Onset Of Smoking Research Articles

Does having one or more smoking friends mediate the transition from e-cigarette use to cigarette smoking: a longitudinal study of Canadian youth.

Studies have shown consistent associations between youth e-cigarette use and subsequent smoking uptake. However, it remains unclear why, as limited evidence exists regarding the mechanisms underlying these associations. Our study investigated whether having one or more smoking friends mediated the association between e-cigarette use and cigarette smoking onset among a longitudinal sample of Canadian youth who were never smokers at baseline. A longitudinal sample of youth that participated in three waves of the COMPASS study (2015-2016 to 2017-2018) was identified (N = 5,535). The product of coefficients method was used to assess whether having one or more smoking friends mediated the association between: (1) past 30-day e-cigarette use and cigarette smoking onset and (2) past 30-day e-cigarette use and subsequent dual use of e-cigarettes and cigarettes. Having one or more smoking friends did not mediate the association between (1) past 30-day e-cigarette use and cigarette smoking onset (β = 0.38, 95% CI -0.12, 0.89) or (2) past 30-day e-cigarette use and subsequent dual use (β = 0.46, 95% CI -0.16, 1.07). Post hoc tests indicated that smoking friends significantly predicted past 30-day e-cigarette use and cigarette smoking at wave 3 (aOR 1.68 and 2.29, respectively). Having smoking friends did not explain the association between e-cigarette use and smoking uptake despite being a common risk factor for both e-cigarette use and cigarette smoking. Prevention efforts should consider how best to incorporate effective programming to address these social influences.

Seasonal Variation in Demand for Smoking Cessation Treatment and Clinical Outcomes.

Smoking behaviour shows seasonal variation, with cigarette consumption and youth smoking onset highest in summer and smoking-related web searches and sales of nicotine replacement products highest in winter. Variation in demand for clinical care and in outcomes has not been explored. We measure seasonal variation in enrolments, total clinical visits, visits per enrolment, and treatment outcome (7-day abstinence at 6-month follow-up) from 2015 to 2018 in a large (n = 85 869) clinical cohort from 454 clinics across Ontario, Canada. We model seasonality using harmonic logistic and negative binomial regression. For individual-level outcomes, we adjust for variables, selected a priori, known to be associated with treatment use or outcomes. Data are nearly complete for 3 outcomes, but 6m abstinence is missing for 45% of participants. We use multiple imputation to adjust for missing data. All four outcomes showed significant seasonal variation (all p <.001). Total enrolments and visits were 20%-25% higher in January-April than in June-September. Visits per enrolment varied slightly, with lowest levels from May-July. Abstinence at 6 months was lowest among individuals enrolled from February-May and highest for those enrolled from July-November, with an absolute peak-trough difference of 4.3% (95% CI = 3.2% to 5.5%). There is meaningful seasonal variation in demand for, and outcomes of, smoking cessation treatment. Climate and weather may be indirectly responsible. Seasonal differences underscore the general importance of contextual factors in smoking cessation, may be useful in program promotion, and may explain some variability in outcomes in evaluation and research. Demand for tobacco cessation treatment and clinical outcomes vary seasonally. This underscores the importance of context in substance-related problems, and implies that some variability in research and evaluation results may be due to the time of year data were collected. Promotion efforts might usefully consider seasonal effects to smooth out demand and possibly improve outcomes.

Assessing factors influencing smoking and smoking cessation within Chinese communities in the Greater Vancouver Area: A qualitative exploratory study.

