Use Of Tobacco Products Research Articles

Biomarkers of exposure to nicotine and selected toxicants in individuals who use alternative tobacco products sold in Japan and Canada in 2018-2019.

Comparisons of nicotine and toxicant exposure between people who use different alternative tobacco products remains underexplored. This cross-sectional, multi-country study analyzed urinary metabolites of nicotine, NNK, and volatile organic compounds (acrolein, acrylamide, acrylonitrile) among established users (n=550) in Japan and Canada. Participants exclusively or concurrently used nicotine vaping products (NVPs; Canada only), heated tobacco products (HTPs; Japan only), and combustible cigarettes (CCs; Japan and Canada), or abstained (Japan and Canada). All product groups showed substantial nicotine exposure. Both HTPs and NVPs exposed exclusive users to lower toxicant levels than exclusive CC use. Canadian participants who exclusively used NVPs exhibited lower NNK and acrolein exposure but higher acrylamide exposure than Japanese participants who exclusively used HTPs. Concurrent use of CCs alongside alternative products exposed users to higher toxicant levels compared to exclusive use of either alternative product. Exclusive use of alternative tobacco products results in significant nicotine exposure but substantially lower toxicant exposure compared to exclusive CC use. People who use HTPs in Japan may experience higher exposure to nicotine and certain toxicants (NNK, acrolein) than people who use NVPs in Canada. Concurrent use results suggest that partially substituting CCs with alternative products may reduce toxicant exposure, but to a lesser extent than completely transitioning to alternative products. Exposure patterns between two popular alternative tobacco products differ. The overall toxicant exposure from these products is lower than CCs, providing critical data for regulatory decisions and public health considerations.

Smoking Cessation Awareness Among Active and Passive Smokers in Surabaya

Tobacco consumption is still relatively high and increasing compared to the results of 2007 and 2013. The burden of disease in Indonesia is increasing every year, and smoking is one of the leading causes. The critical issue that has to be addressed is a lack of smoking cessation awareness among active and passive smokers. The prolonged use of tobacco products and the exposure of non-smokers to dangerous secondhand smoke both occur as the consequences of this ignorance. This study aimed to assess the willingness to quit smoking and the awareness of existing Nicotine Replacement Therapy (NRT) or QUITLINE Program. The subjects were chosen by convenient sampling for those who met the inclusion criteria, including Surabaya citizens aged 18 years and above, active smokers and passive smokers due to living/staying with active smokers. The data were collected using a self-administered questionnaire. The data were analyzed descriptively using IBM SPSS software version 26.0. About 106 subjects participated in the study consists of 77% male, 23% female, with ages ranging from 19 to 62 years. The data showed that 57.55% (n=61) of smokers, 42.45% (n=45) non-smokers. Of 106 respondents, 67 (63.2%) had never heard about Nicotine Replacement Therapy (NRT) and 98.4% (60 smokers) had never heard of QUITLINE Program. Encouragingly, 63.9% (39 smokers) of the smokers were aware of the dangers of smoking. From this study, it can be concluded that the awareness of smoking cessation among the residents in Mulyorejo, Surabaya, was high. However, some of them were not convinced yet to stop smoking because their intention to quit smoking was low.

Smoking behavior and social identity: Correlates of Phantom Smoking Among Lesbian, Gay, Bisexual, Transgender, and Other Sexual and Gender Diverse Young Adults.

