Non-daily Smokers Research Articles

Trends in non-daily cigarette smoking in England, 2006–2024

BackgroundCigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption.MethodsData were collected monthly between November 2006 and April 2024 as part of a nationally representative, repeat cross-sectional survey of adults (≥ 18 years; n = 353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods.ResultsThe proportion who smoked non-daily was relatively stable between November 2006 and November 2013, at an average of 10.5% [10.1–10.9%] of cigarette smokers, then increased to 27.2% [26.0–28.4%] of cigarette smokers (4.0% [3.7–4.2%] of adults) by April 2024. This increase was particularly pronounced among younger adults (e.g. reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April 2024) and those who vape (reaching 34.2% among vapers vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers’ mean weekly cigarette consumption (from 34.3 in 2006–2009 to 21.1 in 2021–2024), urges to smoke (e.g. the proportion reporting no urges increased from 29.2 to 38.0%), and motivation to stop smoking (e.g. the proportion highly motivated to quit within the next 3 months decreased from 30.8 to 21.0%).ConclusionsAn increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit.

Does perceived vaping addiction predict subsequent vaping cessation behaviour among adults who use nicotine vaping products regularly?

BackgroundThis study aimed to investigate whether perceived vaping addiction is a predictor of quitting nicotine vaping product (NVP) use among adults who have ever smoked and currently vape exclusively or predominantly in four countries: Australia, Canada, the US, and England. MethodData analysed (n = 574) came from participants (aged 18 + ) who completed the International Tobacco Control (ITC) Four Country Smoking and Vaping survey in 2018 and again in 2020. Baseline inclusion criteria were: (1) currently not smoking or non-daily smoking; and (2) using NVPs daily/weekly for a period of at least 4 months. Association of self-reported baseline levels of perceived vaping addiction with making any attempts to quit vaping and successful attempts reported at follow-up were examined using logistic regression models, controlling for potential sociodemographic and smoking/vaping-related confounders. ResultsParticipants who perceived themselves as being addicted to vaping were less likely to attempt to quit vaping than those who perceived themselves as not addicted. Among those who tried, those who perceived themselves being addicted were also less likely to succeed than those who perceived themselves as not addicted. No significant country differences in associations were observed for both outcomes. ConclusionsPerceived vaping addiction was shown to have predictive utility for vaping cessation behaviours, possibly acting as an indicator of task difficulty, and thus may serve as a useful screening tool for identifying NVP users who may benefit from tailored cessation support programs if they want to stop using these products.

Smoking, all-cause, and cause-specific mortality in individuals with diabetes in Mexico: an analysis of the Mexico city prospective study

ObjectiveEvidence from low- and middle-income countries regarding the effect of smoking in people with diabetes is lacking. Here, we report the association of smoking with mortality in a large cohort of Mexican adults with diabetes.MethodsParticipants with diabetes mellitus (self-reported diagnosis, use of antidiabetic medications or HbA1c ≥ 6.5%) aged 35–74 years when recruited into the Mexico City Prospective Study were included. Cox regression confounder-adjusted mortality rate ratios (RRs) associated with baseline smoking status were estimated.ResultsAmong 15,975 women and 8225 men aged 35–74 years with diabetes but no other comorbidities at recruitment, 2498 (16%) women and 2875 (35%) men reported former smoking and 2753 (17%) women, and 3796 (46%) men reported current smoking. During a median of 17 years of follow-up there were 5087 deaths at ages 35–74 years. Compared with never smoking, all-cause mortality RR was 1.08 (95%CI 1.01–1.17) for former smoking, 1.11 (95%CI 1.03–1.20) for current smoking, 1.09 (95%CI 0.99–1.20) for non-daily smoking, 1.06 (95%CI 0.96–1.16) for smoking < 10 cigarettes/day (median during follow-up 4 cigarettes/day), and 1.28 (95% CI 1.14–1.43) for smoking ≥ 10 cigarettes/day (median during follow-up 15 cigarettes/day). Mortality risk among daily smokers was greatest for COPD, lung cancer, cardiovascular diseases, and acute diabetic complications.ConclusionIn this cohort of Mexican adults with diabetes, low-intensity daily smoking was associated with increased mortality, despite observing smoking patterns which are different from other populations, and over 5% of total deaths were associated with smoking.

