Quit Cigarette Smoking Research Articles

Discrimination, Mental Health, and Readiness to Quit Smoking.

We conducted a cross-sectional study, examining the mediation effects of depression and anxiety on the association between discrimination and readiness to quit cigarette smoking among African American adult cigarette smokers experiencing homelessness. Using a convenience sample, participants were recruited from a homeless shelter in Southern California. Scores of discrimination, depressive, and anxiety symptoms, and readiness to quit smoking were analyzed using linear regression modeling. We enrolled 100 participants; 58 participants were male. In the final model, discrimination had no association with readiness to quit (b = 0.02; 95% CI [-0.04, 0.08]; p = 0.47). The indirect effects of depression (b = 0.04, [0.01, 0.07]; p = 0.02) and anxiety (b = 0.03; [0.01, 0.05]; p = 0.04) reached statistical significance; the direct effects of depression (b = -0.01; [-0.09, 0.04]; p = 0.70) and anxiety (b = -0.00; [-0.09, 0.06]; p = 0.86) did not. Future studies should explore these associations to enhance smoking cessation programs for this population.

Testing the Efficacy of a Scalable Telephone-Delivered Guided Imagery Tobacco Cessation Treatment: Protocol for a Randomized Clinical Trial.

Tobacco use continues to be a leading preventable cause of death and disease in the United States, accounting for >480,000 deaths each year. Although treatments for tobacco use are effective for many, there is substantial variability in outcomes, and these approaches are not effective for all individuals seeking to quit smoking cigarettes. New, effective therapeutic approaches are needed to meet the preferences of people who want to stop smoking. Guided imagery (GI) is a mind-body technique that involves the guided visualization of specific mental images, which is enhanced with other sensory modalities and emotions. Preliminary evidence provides initial support for the use of GI as a treatment for cigarette smoking. Meta-analyses have shown that standard treatment for cigarette smoking delivered over the telephone via quitlines is effective. A telephone-based intervention that uses GI might provide another effective treatment option and increase the reach and effectiveness of quitlines. This study aims to test the efficacy of Be Smoke Free, a telephone-delivered GI treatment for smoking cessation. This multisite randomized clinical trial (RCT) will compare a novel telephone-delivered GI tobacco cessation treatment with a standard evidence-based behavioral treatment. The study will be conducted over 5 years. In phase 1, we refined protocols and procedures for the New York State and West Virginia sites for use in the RCT. During phase 2, we will conduct an RCT with 1200 participants: 600 (50%) recruited via quitlines and 600 (50%) recruited via population-based methods. Participants will be randomly assigned to either the GI condition or the behavioral condition; both treatments will be delivered by trained study coaches located at the University of Arizona. Assessments will be conducted at baseline and 3 and 6 months after enrollment by University of Arizona research staff. The primary outcome will be self-reported 30-day point prevalence abstinence 6 months after enrollment. Secondary outcomes include biochemically verified 7-day point prevalence abstinence 6 months after enrollment. Recruitment in West Virginia and New York began in October 2022. As of March 31, 2023, a total of 242 participants had been enrolled. Follow-up assessments began in November 2022. As of March 31, 2023, of the 118 eligible participants, 97 (82.2%) had completed the 3-month assessment, and 93% (26/28) of eligible participants had completed the 6-month assessment. Biochemical verification and qualitative interviews began in April 2023. Recruitment will continue through 2025 and follow-up assessments through 2026. Primary results are expected to be published in 2027. The Be Smoke Free study is a first-of-its-kind RCT that incorporates GI into telephone-based tobacco cessation treatment. If successful, Be Smoke Free will have substantial benefits for the long-term health of people who use tobacco across the United States. ClinicalTrials.gov NCT05277831; https://clinicaltrials.gov/ct2/show/NCT05277831. PRR1-10.2196/48898.

Predictors of Female Smokers’ Empowerment to Quit Smoking Cigarettes

Predictors of Female Smokers’ Empowerment to Quit Smoking Cigarettes

Diverse e-cigarette regulations in the Asia Pacific: A health economic perspective.

