Dual Use Research Articles

Prevalence of dual use of combustible tobacco and E-cigarettes among pregnant smokers: a systematic review and meta-analysis

Prevalence of dual use of combustible tobacco and E-cigarettes among pregnant smokers: a systematic review and meta-analysis

Association of Cigarette-E-Cigarette Transitions With Respiratory Symptom Resolution.

Adults increasingly use e-cigarettes for cigarette cessation because of the perceived reduced risk. While e-cigarette use is associated with reduced toxicant exposure compared with smoking, it is unclear whether transitioning from cigarettes to e-cigarettes is associated with resolution of respiratory symptoms. Data were obtained from the Population Assessment of Tobacco and Health (PATH) study waves 1-5. US adult participants were separated into observations with cigarette-e-cigarette exposure intervals determined from PATH waves 1-2, 2-3, and 3-4. Observations were included if the participant reported exclusively smoking at baseline and reported a baseline cough or wheeze. Mixed-effect Poisson models measured the association between cigarette-e-cigarette transitions over the two-wave exposure interval (from smoking to nonuse, exclusive e-cigarette use, continued smoking, or dual use) and the reported resolution of the participant's cough or wheeze. Among 5210 (3362 unique) observations, transitioning from cigarettes to e-cigarettes was associated with increased rates of wheeze resolution (incidence rate ratio [IRR] = 1.33; 95% confidence interval [CI] = 1.01 to 1.75) but not cough resolution (IRR = 1.18; 95% CI = 0.93 to 1.50) compared with persistent smoking. Cigarette to dual-use transitions were not associated with improvements in symptom resolution, and those who switched to dual use and maintained or increased their smoking intensity had 15% decreased rates of respiratory symptom resolution compared with persistent smoking. E-cigarette-assisted smoking cessation may increase rates of respiratory symptoms resolution among smokers who completely transition to e-cigarettes; however, there is risk for additional harm among those who initiate e-cigarette use without decreasing their smoking intensity. Government agencies are increasingly weighing the risks and benefits of e-cigarette-assisted cigarette cessation given the reduced harm associated with e-cigarette use. This study provides novel evidence that completely transitioning from cigarettes to e-cigarettes is associated with increased rates of resolution from self-reported wheeze symptoms. However, risk exists in e-cigarette-assisted cigarette cessation, as those who transitioned from exclusive cigarette smoking to dual use and did not reduce their cigarette smoking intensity had decreased rates of respiratory symptom resolution compared with persistent smokers.

Post-discharge tobacco abstinence in a Mumbai hospital after implementation of tobacco cessation counseling: A pragmatic evaluation of the LifeFirst program.

Hospitalization provides a key opportunity to address tobacco use. Few studies have examined cessation treatment in hospitals in low- and middle-income countries (LMIC). We aimed to measure tobacco abstinence among individuals discharged from a Mumbai hospital after the implementation of cessation counseling compared to abstinence among those discharged pre-implementation. Pre-post intervention study in the Prince Aly Khan Hospital, Mumbai pre- (11/2015-10/2016) and post-implementation (02/2018-02/2020) of LifeFirst counseling. LifeFirst is multi-session (up to six sessions) counseling extending from hospitalization up to six months post-discharge. Primary analyses compare self-reported 6-month continuous abstinence among hospitalized individuals post-implementation (intervention) with pre-implementation (comparator) using an intent-to-treat approach that includes all participants offered LifeFirst post-implementation in the intervention group. Secondary analyses compare those who received ≥ 1 LifeFirst session with the pre-implementation group. We enrolled n = 437 individuals pre-implementation (8.7% dual use, 57.7% smokeless tobacco, 33.6% smoking) and n = 561 post-implementation (8.6% dual use, 64.3% smokeless tobacco, 27.1% smoking). Post-implementation, 490 patients (87.3%) accepted ≥ 1 counseling session. Continuous abstinence 6-months post-discharge was higher post-implementation (post: 41.6% vs. pre: 20.0%; adjusted odds ratio [aOR]: 2.86, 95% confidence interval [CI] 1.94-4.21). Those who received LifeFirst had higher odds of continuous abstinence compared to pre-implementation (aOR: 2.95, 95% CI 1.98-4.40). Post-discharge abstinence was more common after implementation of a multi-session tobacco counseling program for hospitalized patients compared to abstinence among patients hospitalized before implementation. These findings represent observational evidence of a promising association between post-discharge abstinence and a hospital-based tobacco cessation program implemented within routine practice in an LMIC setting.

