Research digest September 2020

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

 Search period: 29/08 - 02/10

Research Trawl 26^th September - 2^nd October

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

Published: 29/10/2020, Tobacco Control

Results There was substantial growth in research seeking to evaluate the equity impact of tobacco control interventions, but the majority of new studies showed mixed/unclear results. Findings for price increases and targeted cessation support continue to suggest an equity-positive impact, but limitations in the available evidence make further assessment difficult. Substantial differences in the context, scale and implementation of tobacco control policies make straightforward comparison of findings from the previous 2014 and current reviews problematic.

Awareness, trial and use of heated tobacco products among adult cigarette smokers and e-cigarette users: findings from the 2018 ITC Four Country Smoking and Vaping Survey

Published: 29/09/2020, Tobacco Control

Results Overall, 30.2% of respondents reported being aware of HTPs (EN=31.0%), 2.4% had ever tried HTPs (EN=2.4%) and 0.9% currently used HTPs at least monthly (EN=1.2%). Trial and current use were higher among those who concurrently smoked and vaped (at least monthly) versus other nicotine use categories (trial: 10.9% v. 1.2%–2.0%, ; current use: 8.4% v. 0.1%–1.0%). Odds of trial and current use were lower where HTPs were unavailable. Odds of HTP trial did not differ by regulatory environment when restricting analysis to HTP-aware concurrent smokers–vapers.

Gender differences in reasons for using electronic cigarettes and product characteristics: Findings from the 2018 ITC Four Country Smoking and Vaping Survey

Published: 30/09/2020, Nicotine and Tobacco Research

Results sample, 54% were male. The most commonly cited reasons for vaping in females were ‘less harmful to others’ (85.8%) and in males were ‘less harmful than cigarettes’ (85.5%), with females being more likely to cite ‘less harmful to others’ and ‘help cut down on cigarettes’ than males. Significant gender differences were found in EC device type used. Females were less likely to report using e-liquids containing >20 mg/ml of nicotine, and tank devices with >2ml capacity than males. There was no significant gender difference in use of flavoured e-liquids, with fruit being the most common flavour for both males (54.5%) and females (50.2%).

Racial/Ethnic Discrimination, Sexual Orientation Discrimination, and Severity of Tobacco Use Disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III

Published: 30/09/2020, Nicotine and Tobacco Research

Conclusions Sexual minorities and heterosexuals who experience higher levels of racial/ethnic discrimination are at heightened risk of having moderate-to-severe tobacco use disorder (TUD). Exposure to higher levels of discrimination also increases the risk of having any TUD among sexual minority adults. Health providers and tobacco cessation professionals should be cognizant of the minority stressors experienced by their clients and their potential impact on TUD severity.

Active Cigarette Smoking is Associated with an Exacerbation of Genetic Susceptibility to Diabetes

Published: 01/10/2020, Diabetes

Conclusion: Smoking cessation is especially important for people who are more genetically predisposed to diabetes.

Effect of free-base and protonated nicotine on nicotine yield from electronic cigarettes with varying power and liquid vehicle

Published: 01/10/2020, Scientific Reports

Conclusion: The amount of nicotine emitted by an ECIG is independent of whether the nicotine is free-base or protonated, however the liquid vehicle has a strong effect on yield. Regulations intended to limit nicotine emissions must consider not only nicotine concentration, but also liquid vehicle and device power.

Association between active tobacco use during pregnancy and infant respiratory health: a systematic review and meta-analysis

Published: 30/09/2020, BMJ Open

Conclusion: Infants born to mothers who actively smoked during pregnancy are at higher odds of having wheeze and may have lower lung function. Smokeless tobacco use in pregnancy may increase the risk of apnoea in infancy.