LGBTQ+ populations and people who smoke face stigma. This may lead to distancing oneself from smoking-related stigma by becoming phantom smokers (i.e., reporting smoking, but not identifying as a smoker). We explored correlates of phantom cigarette smoking among LGBTQ+ young adults. Participants were U.S. young adults (18 to 24 years) who identified as LGBTQ+, reported any past 30-day cigarette smoking and had a valid response for smoker self-identification (unique N= 5,545). We incorporated data from participants who completed one or more of the seven surveys from FDA's This Free Life campaign evaluation (February 2016-July 2019). Multivariable panel regression models with unweighted data examined phantom smoking correlates. Over 60% of the sample were phantom smokers. Compared with self-identified smokers, phantom smokers were younger, more likely to be gay men than lesbian/gay women, and more likely to be non-Hispanic White than non-Hispanic Black, Hispanic or non-Hispanic people of other races/ethnicities. Phantom smokers were more likely to have a college plus education (vs. high school or less) and report past 30-day alcohol use. Phantom smokers smoked on fewer of the past 30 days and were less likely to report positive cessation attitudes, nicotine dependence, and current e-cigarette or other tobacco product use. This is the first known study to explore factors associated with phantom smoking among LGBTQ+ young adults. Over half of young adult smokers were phantom smokers. Tobacco education for LGBTQ+ populations should consider phantom smoking and cessation implications to tailor content for phantom and self-identified smokers. We examined predictors of phantom smoking (current smoking but denying smoker identity) among LGBTQ+ young adult smokers, which has not yet been explored among this population. Phantom (vs. self-identified) smokers were less likely to be lesbian/gay women (vs. gay men) or from a racial/ethnic minority group and more likely to report past 30-day alcohol use. Phantom smokers reported less tobacco use, lower nicotine dependence, and less favorable cessation attitudes. Phantom smokers comprised most smokers in our sample. Findings suggest the importance of addressing this unique aspect of LGBTQ+ smoking in research, clinical settings, and tailored tobacco public education messages.

Association between cigarette and heated tobacco use and breastfeeding cessation within 6 months postpartum in Japan: an internet-based cross-sectional study

This study examined the association between cigarette and heated tobacco product (HTP) use before and during pregnancy and after six months postpartum and premature breastfeeding cessation (within 6 months postpartum). An internet-based cross-sectional survey was conducted from July to August 2021 in Japan, and the data of 4,005 women who gave birth between January 2019 and February 2021 were analyzed. The Poisson regression model with robust error variance showed that pre-pregnancy cigarette-only (adjusted prevalence ratio [aPR], 1.34; 95% confidence interval, [CI] 1.06 – 1.70) and combination users (i.e., cigarettes and HTPs) (aPR, 1.34; 95% CI, 1.02 – 1.77) and quitters during pregnancy (aPR, 1.37; 95% CI, 1.15 – 1.64) were more likely to cease breastfeeding prematurely than non-users. HTP-only users before (aPR, 1.32; 95% CI, 0.99 – 1.76) and during pregnancy (aPR, 1.08; 95% CI, 0.61 – 1.92) had no association with premature breastfeeding cessation. The multinomial logistic regression model showed that premature breastfeeding cessation was associated with cigarette-only (adjusted relative risk ratios [aRRR], 2.17; 95% CI, 1.22 – 3.85) and combination-use (aRRR, 2.62; 95% CI, 1.17 – 5.87) after 6 months postpartum. Women with cigarette or combination-use histories, despite quitting during pregnancy, tended to terminate breastfeeding prematurely, but this was not the case for HTP-only users.

Effect of fruit and mint flavored Rogue® oral nicotine product use on smoking reduction and quitting in a 6-Month prospective cohort of adults who smoke cigarettes