Intrinsic Natural Resistance of Various Plant Pathogens to Ipflufenoquin, a New DHODH (Dihydroorotate Dehydrogenase)-inhibiting Fungicide, in Relation to Unaltered Amino Acid Sequence of the Target Site.

In recent years, increasingly stringent pesticide regulations have made the development of new chemistries challenging. Under these regulations, the new fungicide ipflufenoquin (FRAC Code 52) was first released in Japan. Its mode of action is new; it inhibits dihydroorotate dehydrogenase (DHODH), a key enzyme in the biosynthesis of pyrimidine-based nucleotides. However, because it is a single-site inhibitor, the risk of resistance developing in pathogens must be carefully considered. The risk for dual use of DHODH inhibitors in agriculture and medicine has also become a great concern because a new antifungal olorofim is under development against human pathogens now and cross-resistance has recently been reported between ipflufenoquin and olorofim in Aspergillus fumigatus. In this study, the sensitivity to ipflufenoquin was examined in culture and in plants using "baseline" isolates, which had never been exposed to DHODH inhibitors. Isolates of Alternaria alternata, Botrytis cinerea, B. elliptica, Colletotrichum fioriniae, C. fructicola, C. nymphaeae, C. orbiculare, C. siamense, C. tropicale, C. truncatum, and Sclerotinia sclerotiorum were highly sensitive to ipflufenoquin in culture, but isolates of Coniella vitis, Corynespora cassiicola, Pseudocercospora fuligena, and Rhizoctonia solani were inherently resistant. Ipflufenoquin had low efficacy against C. cassiicola and C. vitis after inoculation of cucumber and grapevine leaves, respectively. To understand the mechanism of natural resistance, we analyzed the partial sequence of pyrE genes, which encode the DHODH enzyme, but did not find any differences in the deduced amino acids that were thought to be associated with resistance. Thus, mechanisms other than target-site mutations might be involved in the intrinsic resistance.

Cpvlib: A comprehensive open-source tool for modeling CPV systems

The design and simulation of concentrator photovoltaic (CPV) systems necessitate precise modeling tools, for which some commercial and open-source options exist. However, when new technologies or applications need to be modeled, they can present some limitations: lack of documentation transparency and inability to extend existing models, or little flexibility to do it. For instance, the novel hybrid CPV/flat-plate module, conceived by Insolight and developed within the HIPERION project, required the ability to model integrated tracking and dual use of incident irradiance, which was not possible with existing tools. Addressing these issues, cpvlib is introduced as a comprehensive, open-source tool offering modular and adaptable functionalities for CPV-based systems, built as an extension of the popular pvlib python library.cpvlib's design enables the simulation of various CPV-based configurations, incorporating advanced architectures such as integrated tracking and hybrid CPV-flat plate modules. The library uses PVSyst's utilization factors to model deviations from the single-diode model, accounting for spectral and thermal effects. Its class structure leverages object-oriented programming principles, ensuring ease of use and extension.The validation of cpvlib is carried out through the modeling and long-term monitoring of Insolight's hybrid Si/III-V translucent planar micro-tracking modules, achieving a root mean square error of 3.5 % in case of Si cells and 2.7 % for III-V CPV cells. The tool accounts for complex behaviors like air mass impact on CPV performance, angle of incidence limits, and light spillage. The annual energy yield for a hybrid module is computed using typical meteorological year data, showcasing cpvlib's practical application.

