Harms Of Smoking Research Articles

P0442 Prevalence and Impact of E-cigarettes on Disease Outcomes in Patients with Inflammatory Bowel Disease

Abstract Background Electronic cigarettes (EC) have gained popularity as an alternative to traditional cigarette smoking. The harms of traditional cigarette smoking in Crohn’s disease (CD) are well established, but it is unclear if EC have similar harmful effects. Our aim was to determine the prevalence, predictors and impact of EC on clinical outcomes in patients with IBD. Methods This a cross-sectional study of a prospectively maintained single-center IBD registry from September 1st 2023-September 30th, 2024. The study included all patients aged 14-years and older who had a confirmed diagnosis of IBD including CD, ulcerative colitis (UC), IBD-unclassified (IBD-U), excluding those with pouchitis. The Primary outcomes were to determine the prevalence and predictors of EC use among patients diagnosed with IBD. The secondary outcomes assessed the impact of EC on clinical outcomes in IBD patients including the need for surgical intervention, CD progression (perianal disease, stricturing or penetrating complications), need for > 2 advanced therapies and composite outcome (intestinal surgery, disease progression, > 2 advanced therapies). Results A total of 412 patients were enrolled in the study (mean age 33 ± 13 years; 68% with CD) and 55% were male. Overall, 25% (n=102) of the cohort had traditional cigarette smoking history. EC use prevalence among IBD patients was 10.2% (n=42) (6.6% current, 3.6% previous users). Compared to non-users, EC-previous/current users were more likely to be male and have and have history of traditional cigarette smoking (Table 1). The prevalence of EC use was similar between patients with and without a history of intestinal surgery (10% for both, p > 0.9), with no significant differences noted in CD (p = 0.4) or UC (p = 0.5) subgroups. In CD, the prevalence of EC use was similar in patients with and without stricturing disease (8.9% vs. 13%; p=0.3), and perianal disease (13% vs. 11%; p=0.7). For penetrating disease, EC use was 7.8%, compared to 16% in those without penetrating disease (p=0.06). No difference in EC use was found in those patients who required > 2 advanced therapies (10%; n=4) vs. those who required ≤ 2 advanced therapies (10%; n=38) (p > 0.9). EC use was noted in 11% (n=29) in patients who developed the composite outcome vs. 8.2% (n=13) in those who did not (p=0.3). Conclusion Up to 10% of IBD patients reported EC use, which was associated with male sex and history of traditional cigarette smoking. In our cohort, no association between EC use and unfavourable clinical outcomes was noted but larger studies with longer follow up duration are needed to further elucidate the impact of EC use on clinical outcomes in IBD.

Trends and patterns of dual use of combustible tobacco and e-cigarettes among adults in England: A population study, 2016-2024.

E-cigarettes are frequently used by people who smoke. This study measured how the prevalence and patterns of smoking and vaping ('dual use') in England have changed as the vaping market has rapidly evolved. Representative monthly cross-sectional survey, July 2016 to April 2024. England. 128 588 adults (≥18y). Logistic regression estimated associations between survey wave and dual use. Descriptive statistics were used to analyse patterns of smoking and vaping, overall and by sociodemographic, smoking and vaping characteristics and harm perceptions of e-cigarettes vs. cigarettes. Across the period, the overall prevalence of dual use increased non-linearly from 3.5% to 5.3% of adults [prevalence ratio (PR) = 1.49 (1.25-1.76)]. Among adults who smoked, the proportion who also vaped was relatively stable up to mid-2021, at an average of 18.6% between July 2016 and May 2021, then increased rapidly to 34.2% by April 2024 [PR = 1.76 (1.48-2.09)]. This increase was greatest at younger ages [e.g. from 19.6% to 59.4% among 18- to 24-year-olds; PR = 3.04 (2.28-4.23)]. The most common pattern of dual use across the period was daily cigarette smoking with daily vaping [49.0% (47.3-50.8%)]. Over time, the proportion of dual users reporting daily cigarette smoking with non-daily vaping decreased [from 35.2% to 15.0%; PR = 0.43 (0.29-0.63)], offset primarily by an increase in the proportion reporting non-daily cigarette smoking with daily vaping [from 7.6% to 21.5%; PR = 2.84 (1.71-4.72)]. Daily cigarette smoking with daily vaping was more common (and non-daily cigarette smoking with daily vaping less common) among dual users who were older, less advantaged, mainly smoked hand-rolled cigarettes, had stronger urges to smoke and had been vaping for ≤6months. Daily vaping was more common among dual users who thought e-cigarettes were less/equally harmful as cigarettes, or were unsure. In England, vaping prevalence has increased rapidly among adults who smoke since 2021, which was when disposable e-cigarettes started to become popular. Since 2016, patterns of dual use have shifted away from more frequent smoking towards more frequent vaping. This may be the result of increasing prevalence of dual use among younger adults, who are more likely than older dual users to smoke non-daily and vape daily.

