Assess Tobacco Use Research Articles

Effectiveness of the Brief Guided Self-Change Therapy Combined with Varenicline under “Real-Life” Conditions and Mediators for Smoking Cessation

Background : Brief therapies have proven to reduce tobacco cost-effectively, however, unsuccessful quit attempts remain notable in real-life conditions, and the underlying mechanisms of treatment success are still unclear. Objectives : We aimed to analyze the effectiveness of the Guided Self-Change (GSC) therapy combined with varenicline (VAR+T) in public health services against varenicline alone (VAR), and to identify mediators of treatment outcomes. We conducted a two-arm quasi-experimental study with 126 treatment-seeking smokers (age=57.3±9.1 years; 59.5% women). Before treatment, and at weeks 12 and 24, we assessed tobacco use and five potential mediators: withdrawal, craving, motivation to quit, anxiety, and depression. Results : Only 25% of participants adhered to varenicline prescription, and 54% to GSC therapy. VAR+T group showed a greater proportion of abstainers compared to VAR group at week 12 (75% vs 57.4%; φc=0.21) and week 24 (62.9% vs 52.5%; φc=0.10). When controlling for weeks taking varenicline, motivation showed a significant indirect effect over abstinence rates in VAR+T compared with VAR (a1b1=1.34; 95%CI=0.04, 5.03). Conclusions : The GSC effectiveness seems to increase motivation which in turn contributes to reducing tobacco use. The implementation of GSC therapy in public health services could minimize treatment duration and increase smoking abstinence in ‘real-life’ conditions where varenicline adherence remains low.

Assessing tobacco use in Swedish young adults from self-report and urinary cotinine: a validation study using the BAMSE birth cohort

ObjectivesStudies on health effects of tobacco often rely on self-reported exposure data, which is subjective and can lead to misclassification. The aim of this study was to describe the prevalence...

Smoking cessation support and knowledge among newly diagnosed individuals at community cancer centers (ECOG-ACRIN trial EAQ171CD).

1522 Background: ASCO recommends that all individuals diagnosed with cancer who smoke receive tobacco treatment support. Oncology clinicians can use the 5As (Ask, Advise, Assess, Assist (e.g., talk about quitting and recommend medication), and Arrange follow-up) to provide this support. Previous studies that have typically assessed clinician-reported delivery of 5As, so we assessed patient-reported receipt of 5As to 1) assess prevalence of 5As receipt and variations by tumor type (smoking vs non-smoking-related) and 2) associations between 5As receipt and patient knowledge about smoking risks and motivation to quit. Methods: We analyzed baseline data of 306 patients enrolled in a randomized trial coordinated by the ECOG-ACRIN NCI Community Oncology Research Program (NCORP) Research Base from 37 sub-affiliate Community and Minority/Underserved practices to ascertain whether 5A receipt differs for individuals with a smoking-related vs non-smoking-related tumor and whether patients’ motivation and knowledge of the risks of continued smoking (0 to 10) differs by smoking-related tumor and 5As receipt. Eligibility criteria included a recent cancer diagnosis, English or Spanish-speaking, having smoked a cigarette in the past 30 days, and planning to receive treatment at a participating site. Results: 306 patients enrolled between 08/2019 and 12/2022 (70.9% female; 84.9% white non-Hispanic, 8.8% Black; 3% Hispanic; median age = 57 years); 51% had non-smoking-related tumors. Quit motivation was lower for non-smoking-related vs. smoking-related tumors (median= 7 (interquartile range (IQR): 5,9) vs median= 9 (IQR: 5,9) but knowledge of smoking risks (e.g., How much quitting improves chances of getting the full benefit of treatment) were similar (median = 10 (IQR: 8,10) vs 10 (IQR: 9,10)). Rates of Ask and Advise were high and similar for non-smoking-related and smoking-related tumors (Ask =94.7% vs 96.5% and Advise =89.3% vs 91.0%, respectively). However, rates of Assist were lower for non-smoking-related tumors vs. smoking-related tumors (e.g., talked about quitting =70.0% vs 79.2%; recommended cessation medication =63.3% vs. 72.2%) and Arrange follow-up =27.3% vs 37.5%. Quit motivation was lower for those who had not received the 5As (Ask median=7 (IQR 5,9) vs 9 (IQR 5,9); Assist talked about quitting median=7 (IQR: 5,9) vs 9 (IQR: 5,9) or Assist recommended cessation medication (median=6 (IQR: 5,9) vs 9 (IQR: 5,9)). Conclusions: Rates of assessing tobacco use and advising cessation at community cancer centers are high for addressing smoking but lower for actual assistance, particularly among patients with non-smoking-related tumors. This underscores the importance of clinicians discussing smoking, highlighting persistent smoking risks and the benefits of cessation, and providing actionable recommendations to reduce smoking risks for all patients. Clinical trial information: NCT03808818 .