Tobacco and nicotine products use among adolescents in Serbia – Latent class analysis

Abstract Background In parallel with a decline in cigarette smoking in the previous decade, other tobacco and nicotine products (TNPs), that are often used concurrently, have gained popularity among adolescents. The purpose of this study was to identify patterns of tobacco and nicotine product use among Serbian adolescents. Methods Data for this study were obtained from Health Behavior in School-aged Children (HBSC), a WHO collaborative cross-national study of adolescent health and well-being, that was conducted in Serbia in 2022 on a sample of 3713 students 11,13 and 15 years old. Descriptive statistics was used as well as latent class analysis to classify students based on their past-month use of cigarettes, e-cigarettes, heated tobacco products, waterpipes, and oral tobacco/nicotine products. Results Among students 11,13 and 15 years old, 10.2% smoke cigarettes, 13% use e-cigarettes, 11.1% waterpipes, 3.7% oral tobacco/nicotine products, and 4.5% heated tobacco products with differences by age and sex. We found high percentages of dual use of TNPs among cigarette smokers. Among students who smoke cigarettes, 61.6% also use e-cigarettes, 36.2% smoke waterpipes, 30.2% heated tobacco products, and 24.1% oral tobacco/nicotine products. Latent class analysis identified three classes as optimal solution: (1) dual e-cigarette and cigarette users (6.9%); (2) minimal/non-users (83.2%) and (3) poly tobacco and nicotine products users (9.9%). Statistically significant differences between classes were found in age and sex. Conclusions Dual and poly-tobacco and nicotine use is common among Serbian adolescents and presents a challenge for monitoring and public health response. Findings contribute to a better understanding of patterns and heterogeneity of TNPs use among adolescents and might have implications for prevention and cessation interventions for youth. Key messages • Among students 11,13 and 15 years old, tobacco and nicotine products, other than cigarettes is gaining popularity and with the e-cigarettes being the most popular product. • Dual and poly tobacco and nicotine products use is new challenged that should be taken into account in tobacco and nicotine monitoring, cessation and prevention.

Ethical Impact Assessment of Sharing Nanosafety Data

Decades of research on environmental, health and safety impacts of nanomaterials have generated large amounts of nanosafety data, but not all data are available online following the Findable, Accessible, Interoperable, and Reusable (FAIR) principles. This lack of FAIR data delays progress in regulatory research, needed by regulators to develop evidence-based policies. In this context, researchers collaborating in the EU NanoSafety Cluster (www.nanosafetycluster.eu) engaged in a discussion on the ethical impacts related to (not) sharing nanosafety data. Screening the potential ethical impacts suggested that openly sharing nanosafety data relevant to risk governance of nanomaterials could give rise to ethical issues related to health and to liberties, and that these data might be misused. On the other hand, not openly sharing such nanosafety data could raise issues related to health, equity, common good, environment, and sustainability. A small-scale Ethical Impact Assessment (EIA) was performed between June 2022 and April 2024 to identify and evaluate more specific ethical issues and to propose recommendations for remediating ethical concerns. Preliminary results were presented in scientific conferences (one poster and three oral presentations), while the comments of the participants were incorporated in the final version of the presented paper. The EIA identified ethical issues and value conflicts related to the following sectors: intellectual property, social justice, public health, dual use, environmental ethics and animal ethics. Some recommendations for remediation are the competence of research organisations. Other recommendations call for societal dialogue and engagement. Yet other recommendations call for political action.

Hyperdimensional computing: a framework for stochastic computation and symbolic AI

Hyperdimensional Computing (HDC), also known as Vector Symbolic Architectures (VSA), is a neuro-inspired computing framework that exploits high-dimensional random vector spaces. HDC uses extremely parallelizable arithmetic to provide computational solutions that balance accuracy, efficiency and robustness. The majority of current HDC research focuses on the learning capabilities of these high-dimensional spaces. However, a tangential research direction investigates the properties of these high-dimensional spaces more generally as a probabilistic model for computation. In this manuscript, we provide an approachable, yet thorough, survey of the components of HDC. To highlight the dual use of HDC, we provide an in-depth analysis of two vastly different applications. The first uses HDC in a learning setting to classify graphs. Graphs are among the most important forms of information representation, and graph learning in IoT and sensor networks introduces challenges because of the limited compute capabilities. Compared to the state-of-the-art Graph Neural Networks, our proposed method achieves comparable accuracy, while training and inference times are on average 14.6× and 2.0× faster, respectively. Secondly, we analyse a dynamic hash table that uses a novel hypervector type called circular-hypervectors to map requests to a dynamic set of resources. The proposed hyperdimensional hashing method has the efficiency to be deployed in large systems. Moreover, our approach remains unaffected by a realistic level of memory errors which causes significant mismatches for existing methods.