Cigarette smoking and perceived risk of cardiovascular disease in Iran

IntroductionStudies have consistently demonstrated a strong link between cigarette smoking and an increased risk of cardiovascular diseases (CVD). On the other hand, studies have shown that most smokers do not have a real understanding of the cardiovascular health hazards of smoking. Therefore, the study aimed to determine the perceived risk of Myocardial Infarction (MI), Hypertension (HTN), and Stroke among current smokers in Iran.MethodsThis cross-sectional study was conducted between January and May 2023, and recruited 380 smokers by convenience sampling who smoked at least 100 cigarettes in their lifetime. The data were collected using three questionnaires (1) the questionnaire to assess the risk perception for MI, HTN, and Stroke, (2) the smoking stage of change questionnaire, and (3) the Fagerström Test for nicotine dependence (FTND). The CVD risk perception consisted of two parts, perceived susceptibility and perceived severity. Each part scores between 0 and 10 and finally gets a total score of 0–20. A score of zero indicated the lowest risk perception while a score of 20 indicated the highest risk perception. We examined the relationship between the demographic and smoking-related variables and the smokers’ perceived risk of MI, stroke, and HTN by using multiple linear regression.FindingsThe mean age of participants was 35.57 ± 12.05 years, and 77.1% were male. The perceived risk score of MI was 10.68 ± 4.69 out of 20. The scores related to stroke and HTN were 10.00 ± 4.65 and 10.89 ± 4.73, respectively. Identified variables collectively contributed significantly to predicting the perceived risk of MI (p <.0001, Adj R-squared = 0.05%), stroke ( p <.0001, Adj R-squared = 0.08%), and HTN (p <.0001, Adj R-squared = 0.06%). We found that longer smoking duration [coefficient=-1.96 (95% CI= -3.91, − 0.09)] for 20–29 years and − 4.08 ( 95% CI= -6.70, -1.46 ) for 30 + years), older smoking age onset [coefficient=-2.10 ( 95% CI= -3.24, − 0.96 )] for 20 + years), and dual tobacco users [coefficient= -1. 04 (95% CI= -2.08, − 0.06)] were significantly associated with lower perceived risk for MI. We also found that longer smoking duration [coefficient=-2.23 (95% CI= -4.13, − 0.32)] for 20–29 years and − 5.01 (95% CI= -7.565734, -2.462361 ) for 30 + years), older smoking age onset [coefficient=-1.86 (95% CI= -2.970021, − 0.75 ] for 20 + years), and being male [coefficient= -2. 00, (95% CI= -3.53, − 0.47)] were significantly associated with lower perceived risk for stroke. We found that longer smoking duration (coefficient=-4.40 for 30 + years), older smoking age onset [coefficient=-2.02 (95% CI= -3.14, − 0.87,)] for 20 + years), and being dual users [coefficient=-1.36, 95% CI= -2.40, − 0.3241238)] were significantly associated with lower perceived risk for HTN.ConclusionThe results of this study demonstrated a moderate perceived risk of participants to CVD. Also, the perceived risk decreases as the duration of smoking and the age for the smoking onset increases to 20 years and above. It seems necessary to carry out interventions to inform the public about the harms of smoking, especially for adolescents and young adults, and its risks in causing cardiovascular disease.

A systematic review on risk factors and reasons for e-cigarette use in adolescents.