Healthy lifestyle behaviors among a diverse population of early posttreatment adolescent and young adult (AYA) survivors participating in a virtual stress management program.

e24048 Background: Adolescent and young adults (AYA) cancer survivors have worse long-term physical health than survivors of adult cancers. Healthy lifestyle behaviors can maximize physical health and enhance quality of life. The National Comprehensive Cancer Network (NCCN) publishes survivorship guidelines for healthy behaviors; however, it is unclear if AYA survivors follow these recommendations. Methods: This is a secondary analysis of a waitlist-controlled trial of an adapted mind body stress management group program for AYA survivors recruited between 03/2019-09/2020. Participants completed self-report questionnaires assessing tobacco use, e-cigarette use, alcohol use, physical activity, and sleep quality both before and after completing the 8-week group program. Descriptive statistics were used to characterize the proportions of survivors meeting NCCN guidelines at time of enrollment. Results: Seventy-two AYA survivors participated in this study (mean age 24, 74% female, 60% Non-Hispanic White, 21% Hispanic, 4% Black, 53% hematologic malignancy, mean 1.6 years post-treatment).Table 1 summarizes NCCN guidelines and concordant behavior at enrollment. Most participants met guidelines for tobacco and e-cigarette use at study entry, with the majority reporting they abstained from using tobacco (85%) and e-cigarettes (90%). Only 28% reported abstaining from any alcohol use. Of those who consumed alcohol, most reported consuming < 3 drinks per day (83%), but 65% endorsed at least occasional binge drinking behavior ( > 5 drinks). Only 52% met guidelines for vigorous- or moderate- intensity activity (i.e. 75 and 150 minutes weekly, respectively). Specifically, participants reported a median of 47.5 minutes/week (IQR 0-120 min/week) of vigorous-intensity activity and 60 minutes/week (IQR 30-140) of moderate-intensity activity. Many experienced sleep concerns, with only 30% reporting good or very good sleep (i.e. > 4 on a 1 (very poor)-5 (very good) Likert scale). Conclusions: In a racially/ethnically diverse sample of AYA survivors, NCCN survivorship guideline concordance for healthy lifestyle was mixed. Of concern was that AYA survivors’ use of tobacco and e-cigs was similar to the general population. Furthermore, alcohol and physical activity recommendations were mostly not followed, and reported sleep quality was poor. These results highlight the need to better understand barriers and promote healthy lifestyles to optimize post-treatment outcomes. [Table: see text]

IQOS® Cross-Sectional and Cohort US Study Documentation

BACKGROUND: The FDA’s modified risk authorization for IQOS® is contingent upon approved post-market surveillance studies. The IQOS® Cross-Sectional Post-Market Adult Consumer Study (hereinafter termed IQOS® CS PACS) and the IQOS® Longitudinal Cohort Post-Market Adult Consumer Study (hereinafter termed IQOS® LC PACS) are contiguous surveys designed to fulfill this proviso. OBJECTIVES: IQOS® CS PACS seeks to assess tobacco use patterns in IQOS® users, risk perceptions of IQOS®, and tobacco transition and cessation behaviors related to IQOS®. The IQOS® LC PACS aims to follow over time, and in comparison with cigarette users, these same parameters with additional emphasis on transitions and health outcomes. METHODS AND RESULTS: The IQOS® CS PACS is a repeated cross-sectional study to be conducted annually for four years. The IQOS® LC PACS is a longitudinal study, planned to follow a cohort of new IQOS® users for two years. Potential adult IQOS® consumers aged 21 and older will be recruited from an IQOS® consumer database. Both studies will use self-administered online screening and survey assessment. At least 250 adult ever established IQOS® users (current and former) constitute the target sample size for each administration of the IQOS® CS PACS. The target sample size for the IQOS® LC PACS is 2,100 adult IQOS® users and 1,600 adult cigarette smokers as control. Data analysis includes descriptive statistics for pre-defined outcomes and inferential statistics (e.g., generalized estimating equations and propensity scoring) to compare outcomes among IQOS® and cigarette smokers. The IQOS® CS PACS is designed to commence one year after IQOS® modified risk tobacco product authorization (MRTPA) and will recur annually over the course of four years. The IQOS® LC PACS will begin two years after issuance of the IQOS® modified risk order and has been designed to follow up with participants at 3-, 6-, 12-, 18-, and 24-months from initiation. Final reports will be generated and shared with the FDA when the studies are completed. CONCLUSIONS: Postmarket studies can help inform outcomes related to risk perceptions, tobacco use patterns, and health status related to IQOS® use in a real-world setting.