Prevalence and Factors Associated with Electronic Cigarette Use Among Young Adult Cancer Survivors Using Behavioral Risk Factor Surveillance System, 2016-2018

Published: 30/09/2020, Journal of Adolescence and Young Adult Oncology

Results: Among young adult cancer survivors, lifetime e-cigarette use increased from 40.1% in 2016 to 47.4% in 2018. Former smokers were 5.47 times, more likely to be lifetime e-cigarette users and  more likely to be current e-cigarette users compared to never smokers. Current smokers were over sixteen folds more likely (adjusted odds ratio: 16.50) to be lifetime e-cigarette users and 2.1 times more likely to be current e-cigarette users relative to never smokers. Furthermore, binge drinking and depression were associated with higher odds of lifetime e-cigarette use, while increasing age was associated with lower odds of e-cigarette use. Compared to females, males were significantly more likely to be current users of e-cigarettes relative to former users

Changes in Smoking and Vaping over 18 Months among Smokers and Recent Ex-Smokers: Longitudinal Findings from the 2016 and 2018 ITC Four Country Smoking and Vaping Surveys

Published: 27/09/2020, International Journal of Environmental Research and Public Health

Overall, this study found that the vast majority of smokers were smoking 18 months later. Non-daily smokers were more likely than daily smokers to have discontinued smoking (p < 0.0001) and to have switched to exclusive vaping (p = 0.034). Exclusive non-daily smokers were more likely than exclusive daily smokers to have initiated vaping (p = 0.04). Among all W1 daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers; however, concurrent users were more likely than exclusive daily smokers to have decreased to non-daily smoking (p < 0.001) or to have switched to vaping by W2 (p < 0.001). Among all W1 non-daily smokers, there were no significant differences in increased smoking or discontinued smoking between concurrent users or exclusive smokers. Most ex-smokers remained abstinent from smoking, and there was no difference in relapse back to smoking between those who vaped and those who did not.

The effects of polygenic risk for psychiatric disorders and smoking behaviour on psychotic experiences in UK Biobank

Published: 28/09/2020, Translational Psychiatry

Results: …Smoking status, maternal smoking, and number of packs smoked/year were associated with psychotic experiences…

Change over time in adolescent smoking, cannabis use and their association: findings from the School Health Research Network in Wales

Published: 29/09/2020, Journal of Public Health

Results: No change in regular youth tobacco smoking was observed between 2013 and 2019. In contrast, current cannabis use increased during this time, and cannabis users had significantly greater odds of regular tobacco smoking. After adjusting for change in cannabis use, a significant decline in youth tobacco smoking was observed (OR 0.95; 95% confidence intervals: 0.92, 0.97).

Research Trawl 19^th – 25^th September

Smoking cessation among US adults: use of e-cigarettes, including JUUL, and NRT use

Published: 21/09/2020, Tobacco Control

Results Among former smokers (n=157), 21.2% used e-cigarettes and/or NRTs to help them quit. Specifically, 2.2% used JUUL only, compared with 10.3% who used NRTs only, and 6.9% used other e-cigarettes only to quit. Among current smokers with a quit attempt (n=308), 24.0% used any product (NRT or e-cigarettes) to quit, and only 1.1% used JUUL only. Current smokers reported relatively low use of NRTs only (10.1%), other e-cigarettes only (5.6%) and other e-cigarettes and NRTs (5.1%).

Conclusions Data suggest that few smokers in the US use e-cigarettes, and JUUL specifically, for cessation, and NRTs use is relatively low. All e-cigarettes should undergo FDA review to minimise recreational use and understand their cessation efficacy

Increased support for standardised packaging in the UK: a longitudinal online survey

Published: 23/09/2020, Tobacco Control

Aim: Since 20 May 2017, cigarettes and rolling tobacco in the UK must be sold in standardised packs. We explored whether support for standardised packaging changed following the introduction of this policy.

Boosting the Tobacco Control Vaccine: recognizing the role of the retail environment in addressing tobacco use and disparities

Published: 23/09/2020, Tobacco Control

Abstract: Much of the progress in reducing cigarette smoking and tobacco-related morbidity and mortality among youth and adults is attributable to population-level strategies previously described in the context of the Tobacco Control Vaccine. This commentary provides an overview of the importance of incorporating strategies focused on the tobacco retailer environment (availability; pricing and promotion; advertising and display; age of sale; and retail licensure) as part of a comprehensive approach to tobacco prevention and control.