Diverse e-cigarette regulations in the Asia Pacific: A health economic perspective.

Machine learning application for predicting smoking cessation among US adults: An analysis of waves 1-3 of the PATH study.

Identifying determinants of smoking cessation is critical for developing optimal cessation treatments and interventions. Machine learning (ML) is becoming more prevalent for smoking cessation success prediction in treatment programs. However, only individuals with an intention to quit smoking cigarettes participate in such programs, which limits the generalizability of the results. This study applies data from the Population Assessment of Tobacco and Health (PATH), a United States longitudinal nationally representative survey, to select primary determinants of smoking cessation and to train ML classification models for predicting smoking cessation among the general population. An analytical sample of 9,281 adult current established smokers from the PATH survey wave 1 was used to develop classification models to predict smoking cessation by wave 2. Random forest and gradient boosting machines were applied for variable selection, and the SHapley Additive explanation method was used to show the effect direction of the top-ranked variables. The final model predicted wave 2 smoking cessation for current established smokers in wave 1 with an accuracy of 72% in the test dataset. The validation results showed that a similar model could predict wave 3 smoking cessation of wave 2 smokers with an accuracy of 70%. Our analysis indicated that more past 30 days e-cigarette use at the time of quitting, fewer past 30 days cigarette use before quitting, ages older than 18 at smoking initiation, fewer years of smoking, poly tobacco past 30-days use before quitting, and higher BMI resulted in higher chances of cigarette cessation for adult smokers in the US.

Abstract 63: Mobile Health Technology for Tailored Tobacco Cessation Support in Lao People’s Democratic Republic: A Pilot Trial

Abstract Purpose: Tobacco smoking (cigarettes: >90%) is the leading cause of preventable cancer morbidity and mortality in Lao People’s Democratic Republic (Lao PDR). Nonetheless, there are very few tobacco treatment programs in Lao PDR and none are accessible nationwide. Our parent project aims to use mobile health (mHealth) technology, which is highly scalable and affordable, to help Lao people quit smoking cigarettes. The aim of this pilot randomized controlled trial is to assess the feasibility, acceptability, and preliminary efficacy of our novel mHealth intervention. Methods: Fifty participants were recruited from Setthathirath Hospital in Vientiane and Champasak Hospital in Champasak Province (n=25/site). Participants were randomized to Standard Care (SC, n=25) or Automated Messaging (AM, n=25). SC comprised of brief advice to quit, a 2-week supply of nicotine patches, and self-help materials (prepared and printed by our team based on the World Health Organization’s guide to quit). AM consisted of the SC components plus a fully automated smartphone-based treatment program that involved interactive and tailored proactive messaging for 3 months (~2-3 messages per day), delivered by our InsightTM system. Results: All participants were Lao ethnicity and 14.3% were female. Results indicated high feasibility of the intervention (i.e., 90.7% of study messages/weekly assessments were delivered and 88.7% of these were read/completed). There was no loss to follow-up at 3 months. AM was highly acceptable: 91.6% agreed or strongly agreed that the InsightTM app was easy to use, 100% of AM participants agreed or strongly agreed that the message content was easy to understand, and 95.8% felt comfortable with opening messages in public places. Regarding preliminary efficacy, changes in self-efficacy to avoid smoking in various social situations (measured on a 5-point Likert scale) from baseline to the 3-month follow-up was 0.41 for AM participants and -0.12 for SC participants (P=0.68). Biochemically verified 7-day point prevalence abstinence at 3 months follow-up were comparably high for both groups (29.2% for AM and 28.0% for SC, relative risk: 0.96, 95% confidence interval: 0.39, 2.32). Conclusion: Our mHealth-based AM program for smoking cessation is highly feasible, disseminable, acceptable, and potentially efficacious in Lao PDR. Citation Format: Shweta Kulkarni, Phonepadith Xangsayarath, Dalouny Xayavong, Chanthavy Soulaphy, Khatthanaphone Phandouangsy, Phayvanh Keopaseuth, Khamsing Keothongkou, Tina Le, Damon Vidrine, Jennifer Vidrine, Summer Frank-Pearce, Michael Businelle, Thanh Bui. Mobile Health Technology for Tailored Tobacco Cessation Support in Lao People’s Democratic Republic: A Pilot Trial [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 63.