34 Normative beliefs about tobacco products differ by age: Implications for smoking cessation and harm reduction

OBJECTIVES/GOALS: The prevalence of combusted cigarette (CC) smoking among older adults is stagnant, with zero declines attributable to e-cigarette (EC) use. Normative beliefs predict quitting and switching to ECs (a behavior likely to yield health benefits for those unable to quit), so this study seeks to characterize the role of age in norms about CC and EC use. METHODS/STUDY POPULATION: Data come from Wave 5 (2018-2019) of the adult Population Assessment of Tobacco Use and Health (PATH) study, a nationally-representative, U.S. longitudinal cohort. Analyses were restricted to people with established CC use (smoked CCs in the past year, currently smoke regularly, and smoked ≥100 lifetime CCs; n=8,590). Cross-sectional weighted estimates of the prevalence of normative beliefs about CCs and ECs were calculated by age using the Balanced Repeated Replication (BRR) method with Fay=0.3. We used chi-square tests to examine the association of age group (18-24, 25-34, 35-44, 45-54, 55-64, or ≥65) with the prevalence of 2 descriptive and 4 personal social norms. RESULTS/ANTICIPATED RESULTS: The prevalence of the normative belief that most people disapprove of CCs (p DISCUSSION/SIGNIFICANCE: Older adults are more likely than younger adults to endorse anti-tobacco norms, which prior work shows is associated with quitting smoking. These beliefs could be leveraged to create targeted communications towards older adults encouraging smoking cessation. More research is needed to assess age-related tobacco beliefs and switching from CC to EC.

Motives of Tobacco Use Among Young Adults in the United States Air Force.

Research has focused on cigarette use motives and have not included military personnel. The current study assessed tobacco use motives for different products, and differences within males and females and those with different racial identities given historical disparities in tobacco use. A cross-sectional survey about tobacco use was administered from October 2019 to February 2022. Four Technical Training bases in the US. Air Force Airmen who used tobacco (N = 3243). Questions were about sociodemographic characteristics, tobacco use, and the Tobacco Motives Inventory (representing affect regulation, boredom, enhancement, and social motives). Linear regressions assessed associations between overall tobacco use and motives. Stratified analyses assessed associations between tobacco use and motives among males and females, and individuals from different racial backgrounds. Logistic regressions assessed differences in motives and use of different tobacco products between "some day" and "everyday" users. Overall, boredom (B = .09, SE = .01) and affect regulation (B = .05, SE = .00) motives were associated with higher tobacco use. Males and females and individuals from different racial backgrounds endorsed different motives, but all endorsed boredom as a motive for higher tobacco use. Individuals who used cigarettes, e-cigarettes, or smokeless tobacco "some days" endorsed higher social motives than everyday users, but everyday users endorsed different motives across products. There are motives differentiating between "some day" and "everyday" users of tobacco products, which may need to be differentially targeted in intervention programs. Additionally, there are some overlapping motives (affect regulation, boredom) that may be beneficial to address with all tobacco users.

Changes in Substance Use Treatment Providers' Delivery of the 5A's for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation.

