Tobacco-related Diseases Research Articles

State-Specific Prevalence of Adult Tobacco Product Use and Cigarette Smoking Cessation Behaviors, United States, 2018-2019.

Increasing quitting among people who smoke cigarettes is the quickest approach to reducing tobacco-related disease and death. We analyzed data from the 2018-2019 Tobacco Use Supplement to the Current Population Survey for 137,471 adult self-respondents from all 50 US states and the District of Columbia to estimate state-specific prevalence of current tobacco product use, interest in quitting smoking, past-year quit attempts, recent successful cessation (past-year quit lasting ≥6 months), receipt of advice to quit smoking from a medical doctor, and use of cessation medications and/or counseling to quit. Prevalence of current any-tobacco use (use every day or some days) ranged from 10.2% in California to 29.0% in West Virginia. The percentage of adults who currently smoked cigarettes and were interested in quitting ranged from 68.2% in Alabama to 87.5% in Connecticut; made a past-year quit attempt ranged from 44.1% in Tennessee to 62.8% in Rhode Island; reported recent successful cessation ranged from 4.6% in West Virginia and Wisconsin to 10.8% in South Dakota; received advice to quit from a medical doctor ranged from 63.3% in Colorado to 86.9% in Rhode Island; and used medications and/or counseling to quit ranged from 25.5% in Nevada to 50.1% in Massachusetts. Several states with the highest cigarette smoking prevalence reported the lowest prevalence of interest in quitting, quit attempts, receipt of advice to quit, and use of counseling and/or medication, and the highest prevalence of e-cigarette, smokeless tobacco, and cigar use. Adults who smoke struggle with smoking cessation and could benefit from additional intervention.

Impact of the tobacco law on hospitalizations for tobacco-related diseases in adults in Portugal

Abstract Introduction Tobacco contributes to about 8 million deaths per year worldwide, of which 1.2 million are due to passive exposure to tobacco smoke, according to WHO data. Ambitious anti-tobacco policies have been implemented in European countries, but few have been evaluated. The present research measures the impact of the anti-tobacco laws implemented in Portugal in 2007, and reinforced in 2015, in the adult population residing in Portugal, between January 1, 2002 and December 31, 2018. Methods We used data for all in-patient stays at all public hospitals over the 2002-2018 period. A quasi-experimental interrupted time series study was applied, considering the years 2008 and 2016 as exogenous shocks. The dependent variables under study are the incidence of hospitalizations by municipality of residence and year for tobacco-related diseases, namely: AMS, stroke, lower respiratory tract infections, COPD and asthma. We adjusted the analysis by the percentage of women, percentage of people aged >65, and purchasing power. We produced time trend graphs for each variable, with subsequent adjustment to the Poisson regression model to predict its evolution. A comparison was made between the values observed after the implementation of the law and its reformulation and the values projected based on the regression model selected, to identify the percentage difference between the two. Expected Results In line with the international literature, a generalized decrease in the incidence of hospitalizations for tobacco-related diseases was observed after the implementation of the tobacco law. Likewise, after the changes added in its reformulation, the reduction in incidence was stronger, although not as sharply, compared to 2007. Conclusions Anti-tobacco laws in Portugal have been effective in reducing tobacco-related hospitalizations, with expected gains in life expectancy and reduced burden for the health system. Key messages • Tobacco contributes to about 8 million deaths per year worldwide, of which 1.2 million are due to passive exposure to tobacco smoke. • Generalized decrease in the incidence of hospitalizations for tobacco-related diseases was observed after the implementation of the tobacco law.

CYP2A6 associates with respiratory disease risk and younger age of diagnosis: a phenome-wide association Mendelian Randomization study.