The associations between cigarette smoking behavior and the use of heated tobacco products among Arab cigarette smokers: Findings from Saudi Arabia, Egypt, Kuwait, and Yemen

As the availability of tobacco forms has evolved, emerging products known as heated tobacco products (HTPs) are increasingly being consumed worldwide and are claimed to be less harmful than tobacco cigarette smoking. To date, it is unknown whether Arab cigarette smokers are using or susceptible to HTPs. Therefore, this study aimed to assess the association between cigarette smoking behavior and the use of and susceptibility to HTPs in the Eastern Mediterranean region. Arab cigarette smokers (n = 628) from Saudi Arabia, Egypt, Kuwait, and Yemen were recruited using a convenience sampling technique. A cross-sectional survey comprised questions related to sociodemographic characteristics, cigarette smoking behavior characteristics (quitting attempts and desire to quit cigarette smoking, nicotine dependence, and consideration of switching to nicotine products with reduced health risks), and awareness of, use of, and susceptibility to use of HTPs. Descriptive and logistic regression models were used for analysis. The participants indicated a high frequency of past quitting attempts and a desire to quit smoking cigarettes. They were also considering switching to a nicotine product with reduced health risks. However, their awareness of HTPs was relatively low (24.2%), and the proportion of participants who had ever used HTPs or were currently using them was quite low as well (10.7% and 5.0%, respectively). A history of quit attempts was associated with more likely lifetime use of HTPs (adjusted odds ratio [AOR] = 2.63, 95% confidence interval [CI] [1.21–5.71]). Nicotine-dependent cigarette smokers were more likely to be susceptible to HTP use (AOR = 1.12, 95% CI [1.01–1.24]). Moreover, those who would consider switching to a product that provided nicotine and could reduce health risks by 99% were more likely to be susceptible to using HTPs (AOR = 2.17, 95% CI [1.05–4.51]). Awareness of HTPs is relatively low among Arab cigarette smokers. Attempts to quit cigarette smoking, nicotine dependence, and the consideration of switching to a product that delivers nicotine with reduced health risks were significantly associated with using HTPs. The findings of this study provide potential for evidence-based treatment for smokers and will help prevent the use of tobacco industry tactics in marketing HTPs.

Response to health warnings on cigarette packs as a predictor of future smoking among current tobacco smokers

The United States (US) Food and Drug Administration (FDA) requires health warning labels on all cigarette packages as part of a campaign to reduce tobacco smoking. Prior research has revealed the mixed effectiveness of these health warning labels. The present study used nationally representative, longitudinal data from the Population Study of Tobacco and Health (PATH) Study to assess whether reported reactions to health warning labels on cigarette packs predict smoking frequency and smoking cessation two years later. We hypothesized that individuals who reported strong reactions to health warnings at Wave 1 of the PATH Study would engage in less frequent smoking behavior and would be more likely to have completely quit cigarette smoking two years later (Wave 3), compared with individuals who did not report strong reactions. Multinomial and binary logistic regressions were used to estimate the associations between attitudes toward health warning labels and later smoking frequency and smoking cessation. Our hypotheses were partially supported; results indicated that several attitudes toward health warnings predict later smoking behaviors. These findings indicate general effectiveness of health warning labels and support the FDA’s initiative to require more attention-grabbing health warning labels on cigarette packs.