BackgroundQuitting cigarette smoking can substantially reduce or eliminate the risk of developing numerous chronic diseases. Use of flavored tobacco or nicotine products is commonly cited by adults who smoke cigarettes to be important in helping them reduce or quit smoking. The purpose of this analysis was to understand the association between the levels of use of flavored oral nicotine products and smoking reduction and quitting and how reduction or quitting may differ between predominant users of fruit/other versus mint flavored oral nicotine products after six months of use.MethodsParticipants were provided with their choice of a variety of forms and flavors of Rogue® nicotine products (Study Products) over a 6-month actual use period and completed online surveys assessing tobacco, nicotine and Study Product use at Baseline and Months 1, 2, 4, and 6 thereafter.ResultsAmong the 1393 participants at Month 6, 41.4% and 52.5% used predominantly fruit/other or mint Study Product flavors, respectively. Compared to predominant mint users, predominant fruit/other users had greater cigarette reduction (mean reduction: 50.0% vs. 48.4%) and a higher proportion had quit smoking (proportion quit: 15.4% vs. 11.6%) at Month 6. Additionally, 38.8% of predominant fruit/other users and 39.3% of predominant mint users reduced their cigarette consumption by ≥ 50% from Baseline. Increased use of fruit/other flavors was independently associated with smoking reduction (8.6% greater reduction per 10 pieces/day; p < 0.001) and odds of quitting smoking (OR = 1.29 [95% CI: 1.04–1.59] per 10 pieces/day; p = 0.017). Increased use of mint flavors was independently associated with smoking reduction (7.5% greater reduction per 10 mint pieces/day; p < 0.001) but not with odds of quitting smoking.ConclusionsIncreased use of either fruit/other or mint flavored Study Products at Month 6 was associated with significantly increased smoking reduction, whereas only increased use of fruit/other flavors was associated with greater odds of quitting smoking among participants in the study.Trial RegistrationThis study was observational. Participants were not prospectively assigned to one or more health-related interventions and could choose to use or not use the commercially available study products provided during the study. Thus, the study was not registered in a trial database by the Sponsor.

Regarding the problematic issues of the application of certain provisions of the Law of Ukraine «On measures to prevent and reduce the use of tobacco products and their harmful effects on the health of the population» No. 2899-IV

The article examines the problematic aspects of the practical implementation of Articles 16, 16¹ of the Law of Ukraine «On measures to prevent and reduce the use of tobacco products and their harmful effects on the health of the population» in the context of distinguishing between the concepts of advertising and promotion of the sale of tobacco products, as well as advertising and promotion of sales devices for consuming tobacco products without burning them. On the basis of the analysis of current legislation, answers to the following questions were formulated: firstly, whether the promotion of the sale of tobacco products is the placement of a QR code on the tables of a restaurant, which contains a link to the Internet, which contains the menu of the restaurant and information about the available sale of tobacco products, hookah devices, hookah preparation services, devices for consumption of tobacco products without burning them, electronic cigarettes (Article 16 of Law No. 2899-VI); secondly, whether advertising and promoting the sale of tobacco products, placement of tobacco products and/ or information about them on visible elements of equipment or on shop windows of business entities in illuminated boxes or on elements that contain images, drawings, background inserts, color which differs from the color of commercial equipment (Article 16 of Law No. 2899-VI); thirdly, whether advertising and promoting the sale of devices for consumption of tobacco products without burning them, placing devices for consumption of tobacco products without burning them and/or information about them (description, prices, etc.) in retail trade places on external elements of the equipment of illuminated advertising structures, background inserts, the color of which is different from the color of retail equipment, and which contain devices for consuming tobacco products without burning them and/ or information about them (description, prices, etc.) (Article 16¹ of Law No. 2899-VI); fourth, whether it is advertising and promoting the sale of devices for consuming tobacco products without burning them, placing information about the manufacturer of devices for consuming tobacco products without burning them, as well as placing devices for consuming tobacco products without burning them outside the places of sale of these products (Article 16¹ of Law No. 2899-VI).

Evaluating the human abuse potential of concurrent use of electronic cigarettes and low nicotine cigarettes among adults who smoke.