Joint optimal PMU and DULR placement in distribution network considering fault reconstruction and state estimation accuracy

Due to the rapid development of the distribution network, there is an urgent need for high-precision state estimation and safe and stable operation, this paper proposes a joint optimal placement method for Phasor Measurement Unit (PMU) and Dual Use Line Relay (DULR) in distribution networks considering fault reconstruction and state estimation accuracy. The proposed method aims to minimize the cost of PMU and DULR configuration. Based on the known pseudo-measurements and Supervisory Control and Data Acquisition (SCADA) measurements, we use the E-optimal standard design of the state estimation error covariance matrix to form the state estimation accuracy index and take the relay protection function of Feeder Terminal Unit (FTU) device and DULR device into consideration of the fault reconstruction. By solving the mixed integer semidefinite programming (MISDP) model, the optimal placement result is obtained, so that the network under normal condition and the network after multiple fault reconstruction can meet the constraints of state estimation accuracy and load loss rate respectively. The proposed method is tested on IEEE 33-node, 123-node systems as an example. The experimental results show that the proposed method is effective and practical.Note to Practitioners—This study is stimulated by the need for optimizing the placement of Micro-PMU (µPMU) in distribution network. Since the new µPMU device DULR has the same relay protection function as FTU, and distributed generation can supply power to the island after failure, this paper adds the load loss rate to the constraint conditions to study the influence of fault reconstruction on the placement scheme. A new two-step SE method considering mixed measurements was used in this paper to improve the computational efficiency of real-time SE of large-scale system while ensuring the accuracy of the calculation results. We have conducted tests in IEEE-33 and IEEE-123 systems. After preliminary verification, compared with the single fault scenario, we find that the placement scheme considering multiple fault scenarios can effectively improve the accuracy of state estimation and reduce the load loss rate of each fault scenario and only increase the cost a little. The increase in the number of DG and contact lines in the network will also effectively improve the feasibility of the placement scheme. The increase of the number of FTU configurations can effectively reduce the configuration of DULR by adding a small amount of µPMU, reduce the total cost as a result. In future studies, we will further consider the integrated configuration of µPMU, DULR and FTU, to meet more failure scenarios while reducing costs.

Desires and Needs for Quitting Both e-Cigarettes and Cigarettes Among Young Adults: Formative Qualitative Study Informing the Development of a Smartphone Intervention for Dual Tobacco Cessation.

Dual use of both e-cigarettes and cigarettes is popular among young adults and may lead to greater nicotine dependence and additive adverse health effects than single-product use. However, existing cessation programs target quitting either e-cigarettes or cigarettes, highlighting a need for interventions to help young adults quit both products (ie, dual tobacco cessation). This formative study is part of a larger project to develop a smartphone intervention for dual tobacco cessation among young adults. This study aimed to (1) explore desires for and experiences with quitting both e-cigarettes and cigarettes and (2) identify needs and preferences for dual tobacco cessation intervention programming. Semistructured interviews were conducted to elicit the need for and experience with dual tobacco cessation among 14 young adults (18-29 years old) recruited through Instagram (Meta) advertisements in 2023. We conducted a thematic analysis to identify common themes related to quitting experiences and cessation needs. Participants expressed a strong desire for dual tobacco cessation and had attempted to quit both tobacco products, mostly "cold turkey." The priority product for quitting first varied by the individual's perceived harm or level of consumption. Targets for dual tobacco cessation interventions included (1) highlighting the health effects of dual tobacco use compared with single product use, (2) providing cessation support to quit one prioritized product while cutting down the other product with the explicit goal to quit both, (3) emphasizing unique facilitators and barriers to quitting each product (eg, unpleasant smell of cigarettes facilitating smoking cessation and accessibility and flavors of e-cigarettes hindering vaping cessation), and (4) addressing co-use of tobacco with alcohol or cannabis. Participants wanted personalized interventions through smartphone apps that would tailor support to their tobacco use patterns and unique quitting goals and needs. They also suggested presenting intervention content in multimedia (eg, videos, graphic pictures, quizzes, and games) to increase engagement. This study provides important insights into young adults' experiences, needs, and preferences for dual tobacco product cessation. We highlight important targets for future smartphone apps to deliver personalized and tailored support to meet the heterogeneous needs and preferences of young people who want to quit using both e-cigarettes and cigarettes.