CYP2A6, a genetically variable enzyme, inactivates nicotine, activates carcinogens, and metabolizes many pharmaceuticals. Variation in CYP2A6 influences smoking behaviors and tobacco-related disease risk. This phenome-wide association study examined associations between a reconstructed version of our weighted genetic risk score (wGRS) for CYP2A6 activity with diseases in the UK Biobank (N = 395 887). Causal effects of phenotypic CYP2A6 activity (measured as the nicotine metabolite ratio: 3'-hydroxycotinine/cotinine) on the phenome-wide significant (PWS) signals were then estimated in two-sample Mendelian Randomization using the wGRS as the instrument. Time-to-diagnosis age was compared between faster versus slower CYP2A6 metabolizers for the PWS signals in survival analyses. In the total sample, six PWS signals were identified: two lung cancers and four obstructive respiratory diseases PheCodes, where faster CYP2A6 activity was associated with greater disease risk (Ps < 1×10-6). A significant CYP2A6-by-smoking status interaction was found (Psinteraction < 0.05); in current smokers, the same six PWS signals were found as identified in the total group, whereas no PWS signals were found in former or never smokers. In the total sample and current smokers, CYP2A6 activity causal estimates on the six PWS signals were significant in Mendelian Randomization (Ps < 5×10-5). Additionally, faster CYP2A6 metabolizer status was associated with younger age of disease diagnosis for the six PWS signals (Ps < 5×10-4, in current smokers). These findings support a role for faster CYP2A6 activity as a causal risk factor for lung cancers and obstructive respiratory diseases among current smokers, and a younger onset of these diseases. This research utilized the UK Biobank Resource.

Effects of Modified Risk Tobacco Product Claims on Consumer Responses.

US tobacco manufacturers can seek authorization from the US Food and Drug Administration (FDA) to market products using modified risk tobacco product (MRTP) claims. To inform regulatory decisions, we examined the impact of MRTP claim specificity and content, including whether the claims produced halo effects (ie, inferring health benefits beyond what is stated). Participants were 3161 US adult cigarette smokers. Using a two (general vs. specific) × 2 (risk vs. exposure) plus independent control design, we randomized participants to view one message from these conditions: general risk claim (eg, "smoking-related diseases"), general exposure claim (eg, "chemicals in smoke"), specific risk claim (eg, "lung cancer"), specific exposure claim (eg, "arsenic"), or control. Claims described the benefits of completely switching from cigarettes to the heated tobacco product IQOS. MRTP claims of any sort elicited a higher willingness to try IQOS relative to control (d = 0.09, p = .043). Claims also elicited lower perceived risk of disease and exposure to harmful chemicals for completely switching from cigarettes to IQOS (d = -0.32 and -0.31) and partially switching (d = -0.25 and d = -0.26; all p < .05). Relative to specific MRTP claims, general MRTP claims led to lower perceived risk and exposure for complete switching (d = -0.13 and d = -0.16) and partial switching (d = -0.14 and d = -0.12; all p < .05). Risk and exposure MRTP claims had similar effects (all p > .05). MRTP claims led to lower perceived risk and exposure, and higher willingness to try IQOS. General claims elicited larger effects than specific claims. MRTP claims also promoted unintended halo effects (eg, lower perceived risk of disease and chemical exposure for partial switching). We found evidence that MRTP claims promoted health halo effects. In light of these findings, the FDA should require research on halo effects prior to authorization. Further, if an MRTP claim is authorized, FDA should require tobacco manufacturers to conduct post-market surveillance of how the claim affects consumer understanding, including partial switching perceived risk and exposure beliefs, as well as monitoring of dual-use behaviors.

Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study

BackgroundNearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam.MethodsWe established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors.ResultsAt follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage.ConclusionsInterventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers’ beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers’ intention to quit.

A thematic content analysis of 2010–2015 state tobacco control legislation in the United States: Bill rationales and priority populations

ObjectiveTobacco use causes numerous types of cancers, heart diseases, and chronic illnesses, and is responsible for nearly 1 in every 5 deaths in the United States (U.S.) annually. This study assessed whether tobacco control laws introduced in state legislatures between 2010 and 2015 provided a rationale for the proposed bill and/or specified priority population groups, and we then examined emerging themes in the text that did so. MethodsUsing LexisNexis® State Net®, we identified tobacco control bills introduced in all states and coded their bill rationales and population category. We then conducted qualitative thematic analysis on a sample of bills with rationales or specified populations. ResultsOf the 2815 tobacco control bills introduced in state legislatures in the analysis period, 422 (15.0%) included a bill rationale, and 1309 (46.5%) specified at least one priority population. Four overarching themes emerged: 1) Addressing tobacco-related health harms and financial costs incurred to society; 2) Protecting the public from tobacco-related harms as a government responsibility; 3) Providing services to priority populations; 4) Exempting or preempting some population groups and localities. ConclusionsRationalizing tobacco control legislation by focusing on both health and cost implications was a key feature of tobacco policy bill text we analyzed; given the history of this approach, it is likely to remain so in the future. Our study may serve as a benchmark for tracking current and future tobacco control legislation to examine whether there is a growth in prioritizing populations experiencing unjust burdens of tobacco use and related disease.