Opioid use disorder trends from 2002 to 2017 by cigarette smoking status in the United States

Published: 22/09/2020, Nicotine and Tobacco Research

Results: In 2017, opium use disorder (OUD) was significantly more common among persons with daily (2.6%) and non-daily (1.5%) smoking compared to those with former (0.5%) or never (0.2%) smoking. Overall, the prevalence of OUD increased between 2002-2017, although trends differed by smoking status. Adjusting for demographics, the prevalence of OUD increased significantly among individuals with daily (AOR=1.06, 95% CI: 1.04, 1.07), non-daily (AOR=1.03, 95% CI: 1.01, 1.05), and former smoking (AOR=1.05; 95% CI: 1.02, 1.09), but decreased among those who never smoked (AOR=0.98; 95% CI: 0.97, 0.99).

Applying the Population Health Standard to the Regulation of Electronic Nicotine Delivery Systems

Published: 22/09/2020, Nicotine and Tobacco Research

Abstract Regulatory authorities have devoted increasing attention and resources to a range of issues surrounding the regulation of novel nicotine and tobacco products. This review highlights the inherent complexity of evaluating prospective policies that pertain to products that heat solutions containing nicotine but not tobacco leaf, sometimes referred to as electronic nicotine delivery systems (ENDS).

The importance of socioeconomic position in smoking, cessation and environmental tobacco smoke exposure during pregnancy

Published: 24/09/2020, Scientific Reports

Conclusion: This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Published: 12/09/2020, Addictive Behaviour

Outline: In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions.

Effects of E-cigarettes and vaping devices on cardiac and pulmonary physiology

Published: 25/09/2020, Journal of Physiology

Abstract: E-cigarette aerosols are exceedingly different from conventional tobacco smoke, containing dozens of chemicals not found in cigarette smoke. It is highly likely that chronic use of e-cigarettes will induce pathologic changes in both the heart and lungs. Here we review human and animal studies published to date and summarize the cardiopulmonary physiologic changes caused by vaping.

The experience of general practitioners with Very Brief Advice in the treatment of tobacco addiction

Published: 25/09/2020, NPJ Primary Care and Respiratory Medicine

Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study [in The Netherlands], we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.

Clinical impact and cost-effectiveness of integrating smoking cessation into lung cancer screening: a microsimulation model

Published: 22/09/2020, CMAJ Open

Results: Offering a smoking cessation intervention in the context of lung cancer screening could lead to an additional 13% of smokers quitting smoking. It could potentially prevent 12 more lung cancers and save 200 more life-years for every 1000 smokers screened, at a cost of $22 000 per quality-adjusted life-year (QALY) gained. The results were most sensitive to quit rate. The intervention would cost over $50 000 per QALY gained with a permanent quit rate of less than 1.25% per attempt

Effects of smokıng on patıents wıth obstructıve sleep apnea syndrome

Published: 22/09/20202, The Clinical Respiratory Journal

Conclusion: It was revealed that patients with severe Obstructive Sleep Apnea (OSAS) were heavy smokers, and increased smoking increased the OSAS severity both by increasing AHI and by reducing oxygen saturation overnight. One unit increase in the package-year results in a 15.3% increase in the AHI.

Research Trawl 12^th – 18^th September 

Disparities in the prevalence of cigarette smoking among bisexual people: a systematic review, meta-analysis and meta-regression

Published: 10/09/2020, Tobacco Control

Conclusions: Cigarette smoking was more prevalent among bisexuals than lesbians/gays and heterosexuals, with the estimates showing a greater magnitude among bisexual women relative to all other sexual orientation/gender subgroups.

Changes in adults’ vaping and smoking behaviours associated with aerosol-free laws

Published: 15/09/2020, Tobacco Control

Results: After the bans, e-cigarette use in the past 30 days did not change significantly in provinces with a ban compared with provinces without a ban. The bans also had no impact on current combustible cigarette use. There is evidence of ban evasion among young people aged 19–24 who, after the bans, reported higher use of e-cigarettes when unable to smoke combustible cigarettes.

Effectiveness of Electronic Cigarettes in Smoking Cessation: a Systematic Review and Meta-Analysis 

Published: 17/09/2020, Nicotine and Tobacco Research

Discussion: Our results suggest that nicotine-ECs may be more effective in smoking cessation when compared to placebo ECs or NRT. When compared to counselling alone, nicotine ECs are more effective short-term but its effectiveness appears to diminish with later follow-ups. Given the small number of studies, heterogeneous design and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations.

