Form Of Tobacco Use Research Articles

Determinants of tobacco use in Sudan: secondary analysis of STEPwise Survey 2016.

Tobacco is a leading cause of death and illness despite > 50 years of antitobacco efforts. To establish the determinants of current and former smoking and smokeless tobacco use in Sudan as measured by the STEPwise Survey 2016. A household-based cross-sectional World Health Organization STEPwise Survey was conducted among 7745 Sudanese citizens aged 18-69 years across 11 states in Sudan. A 4-stage stratified cluster sampling design was implemented. The generic STEPS Instrument (version 3.2) was used and questions were tailored to the Sudanese context. Among current male smokers, 63.7% were aged ≤ 35 years, 50.7% were illiterate or did not complete primary school, 84.5% were employed and 52.4% were in the lowest 2 quintiles of income. Among male smokeless tobacco users, 54.8% were aged ≤ 35 years, 48.4% were illiterate or did not complete primary school, 89.7% were employed and 52.2% were in the lowest 2 quintiles of income. Using multivariate logistic regression models, current smoking in men was associated with older age, informal education, unemployment and lower income. Smokeless tobacco use was associated with age 18-25 years, informal education, unemployment and lower income. Both forms of tobacco use were associated with poor socioeconomic status and unemployment. Smokeless tobacco use was associated with age 18-25 years as opposed to smoking tobacco use. These results can inform the target audience of the future tobacco control plans.

Disparity and compatibility, familiarity and perception among waterpipe tobacco smokers (Shisha) in Malaysia: A comparative study

Background: In Malaysia, although the number of Shisha smokers has not exceeded the regular cigarette users, waterpipe smoking (Shisha) has been appeared as a new form of tobacco use, especially among the new generation. This study aims to describe the comparative characteristics, familiarities, and motives for Shisha use in some states of Malaysia.  Methods: A cross-sectional survey using a new validated self-administered, bilingual questionnaire was conducted among Shisha smokers in Pulau

The CHRNA5 polymorphism (rs16969968) and its association with waterpipe smoking addiction among Jordanians

Waterpipe smoking is a form of tobacco use that causes nicotine/tobacco dependence and has become a global health problem. In this study, the association of rs16969968 SNP in the CHRNA5 gene with waterpipe dependence was investigated. A total of 386 men and women who used a waterpipe to smoke tobacco were recruited and divided into less dependent and more dependent smokers based on their score on the Lebanon Waterpipe Dependence Scale (LWDS). Results showed a significant difference in the distribution of GG, GA, and AA genotypes by waterpipe dependence status (p < .001). The more dependent group showed a higher frequency of the AA genotype than the less dependent smokers’ group (38% vs. 23%, respectively). In addition, the more dependent smokers exhibited more A allele than less dependent smokers (53% vs. 37% respectively, p < .001). In conclusion, there is an association between the rs16969968 SNP and waterpipe dependence as assessed by the LWDS.

Hookah Smoking with Health Risk Perception of Different Types of Tobacco

Hookah is a tobacco product that is gaining popularity in the United States and other countries, particularly among the youth. In this paper, we examine the perception of health risks of different types of tobacco use in comparison to hookah use among 671 participants respond to a survey conducted in Detroit Metropolitan Area, Michigan who never smoke or smoke “cigarette, hookah, both cigarette and hookah”; and determine whether smoking status influenced the perceived health risks of hookah smoking when compared to other forms of tobacco use. The survey had 43 questions including questions about demographics, socioeconomic status, health care, etc. All statistical analyses were done using SPSS version 22. This study found that 44.1% of the participants believed that hookah was less harmful than each of the other tobacco products studied. Approximately 26% of cigarette smokers are likely to smoke hookah also. These findings emphasize the importance of spreading awareness about the health risks associated with hookah smoking and implementing strict laws for showing tobacco-related warnings in hookah advertisements and on the packets of hookah accessories given the increasing popularity of hookah, especially among the youth, in the United States.