The aim was to establish EC use risk and protective factors, the reasons for use, associations with tobacco and other substance use, and use for smoking cessation. A systematic review following PRISMA guidelines was registered in PROSPERO (CRD42024532771). Searches in Web of Science and PubMed/MEDLINE (March-April 2024) used terms like 'electronic cigarette' and 'adolescents' with a PICO framework. Inclusion criteria covered studies on adolescents aged 10-19 years, published in English or Spanish (2018-2024). Three reviewers independently screened studies, achieving 96% inter-rater reliability. Data extraction followed standardized tables, and methodological quality was assessed using MMAT and GRADE tools, ensuring a robust evaluation of evidence on adolescent electronic cigarette use. From 895 studies, 50 met the inclusion criteria. The strongest risk factors for adolescent EC use include social acceptance and use within peer or family circles (13 studies), male gender (10 studies), low risk perception (6 studies), younger age (3 studies), and greater financial resources (3 studies). Motives for use include low perceived risk and appealing flavors, supported by both longitudinal and cross-sectional studies. EC use is significantly associated with smoking initiation (7 studies), cannabis consumption (8 studies), and alcohol use (4 studies). Evidence on the effectiveness of ECs as harm reduction or smoking cessation tools in adolescents remains inconclusive, with some cross-sectional studies supporting their utility and others finding contrary evidence. High-quality research indicates ECs are predominantly used alongside traditional cigarettes, with dual nicotine consumption patterns commonly observed. Evidence on adolescent EC use identifies risk factors, motives, and links to substance use. However, its role in harm reduction and smoking cessation remains insufficient and controversial. High-quality research is needed, as most studies are low quality. Targeted prevention strategies addressing social influences, perceptions, and accessibility are crucial to reduce adolescent EC use.

Maternal Smoking during Pregnancy Interacts with Genetic Factors to Increase Risk for Low Birth Weight but not Harmful Offspring Smoking Behaviors in Europeans.

Pregnant individuals who smoke face increased health risks because smoking harms both the mother and their developing offspring. Using 307 417 Europeans from the UK Biobank, we examined whether exposure to maternal smoking during pregnancy (MSP) interacts with genetic risk to predict offspring birth weight (BW) and smoking behaviors. We investigated interactions between MSP and genetic risk at multiple levels: single variant, gene-level, and polygenic score. We examined self-reported BW, smoking initiation status (SI), age of smoking initiation, cigarettes per day, and smoking cessation status. One locus tagged by SNP rs72689499 on chromosome 14 reached significance for an interaction with MSP on the multiplicative (log10) scale for BW (p = 5.13x10-9). In gene-level testing, three genes on chromosome 1 and one gene on chromosome 14 reached significance for an interaction with MSP on both the additive and multiplicative scale for BW. These genes include: PTCH2, EIF2B3, PLK3, and TSHR. SNP and gene-level results were insignificant for all offspring smoking behaviors. We also detected an interaction between polygenic risk for smoking and MSP on SI on both the additive (p = 4.4x10-5) and multiplicative (p = 1.0x10-5) scale. We found evidence of gene-environment correlation in the polygenic risk analysis using a post-hoc t-test which showed that MSP-exposed offspring had a higher SI PGS than those unexposed to MSP (p = 5.9x10-623). Our results support the main effect of MSP on BW and show a genetic interaction between MSP and genetic factors influencing BW. We detected interactions between maternal smoking and genetic factors to influence birth weight; these interactions were detectable at both the SNP and gene level. Many of the genes detected to interact with maternal smoking to influence birth weight have other reported associations with height or smoking-related traits. For smoking initiation, we detected a negative interaction between maternal smoking and polygenic risk, as well as evidence of gene-environment correlation.

E-Cigarette effects on oral health: A molecular perspective.

Electronic cigarettes (e-cigarettes) have emerged as a potential alternative to traditional smoking and may aid in tobacco harm reduction and smoking cessation. E-cigarette use has notably increased, especially among young non-tobacco users, raising concerns due to the unknown long-term health effects. The oral cavity is the first and one of the most crucial anatomical sites for the deposition of e-cigarette aerosols. E-cigarette aerosols contain nicotine, flavors, volatile organic compounds, heavy metals, carcinogens, and other hazardous substances. These aerosols impact the oral cavity, disrupting host-microbial interactions and triggering gingivitis and systemic diseases. Furthermore, oral inflammation and periodontitis can be caused by proinflammatory cytokines induced by e-cigarette aerosols. The toxic components of e-cigarette aerosols increase the cellular reactive oxygen species (ROS) levels, reduce antioxidant capacity, increase DNA damage, and disrupt repair processes, which may further contribute to harmful effects on oral epithelum, leading to inflammatory and pre-malignant oral epithelial lesions. In this review, we analyze the toxicological properties of compounds in e-cigarette aerosols, exploring their cytotoxic, genotoxic, and inflammatory effects on oral health and delving into the underlying molecular mechanisms. Further research is essential to understand the impact of e-cigarettes on oral health and make informed regulatory decisions based on reliable scientific evidence.

Misperceptions about the effectiveness of cutting down and low-rate daily smoking for reducing the risk of tobacco-caused harm.

