Tobacco Harm Research Articles

Introduction to the Special Section on Tobacco Harm Reduction

Introduction to the Special Section on Tobacco Harm Reduction

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

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

Protocol for a Cluster Randomized Controlled Trial to Reduce Susceptibility to Tobacco Use Among School Going Adolescents in a South-Indian District—(Project TEACH)

Background: Adolescents are susceptible to using tobacco because of early exposure to tobacco through family members, easy access, or peer pressure. School-based educational programs are crucial for raising awareness of the harms of tobacco, thus preventing its uptake among adolescents. Studies conducted recently have recognized the need to bring change and reinforce ongoing school-based anti-tobacco education programs. Our study protocol aims to evaluate the effectiveness of a revised school-based anti-tobacco education on susceptibility to tobacco use among school-going adolescents. Method: Project TEACH (Tobacco Education and Awareness for Creating Healthier Adolescents) is an educational intervention that will comprise an animated video on the effects of tobacco on physical and mental health, along with dispelling myths about tobacco, which will be delivered along with a standard education program. The control group will only receive the standard school-based anti-tobacco education program. It will be conducted among students between 6th to 10th grade, with a sample size of 3,310 students. Results: Bivariate relations between the main socio-demographic characteristics and susceptibility to tobacco use will be tested using Pearson or Spearman’s correlation coefficients. For multivariable analyses, the binary logistic regression analysis is used to establish a risk model to correlate the socio-demographic factors with susceptibility to tobacco use and awareness of the harms of tobacco. Conclusion: Project TEACH aims to provide a sustainable school-based anti-tobacco education intervention. It will help test the effectiveness of the revised intervention, which could be incorporated into the current school education program being conducted in the district.

Global rapid review of interventions to tackle the harms of illicit tobacco

ObjectiveThis review aimed to assess interventions designed to reduce harm from illicit tobacco (IT). We evaluated health outcomes, cost-effectiveness, the advantages and disadvantages of interventions, and contextual factors affecting implementation.Data...

Patterns and perceptions of vaping among adults living in social housing: a representative survey in Great Britain, 2023

BackgroundVaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types.MethodsData were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245). Logistic regression tested cross-sectional associations between living in social (vs. other) housing and current vaping among adults; vaping frequency, device type, nicotine concentration, and source of purchase among current vapers; use of vaping products as a smoking cessation aid among past-year smokers who tried to quit; and harm perceptions of vaping products relative to cigarettes among current smokers.ResultsCurrent vaping prevalence was twice as high among adults living in social housing (19.4%) compared with those in other housing types (10.4%; OR = 2.07, 95%CI = 1.84–2.33). This was partly explained by differences in sociodemographic characteristics and smoking status; after adjustment, the odds of being a current vaper were 33% higher (ORadj=1.33, 95%CI = 1.14–1.54). Among vapers, there were no notable differences by housing tenure in vaping frequency, main device type used, usual nicotine concentration, usual source of purchase, or use as a smoking cessation aid. However, current smokers living in social housing were more likely to think vaping is more harmful than cigarettes (31.6% vs. 21.8%; ORadj=1.61, 95%CI = 1.30–1.99).ConclusionsIn Great Britain, adults who live in social housing are more likely to vape than those who live in other housing types, even after accounting for their younger age and higher smoking rates. However, misperceptions about the relative harms of vaping products and tobacco are common among smokers living in social housing. Interventions addressing these misperceptions could help encourage more people living in social housing to switch from smoking to vaping and reduce smoking-related health inequalities.Pre-registrationThe study protocol and analysis plan were pre-registered on Open Science Framework (https://osf.io/n3mvs/).

Urine levels of nicotine and its metabolites in young population exposed to second-hand smoke in nightclubs: a pilot study.