Determinants of tobacco use transitions in smoker nursing students in Catalonia: A prospective longitudinal study.

The use of emerging tobacco and nicotine products affects tobacco use behaviors among college students. Thus, we aimed to examine transitions in tobacco use patterns and identify their predictors among smokers in a cohort of nursing students in Catalonia (Spain). We conducted a prospective longitudinal study of Catalan nursing students between 2015-2016 and 2018-2019. We examined transitions in tobacco use patterns between baseline and follow-up among smokers from: 1) daily to non-daily smoking, 2) non-daily to daily smoking, 3) cigarette-only use to poly-tobacco use, 4) poly-tobacco use to cigarette-only use, 5) between products, 6) reducing consumption by ≥5 cigarettes per day (CPD); and 7) quitting smoking. We applied a Generalized Linear Model with a log link (Poisson regression) and robust variance to identify predictors of reducing cigarette consumption by ≥5 CPD and quitting smoking, obtaining both crude and adjusted (APR) prevalence ratios and their 95% confidence intervals (CIs). Among daily smokers at baseline, 12.1% transitioned to non-daily smoking at follow-up, while 36.2% of non-daily smokers shifted to daily smoking. Among cigarette-only users, 14.2% transitioned to poly-tobacco use, while 48.4% of poly-tobacco users switched to exclusive cigarette use. Among all smokers (daily and non-daily smokers), 60.8% reduced their cigarette consumption by ≥5 CPD and 28.3% quit smoking. Being a non-daily smoker (APR=0.33; 95% CI 0.19-0.55) and having lower nicotine dependence (APR=0.78; 95% CI 0.64-0.96) were inversely associated with reducing cigarette consumption, while being a non-daily smoker (APR=1.19; 95% CI: 1.08-1.31) was directly associated with quitting smoking. Nursing students who smoked experienced diverse transitions in tobacco use patterns over time. Evidence-based tobacco use preventive and cessation interventions are needed to tackle tobacco use among future nurses.

Does e-cigarette use predict short-term smoking cessation behaviors among adults who smoke in Mexico? A longitudinal study

IntroductionThis study assessed quit attempts among adults who use cigarettes either exclusively or with e-cigarettes in Mexico, where non-daily smoking predominates. MethodsAn open cohort of Mexican adults who smoke was surveyed every four months from November 2018 to March 2021. Participants followed to the next survey were analyzed (n = 2220 individuals, 4560 observations). Multinomial logistic models regressed smoking quit attempts reported at the followup survey (ref = no attempt; tried to quit; sustained attempt of ≥30 days) on e-cigarette use frequency (none = ref; 1–2 days/week; ≥3 days/week), adjusting for sociodemographics and smoking-related variables. Additional models subdivided e-cigarette users by intentions to quit smoking in the next six months (i.e., yes/no), use of nicotine (i.e., yes/no), and vaping device used (i.e., open/closed). ResultsAt 4-month follow-up, 32.7 % had tried to quit, and 2.9 % had quit for 30 days or more. Compared to those who smoke exclusively, occasional, and frequent e-cigarette users were more likely to try to quit (Adjusted Relative Risk Ratio or ARRR = 1.26 and 1.66, respectively) but no more likely to sustain their quit attempt. Among those who intended to quit smoking, e-cigarette users were no more likely to either try or sustain quit attempts. Furthermore, use of e-cigarettes with nicotine (59.6 %) was unassociated with cessation except that those who frequently used e-cigarettes with nicotine were more likely to try to quit than those who smoke exclusively (ARRR = 1.88). Device type used was not differentially associated with outcomes. ConclusionsMexicans who smoke and use e-cigarettes appear more likely than those who smoke exclusively to try to quit but not to sustain abstinence.

Trends in Daily Cigarette Consumption Among Smokers: A Population Study in England, 2008-2023.

