Harms Of Smoking Research Articles

A mixed methods study on men's and women's tuberculosis care journeys in Lusaka, Zambia-Implications for gender-tailored tuberculosis health promotion and case finding strategies.

Men and women with undiagnosed tuberculosis (TB) in high burden countries may have differential factors influencing their healthcare seeking behaviors and access to TB services, which can result in delayed diagnoses and increase TB-related morbidity and mortality. A convergent, parallel, mixed-methods study design was used to explore and evaluate TB care engagement among adults (≥18 years) with newly diagnosed, microbiologically-confirmed TB attending three public health facilities in Lusaka, Zambia. Quantitative structured surveys characterized the TB care pathway (time to initial care-seeking, diagnosis, and treatment initiation) and collected information on factors influencing care engagement. Multinomial multivariable logistic regression was used to determine predicted probabilities of TB health-seeking behaviors and determinants of care engagement. Qualitative in-depth interviews (IDIs; n = 20) were conducted and analyzed using a hybrid approach to identify barriers and facilitators to TB care engagement by gender. Overall, 400 TB patients completed a structured survey, of which 275 (68.8%) and 125 (31.3%) were men and women, respectively. Men were more likely to be unmarried (39.3% and 27.2%), have a higher median daily income (50 and 30 Zambian Kwacha [ZMW]), alcohol use disorder (70.9% [AUDIT-C score ≥4] and 31.2% [AUDIT-C score ≥3]), and a history of smoking (63.3% and 8.8%), while women were more likely to be religious (96.8% and 70.8%) and living with HIV (70.4% and 36.0%). After adjusting for potential confounders, the probability of delayed health-seeking ≥4 weeks after symptom onset did not differ significantly by gender (44.0% and 36.2%, p = 0.14). While the top reasons for delayed healthcare-seeking were largely similar by gender, men were more likely to report initially perceiving their symptoms as not being serious (94.8% and 78.7%, p = 0.032), while women were more likely to report not knowing the symptoms of TB before their diagnosis (89.5% and 74.4%; p = 0.007) and having a prior bad healthcare experience (26.4% and 9.9%; p = 0.036). Notably, women had a higher probability of receiving TB diagnosis ≥2 weeks after initial healthcare seeking (56.5% and 41.0%, p = 0.007). While men and women reported similar acceptability of health-information sources, they emphasized different trusted messengers. Also, men had a higher adjusted probability of stating that no one influenced their health-related decision making (37.9% and 28.3%, p = 0.001). In IDIs, men recommended TB testing sites at convenient community locations, while women endorsed an incentivized, peer-based, case-finding approach. Sensitization and TB testing strategies at bars and churches were highlighted as promising approaches to reach men and women, respectively. This mixed-methods study found important differences between men and women with TB in Zambia. These differences suggest the need for gender-tailored TB health promotion, including addressing harmful alcohol use and smoking among men, and sensitizing HCWs to prolonged delays in TB diagnosis among women, and also using gender-specific approaches as part of community-based, active case-finding strategies to improve TB diagnosis in high burden settings.

Abstract 64: Multilevel Barriers and Facilitators of Smoking Cessation in People Living With HIV in Vietnam: A Qualitative Analysis

Abstract Purpose: In Vietnam, tobacco smoking is highly prevalent among people living with HIV (PLWH) and increases their risk of cancer, cardiovascular disease, and life-threatening opportunistic infections. However, research on effective tobacco use treatment (TUT) for PLWH is lacking. To fill this gap, we aimed to identify multilevel barriers and facilitators (B&Fs) of smoking cessation and their implications for TUT implementation for PLWH in Hanoi, Vietnam. Methods: We conducted individual in-depth interviews with 24 patients and 13 healthcare providers at three HIV outpatient clinics (OPCs) in Hanoi to explore B&Fs of smoking cessation at the patient, provider, and system level. Two coders carried out a two-phase abductive thematic analysis using Atlas.ti and guided by the Theoretical Domains Framework. Results: Participants described several patient-level barriers to smoking cessation: limited knowledge, misperceptions about smoking harms, lack of familiarity with cessation aids, exposure to environments in which smoking is common, emotional issues (i.e., stress/depression), substance use, and social norms that promote male smoking and tie smoking to masculinity. Both patients and providers described self-determination to quit as a major facilitator of smoking cessation (Everything can be overcome if there is determination). Patients reported that strong determination to quit is influenced by concerns about the harms of smoking; family support and pressure to quit; and the potential for improving health of themselves and their family and for reducing tobacco-related expenses from tobacco purchases. Provide-reported barriers included a lack of resources and capabilities to assess and intervene on smoking behaviour at the OPCs, and at the system level affordable and accessible tobacco products. However, providers endorsed the importance of supporting patients to quit and were optimistic about tailoring and integrating TUT into OPCs if they were equipped with training, personnel, and financial support. Trust and patient-provider solid relationships were potential facilitators of cessation. Conclusion: The study suggested the need to intervene at patient, provider, and system levels to increase engagement among PLWH in smoking cessation treatment. Provider training, patient education and resources are needed to facilitate treatment. Findings also suggest a need to tailor existing treatment options developed in other contexts to this population and setting. Citation Format: Thanh Hoang, Claire VT Nguyen, Gloria Guevera Alvarez, Trang Nguyen, Nam Nguyen, Louise Adermark, Nawi Ng, Donna Shelley, Mari Armstrong-Hough. Multilevel Barriers and Facilitators of Smoking Cessation in People Living With HIV in Vietnam: A Qualitative Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 64.