INTRODUCTIONThe prevalence of smoking is high within Chinese-Canadian communities and there is a lack of culturally and linguistically appropriate smoking cessation resources and services. We aimed to ascertain factors affecting smoking and smoking cessation from the perspectives of current smokers and key informants.METHODSAs part of a multistage mixed-methods study taking place from January 2013 to June 2014, a qualitative exploratory study design was conducted applying a community-based participatory research approach. Focus groups and interviews were conducted with adult (aged ≥19 years) Chinese-Canadian current smokers (≥5 cigarettes per day for the past 30 days) and interviews were held with key informants in Vancouver, Canada. A constant comparison method was applied to code data, and an inductive approach was used to identify emergent themes.RESULTSIn all, 35 smokers from the target communities (11 female, 24 male) participated in 4 focus group sessions and 17 key informants (14 female, 3 male) were individually interviewed. Internal and external factors influencing smoking onset, continuation, and cessation from the perspectives of smokers and key informants were identified. Male smokers thought that the most influential factor influencing smoking initiation was social pressure, while female smokers thought that it was stress. Female smokers reported refraining from seeking cessation assistance due to a perceived negative image of female smokers within the community. Both key informants and participants indicated that involving friends and family in the quitting process may help to motivate smokers.CONCLUSIONSSmokers from Chinese-Canadian communities may benefit from linguistically appropriate and culturally relevant smoking cessation interventions that consider prevailing attitudes, perceptions, and beliefs. The knowledge gained may inform the development of future smoking cessation programs and resources for the target community, while our approach may be applicable to other ethnocultural or immigrant communities.

Trends in the Age of Cigarette Smoking Initiation Among Young Adults in the US From 2002 to 2018

Success in reducing the prevalence of adolescent smoking could reflect complete prevention of smoking initiation or a shift in the age of cigarette smoking initiation from adolescence into early adulthood. To assess trends in early adult (ages 18-23 years) vs adolescent (age <18 years) cigarette smoking initiation and transition to daily cigarette smoking from 2002 to 2018. Ages at initiation of smoking and the transition to daily smoking were ascertained from the National Survey on Drug Use and Health (2002-2018), an annual, population-based, repeated cross-sectional study representative of the US population. This cross-sectional analysis was restricted to young adults who completed the survey at ages 22 to 23 years during survey years 2002 to 2018 to limit potential age-related recall bias. Retrospectively collected age of cigarette smoking initiation was assessed among ever cigarette smokers; age of transition to daily smoking was assessed among ever daily cigarette smokers. Data analysis was performed from June 2019 to July 2020. Calendar year of survey (2002 to 2018). The main outcomes were population-weighted cigarette smoking prevalence and cigarette smoking initiation and transition to daily smoking in adolescence (age <18 years) vs early adulthood (ages 18-23 years). Among 71 756 young adults aged 22 to 23 years (38 226 women [50.5%]), ever cigarette smoking prevalence decreased from a population-weighted estimate of 74.6% (95% CI, 73.1%-75.9%) in 2002 to 51.4% (95% CI, 49.3%-53.5%) in 2018 (P < .001). Daily smoking prevalence rates similarly decreased from 41.1% (95% CI, 39.1%-43.1%) in 2002 to 20.2% (95% CI, 18.6%-21.8%) in 2018 (P < .001). However, among 48 015 ever smokers, the proportion initiating smoking in early adulthood (ages 18-23 years) increased over this time, from 20.6% (95% CI, 18.5%-22.8%) in 2002 to 42.6% (95% CI, 39.6%-45.7%) in 2018 (P < .001). Similarly, among 24 490 daily cigarette smokers, the proportion who transitioned to daily smoking in early adulthood increased from 38.7% (95% CI, 35.9%-41.6%) in 2002 to 55.9% (95% CI, 52.0%-59.8%) in 2018 (P < .001). A substantial proportion of beginning smokers and most new daily smokers are now young adults, reflecting a shift from adolescence to early adulthood, a population segment once considered beyond the critical risk period for cigarette smoking onset. Expanding the long-standing emphasis on adolescent surveillance and prevention in adolescence to include the young adult population is warranted.