Research Progress in the Medicine-Food Dual Use of Astragalus for Gastrointestinal Tumors.

Gastrointestinal tumors have a major impact on human life expectancy and quality of life and are a major cause of personal and social hygiene stress. Gastrointestinal tumors are the main cause of cancer-related death, and the main treatment methods are surgery, radiotherapy, and chemotherapy. However, they also cause great damage to the body and have a poor prognosis after surgery. Therefore, we urgently need safe and effective drugs to intervene in gastrointestinal tumors. In recent years, Traditional Chinese Medicine has been widely used in tumor treatment as a complementary and alternative therapy. Astragalus membranaceus is one of the main herbal medicines with tonic effect and one of the important components of many antitumor herbal compounds. Astragalus polysaccharides, saponins, and flavonoids are the main active components of Astragalus, all of which have antitumor effects. In this article, we studied the mechanism of action of Astragalus and its active ingredients in the intervention of gastrointestinal tumors in recent years and suggested a new approach for the study of Astragalus intervention in gastrointestinal tumors from the perspective of the homology of medicine and food.

Economic and Social Benefits of Aquavoltaics: A Case Study from Jiangsu, China

Aquavoltaics is an innovative and beneficial solution that makes dual use of water area for photovoltaic (PV) power generation and aquaculture. Currently, China has made remarkable developments in aquavoltaics. This paper first analyzes the current development status of aquavoltaics in China, then takes the TW “fishery–PV integration” base project in Nanjing, Jiangsu Province, as a case study to analyze its economic and social benefits, and finally puts forward countermeasure suggestions for the development of aquavoltaics in China. It is found that Jiangsu Province is one of the clustering areas for the development of aquavoltaics in China, and the development of aquavoltaics in this province has a high level of specialization. The payback period (PP) of the TW “fishery–PV integration” base project is 10.44 years, the net present value (NPV) is USD 18.5334 million (the discount rate is 5%), and the internal rate of return (IRR) is 8.06%. The social benefits of this project are mainly reflected in the promotion of energy conservation and emission reduction, the alleviation of energy shortages, the optimization of land use, and the development of culture, tourism, science, and education. The development of aquavoltaics should be promoted by strengthening scientific research, paying attention to the impact of PV panel erection on the ecological environment of the waters, emphasizing the fishery farming part of the aquavoltaic project, and improving the commercial operation mode of the aquavoltaic project.

Wanting to be "accepted and heard": Perspectives about cessation messages from LGBTQ+ individuals who dual use cigarettes and e-cigarettes.

Dual use of cigarettes and e-cigarettes is especially prevalent among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) adults in the US. This is concerning as health risks of dual use may be as high or higher than exclusive smoking. We sought to learn about people who dual use and identify as LGBTQ+'s perspectives about dual use, quitting, and cessation ads. Nineteen LGBTQ+ adults who dual use participated in virtual semi-structured interviews in North Carolina in 2022. We asked about perceptions of smoking and vaping in LGBTQ+ communities, their thoughts about quitting, and their opinions on four cessation ads. The ads advocated quitting one or both products. Transcripts were coded using ATLAS.ti and reviewed using a thematic content analysis approach. Participants described how within LGBTQ+ communities, smoking and vaping are common and accepted and are used to cope or to socialize. Most participants made past quit attempts. Many said they were not ready to quit both products, but some were open to quitting smoking. Some thought e-cigarettes may be as harmful as cigarettes, reducing their motivation to quit smoking cigarettes due to the lack of perceived health benefits. Participants sought cessation ads that explicitly address dual use and are representative and supportive. They disliked ads that felt stereotypical or patronizing. Dual use in LGBTQ+ communities appears driven by both internal and external pressures. Participants were generally open to quitting cigarettes, and LGBTQ+ smoking cessation may be best encouraged with authentic ads that explicitly address both products. These qualitative findings about smoking and vaping among LGBTQ+ individuals provide guidance for communication ad campaign design to help reduce the high dual use rates among LGBTQ+ young adults.

