Daily Tobacco Smoking Research Articles

Public awareness, prevalence, and regulations for the sale of electronic cigarettes in Arab countries: A narrative review.

The majority of the Arab countries have high records of daily tobacco smoking. Electronic cigarettes (e-cigarettes) use has exponentially increased in the past decade in Arab countries. Consumers' willingness to quit smoking traditional cigarettes and their perception of e-cigarettes as a safer alternative to conventional cigarettes have increased the demand for these devices. This narrative review aimed to gather and discuss the available literature on the awareness, prevalence, and sales regulations of e-cigarettes in Arab countries. A search was conducted on electronic databases such as PubMed, Medline, Scopus, and Google Scholar with no time limits until the end of 2021. Some of the recent studies (2019-2021) considered in this review have reported that more than 25% of participants were e-cigarettes users. The prevalence of e-cigarettes has increased drastically with raised awareness of e-cigarettes among the population in these Arab countries. Most of the users of e-cigarettes are young males. In addition, an increase in e-cigarettes use has been reported in females. The policies which regulate trade and sale of e-cigarettes and related products were issued in only three Arab countries. In contrast, regulations for the trade and sale of traditional cigarette products are also applied in some countries to e-cigarette products, banning the sale of e-cigarettes to minors and/or amend smoke-free laws to restrict public use of e-cigarettes. There is a need for a concerted effort to assess the prevalence and significant rise of e-cigarettes consumption in Arab societies to help implement and improve harm reduction policies.

Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021

While rates of cigarette use are declining, more US adults are using cannabis. Perceptions of safety are important drivers of substance use and public policy; however, little is known about the comparative views of US adults on tobacco and cannabis safety. To compare public perceptions of safety of cannabis vs tobacco smoke and evaluate how perceptions may be changing over time. This longitudinal survey study was conducted using a web-based survey administered in 2017, 2020, and 2021. US adults participating in Ipsos KnowledgePanel, a nationally representative, population-based survey panel, were included. Data were analyzed from March 2021 through June 2023. Two questions directly compared the perception of safety of cannabis vs tobacco in terms of daily smoking and secondhand smoke exposure. Additional questions assessed perceptions of safety of secondhand tobacco smoke for adults, children, and pregnant women, with an analogous set of questions for secondhand cannabis smoke. A total of 5035 participants (mean [SD] age, 53.4 [16.2] years; 2551 males [50.7%]) completed all 3 surveys and provided responses for tobacco and cannabis risk questions. More than one-third of participants felt that daily smoking of cannabis was safer than tobacco, and their views increasingly favored safety of cannabis vs tobacco over time (1742 participants [36.7%] in 2017 vs 2107 participants [44.3%] in 2021; P < .001). The pattern was similar for secondhand cannabis smoke, with 1668 participants (35.1%) responding that cannabis was safer than tobacco in 2017 vs 1908 participants (40.2%) in 2021 (P < .001). Participants who were younger (adjusted odds ratio [aOR] for ages 18-29 years vs ≥60 years, 1.4 [95% CI, 1.1-1.8]; P = .01) or not married (aOR, 1.2 [95% CI, 1.0-1.4]; P = .01) were more likely to move toward safer views of cannabis use over time, while those who were retired (aOR vs working, 0.8 [95% CI, 0.7-0.9]; P = .01) were less likely to move toward a safer view of cannabis. Participants were also more likely to rate secondhand smoke exposure to cannabis vs tobacco as completely or somewhat safe in adults (629 participants [12.6%] vs. 119 participants [2.4%]; P < .001), children (238 participants [4.8%] vs. 90 participants [1.8%]; P < .001), and pregnant women (264 participants [5.3%] vs. 69 participants [1.4%]; P < .001). This study found that US adults increasingly perceived daily smoking and secondhand exposure to cannabis smoke as safer than tobacco smoke from 2017 to 2021. Given that these views do not reflect the existing science on cannabis and tobacco smoke, the findings may have important implications for public health and policy as the legalization and use of cannabis increase.

Alcohol versus combined alcohol and energy drinks consumption: Risk behaviors and consumption patterns among European students.