Reducing the amount smoked per day, or smoking at a low rate, confers limited protection from smoking harms. We aimed to quantify the prevalence of misperceptions about cutting down and low-rate smoking among Australian adults who smoke. Cross-sectional online survey in April/May 2022 (N=2,740). Participants were asked whether they agreed (misperception) or disagreed that "Reducing the number of cigarettes smoked per day is an effective way to reduce the risk of experiencing the health harms of smoking". They were also asked whether the statement "Smoking 1 cigarette per day is about 1/20th as dangerous as smoking a pack of 20 cigarettes per day" sounded about right (misperception) or if it was less dangerous (misperception) or more dangerous than that. The misperception that reducing the number of cigarettes smoked is an effective way to reduce risk was held by 72.0% of people who smoke overall, but was more common among those who smoked <5 cigarettes daily (76.3%; Adj PR=1.11 [95% CI 1.01-1.21]) or only occasionally (79.7%; Adj PR=1.14 [1.06-1.23]) compared with those who smoked 5+ cigarettes daily (66.7%). Over two-thirds (67.9%) underestimated the dangers of smoking 1 cigarette per day, and this misperception was also more common among low-rate smokers (77.6%, Adj PR=1.14 [95% CI 1.04-1.26]) compared to those who smoked 5+ cigarettes daily (63.1%). Misperceptions about the value of cutting down and low-rate smoking for reducing the risk of tobacco-caused harm are pervasive, especially among those who currently smoke at a low-rate or only occasionally. Recent epidemiological evidence confirms that the risks of harm associated with low-rate smoking and cutting down are much higher than would be expected if the relationship between consumption and harm was linear. Findings from this study indicate that misperceptions about the benefits conferred by these smoking patterns are pervasive among people who smoke, particularly among those who currently smoke at a low rate. Corrective education that explains the mechanisms for the increased risk posed by these behaviours could be delivered via package health warnings and/or public health campaigns and may provide low-rate and occasional smokers with additional reasons to quit.

Messages about climate, pollution and social justice harms of tobacco as motivators to quit: an untapped communication opportunity?

BackgroundCampaigns highlighting the health harms of smoking have demonstrated success in motivating people who smoke to quit. Tobacco production and use also exert a toll on the environment, sustainable development...

Tobacco Smoke Exposure and Lactation.

Tobacco smoke exposure remains a significant public health concern, particularly for lactating women and their infants. Despite widespread awareness of the harms of smoking during pregnancy, many women continue to smoke postpartum, directly impacting lactation success and infant health. Studies have shown that nicotine, the primary component of tobacco smoke, inhibits prolactin production and the milk ejection reflex, resulting in a decreased milk supply and poor breastfeeding outcomes. Additionally, the presence of harmful chemicals in tobacco smoke, such as cadmium and lead, can accumulate in breast milk, exposing infants to toxic substances with potential long-term health implications. Maternity professionals play a crucial role in supporting smoking cessation efforts among postpartum women, providing evidence-based counseling, resources, and referrals to cessation programs. This review aims to provide an update for maternity professionals on the effects of tobacco smoke exposure on lactation and breastfeeding outcomes. In this review, we will explore the physiological mechanisms through which tobacco smoke components can interfere with lactation. Furthermore, we will discuss the challenges faced by lactating women who smoke, including increased risk of mastitis, reduced breastfeeding duration, and impaired infant growth and development. Finally, we will highlight emerging research on novel interventions to reduce the adverse effects of tobacco smoke exposure on lactation, including pharmacological treatments and behavioral interventions tailored to postpartum women.

Two decades of electronic nicotine delivery systems discussions in Türkiye: AI-driven text analysis