Pentadic Cartography and India’s Foreign Policy: Insights from Jaishankar’s GLOBSEC Forum Interview

ABSTRACT India’s rise as the world’s largest democracy and its challenge to the Western-defined global order have attracted significant scholarly, political, and media attention. Using Anderson and Prelli’s pentadic cartography to enhance discursive analysis in international relations, this paper looks at journalist Maithreyi Seetharaman’s interview with Subrahmanyam Jaishankar, India’s External Affairs Minister at the GLOBSEC Forum in Bratislava, Slovakia. Depicting three interlocking maps of the symbolic landscape of the interview, we highlight the use of Seetharaman and Jaishankar’s scene-act ratio, situating India’s actions in its geopolitical contexts. Jaishankar’s dual use of materialist and idealist discourses presents India as both a reactive agent influenced by external circumstances and a proactive agent with its own distinct goals and ethical considerations. This approach offers a comprehensive understanding of international politics, balancing dominant empirical narratives in IR and emphasising a complex interplay of motives that drive state behaviour. Through this case study, we advocate for a broader application of pentadic cartography in international relations to uncover the deeper meanings and contexts that shape state actions, providing a richer, more textured understanding of geopolitics, global diplomacy and state interaction.

Analysis of Barbie’s Impact in Mexico through a Colorist Lens: Challenging the Persistence of a Stereotyped Pink Society

This article delves into the intricate and layered concept of Mexican pink, a color with deep historical and cultural roots. It commences by tracing the colonial origins of this vibrant hue, highlighting its association with colorism as depicted in caste paintings. These artworks, serving as portraiture, often reinforced social hierarchies based on skin color. From this historical perspective, Mexican pink has transitioned to symbolize femininity and feminist resistance against gender violence. In the 1940s, Mexican pink gained prominence, largely due to the innovative fashion designer Ramón Valdiosera. His pioneering work played a pivotal role in bringing this color to the forefront of the fashion industry, making it a significant representation of Mexican identity. However, the narrative around Mexican pink has continued to evolve, particularly recently. Feminist groups have increasingly adopted this color as a powerful tool to raise awareness about feminicide. This dual use underscores the complexity of the color, which serves as both a symbol of national identity in Mexico and a rallying cry for justice. The article also addresses the tensions arising from the commercialization of pink, mainly when used for feminist purposes. This commercialization can dilute the original meaning and importance of color, leading to debates about the authenticity and commodification of feminist ideals. In conclusion, I analyze the potential impact of Greta Gerwig's Barbie 2023 film on the feminist movement in Mexico. With its significant social media presence, the film has sparked much debate. Four influential Mexican TikTok creators, who became the most followed on the platform between June and August 2023, have been instrumental. Their content, which primarily appeals to young women interested in fashion, makeup, and feminism, creates a unique intersection, further highlighting Mexican pink's ongoing relevance in contemporary culture. This article examines the relationship between the content produced by these influencers and the representation of Barbie pink, which closely resembles Mexican pink. By analyzing this connection, we aim to understand if it is possible to forge a link between the two that can enhance the feminist struggle. Given that Gerwig's film has been framed as a feminist statement, exploring three different, yet similar, shades of pink reveal how they can integrate narratives of consumption with those of feminist activism, ultimately enriching the discourse around both color and the movement it represents.

Statistical Analyses Plan for “MAGnItude of cigarette substitutioN after Initiation oF e-cigarettes and its ImpaCt on biomArkers of exposure and potenTial harm in dual users”: MAGNIFICAT trial