Qualitative exploration of longer versus shorter quit attempts among adults using E-Cigarettes for combustible cigarette cessation

Empirical evidence about the effectiveness of using e-cigarettes to quit smoking cigarettes remains inconclusive, yet e-cigarettes are commonly used for smoking cessation. Moreover, people who have longer duration quit attempts are likely to have even longer quit attempts in the future. Researchers analyzed 40 qualitative interviews to assess adults’ experiences using e-cigarettes during their longest duration quit attempt. Interviewees quit smoking for ≥ one month (n = 20) or for shorter durations (n = 20). Thematic and comparative content analyses were used to analyze interview transcripts for factors facilitating or impeding the duration of quit attempts when using e-cigarettes. Participant narratives were mostly similar irrespective of their quit attempt duration. Six themes common across groups as well as themes more often discussed by people with shorter quit attempts are described. Most participants discussed using e-cigarette devices and flavors to either replace sensations similar to smoking combustible cigarettes (e.g., inhaling from a cylindrical object) or to distract themselves from cravings to smoke. E-cigarettes also were described by the majority of participants as useful for smoking cessation because they approximate combustible cigarette use, potentially reduce health-related harms, save money, and lead to reduced social stigma compared to smoking cigarettes. Those who reported shorter duration quit attempts shared e-cigarette product challenges, health concerns, needs for support. Study findings demonstrate the need for additional research on the factors that may increase the likelihood that using e-cigarettes will result in longer and sustained e-cigarette-based quit attempts among adults.

"Appagalo" a Customized Mobile Health Intervention (mHealth) for Smoking Cessation in Women: A Randomized Controlled Trial.

Almost 30% of Chilean women report cigarette smoking with important repercussions on their health. Design and test a mobile phone intervention for smoking cessation in young women. A mobile application (app) was created using the best available evidence and consumer input. Its effectiveness was assessed through a randomized clinical trial. Women 18 to 44years old from middle-class neighborhoods in Santiago, Chile. Inclusion criteria were intention to quit cigarette smoking in the following month and having a smartphone cell phone. Women with positive screening for risky alcohol consumption were excluded. App with content to support cigarette smoking cessation over 6 months. The control arm included an app that delivered general messages to promote permanence in the study. Telephone follow-up was performed at 6 weeks, and at 3 and 6 months after randomization. No smoking in the past 7days at 6weeks from enrolment. Intention-to-treat analysis was carried out using SPSS 17.0 with a significance level set at .05. 309 women entered the study. Mean number of cigarettes smoked in a day was 8.8. 58.6% of the participants (n = 181) completed the follow-up for the primary outcome. With intention-to-treat analysis, 9.7% of participants in the intervention group reported not having smoked any cigarettes in the last 7days vs 3.2% in the control group (RR 2.98 CI 95% 1.11-8.0, P = .022). Additionally, 12.3% vs 1.9% of the participants in the intervention group and control group reported continuous abstinence at 6weeks, respectively (RR 6.29 95% CI 1.9-20.8, P < .001). Continuous abstinence was also significant at 6 months (P-value of .036). The "Appagalo" app is an effective tool to support smoking cessation in young women. It is a simple mHealth alternative for smoking cessation that can contribute to improving women's health in the Americas and worldwide.

Motivational Factors for Cessation of Cigarette Smoking among Current Smokers in Aseer Region: A Cross-Sectional Study

Introduction: Smoking is considered one of the leading public health problems with a direct heavy toll on lives, and indirectly, via passive inhalation of tobacco smoke. Smoking is a severe public health problem and can lead to substantial health and economic consequences. Aim of Study: To identify factors motivating smokers to quit smoking among adult Saudi smokers in the Aseer Region, Saudi Arabia. Methods: This study followed a cross-sectional research design. It included 428 Saudi adults, who are currently cigarette smokers, registered at the Smoking Cessation Clinics in Aseer Region, and who wish to quit smoking. The selection of participants was done by systematic random sampling. The data was collected by using the “Tobacco Programme Management System” questionnaire, along with some other motivational factors for getting the maximum responses from the participants. Results: The majority of quitters were males (95.6%). Almost two-thirds of quitters (60.3%) started smoking by the age of 15-20 years. Most quitters (75%) were cigarette smokers for more than 15 years. The main motives for quitting cigarette smoking were to improve health status (39.5%), followed by having a better quality of life (27.3%), and to save the costs of smoking cigarettes (19.9%). Motives for quitting differed significantly according to their place of residence, age groups, and educational level. Conclusion: The majority of current Saudi cigarette-smoking quitters are young males, well-educated with no or low monthly income. Most smokers start cigarette smoking during their adolescence. Recommendations: Parents should play an important role to motivate quitting smoking and keeping their young kids away from smoking. School-based tobacco prevention and cessation programs should be enforced. Keywords: Cigarette Smoking, Smoking Cessation, Motives, Fagerström Scores.