A CURIOUS CASE OF GRANULOMATOUS INFLAMMATION OF THE LUNG

SESSION TITLE: Medical Student/Resident Tobacco Cessation and Prevention Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Young patients may have a multitude of causes for incidental lung lesions. Granulomatous lung lesions are frequently associated with infections, less common causes such as toxin mediated and vasculitis should be ruled out. We present the case of a patient who presented with granulomatous nodules due to water pipe smoking (WPS). CASE PRESENTATION: 21 year-old female presented with chest pain and dyspnea. She reported a 3-year history of tobacco use in the form of WPS and a remote history of vaping. Chest x-ray revealed a right middle lobe infiltrate concerning for pneumonia which was treated with antibiotics. CT chest further characterized the lesion as a 4 cm mass with additional clusters of irregular sub-centimetre nodules with subcarinal and mediastinal lymphadenopathy (Fig 1). Bronchoscopy showed large endobronchial lesions and histology showed necrotizing granulomas with negative stains and cultures for fungal or tuberculosis or evidence of malignancy. lymph node biopsy tissue samples demonstrated necrotizing granulomas. The patient was subsequently discharged from the hospital for outpatient management with a brief course of corticosteroids and was lost to follow up thereafter. DISCUSSION: Our patient who presented with an incidental lung lesion on her radiographs was found to have granulomatous lung nodules on histology. Workup remained negative for common causes such as Fungal infections, Tuberculosis or malignancy and she was eventually presumed to have WPS induced granulomatous lung disease given her prolonged and recent exposure. WPS as a trend has been silently picking up among certain young adult populations in the West with some studies indicating usage rates as high as 46.4% among college students. Contents in water pipe smoke such as ultrafine particulate matter (PM), carcinogenic particles and heavy metals have been implicated in a host of lung pathologies ranging from emphysema to infections and even lung cancers. Granulomatous inflammation however remains an infrequent complication and the mechanism underlying this pathology has yet to be elucidated. Such a finding has only been reported once before by Dyal et al who described the case of a young female with bilateral granulomatous secondary to WPS who was treated successfully with steroids, suggesting a component of underlying inflammation. CONCLUSIONS: Detailed and updated review could help strengthen evidence for the truly disastrous effects of WPS on long term health of our young adults, and potentially support litigation for the ban on sale and use of these products, as was accomplished recently in case of E-cigarettes or vaping. Reference #1: American Lung Association. Hookah smoking: a growing threat to public health [accessed 2016 Apr 9] Reference #2: Shafagoj Y.A., Mohammad F.I. Levels of maximum endexpiratory carbon-monoxide and certain cardio vascular parameters following hubble-bubble smoking. Saudi. Med. J. 2002;23:953958 Reference #3: Dyal H, Singhvi A, Patel R, et al. 2014. A case of Eosinophilic pneumonia following recent onset of hookah smoking. Chest 146:406A DISCLOSURES: No relevant relationships by Sanjay Dogra, source=Web Response No relevant relationships by Sandeep Kumar, source=Web Response No relevant relationships by Shaiva Meka, source=Web Response No relevant relationships by Syed Mustafa, source=Web Response No relevant relationships by Ehsun Naeem, source=Web Response

Ancestral childhood environmental exposures occurring to the grandparents and great-grandparents of the ALSPAC study children.

Background: Cohort studies tend to be designed to look forward from the time of enrolment of the participants, but there is considerable evidence that the previous generations have a particular relevance not only in the genes that they have passed on, their cultural beliefs and attitudes, but also in the ways in which previous environmental exposures may have had non-genetic impacts, particularly for exposures during fetal life or in childhood. Methods: To investigate such non-genetic inheritance, we have collected information on the childhoods of the ancestors of the cohort of births comprising the original Avon Longitudinal Study of Parents and Children (ALSPAC). The data collected on the study child's grandparents and great grandparents comprise: (a) countries of birth; (b) years of birth; (c) age at onset of smoking; (d) whether the ancestral mothers smoked during pregnancy; (e) social class of the household; (f) information on 19 potentially traumatic situations in their childhoods such as death of a parent, being taken into care, not having enough to eat, or being in a war situation; (g) causes of death for those ancestors who had died. The ages at which the individual experienced the traumatic situations distinguished between ages <6; 6-11, and 12-16 years. The numbers of ancestors on which data were obtained varied from 1128 paternal great-grandfathers to 4122 maternal great grandmothers. These ancestral data will be available for analysis to bona fide researchers on application to the ALSPAC Executive Committee.