This study aimed to estimate time trends in cigarette consumption among smokers in England between 2008 and 2023 and toexplore differences by key potential moderators. We used data from 57778 adult cigarette smokers participating in a nationally representative monthly cross-sectional survey between January 2008 and September 2023. We estimated monthly time trends in mean daily consumption of (1) any, (2) manufactured, and (3) hand-rolled cigarettes among all smokers and by main type of cigarettes smoked, smoking frequency, age, gender, occupational social grade, region, nicotine replacement therapy use, and vaping status. Overall cigarette consumption fell from 13.6 [95% CI = 13.3 to 13.9] to 10.6 [10.5 to 10.8] per day between January 2008 and October 2019 (a 22% decrease), then remained stable up to September 2023. Over this period, the proportion mainly orexclusively smoking hand-rolled cigarettes increased (from 30.6% [29.1%-32.1%] in 2008 to 52.1% [49.7%-54.5%] in 2023). As a result, manufactured cigarette consumption fell by 47%, from 9.5 [9.2-9.8] per day in January 2008 to 5.0 [4.7-5.3] in September 2023, while hand-rolled cigarette consumption increased by 35%, from 4.2 [3.9-4.4] to 5.6 [5.3-5.9], respectively. The decline in overall cigarette consumption was observed across all subgroups, but was greater among non-daily smokers, younger smokers, and those who vaped. Over the last 15 years, the average number of cigarettes consumed each day by smokers in England has fallen by almost a quarter, but has plateaued since October 2019. There has been a sharp decline in the number of manufactured cigarettes consumed and an increase in the number of hand-rolled cigarettes consumed, as smokers have increasingly shifted towards using hand-rolled tobacco. While average cigarette consumption in England has fallen over the past 15 years, this declining trend has stalled (and reversed in some population groups) since 2019. The availability of cheap, hand-rolled tobacco appears to be undermining policies that aim to reduce smoking by raising the price of tobacco (eg, through taxation) and could be targeted to reignite the decline in cigarette consumption.

Prevalence and perceptions of flavour capsule cigarettes among adults who smoke in Brazil, Japan, Republic of Korea, Malaysia and Mexico: findings from the ITC surveys

IntroductionThe global market of flavour capsule cigarettes (FCCs) has grown significantly over the past decade; however, prevalence data exist for only a few countries. This study examined prevalence and perceptions...

Association of the blood levels of specific volatile organic compounds with nonfatal cardio-cerebrovascular events in US adults

BackgroundCardio-cerebrovascular diseases constitute a major global public health burden. Volatile organic compounds (VOCs) exposure has become progressively severe, endangering human health and becoming one of the main concerns in environmental pollution. The associations of VOCs exposure with nonfatal cardio-cerebrovascular events have not been identified in observational study with a large sample size, so we aim to examine the association in US adult population.MethodsAdults aged > 18 years with complete data regarding selected blood levels of VOCs (including benzene, ethylbenzene, o-xylene, and m-/p-xylene) and nonfatal cardio-cerebrovascular events were included in the analysis (n = 3,968, National Health and Nutrition Examination Survey, NHANES, 2013–2018 survey cycle). Participants were classified into low- and high-exposure based on whether above selected VOCs low limit detect concentration or median value. Weighted multivariate logistic analyses and subgroup analyses were used to detect the association between selected VOCs exposure and nonfatal cardio-cerebrovascular events in US adults.ResultsWeighted multivariate logistic analyses showed that the high-VOCs exposure group had an increased risk of nonfatal cardio-cerebrovascular events compared with the low-VOCs exposure group; the adjusted odds ratios (OR) and 95% confidence intervals (CI) of nonfatal cardio-cerebrovascular events for the high-VOCs exposure group were 1.41 (0.91, 2.19), 1.37 (0.96, 1.95), 1.32 (0.96, 1.82), and 1.17 (0.82, 1.67) for benzene, ethylbenzene, o-xylene, and m-/p-xylene, respectively, which was not significant assuming statistical significance at a 0.05 significance level (95% CI) for a two-tailed test. Lastly, we found high-VOCs exposure was associated with increased incidence of nonfatal cardio-cerebrovascular events in both daily smokers an non-daily smokers (p-interaction > 0.01), but the association was not statistically significant in non-daily smokers.ConclusionsThis study found that VOCs (benzene, ethylbenzene, o-xylene, and m-/p-xylene) exposure was associated with increased incidence of nonfatal cardio-cerebrovascular events in US adults, and the results need to be confirmed by larger cohort studies.