Predictors of Cigarette Smoking, Smokeless Tobacco Consumption, and Use of both forms in Adolescents in South Asia: A Secondary Analysis of the Global Youth Tobacco Surveys.

Tobacco uptake in adolescents is associated with a range of predictors. We examined the predictors of cigarette smoking, smokeless tobacco (ST) consumption, and use of both ST and cigarettes among adolescents in four South Asian countries. We analyzed the Global Youth Tobacco Surveys (GYTS) data for Bangladesh (2013), India (2009), Pakistan (2013), and Sri Lanka (2015), using multinomial regression to examine associations between several predictors and tobacco use. Data from 23 681 adolescents were analyzed. Overall, 82.8% of the study population were between 13 and 15 years and 52.7% were girls, 2% were cigarette smokers, 6.5% were ST users, and 1.1% used both ST and cigarettes, in the past 30 days. Exposure to smoking in public places was associated with past 30-day smoking (relative risk ratio [RRR] 5.59, 95% confidence intervals [CI] 4.28-7.28), ST use (RRR 2.07, 95% CI 1.84-2.32), and use of both ST and cigarettes (RRR 11.42, 95% CI 7.44-17.54). Exposure to tobacco use in electronic media and being offered free tobacco products were associated with all forms of tobacco use. Shopkeepers' refusal to sell cigarettes protected adolescents from smoking (RRR 0.47, 95% CI 0.36-0.63) and ST use (RRR 0.65, 95% CI 0.45-0.95). However, exposure to antitobacco mass media messages was not protective for any form of tobacco use. Adolescents taught at school about harmful effects of tobacco were less likely to use ST; no evidence of this association was observed for smoking. The associations between tobacco use and protobacco factors were strong, but the associations with antitobacco factors lacked strength and consistency in this study population. The predictors of adolescents using different tobacco products, crucial to inform and evaluate tobacco control efforts, are poorly understood. We investigated the associations between several environmental-level factors and cigarette smoking, ST consumption, and use of both forms among adolescents, whereas most of the previous studies focused on individual-level factors. Our study found strong associations between tobacco use and protobacco factors and lack of strength and consistency in associations between antitobacco factors and tobacco use in the study population. Our results indicate that the current tobacco control policies need strengthening to curb the tobacco epidemic in these countries.

Water-Pipe Smoking Exposure Deregulates a Set of Genes Associated with Human Head and Neck Cancer Development and Prognosis.

Water-pipe smoking (WPS) is becoming the most popular form of tobacco use among the youth, especially in the Middle East, replacing cigarettes rapidly and becoming a major risk of tobacco addiction worldwide. Smoke from WPS contains similar toxins as those present in cigarette smoke and is linked directly with different types of cancers including lung and head and neck (HN) carcinomas. However, the underlying molecular pathways and/or target genes responsible for the carcinogenic process are still unknown. In this study, human normal oral epithelial (HNOE) cells, NanoString PanCancer Pathways panel of 770 gene transcripts and quantitative real-time polymerase chain reaction (qRT-PCR) analysis were applied to discover differentially expressed genes (DEG) modulated by WPS. In silico analysis was performed to analyze the impact of these genes in HN cancer patient’s biology and outcome. We found that WPS can induce the epithelial–mesenchymal transition (EMT: hallmark of cancer progression) of HNOE cells. More significantly, our analysis of NanoString revealed 23 genes deregulated under the effect of WPS, responsible for the modulation of cell cycle, proliferation, migration/invasion, apoptosis, signal transduction, and inflammatory response. Further analysis was performed using qRT-PCR of HNOE WPS-exposed and unexposed cells supported the reliability of our NanoString data. Moreover, we demonstrate those DEG to be upregulated in cancer compared with normal tissue. Using the Kaplan–Meier analysis, we observed a significant association between WPS-deregulated genes and relapse-free survival/overall survival in HN cancer patients. Our findings imply that WPS can modulate EMT as well as a set of genes that are directly involved in human HN carcinogenesis, thereby affecting HN cancer patients’ survival.