Onset of smoking amongst middle school students in Switzerland

Abstract Smoking is a major concern amongst youth in Switzerland. This study aims to understand the longitudinal drivers of smoking initiation among middle school students in Switzerland. Data was collected as part of an ongoing longitudinal survey study. Participants were students from middle schools in Switzerland. 1076 adolescents were surveyed in four waves from 2015 to 2019. All participants were non-smokers at the start of the study, when they were aged 10 respectively 11. Furthermore, data from adolescents' parents were collected, including their smoking behavior, perceived quality of relation with their child, as well as parental monitoring behavior. A survival analysis was carried out, describing if and when the event of smoking initiation occurs among adolescents. Our life table showed that 31% (n = 330) of participants started smoking between the first and fourth years of their schooling. The proportion of non-smoking participants decreased yearly. The proportions of non-smokers were 0.98, 0.93, 0.86, and 0.83 in 2016, 2017, 2018 and 2019 respectively. A life table was used to describe and summarize the sample distribution of smoking initiation and the percentage of risk. Second, a Discrete-Time Hazard Model was tested with parental smoking behavior, perceived quality of relation with their child and parental monitoring behavior as drivers to predict adolescents' smoking initiation. The findings show that the number of smokers and new smokers increases over time among adolescents. Parental smoking behavior and the perceived quality of relationship with their offspring are factors that influence an adolescent's smoking initiation. This suggests that there may be sharing and normative influences amongst the cohorts as students move up the school grades. Future studies should investigate personal and environmental factors that contribute to smoking initiation amongst adolescents. Key messages Findings show that the number of smokers and new smokers increases over time among adolescents. Sharing and normative influences among adolescents as they move up the school grades may influence smoking initiation.

Smoking prevalence, nicotine dependence, and intention to quit among cigarettes smokers

Abstract Introduction Tobacco consumption remains a challenging issue to the global and public health that requires close monitoring of the spread of this epidemic and its impact. This study aims to assess the national prevalence and determinates of cigarette smoking and nicotine dependence in Saudi Arabia. Methods A cross-sectional national survey of a sample of 5148 of Saudi residents' ages 18 years or older was conducted through web-based-computer assisted telephone interviews. The two main measurements were current cigarette smoking status and nicotine dependence assessed using the Fagerstrom Test for Nicotine Dependence. Data was weighted by age, gender, and region to account for the different probabilities of selection. Descriptive and logistic regression analyses were used to assess cigarette smoking and nicotine dependence determinants. Results The national prevalence of cigarette smoking was 16.18% (95% CI:14.59-17.77) with 14.12% (95% CI:12.64-15.59) current daily smoking prevalence. Almost 72% of smokers started smoking before the age of 22 and 27% of smokers were highly dependent on nicotine. Having a smoker parent (AOR=1.84[95%CI:1.31-2.58], P &amp;lt; 0.001) or a smoker close friend (AOR=6.49[95%CI:3.89-10.81], P &amp;lt; 0.001) were significantly associated with being a smoker. Higher nicotine dependence level was significantly associated with early onset of regular smoking (ages&amp;lt;18) (AOR=2.71 [95%CI:1.38-5.34],P&amp;lt;0.001) and lower attempting to quit (AOR=0.51[95% CI:0.32-0.83],P&amp;lt;0.01). Conclusions Cigarettes smoking and nicotine dependence are prevalent in Saudi Arabia. The study found the majority of smokers started regular smoking before the age of 22 and the early onset of smoking was associated with a higher nicotine dependence level. Restrict access to tobacco products to those below the age of 22 will help reduce smoking prevalence and lifetime addiction to nicotine. Key messages Majority of smokers initiated smoking by the age of 21 and early regular smoking initiation was associated with higher nicotine dependence. Strategies to prevent initiation before the age of 21 will help prevent addiction to nicotine.

Association Between Age at Smoking Onset and Binge Drinking Among Adults in the Republic of Korea

We aimed at investigating the association between age at smoking onset and adult binge drinking among Korean adults. We cross-sectionally analyzed nationally representative secondary data obtained from 11,296 adults in 2013. We conducted survey data analyses to incorporate a complex sampling design in our analyses. Specifically, we conducted a multivariate logistic regression analysis to investigate the relationship of age at smoking onset with binge drinking. In our study, about 28% of adults were past 30-day binge drinkers. We found the greatest risks of past 30-day binge drinking among those who started smoking at 14 years or younger. Additionally, greater risk of adult binge drinking was significantly associated with the male sex, younger age, higher income, employed status, past 30-day smoking, exercise, higher anxiety, and depressive feelings. Smoking prevention strategies should be implemented in earlier adolescence because they may play pivotal roles in reducing both alcohol- and cigarette-related problems in adulthood.