Abstract Background As Turkiye ranks second in cigarette consumption in Europe, the increasing shift to Electronic Nicotine Delivery Systems (ENDS) presents emerging public health concerns. This study aims to introduce a hybrid approach by combining AI-driven large language models (LLM) with traditional thematic analysis to explore 20 years of ENDS discourse on Eksisozluk, a popular Turkish social media platform, using the Health Belief Model (HBM). Methods This mixed-methods study, analyzed 5,907 comments about ENDS from 2003 to 2023, sourced from a renowned online user-generated forum in Turkiye. Utilizing an LLM, comments were first categorized according to the HBM. Subsequently, the LLM’s generative capabilities were employed to identify sub-themes through thematic analysis. A temporal analysis was then conducted to examine the evolving trends over the 20-year span. Results ENDS popularity peaked in 2017, dipped during the COVID-19 pandemic, and later rebounded. Using an LLM with 70% accuracy, validated by a manually labeled sample, we discerned two main themes: perceived benefits (40.5%) - primarily using ENDS as for harm reduction (32.8%) and smoking cessation tools (21.6%)- and perceived barriers (27.7%), with cost and accessibility (21.9%) being the most significant throughout the period. Initially, the focus was on cessation, but shifted to harm reduction post-pandemic. Conclusions Our study indicates that consumers in Turkiye initially used ENDS for cessation but recognized their ineffectiveness over time. During the COVID-19 pandemic, usage shifted towards harm reduction, likely influenced by the rhetoric of the Tobacco Industry. Despite a national ban, ENDS remain widely used in Turkiye. Key messages • Turkiye should develop a social marketing strategy to raise awareness that ENDS is not a valid tool for harm reduction. • Although the sale of ENDS is prohibited in Turkiye, enforcement of bans should be strengthened as part of an effective control strategy.

Unrealistic risk perceptions of Iranian current cigarette smokers on developing lung cancer and chronic obstructive pulmonary disease (COPD): a cross-sectional study

Cigarette smoking causes serious complications and diseases in a person’s life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in current smokers. This cross-sectional study which was conducted between January-May 2023, recruited 380 current smokers by convenience sampling in community setting. The data were collected face to face using three questionnaires (1) the risk perception for lung cancer and COPD questionnaire, (2) the smoking stage of change questionnaire, and (3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers’ perceived risk of lung cancer and COPD by using multiple linear regression. We found that lower education (coefficient = 3.60, 95%CI [1.00, 6.19], P < 0.0001) for elementary level and (coefficient = 2.81, 95% CI [0.36, 5.26], P < 0.05) for secondary level had greater lung cancer perceived risk. Besides, smoking age onset for 20 + years (coefficient=-1.36, 95%CI [-2.42, -3.17], P < 0.0001) lower than those who started before the age of 20 were associated with lower perceived risk for lung cancer. Regarding COPD, results indicated that lower education (coefficient = 4.54, 95% CI [1.87, 7.21], p < 0001) for elementary level (coefficient = 3.35, 95% CI [0.83, 5.87], p < 0.001) for secondary level and (coefficient = 3.03, 95% CI[-0.67, 4.25], P < 0.05) for high school dropout, and employment status (coefficient = 3.62, 95% CI[0.66, 6.59], p < 0.05) of employer and (coefficient = 3.23, 95% CI [0.14, 6.33], p < 0.05) for homemaker reported greater perceived risk. This study’s results showed that participants’ perceived risk was relatively low. It seems necessary to carry out interventions to inform about the harms of smoking and to enhance public awareness about the heightened risks of diseases such as lung cancer and COPD among cigarette smokers.

Harm to myself or others? A qualitative study of the preferences of people who smoke for messages to be included in cigarette pack inserts.

Tobacco package inserts [TPIs] are a novel channel to transmit smoking cessation messages. Research has shown associations between inserts, intentions to quit and increased self-efficacy. In Israel, TPIs have been legislated, but not yet implemented. This study aimed to learn what kind of messages would appeal to people who smoke, for the purpose of developing effective TPIs. Semi-structured interviews with 25 people who smoke or formerly smoked, aged 18-67. An inductive and deductive thematic analysis was conducted to enable a dynamic process coding and identifying themes and categories across interviews. Two main themes identified were: harms of smoking and motivators for quitting. Many participants were averse to information about the harms of smoking but interested in specific information about the harm of smoking to others, particularly children, on comparative risks of different tobacco/nicotine products, and about how to address the challenge of addiction. There was a preference for motivational messages encouraging quitting, including how the body recovers, personal quit stories, practical quit tips, and information on cessation services. Adult who smoke were receptive to the idea of TPI, but considered some types of information superfluous. It is important to emphasize harm to others, provide information on quit services, and deliver information that is reliable, specific, and evidence-based regarding quitting, so that it can be encouraging, useful, and practical. The merits of providing information to people who smoke on relative risks of different nicotine and tobacco products should also be considered. The findings provide a basis for developing TPI content. A large proportion of adults who smoke are interested in quitting. Pack inserts with positive motivating messages, quitline details, and novel information about risks to people who smoke and particularly to others, should be developed and tested, and subsequently distributed nationally to reach all those who open a cigarette package.