Rethink Vape: Development and evaluation of a risk communication campaign to prevent youth E-cigarette use

IntroductionE-cigarettes are now the most common form of tobacco use among adolescents, and use is associated with increased risk of initiation of cigarette smoking. This project used a community-engaged research process to develop and pilot a risk communication campaign to prevent youth vaping. MethodThe research team worked with a 36-member Teen Advisory Council and a 19-member Expert Panel. Together, the team employed survey (N = 674) and focus group (N = 82) methodologies, and hired a marketing company to partner on development of the campaign. Campaign concepts were developed, eliminated, and/or modified through an iterative process of feedback and refinement. The final campaign included video ads (https://bit.ly/2QMR8gH) a microsite (rethinkvape.org), and social media sites (@rethinkvape). The campaign communicated three messages to teens: what’s in the vapor, health risks, and connections to big tobacco. Prior to launch of the campaign, a randomized controlled 2 (time) × 2 (group) online experiment was conducted to evaluate the campaign (N = 268). ResultsRepeated measures mixed analyses of variance indicated that vaping knowledge, perceptions of risk, and anti-vape intentions significantly increased among teens viewing the Rethink Vape Materials compared to their own baseline, while control participants did not change. Following evaluation, the team launched a 6-week online media campaign with a teen-targeted geo-fence radius to deliver 3,838,465 impressions, 770,443 completed video views, and 18,316 clicks in mobile app, Snapchat, YouTube, and Spotify platforms. The majority of placements exceeded industry standards, with mobile pre-roll and Snapchat as top performers. ConclusionsThe e-cigarette campaign showed promising signs of effectiveness and scalability.

Prevalence of Potentially Malignant Lesions and Oral Cancer Among Smokers in an Egyptian cohort: A Hospital-based Cross-Sectional Study

Objectives: This cross-sectional study was designed to determine the prevalence of potentially malignant lesions and oral cancer among smokers. Methods: The current observational cross-sectional study was conducted in the Clinics of Oral Medicine and Periodontology department and the Diagnostic center, Faculty of Dentistry - Cairo University in Cairo- Egypt. Smokers from all age groups and both genders who agreed to sign the informed consent were included in the study. Detailed history of tobacco consumption, different forms of tobacco use, drugs, alcohol consumption and quitting trials were recorded and followed by clinical examination and histopathological assessment of suspicious lesions. Results: Among the 1664 enrolled participants, 3.54% had leukoplakia, 2.88% had oral lichen planus, 1.5% had oral squamous cell carcinoma and 0.12% had verrucous carcinoma. Conclusion: leukoplakia was the most frequently encountered lesion followed by oral lichen planus. Dentists must be aware of the risk of smoking on oral mucosa and the early signs of developing premalignant or malignant lesions.

Female Smoking: A Rising Concern in India

Cigarette smoking is the dominant form of tobacco use across the world. There is growing concern about to the increasing trend of female smoking in India. The overall female smoking is growing at a faster rate than male, which is an emerging concern and requires attention of policy makers. A recent WHO report stated that, ‘in quickly developing India, female cigarette smoking exists mainly among the urban elite classes of large cosmopolitan cities, which may reflect women’s aspiration to ‘equal’ the social position of men’. Our result suggests smoking cannot be defined with education, and for occupation cigarette smoking is mostly among the higher income groups whereas bidi, gutkha are mostly among the low-income groups.

Smoking Assessment and Current Smoking Status Among Adolescents in Primary Care Settings.

Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued use into adulthood. Primary care visits provide opportunities for the assessment and treatment of tobacco use; however, little is known about prevalence and correlates of assessing smoking status and current use among adolescents in these settings. Using electronic health record data from the OCHIN network, we identified adolescents with greater than or equal to one primary care visit to a study clinic (n = 366 clinics from 15 US states) during January 1, 2016 to December 31, 2017. We estimated odds ratios of smoking assessment and current smoking status by patient covariates. Of 140 887 patients, 87.4% were assessed for smoking. Being Latino or Black (adjusted odds ratio = 1.22, 95% confidence interval: 1.13-1.32; adjusted odds ratio = 1.17, 95% confidence interval: 1.07-1.29, respectively, vs. non-Hispanic White), publicly insured, having more visits, and having an asthma diagnosis or other respiratory symptoms were associated with higher odds of assessment. Odds were lower if the patient was male and uninsured. Of those assessed, 1.6% identified as current smokers. Being older, having more visits, an asthma diagnosis, other respiratory symptoms, and lower household income was associated with higher odds of being a current smoker. Latinos and Blacks had lower odds than non-Hispanic Whites. Although some commonly reported tobacco-related disparities were not present, smoking assessment and current smoking status differed significantly by most patient demographics. Implementation of adolescent tobacco assessment protocols and the development of interventions to target subpopulations of adolescents with higher rates of smoking could mitigate disparate rates of assessment and smoking, respectively. Clinical guidelines recommend screening adolescents for tobacco use in primary care settings. We found that most adolescents seen in US safety-net primary care clinics were assessed for smoking. We also found that smoking assessment and current smoking status differed significantly by most patient demographics. Implementing tobacco assessment protocols specific to adolescents could mitigate disparate rates of assessment and ensure accurate documentation of all forms of tobacco use, given the evolution of alternative tobacco products and poly use among adolescents. Interventions to target subpopulations of adolescents with higher smoking rates are needed to prevent the negative health effects of continued smoking.

A Study on Angiographic profile of Acute Coronary Syndrome in Smokers

Background: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Cardiology Katuri Medical College &amp; Hospital, Guntur.Subjects and Methods:A total of 208 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease in smokers vs non-smokers at Katuri Medical College, Andhra Pradesh.Results:Study group consisted of 208 subjects, of which 108(51.9%) subjects were smokers including all forms of tobacco use and 100(48.1 Out of 108 study subjects in the smokers group, family history of CAD was present in 21(19.4%) subjects. Killip class is not applicable to 13 (12%) study groups as they presented with Unstable Angina with ECG changes. Killip class 1 was most common presentation (67.6%) in smokers. 28 patients (25.9%) had LV dysfunction with EF &lt; 50% by echocardiography. 80 patients (74.1%) had normal LV function. The mean EF was 55.56+/-10.16%. The median EF was 56.5%. LAD was type 3 in 100 (92.6%) patients and type 4 in 8 (7.4%) patients out of 108 study subjects.LAD type 3 was statistically significant with P value &lt; 0.05 when compared with LAD type 4. No statistically significant difference was seen with respect to the Normal coronary arteries as CAG diagnosis between smokers and non-smokers(6.7% versus 8%,p&gt;0.1,Not significant).Conclusion: Smokers were predominantly male and around 3 years younger than non-smokers. Diabetes mellitus and hypertension were less common among smokers and single-vessel disease was the more common angiographic finding for smokers as compared to 3-vessel disease for non-smokers. ST-segment elevation myocardial infarction in smokers despite younger age and the low atherosclerotic risk profile, in our region, emphasize the need for nicotine addiction management and smoking cessation campaigns at large and for pre-discharge counseling.

Tobacco and Nicotine Cessation During Pregnancy: ACOG Committee Opinion, Number 807.

Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity. Pregnancy influences many women to stop smoking, and approximately 54% of women who smoke before pregnancy quit smoking directly before or during pregnancy. Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. The greatest benefit is observed with cessation before 15 weeks of gestation. Although cigarettes are the most commonly used tobacco product in pregnancy, alternative forms of tobacco use, such as e-cigarettes or vaping products, hookahs, and cigars, are increasingly common. Clinicians should advise cessation of tobacco products used in any form and provide motivational feedback. Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. Available cessation-aid services and resources, including digital resources, should be discussed and documented regularly at prenatal and postpartum follow-up visits.