Parents' smoking onset before conception as related to body mass index and fat mass in adult offspring: Findings from the RHINESSA generation study.

Emerging evidence suggests that parents' preconception exposures may influence offspring health. We aimed to investigate maternal and paternal smoking onset in specific time windows in relation to offspring body mass index (BMI) and fat mass index (FMI). We investigated fathers (n = 2111) and mothers (n = 2569) aged 39-65 years, of the population based RHINE and ECRHS studies, and their offspring aged 18-49 years (n = 6487, mean age 29.6 years) who participated in the RHINESSA study. BMI was calculated from self-reported height and weight, and FMI was estimated from bioelectrical impedance measures in a subsample. Associations with parental smoking were analysed with generalized linear regression adjusting for parental education and clustering by study centre and family. Interactions between offspring sex were analysed, as was mediation by parental pack years, parental BMI, offspring smoking and offspring birthweight. Fathers' smoking onset before conception of the offspring (onset ≥15 years) was associated with higher BMI in the offspring when adult (β 0.551, 95%CI: 0.174-0.929, p = 0.004). Mothers' preconception and postnatal smoking onset was associated with higher offspring BMI (onset <15 years: β1.161, 95%CI 0.378-1.944; onset ≥15 years: β0.720, 95%CI 0.293-1.147; onset after offspring birth: β2.257, 95%CI 1.220-3.294). However, mediation analysis indicated that these effects were fully mediated by parents' postnatal pack years, and partially mediated by parents' BMI and offspring smoking. Regarding FMI, sons of smoking fathers also had higher fat mass (onset <15 years β1.604, 95%CI 0.269-2.939; onset ≥15 years β2.590, 95%CI 0.544-4.636; and onset after birth β2.736, 95%CI 0.621-4.851). There was no association between maternal smoking and offspring fat mass. We found that parents' smoking before conception was associated with higher BMI in offspring when they reached adulthood, but that these effects were mediated through parents' pack years, suggesting that cumulative smoking exposure during offspring's childhood may elicit long lasting effects on offspring BMI.

Natural Course of Nicotine Dependence Among Adolescent Waterpipe and Cigarette Smokers

PurposeWaterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers. MethodsA cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years. This study was based on 283 current exclusive WP and 146 current exclusive cigarette smokers. Kaplan–Meier survival analyses were conducted to evaluate 50% cumulative probability for the development of initial Hooked on Nicotine Checklist symptoms and the International Classification of Diseases, 10th revision (ICD-10) ND. ResultsAn initial Hooked on Nicotine Checklist symptom was endorsed by 59% of WP and 50% of cigarette smokers after smoking onset. Among those, 50% of both WP and cigarette smokers did so within 9.7 and 18.5 months, respectively. Approximately 28% of WP smokers and 22% of cigarette smokers developed ICD-10 ND. Among those, 50% of both WP and cigarette smokers did so within 15 and 22 months, respectively. The most common first to fourth ICD-10 criteria reported by WP smokers were “a strong desire to use tobacco,” “difficulties in controlling tobacco taking behavior,” “neglect of alternative pleasure,” and “use despite harm.” The most common first to fourth ICD-10 criteria reported by cigarette smokers were “a strong desire to use tobacco,” “difficulties in controlling tobacco taking behavior,” “withdrawal,” and “tolerance”. ConclusionsCompared with adolescent cigarette smokers, initial ND symptoms and ICD-10 ND can develop sooner after starting to smoke and progress more rapidly among adolescent WP smokers. Developing, implementing, and evaluating intervention programs with adolescent WP smokers should be guided by the WP-specific trajectory of ND.