Effects of the grade/price and thickness of cigarette on the PM2.5 concentration of smoke.

In an attempt to promote sales of high-grade/price and slim cigarettes with lower tar and nicotine content, the State Tobacco Monopoly Administration (STMA) also known as the China National Tobacco Corporation (CNTC), whose monopoly controls all aspects of tobacco production, marketing, and distribution in China, have advertised them as safe cigarettes that cause less tobacco smoke pollution (TSP). However, cigarette smoke contains thousands of harmful components, and the effects of only tar and nicotine cannot be used to represent TSP. This study aimed to evaluate the impact of cigarette grade/price and size on TSP by measuring PM2.5 concentrations for three different grades/prices and two sizes of popular cigarettes in China. The results showed that cigarette grade/price did not significantly affect PM2.5 levels in regular (R) or slim (S) cigarettes in either sidestream or mainstream smoke. However, cigarette size had a significant effect on PM2.5 levels, with R cigarette PM2.5 being 116% higher than S cigarette PM2.5 in sidestream smoke. In mainstream smoke, this difference decreased to 31%, although R-cigarette PM2.5 levels remained higher. While S cigarette PM2.5 levels were lower than those of R cigarettes, this did not necessarily mean that S cigarettes were less harmful. The harmfulness of smoke is not only manifested in PM2.5 but also in other particulate matter such as PM10 and PM1.0. At the same time, it is also affected by smoking habits. Therefore, further experiments are required to evaluate the potential harmfulness of S cigarettes.

Individual and Conjoint Factors Associated With Beliefs About the Harmfulness of Nicotine Replacement Therapies Relative to Combustible Cigarettes Among People Who Smoke: Findings From the 2020 ITC Four Country Smoking and Vaping Survey.

This study examined individual and conjoint factors associated with beliefs about the harmfulness of nicotine replacement therapies (NRTs) relative to combustible cigarettes (CCs). Data analyzed came from 8642 adults (≥18 years) who smoked daily/weekly and participated in the 2020 ITC Four Country Smoking and Vaping Survey in Australia (n = 1213), Canada (n = 2633), England (n = 3057), and United States (n = 1739). Respondents were asked: "Compared to smoking cigarettes, how harmful do you think nicotine replacement products are?" Responses were dichotomized into "much less" versus otherwise for analysis using multivariable logistic regression models, complemented by decision-tree analysis to identify conjoint factors. Percentages believing that NRTs are much less harmful than CCs were 29.7% (95% CI = 26.2% to 33.5%) in Australia, 27.4% (95% CI = 25.1% to 29.8%) in England, 26.4% (95% CI = 24.4% to 28.4%) in Canada, and 21.7% (95% CI = 19.2% to 24.3%) in the United States. Across all countries, believing nicotine is not at all/slightly harmful to health (aOR = 1.53-2.27), endorsing nicotine vaping products (NVPs) as less harmful than CCs (much less harmful: aOR = 7.24-14.27; somewhat less harmful: aOR = 1.97-3.23), and possessing higher knowledge of smoking harms (aOR = 1.23-1.88) were individual factors associated with increased odds of believing NRTs are much less harmful than CCs. With some country variations, these nicotine-related measures also interacted with each other and sociodemographic variables to serve as conjoint factors associated with the likelihood of accurate NRT relative harm belief. Many people who regularly smoke cigarettes are unaware that NRTs are much less harmful than cigarettes. Additionally, beliefs about NRTs relative harmfulness appear to be influenced by both individual and conjoint factors. This study demonstrates that despite past efforts to educate people who smoke about the harms of NRTs relative to CCs, misperceptions around the relative harmfulness of NRTs remain substantial. In all four studied countries, subgroups of people who smoke regularly who are misinformed about the relative harmfulness of NRTs, and who may be reluctant to use NRTs for smoking cessation can be reliably identified for corrective interventions based on their understanding of the harms related to nicotine, NVPs and smoking along with sociodemographic markers. The identified subgroup information can be used to prioritize and inform the development of effective interventions to specifically address the gaps in knowledge and understanding of the various subgroups identified. Our results suggest these may need to be tailored for each country.