Recent research found that drinking alcohol mixed with energy drinks (AmED) could be riskier than drinking alcohol alone. Our aim was to compare rates of risk behaviors in consumers of AmED versus exclusive alcohol drinkers, matching them based on their drinking frequency. Data about 16-year-old students who reported the number of occasions on which they had drunk AmED or alcohol only in the preceding 12 months (n=32,848) were drawn from the 2019 ESPAD study. After matching for consumption frequency, the sample consisted of 22,370 students (11,185 AmED consumers and 11,185 exclusive alcohol drinkers). Key predictors comprised substance use, other individual risk behaviors, and family characteristics (parental regulation, monitoring, and caring). The multivariate analysis showed significantly higher odds of being AmED consumers compared to being exclusive alcohol drinkers in the majority of the investigated risk behaviors, including: daily tobacco smoking, illicit drug use, heavy episodic drinking, truancy at school, engaging in physical fights and serious arguments, having troubles with the police, and having unprotected sexual intercourse. Instead, lower odds were found for reporting high parents' educational level, medium and low family economic status, perceived possibility to freely talk about problems to family members, spending free time reading books or other hobbies. Our study shows that, given the same consumption frequency in the past year, AmED consumers typically reported higher associations with risk-taking behaviors compared to exclusive alcohol drinkers. These findings advance past research that failed to control for the frequency of AmED use versus exclusive alcohol consumption.

Diurnal symptoms of sleepiness and dysfunction predict future suicidal ideation in a French cohort of outpatients (FACE-DR) with treatment resistant depression: A 1-year prospective study about sleep markers

BackgroundPatients suffering from treatment-resistant depression (TRD) are at risk of suicide. Sleep and circadian rhythm alterations are widely recognized as core symptoms of major depressive disorder and are associated with suicidal ideation. Thus, sleep and circadian rhythm alterations may be targeted to prevent suicide. MethodsPatients were recruited from a prospective cohort of the French network of TRD expert centers. Mood, sleep and circadian rhythms were assessed at baseline; suicidal risk was assessed both at baseline and during a one-year follow-up with standardized subjective questionnaires. ResultsExcessive daytime sleepiness (adjusted odds ratio aOR = 1.7(1–3.3), p = 0.04) and daytime dysfunction (aOR = 1.81(1.16–2.81), p = 0.0085) increased the risk of suicidal thoughts over the one-year follow-up period in patients with TRD after adjustment on age, gender, depression, trauma, anxiety, impulsivity, current daily tobacco smoking and body mass index. Hypnotics intake is associated with a reduced risk of suicidal ideation at one-year follow-up after the same adjustments (OR = 0.73(0.56–0.95), p = 0.019). Other associations between sleep quality or circadian rhythms and suicidal ideations at either baseline or one year did not remain significant in multivariate analyses after the same adjustments. LimitationsSleep assessments were based on self-reported questionnaires rather than objective measures. ConclusionsDaytime sleepiness and dysfunction are predictors of suicidal ideations, whereas hypnotics intake is associated with a reduced risk of suicidal ideations. Diurnal symptoms of sleep disturbances are therefore red flags to target for preventing suicide in depressed patients, and hypnotics seem efficient in preventing suicide for patients with TRD.

Prevalence of mortality among covid-19 patients in Kurdistan Region and various parts of the world and the role of ecological and environmental factors in shaping SARS-CoV-2 virulence

Evolutionary theories predict that virulence (host death due to a pathogen) positively associates with the pathogen transmission rates to new susceptible hosts. Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), the causative agent of coronavirus disease 2019 (covid-19) pandemic, like other RNA viruses, has quite variable genetic content due to its unique nucleus enzymes thus mutations can continuously occur during viral replications. Phenotype variations among new viral progeny can include individuals with different replication rates, infectivity, stability in the abiotic environment, and transmission rate. Here, the rate of transmission to new susceptible hosts may be affected by the pathogen’s vitality in the physical environments, and host-related factors such as control measures and vaccination. In this study, we analyzed the mortality rates of covid-19 positive patients among various parts of the world and explain the role of several factors in determining SARS-CoV-2 virulence. We found a weak negative correlation (R2 = 0.3) between the mortality rate of covid-19 patients and each of death rates due to cancer diseases (F = 9.135, P = 0.006) and the number of medical doctors per 10,000 populations (F = 8.104, P = 0.009). Other factors such as the prevalence of current daily tobacco smoking in males/females, life expectancy in males/females, general death rates, cardiovascular diseases, prevalence of COPD, prevalence of asthma and average yearly temperature did not associate with death rates among covid-19 patients. Inclusion, adequacy of healthcare services and proper infection prevention measures are the key factors to reduce the covid-19 mortality rate. More studies are required to better understand the management of SARS-CoV-2 virulence management.