‘Time to first tobacco cigarette soon after waking’ occurs more often among underage newly incident smokers in the United States, 2004–2017

AimsTime to first cigarette (TTFC) after waking is a highly regarded and readily measured manifestation of a tobacco dependence process. We aim to estimate short TTFC as it occurs very soon after the onset of cigarette smoking (CS) in a community sample of newly incident smokers, all 12–21 years of age, and to study risk variation with the age of CS onset. MethodsUnited States National Surveys on Drug Use and Health, 2004–2017, drew large nationally representative samples of 12-to-21-year-old community residents, and used computerized self-interviews to measure tobacco cigarette smoking, the Fagerstrom TTFC construct, and related variables. A ‘short’ TTFC was defined as smoking the first cigarette after waking up within 30 min vs. ‘long’ TTFC or smoking more than 30 min. We studied 8188 newly incident smokers, all assessed within six months after the first puff. Estimated age-specific cumulative incidence proportions (CIP) and odds ratios (OR) are estimated and compared, with due attention to complex survey design and weights. ResultsAmong underage newly incident smokers (12–17 years old), an estimated 5.2% experienced short TTFC within 6 months after CS onset (95% CI = 4.4%, 6.2%), versus 3.7% for older new smokers (18–21 years; 95% CI = 2.8%, 4.6%). Underage smokers are 1.5 times more likely to develop short TTFC compared to older initiates (95% CI = 1.1, 2.1). No male-female variations are seen, but exploratory analysis disclosed findings that involve Census-defined race-ethnicity subgroups. Non-Hispanic African-American initiates are twice as likely to develop short TTFC, and Hispanic initiates are less likely to develop short TTFC, as compared with non-Hispanic White smokers. ConclusionsBased on US community samples our study offers new evidence about TTFC formation observed within six months after the first puff when cigarette smoking starts before age 18 years.

E-cigarette use and onset of first cigarette smoking among adolescents: An empirical test of the ‘common liability’ theory

Background: E-cigarettes have become the most commonly used tobacco products among youth in the United States (US) recently. It is not clear whether there is a causal relationship between e-cigarette use and the onset of cigarette smoking. The “common liability” theory postulates that the association between e-cigarette use and cigarette smoking can be attributed to a common risk construct of using tobacco products. This study aims to investigate the relationship between ever e-cigarette use and cigarette smoking onset in the US using a structural equation modeling approach guided by the “common liability” theory. Methods: The study population is non-institutionalized civilian adolescents living in the US, sampled in the longitudinal Population Assessment of Tobacco and Health study. Information about tobacco product use was obtained via confidential self-report. A structural equation modeling approach was used to estimate the relationship between e-cigarette use at wave 1 and the onset of cigarette smoking at wave 2 after controlling for a latent construct representing a “common liability to use tobacco products.” Results: After controlling for a latent construct representing a “common liability to use tobacco products”, ever e-cigarette use does not predict the onset of cigarette smoking (β=0.13, 95% CI= -0.07, 0.32, p=0.204). The latent “common liability to use tobacco products” is a robust predictor for the onset of cigarette smoking (β=0.38; 95% CI=0.07, 0.69; p=0.015). Conclusions: Findings from this study provide supportive evidence for the ‘common liability’ underlying observed associations between e-cigarette use and smoking onset.

The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature.

Anxiety is one of the most common mental health conditions globally and co-occurs with smoking at a markedly high rate. The present review offers a narrative overview of the most recent research on the role of anxiety in smoking onset, maintenance, and cessation-related outcomes. Additionally, given the rise in electronic cigarette use, we review the emerging literature on the influence of anxiety on e-cigarette use. Evidence across studies varied as to the role of anxiety or anxiety symptoms in smoking behavior. The most consistent findings suggested that those with anxiety are more likely to be a smoker, supporting a high rate of co-occurrence across these conditions. Less consistent evidence was observed for the association between anxiety and onset, indicators of severity, and cessation outcomes. Although there is robust evidence for an association between smoking and anxiety, there were considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes. Future work utilizing more sophisticated methodologies is needed to identify causal relations as well as putative moderators and mediators of the anxiety-smoking relation.

The Association of Smoking Exposure at Home with Attempts to Quit Smoking and Cessation Success: A Survey of South Korean Adolescents Who Smoke.