The aim of this study was to investigate the extent of second-hand smoke exposure in younger population visiting nightclubs in Croatia by comparing the levels of nicotine and its main metabolites cotinine and trans-3'-hydroxycotinine (3HC) in urine samples taken from 22 participants before and after spending about three hours in a nightclub, stratified by smoking status (smokers and non-smokers). The samples were prepared by liquid-liquid extraction and analysed with gas chromatography-mass spectrometry. The presence of nicotine, cotinine, and 3HC was confirmed in all urine samples. Their median concentrations significantly differed between the two measurements in non-smokers. Our findings show that even a three-hour exposure to second-hand smoke can significantly increase the levels of nicotine and its metabolites in urine, which are indicative of exposure to other, harmful tobacco smoke substances. They also call for raising awareness of the health risks of exposure to second-hand smoke in the general population and among individuals who frequent nightclubs in particular.

Perceptions of nicotine vaping products among Australians living with HIV

ABSTRACT People living with HIV (PLHIV) are two to three times more likely to smoke tobacco compared to the general community. Evidence from the general population suggests that nicotine vaping products (NVPs) can be acceptable and effective smoking cessation aids, but there is limited evidence on the extent to which this is the case among PLHIV. This manuscript reports findings from the Tobacco Harm Reduction with Vaporised Nicotine (THRiVe) trial, a mixed-methods study investigating the feasibility of NVPs as smoking cessation aids among 29 PLHIV who smoked tobacco. Surveys and semi-structured interviews explored participants’ experiences and perceptions of NVPs, their features and functions, and support for various NVP regulatory policy options. Participants described seven reasons why NVPs were acceptable cessation aids: they satisfied nicotine cravings; differences between NVPs and cigarettes facilitated habit breaking; fewer adverse effects compared to traditional cessation aids; NVPs allowed for a “weaning process” rather than requiring abrupt abstinence; tobacco became increasingly unpleasant to smoke; NVPs provided an increased sense of control; and participants experienced a deeper understanding of personal smoking behaviours. This study provides valuable insight into the preferred features of NVPs among PLHIV and reasons why NVPs may be effective for promoting smoking cessation among PLHIV.

Balanced Approach Regulatory Measures for Excise Tax on Tobacco and Nicotine-Based Products with Differential Degrees of Harm

This paper reports a study that analyses regulatory measures for excise tax on tobacco and nicotine-based products in Malaysia.The study highlights current non-optimal nature of excise tax due to a lack of differentiation between the varying degrees of harm caused by different tobacco and nicotine-based products within a given category. The study aims to address this issue by proposing a regulatory measure that adopts a balanced approach to taxing harmful tobacco and nicotine-based products. A focus group discussion involving a group of experts in tax and excise tax, medical and pharmacology, and law and policy was conducted to gather expert inputs on policy compliance with international standards for excise tax on tobacco and nicotine-based products; effectiveness of current policies in addressing harm differentials; and setting excise tax rates to balance harm levels and combat illicit trade. This study concludes that, Malaysia should adopt a balanced approach regulatory measures to combat illicit tobacco trade and promote harm reduction and equitable public health outcomes.This study recommends a differentiated excise tax for tobacco products in Malaysia based on harm and addiction levels, aiming tobalance the excise-duty with differential degrees of harm and optimize policy effectiveness towards achieving a smoke-free Malaysia by 2040. The proposed recommendation is aligned with Article 6 Guidelines of the World Health Organization Framework Convention on Tobacco Control.

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study.

Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.

W32 - How did the Removal of IQOS® Tobacco Heating System (THS) From the Market Impact Tobacco Harm Reduction?

W32 - How did the Removal of IQOS® Tobacco Heating System (THS) From the Market Impact Tobacco Harm Reduction?

Prevalence of tobacco smoking and related factors in people aged 15 years and above in Beijing, 2014-2021