Metallomic Signatures of Lung Cancer and Chronic Obstructive Pulmonary Disease.

Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.

South Australia's tobacco retail landscape and its intersection with socioeconomic factors and smoking prevalence.

Tobacco product availability is higher in socioeconomically disadvantaged areas, which can further widen tobacco-related health and disease burden inequities. This study aimed to describe retail availability of tobacco products in South Australia and examine the association between tobacco vendor location, population's socioeconomic status (SES) and tobacco smoking prevalence. Cross-sectional 2022 tobacco vendor licence data and 2021-2022 state-wide population health survey data from the South Australian Department of Health were used. Tobacco vendors were enumerated by Statistical Area 2 (SA2) using geocoding software, with SA2s assigned health survey derived smoking prevalence, SES, remoteness category, area size, and population size. As of 2022, there were 1723 tobacco vendors in South Australia and the overall tobacco smoking prevalence across the state was 11.8%. Regression analyses indicated that tobacco vendor density increased with socioeconomic disadvantage and geographic remoteness, and that smoking prevalence was higher in low SES areas. Vendor density was not related to smoking prevalence. Findings are consistent with existing research indicating greater tobacco availability in socially disadvantaged areas. This supports that tobacco vendor saturation may be directed to areas in a way that promotes tobacco availability for vulnerable populations. Our finding that smoking prevalence was unrelated to tobacco availability contrasts existing literature and should be carefully interpreted. SO WHAT?: This is the first study to map tobacco retailers across South Australia, contributing needed evidence on the intersection of tobacco vendor density, social disadvantage, and smoking prevalence.

Exploring the Presence and Type of Premium Cigar Retailers With Neighborhood Sociodemographic Correlates in the United States, 2019-2021.

Little is known about the location and store type of premium cigar retailers in the United States. Different store types may expose people to secondhand smoke (eg, cigar bar or lounge) and may also have age restrictions (eg, tobacco shops) that could reduce youth exposure to products and marketing. We obtained a national retailer dataset from the Premium Cigar Association (PCA) from 2019 to 2021. We coded store type using nine categories and used generalized estimating equations to examine associations between census tract sociodemographic characteristics and PCA store type. Of the 1279 PCA retailers, the majority were cigar stores (39%), followed by tobacco shops (26%), cigar bars or lounges (20%), and beer, wine, or liquor stores (15%). Overall, there were no statistically significant associations between tract-level sociodemographic characteristics and the odds that a retailer was a specific store type versus another store type. However, PCA retailers located in tracts with a higher percentage of non-Hispanic Black residents were associated with 1.12 times the odds of being a cigar bar or lounge versus another type (95% CI, 1.02 to 1.22). The majority of PCA retailers are specialty cigar stores or cigar bars or lounges, and few are more traditional tobacco retailers, such as convenience stores. We document a higher odds of a store being a cigar bar or lounge for retailers located in neighborhoods with a higher proportion of Black residents, which may contribute to inequities in tobacco-related disease and disability because of potentially greater secondhand smoke exposure. Specialized retailers account for most premium cigar stores. One in five PCA retailers was a cigar bar or lounge, which raises public health concerns around exposure to secondhand smoke for patrons and employees. Local jurisdictions should examine zoning ordinances in tandem with sociodemographic characteristics to ensure inequities in the location of cigar bars or lounges are not produced or sustained given the potential harms associated with secondhand smoke exposure.

Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018.

Using more than one tobacco product increases the risk of tobacco-related diseases. We investigated trends in the prevalence and dual use of factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes (e-cigarettes) in South Africa over a 12-year period. Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South African Social Attitudes Survey (n=14582) were analyzed. The use of FM, roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT), any combustible tobacco products (CTP), any tobacco product (ATP) use, and e-cigarettes was investigated. The dual use of FM cigarettes with either SLT, waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression models were used to explore trends in prevalence over the 12-year period. About 51% of the participants were female, and 51.9% were aged 16-34 years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018) (p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005). Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally low, the prevalence of dual use significantly increased for all product combinations investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018 (adjusted odds ratio, AOR=1.37; 95% CI: 1.06-1.77; p=0.018 and AOR=1.37; 95% CI: 1.08-1.73; p=0.009, respectively) during the 12-year period after adjusting for demographic characteristics. The use and dual use of tobacco and electronic cigarette products have been increasing in recent years in South Africa. Interventions to help users quit and prevent young people from initiating use are urgently needed to curb these increases.