BackgroundThe substitution of combustible cigarettes (CC) with non-combustible nicotine alternatives, such as e-cigarettes (EC), significantly lowers exposure to harmful chemicals. However, many individuals who use ECs continue smoking CCs, becoming dual users and remaining at increased risk of toxin exposure. This study will examine how the reduction in cigarettes smoked per day (CPD) after switching to ECs correlates with changes in biomarkers of exposure (BoE) and potential harm (BoPH) to evaluate the extent of harm in dual users. MethodsThe study is a prospective, non-randomised, observational, longitudinal cohort study in which 250 CC smokers will be invited to use EC as part of a smoking reduction/cessation strategy. Participants will be grouped in five dual use categories based on the change from baseline in CPD at 1, 3 and 6 months, based on self-reported use in the preceding 30 days. The primary outcome of interest is the mean absolute urinary 2-cyanoethyl mercapturic acid (2CyEMA), a well-validated BoE, also assessed at 1, 3 and 6 months. Other BoE will be assessed, together with exploration of the association between varying intensities of dual use and BoPH. The association between the dual use category and levels of BoE will be evaluated using analysis of variance (ANOVA), in order to understand which BoE are best suited to identifying different levels of dual use. Exploratory assessment of the value of BoPH will similarly be evaluated, to assess whether their predictive power extends from the binary smoker/non-smoker categorization to a more nuanced dual use categorization. The specific details of the own-brand CC will be available once smokers' enrollment in the study is complete. The EC used in the study will be the KIWI 2 Pen refillable pod system, with participants given the option to choose from three different flavored e-liquids: LEAF, MIDWAY, and GLACIAL, all containing 0.9% nicotine. For specialized equipment used for biomarker analysis please refer our previous publication: https://pubmed.ncbi.nlm.nih.gov/38584934/ ConclusionEC are increasingly adopted as a harm reduction strategy in CC smokers who wish to quit smoking, the outlined Statistical Analysis Plan (SAP) provides a robust approach to understand the impact of EC on CC use and to quantify the impact of dual use on clinical outcomes using BoPH. For statistical calculations we will use R software.The subject of this SAP manuscript – trial research – due to planned medical procedures, is a subject of verification by proper ERB (Ethics Review Board) in Poland and gained required approval prior to the start of the actions. The positive opinion was granted on 22nd February 2024, with the signature number 04/24.

Patterns and Determinants of Exclusive Smokeless Tobacco (Snus) Use, Exclusive Smoking and Dual Use in General Population During 20 Years.

We investigate smokeless tobacco (snus) use and its correlates over 20 years in a country where selling snus is prohibited but a large import quota and illicit market exists. Repeated cross-sectional population-based surveys during 2000 to 2020 in Finland, including N = 57 111 adults aged 20 to 64 years. The outcome measures were current tobacco use (exclusive snus use, dual use, exclusive smoking, no tobacco use) and snus use (daily, occasional, no snus use). Study years, gender, age, education, marital status, self-rated health, body mass index, and binge drinking were used as explanatory variables. Exclusive snus use and dual use increased 3.6% units and 2.6% units from 2000 to 2005 and from 2018 to 2020, respectively. Overall decrease of tobacco use was led by decreasing exclusive smoking from 30.1% to 18.2%. The shared risk factors for snus use and dual use were male gender, age group 20 to 34 years, and binge drinking. The increases in snus and dual use over time were also most prevalent among these groups. Among men, occasional smoking increased the likelihood of daily (relative risk ratio [RRR] 2.38, 95% confidence interval [CI] 1.42, 3.99) and occasional (RRR 3.11, 95% CI 1.93, 5.03) snus use. Snus use has increased among the general adult population in Finland during 2000 to 2020 yet remains less common than smoking. Snus use and dual use share some common risk factors. Snus use should be considered in cessation services, with support for quitting developed and targeted predominantly for men, younger adults, and persons drinking to intoxication.

Heterogeneous Association Between E-Cigarette Use and Diabetes Prevalence Among U.S. Adults

IntroductionE-cigarette use has increased among US adults. While the association between traditional cigarette smoking and the diabetes/prediabetes prevalence is well established, the relationship between e-cigarette use and these conditions remains unclear. This study examines the association between different types of cigarette use (including e-cigarettes alone, combustible cigarettes alone, and dual use) and the prevalence of prediabetes and diabetes among US adults. MethodsWe analyzed 1,285,783 observations from the 2020-2022 Behavioral Risk Factor Surveillance System surveys. Self-reported prediabetes and diabetes diagnoses were outcomes of interest. Propensity score matching with one-to-one nearest-neighbor matching was used to create balanced groups of smokers and non-smokers. Multivariable logistic regressions examined associations between self-reported smoking status and outcomes. We also conducted subgroup analyses to assess potential variations in these associations. Analyses were performed in September-December 2023. ResultsAfter propensity score matching and adjusting for covariates, sole e-cigarette users (adjusted odds ratio [AOR], 1.07; 95% CI, 1.03-1.11) and dual users (AOR, 1.28; 95% CI, 1.23-1.33) had higher odds of prediabetes diagnosis compared with never users. Sole e-cigarette use was not associated with diabetes risk, but dual users showed higher odds for diabetes diagnosis (AOR, 1.09; 95% CI, 1.06-1.11) versus never users. E-cigarette use was associated with varying odds of prediabetes and diabetes across different demographic groups. ConclusionsThis cross-sectional analysis found that e-cigarette use is associated with higher odds of prediabetes, with dual use potentially linked to increased odds of both prediabetes and diabetes. However, due to study limitations, including its cross-sectional design, self-reported data, and unmeasured confounders, these findings should be interpreted cautiously. As causal relationships and temporal sequences cannot be established, large prospective studies are needed to explore the metabolic health implications of emerging tobacco product use.