Synergic evacuation device helps smoke control during endoscopic thyroid surgery

BackgroundSurgical plumes in small cavities, such as transoral endoscopic thyroid surgery, have never been satisfactorily resolved. We aimed to study the use of a smoke evacuation system and evaluate its efficacy, including the field of view and operating time. Study DesignWe retrospectively reviewed 327 consecutive patients who underwent endoscopic thyroidectomy. They were separated into 2 groups based on whether the smoke evacuation system was used. To reduce the possible experience bias, only patients 4 months before and after implementing the evacuation system were included. Recorded endoscopic videos were evaluated, including the field of view, the incidence of scope clearance, and time spent during air-pocket creation. ResultsOverall, there were 64 patients with a median age of 43.59 years and a median body mass index of 22.87 kg/m2, including 54 women, 21 thyroid cancers, and 61 hemithyroidectomies. The operative duration was comparable between the groups. The group where the evacuation system was used scored more as good in terms of endoscopic views (8/32, 25% vs 1/32, 3.13%, P = .01), fewer incidences of endoscope lens pull out for clearance (3.5 vs 6.0 times, P < .01), less time for clear view after energy device activation (2.67 vs 5.00 seconds, P < .01), and less time spent (8.67 vs 12.38 minutes, P < .01) during air-pocket creation. ConclusionIn conjunction with the synergy function of energy devices, evacuators enhance the field of view and optimize the time spent in the real clinical setting of low-pressure and small-space endoscopic thyroid procedures, in addition to the benefit of reducing smoke harm.

A New Questionnaire to Assess Respiratory Symptoms (The Respiratory Symptom Experience Scale): Quantitative Psychometric Assessment and Validation Study.

Smokers often experience respiratory symptoms (eg, morning cough), and those who stop smoking, including those who do so by switching completely to electronic nicotine delivery systems (ENDS), may experience reductions in symptoms. Existing respiratory symptom questionnaires may not be suitable for studying these changes, as they are intended for patient populations, such as those with chronic obstructive pulmonary disease (COPD). This study aimed to develop a respiratory symptom questionnaire appropriate for current smokers and for assessing changes when smokers stop smoking. The Respiratory Symptom Experience Scale (RSES)was derived from existing instruments and subject matter expert input and refined through cognitive debriefing interviews (n=49). Next, for purposes of the quantitative psychometric evaluation, the RSES was administered to smokers (n=202), former smokers (no tobacco use in >6 months; n=200), and switchers (n=208, smokers who switched to ENDS for >6 months), all of whom had smoked for at least 10 years (mean age 33 years). Participants, who averaged 62 (SD 12) years of age, included 28% (173/610) with respiratory allergy symptoms and 17% (104/610) with COPD. Test-retest reliability was assessed by repeat assessment after 1 week in 128 participants. A generalized partial credit model confirmed that the response options were ordered, and a parallel analysis using principal components confirmed that the scale was unidimensional. With allowance for 2 sets of correlated errors between pairs of items, a 1-factor graded response model fit the data. Discrimination parameters were approximately 1 or greater for all items. Scale reliability was 0.80 or higher across a broad range of severity (standardized scores -0.40 to 3.00). Test-retest reliability (absolute intraclass correlation) was good, at 0.89. RSES convergent validity was supported by substantial differences (Cohen d=0.74) between those with and without a diagnosis of respiratory disease (averaging 0.57 points, indicating that differences of this size or smaller represent meaningful differences). RSES scores also strongly differentiated those with and without COPD (d=1.52). Smokers' RSES scores were significantly higher than former smokers' scores (P<.001). Switchers' RSES scores were significantly lower than smokers' scores (P<.001) and no different from former smokers' scores (P=.34). The RSES fills an important gap in the existing toolkit of respiratory symptom questionnaires; it is a reliable and valid tool to assess respiratory symptoms in adult current and former smokers, including those who have switched to noncombusted nicotine products. This suggests that the scale is sensitive to respiratory symptoms that develop in smokers and to their remission when smokers quit or switch to noncombusted nicotine products intended to reduce the harm of smoking. The findings also suggest that switching from cigarettes to ENDS may improve respiratory health.