Assessment of physiological and psychological dependence of tobacco use among patients visiting the tobacco cessation center in the tertiary institute of Shimla–Himachal Pradesh

ABSTRACT Background: The study aimed to assess the physiological and psychological dependence of tobacco use among patients visiting the Tobacco Cessation Center in the tertiary institution. Methods: A cross-sectional study design with simple random sampling was used. The information obtained from the subject was through interview recorded on a structured pro forma. The information included demographic details, dependence status based on smoking history and behavior, the Fagerstrom Test for Nicotine Dependence (FTND) for physiological dependence, and the Kano Test for Social Nicotine Dependence (KTSND) for psychological dependence. Tobacco use for both the smoked tobacco (ST) and smokeless tobacco (SLT) was recorded as the number of packs per day. Results: The mean pack year score was 122.6 ± 143.8. Similarly, the mean FTND score was 6.8 ± 2.4 and the mean KTSND score was 14.3 ± 4.1. The study subjects in various behavioral stages were precontemplation (26.1%), contemplation (21.1%), preparation (31.4%), action (20%), and maintenance (1.4%), respectively. Simple linear regression shows that the mean pack year, FTND, and KTSND scores were weakly explained for various stages of behavioral changes. Conclusion: Pack year is related to dose-response relationship which indicates both intensity and duration for developing tobacco-related diseases. The mean FTND score for physiological nicotine dependence for various variables clearly indicates price inelasticity for tobacco use. The mean KTSND score for psychological nicotine dependence for various variables clearly indicates some price elasticity for tobacco use and socio-behavioral factors related to the pattern of use. Price elasticity is important for the given scale that is used for the type of nicotine dependence considering ST is price inelastic and SLT as price elastic.

Ending Tobacco Use Through Interactive Tailored Messaging for Cambodian People With HIV (Project EndIT): Protocol for a Randomized Controlled Trial.

The prevalence of smoking remains high in many low- and middle-income countries (LMICs), including the Southeast Asian nation of Cambodia. Smoking is especially hazardous for people with HIV. In Cambodia, approximately 43%-65% of men with HIV and 3%-5% of women with HIV smoke cigarettes. Thus, there is a critical need for cost-effective smoking cessation interventions for Cambodian people with HIV. This paper describes the design, methods, and data analysis plans for a randomized controlled trial assessing the efficacy of a theory-based mobile health smoking cessation intervention in Cambodian people with HIV. This 2-group randomized controlled trial compares the efficacy of a mobile health-based automated messaging (AM) intervention versus standard care (SC) in facilitating smoking cessation among Cambodian people with HIV. Cambodian people with HIV who currently smoke and are receiving antiretroviral treatment (target, N=800) will be randomized to (1) SC or (2) the AM intervention. SC participants will receive brief advice to quit smoking, written self-help materials, nicotine patches, and will complete weekly app-delivered dietary assessments for 26 weeks. AM participants will receive all SC components (but will complete smoking-related weekly assessments instead of dietary assessments), in addition to a fully automated tailored messaging program driven by the weekly assessments to facilitate smoking cessation. In the Phase-Based Model of smoking cessation, the cessation process is partitioned into 4 phases: motivation, preparation (precessation), cessation (quit date to 2 weeks post quit), and maintenance (up to 6 months post quit). Our AM program targets processes within these phases, including increasing motivation to quit, enhancing self-efficacy, obtaining social support, skills to cope with nicotine withdrawal symptoms and stress, and skills to maintain abstinence. All participants will complete baseline and 3-, 6-, and 12-month in-person follow-up assessments. The primary outcome is biochemically confirmed abstinence at 12 months, with 3- and 6-month abstinence as secondary outcomes. Potential mediators and moderators underlying treatment effects will be explored, and cost-effectiveness will be assessed. This study was approved by all relevant domestic and international institutional and ethical review boards. Participant recruitment commenced in January 2023. Data collection is expected to conclude by the end of 2025. By demonstrating the greater efficacy and cost-effectiveness of AM relative to SC, this study has the potential to transform HIV care in Cambodia and prevent tobacco-related diseases. Furthermore, it may be adapted for use in other Cambodian populations and in other low- and middle-income countries. Ultimately, the AM approach to smoking cessation could greatly improve public health in the developing world and beyond. ClinicalTrials.gov NCT05746442; https://clinicaltrials.gov/ct2/show/NCT05746442. PRR1-10.2196/48923.