This study aimed to examine the association of smoking exposure at home with attempts to quit smoking and the success or failure of such attempts among South Korean adolescents. We utilized the data of 28,652 South Korean adolescents who smoked from the 2015–2017 Korea Youth Risk Behavior Web-based Survey, including demographic variables (age, sex, and family structure), socioeconomic variables (allowance per week, household income level, and grade), and health-related characteristics (alcohol consumption, intensity of physical activity, stress level, self-reported health status, attendance in smoking cessation programs, and smoking onset). A multiple logistic regression analysis revealed that attempting to quit smoking was less likely among those exposed to smoking at home every day compared to those without such exposure (boys exposed to smoking every day: OR = 0.52, CI = 0.45–0.60; girls exposed to smoking every day: OR = 0.48, CI = 0.38–0.61); cessation success showed similar results (boys exposed to smoking every day: OR = 0.51, CI = 0.46–0.58; girls exposed to smoking every day: OR = 0.56, CI = 0.47–0.66). These findings highlight the impacts of smoking exposure at home and the importance of considering this exposure when supporting adolescents to quit.

Abstract A022: “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C.

Abstract Background: In the U.S., lesbian, gay, bisexual, and transgender individuals (LGBT) are medically underserved, understudied, and are often difficult for researchers to access due in part to risks to participation (i.e., discrimination and stigma). While evidence regarding combustible tobacco use among LGBT adults is relatively underdeveloped, significant health disparities exist in this population. LGBT young adults in particular are nearly twice as likely to use tobacco compared to their heterosexual and cisgender counterparts, indicating that LGBT smokers have higher rates of tobacco-related cancers, including lung cancer. Informed by the Theory of Planned Behavior, this qualitative pilot study explored in depth attitudes, subjective norms, and perceived behavioral control toward combustible tobacco product use and cessation behaviors among a sample of young adult LGB smokers residing in Washington, D.C. Methods: Semistructured face-to-face interviews were conducted with self-identified lesbian (n=1), gay (n=5), and bisexual (n=2) young adult smokers. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis methodology. Digital audio recordings of the interviews were transcribed verbatim and edited to remove identifiers. Results: Participants ranged in age from 18 to 25 (M = 23.25, SD = 2.05). Five participants identified as African American and four identified as male. Three participants reported part-time employment and four reported that they “don’t meet basic expenses”. The mean age for cigarette smoking onset was 15.6. All participants reported menthol cigarette preference, four reported daily menthol cigarette use, and five reported past 30-day little cigar/cigarillo use. Attitudes, subjective norms, and perceived behavioral control toward combustible tobacco use and cessation behaviors fell under the broad themes of individual-level factors (self-image), psychosocial factors (stress and anxiety), socio-cultural factors (pro-smoking social norms), and stage of readiness. Intention to quit smoking in the next six months was low and influenced by pro-smoking attitudes and behaviors in the social environment surrounding LGBT young adults. Conclusions: Study findings contribute to a limited body of research investigating theoretically grounded variables related to combustible tobacco use among sexual minority young adult smokers. Multilevel cessation interventions are needed to address the psychosocial, socioeconomic, and cultural underpinnings of combustible tobacco use by distinct sexual identity. Additionally, study findings suggest opportunities to inform prevention campaigns like “This Free Life,” the Food and Drug Administration’s public education campaign designed to prevent and reduce tobacco use among LGBT young adults. Citation Format: Sabrina L Smiley. “Let me smoke that”: Exploring combustible tobacco use and smoking cessation behavior among sexual minority young adult smokers in Washington, D.C. [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A022.

The Effect of Maternal or Paternal Smoking on the Age at Onset of Smoking, Nicotine Dependence and Gender; a Single Center Experience in 902 Patients from the Smoking Cessation Clinic at İstanbul Medical Faculty

The Effect of Maternal or Paternal Smoking on the Age at Onset of Smoking, Nicotine Dependence and Gender; a Single Center Experience in 902 Patients from the Smoking Cessation Clinic at İstanbul Medical Faculty

Towards a better understanding of factors affecting smoking uptake among Saudi male adolescents: A qualitative study.