Tobacco use treatment is not prioritized in substance use treatment centers (SUTCs), leading to tobacco-related health inequities for patients with substance use disorders (SUDs) and necessitating efforts to enhance providers' care provision. Training providers on how to treat tobacco use increases their intervention on patients' smoking, but limited work addresses its effects on their non-cigarette tobacco use intervention provision. This study redressed this gap using data from 15 unaffiliated SUTCs in Texas (serving 82,927 patients/year) participating in a tobacco-free workplace program (TFWP) that included provider education on treating tobacco use, including non-cigarette tobacco use. SUTC providers completed surveys before (n = 259) and after (n = 194) TFWP implementation. Past-month screening/intervention provision for non-cigarette tobacco use (the 5A's; ask, advise, assess, assist, arrange) and provider factors theoretically and practically presumed to underlie change [i.e., beliefs about concurrently treating tobacco use disorder (TUD) and other SUDs, self-efficacy for tobacco use assessment (TUA) delivery, barriers to treating tobacco dependence, receipt of tobacco intervention training] were assessed. Generalized linear or linear mixed models assessed changes over time from before to after TFWP implementation; low vs. high SUTC-level changes in provider factors were examined as moderators of changes in 5A's delivery. Results indicated significant improvement in each provider factor and increases in providers' asking, assisting, and arranging for non-cigarette tobacco use over time (ps < 0.04). Relative to their counterparts, SUTCs with high changes in providers' beliefs in favor of treating patients' tobacco use had greater odds of advising, assessing, assisting, and arranging patients, and SUTCs with greater barrier reductions had greater odds of advising and assisting patients. Results suggest that TFWPs can address training deficits and alter providers' beliefs about treating non-tobacco TUD during SUD care, improve their TUA delivery self-efficacy, and reduce intervention barriers, ultimately increasing intervention provision for patients' non-cigarette tobacco use. SUTCs with the greatest room for improvement in provider beliefs and barriers to care provision seem excellent candidates for TFWP implementation aimed at increasing non-cigarette tobacco use care delivery.

The Association of Smoking with Contact Dermatitis: A Cross-Sectional Study.

Contact dermatitis is a chronic inflammatory skin disorder with a highly variable prevalence worldwide. Smoking plays a crucial role in mediating inflammatory skin conditions such as contact dermatitis. The present study aimed to investigate the association between smoking status and contact dermatitis in the Saudi population. The patients in the present study were individuals older than 18 years who were diagnosed with contact dermatitis and received a patch test at the Department of Dermatology of King Saud University Medical City from March 2003 through February 2019. All patients were interviewed by phone to complete a specific pre-designed questionnaire to assess tobacco use or exposure history. The total number of enrolled patients in the study was 308 (91 males and 217 females), all with contact dermatitis. Data from the present study suggest that the prevalence of allergic contact dermatitis in smokers may be less than that in non-smokers. Moreover, the prevalence of irritant contact dermatitis in smokers is more significant than in non-smokers. Finally, left-hand contact dermatitis is significantly associated with smoking. Therefore, there is a strong association between smoking and irritant contact dermatitis, especially in the Saudi population, regarding the left hand. Further epidemiologic studies are needed to further explore the role of smoking in the occurrence of contact dermatitis and to explore the possible mechanisms.

Awareness regarding the antitobacco laws and perceptions regarding interventions for effective tobacco control among young adults of Haryana, India.

Tobacco is one of the major behavioral risk factors for noncommunicable diseases in India. Tobacco control depends on public awareness regarding prevalent antitobacco measures. The present study documents the understanding of young adults (<25 years) regarding the antitobacco laws and their perception regarding interventions for effective tobacco control. A cross-sectional study was conducted in two districts of Haryana. A semistructured questionnaire was used to assess tobacco use, participants' awareness of sections 4, 5, 6 (a), and 8 of the Cigarette and Other Tobacco Products Act (COTPA, 2003), sources of information about antitobacco laws, and their implementation. The perception of participants about the effectiveness of laws and provisions was assessed using a three-point Likert scale. Of the 1470 participants, 517 (35.2%) smoked or used smokeless products. They reported the media (84.6%) to be the most critical source of information about antitobacco laws, followed by the health department (57.6%) and family/peer group (44.9%). Most participants were aware of the prohibition of smoking in offices or banks, educational institutions, hospitals, and other public places. Both tobacco users and nonusers perceived health education programs to be an effective intervention to reduce tobacco use (P < 0.01). The awareness regarding COTPA has increased among the general population. The media could be a powerful tool to counteract the pro-tobacco cues in society. The need of the hour is to focus on improving compliance with antitobacco laws at the population level to achieve a tobacco-free India.