Brain morphology predictors of alcohol, tobacco, and cannabis use in adolescence: A systematic review

In the last decade, extensive research has emerged on the predictive value of brain morphology for substance use initiation and related problems during adolescence. This systematic review provides an overview of longitudinal studies on pre-existing brain variations and later initiation of alcohol, tobacco, and cannabis use (N = 18). Adolescent structural neuroimaging studies that started before substance use initiation suggest that a smaller anterior cingulate cortex (ACC) volume, thicker or smaller superior frontal gyrus, and larger nucleus accumbens (NAcc) volume are associated with future alcohol use. Also, both smaller and larger orbitofrontal cortex (OFC) volumes were associated with future cannabis and combined alcohol/cannabis use. Smaller amygdala volumes were related to future daily tobacco smoking. These findings could point to specific vulnerabilities for adolescent substance use, as these brain areas are involved in cognitive control (ACC), reward (NAcc), motivation (OFC), and emotional memory (amygdala). However, the reported findings were inconsistent in directionality and laterality, and the largest study on alcohol use predictors reported null findings. Therefore, large population-based longitudinal studies should investigate the robustness and mechanisms of these associations. We suggested future research directions regarding sample selection, timing of baseline and follow-up measurements, and a harmonization approach of study methods.

Characterizing tobacco and marijuana use among youth combustible tobacco users experiencing homelessness \u2013 considering product type, brand, flavor, frequency, and higher-risk use patterns and predictors

BackgroundCigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention.MethodsThis study included 96 youth (ages 14–24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana.ResultsMost youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one’s housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors.ConclusionsYoung combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.

The Prevalence of Tobacco, Heated Tobacco, and E-Cigarette Use in Poland: A 2022 Web-Based Cross-Sectional Survey.

Monitoring tobacco use on a regular schedule is a basic tool of tobacco control policy. This study aimed (1) to assess the current prevalence and patterns of tobacco and e-cigarette use, as well as (2) to identify socioeconomic factors associated with smoking behavior among adults in Poland. This cross-sectional study was carried out in March 2022 on a nationwide, representative sample of 1090 adults in Poland. The computer-assisted web interview (CAWI) technique was used. Daily tobacco smoking was declared by 28.8% of respondents (27.1% of females and 30.8% of males; p = 0.2) and 4.2% were occasional smokers (4.2% of females and 4.3% of males; p = 0.8). Most of the current smokers (62.1%) smoked regular cigarettes and 25.2% smoked hand-rolled cigarettes. The prevalence of daily e-cigarette use was 4.8% (4.0% among females and 5.6% among males; p = 0.2). Daily heated tobacco use was declared by 4.0% of respondents (5.1% of females and 2.9% of males; p = 0.07). Age, having children, and educational level were significantly associated with current daily tobacco smoking. This study revealed a high prevalence of tobacco and e-cigarette use among adults in Poland. The presented data underscore the importance of further improvements in adopting a comprehensive tobacco control strategy in Poland.