Factors Associated With Abstinence Among Young Adult Smokers Enrolled in a Real-world Social Media Smoking Cessation Program.

Social media platforms are promising to provide smoking cessation support. This study aimed to identify baseline factors associated with cigarette smoking abstinence among young adult smokers enrolled in a real-world social media-based smoking cessation program. We analyzed data from young adult smokers (aged 18-30 years) participating in a publicly available Facebook-based smoking cessation program serving the San Francisco Bay Area. The analytic sample consisted of 248 participants who completed both the baseline and follow-up surveys at 3 months. Multivariable logistic regression analysis determined baseline factors significantly associated with self-reported 7-day cigarette smoking abstinence at 3 months. Participants were race/ethnically diverse, well-educated, and 47.6% reported LGB + sexual identity. Those who reported dual use of cigarettes and e-cigarettes in the past 30 days (vs. cigarette use only), current alcohol users (vs. non-users), and those aged 25-30 years (vs. 18-24 years) were significantly less likely to report 7-day abstinence at 3 months. Non-daily smokers (vs. daily smokers) and those with high desire to quit smoking (vs. low to moderate desire) were more likely to report abstinence. Results also showed reduction in the percentage of e-cigarette and other tobacco product use among participants. Social media interventions may be more effective for young adult non-daily smokers and those with high desire to quit smoking. Smoking cessation programs may help reduce use of other tobacco products among treatment-seeking smokers. Smoking cessation interventions for young adults need to explicitly address dual use of cigarettes and e-cigarettes and use of alcohol. Findings of this study highlight the need for future interventions to address dual use of cigarettes and e-cigarettes and use of alcohol to improve cigarette smoking abstinence outcomes. The reduction in the use of other tobacco products among program participants indicates that social media smoking cessation programs may exert a broader positive influence on overall tobacco consumption. The large number of LGB+ smokers participating in the program suggests social media is a promising cessation channel for this hard-to-reach group, warranting further study.

Impact of prolonged exposure to occasional and regular waterpipe smoke on cardiac injury, oxidative stress and mitochondrial dysfunction in male mice.

Regular waterpipe smoking (Reg-WPS) is well recognized for its deleterious effect on the heart. However, there is a paucity of experimental studies on the impact of occasional waterpipe smoking (Occ-WPS), also known as nondaily smoking, versus Reg-WPS on cardiac homeostasis, and the mechanisms underlying these effects. Hence, we aimed, in the present study, to investigate the effect of Occ-WPS (30min/day, 1day/week) versus Reg-WPS (30min/day, 5days/week) for 6months on systolic blood pressure (SBP), cardiac injury, oxidative markers, chemokines, proinflammatory cytokines, DNA damage and mitochondrial function compared with air (control) exposed mice. Our results show that SBP was increased following exposure to either Occ-WPS or Reg-WPS compared with air-exposed mice. Moreover, we found that only Reg-WPS induced a significant elevation in the levels of troponin I, brain natriuretic peptide, lactate dehydrogenase, and creatine phosphokinase. However, the atrial natriuretic peptide (ANP) was significantly increased in both Occ-WPS and Reg-WPS groups. Compared with air-exposed mice, the levels of lipid peroxidation, reduced glutathione and monocyte chemoattractant protein-1 were only significantly augmented in the Reg-WPS. However, catalase, superoxide dismutase, and CXCL1 were significantly increased in both Occ-WPS and Reg-WPS. The concentrations of the adhesion molecules E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 were solely elevated in the heart of mice exposed to Reg-WPS. Similarly, the concentrations of interleukin-1β and tumor necrosis factor α were only significantly augmented in the Reg-WPS. However, both Occ-WPS and Reg-WPS triggered significant augmentation in the levels of IL17 and DNA damage compared to the control groups. Furthermore, while Occ-WPS induced a slight but statistically insignificant elevation in the concentrations of mammalian targets of rapamycin and nuclear factor erythroid-derived 2-like 2 (Nrf2) expression, Reg-WPS exposure increased their levels substantially, in addition to p53 and mitochondrial complexes II & III, and IV activities compared with air-exposed mice. In conclusion, our findings show that while the long-term Occ-WPS exposure induced an elevation of SBP, ANP, antioxidant enzymes, IL17, CXCL1, and cardiac DNA damage, Reg-WPS exposure was consistently associated with the elevation of SBP and occurrence of cardiac damage, inflammation, oxidative stress, DNA damage and mitochondrial dysfunction.