Using the Past to Understand the Future of U.S. and Global Smoking Disparities: A Birth Cohort Perspective

Using the Past to Understand the Future of U.S. and Global Smoking Disparities: A Birth Cohort Perspective

Tobacco smoking and substance use among medical undergraduates in Najaf, Iraq: prevalence and associated factors

ABSTRACT Background Tobacco smoking and substance use is a public health hazard. The investigations studying tobacco smoking, substance use, and their associated factors among Iraqi undergraduates are limited. Our study aimed to examine tobacco smoking, and substance use among medical undergraduates in Najaf, Iraq, and report associated characteristics. Methods A piloted questionnaire was utilized to conduct a descriptive cross-sectional web-based survey. The snowball technique was used for sampling. The subjects’ features, perceived risk of harm, location, motivations, and effects of cigarette smoking and substance misuse were used to conduct association testing. Results Tobacco smoking was reported in 17.3% of the students (at least once in the previous month), and substance use in 3%. Mostly, the age of initiation was <15 years, and psychological stress (50.9%) was the reason for tobacco smoking and substance use. However, the presence of a smoker or user friend or family member was significantly associated (p-value <.05) with tobacco smoking and substance use. Conclusion The prevalence of tobacco smoking and substance use and several risk factors were identified. In addition to promoting awareness about tobacco smoking and substance use and its potential consequences, the associated characteristics reported in this study are useful when developing effective counteracting policy initiatives.

Young adult–targeted vaping cessation media campaigns: Promising themes

Objective: With the proliferation of vaping in recent years, vaping-related mass media campaigns have been implemented to discourage vaping among youth and young adults. Research on salient vaping-related themes for vaping cessation is lacking. This study aimed to identify promising belief themes for use in young adult-targeted vaping cessation media campaigns. Design, Setting and Method: In 2020, we conducted an online survey of 620 New York residents aged 18 to 35 years who were currently using vape products. We asked respondents about vaping-related beliefs across multiple domains and about their intentions to quit vaping. We assessed endorsement with various belief themes and strength of association between belief themes and intention to quit vaping to identify promising themes for vaping cessation messaging. Results: Most belief themes had moderate endorsement and thus ample room to move. Among dual users and vapers only, themes of harmful ingredients and the health consequences of vaping demonstrated strong promise as themes for message targeting. Among dual users, all but two themes (smoking cessation and harm to others) demonstrated positive, statistically significant associations with intentions to quit vaping and potential percentage to gain scores with confidence intervals that did not overlap with zero. Among vapers only, themes of harmful ingredients and health consequences of vaping had the strongest association with intentions to quit vaping and the highest potential percentage to gain. Conclusion: This study demonstrates that most belief themes have substantial room to move, and that themes of harmful ingredients and health consequences of vaping are particularly promising for vaping cessation campaigns aimed towards dual users and vapers only. Study findings can be used by planners to inform the development and implementation of high-impact media campaigns to promote vaping cessation among young adults.

Effect of Smoking on Lung Function Decline in a Retrospective Study of a Health Examination Population in Chinese Males.