Sociodemographic factors associated with daily tobacco smoking and binge drinking among Zambians: evidence from the 2017 STEPS survey

BackgroundThe burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in the African context. This study aimed to determine the sociodemographic factors associated with daily tobacco smoking and binge drinking in Zambia.MethodsThe study stems from nationwide population-based representative survey data collected using the World Health Organization’s STEPwise approach for non-communicable disease risk factor surveillance in 2017 among 18–69-year-old Zambians. The main outcomes were daily tobacco smoking and binge drinking, and the demographic and socioeconomic variables included sex, marital status, age, residence, level of education and occupation. Prevalence ratios (PR) were calculated using log-binomial regression analysis.ResultsOverall, 4302 individuals (weighted percentage 49.0% men and 51.0% women) participated in the survey. The prevalence of daily tobacco smoking was 9.0%, and 11.6% of participants engaged in binge drinking, both of which were higher among men than women (17.1% vs. 1.3% and 18.6% vs. 5.3%, respectively). The adjusted prevalence of daily tobacco smoking was 14.3 (95% CI: 9.74-21.01) times higher in men than women, and 1.44 (95% CI 1.03-1.99) times higher in the > 45-year-old group compared to the 18–29-year-old group. Significant positive associations with daily tobacco smoking were found among those with no education 2.70 (95% CI 1.79- 4.07) or primary education 1.86 (95% CI 1.22-2.83) compared to those with senior secondary or tertiary education. The adjusted prevalence of daily tobacco smoking was 0.37 times lower (95% CI 0.16-0.86) among students and homemakers compared to employed participants. The adjusted prevalence of binge drinking was 3.67 times higher (95% CI 2.83-4.76) in men than in women. Significantly lower adjusted prevalences of binge drinking were found in rural residents 0.59 (95% CI: 0.46-0.77) compared to urban residents and in students/homemakers 0.58 (95% CI: 0.35-0.94) compared to employed participants.ConclusionThis study shows huge differences between men and women regarding tobacco smoking and binge drinking in Zambia. A high occurrence of tobacco smoking was observed among men, older members of society and those with lower levels of education, while binge drinking was more common in men and in those living in urban areas. There is a need to reshape and refine preventive and control interventions for tobacco smoking and binge drinking to target the most at-risk groups in the country.

Burden of tobacco in Nepal: a systematic analysis from the Global Burden of Disease Study 1990–2017

ObjectiveThis study systematically reviews the data extracted from the Global Burden of Disease Study and sets out to assess the age-specific and sex-specific mortality and disability attributable to different forms...

Patterns and Prevalence of Daily Tobacco Smoking in Australia by Industry and Occupation: 2007-2016.

Australian workers' daily tobacco smoking over time was examined by industry and occupation, to identify factors associated with high and/or low prevalence. Secondary analyses of 2007, 2010, 2013, and 2016 National Drug Strategy Household Surveys were undertaken (pooled n = 49 395). Frequency analyses informed subsequent modeling of select industries and occupations. Four logistic regression models estimated adjusted effects of demographics on daily smoking in industries with high (≥20%) and low (≤15%) daily smoking prevalence and occupations with high (≥20%) and low-moderate (<20%) daily smoking prevalence. The sample comprised 55.7% men, 34.1% 25-39-year-olds, 31.4% New South Wales residents, 70.1% metropolitan residents, 66.9% high socioeconomic status workers, and 70.6% with low psychological distress. Daily smoking prevalence differed by industry and occupation in 2007, generally decreasing between 2007 and 2016. In high prevalence industries, daily smoking was associated with male gender and age (25-39-year-olds) and in low prevalence industries with males and nonmetropolitan workers. In high prevalence occupations, daily smoking was associated with males, female nonmetropolitan workers, and age 25-39 years and in low-moderate prevalence occupations with nonmetropolitan workers and negatively associated with females aged 14-24 years. In all models, increased odds of daily smoking were associated with low socioeconomic status and very high psychological distress. Low socioeconomic status and very high psychological distress were risk factors for daily smoking regardless of industry, occupation, or high preexisting smoking prevalence. Targeted, as well as universal, interventions are required for workplaces and workers with greatest smoking vulnerability and least smoking cessation progress. Specific strategies are warranted for identified industries, occupations, and subgroups with increased odds of daily tobacco smoking. Industries and occupations with low-moderate smoking prevalence may confer workers some protection but are not without risk; some subgroups in these settings (eg, nonmetropolitan areas) had elevated daily smoking risk. Hence, the following are supported: (1) universal interventions directed at low socioeconomic workers and workers with very high psychological distress regardless of workplace; (2) interventions targeted at high prevalence industries; (3) cessation efforts targeted for young workers in high prevalence industries and occupations; and (4) focused interventions addressing specific needs of nonmetropolitan at-risk workers in low prevalence industries.