Cigarette and ENDS dual use longitudinal transitions among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 4–5 (2016–2019)

IntroductionThe study assessed longitudinal transitions among adult (18 and older) past 30-day daily and non-daily dual users of cigarettes and electronic nicotine delivery systems (ENDS). MethodsUsing data from Wave 4 (W4; 2016/17) and Wave 5 (W5; 2018/19) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of US adults, multivariable regressions were conducted among W4 dual users of cigarettes and ENDS to examine past 30-day cigarette smoking at W5. The study also analyzed changes in frequency of past 30-day smoking and cigarettes smoked per day between W4 and W5, stratified by W4/W5 daily/non-daily ENDS use among W4 daily and non-daily cigarette smokers. ResultsAmong W4 dual users, those smoking daily and using ENDS non-daily had higher odds of daily cigarette smoking at W5 than daily users of both products (AOR: 2.32, 95 % CI: 1.38–3.90). W4 daily smokers who used ENDS daily at Wave 5 smoked cigarettes on fewer days at Wave 5 than W4 daily smokers who were either daily ENDS users at Wave 4 (B = −4.59; SE = 1.43, p < 0.01) or non-daily ENDS users at Wave 4 (B = −4.55; SE = 1.24, p < 0.001). Among W4 non-daily cigarette smokers, W4 non-daily ENDS users who used daily at W5 smoked cigarettes on fewer days (B = −4.04, SE = 1.82) at W5 than those who were non-daily ENDS users at W4 and W5. ConclusionsFindings highlight the importance of frequency of ENDS use in reducing cigarette smoking and could inform smoking cessation interventions among daily cigarette smokers.

Why Do University Students Smoke Tobacco? French Validity of Brief Wisconsin Inventory of Smoking Dependence Motives Among (non-) Daily Smokers and Associations With Psychological Variables

This study investigates the validity of the Brief Wisconsin Inventory of Smoking Dependence Motives (B-WISDM) among French daily and non-daily university student smokers. Measurement models, measurement invariances, and concurrent and convergent validity with psychosocial and psychopathological variables were tested. Results (1) confirmed the B-WISDM dimensionality in 11 first-order intercorrelated factors; (2) showed its measurement invariance for the types of smokers; (3) showed that tobacco dependence is only and positively predicted by primary dependence motives, which confirm that they are core components of tobacco dependence; and (4) highlighted specific associations between smoking motives and psychological variables, such as smoking identity and perceived behavioral control with some primary dependence motives, social goads with social norms, and weight control with eating disorders. Thus, external validity of the B-WISDM is extended to non-daily smokers. Specific associations of B-WISDM with smoking-related psychological potentially make it a very useful diagnostic tool to support smokers toward quitting.