China has established a goal of reducing adult smoking prevalence from 27.7% to 20% by 2030. Understanding the possible ongoing impairment in lung function in smokers, is critically important to encourage the populations to change their smoking behavior. A total of 14,273 males joined the health examination at Huadong Sanatorium from Jan 2012 to Dec 2019 were included. In cross-sectional analysis, we used multiple linear regression to evaluate the association between baseline lung function and smoking status. Then, 3,558 males who received ≥2 spirometry exams were analyzed in longitudinal study. Annual lung function decline was compared using mixed linear models adjusted for confounders. In cross-sectional analysis, compared with never-smokers, decreases of -133.56 mL (95% CI: -167.27, -99.85) and -51.44 mL (-69.62, -33.26) in FEV1, -1.48% (-1.94, -1.02) and -1.29% (-1.53, -1.04) in FEV1/FVC were observed in former and current smokers. In longitudinal analysis, significant declines were observed in FEV1 [5.04 (2.30, 7.78) mL] and FEV1/FVC [0.09 (0.05, 0.13) %] in current smokers but not observed in former smokers after adjustment. Participants with long duration of smoking cessation had decelerate lung function than short duration. The annual decline rate of current smokers with high smoking intensity (≥30 cigarettes per day) was 13.80 and 14.17 times greater than that of never-smokers in FEV1 and FVC. Thus, early smoking cessation can slow down lung function decline trend for current smokers. The harms of current smoking on lung function emphasize the necessity of smoking cessation, especially for those with comorbidities.

Comparative Evaluation of the Effect of Loss- and Gain-framed Tobacco Cessation Messages on Smoking Behavior: A Systematic Review

Abstract The current systematic review aimed to compare the available literature on the effect of loss-and gain-framed tobacco cessation messages on smokers. Databases such as Scopus, PubMed, Cochrane, Science Direct, Lilac, Science Direct, Web of Science, and Google Scholar were searched comprehensively from the earliest available date till May 31, 2023. Observational, prospective experimental studies, and randomized controlled trials were included in the review. Ten full-text articles fulfilled the eligibility criteria and were further processed for the data extraction. Gain-framed messages were preferred by majority of the study participants over loss-framed messages in motivating them to quit. Smokers have been exposed to loss-framed warning messages quite frequently (like on cigarette packets), and as a result, they may have learned everything there is to know about the potential harms of smoking, perhaps leading to wear-out effects. Gain-framed messages could be perceived as feeling fairly fresh, which lowers the risk of wear-out consequences. However, the outcome varied based on the moderators used in the studies. Based on the results, a strategic combination of gain-framed and loss-framed messages with appropriate moderators and long follow-up needs to be developed based on the study population for assessing the effectiveness of these messages on actual smoking behavior and habit cessation.

Cigarette Gifting Among Nonsmokers in China: Findings From the International Tobacco Control China Survey.

Cigarette gifting is commonly practiced in China and has contributed to the social acceptability and high prevalence of cigarette smoking in the country. As a result, nonsmokers in China are particularly susceptible to smoking. While previous studies have examined cigarette gifting behaviors among smokers, little is known about cigarette gifting among nonsmokers. This study aimed to examine the percentage and correlates of giving and receiving cigarettes as gifts among adult nonsmokers in China. We analyzed nonsmokers (N = 1813) aged ≥18 years using data from the International Tobacco Control China Wave 5 Survey. Descriptive statistics summarized the characteristics of those who gave and received cigarettes as gifts. Multivariable logistic regression models were used to identify factors associated with the two behaviors. Among nonsmokers, 9.9% reported giving cigarettes as gifts to family or friends in the last 6 months. A higher level of knowledge about smoking harms was associated with lower adjusted odds of gifting cigarettes. Nonsmokers aged 25-39 years, with middle income, positive attitude toward cigarette gifts, exposure to anti-smoking information, and exposure to smoking promotion, and those who reported receiving cigarettes as gifts from family or friends were more likely to give cigarettes as gifts. A total of 6.6% of nonsmokers reported receiving cigarettes as gifts in the last 6 months. High education, neutral or positive attitude toward cigarette gifts, exposure to anti-smoking information, exposure to smoking promotion, and having smoking friends were associated with receiving cigarettes as gifts. It is concerning that Chinese cultural norms that support cigarette gifting have extended to giving nonsmokers cigarettes as gifts. Effective anti-smoking messages are needed. Changing the norms around cigarette gifting and increasing knowledge about smoking harms should help reduce cigarette gifting among nonsmokers. Easy access to cigarettes received as gifts, along with the wide acceptance of smoking in China, places Chinese nonsmokers in a risky position. More educational campaigns targeting nonsmokers to proactively prevent them from smoking are called for. The ineffectiveness of existing anti-smoking information highlights the need for more effective anti-smoking messages. That attitude toward cigarette gifts is the strongest predictor of giving cigarettes as gifts suggests the need for interventions to reverse the positive attitude about cigarette gifting to decrease the popularity of this activity.