Changing patterns and prevalence of daily tobacco smoking among Australian workers: 2007–2016

ObjectiveTo map patterns and prevalence of daily smoking among employed Australians over time. MethodsData from four waves of the triennial National Drug Strategy Household Survey (2007, 2010, 2013 and 2016) were used to assess daily smoking. Frequency analyses and significance testing examined smoking prevalence by sex, age, state, remoteness, Indigeneity, socioeconomic status (SES) and psychological distress. Logistic regression models estimated adjusted effects of demographics on smoking prevalence. ResultsWorkers’ daily smoking prevalence reduced by 32% between 2007 and 2016. The adjusted model showed the lowest smoking reductions among men and non‐metropolitan workers. Other interaction effects showed the highest daily smoking rates for: male workers aged 14–39 years; low SES non‐metropolitan workers; and low SES workers aged 40–59 years. ConclusionsSpecific workplace policies, prevention and intervention strategies are warranted for male workers, especially those aged 14–39; non‐metropolitan workers, especially low SES rural workers; and low SES workers especially 40–59‐year‐olds. Implications for public healthIn spite of significant smoking reductions among workers over time, reductions were unevenly distributed. Tailored, innovative workplace prevention and intervention strategies that apply principles of proportionate universalism and address individual, workplace settings and cultural factors are warranted to reduce smoking disparities among male, rural and low SES workers.

Child maltreatment and neglect in the United Arab Emirates and relationship with low self-esteem and symptoms of depression

Objectives To our knowledge, this study is the first in the United Arab Emirates (UAE) to investigate the prevalence of child maltreatment in relation to depressive symptoms and self-esteem. Study design Exposure to physical maltreatment, emotional abuse and neglect was evaluated in 518 adolescents (86% response rate) randomly selected from schools in Al Ain in the Emirate of Abu Dhabi. The Rosenberg self-esteem scale and the Beck Depression Inventory were used to measure self-esteem and depressive symptoms by using multivariate logistic regression analyses. Results The mean age of study participants was 14.3 years. Emotional abuse was the most frequent form of maltreatment (33.9%), physical abuse (12.6%) and neglect (12.1%) followed. Male sex was a positive predictor of physical abuse (OR = 2.12; 95% CI 1.18–3.77), whilst higher maternal level of education was protective (OR = 0.40; 95% CI 0.19–0.86). Daily screen time (OR = 2.77; 95% CI 1.17–6.56) and tobacco smoking (OR = 1.86; 95% CI 1.09–3.18) positively predicted emotional abuse. Emotionally maltreated and neglected participants were less likely to report high level of self-esteem and more likely to report symptoms of depression. Conclusions Child maltreatment in the UAE is of a similar magnitude to what reported in other countries around the world and significantly associated with low self-esteem and depressive symptoms.

Age, Period and Cohort Analysis of Smoking Prevalence in Iranian Population over a 25-Year Period.

Current and daily smoking prevalence rates have been have investigated in several cross-sectional studies. However, analyses in terms of age-period-cohort (APC) have not been carried out. We assessed daily smoking dynamics over a 25-year period using the APC model. In our analyses, we used data from 214,652 people aged 15 to 64 years, collected by national health surveys conducted in 1990-1991, 1999, 2005, 2007, 2011 and 2016. The Intrinsic Estimator model was used to analyze the impact of APC on daily smoking prevalence. Males were found to exhibit a higher prevalence of smoking compared to females (26.0% against 2.7%). Prevalence of smoking increased by age, peaking at the age groups of 40-44 in men and 45-49 in women, followed by a decreasing trend. The 1990 period had the highest prevalence in both genders, and the 2016 period had the lowest. The coefficients of birth cohort effects showed different patter19s of fluctuations in the two genders with the maximum and minimum coefficients for men calculated in the 1966-1970 and 1991-95 birth cohorts, and for females the 1931-1935 and 1971-1975 birth cohorts, respectively. We showed the impact of APC on daily tobacco smoking prevalence, and these factors should be considered when dealing with smoking.

Experimenting first with e-cigarettes versus first with cigarettes and transition to daily cigarette use among adolescents: the crucial effect of age at first experiment.