Objective: To evaluate the effect of the implementation of Beijing Smoking Control Regulation in 2015 on the smoking prevalence in people aged ≥15 years in Beijing during 2014-2021, and explore factors associated with tobacco use behavior in local population. Methods Using a pooled cross-sectional design, data from Beijing Adult Tobacco Survey in 2014, 2016, 2019 and 2021 (4 surveys) were combined into one dataset. The 4 surveys used same multistage cluster sampling procedure. After complex survey weighting, multiple logistic regression models were constructed to analyze factors influencing smoking status. Results: A total of 8 484, 9 372, 8 534 and 10 551 respondents were included in the surveys in 2014, 2016, 2019 and 2021, respectively. The smoking prevalence rate was 23.4%, 22.3%, 20.3% and 19.9%, respectively, in Beijing residents aged ≥15 years, exhibiting a linear declining trend (P=0.010). Factors associated with current smoking in men were age 25-44 years (OR=2.22, 95%CI: 1.68-2.95) and 45-64 years, (OR=2.64, 95%CI: 2.06-3.39), educational level of high school (OR=0.69, 95%CI: 0.49-0.95) and undergraduate and above (OR=0.46, 95%CI: 0.33-0.63), and awareness of smoking causing stroke (OR=0.71, 95%CI: 0.61-0.81), and awareness of smoking causing lung cancer (OR=0.53, 95%CI: 0.42-0.66), the differences were significant (all P<0.05). After controlling interfering factors, the current smoking prevalence in men in 2019 (OR=0.73, 95%CI: 0.63-0.87, P<0.001) and 2021 (OR=0.72, 95%CI: 0.61-0.88, P<0.001) were significantly lower than that in 2014. Factors associated with current smoking in women were living alone (OR=1.80, 95%CI: 1.33-2.44), educational level of undergraduate and above (OR=0.43, 95%CI: 0.27-0.69), other occupations except doctor and teacher (OR=8.54, 95%CI: 2.80-26.02) or being retired/unemployed (OR=9.39, 95%CI: 3.19-27.65), and awareness of smoking causing cardiovascular events (OR=0.58, 95%CI: 0.39-0.84), and awareness of smoking causing lung cancer (OR=0.54, 95%CI: 0.35-0.83), the differences were significant (all P<0.05). No significant change in smoking status in women was found in 4 surveys. Conclusions: The smoking prevalence rate in men in Beijing has declined since the implementation of Beijing Smoking Control Regulation 5 years, indicating the effectiveness of legislative approach in tobacco control. Socio-demographic factors and the awareness level of tobacco harm could influence smoking status. Future tobacco control programs should target the people with lower education level, young men, women living alone, and those with occupations other than teachers/doctors or the unemployed/retired and include more comprehensive health education.

Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases.

Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

The effect of active and passive smoking during pregnancy on birth outcomes: A cohort study in Shanghai.

China is the largest tobacco consumer in the world, and tobacco poses a serious threat to the health of pregnant women. However, there are relatively few domestic studies on smoking during pregnancy and childbirth outcomes among pregnant women. The purpose of this study was to analyze the effect of active and passive smoking on pregnant women and their pregnancy outcomes, providing evidence and recommendations for intervention measures. This was a cohort study in Shanghai from April 2021 to September 2023. According to the smoking status of pregnant women, they were divided into three groups: active smokers, passive smokers and non-smokers. A self-designed questionnaire was utilized to conduct the survey, and their pregnancy outcomes were tracked and followed up. A total of 3446 pregnant women were included in this study, among which 2.1% were active smokers, 43.5% were passive smokers, and 54.4% were non-smokers. The average age of the pregnant women was 29.9 years, and 41.2% had a university degree or higher. The education level of active smokers and passive smokers was significantly lower than that of non-smokers (p<0.05).The average gestational age of non-smokers was 38.6 weeks, and the birth weight was 3283.2 g, which was higher than those of active smokers and passive smokers (p<0.05). Logistic regression analysis showed that passive smoking increased the likelihood of preterm birth (AOR=1.38; 95% CI: 1.05-1.81), low birth weight (AOR=1.53; 95% CI: 1.10-2.12), and intrauterine growth restriction (AOR=1.35; 95% CI: 1.02-1.79), while active smoking increased the likelihood of preterm birth (AOR=2.98; 95% CI: 1.50-5.90), low birth weight (AOR=4.29; 95% CI: 2.07-8.88), intrauterine growth restriction (AOR=2.70; 95% CI: 1.37-5.33) , and birth defects (AOR=2.66; 95% CI: 1.00-6.97). Our findings illustrate that active and passive smoking can lead to adverse pregnancy outcomes. This study provides data on the relationship between smoking during pregnancy and delivery outcomes among pregnant women. In the future, we need more effective strategies to protect pregnant women from the harm of tobacco.