The association of current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes with psychological distress among U.S. adults

This observational study examines the association of current e-cigarette use and dual use of e-cigarettes and cigarettes (dual use) with psychological distress among U.S. adults. We differentiate dual use based on the smoking frequency and compare the relationship between dual use and psychological distress to that of exclusive cigarette smoking with the same smoking frequency.Using data from the 2015–2018 National Health Interview Surveys, we analyzed adults aged 18+ (N = 55,780) who currently use e-cigarettes or/and cigarettes and have no history of using other tobacco products, and adults who never used any tobacco. Multinomial logistic regression models estimate the association of current e-cigarette use and dual use with psychological distress severity (no/mild, moderate, and severe).In the sample, 15.3% and 2.9% of adults experienced moderate and severe psychological distress. Compared to never tobacco users, current exclusive e-cigarette users and dual users who smoke daily had higher odds of moderate and severe psychological distress. Dual users who smoke nondaily had higher odds of moderate, but not severe psychological distress than never tobacco users. Compared to exclusive daily smokers, dual users with daily smoking had higher odds of moderate and severe psychological distress. Compared to exclusive nondaily smokers, dual users with nondaily smoking had higher odds of moderate but not severe psychological distress.Our findings suggest that exclusive e-cigarette use is associated with psychological distress severity. Dual use is associated with higher odds of psychological distress severity compared to never tobacco users and exclusive cigarette smoking, and this association differs by smoking frequency.

Association of non-daily hookah tobacco smoking and cardiovascular disease-related exposure biomarkers among U.S. users: The Population Assessment of Tobacco and Health Study

Hookah smoking has grown to become a global tobacco epidemic. While cigarette smoking is a well-established cardiovascular disease (CVD) risk factor, the CVD risks of hookah smoking are unknown, particularly among regular U.S. adult hookah users who are predominantly non-daily users. Herein, we examined the association between hookah smoking and biomarkers of CVD risk among regular exclusive hookah smokers (n = 75), compared to regular exclusive cigarette smokers (n = 1773), dual hookah and cigarette smokers (n = 43) and never tobacco users (n = 757), using data from a nationally representative sample of adults from the Population Assessment of Tobacco and Health Study (2013–2014). Whereas 84% of cigarette smokers reported daily use, only 8% of hookahsmokers reported daily use, with more than a third reporting monthly use. Adjusting for age and sex and as compared to exclusive cigarette smokers, exclusive hookah smokers had significantly lower geometric mean concentrations in serum sICAM-1 and urinary F2-isoprostane (p < 0.05). Although not statistically significant, a signal of increased oxidative stress was observed among hookah smokers as compared to never tobacco users (urinary F2-isoprostane). CVD-related harm biomarkers appear to be lower among hookah smokers than cigarette smokers. These findings represent patterns of hookah smoking predominantly shared among adult U.S. users who report non-daily occasional use and do not reflect solitary, daily use as is common in the Middle East. Future studies with longer exposure and longitudinal hookah use are warranted to explore the association between hookah smoking and CVD risk.

Smoking Dependence, Time-Discounting, and Sustained Cessation Behavior: A Longitudinal Study of Predominantly Light Smokers.

This study aimed to assess whether two established psychosocial predictors of smoking abstinence, nicotine dependence and time-discounting, also apply to a population of predominantly cigarette light smokers, which is the dominant pattern of smoking in countries like Mexico. Relatively infrequent smoking is increasingly prevalent, yet still harmful, making it important to understand the predictors of cessation in this population. Mexican adult smokers recruited from an online consumer panel were surveyed every 4 months between November 2018 and July 2020. We considered respondents who reported a quit attempt in between surveys (n = 1288). Dependence was measured with a 10-item version of the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Time-discounting was assessed with five branching questions about hypothetical reward scenarios. Logistic models regressed sustained quit attempts (≥30 days of abstinence) at time t + 1 on study variables at time t. We found strong interitem reliability (α = 0.92) and intraindividual consistency of our brief WISDM (ρ = 0.68), but moderate intraindividual consistency of the time-discounting measure (ρ = 0.48). Forty-eight percent of the sample reported sustained quit attempts, and 79% were non-daily or light daily smokers (≤5 cigarettes per day). Smokers with higher WISDM-10 had lower odds of sustained quitting and this result remained when controlling for smoking frequency and the Heaviness of Smoking Index (adjusted odds ratio [AOR] = 0.768). Time-discounting was unassociated with sustained quitting. Our findings suggest that a brief, 10-item multidimensional measure of dependence is useful for predicting sustained quitting in a context of relatively light smoking; time-discounting appears less relevant, although our results are not conclusive because of the low test-retest reliability of our measure. Given the increase in non-daily and light daily cigarette smoking in many countries, including in Mexico, and the health risks this still poses, it is important to understand the predictors of cessation among relatively light smokers. The WISDM-10 multidimensional measure seems to be a good instrument to assess dependence and predict successful quitting in this population, and possibly more appropriate than physical dependence measures. As such, it could help design and target more suitable cessation treatments for non-daily and daily light cigarette smokers. While this study did not find time-discounting to be a relevant predictor of smoking abstinence, future studies should explore other measures.