Nicotine and cannabis routes of administration and dual use among U.S. young adults who identify as Hispanic, non-Hispanic Black, and non-Hispanic White

BackgroundUse of cannabis and nicotine is at record levels among young adults, and health consequences vary by route of administration. However, there is a paucity of research characterizing use of both substances, especially among individuals of racial/ethnic minoritized identities. MethodParticipants (N = 1,032; age 18–25 years) completed a cross-sectional survey administered through an online panel in 2021 in eight U.S. states where cannabis was legal for both recreational and medical use and eight states where cannabis was not legal for medical or recreational purposes. Sampling was stratified by race/ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White) and gender (male, female). Survey weighting was based on state-level gender and race/ethnicity data in the 2021 U.S. Census Bureau. ResultsOver one third (37.9%) of respondents reported current use of both cannabis and tobacco, more than double the proportion using tobacco (12.1%) or cannabis (4.1%) only. Vaporization was the most common method for using nicotine (40.2%). Disposable nicotine vape products were used more than any other method (27.1%). Smoking was the most common route of administration for cannabis (35.7%). Simultaneous use of tobacco and cannabis was common (27.0%) overall and greater among those who identify as non-Hispanic Black than non-Hispanic White. There were few differences in product use by gender or state legality. DiscussionDual cannabis and tobacco use is prevalent among young adults. Given the dynamic regulatory landscape, continued monitoring of specific cannabis formulations and tobacco products is recommended. Trends in simultaneous use of cannabis and tobacco and associated adverse effects warrant continued assessment.

Electronic cigarette use and consumption patterns in medical university students.

A major public health hazard is youth e-cigarette use. Although new, e-cigarette health hazards are becoming well-known in the literature. E-cigarette sale restrictions and laws differ globally. In this cross-sectional study, we studied medical university students' tobacco and e-cigarette use and characteristics in a country where sales and import of e-cigarettes are banned. The primary objective is to determine the prevalence of electronic cigarette use and understand consumption patterns among medical faculty students in this setting. The questionnaire was sent using a web-based student information system. Sociodemographic features, tobacco and e-cigarette use, consumption patterns, and e-cigarette risk perceptions were covered in 54 questions. The study comprised 1,054 students (48.7% male) aged 21.5 ± 2.6 years who completed the questionnaire. 37.7%, 20.9% and 23.6% have smoked cigarettes, e-cigarettes, or water pipes. Current cigarette smokers were 17.0%, e-cigarette users 4.0%, and water pipe smokers 4.5%. E-cigarette users were 52.3% dual smokers. The most common symptoms reported by e-cigarette users were cough (58.4%) and dyspnea (54.2%). Multivariable models showed that the male sex, greater monthly income, and a current smoker friend were independent risk factors for e-cigarette ever use, while the male sex, paternal current smoking, and close friends' current smoking status were risk factors for dual use among medical trainees. Many medical students who used electronic cigarettes underestimated nicotine's health hazards and harmful chemicals in e-cigarettes. Despite e-cigarette sales being prohibited in our country, 56.4% and 25.4% of e-cigarette users provided e-cigarettes from tobacco shops and through online sales, respectively. Medical university students use tobacco most often by smoking cigarettes. Despite medical university students being aware of the health hazards of e-cigarettes, the current use of electronic cigarettes is 4.0%. Male sex, greater monthly income, and having current smoker friends are independent risk factors for e-cigarette use, while paternal smoking is a risk factor for dual use among medical trainees. Although in the country, sales of e-cigarettes are banned, ever-use rates for e-cigarettes were remarkably high at 20.9%, and the ease of accessing e-cigarettes was striking.