E-Cigarettes in Smoking Cessation and Harm Reduction: A Comprehensive Review of Recent Evidence and Potential Risks

The global prevalence of tobacco use has significantly decreased over the years, with projections indicating further decline. However, the rise of new nicotine products suggests that nicotine addiction will remain a major public health issue. Electronic cigarettes (e-cigarettes) are increasingly recognized as potential tools for smoking cessation and harm reduction. This review evaluates the safety and effectiveness of e-cigarettes both as standalone treatments and in combination with other therapies, such as nicotine replacement therapy (NRT), varenicline, cytisine, and behavioral approaches. A comprehensive analysis of studies published over the past decade, including systematic reviews, meta-analyses, and randomized controlled trials, shows that e-cigarettes can enhance smoking cessation rates and reduce tobacco-related harm. They exhibit comparable short-term efficacy to traditional treatments, with promising results in alleviating withdrawal symptoms and lowering smoking rates. However, the long-term safety and effectiveness of combining e-cigarettes with other therapies remain uncertain and require further investigation. Despite their potential benefits, e-cigarettes pose significant safety concerns, underscoring the need for ongoing research to refine cessation strategies and ensure their safe, long-term use. Rigorous evaluation and regulatory oversight are essential to optimize e-cigarettes' role in reducing tobacco harm.

Aachen smoking cessation and harm reduction (ASCHR) trial study protocol – scientific evaluation of a psychological-telemedical counseling concept for smoking cessation in patients with vascular diseases

BackgroundSmoking is a major risk factor of cardiovascular diseases, notably peripheral arterial disease (PAD). Despite this link, research on smoking cessation interventions in PAD patients remains scarce and inconclusive regarding the efficacy of such interventions.Therefore, elucidating it is crucial and should address both individuals who smoke that are motivated to quit and individuals who smoke heavily lacking the motivation to quit.Methods/DesignThe Aachen Smoking Cessation and Harm Reduction (ASCHR) trial is a prospective randomized controlled study (RCT) on the benefits of telemedical-psychological support for smoking cessation in patients with PAD, funded by the “Innovation Fund” of the Joint Federal Committee in Germany. This trial aims to scientifically assess the efficacy, feasibility, acceptance, and efficiency of a multi-stage smoking cessation program based on the recommendations of the German guideline for smoking cessation tailored to patients with PAD, compared to a control group receiving no intervention. Central to the program is psychological counseling utilizing motivational interviewing techniques, delivered through telemedicine via video consultations. The primary endpoint of the ASCHR trial is the smoking cessation rate after 8 months of intervention, with a secondary endpoint evaluating sustained abstinence at a further 6 months follow-up. Smoking cessation is defined as a carbon monoxide level in exhaled air of less than 6 ppm. We hypothesize that the group receiving the multi-stage cessation program will yield a cessation rate at least 10 percentage points higher than that of usual care. Anticipating a dropout rate of around 35%, the planned sample size is at least N = 1032 study participants.DiscussionShould the trial demonstrate significant positive outcomes, efforts should be made to integrate the program into routine care in Germany, potentially offering a promising base for future smoking cessation support among PAD patients.

A meta-analysis on polymorphic trait of taste perception mediated by TAS2R38 genotype.

The objective of this study is to review the association of TAS2R38 polymorphisms and taste phenotypes to bitter compounds (phenylthiocarbamide [PTC]/propylthiouracil [PROP]), and its association among persons who drink alcohol and individuals with smoking behavior. A literature search was carried out in PubMed, ScienceDirect, Cochrane, and Wiley online library databases using the keyword "(Bitter taste receptor genes OR TAS2R38) AND (PROP OR propylthiouracil) AND (PTC OR phenylthiocarbamide)," "(Bitter taste receptor genes OR TAS2R38) AND (alcohol)," "(Bitter taste receptor genes OR TAS2R38) AND (tobacco OR smoker)" to find articles evaluating the association of taste phenotypes and TAS2R38 polymorphisms, and its association among persons who drink alcohol and individuals with smoking behavior. The analysis show that TAS2R38 taster genotype (proline-alanine-valine [PAV] allele) was significantly (OR, 5.88; CI [3.87, 8.95], p < .001) associated with taster phenotype for bitter compounds (PTC/PROP), and TAS2R38 nontaster genotype (alanine-valine-isoleucine allele) was significantly (OR, 6.73; CI [4.57, 9.90], p < .001) associated with nontaster phenotype for bitter compounds. Further, TAS2R38 taster genotypes (PAV homozygotes and heterozygotes) were significantly associated with higher alcohol intake (OR, 5.15; 95% CI [2.66, 9.98]; p < .001) and among individuals with smoking behavior (OR, 1.73; 95% CI [1.24, 2.42]; p = .001). This suggests that TAS2R38 single nucleotide polymorphisms can be identified by clinically assessing taste phenotype status for bitter compounds and can be used as a potential therapeutic target in the prevention and treatment of harmful higher alcohol intake and smoking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of the introduction of tobacco product plain packaging on consumer responses in Ireland: a real-world policy evaluation stratified by socioeconomic groups.