The U.S. Food and Drug Administration has stated its intention to reduce the nicotine content of combustible cigarettes to render them less addictive. This study evaluated the impact of providing adults who smoke with both very low nicotine content cigarettes (VLNCCs) and electronic cigarettes (ECs) of varying nicotine content on measures of human abuse potential. Participants (n = 213) were adult combustible cigarette users. They smoked their usual brand cigarettes (UBCs) during Phase 1 (baseline; week 1) and were provided with and encouraged to exclusively use VLNCCs during Phase 2 (weeks 2-4). During dual-product Phases 3 (weeks 5-7) and 4 (weeks 8-10), participants received both VLNCCs and ECs (assigned to one of two EC devices in higher or lower nicotine concentrations and choice of flavor), with instructions to use them freely in Phases 3 and 4. Assessments included product use, exposure, acceptability, risk perception, and withdrawal-related measures. Results indicated that participants used significantly fewer UBCs during the VLNCC and dual-product phases and smoked fewer VLNCCs during the dual-product phases than the VLNCC-only phase. Neither EC liquid nicotine concentration nor flavor influenced product use. The three study product phases resulted in less product liking and more withdrawal symptoms than the UBC phase. These results suggest that adults who smoke are able to switch much of their tobacco product use from UBCs to VLNCCs and will substitute combustible UBCs and VLNCCs with noncombustible nicotine-containing ECs, but most remain dual users, at least in the short term. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Feasibility of recruiting young adults with low socioeconomic status for formative evaluation of a smoking cessation mobile intervention.

Participant recruitment is critical to the success of smoking cessation trials. However, recruitment feasibility studies for inclusion and exclusion criteria commonly used in smoking cessation research remain scarce. We assessed the feasibility of recruiting potential research volunteers (PRVs) under two sets of inclusion criteria to inform eligibility requirements for a smoking cessation mobile intervention trial. We invited PRVs nationwide to participate in qualitative evaluation of a smoking cessation mobile application. To be eligible under Criteria I, participants were aged 18-29 years, neither four-year college graduates nor enrollees, exclusive cigarette smokers, willing to quit within 30 days, and not using cessation aids. Criteria II expanded eligibility to those using cigarettes and non-combustible tobacco products (e.g. e-cigarettes) and willing to quit within 6 months. We calculated recruitment yields and associated costs. Of 10533 PRVs screened for eligibility, 48 were enrolled. Only 54 (0.5%) participants qualified under Criteria I and 164 (1.6%) under Criteria II. Age ineligibility was the top reason for exclusion (66.7%), whereas lifetime smoking, quit timeframe, and other tobacco product use contributed to ineligibility rates ranging from 46.5% to 65.3%. Enrolled participants were equally split by sex and roughly reflected the racial/ethnic composition of the United States. American Indians, who have the highest smoking prevalence, were <5% of enrolled participants. Recruitment costs averaged $106 per PRV. Eligibility requirements used in cessation trials were restrictive for recruitment efforts. Relaxing inclusion criteria will reflect current tobacco use patterns and facilitate the timely completion of trials within budgetary thresholds.

Flavored Tobacco Product Use Among California Adolescents Before and Immediately After a Statewide Flavor Ban.

In December 2022, a California law banned the retail sale of most flavored tobacco products (including e-cigarettes). This investigation evaluates adolescents' use of flavored tobacco before and after enactment. The Teens Nicotine and Tobacco Project included online surveys of California adolescents (age 12-17) in 2022 (N=5127) and 2023 (N=5015) that assessed past 30-day use of various tobacco products, flavored product use, and perceived access to flavored e-cigarettes. Eight focus groups conducted in 2023 and 2024 (total N=35) queried flavored tobacco experiences and perceptions. Among participants who used specific products, the prevalence of flavored product use declined for cigarettes (2022: 72.0%; 2023: 57.2%), cigars (2022: 87.2%; 2023: 67.4%), and smokeless tobacco (2022: 93.1%; 2023: 83.1%) but not for e-cigarettes (2022: 91.0%; 2023: 90.7%) or hookah (2022: 88.1%; 2023: 85.6%; the flavor law exempted some hookah sales). In 2023, 10.2% of all participants used any flavored tobacco product (2022: 10.0%), primarily flavored e-cigarettes (2022: 8.6%; 2023: 8.8%). In 2023, 22.0% of all participants were aware of the statewide flavor ban, including 44.1% of participants who reported tobacco use. Few focus group participants were aware of the statewide law or perceived difficulties accessing flavored e-cigarettes. Shortly following a statewide flavor ban, adolescent use of flavored cigarettes, cigars, and smokeless tobacco declined, but flavored e-cigarette use was unchanged. More time for implementation and enforcement may be needed to see full policy impact. These finds suggest that a statewide flavored tobacco policy in California was followed shortly by declines in adolescent use of some flavored tobacco products. Additional time for implementation and enforcement, along with potential further actions, such as greater restrictions on online sales, could be necessary to curb youth access to flavored e-cigarettes.