Longitudinal association between harm perceptions and tobacco behaviors among adults who smoke cigarettes: Differential associations across age groups using the PATH study.

The relationship between e-cigarette and cigarette harm perceptions and tobacco behaviors may vary by age. We examined longitudinal associations of harm perceptions with tobacco use behaviors among adults who smoke cigarettes. Data were from Waves 4 (2016-2018) and 5 (2018-2019) of the Population Assessment of Tobacco and Health survey. Weighted multivariable logistic regressions identified independent associations between relative and absolute e-cigarette and cigarette harm perceptions at baseline and continued smoking, dual use, complete switching, and quit intention at follow-up, stratified by age (young adults [YAs] 18-24, middle-aged adults [MAs] 25-44, and older adults [OAs] ≥45) among U.S. adults who smoke (n=8,231). Perceiving e-cigarettes as less harmful than cigarettes was associated with higher odds of complete switching from cigarettes to e-cigarettes (aORs overall: 1.52; MAs: 1.68). Perceiving e-cigarettes as very/extremely harmful was associated with lower odds of dual use (overall aOR: 0.75; MAs: 0.72) and higher odds of quit intention (aOR among OAs: 1.34). Perceiving cigarettes as very/extremely harmful was associated with lower odds of continued smoking (overall aOR: 0.69; MAs: 0.76; OAs: 0.53), and higher odds of complete switching (overall aOR: 1.65; MAs: 1.86) and quit intention (overall aOR: 1.58; MAs: 1.42; OAs: 1.80). No findings reached significance for YAs. E-cigarette relative and absolute harm perceptions were associated with different tobacco behaviors by age. Low cigarette harm perceptions were similarly associated with continued smoking and lower quit intentions in MAs and OAs. Future research should explore what beliefs inform these perceptions and age-related differences. The associations between harm perceptions and subsequent tobacco behaviors differed by age among adults who smoke. This study adds that low relative harm perceptions of e-cigarettes can promote complete switching among MAs who smoke. High absolute harm perceptions of e-cigarettes may deter dual use among MAs. Additionally, high absolute harm perceptions of cigarettes may reduce smoking and increase cigarette smoking quit intentions among MAs and OAs. Future research is needed to understand the beliefs that support harm perceptions among different age groups and why their effects differ by age, and what factors influence YAs' tobacco use behaviors.

The Impact of Electronic Cigarettes Smoking on the Health of Adolescents and Young Adults

Introduction: Electronic cigarettes, or electronic nicotine delivery devices, have recently appeared on the global market and become very popular with adolescents and young adults. Manufacturers and distributors of e-cigarettes position them as harmless innovative products that reduce or eliminate exposures to harmful tobacco combustion products and help quit smoking, but this is not true. Objective: To establish health effects of electronic cigarettes and the associated risks for young people by reviewing recent research findings. Material and methods: We have searched eLibrary,PubMed, CyberLeninka databases for publications on the topic using the following keywords: electronic cigarettes, vapes, health effects, adolescents, and youth. Of 328 sources initially selected, we included 38 papers published in 2017 to 2023 and reporting results of prevalence of smoking electronic cigarettes, assessing health risks posed by the use of e-cigarettes in the review. Results: Our study revealed the extensive use of electronic cigarettes, specifics of their health effects in young people, the potential for developing nicotine dependence and a whole number of diseases of the respiratory, cardiovascular and digestive systems and other disorders in e-cigarette smokers. According to our findings, e-cigarettes are widely available and easily accessible to schoolchildren and are used not only at home, but also at school. These devices and chemicals contained in the generated aerosols, many of which are carcinogenic to humans, can induce multiple diseases in users. It also demonstrated that young people are poorly aware of adverse outcomes of using the devices. Conclusions: Electronic cigarettes and the substances contained in vaping liquids, many of which are carcinogenic, can have negative effects on health. In order to ensure the health savings of the child population and youth, strict compliance with the already existing introduced legislative restrictions, the implementation of measures restricting the sale of electronic cigarettes and their advertising, as well as the development and implementation of preventive programs for children, adolescents and youth in educational organizations is necessary. Vaping prevention programs implemented at schools should include information about adverse human health effects of electronic cigarettes and possible consequences in case of non-compliance with restrictive legislative measures.