Smoking prevalence remains high in Europe and widening socioeconomic group differences are driving health inequalities. While plain packaging policies disrupt tobacco industry tactics that sustain smoking, evidence of their equity impact is sparse. This study evaluated the implementation of plain packaging in Ireland in 2018 on consumer responses, overall and by the socioeconomic group. Consecutive nationally representative cross-sectional surveys (2018, n = 7701 and 2019, n = 7382) measured changes in 13 consumer responses among respondents who smoked across three domains: product appeal, health warnings effectiveness, and perceived harmfulness of smoking. Multiple logistic regression-derived adjusted odds ratios with 95% confidence intervals to compare responses post- versus pre-implementation adjusting for age, gender, educational level, and heaviness of smoking. A stratified analysis examined changes by socioeconomic group indexed using educational level. There were statistically significant changes in consumer responses to plain packaging policy implementation across 7/13 outcomes studied. Five changes were aligned with expected policy impacts (2/6 product appeal outcomes and 3/4 health warning effectiveness outcomes). Two responses were also observed which were not expected policy impacts (1 appeal-related and 1 perceived harm-related outcome). There was no change in five outcomes. Differences in consumer responses between educational groups were generally small, mixed in nature, and indistinguishable when interval estimates of effect were compared. Implementation of plain packaging in Ireland had intended impacts on consumer responses. Including plain packaging requirements in revising the European Union's legislative frameworks for tobacco control will help build progress towards a Tobacco-Free Europe without exacerbating smoking inequalities.

Association Between Cigarette and Bidi Purchase Behavior (Loose vs Pack) and Health Warning Label Exposure: Findings From the Tobacco Control Policy India Survey and In-Depth Interviews With People Who Smoke.

The sale of loose cigarettes or bidis can undermine the purpose of requiring health warning labels (HWLs) on cigarette packs and bidi bundles by diminishing their visibility and legibility. This mixed-methods study aims to examine the association between purchase behavior (loose vs pack or bundle), HWL exposure, and responses to HWLs among Indian adults who smoke. Data were analyzed from the 2018-2019 India Tobacco Control Policy Survey and from 28 in-depth interviews conducted with Indian adults who smoked in 2022. The Tobacco Control Policy Survey sample included tobacco users who bought cigarettes (n=643) or bidis (n=730), either loose or in packs or bundles at their last purchase. Ordinal regression models were fit separately for cigarettes and bidis, whereby HWL variables (noticing HWLs, reading and looking closely at HWLs, forgoing a cigarette or bidi because of HWLs, thinking about health risks of smoking, and thinking about quitting smoking cigarettes or bidis because of HWLs) were regressed on last purchase (loose vs packs or bundles). In-depth interviews with participants from Delhi and Mumbai who purchased loose cigarettes in the last month were conducted, and thematic analysis was used to analyze the interview data. Survey findings indicated that about 74.3% (478/643) of cigarette users and 11.8% (86/730) of bidi users reported having bought loose sticks at their last purchase. Those who purchased loose cigarettes (vs packs) noticed HWLs less often (estimate -0.830, 95% CI -1.197 to -0.463, P<.001), whereas those who purchased loose bidis (vs bundles) read and looked closely at HWLs (estimate 0.646, 95% CI 0.013-1.279, P=.046), thought about the harms of bidi smoking (estimate 1.200, 95% CI 0.597-1.802, P<.001), and thought about quitting bidi smoking (estimate 0.871, 95% CI 0.282-1.461, P=.004) more often. Interview findings indicated lower exposure to HWLs among those who purchased loose cigarettes, primarily due to vendors distributing loose cigarettes without showing the original cigarette pack, storing them in separate containers, and consumers' preference for foreign-made cigarette brands, which often lack HWLs. While participants were generally aware of the contents of HWLs, many deliberately avoided them when purchasing loose cigarettes. In addition, they believed that loose cigarette purchases reduced the HWLs' potential to deliver consistent reminders about the harmful effects of cigarette smoking due to reduced exposure, an effect more common among those who purchased packs. Participants also noted that vendors, especially small ones, did not display statutory health warnings at their point of sale, further limiting exposure to warning messages. Survey and interview findings indicated that those who purchased loose cigarettes noticed HWLs less often. Loose purchases likely decrease the frequency of exposure to HWLs' reminders about the harmful effects of smoking, potentially reducing the effectiveness of HWLs.