Tobacco Consumption and Quality of Life

Background: Smoking is the main cause of illness and death worldwide. It is a serious public health problem and a habit that has consequences for the individual’s quality of life (QoL). The aim of the study was to evaluate the QoL of patients undergoing tobacco cessation treatment in a multidisciplinary program in Brazil. Materials and Methods: The current retrospective study was performed on patients undergoing tobacco cessation treatment in a multidisciplinary program of the Institute of Science and Technology, São Paulo State University (UNESP), Brazil, São José dos Campos, from March to December 2015. The 36-Item Short Form Survey (SF-36), Fantastic Lifestyle, Self-Reporting (SRQ-20), Medical Outcomes Study (MOS), and the State Trait Anxiety Inventory Questionnaires (STAI s/t) were administered to 71 participants who were selected according to the inclusion criteria. Results: The smoking habit affected the QoL of the user, especially in the physical functioning, social aspect, vitality, and mental health domains of the SF-36 survey and the Fantastic Lifestyle Questionnaire. It also influenced depression and the social support of the patient as we could see by the application of the SRQ-20 questionnaire and by the MOS questionnaire, respectively. Conclusion: We could see that there is a negative relationship between smoking and QoL and that smoking influences depression and the social support of the user. These findings highlight that effective tobacco cessation interventions are crucial. Healthcare providers and policymakers must prioritize tobacco control to reduce the burden of tobacco-related diseases and improve community well-being.

1474-P: Identification and Management of MODY2 Pregnancy Patients

Precise differentiation of glucokinase (GCK) monogenic diabetes, MODY2, from gestational diabetes mellitus (GDM) is critical for accurate management of the pregnancy outcome. We screened MODY2 complicating pregnancies in Chinese GDM patients, explored the pathogenesis of novel GCK mutations, and evaluated the patients’ pregnancy outcome and management. The GCK gene from 411 GDM patients was screened with PCR-direct sequencing and multiplex ligation-dependent probe amplification (MLPA) and 15 GCK mutations were identified. We also retrospectively analyzed a total of 65 pregnancies from 21 MODY2 families, wherein 41 were from 15 maternal families and 24 were from six paternal families. Bioinformatic analysis and biochemical functional study were conducted to identify novel GCK mutations. In total, we identified 21 GCK mutations: 15 from the 411 GDM patients and six from 24 fathers. Of the Asp78Asn (GAC → AAC), Met87Arg (ATG → AGG), Leu451Val (CTT → GTT), Leu451Pro (CTG → CCG) and 1019 + 20G &amp;gt; A mutations, five, i.e., were novel and deleterious, with markedly decreased enzyme activity and thermal stability. The unaffected offspring of GCK mutation affected mothers were heavier than affected offspring (p&amp;lt;0.001). Of 21 insulin-treated affected mothers, 10 had maternal hypoglycemia (47.6%) and seven had perinatal complications (33.3%), and the affected offspring of the insulin-treated affected mothers had significantly lower birth weights than that of the 20 diet-control affected mothers (p=0.031). In this study, the prevalence of MODY2 complicating pregnancy in Chinese GDM patients was 3.6% (15/411). The defective GCK may contribute to the hyperglycemia in MODY2. Insulin therapy is not beneficial for MODY2 complicating pregnancy and therefore should not be recommended. Disclosure L.Liu: None. Y.Jiang: None. Y.Chen: None. C.Liu: None. T.Li: None. Funding National Natural Science Foundation of China (81970686, 81770791, 81471012, 82070823, 81270876); Interdisciplinary Program of Shanghai Jiao Tong University (YG2019ZDA08); Shanghai Leading Talent (SLJ15055); National Institutes of Health (SC1DK104821); Tobacco-Related Disease Research Program (T31IR1603)

The efficacy of tobacco cessation treatment for African American adults: a systematic review.