Implementation strategies to increase smoking cessation treatment provision in primary care: a systematic review of observational studies

BackgroundInternationally, there is an ‘evidence-practice gap’ in the rate healthcare professionals assess tobacco use and offer cessation support in clinical practice, including primary care. Evidence is needed for implementation strategies enacted in the ‘real-world’. Aim: To identify implementation strategies aiming to increase smoking cessation treatment provision in primary care, their effectiveness, cost-effectiveness and any perceived facilitators and barriers for effectiveness.Methods‘Embase’, ‘Medline’, ‘PsycINFO’, ‘CINAHL’, ‘Global Health’, ‘Social Policy & Practice’, ‘ASSIA Applied Social Sciences Index and s’ databases, and grey literature sources were searched from inception to April 2021. Studies were included if they evaluated an implementation strategy implemented on a nation-/state-wide scale, targeting any type of healthcare professional within the primary care setting, aiming to increase smoking cessation treatment provision. Primary outcome measures: implementation strategy identification, and effectiveness (practitioner-/patient-level). Secondary outcome measures: perceived facilitators and barriers to effectiveness, and cost-effectiveness. Studies were assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. A narrative synthesis was conducted using the Expert Recommendations for Implementing Change (ERIC) compilation and the Consolidated Framework for Implementation Research (CFIR).ResultsOf 49 included papers, half were of moderate/low risk of bias. The implementation strategy domains identified involved utilizing financial strategies, changing infrastructure, training and educating stakeholders, and engaging consumers. The first three increased practitioner-level smoking status recording and cessation advice provision. Interventions in the utilizing financial strategies domain also appeared to increase smoking cessation (patient-level). Key facilitator: external policies/incentives (tobacco control measures and funding for public health and cessation clinics). Key barriers: time and financial constraints, lack of free cessation medications and follow-up, deprioritisation and unclear targets in primary care, lack of knowledge of healthcare professionals, and unclear messaging to patients about available cessation support options. No studies assessed cost-effectiveness.ConclusionsSome implementation strategy categories increased the rate of smoking status recording and cessation advice provision in primary care. We found some evidence for interventions utilizing financial strategies having a beneficial impact on cessation. Identified barriers to effectiveness should be reduced. More pragmatic approaches are recommended, such as hybrid effectiveness-implementation designs and utilising Multiphase Optimization Strategy methodology.Protocol registrationPROSPERO:CRD42021246683

Tobacco use in Kurnool – A Perspective using Global Adult Tobacco Survey Questionnaire

Background: Tobacco is a commonly used addictive substance which is one of the leading causes of morbidity and mortality worldwide. In India, tobacco is used in the form of smoking and smokeless tobacco. The diverse demographics of tobacco use, monitoring, raising awareness, and control policies are effective in halting the tobacco epidemic. In order to obtain these various data, the present study was undertaken with an aim to assess tobacco use among the people of Kurnool, India. Materials and Methods: A cross-sectional study was conducted which was a household interview-based survey. The study consists of demographic details such as age, education, occupation, and Global Adult Tobacco Survey questionnaire which consist of 20 questions on the usage and type of smoke and smokeless tobacco, second-hand smoke, cessation, anti-cigarette advertising, and economics. A total sample of 950 participants were included which was collected through cluster sampling method in Kurnool district. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 24. Descriptive statistics including frequency and percentages were calculated. Results: The study comprised 656 (69.1%) males and 294 (30.9%) females. The prevalence of tobacco smokers and smokeless tobacco were 163 (17.2%) and 46 (4.8%), respectively. A greater percentage of subjects who smoke inside the home daily and weekly were observed among male subjects and 15–30 years of age group. Conclusion: The prevalence was high among tobacco smokers compared to smokeless tobacco users. Furthermore, tobacco usage in the form of smoking and smokeless tobacco, which made quit attempt were observed more among male subjects, 41–50 years of age group, illiterates, and unskilled workers.