Are relative educational inequalities in multiple health behaviors widening? A longitudinal study of middle-aged adults in Northern Norway.

Educational inequality in multiple health behaviors is rarely monitored using data from the same individuals as they age. The aim of this study is to research changes in relative educational inequality in multiple variables related to health behavior (smoking, physical activity, alcohol intake, and body mass index), separately and collectively (healthy lifestyle), among middle-aged adults living in Northern Norway. Data from adult respondents aged 32-87 in 2008 with repeated measurements in 2016 (N = 8,906) were drawn from the sixth and seventh waves of the Tromsø Study. Logistic regression was used to assess the relative educational inequality in the variables related to health behavior. The analyses were performed for the total sample and separately for women and men at both baseline and follow-up. Educational inequality was observed in all the variables related to health behavior at baseline and follow-up, in both men and women. Higher levels of educational attainment were associated with healthier categories (non-daily smoking, physical activity, normal body mass index, and a healthy lifestyle), but also with high alcohol intake. The prevalence of daily smoking and physical inactivity decreased during the surveyed period, while high alcohol intake, having a body mass index outside of the normal range and adhering to multiple health recommendations simultaneously increased. The magnitude of relative educational inequality measured at baseline increased at the follow-up in all the variables related to health behavior. Differences were larger among women when compared to men, except in physical inactivity. Persistent and increasing relative disparities in health behavior between the highest education level and lower education levels are found in countries with well-established and comprehensive welfare systems like Norway. Addressing these inequalities is essential for reducing both the chronic disease burden and educational disparities in health.

Prevalence and Determinants of Non-daily Smoking Among Iranian University Students: A Web-based Survey

Background and aims: Usually non-daily smokers do not consider themselves smokers, and they are at a higher level of health risks due to smoking compared to non-smokers. This study aimed to identify the prevalence of non-daily smoking (NDS) and its associated factors among university students. Methods: This cross-sectional web-based study was performed in Tabriz, Iran. A proportional random sample of 3666 students from all universities of Tabriz were recruited from July to August, 2019, and an online questionnaire was used to collect data. Predictors of NDS were investigated using a multiple logistic regression model. Results: A total of 15.7% and 7.8% of the students were daily and NDSs, respectively. Compared to the non-smokers, the NDSs were more likely to exhibit high-risk behaviors such as substance abuse (odd ratio [OR]=2.96; 95% CI: 2.12-4.13), alcohol drinking (OR=2.54; 95% CI: 1.78-3.62), hookah smoking experience (OR=9.30; 95% CI: 6.06-14.25), and regular hookah use (OR=24.22; 95% CI: 14.86-39.46). Compared to daily smokers, NDSs were more likely to be female gender (OR=0.16; 95% CI: 0.10-0.24), denial of being a smoker (OR=11.69; 95% CI: 6.86-19.91), not addicted to nicotine (OR=10.02; 95% CI: 4.21-23.85), and less likely to have an intention for quitting in recent months (OR=2.27; 95% CI: 1.28-4.04). Conclusion: Non-daily smokers do not consider themselves smokers and have no intention to quit smoking. They are more prone to present high-risk health behaviors. Health policymakers should pay more attention to NDSs while planning smoking cessation programs.

Transitions in smoking status in nursing students: A prospective longitudinal study.