Despite proliferation of evidence-based tobacco cessation treatments, African American adults still suffer higher rates of tobacco-related diseases than White adults. Although tobacco cessation treatment is efficacious, there is a need to reassess the efficacy of tobacco cessation treatment for African American adults. Previous reviews of tobacco cessation treatment studies conducted through 2007 among African American adults highlight the limited research in this area and inconsistent findings on treatment characteristics impacting efficacy. This systematic review examined the efficacy of combined behavioral and pharmacological tobacco cessation treatment for African American adults. Database searches were used to identify studies examining tobacco cessation treatment for predominantly African American samples (>50%). Eligible studies were completed between 2007 and 2021 and (i) involved randomization comparing active combined treatment to a control comparison group and (ii) reported abstinence outcomes at 6 and/or 12 months. Ten studies met inclusion criteria. Active treatment groups typically consisted of a combination of nicotine replacement therapy and behavioral counseling. Abstinence rates for African American adults ranged from 10.0% to 34% in active treatment groups compared to 0.0%-40% in comparison control groups. Our results support the efficacy of combined treatment for tobacco cessation among African American adults. However, cessation rates for African American adults found in this review are lower than those in the general adult population (15%-88%). Additionally, our findings highlight the limited number of studies examining African American tobacco cessation rates and testing of tailored treatment for this population.

Stagnant daily smoking prevalence between 2008 and 2019 among Black and Hispanic adults with serious psychological distress

BackgroundRacial/ethnic minority status and mental illness independently drive inequity in cigarette smoking and related morbidity. Racial/ethnic minority groups suffer a disproportionate burden of tobacco-related diseases. People with serious mental illness (SMI) smoke at up to 7 times the rate of the general population. There is a need to quantify smoking prevalence and trends among people at the intersection of both groups. MethodsThis study analyzes 2008–2019 data from the National Survey on Drug Use and Health. Linear time trends of daily smoking prevalence were assessed among people with serious psychological distress (SPD; marker for SMI) and people without SPD reporting White, Black, Hispanic, and Other race/ethnicity using logistic regression, with survey year as the predictor. Models with year-by-smoking status interaction terms and F-tests assessed differential time trends. ResultsThe prevalence of daily smoking among people without SPD decreased over time among people reporting White (aOR=0.96, p<0.001), Black (aOR=0.96, p<0.001), Hispanic (aOR=0.95, p<0.001), and Other (aOR=0.97, p=0.002) race/ethnicity. Among people with SPD, the smoking prevalence decreased among people with White race/ethnicity (aOR=0.95, p<0.001), with no significant changes among people of Black, Hispanic, and Other race/ethnicity. ConclusionsSmoking among people with SPD who report Black and Hispanic race/ethnicity has not changed significantly in the past 11 years, despite decreasing among non-SPD and White groups. People who are Black/Hispanic and people with SPD struggle to quit smoking, which is amplified intersectionally. Tailored interventions may be a better mechanism to reduce barriers to smoking cessation in this population.

Tobacco-Related Disease, Health Beliefs, and Post-hospital Tobacco Abstinence

Most hospitalized patients who smoke resume after discharge. Associations of tobacco-related disease and health beliefs with post-hospitalization abstinence were examined. This was a cohort study using data from a 2018-2020 multicenter trial of hospitalized adults who smoked and wanted to quit. Tobacco-related disease was defined using primary discharge diagnosis codes. Baseline health beliefs included (1) smoking caused hospitalization, (2) quitting speeds recovery, and (3) quitting prevents future illness. Outcomes included self-reported 7-day point prevalence abstinence 1, 3, and 6 months after discharge. Separate logistic regression models for each of the three health beliefs were constructed. Models stratified by tobacco-related disease explored effect modification. Analysis was performed in 2022-2023. Of 1,406 participants (mean age 52 years, 56% females, 77% non-Hispanic White), 31% had tobacco-related disease, 42% believed that smoking caused hospitalization, 68% believed that quitting speeds recovery, and 82% believed that quitting prevents future illness. Tobacco-related disease was associated with higher 1-month point prevalence abstinence in each health belief model (AOR=1.55, 95% CI=1.15, 2.10; 1.53, 95% CI=1.14, 2.05; and 1.64, 95% CI=1.24, 2.19, respectively) and higher 6-month point prevalence abstinence in models including health beliefs 2 and 3. Quitting speeds recovery was the only belief associated with higher 1-month point prevalence abstinence (AOR=1.39, 95% CI=1.05, 1.85). Among patients with tobacco-related disease, the belief that quitting prevents future illness was associated with higher 1-month point prevalence abstinence (AOR=2.00, 95% CI=1.06, 3.78). Tobacco-related disease predicts abstinence 1 and 6 months after hospitalization independent of health beliefs. Beliefs that quitting speeds recovery and prevents future illness may serve as targets for smoking-cessation interventions.