The Effectiveness of Gum and Mint Candy in Quitting Smoking in Adolescents

Background: Smoking is a bad habit that can cause various diseases for a long-term period with high frequency. Adolescents are the nation's assets and are expected to have optimal health status. Thus, it is necessary to make efforts to quit smoking, such as the use of gum and mint candy as a substitute for cigarettes to reduce the number of cigarette consumption or even stop smoking behavior in adolescents. Objective: This study aimed to determine the differences in the effectiveness of chewing gum and mint candy on quitting smoking in adolescents. Methods: This was quantitative research with a quasi-experimental design. The sample was 62 students of SMK Ma'arif 1 Kroya who were selected through a simple random sampling method. Then, survey sheets and observation books were used as the instruments. Afterward, the data were analyzed using the Wilcoxon test and Mann-Whitney test. Results: The result of the Wilcoxon test indicated that the number of cigarette consumption before and after the gum intervention was 0.001. meanwhile, the number of cigarette consumption before and after the intervention of mint candy was 0.003. It meant that both were effective in qutting smoking efforts. In addition, the result of the Mann-Whitney test was 0.070. It meant no difference in the effectiveness of gum and mint candy on qutting smoking in adolescents. Conclusion: There was no significant difference between the gum and mint candy in quitting smoking cigarettes in the adolescent.

Longitudinal analysis of peer social support and quitting Smoking: Moderation by sex and implications for cessation interventions

Social support predicts better health and lower mortality, but the benefits of peer social support for helping cigarette smokers quit are unclear. Moreover, sex as a moderating factor has not been investigated despite sex differences in social support processes. This study of smokers’ perceived availability of peer social support in quitting cigarette smoking is a secondary analysis of 1,010 individuals enrolled in an RCT that provided quitting assistance using tailored emails scheduled around a quit date. Participants completed measures of peer support for quitting cigarettes at enrollment (baseline), and at 1-, 3-, and 6-month follow-ups. Peer support at follow-ups was categorized as never-present, always-present, or mixed. A Generalized Estimating Equation (GEE) examined the association between peer support and 7-day point prevalence abstinence at follow-ups, controlling for baseline peer support, experimental condition, stress, depression, and sociodemographic and smoking behavior-related variables. Interactions of peer support × time, and peer support × sex, were tested. Results indicated that among women, always-present or mixed peer support was associated with, respectively, odds of abstinence that were 4.36 (95 % CI, 2.54–7.49, p = 0.0001), and 2.21 (OR = 2.21, 95 % CI, 1.27–3.85, p = 0.005) greater than among women reporting never-present peer support. Among men, peer support did not predict abstinence. Women who smoke may be especially receptive to the benefits of peer support when attempting to quit. Investigation of the basis of their perceptions, how they might be increased, and whether interventions to change them would be effective, is warranted.

The effect of vaping cues in e-cigarette advertisements on normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes in Boston

IntroductionE-cigarette advertising frequently involves vaping cues–hand to mouth motions and vapor–that physically resemble traditional cigarette smoking cues. There has been concern that these vaping cues could make cigarettes seem more frequently used and acceptable by society. This analysis examined whether exposure to vaping cues in e-cigarette ads influence descriptive and injunctive normative perceptions about cigarettes among young adults who use cigarettes and e-cigarettes (dual use). MethodSecondary analysis was conducted on an experiment that randomly exposed young adults living in Boston who dual used in the past-week to either 1) E-cigarette ads with vaping cues; 2) E-cigarette ads that edited out vaping cues; or 3) Beverage ads. Descriptive and injunctive normative perceptions about cigarettes were compared across participants who viewed e-cigarette ads with vaping cues versus those who viewed ads without vaping cues. ResultsThose who viewed e-cigarette ads with vaping cues had decreased perceptions that cigarette smoking was common compared to those who viewed e-cigarette ads without vaping cues. Exposure to e-cigarette ads with vaping cues also led to increased perceptions of other peoples’ unfavorable views toward cigarette smoking in general and their own cigarette smoking. ConclusionContrary to renormalization concerns, vaping cues in e-cigarette ads increased anti-smoking normative perceptions among people who dual used in the past week. Further research is needed to examine the impact of vaping cues in e-cigarette ads on normative perceptions among those who don’t smoke or quit smoking cigarettes.