Risk factors for the development of bronchopulmonary pathology in workers producing synthetic polyacrylonitrile fiber

Aim of the study was to assess the risk of bronchopulmonary pathology in workers of the production of synthetic polyacrylonitrile fiber as a result of exposure to harmful chemicals and smoking tobacco products . Material and methods . During the periodic medical examination , the function of external respiration and adherence to smoking in 137 employees were studied , medical records were analyzed (025/u accounting form ). Hygienic assessment of working conditions was carried out on the basis of the results of in-situ sanitary and hygienic studies . Results and discussions . As a result of a hygienic assessment of working conditions , it was found that workers engaged in the production of polyacrylonitrile fiber are subject to the combined intermittent effects of harmful chemicals of hazard classes 1–3 ( acrylonitrile , methyl acrylate , hydrocyanide , ammonia , sodium rhodanide , sulfuric acid , methanol , isopropyl alcohol , ethylene glycol ), the content of which in the working area exceeded the maximum permissible concentrations in 1.6% of samples . The occupational risk of developing bronchopulmonary diseases in groups of workers who smoke is assessed as unacceptably high , while in people exposed to harmful chemicals , its level is 28.46 times higher than in people who are not exposed to these effects . The risk of the formation of ventilation disorders in groups of smoking workers is unacceptably high , while its level is 2.46 times higher in workers exposed to harmful chemicals than in non-workers in such conditions . In groups of workers exposed to harmful chemicals , the occupational risk of obstructive disorders is unacceptably high , in the group of smokers the risk is 2.32 times higher . Conclusions . Among the employees of the enterprise producing synthetic polyacrylonitrile fiber , the influence of tobacco smoking on the development of bronchopulmonary pathology is higher than the influence of harmful working conditions , and the use of smoking tobacco products significantly increases the negative effect of chemical pollutants .

Evaluation of Prevalence and Predictors of Waterpipe (Shisha) use among Pre-medicine and Pharmacy students in the Muscat Region- A Pilot Study

Tobacco epidemic has become one of the biggest public health threats to the world as it kills more than 8 million people annually. The purpose of this study was to assess the prevalence and predictors of waterpipe (shisha) use among Pre-medicine and Pharmacy students in the Muscat region. A validated questionnaire containing 32 questions on shisha use, knowledge &amp; attitudes concerning shisha use, cessation, initiation trends and exposure to second hand smoke (SHS) was self-administered to 140 students. Approximately half of the students were Omanis and 19.4% of the students had smoked shisha at least once. About 22.9% of the students, felt that smoking made them more comfortable in social gatherings. Approximately 21.6% students smoked in places outside their homes, contributing to SHS. The prevalence of shisha and cigarette smoking were 2.9% and 4.3% respectively. Males and non-Omanis (64.7% and 42.4%) were found to be more susceptible to initiate smoking within a year. This study indicated that shisha smoking and cigarette smoking are on the rise among young adults. Hence, there is a need to educate students about the harms of shisha smoking, to quit smoking and to protect the non-smokers from being initiated into this vicious habit.

Female University Students’ Experiences of Hookah Smoking: Cool Habit and Non-predictable Imminent Consequences and Risks

Background: There are debates on the risk and harm of Hookah smoking among university students. There is a dearth of studies describing students’ experiences, causative factors and consequences of Hookah smoking among female university students. Purpose: The purpose of this study was to describe the experience of adopting Hookah smoking among female university students. Methods: A descriptive qualitative design was used for this study. A purposive sample of 14 female university students participated through face-toface interviews. Results: The study results included six main themes: Hookah smoking is cool and entertaining; attracting factors for Hookah smoking; Hookah smoking versus cigarette smoking; socio-cultural acceptance of female Hookah smoking; imminent hazardous consequences of Hookah smoking; strategies to combat Hookah smoking among female students. Conclusion: Hookah smoking has become culturally accepted by female university students. Serious attention and initiatives should be considered to enhance female internal awareness to prevent peer pressure to start Hookah smoking. This habit started at home, became accepted by parents and is now accepted in public places. Therefore, it is crucial to implement culturally competent interventions to combat Hookah smoking in private and public places. Implications for Nursing: Nurses and policy makers should address the triggering factors for increased Hookah smoking among adults. Nurses should use effective approaches for combating Hookah smoking in different community settings. Also, they should conduct and implement culturally competent preventive programs to combat Hookah smoking in different settings and among all age groups, specifically university and school students, and enhance their awareness. Additionally, it is significant to enforce legislations and policies for the prevention of Hookah smoking among adults. Keywords: Hookah, Smoking, Female, University, Students, Cigarettes.