Patterns of e-cigarette use and subsequent cigarette smoking cessation over two years (2013/2014 to 2015/2016) in the Population Assessment of Tobacco and Health (PATH) Study 

Published: 17/09/2020, Nicotine and Tobacco Research

Conclusion: Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices. Less frequent, unstable, past or never e-cigarette users were less likely to quit smoking. Monitoring the relationship between patterns of e-cigarette and cigarette use is complex but critical for gauging the potential of e-cigarettes as a harm reduction tool.

Banning smoking at Army Foundation College, Harrogate: a military phase I training establishment's experience of introducing a smoking ban

Published: 16/09/2020, BMJ Military Health

Excerpt: In September 2019, Harrogate Army Foundation College (AFC) introduced what is believed to be the British Army's first smoking ban. Success when introducing a smoking ban in a military establishment is dependent on early planning and clear communication between the chain of command and the medical centre. As the military moves towards a larger scale smoking ban, lessons from AFC's experience may help guide other military establishments with the implementation process.

Electronic cigarette and moist snuff product characteristics independently associated with youth tobacco product perceptions

Published: 28/08/2020, Tobacco Induced Diseases

Results: Each e-cigarette and moist snuff characteristic was independently associated with multiple product perceptions. All non-tobacco flavors were associated with more curiosity and perceived ease-of-use but lower perceived danger. Tank and pod-type e-cigarettes were viewed as easier to use and garnered more curiosity than 'cigalike' or 'drip-mod' devices. Smaller vapor cloud e-cigarettes and lower-price moist snuff were viewed as less dangerous, less buzz-inducing, and easier to use. Product ever users held stronger perceptions than never users about device type (e-cigarettes) and brands (moist snuff), while product naïve participants more strongly associated flavor with danger and buzz.

Effects of Smoking and Smoking Cessation on the Intestinal Microbiota

Published: 14/09/2020, Journal of Clinical Medicine

Smoking cessation led to minor changes in the intestinal microbiota. It is unclear if the proven health benefits of smoking cessation lead to salutary changes in the intestinal microbiota.

US regulator adds to confusion around heated tobacco products

Published: 16/09/2020, BMJ

[Editorial] Tobacco manufacturer exploits FDA’s ambiguous ruling

Smartphone health apps for tobacco Cessation: A systematic review

Published: 26/08/2020, Addictive Behaviour

Discussion: The majority of studies that use tobacco cessation apps as an intervention delivery modality are mostly at the pilot/feasibility stage. The growing field has resulted in studies that varied in methodologies, study design, and inclusion criteria. More consistency in intervention components and larger randomized controlled trials are needed for tobacco cessation smartphone apps.

A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

Published: Oct/2020, World Psychiatry

Excerpt: There is increasing academic and clinical interest in how "lifestyle factors" traditionally associated with physical health may also relate to mental health and psychological well-being. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non-pharmacological sleep-focused interventions.

Associations of history of mental illness with smoking and vaping among university students aged 18-24 years in New Zealand: Results of a 2018 national cross-sectional survey

Published: 01/09/2020, Addictive Behaviors

Results: 18.5% reported an history of mental illness (HMI). Smoking: 49.7% (95% CI 47.0-52.5) reported ever, 10.5% (8.9-12.3) current and 5.0% (3.9-6.4) daily smoking. Vaping: 38.7% (36.0-41.4) reported ever, 6.3% (5.1-7.8) current and 1.9% (1.3-2.8) daily vaping. Participants with HMI were significantly more likely to smoke: ever (64.9% vs 46.3%, p < .001), current (15.1% vs 9.5%, p = .011) and daily (7.5% vs 4.5%, p = .050), and vape: ever (49.4% vs 36.3%, p < .001) and current (9.2% vs 5.7%, p = .044) than participants without HMI. The model containing all predictors of HMI was significant, χ2 (5, N = 1293) = 24.09, p < .001. Gender (OR 0.54, (0.4-0.75)), current smoking (OR 1.82, (1.19-2.78)) and current vaping (OR 1.73, (1.02-2.93)) made unique significant contributions to the model.

Maternal smoking and preterm birth: An unresolved health challenge

Published: 14/09/2020, PloS Medicine

In this issue of PLOS Medicine, two studies provide new insights into the implications of exposure to tobacco smoke in pregnancy for perinatal and childhood outcomes.