Uncovering the Smoking Habits of Undergraduate University Students: A Comprehensive Assessment of different varieties Tobacco Use

Uncovering the Smoking Habits of Undergraduate University Students: A Comprehensive Assessment of different varieties Tobacco Use

Tobacco use associations with multi-dimensional adverse health outcomes among in-school adolescents in four Caribbean countries

ABSTRACT The aim of the study was to assess tobacco use associations with multi-dimensional adverse health outcomes among adolescents in four Caribbean countries. Cross-sectional national adolescent school survey data (N = 9,143, median age 15 years) from Suriname, Jamaica, Trinidad and Tobago, and the Dominican Republic in 2016–2017 were analysed. Results show that 13.5% of participants were current tobacco users. Tobacco consumption increased the odds of multi-dimensional adverse health outcomes, including six inadequate mental health indicators, nine health risk behaviours, and five social-environmental outcomes. Tobacco use prevention should address the multi-dimensional adverse health outcomes.

Prevalence and denial of current tobacco product use: Combustible and heated tobacco products, Japan, 2022

Monitoring tobacco use has become more complex with the proliferation of novel tobacco products, including heated tobacco products (HTPs). We assessed the latest prevalence and denial of tobacco product use in Japan, a major market for HTPs. 28,124 individuals aged 16–74 responded to a nationwide, internet-based, self-reported survey. Current (past-30-day) tobacco use was assessed for HTPs, cigarettes, non-cigarette combustible tobacco, and dual (combustible plus HTP) use. Denial of current tobacco use was determined when respondents reported past-30-day use of a specific tobacco product (“On how many days did you use [the respective products]?”) but denied having used any tobacco (“Do you currently use tobacco?”) in the past 30 days. Descriptive and multivariable analyses were weighted to account for the selectivity of the internet-based sample. In 2022, current tobacco use was 11.8 % (HTPs), 19.4 % (cigarettes), 3.6 % (non-cigarette combustible tobacco), and 6.8 % (dual use). Among past-30-day users of specific tobacco products (N = 6,343), 19.5 % denied current tobacco use including single-product users of HTPs (10.0 %), cigarettes (21.7 %), and non-cigarette combustible tobacco (53.3 %), and dual users (20.2 %). The likelihood of denying current tobacco use was lower among exclusive HTP users and dual users compared to exclusive cigarette smokers; the likelihood was higher among females, never/non-current drinkers, less-frequent tobacco users, and those not reporting tobacco dependence. HTP use remained high in Japan. One-fifth of past-30-day tobacco users denied having used any tobacco products in the past 30 days. Increasing the sensitivity of questions to assess tobacco use can mitigate nondisclosure of tobacco use status.

Engaging Native American Students in Research Methodology through Development and Validation of a Tobacco Survey

Background: The purpose of this project was to provide a learning experience for AIAN undergraduate students participating in a summer academic enrichment program, Native Americans into Medicine (NAM). Through NAM, operated by the Center of American Indian and Minority Health, students learned quantitative and qualitative research skills. They applied these skills through the development of a culturally relevant survey to measure commercial tobacco use in AIAN teens and analysis of the survey results. Methods: In Phase/year 1, students learned qualitative research methods and interviewed participants of a regional Tribal community powwow to inform the cultural adaptation of the National Youth Tobacco Survey. In Phase/year 2, the students learned about quantitative research methods through the conduct of a cross-sectional study in which the survey was distributed to rural Minnesota schools to assess tobacco attitudes, use, intent to use, and factors influencing tobacco use in AIAN youth. NAM student participants then analyzed the survey data. Benchmarks for student success included: development of a tool to assess tobacco use in AIAN youth, conduct of research study, and dissemination of research results. Results: At the pow wow in year 1, twenty-six youth ranging between 12 and 18 years of age who self-identified as AIAN were recruited to participate in cognitive interviews. As a group, student researchers reviewed each survey question for possible revision and consideration for inclusion in the final survey. In year 2, completed surveys were obtained from 281 (15% of eligible) students from 5 schools; 256 surveys were usable. Thirty-one percent (N=80) students self-identified as AIAN; 56% were male. Students’ mean age was 15.8 years. Thirty-eight percent had ever tried cigarette smoking, even one or two puffs, and had ever vaped. As a cohort, students presented research results to health directors and providers at 2 tribal clinics. Discussion: In conclusion, this two-year cohort approach to teaching qualitative and quantitative research skills to AIAN students was successful by internal benchmarks, namely student researchers developed, implemented, and analyzed a survey appropriate for AIAN high school students, and all student researchers presented their research results at least once.

