusions: Current smoking was associated with a fatal event as the first manifestation of clinical CVD
Straw cigarette branding: misleading descriptors and a new Marlboro man
Conclusion We identified an increase in availability of unique straw cigarette packs, strong branding and use of misleading descriptors on the packs. The adoption of plain packaging and the implementation of Brazil’s additive ban could help to reduce the appeal of straw cigarettes and curb the current increase in use among youth.
Trends in Cigar Sales and Prices, by Product and Flavor Type — United States, 2016–2021
Conclusions: Cigar sales and price vary by type over time in the U.S., including sales of cigarillos (94.2% of unit sales) increasing as their prices have decreased in recent years. Public health strategies are warranted to address the full scope of cigar types being used in the U.S.
Tobacco industry compliance with the EU track and tracing system in Lithuania
Published: 16/11/2021, Tobacco Control
Conclusion The tobacco industry most likely disregarded the EU T&T transitional period as no packs with UIs were found up until the full implementation. Packs without UIs were still found 4 months after the full implementation of the EU T&T system.
It is time for governments to support retailers in the transition to a smoke‐free society
Published: 15/11/2021, Medical Journal of Australia
Perspective: Phasing out tobacco retailing is gaining traction as the natural next step in controlling the tobacco pandemic
Age related interactions on key theoretical determinants of smoking cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020)
Published: 10/11/2021, Nicotine and Tobacco Control
Conclusions: Models of smoking abstinence are significantly improved by including motivational predictors of smoking. Age was an important moderator of the association between abstinence for both dependence and motivational variables.
What helps and what hinders the creation of a smoke-free home: A qualitative study of fathers in Scotland
Published: 10/11/2021, Nicotine and Tobacco Research
Conclusions: Fathers’ abilities to create a smoke-free home are shaped by a range of capabilities, opportunities and motivations, some of which relate to their role as a father. Establishing a fuller understanding of the contextual and gender-specific factors that shape fathers’ views on smoking in the home will facilitate the development of interventions and initiatives that fathers can identify and engage with, for the broader benefit of families and to improve gender equity and health.
A measure of illness awareness in individuals with nicotine dependence – Nicotine Use Awareness and Insight Scale (NAS)
Published: 12/11/2021, Nicotine and Tobacco Research
Conclusions: This study provides initial support for the validity and reliability of the NAS, a scale measuring impaired illness awareness in individuals with dependence on nicotine. The NAS can be used in research and clinical practice to evaluate the impact of impaired illness awareness in seeking nicotine cessation treatment.
Healthy People Countdown 2030: reaching 5% cigarette smoking prevalence among US adults through state cigarette excise tax increases
Published: 09/11/2021, Tobacco Control
Conclusions: The feasibility of reaching the Healthy People 2030 goal would critically depend on the acceleration of progress in tobacco control. Tax increases tailored to the needs of individual states combined with scaled-up non-tax tobacco control policy interventions can help achieve the desired progress.
Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping
Aim: This review attempts to discuss the current literature on nicotine and alcohol co-use in the context of the vaping epidemic, predominantly focusing on addiction-related outcomes and why e-cigarette use may be unique.
Within-person longitudinal associations between electronic nicotine delivery systems use and smoking cessation efforts among U.S. continuing adult cigarette smokers
Published: 09/11/2021, Nicotine and Tobacco Research
Conclusions: ENDS use among continuing smokers may help increase the number of quit attempts and smoking abstinent days. Given that the study sample is continuing smokers who failed in complete smoking cessation, future research would be desirable that evaluates whether such abstinent behaviors sustain and manifest harm reduction with improved health outcomes.
What factors are associated with waterpipe smoking cessation? A secondary data analysis
Published: 09/11/2021, Nicotine and Tobacco Control
Conclusions: In addition to nicotine dependency, social factors such as home restrictions on smoking, and not sharing waterpipe were identified as predictors of waterpipe smoking cessation. To help waterpipe smokers quit, social environment may be just as or even more important than well-known physical and psychological factors.
Internalizing problems are associated with initiation and past 30-Day use of flavored tobacco products
Published: 26/10/2021, Addictive Behaviour
Conclusions: Flavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.
Progress Against Cancer Mortality 50 Years After Passage of the National Cancer Act
Published: 11/11/2021, JAMA Oncology
Discussion: The cancer mortality rate has reduced considerably since 1971 overall and for most cancer sites because of improvements in prevention, early detection, and treatment. Specifically, the decline in lung, oral cavity, and bladder cancers largely reflects reduction in smoking because of enhanced public awareness of health consequences, implementation of increased cigarette excise taxes, and comprehensive smoke-free laws.2 Adult smoking prevalence in the US has decreased from 42% in 1965 to 14% in 2018.3
Analysis of Wholesale Cigarette Sales in Canada After Menthol Cigarette Bans
Published: 09/11/2021, JAMA Network Open
Discussion: This economic evaluation found that the bans restricting the sale of menthol cigarettes in Canadian provinces were associated with significant reductions in menthol cigarette sales and total cigarette sales. Previous behavioral studies have suggested that menthol cigarette smokers were likely to attempt to quit smoking after the ban
Effects of IQOS health warnings and modified risk claims among young adult cigarette smokers and non-smokers
Published: 29/10/2021, Tobacco Control
Conclusions: Among young adult smokers, health warnings increased perceived effectiveness at discouraging IQOS use and perceived credibility. Among non-smokers, warnings and claims increased perceived credibility and warnings increased perceived effectiveness, but the Food and Drug Administration-authorised reduced exposure claim increased intentions to use IQOS. Research is warranted to understand how the content of modified risk claims and health warnings for IQOS affects IQOS use in this population.