Most studies in English-speaking countries have found a positive association between e-cigarette experimentation and subsequent daily tobacco smoking among adolescents. However, this result may not be valid in other cultural contexts; in addition, few studies have assessed whether this association varies with the subject' age at the time of e-cigarette experimentation. This study aimed to estimate the association between experimenting first with e-cigarette (rather than tobacco) and subsequent daily smoking according to age at the time of experimentation. Secondary analysis; risk ratios (RRs) computed using modified Poisson regressions with inverse probability weighting. A cross-sectional nation-wide representative survey performed in 2017 in France. French adolescents (n=24 111), aged 17 to 18.5years, who had previously experimented with either e-cigarettes or tobacco. Exposure was defined as the experimentation with e-cigarettes first (whether or not followed by experimentation with tobacco); the outcome as daily tobacco smoking at the time of data collection. Gender, age, literacy, socio-economic status, pre-exposure repeat school years and experimentation with drunkeness, 3 licit and 8 illicit drugs were adjusted for. Uncertainties about the sequence of events defining exposure were handled by the definition of three patterns of exposure, to avoid a misclassification bias. Exposure reduced the risk of transition to daily smoking: RR=0.58, 95% confidence interval (CI)=0.54, 0.62. This effect increased in a linear manner with age at exposure (RR=0.87, 95% CI=0.78; 0.98 for 1year, P<0.001): from RR=1.30, 95% CI=1.09; 1.54 at age 9 to RR=0.38, 95% CI=0.32; 0.45 at age 17. Experimenting with e-cigarettes first (as opposed to tobacco first) appears to be associated with a reduction in the risk of daily tobacco smoking among French adolescents aged 17-18.5, but this risk varies negatively with age at experimentation, and early e-cigarette experimenters are at higher risk.

Predictors of electronic cigarette use among Swedish teenagers: a population-based cohort study

ObjectivesThe aim was to identify predictors of electronic cigarette (e-cigarette) use among teenagers.Design and settingA prospective population-based cohort study of schoolchildren in northern Sweden.ParticipantsIn 2006, a cohort study about asthma...

Substance use, mental health, and life satisfaction in Czech straight and sexual-minority population

Abstract Background Evidence shows that sexual minorities are more vulnerable to substance use and psychological distress as a result of minority stress compared with heterosexuals. So far, research conducted outside North America or Western Europe has been underrepresented. This research compares for the first time the substance use, quality of mental health and life satisfaction between the sexual minority people and heterosexuals using a nationally representative probability sample in the Czech population. Methods Sample of the general population aged 15+ years surveyed within the National Survey on Substance Use in 2016 in randomly selected households (N = 3,601, F2F interviews). Prevalence of licit and illicit substance use, psychological distress (MHI-5 scale) and life satisfaction (SWLS scale) were analyzed by respondents' self-reported sexual identity and behaviors. Logistic regressions were applied to evaluate the differences between groups. Adjustment for basic sociodemographic characteristics was performed. Results 2.8% of adults identified as sexual minorities, including 0.5% lesbians or gays and 2.3% bisexuals. Sexual minorities were more likely to experiment with (illicit) substance use in the last 12 months (OR = 1.74, 95% CI: 1.03-2.94), more often experience psychological distress (OR = 2.56, 95% CI: 1.50-4.38), and were slightly less often satisfied with their lives (OR = 0.79, 95% CI: 0.46-1.37) compared to heterosexuals. Sexual minority status was not found as a significant predictor for daily tobacco smoking nor for frequent excessive/binge alcohol consumption. Conclusions In accordance with international evidence, sexual minorities represent a vulnerable group from the perspective of substance use and psychological distress. Factors influencing life satisfaction of sexual minority people living in geographically underrepresented regions need to be further investigated using measures more sensitive to local cultural circumstances.

Associations of cannabis- and tobacco-related problem severity with reward and punishment sensitivity and impulsivity in adolescent daily cigarette smokers.