Development of a panel of U.S. adult tobacco users to inform tobacco regulatory science

The National Panel of Tobacco Consumer Studies (TCS Panel) is a probability-based panel of about 4,000 U.S. adult cigarette, cigar, and smokeless tobacco users developed by the U.S. Food and Drug Administration’s Center for Tobacco Products to conduct observational and experimental studies to inform tobacco regulatory activities. This paper describes the methods and characteristics of the current panel. The TCS Panel employed a stratified 4-stage sample design and in-person screening of U.S. sampled households. Selected eligible adults participated in an enrollment interview and completed a baseline survey assessing tobacco use behaviors to enroll in the Panel; 3,893 individuals were enrolled from September 2016–August 2017. Replenishment occurred from July 2019–December 2019 with 2,260 new members, for a current panel of 3,929 members. Demographic and tobacco use characteristics of the current panel were analyzed in 2020. Most demographic characteristics of the TCS Panel are similar to those of U.S. tobacco users in the 2018 National Health Interview Survey, suggesting a lack of systematic bias in the Panel. Small, but statistically significant, differences were observed in the proportion of 18- to 25-year-olds; high school diploma and bachelor’s degree/higher; never married and married (p < 0.05 for all). The TCS Panel appears to be representative of U.S. cigarette, cigar, and smokeless tobacco users; such panels can be a feasible method for conducting tobacco regulatory science research. The TCS Panel has been used to field studies examining purchasing behaviors, receipt and use of free samples/coupons, and the impact of a hypothetical tobacco product standard.

Abstract 3677: Incorporating societal determinants of health with implementation science to increase tobacco cessation patient and community responsiveness

Abstract Background: Implementing tobacco cessation has been challenging across multi-racial and multi-ethnic regional communities. Multilayered influences of Societal Determinants of Health (SDH), social risks, environment, role of stress and perceived levels, tobacco addiction and behaviors are complex. Effective identification of social risk factors and unmet social needs of individuals can enhance tobacco treatment quality, and care coordination across the healthcare continuum. Integrating SDH and Implementation science into electronic health record (EHR) can provide both value and principles that promises to enhance patient and community responsiveness to address Catchment Area cancer burden and health disparities. Methods: We included a 33 item SDH measure to our tobacco use assessment (TUA) instrument and applied implementation science with tobacco cessation program at City of Hope (COH). Our SDH assesses patients’ appraisal of their contextual distress including access to primary and cancer related medical care, technology and digital access and proficiency, food insecurity, career/job, income, education distress; housing, living situation and social network/isolation and racism and discrimination stress. The measure follows a 5pt likert scale ranging from extreme stress to no stress. Results: This study compared 173 self-reported TUA. The mean age of first smoked a cigarette was 16 y.o. The mean age of first began smoking cigarettes regularly was 18 y.o. The mean total years of smoking was 36 years. Most participants were everyday smokers and on average, participants smoked I pack/day. &amp;gt;50% of the patients lived in a place where other people smoked cigarettes indoors. 55% of the patients tried to quit in the past 30 days. 60% of the patients indicated that it is EXTREMELY important for them to quit smoking/tobacco and indicated interest in tobacco cessation. Half of the patients indicated they are NOT SO confident in their ability to quit smoking/tobacco. Below are the items commonly endorsed as extreme stressful: Health and cancer outcomes, using telehealth (e.g., using a smartphone or tablet for tele/virtual clinical visits, patient portal, completing online forms, virtual classes), money or finances, and functional strain (e.g., family demands). Conclusions: SDH is complex and multilayered as well as understudied. The results support the small body of research documenting the necessity and utility of measuring and addressing SDH to correct health disparities. Increased prioritization including assessing and intervening with strategic planning and IT integration is required to better understand and address the cancer impact including tobacco cessation relevant to SDH. Successful tobacco control programs can benefit from IT integrated, culturally and community informed SDH assessments using implementation science principles. Citation Format: Kimlin T. Ashing, Sophia Yeung, Cary A. Presant, Jonjon Macalintal, Brian Tiep, J Sandoval, Brenda Gascon, R Salgia, Susan J. Brown, Steven Rosen. Incorporating societal determinants of health with implementation science to increase tobacco cessation patient and community responsiveness [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3677.