To describe transitions in smoking status and their determining factors among nursing students between baseline (2015-2016) and follow-up (2018-2019). Observational prospective longitudinal study of 4381 nursing students in Catalonia (Spain). We examined transitions in smoking status from: (i) current smokers to recent quitters, (ii) never smokers to new smokers and (iii) former smokers to quitters who relapsed. We fitted logistic regression models to assess the predictors of quitting smoking. The proportion of current smokers decreased from 29.7% at baseline to 23.6% at follow-up, with a cumulative incidence rate of quitting of 28.3% during follow-up. Nondaily smokers were more likely to quit than daily smokers. Of those who were never smokers at baseline, 4.6% were smokers at follow-up, and 23.2% of former smokers at baseline had relapsed at follow-up. Nondaily smokers were more likely to have quit smoking at follow-up among this cohort of nursing students. The early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and cessation support during college years may decrease tobacco use among nursing students. Nursing students' tobacco use is concerning, as they are the future workforce of nurses who have a key role in tobacco product use prevention and cessation. During college years, nursing students have a greater likelihood of experimenting with several smoking status changes as well as to consolidate smoking behaviors. This is the first longitudinal study to highlight the factors associated with quitting smoking among a cohort of Spanish nursing students. Being a nondaily smoker at baseline predicted quitting at follow-up. Our findings support the early implementation of a comprehensive tobacco control program that includes tobacco-free campus policies, tobacco prevention interventions and tobacco cessation support during college years to decrease tobacco product use prevalence among nursing students. We have adhered to STROBE guidelines. No Patient or Public Contribution. This observational study has not been registered.

People with HIV who smoke cigarettes non-daily

ABSTRACT Cigarette smoking is a leading cause of mortality in people with HIV (PWH) in the United States (US). A rising proportion of US tobacco users smoke non-daily, a phenomenon that is common among PWH. PWH who smoke non-daily may be attractive targets for cessation efforts, and, thus, a fuller understanding of non-daily smoking in PWH is important. We merged datasets from two randomized controlled tobacco treatment trials for PWH conducted in three cities from 2014-2020. The final dataset included 872 PWH. We analyzed sociodemographic characteristics and behavioral measures, such as nicotine dependence, motivation to quit, anxiety, and other substance use for associations with non-daily smoking, and we assessed non-daily smoking as a predictor of cessation. 13.4% of the sample smoked non-daily. In multivariable analyses, non-White race, higher anxiety, and higher motivation to quit were associated with non-daily smoking. PWH who smoked non-daily had 2.14 times the odds of those who smoked daily of quitting at six-months (95% C.I.:1.30-3.51, P=0.002). PWH who smoke non-daily differ in some demographic and behavioral characteristics from those who smoke daily. PWH reporting non-daily smoking were more likely to quit in our trials and targeting them should be a priority of future cessation efforts.

The Indirect Effect of Smoking Level in the Association Between Urban Stress and Readiness to Quit Smoking among Adults Experiencing Homelessness.

Over 70% of adults experiencing homelessness are cigarette smokers, a fivefold greater rate than in the general U.S. population. Consequently, tobacco-related conditions are the leading causes of disease and death for this group. Adults experiencing homelessness tend to seek shelter in urban areas. Thus, they not only experience the daily stressors of being homeless, they may additionally experience unique or additive urban stressors (e.g., stress related to using public services, crime and violence, and/or cultural conflicts with others). For some smokers, stress is known to increase smoking rates and decrease readiness to quit smoking. Likewise, increased smoking rates alone may lead to a lower likelihood of making a quit attempt. The current study examined the potential mediating role of smoking level in the association of urban stress and quit readiness among adults experiencing homelessness (N=411). Two multinomial logistic regression analyses revealed that urban stress was positively associated with smoking level (p = 0.02). The odds ratio for one-unit increase in stress was 1.047 (CI.95:1.014, 1.082) for being a heavy vs. non-daily smoker. Furthermore, analyses revealed smoking level mediated the effect of stress on quit readiness (ab= -0.005, CI.95:-0.010, -0.002]). Homeless smokers who report high levels of stress might smoke at higher levels, which could attenuate quit readiness.