Cannabis and tobacco use and related disorders have been separately associated with sensitivity to reward (SR), sensitivity to punishment (SP), and impulsivity. Given the frequent co-occurrence of cannabis and tobacco consumption in adolescents, it is important to understand how SR, SP and impulsivity may relate to both cannabis-use and tobacco-use co-occurrences and problem severities. Presently, sixty-five adolescents (14-21 years, 65% male), including 36 adolescents with daily tobacco smoking and regular cannabis use and 29 non-smoking healthy controls (HCs), completed self-report questionnaires assessing substance use, addiction severity, SR, SP, and impulsivity. Adolescent smokers had decreased SP and increased impulsivity compared to HCs. SR and impulsivity were independent predictors of concurrent cannabis-related problem severity among smokers. These findings suggest that specific approach/avoidance motives and impulsivity warrant further investigation as potential treatment targets in adolescents who consume both tobacco and cannabis.

MP50: Vaping, tobacco and cannabis among patients presenting to the emergency department: a cross-sectional study

Introduction: Inhaled toxins from tobacco smoking, cannabis leaf smoking as well as vaping/e-cigarette products use are known causes of cardio-respiratory injury. While tobacco smoking has decreased among Canadian adults, there are now several other forms of legal inhalant products. While legal, the evidence of benefit and safety of vaping is limited. Of concern, cases of e-cigarette or vaping products use associated lung injury (EVALI) have been accumulating in the U.S. and now in Canada. Despite this, very little is known about the inhalation exposure of emergency department (ED) patients; this study was designed to explore lung health in the ED. Methods: We investigated the prevalence of exposure to vaping, tobacco and cannabis among patients presenting to a Canadian ED from July to November 2019. Ambulatory (CTAS 2 to 5), stable, adult (≥ 17 years) patients were prospectively identified and invited to complete a survey addressing factors related to lung health (previous diagnosis of respiratory conditions and respiratory symptoms at the ED presentation) and information on current exposure to vaping, tobacco and cannabis smoking. Categorical variables are reported as frequencies and percentages; continuous variables are reported as medians with interquartile range (IQR). The study was approved by the Health Research Ethics Board. Results: Overall, 1024 (71%) of 1433 eligible patients completed the survey. The median age was 43.5 (IQR: 29, 60), and 51% were female. A total of 351 (31%) participants reported having been previously diagnosed with ≥1 respiratory conditions, and 177 (17%) were visiting the ED as a result of ≥1 respiratory symptoms (e.g., cough, shortness of breath, wheezing). Daily tobacco smoking was reported by 190 (19%), and 83 (8%) reported using vaping/e-cigarette products. Cannabis use within 30 days was described by 80 (15%) respondents. Exposure to tobacco and vaping products was reported by 39 (4%) participants, 63 (6%) reported using tobacco in combination with cannabis smoking, and 3% reported combining vaping and cannabis use. Conclusion: Patients seeking care in the ED are exposed to a large quantity of inhaled toxins. Vaping products, considered the cause of the most recent epidemic of severe lung injury, are used in isolation and in combination with other smoking products in Canada. These exposures should be documented and may increase the risk of lung health injuries and exacerbations of chronic respiratory conditions.

The Prevalence of Tobacco and E-Cigarette Use in Poland: A 2019 Nationwide Cross-Sectional Survey.

Monitoring of tobacco use is one of the key tobacco control activities. This study aimed to assess the current prevalence and patterns of tobacco and e-cigarette in Poland as well as to investigate socioeconomic factors associated with cigarette smoking and e-cigarette use. This cross-sectional study was carried out in 2019, on a representative nationwide sample of 1011 individuals aged 15+ in Poland. Daily tobacco smoking was declared by 21.0% of participants; 1.3% of participants were occasional tobacco smokers, and 10.7% were former tobacco smokers. Heated tobacco was used by 0.4% of participants. Ever e-cigarette use was declared by 4.0% of participants and 1.4% were current e-cigarette users. A higher proportion of daily smokers was observed among men than women (24.4% vs. 18.0%; p < 0.0001). The age group 30 to 49 years, of a lower educational level and living in a medium-sized city (between 20,000 and 500,000 residents), was significantly associated with current daily smoking. This is the most up-to-date study on the prevalence of smoking in Poland. Further tobacco control activities are needed to reduce tobacco use in Poland.