Impact of Smoking on Adolescents Development

This research investigates how smoking affects cognitive development in adolescents, emphasizing both the short-term and long-term consequences of nicotine on the brain. The research highlights the significant disruption caused by nicotine to critical brain regions such as the prefrontal cortex and hippocampus, which are essential for decision-making, impulse control, and memory retention. The incidence of smoking among adolescents, particularly the rise in e-cigarette use, is attributed to targeted marketing, affordability, and accessibility. These factors exacerbate the psychological and academic challenges faced by adolescents, linking smoking to issues such as depression, anxiety, and poor academic performance. The paper emphasizes the necessity of comprehensive educational programs, parental and community involvement, and stricter regulations to curb the use of tobacco products among young people. Future research directions include establishing a causal relationship between smoking and cognitive development, conducting longitudinal studies, and integrating mental health support with smoking prevention programs. By addressing these areas, the study aims to inform public health policies and promote healthier lifestyles among adolescents.

The effect of national school health strategy components on the quality of health services: An Analytical research in Baghdad Governorate

Purpose: The research objective is to diagnose the extent to which the National School Health Strategy contributes to the quality of health services. Theoretical framework: The quality of health services can provide schools with benefits through building a healthy school community in line with the sustainable development goals, especially regarding quality education, good health, and well-being and through school health, we may be improving the health and well-being of elementary and secondary students, and the necessity of providing healthy foods reduction of fat content in school meals, and awareness to prevent the use of tobacco products and drugs. Design/methodology/approach: The research relied on the descriptive -analytical method and the research sample is a random sample of primary schools (governmental and private). The research tool is represented by using a questionnaire to collect data. Findings: Although there is a big school community represented by students compared to their society, studies in most countries of the world are still limited in discussing the quality of health services provided to them and the limited solutions. Research, Practical &amp; Social implications: We suggest future research to evaluate the national school health strategy: a comparative study between two governorates. Originality/value: The results indicate that commitment to implementing school health programs positively affects the quality of health services provided to students of school age and that any defect in their application reflects negatively on the health of students currently and society in the future.

Religiosity vs tobacco use: Religion’s impact on tobacco use among adult Indian population – A cross sectional study

ABSTRACT Background: Tobacco use is major serious threats to health and well-being killing approximately 1 million people each year. One of the better ways for tobacco cessation is by promoting the cultural-religious belief that may influence a person’s tobacco-related habits. Methods: A Descriptive cross-sectional study was conducted among 174 adult subjects of smoking and smokeless tobacco users. The questionnaire consisted of demographic information and the Duke University Religion Index was used to assess the influence of religious belief and the use of tobacco products. The appropriate statistical tests were done using the Chi square test and ANOVA. Result: The study involved 174 participants of smoking and smokeless tobacco users. The participants were predominantly males (96%) with a mean age of 36 years, and more than half were Hindus (71.85). Among the study participants, 37.4% were graduates and 17.8% were illiterates. With regard to Occupation, the majority of the respondents were Professionals (24.7%). Majority of tobacco users had religious beliefs and strongly accepted that using tobacco during the fasting period was against their religious beliefs. Conclusion: The study concluded that there is a strong influence of religious belief on tobacco usage. Hence, there is a need to conduct community awareness programs for the adult population about the consequences of tobacco use.