Approaches to Smoking Cessation

Smoking cessation is a critical public health issue. Smoking cessation techniques are essential in reducing the burden of tobacco-related diseases and deaths. Medical practitioners have the potential to assist patients in quitting smoking, but deficits exist in the amount and type of training received in smoking cessation counseling.&#x0D; Smoking cessation is not a single event but a process that involves a change in a person's lifestyle, values, social circles, thinking and feeling patterns, and coping skills. Overcoming the hurdles associated with smoking cessation can increase an individual's self-efficacy in their ability to succeed at their quit attempt, which in turn acts to reduce the likelihood of a relapse and increase the likelihood of long-term sustained smoking cessation. Innovative techniques of treatment are necessary to provide effective smoking cessation intervention, especially for difficult cases.&#x0D; The use of pharmacotherapy, including nicotine replacement therapy and other medications, is an effective smoking cessation technique. Behavioral therapy is also a useful approach, including motivational interviewing, cognitive-behavioral therapy, and contingency management. The combination of pharmacotherapy and behavioral therapy can enhance the success rate of smoking cessation.

Tobacco Product Use Among Adults – United States, 2021

Commercial cigarette smoking among U.S. adults has declined during the preceding 5 decades (1,2); however, tobacco product use remains the leading cause of preventable disease and death in the United States, and some populations continue to be disproportionately affected by tobacco use (1,2). To assess recent national estimates of commercial tobacco use among U.S. persons aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed 2021 National Health Interview Survey (NHIS) data. In 2021, an estimated 46 million U.S. adults (18.7%) reported currently using any tobacco product, including cigarettes (11.5%), e-cigarettes (4.5%), cigars (3.5%), smokeless tobacco (2.1%), and pipes (including hookah)* (0.9%).† Among those who used tobacco products, 77.5% reported using combustible products (cigarettes, cigars, or pipes), and 18.1% reported using two or more tobacco products.§ The prevalence of current use of any tobacco product use was higher among the following groups: men; persons aged <65 years; persons of non-Hispanic other races; non-Hispanic White (White) persons¶; residents of rural (nonmetropolitan) areas; financially disadvantaged (income-to-poverty ratio=0-1.99); lesbian, gay, or bisexual (LGB) persons; those uninsured or enrolled in Medicaid; adults whose highest level of education was a general educational development (GED) certificate; who had a disability; and who had serious psychological distress. Continued surveillance of tobacco product use, implementation of evidence-based tobacco control strategies (e.g., hard-hitting media campaigns, smoke-free policies, and tobacco price increases), conducting linguistically and culturally appropriate educational campaigns, and FDA regulation of tobacco products will aid in reducing tobacco-related disease, death, and disparities among U.S. adults (3,4).

Salivary Biomarker IL-8 Levels in Smokers and NonSmokers: A Comparative Study

Abstract Objective It is estimated that the mortality rate from tobacco-related diseases will reach 10 million worldwide by 2030. It is validated that every three out of four oral cancers are caused by the use of tobacco in various forms especially smoking. Early detection is the only way to reduce this burden. Molecular-level analysis has currently become a valuable tool in the diagnosis and prognosis of diseases. Around 1000 different salivary protein biomarkers are being investigated in saliva for this purpose. Some of these markers are being investigated to evaluate the proportionality of cigarette smoking. The objective of this study was to evaluate the levels of salivary biomarker interleukin-8 (IL-8) among smokers and nonsmokers as a control group. Materials and Methods This is a comparative cross-sectional study conducted in Islamabad Dental Hospital, Bhara Kahu. A total of 60 patients were recruited and divided into two equal groups of smokers and nonsmokers. Unstimulated saliva samples were collected and analyzed using an enzyme-linked immunosorbent assay kit. Statistical Analysis The results were then analyzed by SPSS v25 using an independent sample t-test to evaluate the statistical difference and significance. Results A p-value (&lt;0.001) was found to be significant for the IL-8 levels in smokers when compared with nonsmokers. The mean value for smokers was found to be 122.69 pg/mL and the mean for nonsmokers was evaluated to be 20.68 pg/mL. Conclusion As the levels of IL-8 were high, it was concluded to be an effective biomarker for the evaluation of smoking-based initial inflammatory changes detectable from saliva.