Tobacco and Nicotine Cessation During Pregnancy: ACOG Committee Opinion Summary, Number 807.

Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity. Pregnancy influences many women to stop smoking, and approximately 54% of women who smoke before pregnancy quit smoking directly before or during pregnancy. Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. The greatest benefit is observed with cessation before 15 weeks of gestation. Although cigarettes are the most commonly used tobacco product in pregnancy, alternative forms of tobacco use, such as e-cigarettes or vaping products, hookahs, and cigars, are increasingly common. Clinicians should advise cessation of tobacco products used in any form and provide motivational feedback. Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. Available cessation-aid services and resources, including digital resources, should be discussed and documented regularly at prenatal and postpartum follow-up visits.

Tobacco use and vaping in the COVID-19 era.

Health crises have become a popular topic of discussion. In the wave of the ongoing pandemic, experts have suggested the role of vaping and other tobacco product use exemplifying the vulnerability of the population to contract the COVID‐19. We discuss some of the events that led up to these conclusions and also offer a unique insight into another form of tobacco use that is potentially propagating its spread especially in the South Asian region—chewed tobacco. Both of these have been a perennial issue that head and neck cancer surgeons have been dealing with. Governments and head and neck cancer care providers now have an opportunity to deal with a common enemy in the midst of this pandemic.

Prevalence and social determinants of tobacco use in Afghanistan.

BackgroundLimited evidence exists on the prevalence and social determinants of tobacco use in Afghanistan—a fragile post-war context where the tobacco epidemic is on the rise. This study aimed to estimate the prevalence and social determinants of tobacco use in Afghan men and women.MethodsData from the 2015 Afghanistan Demographic and Health Survey of 10 760 men and 29 461 women were used to generate weighted prevalence estimates for smoking, smokeless tobacco (SLT) products including chew and snuff tobacco, ‘any tobacco use’ and ‘dual tobacco use’. We also modelled associations with tobacco outcomes using binary logistic regressions.ResultsWe found that for men, smoking cigarettes was the most prevalent form of tobacco use (21.9% [95% confidence interval {CI} 21.2–22.7]). Prevalence rates were far lower for women, with cigarette/pipe smoking at 3.4% (95% CI 3.2–3.7). For both sexes, tobacco use was inversely associated with education and positively associated with agricultural and skilled and unskilled manual labour occupations. Wealth increased the odds of smoking for men but decreased the odds for women. Media exposure had little influence on tobacco use among women; however, the effects were more varied for men.ConclusionsOur results demonstrate social inequalities in tobacco use among Afghan men and women, which calls for stronger tobacco control measures and continued monitoring of this growing epidemic.

The effect of genetic variations in the choline acetyltransferase gene (ChAT) on waterpipe tobacco smoking dependence.

INTRODUCTIONWaterpipe tobacco smoking (WS) is a popular form of tobacco use, globally. While the impact of genetic variations on smoking behavior has been well-investigated, few studies have examined this issue with regard to WS. In the current study, associations between choline acetyltransferase gene (ChAT) rs1917810 and rs7094248 polymorphisms and WS dependence were examined.METHODSGenotyping of rs1917810 and rs7094248 in 266 Jordanian waterpipe smokers was performed using RFLP-PCR. Dependence on WS was measured using the LWDS-10J scale.RESULTSThe frequency of rs1917810 G allele was 38.5% and that of the rs7094248 G allele was 40.8%. The rs1917810 was significantly associated with the WS dependence level (p<0.05). Carriers of the AA genotype of rs1917810 were more dependent on WS than those with GG genotype (p<0.05). However, no association between rs7094248 single-nucleotide polymorphism (SNP) and dependence on WS was observed (p>0.05).CONCLUSIONSThe rs1917810 in the ChAT gene might be associated with dependence on WS.