Policy on The Prevention and Control of Tobacco Harm in Vietnam

Purpose: The purpose of the article research the policy on the prevention and control of tobacco harm in Vietnam, point out several limitations, shortcomings, and propose recommendations to complete the legal system concerned. Theoretical framework: The research employs theories about the policy on the prevention and control of tobacco harm in Vietnam, regulations on the prevention and control of tobacco harm, and mechanisms apply in Vietnam. Design/methodology/approach: The research employs three common methods in legal science research: (1) Legal analysis method; (2) Legal efficiency evaluation method; and (3) Comparative legal method. The above research methods help compare and contrast theories on the policy on the prevention and control of tobacco harm in Vietnam and bring out some essential findings. Findings: Some valuable findings have been revealed such as the formulation and development of the policy on the prevention and control of tobacco harm in Vietnam, some theoretical issues, and limitations on regulations of the policy on the prevention and control of tobacco harm in Vietnam. Research practical and social implications: The article proposes some tasks remaining undone, and further tasks will be fulfilled in the future. The article may support many developments in future research in Vietnam. Originality/value: The research on the policy on the prevention and control of tobacco harm in Vietnam become more and more urgent and very important in Vietnam.

A qualitative assessment of blunt smokers' perceptions and receptivity to non-tobacco blunt wraps.

The recent debut of the non-tobacco blunt wrap (N-TBW) for smoking cannabis has received little attention from the tobacco control community. The present study is intended to assess blunt smokers' perceptions and receptivity to N-TBWs, which are being marketed as an alternative to cigarillos and other tobacco products used for making blunts. Current blunt smokers (n=41) were recruited from social media platforms to participate in one of nine two-hour focus groups held between October 2022 and May 2023. Six topics ranging from social aspects of blunt smoking to impediments to switching to N-TBWs were discussed. A domain analysis was utilized in uncovering semantic relationships between a given variable (e.g., uneven burn rate) and outcome (e.g., not using N-TBWs). Blunt smokers conveyed interest in the N-TBWs because of health concerns about tobacco. Yet, the following three main barriers impede blunt smokers use of N-TBWs: lack of awareness and accessibility of the N-TBW, familiarity with preparing and smoking a traditional blunt, and incomparability of the tobacco blunt wrap (e.g., cigarillo). The latter was the most formidable challenge as participants expressed several negative product features of N-TBWs (e.g., flimsy material) relative to cigarillos. The N-TBW is unlikely to displace the cigarillo in the near-term future. A more likely scenario is that blunt smokers will continue to use cigarillos with intermittent use of N-TBWs in situational settings. If this occurs, then blunt smokers will continue to be exposed to harmful tobacco products.

Abstract LB086: Measuring oral DNA damage to evaluate electronic cigarette use as a tobacco harmreduction strategy