Smoking Cessation and Tobacco-related Risk Perceptions among People with and without a Diagnosis of Cancer.

Little is known about how cancer diagnosis and tobacco-related risk perceptions are associated with smoking behavior. We used data from Waves (W) 1-3 (2013-2016) of the Population Assessment of Tobacco and Health Study to analyze longitudinal smoking behavior among adults who were current smokers and not previously diagnosed with cancer at baseline (W1; N = 7,829). The outcome was smoking cessation as of follow-up (W3). Explanatory variables were sociodemographics, other tobacco product use, adult at first cigarette, tobacco dependence, cancer diagnosis after baseline, and tobacco-related risk perceptions [cigarette harm perception, worry that tobacco products will damage one's health ("worry"), belief that smoking causes cancer ("belief"), and nondaily smoking harm perception]. Cessation was significantly associated with baseline worry (OR = 1.26; 95% confidence interval, 1.13-1.40), follow-up cigarette harm perception [OR = 2.01 (1.77-2.29)], and follow-up belief [OR = 1.40 (1.20-1.63)]. Cessation was inversely associated with follow-up (W3) worry, and this association was stronger among those without a cancer diagnosis (OR = 0.37 without cancer; OR = 0.76 among individuals diagnosed with cancer; interaction P = 0.001). Cessation is associated with tobacco-related risk perceptions, with different perceptions contributing in unique ways. Cessation is predicted by baseline worry but is inversely associated with worry at follow-up, suggesting that perhaps cessation has alleviated worry. The latter finding was stronger among respondents not diagnosed with cancer. Associations between cancer diagnosis, tobacco-related risk perceptions, and smoking behavior may inform the development of evidence-based smoking cessation interventions.

Differences between smokers and non-smokers in personality traits: the role of sensation seeking and core self-evaluations

ABSTRACT Objectives Smoking is recognized as one of the most important preventable causes of premature death in the world and personality traits as one of the influential factors in people’s tendency to smoke. Therefore, we conducted the present research to compare the sensation seeking and core self-evaluations in the smoking and nonsmoking population. Methods 867 people from the general population of Hormozgan Province participated in this cross-sectional study. We collected the data online using questionnaires of demographic information, smoking, Zuckerman sensation seeking and core self-evaluations. Results 38.2% of the participants in the study were smokers and 61.8% were nonsmokers. The mean scores of awareness of the harms of smoking in non-smokers and smokers were 7.43 (SD = 2.43) and 6.51 (1.72), respectively (p < 0.001). The mean scores of sensation seeking in the non-smokers and smokers were 15.10 (SD = 5.64) and 23.09 (SD = 4.18), respectively (p < 0.001). The mean scores of core self-evaluations in the non-smokers and smokers were 43.46 (SD = 6.79) and 37.9 (SD = 4.82), respectively (p < 0.001). Conclusions According to the findings, smokers have lower core self-evaluations and high sensation seeking compared to non-smokers. Therefore, paying attention to these personality factors is necessary in the design and implementation of preventive therapeutic and psychological interventions in smokers.

Use of a Rapid Qualitative Method to Inform the Development of a Text Messaging Intervention for People With Serious Mental Illness Who Smoke: Formative Research Study.

People with serious mental illness are disproportionately affected by smoking and face barriers to accessing smoking cessation treatments in mental health treatment settings. Text-based interventions are cost-effective and represent a widely accessible approach to providing smoking cessation support. We aimed to identify key factors for adapting text-based cessation interventions for people with serious mental illness who smoke. We recruited 24 adults from mental health programs who had a serious mental illness and currently smoked cigarettes or had quit smoking within the past 5 years. We then conducted virtual qualitative interviews between November 2020 and August 2021. Data were analyzed using the rapid thematic analytic approach. We identified the following 3 major themes: (1) interplay between smoking and having a serious mental illness, (2) social contextual factors of smoking in adults with serious mental illness, and (3) smoking and quitting behaviors similar to the general population. Participants reported barriers and facilitators to quitting across the 3 themes. Within the "interplay between smoking and having a serious mental illness" theme, barriers included smoking to manage stress and mental health symptoms, and facilitators to quitting included the awareness of the harm of smoking on mental health and patient-provider discussions on smoking and mental health. In the "social contextual factors of smoking in adults with serious mental illness" theme, barriers included high social acceptability of smoking among peers. Positive support and the combined social stigma of smoking and having a mental health condition outside of peer groups motivated individuals to quit. Some participants indicated that low exposure to other smokers during the COVID-19 pandemic helped them to engage in cessation efforts. In the "smoking and quitting behaviors similar to the general population" theme, barriers included smoking after eating, having coffee, drinking alcohol, and experiencing negative social support, and facilitators included health concerns, improvement in the general quality of life, and use of evidence-based tobacco treatments when available. People with serious mental illness often smoke to cope with intense emotional states, manage mental health symptoms, or maintain social bonds. Text message content emphasizing equally effective and less harmful ways for stress reduction and mental health symptom management may improve quit rates in individuals with serious mental illness.