Prevalence of non-cancer chronic morbidity in tobacco users among adults in Kolar district: community-based study

Background: Tobacco contains many chemicals which causes cancer and chronic morbidities as evidenced from number of studies. Information regarding the chronic morbidities resulting from tobacco use was lacking in Indian setting. This study was conducted with the objective to find the prevalence of chronic morbidities other than cancer and oral conditions in tobacco users among adults in Kolar district.Methods: This is a community based, cross sectional study conducted in Kolar district among selected sample size of 1534 from six taluks during December 2018 to March 2019. The structured questionnaire was used to collect information at different geographical and social meeting places to represent the sample. The questionnaire contained information about sociodemographic, tobacco use and self-declared morbidity conditions.Results: Study subjects were aged between 18 to 80 years and the mean age was 53.7±18.2 years. The prevalence of chronic morbidity was 14.4% in 1534 subjects and 24.2% in 521 tobacco users. Diabetes mellitus and cardiovascular diseases accounted for 80 percent of morbidities followed by respiratory and other systems. The odd ratio (OR) was 3.4 for tobacco users and chronic morbidities, OR for diabetes mellitus and cardiovascular diseases was 5-19 and 5-22 respectively.Conclusions: The prevalence of diabetes mellitus, cardiovascular diseases and other conditions are high among any form of tobacco use or consumption, illiterates, aged above 51 years and agriculture related workers compared to no tobacco users. There is a need of awareness about early detection of chronic morbidities to reduce the premature deaths and economic loss to the community.

Tobacco Litigation, E-Cigarettes, and the Cigarette Endgame

Among his many contributions to the field of public health law, Professor Richard Daynard is perhaps best known for (a) advancing the idea that affirmative litigation, particularly against the tobacco industry, can serve as an effective public health tool, (b) introducing the discussion of an “endgame,” in which the commercial sale of cigarettes—the most deadly form of tobacco use—is phased out. This article unites these two topics and analyzes the potential for affirmative litigation to hasten the end of commercial cigarette sales. In recent years, the major tobacco companies have suggested that they support moving towards a “smoke-free world,” with non-combustible nicotine products such as e-cigarettes gradually replacing more harmful cigarette smoking. Though this rhetoric is deeply cynical—these same companies continue to spend heavily to promote their cigarette brands—it may nonetheless create a window of opportunity for litigants. Past litigation against tobacco companies has foundered on the absence of a “reasonable alternative design” for cigarettes. Today, the tobacco companies’ own statements can be used to show the availability of such alternatives. More importantly, now-public documents from the tobacco industry’s archives help establish the case for treating e-cigarettes as a “reasonable alternative design” for cigarettes. These documents show that the major tobacco companies developed the essential components of e-cigarette technology decades ago, but they chose not to commercialize these products because they feared they would prove to be viable alternatives to cigarettes. This article reviews how the introduction of e-cigarettes may reinvigorate products liability litigation against the manufacturers of conventional cigarettes. Building on the work of Professor Daynard, it also considers how these lawsuits, even if ultimately unsuccessful in court, might nonetheless benefit public health by pressuring the tobacco industry to live up to its public statements and by catalyzing legislative efforts to phase out the sale of cigarettes.

Tobacco and E-cigarette use among cancer survivors in the United States.