Association Between Tobacco Smoking and the Development of Diabetic Macular Edema.

Introduction: To explore the effect of cigarette smoking on the risk for developing diabetic macular edema (DME) among patients with diabetes. Methods: This retrospective exactly-matched cohort study used claims data for patients from all 50 states in the United States from 2010 through 2020. Patients with an initial diagnosis of diabetes were stratified into 3 cohorts as follows: active smokers, never smokers, and former smokers. After exact matching based on demographics and comorbidities, Kaplan-Meier survival functions for the 3 cohorts were compared using pairwise log-rank tests. Results: After matching, there were 42 298 patients in each cohort. Over 6 years of follow-up, the cumulative risk for DME was significantly higher among never smokers (1.18%) than among active smokers (0.88%) and former smokers (0.90%) (both P < .001). Conclusions: Among patients with diabetes, smoking may decrease the risk for developing DME. Although the harms of smoking far outweigh any potential protective benefits, further investigation into the mechanisms behind these findings has potential to uncover new therapeutic targets.

Impact of Pictorial Health Warnings on Cigarette Packs among Current Smokers of Sub-Metropolitan City of Nepal: A Descriptive Cross-sectional Study

Introduction: Pictorial health warning on cigarette packs is one of the strategies undertaken by Nepal Government as per the directive of World Health Organization Framework Convention on Tobacco Control to control smoking. It has been more than a decade since the introduction of pictorial health warnings on cigarette packs in Nepal. The objective of this study was to assess the impact of the pictorial warnings among current smokers of Dharan, Nepal.Methods: A descriptive cross-sectional study was conducted among current smokers visiting local shops located near ward offices of Dharan after obtaining ethical approval from Institutional Review Committee (Reference number: 204/080/01 -IRC). A structured and validated Nepali questionnaire was used to interview the smokers about the impact of the pictorial warnings based on their noticeability, behavioural and cognitive responses. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0. The responses of the participants were tabulated in frequencies and percentages.Results: The pictorial warnings were noticed by 277 (98.93%) participants in past one month out of which 11 (3.93%) smokers had always read or looked closely at them. Smoking less frequently was the behaviour change reported by 70 (25%) participants and smoking less around others was reported by and 56 (20%) participants. In total, 189 (67.50%) smokers had thought about the harms of smoking and 160 (57.14%) had intention to quit smoking due to the pictorial warnings.Conclusions: The pictorial health warnings were not so effective in bringing about changes in smoking behaviour of smokers.

Differences in Presenting Health Warning Labels on Hookah Venue Menus Between Immersive Virtual Reality and Online Surveys

Background Virtual reality (VR) platforms can simulate the real world, whereas online surveys are efficient settings for assessing and testing information. In this study, the effects of presenting health warning labels (HWLs) on hookah venue menus were compared between these two message-testing settings. Methods Separate studies were conducted in VR (n = 96) and online survey (n = 213) settings. Participants in both studies were randomly assigned to view menus with or without HWLs. This secondary data analysis compared outcomes between settings after propensity score weighting to account for differences in age, race, marital status, and education between studies. Results Significant between-study differences were noted for the effects of HWLs on people’s perceptions of the absolute harm of hookah smoking (p = 0.0363), the relative harm of hookah compared to cigarettes (p < 0.001), the absolute addictiveness of hookah (p < 0.001), and the relative addictiveness of hookah compared to cigarettes (p = 0.0352). When outcome variables differed significantly between the HWL and control conditions in only one of the two studies, smaller p-values were identified for the online survey setting than for the VR setting. Conclusions This study represents the first direct comparison of the effects of hookah HWLs between two message-testing settings. HWLs tested in the online survey setting were associated with larger shifts in attitudes and beliefs than those tested in the VR setting, suggesting that the effectiveness of hookah HWLs on attitudes and beliefs may be moderated by the message-testing platform. Additional real-world experiments remain necessary to determine whether either setting can accurately assess the effectiveness of HWLs.