Neighborhood socioeconomic disadvantage, tobacco use, and cessation indicators among adults with cancer in the United States: Results from 10 ECOG-ACRIN trials.

6514 Background: Tobacco use is a modifiable risk factor for adverse outcomes among patients diagnosed with cancer. Despite ASCO’s recommendation for assessment and treatment of tobacco use, integration into cancer care is suboptimal. Socioeconomic contexts influence access and utilization of tobacco treatment, but little is known about the relationship between neighborhood socioeconomic disadvantage (NSD) and tobacco assessment, assistance, and cessation among cancer patients enrolled in clinical trials. Methods: The NCI Cancer Patient Tobacco Use Questionnaire (C-TUQ) was centrally administered to participants enrolled in 10 ECOG ACRIN clinical trials (9 therapeutic, 1 imaging). We examined associations of NSD with patient-reported rates of receiving brief tobacco cessation support (i.e., Ask, Assist (counseling)) and cessation (past 30d quit attempts and duration). NSD was measured using the national Area Deprivation Index (ADI) based on participant’s zip code. Associations between ADI (low, intermediate, and high) and tobacco variables were evaluated using logistic regression and ANOVA. Results: 740 patients, completing the C-TUQ between June 2017-October 2021, can be classified as 402 (54%) never smokers, 81 (11%) current smokers, and 257 (35%) former smokers. Patients were 70% male; 94% white; 3% Hispanic; mean age 58.8 (SD 9.0). Cancer diagnoses were 36% leukemia; 19% lymphoma, 18% prostate, 11% breast; 9% melanoma, 7% myeloma, and 0.5% head and neck. Patients were categorized into high (33%), intermediate (34%) and low (33%) disadvantaged neighborhoods. Patients in high (vs. low) disadvantaged neighborhoods were more likely to report being asked about smoking (OR = 3.90; 95% CI (confidence interval), 1.61 to 9.46; p = 0.0062) but less likely to report receiving counseling to help quit smoking (OR = 0.20; 95% CI, 0.06 to 0.73; p = 0.0234). Patients from high disadvantaged neighborhoods had the shortest quit duration, followed by patients from intermediate and low disadvantaged neighborhoods (mean = 145.78, 187.66, and 210.98 months, respectively, p = 0.0372). Conclusions: Greater socioeconomic neighborhood disadvantage was associated with increased assessment of tobacco use but decreased tobacco treatment referral, and the shortest quit duration. More research is needed to promote increased referral to tobacco treatment for individuals with cancer from disadvantaged neighborhoods to promote and sustain cessation.

Daily E-cigarette Use and the Surge in JUUL Sales: 2017-2019.

To identify how the 2017 rapid surge in sales of JUUL e-cigarettes affected usage among US youth and young adults. Annual surveys in the Population Assessment of Tobacco and Health Study assess tobacco use by product and brand among the US population. We identified 2 cohorts aged 14 to 34 years, 1 with baseline survey in 2014 before the rapid surge of JUUL and the other in 2017 as the surge in JUUL sales was occurring. For 5 age groups, we compared 2-year incidence of first tobacco use and of new-onset daily tobacco use by product, and report levels of dependence. Sociodemographic variables and rates of experimentation with any tobacco product were similar between cohorts. Among baseline nondaily tobacco users, only those aged 14 to 17 years had an increase in the 2-year incidence of new daily tobacco use (2014 cohort = 4.8%, 95% confidence interval 4.3, 5.5 vs 2017 cohort = 6.3%, 95% confidence interval 5.8-7.0) to rates approaching those in the 1990s. In 2019, three-quarters of new daily tobacco users aged 14 to 17 vaped daily and had e-cigarette dependence scores similar to daily cigarette smokers and older adult e-cigarette vapers. We estimate that about 600 000 Americans aged <21 years used JUUL products daily in 2019, a rate 2.5 times those aged 25 to 34 years. The surge in US JUUL sales was associated with a sharp rise in daily e-cigarette vaping and daily tobacco use among US youth, not young adults.