Research Trawl 5^th – 11^th September

Statement on the potential toxicological risks from electronic nicotine (and non-nicotine) delivery systems (E(N)NDS – e-cigarettes)

Published: Sept/2020

A Report by Public Health England – Committee on Toxicology

The misuse of the precautionary principle in justifying Australia’s ban on the sale of nicotine vaping products 

Published: 10/09/2020, Nicotine and Tobacco Research

Implications: The precautionary principle has been misapplied to NVP regulation in Australia. We recommend that the precautionary principle be used in a way that regulates nicotine products in proportion to their risks.

Tobacco control policies to tackle the problem of adolescent tobacco use 

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

[editorial]

Systematic review of electronic cigarette use (vaping) and mental health comorbidity among adolescents and young adults 

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

Conclusions: Youth EC use is associated with greater mental health problems (compared to non-use) across several domains, particularly among adolescents. Since many existing studies are cross-sectional, directionality remains uncertain. Well-designed longitudinal studies to investigate long-term mental health sequalae of EC use remain needed.

Investigating genetic correlation and causality between nicotine dependence and ADHD in a broader psychiatric context.

Published: 10/09/2020, American Journal of Medical Genetics: Part B, Neuropsychiatric Genetics

Results: We found a high genetic correlation between ND and ADHD, and to a lesser extent also between ND-major depressive disorder and ND-schizophrenia. We did not find evidence for a causal relationship from liability for ADHD to ND (which could be due to a lack of power). The strong genetic correlations might reflect different phenotypic manifestations of (partly) shared underlying genetic vulnerabilities.

Child tobacco smoke exposure and healthcare resource utilization patterns

Published: 06/09/2020, Nature

Impact: i)Tobacco smoke exposure may affect the healthcare resource utilization patterns of children.ii) Evidence is lacking concerning these associations among the highly vulnerable pediatric emergency department patient population.iii) This study examined the association between tobacco smoke exposure and healthcare resource utilization patterns among pediatric emergency department patients.iv) Tobacco smoke exposure increased the risk of pediatric patients having respiratory-related procedures, respiratory-related and non-respiratory-related testing, medications administered during the pediatric emergency department visit, and medications prescribed for home administration.v) Tobacco smoke-exposed patients were more likely to be admitted to the hospital compared to unexposed patients.

Preventing smoking relapse in patients with cancer: A randomized controlled trial.

Published: 09/09/2020, Cancer

Conclusions: A specific ‘smoking relapse prevention’ intervention did not reduce relapse rates overall, compared to usual care, but did appear to have benefited those participants who had the social support of a partner. Future work is needed to extend this effect to the larger population of patients.

Association of heated tobacco product use with smoking cessation in Chinese cigarette smokers in Hong Kong: a prospective study

Published: 09/09/2020, Tobacco Control

Introduction Heated tobacco products (HTPs) are increasingly popular worldwide, but whether they aid or undermine cigarette abstinence remains uncertain. We examined the predictors of HTP initiation and the prospective association of HTP use with cigarette abstinence in community-based smokers in Hong Kong.

Conclusion HTP use was not associated with cigarette abstinence at 6 months in a community-based cohort of smokers with intentions to quit or reduce smoking.

Revisiting the association between worldwide implementation of the MPOWER package and smoking prevalence, 2008–2017

Published: 06/09/2020, Tobacco Control

Background: In 2008, the WHO introduced the ‘MPOWER’ package, comprised of best-practice cost-effective interventions outlined in the WHO Framework Convention on Tobacco Control (WHO FCTC), to assist in the country-level implementation of effective practices to reduce the demand for tobacco. We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country groups. Conclusion A decade after the introduction of the WHO MPOWER package, we observed that the countries with higher initial tobacco control preparedness and higher smoking burden were able to reduce the adult daily smoking prevalence significantly.

Evaluation of an Interprofessional Tobacco Cessation Train-the-Trainer Program for Respiratory Therapy Faculty

Published: 08/09/2020, Respiratory Care

Conclusions: Training respiratory therapy faculty using a train-the-trainer approach had a positive impact on faculty's perceived confidence and ability to teach tobacco cessation at their institutions

Trends in e-cigarette Use in Adults in the United States, 2016-2018

Published: 08/09/2020, JAMA Internal Medicine

Prenatal tobacco use and the risk of mood disorders in offspring: a systematic review and meta-analysis.