Associations Between E-cigarette Use and E-cigarette Flavors With Cigarette Smoking Quit Attempts and Quit Success: Evidence From a U.S. Large, Nationally Representative 2018-2019 Survey.

Although many studies have examined the association between e-cigarette use and smoking cessation, fewer have considered the impact of e-cigarette flavors on cessation outcomes. This study extends previous studies by examining the effects of e-cigarette use and e-cigarette flavors on quit attempts and quit success of smoking. We used data from the 2018-2019 Tobacco Use Supplement-Current Population Survey (TUS-CPS) survey. Multivariate logistic regression analyses were used to investigate the associations between flavored e-cigarette use with quit attempts and quit success of smoking among individuals who smoked 12 months ago. Two current e-cigarette use definitions were used in these logistic regression analyses; currently use every day or some days versus 20+ days in the past 30 days. Compared to those not using e-cigarettes, current every day or someday e-cigarette use with all nontobacco flavors had an adjusted odds ratio (AOR) of 2.9 (95% CI: 2.4 to 3.5) for quit attempts and 1.7 (95% CI: 1.3 to 2.2) for quit success. 20+ days e-cigarette use with flavors had stronger associations with quit attempts (AOR = 4.2, 95% CI: 3.1 to 5.5) and quit success (AOR = 4.0, 95% CI: 2.9 to 5.4). E-cigarette users with nontobacco flavors were more likely to succeed in quitting compared to those exclusively using non-flavored or tobacco-flavored e-cigarettes. Menthol or mint flavor users had slightly higher odds of quit attempts and success than users of other nontobacco flavors. E-cigarette use is positively associated with both making smoking quit attempts and quit success. Those using flavored e-cigarettes, particularly menthol or mint, are more likely to quit successfully. E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products. This suggests that the potential for e-cigarettes to help people who currently smoke quit could be maintained with the availability of menthol or mint-flavored e-cigarettes, even if other nontobacco flavored products, which are associated with e-cigarette use among youth, were removed from the market.

Associations between nicotine vaping uptake and cigarette smoking cessation vary by smokers' plans to quit: longitudinal findings from the International Tobacco Control Four Country Smoking and Vaping Surveys.

Most population studies that evaluate the relationship between nicotine vaping and cigarette cessation focus on limited segments of the smoker population. We evaluated vaping uptake and smoking cessation considering differences in smokers' plans to quit. Longitudinal International Tobacco Control (ITC) Four Country Smoking and Vaping Surveys were conducted in 2016, 2018 and 2020. This study was conducted in the United States, Canada, England and Australia. Participants of this study were adult daily cigarette smokers who had not vaped in the past 6 months at baseline and had participated in two or more consecutive waves of the ITC Four Country Smoking and Vaping Surveys (n= 2815). Plans to quit cigarette smoking was assessed at baseline (within 6 months, beyond 6 months, not planning to quit) and at follow-up (within 6 months vs not within 6 months), cigarette smoking cessation was assessed at follow-up (smoking less than monthly [including complete cessation] vs daily/weekly/monthly smoking) and inter-wave vaping uptake was assesed between baseline and follow-up (none, only non-daily vaping and any daily vaping). Generalized estimating equations were used to evaluate whether inter-wave vaping uptake was associated with smoking cessation at follow-up and with planning to quit at follow-up, each stratified by plans to quit smoking at baseline. Overall, 12.7% of smokers quit smoking. Smokers not initially planning to quit within 6 months experienced higher odds of smoking cessation when they took up daily vaping (32.4%) versus no vaping (6.8%; adjusted odds ratio [AOR], 8.58; 95% CI, 5.06-14.54). Among smokers planning to quit, smoking cessation rates were similar between those who did and did not take up daily vaping (25.1% vs 16.8%; AOR, 1.91; 95% CI, 0.91-4.00), although we could not account for potential use of cessation aids. Daily vaping uptake was associated with planning to quit smoking at follow-up among those initially not planning to quit (AOR,6.32; 95% CI,4.17-9.59). Uptake of nicotine vaping appears to be strongly associated with cigarette smoking cessation among smokers with no initial plans to quit smoking. Excluding smokers not planning to quit from studies on vaping and smoking cessation may underestimate potential benefit of daily vaping for daily smokers.