Patterns of Emerging Tobacco Product Use Among U.S. Adults, 2019-2022

Introduction: Quantifying the use of emerging tobacco products such as nicotine pouches (NPs) and heated tobacco products (HTPs) is crucial for informing public health interventions and measuring their potential effects on tobacco use morbidity, mortality and benefits from complete tobacco cessation. MethodsUsing data from the May 2019 and September 2022 cycles of the Tobacco Use Supplement to the Current Population Survey (TUS-CPS), we calculated U.S. population-wide estimates of ever and/or current use of NPs and HTPs by key socio-demographic characteristics, cigarette smoking status and preference of characterizing flavors in NPs. We present weighted frequencies, proportions and associated 95% confidence intervals. Analyses were conducted in 2024. ResultsIn both survey cycles, a substantial fraction of adults who ever used HTPs had never smoked cigarettes (52.0% in 2019; 27.4% in 2022). Among those who currently used HTPs or NPs (2022 only), many reported having never smoked cigarettes (42.5% and 41.4%, respectively), while many also reported currently smoking (32.2% and 24.8%, respectively). We observed similar sociodemographic characteristics across use of both HTPs and NPs. Mint was the most common flavor choice among adults who currently used NPs (52.8%). ConclusionsContinued surveillance of emerging tobacco products such as HTPs and NPs can inform public health approaches and support future research to better quantify the health consequences from these products.

Tobacco use and readiness to treat tobacco users among primary healthcare professionals in Soweto.

Despite its hampering influence on the willingness of healthcare professionals (HCPs) to implement tobacco cessation treatments, the tobacco use status of these professionals remains understudied in South Africa. This cross-sectional study, which sampled 444 HCPs, was conducted in five community health centres in Soweto. A self-administered questionnaire collected information on socio-demography, tobacco use, quit attempts and readiness to implement tobacco cessation treatments for their patients. The mean age was 41 years. Most were female, 80% (n= 355); single, 54.1% (n= 240) and black professionals, 91.6% (n= 405). About 22% (n= 96) were ever-users of tobacco, 12.6% (n= 56) current users and 9% (n= 40) ex-users. About 56.6% (n= 30) of current users had contemplated quitting in the past year. Approximately 68% (n= 300) and 82.2% (n= 365) of respondents were ready and willing to implement tobacco cessation treatments, respectively. Only 32% (n= 143) of respondents had received any training on tobacco use and cessation treatments. There was no significant association between tobacco use and readiness to implement cessation treatments (p= 0.50). Tobacco use is prevalent among HCPs and does not influence the implementation of cessation treatments in South African primary health care. Although most reported readiness and willingness to quit tobacco use, more training is required in both formal education and continued professional development.Contribution:This study demonstrates the alarming rate of tobacco product use among primary health care professionals in South Africa. While there is a strong willingness to implement tobacco cessation treatments for their patients, most healthcare professionals still require training to enhance their self-efficacy.

Lifestyle habits and openness to alternative tobacco products: insights from the Minerva Project

Abstract Background Recent studies have suggested that the use of alternative tobacco products (ATPs) is a significant predictor of cigarette smoking, particularly among young individuals. The present study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try ATPs among non-smokers. Methods MINERVA (My changINg lifEstyles, our Research, and eVeryone’s heAlth) is an ongoing prospective international cohort study primarily focused on investigating the link between smoking habits and the dietary and lifestyle habits of participants. Subjects are given a web-based survey to report socio-demographic characteristics, dietary and lifestyle habits, smoking habits, and attitudes towards ATPs. This analysis concentrates on respondents from Italy who do not smoke traditional tobacco products. Results The survey included 7,535 respondents from Italy; of these, 40% (2,992 subjects) were non-smokers. Among the non-smokers, 219 (7%) were identified as fast-food consumers (defined as consuming fast-food at least once a week). Fast-food consumers were significantly more likely to consume junk food as snacks (87% vs. 62%) and were less likely to report daily consumption of fruits and vegetables. Notably, fast-food consumers were 2.5 times more likely to be willing to try ATPs compared to those who do not consume junk food (Odds Ratio [OR] 2.55, 95% Confidence Interval [CI] 1.68-3.88). Conclusions Junk food consumption has been identified as being associated with an increased willingness to use ATPs among non-smokers. This finding is significant from a public health standpoint, highlighting the crucial influence of unhealthy eating habits in fostering an interest in ATP use. Key messages • The Minerva study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try alternative tobacco products among non-smokers. • The study underscores the public health importance of addressing dietary patterns alongside smoking habits.