INTRODUCTIONAn increased smoking uptake by Saudi male adolescents and a lack of data about its determinants emphasize the need for a better understanding of factors leading to the onset of smoking and identifying ways to prevent it. The aim of this qualitative study is to explore adolescents’ views on smoking and their opinions about a smoking prevention program.METHODSA total of 103 school-going adolescents, aged 12–16 years, were purposely selected from grades seven, eight and nine from nine schools in Taif in Saudi Arabia. They were interviewed in 11 focus group discussions; five groups were held for smokers and six for non-smokers. An interview scheme was developed based on the I-Change Model, a model used for understanding smoking onset and prevention. We used QDA Lite version 2:0 software for data analysis.RESULTSMost of the participants agreed on the importance of social influences as determining factors to start smoking. The presence of smoking friend(s) and family member(s), especially the father, were mentioned. Factors such as having extra pocket money, absence of alternatives, showing off, to be seen as western, to be seen as an adult and the good taste of cigarettes were also mentioned as beliefs associated with smoking. Adolescents indicated to have low confidence not to smoke under peer pressure, suggesting self-efficacy problems. Intentions to smoke were also often mentioned. Almost all participants agreed that an interactive approach is optimal for an effective smoking prevention program.CONCLUSIONSDeterminants of smoking seem to be very similar to those outlined by previous studies. A smoking prevention program for Saudi adolescents should address how to cope with social pressure to smoke, the advantages connected with smoking, and how to increase self-efficacy. Information should be presented in an interactive rather than static way.

E-cigarette use and onset of first cigarette smoking among adolescents: An empirical test of the ‘common liability’ theory

Background: E-cigarettes have become the most commonly used tobacco products among youth in the United States (US) recently. It is not clear whether there is a causal relationship between e-cigarette use and the onset of cigarette smoking. The "common liability" theory postulates that the association between e-cigarette use and cigarette smoking can be attributed to a common risk construct of using tobacco products. This study aims to investigate the relationship between ever e-cigarette use and cigarette smoking onset in the US using a structural equation modeling approach guided by the "common liability" theory. Methods: The study population is non-institutionalized civilian adolescents living in the US, sampled in the longitudinal Population Assessment of Tobacco and Health study. Information about tobacco product use was obtained via confidential self-report. A structural equation modeling approach was used to estimate the relationship between e-cigarette use at wave 1 and the onset of cigarette smoking at wave 2 after controlling for a latent construct representing a "common liability to use tobacco products." Results: After controlling for a latent construct representing a "common liability to use tobacco products", ever e-cigarette use does not predict the onset of cigarette smoking (β=0.13, 95% CI= -0.07, 0.32, p=0.204). The latent "common liability to use tobacco products" is a robust predictor for the onset of cigarette smoking (β=0.38; 95% CI=0.07, 0.69; p=0.015). Conclusions: Findings from this study provide supportive evidence for the 'common liability' underlying observed associations between e-cigarette use and smoking onset.

E-cigarette use and onset of first cigarette smoking among adolescents: An empirical test of the ‘common liability’ theory

Background: E-cigarettes have become the most commonly used tobacco products among youth in the United States (US) recently. It is not clear whether there is a causal relationship between e-cigarette use and the onset of cigarette smoking. The “common liability” theory postulates that the association between e-cigarette use and cigarette smoking can be attributed to a common risk construct of using tobacco products. This study aims to investigate the relationship between ever e-cigarette use and cigarette smoking onset in the US using a structural equation modeling approach guided by the “common liability” theory. Methods: The study population is non-institutionalized civilian adolescents living in the US, sampled in the longitudinal Population Assessment of Tobacco and Health study. Information about tobacco product use was obtained via confidential self-report. A structural equation modeling approach was used to estimate the relationship between e-cigarette use at wave 1 and the onset of cigarette smoking at wave 2 after controlling for a latent construct representing a “common liability to use tobacco products.” Results: After controlling for a latent construct representing a “common liability to use tobacco products”, ever e-cigarette use does not predict the onset of cigarette smoking (β=0.13, 95% CI= -0.07, 0.32, p=0.204). The latent “common liability to use tobacco products” is a robust predictor for the onset of cigarette smoking (β=0.38; 95% CI=0.07, 0.69; p=0.015). Conclusions: Findings from this study provide supportive evidence for the ‘common liability’ underlying observed associations between e-cigarette use and smoking onset.