The Short-Term and Long-Term Associations Between Receiving Tobacco Discounts or Coupons and Smoking Cessation Among U.S. Adult Cigarette Smokers With Intention to Quit.

To examine the associations between baseline receipt of cigarette and non-cigarette tobacco discounts or coupons and smoking cessation at follow-up among US adult cigarette smokers with the intention to quit at baseline. Data were from the Population Assessment of Tobacco and Health (PATH) study wave 3 (October 2015-October 2016), wave 4 (December 2016-January 2018), and wave 5 (December 2018-November 2019) surveys. Two separate sets of analyses were conducted using wave 3-4 data (N = 3707) and wave 4-5 data (N = 6251). Specifically, wave 4 was used as the 1-year follow-up of wave 3 to examine the short-term association, and wave 5 was used as the 2-year follow-up of wave 4 to examine the longer-term association. Study population were current established cigarette smokers with the intention to quit (within 1 year for wave 3-4 data) at baseline. Exposure was self-reported past 12-month receipt of discounts or coupons for cigarettes and non-cigarette tobacco products at baseline, and outcome was self-reported completely quitting cigarette smoking at follow-up. Baseline single-wave weights were applied, and multivariate logistic regressions were used to estimate the adjusted associations. Participants who received cigarette discounts or coupons at baseline were less likely to quit completely for both 1-year follow-up (aOR = 0.66, 95% CI: 0.48 to 0.90) and 2-year follow-up (aOR = 0.74, 95% CI: 0.61 to 0.90). Baseline receipt of discounts or coupons for non-cigarette tobacco products were not consistently associated with cigarette smoking cessation at follow-up. Receipt of cigarette discounts or coupons was associated with a reduced likelihood of successful quitting among cigarette smokers with intention to quit. Policies restricting cigarette coupons may help them quit completely. This study found that among baseline current established cigarette smokers with intention to quit in the United States, baseline receipt of cigarette discounts or coupons was negatively associated with cigarette smoking cessation for both 1-year follow-up and 2-year follow-up. Baseline receipt of discounts or coupons for e-cigarettes, cigars, and other tobacco products were not consistently significantly associated with cigarette smoking cessation at follow-up. Our study results indicated that policies restricting cigarette coupons may help increase the likelihood of successful smoking cessation for smokers with intention to quit.

Do Social Norms for Cigarette Smoking and Nicotine Vaping Product Use Predict Trying Nicotine Vaping Products and Attempts to Quit Cigarette Smoking Amongst Adult Smokers? Findings From the 2016-2020 International Tobacco Control Four Country Smoking and Vaping Surveys.