Nicotine use in Polish adolescents and sociodemographic factors correlations - PolNicoYouth study

Abstract Background &amp; aim Almost 36% of Polish smokers started their addiction before the age of 17. Polish youth exhibit a higher prevalence of e-cigarette use (29.5%) than traditional cigarettes (26.2%). This study aimed to outline the prevalence of tobacco and nicotine product use based on usage frequency, poly-product use patterns among ever/former/naive users. Methods In the 2020 cross-sectional study, secondary school students from 200 schools, were selected nationwide using a stratified and random approach, making the sample representative of the entire Polish population. Data were collected through Computer-Assisted Web Interviews, using a questionnaire based on the Global Youth Tobacco Survey. Bayesian linear regression was used to assess correlations. Results The study consisted of 16,712 pupils aged 15-18. Almost 30% of participants admitted to current e-cigarette usage. Questions on parental smoking habits showed that 45.95% of parents smoke traditional cigarettes, 13.89% use e-cigarettes, and 13.80% use heated tobacco products (HTP). There was a very strong positive correlation between the female gender and the initiation of smoking with regular cigarettes (log[BF]=10.76). A very strong positive correlation between those studying in vocational schools and with initiation with regular cigarettes during initiation (log[BF]=18.13), while high school students had a greater association with e-cigarettes (log[BF]=11.08). There was also a very strong positive correlation between adolescents initiating smoking with regular cigarettes when their parents are also regular cigarette smokers (log[BF]=8.11) - no corresponding correlations were observed for e-cigarettes and HTP. There is a moderate positive correlation indicating a relationship between younger age (15 vs 18) and initiation by e-cigarette (log[BF]=1.8). Key messages • The type of nicotine product used by adolescents for nicotine initiation correlates differently with various socio-demographic factors and the type of nicotine product used by parents. • Taking these relationships into consideration enables the development of tailored nicotine prevention.

Tobacco and nicotine products use among adolescents in Serbia – Latent class analysis

Abstract Background In parallel with a decline in cigarette smoking in the previous decade, other tobacco and nicotine products (TNPs), that are often used concurrently, have gained popularity among adolescents. The purpose of this study was to identify patterns of tobacco and nicotine product use among Serbian adolescents. Methods Data for this study were obtained from Health Behavior in School-aged Children (HBSC), a WHO collaborative cross-national study of adolescent health and well-being, that was conducted in Serbia in 2022 on a sample of 3713 students 11,13 and 15 years old. Descriptive statistics was used as well as latent class analysis to classify students based on their past-month use of cigarettes, e-cigarettes, heated tobacco products, waterpipes, and oral tobacco/nicotine products. Results Among students 11,13 and 15 years old, 10.2% smoke cigarettes, 13% use e-cigarettes, 11.1% waterpipes, 3.7% oral tobacco/nicotine products, and 4.5% heated tobacco products with differences by age and sex. We found high percentages of dual use of TNPs among cigarette smokers. Among students who smoke cigarettes, 61.6% also use e-cigarettes, 36.2% smoke waterpipes, 30.2% heated tobacco products, and 24.1% oral tobacco/nicotine products. Latent class analysis identified three classes as optimal solution: (1) dual e-cigarette and cigarette users (6.9%); (2) minimal/non-users (83.2%) and (3) poly tobacco and nicotine products users (9.9%). Statistically significant differences between classes were found in age and sex. Conclusions Dual and poly-tobacco and nicotine use is common among Serbian adolescents and presents a challenge for monitoring and public health response. Findings contribute to a better understanding of patterns and heterogeneity of TNPs use among adolescents and might have implications for prevention and cessation interventions for youth. Key messages • Among students 11,13 and 15 years old, tobacco and nicotine products, other than cigarettes is gaining popularity and with the e-cigarettes being the most popular product. • Dual and poly tobacco and nicotine products use is new challenged that should be taken into account in tobacco and nicotine monitoring, cessation and prevention.