Published: 08/09/2020, Social Psychiatry and Psychiatric Epidemiology

Results: Eight cohort and two case-control studies were included in the final meta-analysis. We found an increased pooled relative risk of mood disorders in offspring exposed to maternal prenatal tobacco use RRs 1.43 (95% CI 1.27-1.60) compared to no prenatal tobacco use. Similarly, the pooled relative risks of bipolar and depressive disorders in offspring were 1.44, (95% CI 1.15-1.80) and 1.44, (95% CI 1.21-1.71), respectively. Moreover, the pooled estimated risk of mood disorders was not significantly attenuated in the studies that reported sibling comparison results [RR = 1.21 (95% CI 1.04-1.41)]. Conclusion: Taken together, there was strong evidence for a small (RR < 2) association between prenatal tobacco use and mood disorders in offspring.

Selective Influence of Smoking on Periodontal Treatment Outcomes after 3 Years of Follow-up.

Published: 04/09/2020, Oral Health Prevention Dentistry

Conclusion: Smoking negatively impacted periodontal treatment outcomes at specific tooth sites (deep pockets, maxillary molars) and periodontitis progression, independent of other risk factors.

Research Trawl 29^th August – 4^th September

Preparing for the Quit Day: Comparing beliefs of nondaily versus daily young adult smokers as they prepare for a quit attempt 

Published: 03/09/2020, Nicotine and Tobacco Control

Outline: This study shows that motivations for quitting smoking between daily and nondaily smokers differs significantly. Most research is based on daily/heavy smokers. As there are increasingly more non-daily smokers it is important to better understand how to support this group in their quit attempts.

Exploitation of the COVID-19 pandemic by e-cigarette marketers

Published: 27/08/2020, Tobacco Control

Introduction: Over the last decade, a wide variety of e-cigarette advertisements have claimed superior healthfulness compared with cigarettes. Recently, we recognised a novel form of health reassurance advertising, promotion of e-cigarettes via COVID-19 pandemic themes. This led us to systematically explore COVID-19 marketing of e-cigarette brands and vape stores on their websites and Instagram accounts.

Exposure to health misinformation about COVID-19 and increased tobacco and alcohol use: a population-based survey in Hong Kong

Published: 27/08/2020, Tobacco Control

Conclusion Our results first showed that exposure to health misinformation that smoking/alcohol drinking can protect against COVID-19 was associated with self-reported increases in tobacco and alcohol consumption in Chinese during the pandemic.

Vaping in the Workplace: Implications for Employer-Sponsored Tobacco Cessation Programs

Published: 01/09/2020, Journal of Occupational and Environmental Medicine

Conclusions: Workplace vaping is a trigger for smoking and vaping among current and former tobacco users. A gap exists between desired support for vaping cessation and current employer-sponsored cessation programs.

E-cigarette sharing behavior among college students: An exploratory study.

Published: 02/09/2020, Journal of American College Health

Results: Of the 121 participants, 24% shared e-cigarettes every day and 76% shared some days. The most common setting (91%) for sharing was at social gatherings, and participants shared most often (52%) with one or two people, which happened most often (99%) with friends. The top reason (80%) for sharing e-cigarettes was to feel the effects of nicotine.

Role of e-cigarettes and pharmacotherapy during attempts to quit cigarette smoking: The PATH Study 2013-16.

Published: 02/09/2020, PLoS One

Conclusion: Among US daily smokers who quit cigarettes in 2014-15, use of e-cigarettes in that attempt compared to approved cessation aids or no products showed similar abstinence rates 1-2 years later.

Emerging Chemicals of Health Concern in Electronic Nicotine Delivery Systems

Published: 03/09/2020, Chemicals Research in Toxicology

These findings will contribute to addressing the information gaps pertinent to the presence of emerging chemicals of health concern (ECC)s in ENDS, and warrant further studies for understanding the potential negative health effects and to what extent those chemicals may cause when using the ENDS, and for developing evidence-based standards to regulatory control the types and levels of ECCs in ENDS products.