Abstract Background: Smokers increase their risk of numerous types of diseases, including lung and oral cancer. Despite this knowledge, approximately 18.7% of U.S. adults are smokers, and millions of smokers across the U.S. struggle to quit tobacco every day. Although difficult due to nicotine addiction, you can increase your chances of quitting with the tools available, and help is an important part of any quitting plan. The prevalence of electronic cigarette (e-cigarette) use has increased as users perceive them to be safer than traditional tobacco smoke. Studies have shown that e-cigarettes contain fewer chemicals than tobacco smoke. Therefore, addressing the effectiveness of e-cigarette use in reducing tobacco harm is essential and is currently a priority for the FDA. Aim: To determine whether combustible tobacco users who are provided with free e-cigarettes and free e-liquids reduce the levels of DNA damage in their oral epithelial cells. Methods: Adult smokers who smoked at least 5 cigarettes per day over the past year and did not plan to quit smoking in the next 3 months were enrolled in a randomized 3-arm clinical trial (NCT03113136): “Usual Brand Cigarettes” (UBC), Low Wattage e-cigarettes (LWe), and High Wattage e-cigarettes (HWe). Free combustible cigarettes or e-cigarettes plus e-liquid were provided during the first 12 weeks according to assigned group. Tobacco product use details, CO level, and oral mucosa samples were collected at 0, 4, and 12 weeks. DNA was extracted from oral cells and damage was quantified by q-PADDA, at three time points (Week 0, 4, 12). Data analysis was performed using ANOVA model. Results: Participants who provided samples at all time points were included in this DNA damage study. 201 complete data sets (UBC=77, LWe=61 and HWe=66) were available for DNA damage quantification at the time of this report. At enrolment (week 0), there were no significant differences in age, sex or tobacco product use across groups. At 12 weeks, combustible tobacco use was significantly reduced in smokers also using LWe or HWe (dual users). At 4 and 12 weeks, the CO levels were reduced in dual users of combustible tobacco and e-cigarettes (LWe or HWe), compared to exclusive combustible tobacco users. Compared to combustible tobacco users, dual users of combustible tobacco and LWe or HWe showed a significant reduction in the levels of oral mucosa DNA damage at 4 and 12 weeks (3 to 5 fold). Conclusion: Our study shows that when provided with free e-cigarette devices and e-liquids, smokers who were dual users or completely switched to LWe or HWe significantly reduced the levels of DNA damage in their oral mucosa compared with exclusive combustible tobacco users. These data suggest that LW and HW e-cigarette devices are an effective harm reduction tool and might help to reduce tobacco-associated health effects. Funding: NIH/NCI (R01CA204891, Wagener; R01CA242168, Queimado). Citation Format: Vengatesh Ganapathy, Mayilvanan Chinnaiyan, Daniel Brobst, Balaji Sadhasivam, Jean D. Nshimiyimana, Yan Zhao, Theodore Wagener, Lurdes Queimado. Measuring oral DNA damage to evaluate electronic cigarette use as a tobacco harmreduction strategy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB086.

Mid-Infrared Light Reduces the Nicotine Content and Detoxifies Bidis for Safer Smoking

Tobacco use is dangerous to health and the environment. Despite the numerous measures taken to combat the adverse effects of tobacco, fruitful results are yet to be achieved. Nicotine is the primary psychoactive (and highly addictive) chemical component in tobacco. This study aimed to lower the nicotine content and detoxify bidis (a more harmful tobacco product compared to cigarettes). We subjected the bidi packets to 2–6 µm mid-infrared (midIR) light generated by a specially designed pocket-sized atomizer. The smoke from such mid-IR-treated bidis blown over animate and inanimate objects was non-irritating and harmless. Spectroscopic studies revealed that the applied 2–6 µm mid-IR exerted molecular-level changes and resulted in chemical compound transformations, thus lowering the nicotine content in the bidis. Trials with smokers demonstrated that the mid-IR-treated bidis were more desirable to smoke and also retained smoking pleasure and satiety. Thus, the 2–6 µm mid-IR light can detoxify the bidis and represents a safer way for smoking than attempting complete cessation, which is highly challenging for smokers.

Mid-Infrared Light Reduces the Nicotine Content and Detoxifies Bidis for Safer Smoking

Tobacco use is dangerous to health and the environment. Despite the numerous measures taken to combat the adverse effects of tobacco, fruitful results are yet to be achieved. Nicotine is the primary psychoactive (and highly addictive) chemical component in tobacco. This study aimed to lower the nicotine content and detoxify bidis (a more harmful tobacco product compared to cigarettes). We subjected the bidi packets to 2–6 µm mid-infrared (midIR) light generated by a specially designed pocket-sized atomizer. The smoke from such mid-IR-treated bidis blown over animate and inanimate objects was non-irritating and harmless. Spectroscopic studies revealed that the applied 2–6 µm mid-IR exerted molecular-level changes and resulted in chemical compound transformations, thus lowering the nicotine content in the bidis. Trials with smokers demonstrated that the mid-IR-treated bidis were more desirable to smoke and also retained smoking pleasure and satiety. Thus, the 2–6 µm mid-IR light can detoxify the bidis and represents a safer way for smoking than attempting complete cessation, which is highly challenging for smokers.