UK report underscores potential of e-cigarettes to reduce smoking harms.

Most of the harm from smoking could be prevented if a way could be found to provide the nicotine smokers crave without the harmful constituents of tobacco smoke. 1 Russell MA Low-tar medium-nicotine cigarettes: a new approach to safer smoking. Br Med J. 1976; 1: 1430-1433 Crossref PubMed Scopus (141) Google Scholar E-cigarettes have the potential to reduce smoking harms, but their population health impact depends on their uptake among smokers, the extent to which they completely displace smoking, and, crucially, their health effects compared with smoking. These factors must be weighed against any adverse impacts, such as uptake of e-cigarettes among nicotine-naive young people and their absolute health risks compared with using no nicotine products. A report commissioned by the UK Office for Health Improvement and Disparities, Nicotine Vaping in England: an Evidence Update Including Health Risks and Perceptions, 2022 by Ann McNeill and colleagues, 2 McNeill A Simonavičius E Brose LS et al. Nicotine vaping in England: an evidence update including health risks and perceptions, 2022. A report commissioned by the Office for Health Improvement and Disparities. Office for Health Improvement and Disparities, London2022https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-updateDate accessed: October 3, 2022 Google Scholar provides the most rigorous and comprehensive review on this topic to date. This report's findings provide reassurance to smokers, health services, and policy makers.

An Analysis of Arguments Advanced via Twitter in an Advocacy Campaign to Promote Electronic Nicotine Delivery Systems.

Advocates of electronic nicotine delivery systems (ENDS) increasingly use Twitter to promote liberal ENDS policies. "World Vape Day" (WVD) is an annual campaign organized by pro-ENDS advocacy groups, some of which have links to the nicotine industry (eg, via funding from the "Foundation for a Smoke-Free World"). In 2020, the campaign used dedicated social media accounts to disseminate WVD-branded images and campaign messages. We examined tweets posted as part of WVD 2020 to identify and analyze pro-ENDS policy arguments. We extracted tweets posted between 26 May and 3 June 2020 that included the hashtag #WorldVapeDay. We used qualitative thematic analysis to code a random sample (n = 2200) of approximately half the original English language tweets (n = 4387) and used descriptive analysis to identify the most frequently used co-hashtags. Arguments related to four themes: harm reduction, smoking cessation, rights and justice, and opposition to ENDS restrictions. Tweets criticized individuals and groups perceived as opposing liberal ENDS regulation, and used personal testimonials to frame ENDS as a harm reduction tool and life-saving smoking cessation aid. Tweets also advanced rights-based arguments, such as privileging adults' rights over children's rights, and calling for greater recognition of consumers' voices. Tweets frequently used hashtags associated with the WHO and World No Tobacco Day (WNTD). The WVD campaign presented a series of linked pro-ENDS arguments seemingly aimed at policy-makers, and strategically integrated with the WHO's WNTD campaign. Critically assessing pro-ENDS arguments and the campaigns used to promote these is vital to helping policy actors develop proportionate ENDS policy. Social media platforms have considerable potential to influence policy actors. Tweets are easily generated and duplicated, creating an impression of sizeable and influential stakeholders. Evidence that the "World Vape Day" campaign was supported by groups with industry links, and targeted-at least in part-at WHO officials and those who follow the WHO World No Tobacco Day campaign, highlights the importance of critically reviewing such campaigns. Further research could examine how health advocates could engage in pro-ENDS campaigns to support balanced messaging and informed policy-making.