Pesticides residues in tobacco smoke: risk assessment study

Published: 02/09/2020, Environmental Monitoring and Assessment

Excerpt: These detected residues represent ten different active ingredients (AI), three of these AIs (thiodicarb, alachlor, and endosulfan) are no longer allowed in Europe. A 54.7% of these residues were quantifiable. Furthermore, it was found that with the use of solid-phase extraction sorbent (SPE) as adsorbent and n-hexane as solvent, higher recoveries of the pesticide residues in the tobacco smoke from the amount spiked can be obtained. It was also found that cigarette filters help to reduce the intake of residues of pesticides that may be present in cigarettes. Finally, the study concluded that both active smoking and passive smoking populations are exposed to pesticide residues in the tobacco smoke.

Alteration of smoking habit at time of first diagnosis influences survival of patients with HNSCC

Published: Nov/2020, Molecular and Clinical Oncology

Abstract excerpt: Alteration of smoking at the first diagnosis of Squamous cell carcinoma of the head and neck, led to a significantly beneficial effect on survival outcomes compared with continued smoking, without significant differences between reduction and cessation of smoking. Detailed analysis revealed that this effect was solely dependent on patients treated by surgery only. Lifelong non-smokers exhibited a significant survival advantage compared with active and former smokers, with no difference in survival between these last two groups. These findings indicated that patients should be encouraged to at least minimize smoking following cancer diagnosis

Protecting Youth From Tobacco Around the Globe: Evidence to Practice

Published: 01/09/2020, Paediatrics

[report]

European practice patterns and barriers to smoking cessation after a cancer diagnosis in the setting of curative versus palliative cancer treatment

Published: 29/09/2020, European Journal of Cancer

Results: Responses from 544 oncologists were included. Oncologists appeared to favour addressing tobacco in the curative setting more than in the palliative setting. Oncologists believe that continued smoking impacts treatment outcomes (C: 94%, P: 74%) and that cessation support should be standard cancer care (C: 95%, P: 63%). Most routinely assess tobacco use (C: 93%, P: 78%) and advise patients to stop using tobacco (C: 88%, P: 54%), but only 24% (P)-39% (C) routinely discuss medication options, and only 18% (P)-31% (C) provide cessation support. Hesitation to remove a pleasurable habit (C: 13%, P: 43%) and disbelieve on smoking affecting outcomes (C: 3%, P: 14%) were disparate barriers between the curative and palliative settings (p < 0.001), but dominant barriers of time, resources, education and patient resistance were similar between settings.

Improved rates of treatment success following alcohol and other drug treatment among clients who quit or reduce their tobacco smoking

Published: 31/08/2020, Drug and Alcohol Review

Discussion and conclusions: Despite low overall rates of smoking cessation, our findings suggest clients who do successfully quit have a greater likelihood of achieving reductions in PDOC use and dependence severity. These results reinforce efforts to promote more comprehensive, routine provision of smoking cessation care (i.e. counselling and nicotine replacement therapy). AOD treatment presents a crucial opportunity to deliver smoking cessation care to all clients who smoke, particularly those who are unconcerned about their use, as this group may stand to benefit most.

Impact of smoking behavior on clozapine blood levels - a systematic review and meta-analysis

Published: 01/09/2020, Acta Psychiatrica Scandinavia

Conclusion: Smoking behavior and any change in smoking behavior is associated with a substantial effect on clozapine blood levels. Reductions of clozapine dose of 30% are recommended when a patient on clozapine stops smoking. Reductions should be informed by clozapine steady-state trough levels and a close clinical risk-benefit evaluation.

Severe Neurological Nicotine intoxication by e-cigarette liquids: Systematic Literature Review

Published: 31/08/2020, Acta Neurologica Scandinavia

Abstract Electronic cigarettes are a popular, easily purchased, alternative source of nicotine that is considered safer than conventional tobacco. However, Intentional or accidental exposure to e‐liquid substances, mainly nicotine, can lead to serious, potentially fatal toxicity. Emergency and critical care physicians should keep in mind acute intoxication of this poison with a biphasic toxic syndrome. We highlight its potentially fatal outcome and suggest monitoring the adverse effects of nicotine according to a multimodal protocol integrating somatosensory evoked potentials, electroencephalography and neuroimaging data with anamnestic report and toxicological and laboratory data.