Systemic biomarkers of exposure associated with ENDS use: a scoping review
Published: 03/11/2021, Tobacco Control
Conclusions: Consistent, although limited, evidence shows that exclusive ENDS users have elevated levels of biomarkers of certain volatile organic compounds (VOCs; eg, acrylamide and acrylonitrile), metals (eg, cadmium and selenium) and propylene glycol compared with non-users; however, evidence for biomarkers of other toxicants (eg, acrolein, benzene and chromium) is mixed. Biomarkers of most VOCs are lower in ENDS users compared with cigarette smokers, and cigarette smokers who switch to ENDS consistently show reductions in VOC biomarkers. Evidence comparing metal exposures from exclusive ENDS use, cigarette smoking and dual use is mixed and depends on the metal. ENDS and e-liquid characteristics as well as use patterns may be associated with elevated exposure to VOCs and metals. Additional rigorous, controlled studies can assess biomarker exposures from ENDS use and inform the overall risk–benefit of ENDS use for different user populations.
Smoking-related cancer death among men and women in an ageing society (China 2020–2040): a population-based modelling study
Published: 01/11/2021, Tobacco Control
Conclusions: Coordinated efforts are urgently needed to curtail a rising tide of cancer deaths in China, with intensified tobacco control being key.
Comparing belief in short-term versus long-term consequences of smoking and vaping as predictors of non-use in a 3-year nationally representative survey study of US youth
Results: Believing in both short-term and long-term consequences was associated with outcomes, but short-term beliefs were more highly associated with anti-smoking and anti-vaping intentions and better predicted non-smoking behaviour at follow-up, controlling for prior use.
Examining Truth and State-Sponsored Media Campaigns as a Means of Decreasing Youth Smoking and Related Disparities in the U.S
Published: 29/10/2021, Nicotine and Tobacco Control
Conclusions: Media campaign exposure was associated with a lower likelihood of youth smoking behaviors. Associations were more pronounced for groups disproportionately affected by smoking, including youth of lower socioeconomic status. Media campaigns may be useful in reducing smoking disparities and improving health equity.
Local Tobacco 21 Policies are Associated With Lower Odds of Tobacco Use Among Adolescents
Published: 05/11/2021, Nicotine and Tobacco Control
Conclusions: T21 exposure is associated with lower odds of multiple forms of tobacco use, particularly among younger adolescent populations, supporting the implementation of T21 policies to reduce tobacco use in this population.
The effect of nicotine dependence on the risk of developing post-traumatic stress disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
Published: 03/11/2021, Nicotine and Tobacco Control
Conclusion: Nicotine dependence (ND), but not smoking status, increases a smoker’s risk of developing PTSD. This provides information that could aid in preventive strategies for individuals with ND who are exposed to trauma.
Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study
Published: 01/10/2021, The Lancet
Interpretation: Our results indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with FGR in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile. Prevention should target the entire population as well as specific minority ethnic groups at high risk of adverse pregnancy outcomes, to address risk factors and wider determinants of health.
Smoking Beyond Prison Bans: The Impact of Prison Tobacco Bans on Smoking Among Prison Entrants
Published: 03/11/2021, Journal of Correctional Health Care
Conclusion: No significant association was found between current daily smoking and recent exposure to a prison smoking ban, suggesting that the majority of Australian prisoners exposed to a tobacco ban while incarcerated will return to smoking once released.
Association of Smoking, Alcohol Consumption, Blood Pressure, Body Mass Index, and Glycemic Risk Factors With Age-Related Macular Degeneration: A Mendelian Randomization Study
Published: 04/11/2021, JAMA Opthalmology
Conclusions and relevance: This study provides genetic evidence that increased alcohol intake may be a causal risk factor for geographic atrophy (GA). As there are currently no known treatments for GA, this finding has important public health implications. These results also support previous observational studies associating smoking behaviuor with risk of advanced AMD, thus reinforcing existing public health messages regarding the risk of blindness associated with smoking.
Action on Smoking & Health (Scotland) (ASH Scotland) is a registered Scottish charity (SC 010412) and a company limited by guarantee(Scottish company no 141711). The registered office is 8 Frederick Street, Edinburgh EH2 2HB.
ASH Scotland acknowledges with thanks the support of the British Heart Foundation and the Scottish Government in developing our website.