To examine whether perceived injunctive and descriptive social norms towards cigarette and nicotine vaping product (NVP) use predicted subsequent trying NVPs and attempts to quit cigarette smoking amongst current smokers and whether associations varied across countries. Three waves of longitudinal cohort data from the International Tobacco Control Four Country Smoking and Vaping Survey were collected between 2016 and 2020 from 2290 adult smokers in Canada, Australia, England, and the United States who had never used NVPs at baseline (either wave 1 or wave 2) and followed up at the subsequent wave (wave 2 or wave 3, respectively) were analyzed using Generalized Estimating Equations. Of the injunctive and descriptive norm measures for smoking and NVP use, NVP initiation was only independently predicted by the injunctive interpersonal norm for NVP use, with perceived approval of NVP use by important others predicting higher odds of trying NVPs (AOR = 1.65, 95% CI = 1.20 to 2.27). This predictive effect was independent of baseline quit intention with no country variations found. By contrast, making cigarette smoking quit attempts were independently predicted by both injunctive and descriptive interpersonal norms with perceived disapproval of smoking by important others (AOR = 1.65, 95% CI = 1.38 to 1.99) and close friends using NVPs (AOR = 1.37, 95% CI = 1.04 to 1.79), both associated with higher odds of smoking quit attempts. Adult smokers who perceive NVP use as normative, either because such behavior is socially approved or common within their close social networks, appear more inclined to try NVPs or make smoking quit attempts than smokers who do not. Social norms can shape a person's behavior and result in behavior change. This study shows that initiation of NVP use behavior among smokers can be reliably predicted by their perception of whether NVP use is acceptable to those important to them within their close social networks. Similarly, any attempts to stop cigarette smoking can be predicted by their perception of how acceptable cigarette smoking is among those who are important to them and whether any of their close friends use NVPs. Changing social norms towards cigarette smoking and NVP use could therefore be incorporated into smoking cessation interventions to help smokers to quit and/or switch to NVP use.

A Systematic Review and Meta-analysis of the Association between E-cigarette Use among Cigarette Smokers and Quit Attempts Made to Abstain from Cigarette Smoking.

Objective: Following AMSTAR 2 and PRISMA guidelines, in this synthesis of evidence we sought to identify and characterize any associations between e-cigarette use among cigarette smokers and cigarette smoking quit attempts. Methods: We queried 3 databases from January 1, 2007 to January 5, 2021. Search results were screened using the PICOS review method. Included studies examined e-cigarette use and cigarette smoking quit attempts across e-cigarette use statuses. Risk of bias was assessed according to the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. Finally, 4 random-effects models compared e-cigarette users and non- e-cigarette-users in terms of past year and prospective (6 to 12 months) cigarette smoking quit attempts. Results: We qualitatively synthesized 17 adjusted studies for this review. Two meta-analyses showed past year quit attempts were significantly associated with current e-cigarette users and 2 prospective data analyses found no significant association. Conclusions: The results of the meta- analyses emphasize temporality in the association between e-cigarette use and cigarette smoking quit attempts. Numerous methodological limitations, including inadequate definitions of e-cigarette use and non-adjustment for confounding variables, limit the confidence in conclusions that can be drawn on the causal association between e-cigarette use and cigarettes smoking quit attempts.

Tobacco/nicotine use among individuals using cannabis for therapeutic purposes.

While the relationship between recreational cannabis and nicotine use is well established, little is known about nicotine use among users of cannabis for therapeutic purposes (CTP). Patients attending a medical marijuana dispensary (N = 697; 75.3% White; 60.0% male) completed a survey examining nicotine use, motivation to quit cigarette smoking, routes of administration of nicotine and cannabis, and CTP qualifying conditions. More than one-third (39.3%) of participants reported current nicotine use. Compared to exclusive cigarette smokers, e-cigarette users and non-users of nicotine were approximately four times more likely to vape, rather than to smoke, cannabis. Furthermore, 46.8% of cigarette smokers reported plans to quit smoking in the next 6 months (but not in the next month) and an additional 31.6% planned to quit in the next month. Having a psychiatric condition was associated with nicotine use and higher motivation to quit smoking. Users of CTP are more likely to use nicotine products than the general population and the route of administration of nicotine products is related to the route of administration of CTP. If aerosolized CTP is a less harmful route of administration than smoked CTP, dispensary staff should be aware of this relationship and take this into account when recommending a noncombustible route. This study further characterizes nicotine use behaviors and motivation to quit smoking among users of CTP and may be among the first to examine nicotine use among patients of a medical marijuana dispensary.