BackgroundLimited information exist on tobacco and e-cigarette use patterns in cancer survivors. The purpose of this study is to report on use patterns in cancer survivors compared with non-cancer participants from the Population Assessment of Tobacco and Health (PATH) Study.MethodsSociodemographic data and tobacco product use were analyzed for 32,244 adult participants from the PATH Study in 2013–2014 by cancer status and age. Logistic regression examined the patterns of and factors associated with tobacco use by cancer status.ResultsOverall, cancer survivors represented 7.1% (n = 1,527) of participants, were older, and had a higher proportion of females and non-Hispanic whites than non-cancer participants. In cancer survivors, current and former cigarette smoking was reported in 12.7% and 32.9% respectively, compared with 18.5% and 19.0% in non-cancer adults. Current e-cigarette use was reported by 3.8% of survivors compared with 5.7% of non-cancer participants. Dual tobacco use was reported by 25.0% and poly use by 6.9% of cancer survivors who currently smoked. All other forms of current tobacco use were individually reported by <5% of survivors. Young adult cancer survivors (aged 18–44) reported the highest rates of current cigarette smoking (27.9%) and current e-cigarette use (11.8%). The effects of age, sex, race/ethnicity, education, and income on tobacco use status were comparable for cancer survivors and non-cancer participants. Cancer survivors who were younger, male, of lower educational attainment, and those diagnosed with a tobacco-related cancer were more likely to report current tobacco use.ConclusionsAmong cancer survivors, cigarette smoking remains the predominant form of tobacco use, although other tobacco/nicotine use and dual/poly use are common. The PATH Study provides detailed tobacco product use patterns in survivors, including their adoption of emerging alternative tobacco products.

National prevalence, perceptions, and determinants of tobacco consumption in Saudi Arabia

Introduction &#x0D; Tobacco use has been associated with many health risks that can lead to premature death. This study aims to assess the national prevalence of tobacco consumption and the associated determinants in Saudi Arabia. &#x0D; Methods &#x0D; The study involved a cross-sectional national survey of 5175 individuals conducted across the 13 official regions of Saudi Arabia. The sample included individuals aged 18 years and above from both genders recruited using a quota sampling technique. Data collection was carried out between September 2018 and May 2019 through Web-based computer-assisted telephone interviews (CATIs). Participants were asked to report their current consumption of tobacco products including cigarettes, shisha (waterpipe), smokeless tobacco, cigars, pipes, and electronic cigarettes/vaping. Knowledge of specific health risks associated with smoking and public perceptions of the smoking phenomenon were also assessed among never smokers, smokers, and former smokers.&#x0D; &#x0D; Results &#x0D; The national prevalence of tobacco consumption was 24.02% (1120/5175). Cigarettes were the most prevalent tobacco product consumed (16.18%; 95% CI: 14.5881–17.7663), and daily cigarette smoking prevalence was the highest (14.12%; 95% CI: 12.6433–15.5924). Shisha smoking prevalence was 8.12% (95% CI: 6.8054–9.4352). E-cigarette use prevalence was 2.22% (95% CI: 1.5770–2.8711). The most common tobacco product used among males was cigarettes (15.13%; 95% CI: 13.58–16.67), while shisha was commonly used among females (1.57%; 95% CI: 1.11–2.04). Cigarette smoking prevalence was the highest in the Aljawf region (21.12%; 95% CI: 17.07–25.18), shisha smoking prevalence was the highest in the Makkah region (12.41%; 95% CI: 8.64–16.17), whereas smokeless tobacco use was prevalent in the Najran region (4.75%; 95% CI: 2.81–6.70). Males (AOR: 8.17; 95% CI: 5.98–11.71; P &lt; 0.0001), young adults below 45 years of age (AOR: 2.12; 95% CI: 1.50–2.98; P &lt; 0.0001), and those with below a bachelor’s degree (AOR: 1.34; 95% CI: 1.01–1.77; P = 0.0396) were more likely to consume tobacco compared with others. The population mean knowledge scores of health risks associated with smoking among smokers was 1.91 ± 1.72 (Range: 0–10), with the highest knowledge scores (2.16 ± 1.68) among former smokers. Only 46.53% (95% CI: 44.30–48.75) of the population are bothered “to very large extent” by smoking health consequences.&#x0D; Conclusions &#x0D; Tobacco consumption is prevalent in Saudi Arabia. Different forms of tobacco use were reported, and the most common was cigarettes, followed by shisha and then electronic cigarettes. Tobacco use remains one of the major threats to the health of the population in Saudi Arabia.