The influence of social media and video-on-demand platforms on the appeal and consumption of tobacco and emerging tobacco products: A cross-sectional study.

Digital platforms serve as an avenue for the tobacco industry to promote both conventional tobacco and emerging products, with a notable focus on capturing the attention of young people through sophisticated marketing campaigns. This research aims to analyze the prevalence of different advertising strategies on digital platforms and to assess the impact of exposure to these strategies on the probability of use initiation and increased consumption of conventional tobacco and new tobacco products among young Spaniards. An online survey was conducted on a representative sample of 1730 young Spaniards aged 16-21 years in November 2022 using a comprehensive approach, considering all possible relevant factors and perspectives regarding the issue of the study. A descriptive analysis and two adjusted logistic regression models were employed to explore the association of exposure to digital platforms with the likelihood of conventional tobacco and new tobacco product use among this population. Among the participants, 83.2% reported witnessing individuals smoking, 61.6% observed identifiable logos or explicit advertisements, and 77.6% encountered indirect product placement on social media. Notably, exposure to conventional tobacco product placement (AOR=1.71; 95% CI: 1.27-2.30) emerged as the variable most significantly associated with an increased probability of tobacco use. Furthermore, exposure to advertising related to new tobacco products (AOR=2.47; 95% CI: 1.90-3.21) was linked to a heightened likelihood of subsequent use. Similarly, the direct promotion of these novel products is also associated with a higher probability of conventional tobacco use (AOR=1.58; 95% CI: 1.21-2.07). A reciprocal impact was identified, with the promotion of vaping being associated with an elevated probability of engaging in conventional tobacco smoking. Urgent attention is warranted for formulating public policies to mitigate the adverse effects of such insidious indirect advertising practices on digital platforms.

Association of food insecurity with the use of tobacco products and urine cotinine-measured smoking intensity: evidence from a population-based study in South Korea, 2019–2021

IntroductionThis study explored the association between food insecurity and tobacco product use and urine cotinine-measured smoking intensity.MethodsThis cross-sectional study included 13 705 adults representative of the Korean population. The 18-item...

“Smoker” and “Vaper” identity in people who use both cigarettes and E-cigarettes: Changes over time and associations with smoking behaviors

Background Individuals who use both cigarettes and e-cigarettes may have multiple nicotine product use self-identities, each of which may be associated with patterns of use, including cessation. Objectives This study examined changes in “smoker” and “vaper” identities and product use behaviors over one year among adults who used both cigarettes and e-cigarettes. We hypothesized that stronger baseline vaping identities would be associated with higher odds of smoking cessation, and stronger baseline smoking identities would be associated with continued cigarette use. Methods Participants (N = 364), who were recruited for an observational study of cigarette and e-cigarette use, completed measures of “smoker” and “vaper” identity, nicotine dependence, and product use at baseline and 12 months. We examined associations between smoking and vaping identities and tobacco product use. Logistic regression evaluated the effects of age, gender, and baseline smoking and vaping identities on continued smoking or abstinence at 12 months. Results Smoking and vaping identities were independent at baseline (p = .51) but associated at 12 months (p = .0001). At 12 months, “ex-smokers” had higher e-cigarette use than “smokers” and “social/occasional smokers” (p <.0001). Those who identified as “vapers” at baseline had lower odds of smoking at 12 months (OR = 2.27, “non-/ex-vaper” vs “vaper”; OR = 2.05, “social/occasional vaper” vs “vaper”). Conclusions: Smoking and vaping identities are associated with changes in tobacco product use over time.