scholarly journals How does the use of flavored nicotine vaping products relate to progression towards quitting smoking? Findings from the 2016 and 2018 ITC 4CV Surveys

Author(s):  
Lin Li ◽  
Ron Borland ◽  
K Michael Cummings ◽  
Geoffrey T Fong ◽  
Shannon Gravely ◽  
...  

Abstract Introduction There is limited research on the role of flavors in nicotine vaping products (NVPs) in relation to smoking. We examined patterns of flavor use in NVPs in relation to progression towards quitting. Methods Data come from 886 concurrent users of NVPs (at least weekly) and cigarettes who were first surveyed in 2016 and then successfully recontacted in 2018 as part of the ITC 4CV Surveys conducted in Australia, Canada, England and the United States. Participants were asked about their main vaping flavor categorized as: 1) tobacco or unflavored, 2) menthol/mint flavored, and 3) “sweet” flavors (e.g., fruit/candy). We examined whether flavor was associated with progression towards quitting smoking between survey years. Results Overall, 11.1% of baseline concurrent users quit smoking by 2018. Compared to users of tobacco flavors, those vaping “sweet” flavors were more likely to quit smoking between surveys (13.8% vs. 9.6%; adjusted OR=1.61, 95% CI 1.01-2.58, p<0.05), but those using menthol flavors were no more likely to quit smoking (8.3% vs. 9.6%, aOR=0.87, 95% CI 0.43-1.47, p=0.69). Among those who had quit smoking in 2018, 52.0% were still vaping, which was lower than the 65.8% among continuing smokers (aOR=0.60, 95% CI 0.39-0.92, p=0.02). Sweet flavor users were no more likely to continue vaping compared to tobacco flavor users, either for those continuing smoking or those having quit smoking by 2018. There was a net shift away from tobacco flavor among those who continued to vape at follow-up. Conclusions Use of fruit and other sweet flavored e-liquids is positively related to smokers’ transition away from cigarettes. Implications With multiple jurisdictions considering limiting or banning the sale of flavored NVPs, it is important to consider how such policies may impact smokers using NVPs to transition away from cigarette smoking. Our results indicate that vapers who used sweet flavors were more likely to transition away from cigarette smoking and quit cigarette use, at least in the short term, compared to those who used tobacco or unflavored NVPs. Randomized clinical trials are needed to establish if the observed association between use of flavored e-liquids and smoking cessation is due to self-selection or is truly causal.

Author(s):  
Allison M Glasser ◽  
Mahathi Vojjala ◽  
Jennifer Cantrell ◽  
David T Levy ◽  
Daniel P Giovenco ◽  
...  

Abstract Introduction Understanding the population impact of e-cigarettes requires determining their effect on cigarette smoking cessation. Methods Using the US Population Assessment of Tobacco and Health cohort, we examined smoking cessation among adult current cigarette smokers at Wave 1 with follow-up data at Waves 2 and 3 (n = 9724). Results By Wave 3 (2015/2016), 17.3% of smokers had quit smoking. Smokers using e-cigarettes daily or who increased to daily use over the three waves were two to four times more likely to have quit in the short term (<1 year) and long term (1+ years) compared with never e-cigarette users (p < .001). E-cigarette use in the last quit attempt was associated with a higher likelihood of short-term (<1 year) quitting at Wave 3 (adjusted relative risk ratio: 1.33; 95% confidence interval: 1.04, 1.71) compared with smokers who did not use an e-cigarette in their last quit attempt. Noncurrent (no use in any wave) e-cigarette users and users who were unstable in use frequency were 33% and 47% less likely to quit in the short-term, respectively (p < .001). Flavored (vs nonflavored) and using a rechargeable (vs disposable) e-cigarette device was associated with an increased likelihood of both short- and long-term quitting. Conclusion Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices. Less frequent, unstable, past, or never e-cigarette users were less likely to quit smoking. Monitoring the relationship between patterns of e-cigarette and cigarette use is complex but critical for gauging the potential of e-cigarettes as a harm reduction tool. Implications This study suggests that consistent and frequent e-cigarette use over time is associated with cigarette smoking cessation among adults in the United States. In addition, findings suggest that flavored e-cigarette use and use of rechargeable e-cigarette devices can facilitate smoking cessation. These results underscore the importance of carefully defining and characterizing e-cigarette exposure patterns, potential confounders, and use of e-cigarettes to quit smoking, as well as variations in length of the smoking cessation.


Author(s):  
Karin A. Kasza ◽  
Maciej L. Goniewicz ◽  
Kathryn C. Edwards ◽  
Michael D. Sawdey ◽  
Marushka L. Silveira ◽  
...  

Potential mechanisms by which e-cigarette use may relate to combustible cigarette smoking cessation are not well-understood. We used U.S. nationally representative data to prospectively evaluate the relationship between e-cigarette flavor use and frequency of e-cigarette use among adult cigarette/e-cigarette dual users who attempted to quit smoking cigarettes. Analyses used Population Assessment of Tobacco and Health (PATH) Study data from adult dual users (2015/16) who attempted to quit smoking between 2015/16 and 2016/17 (Wave 3-Wave 4, n = 685, including those who did/did not quit by 2016/17). E-cigarette flavor use (usual/last flavor, past 30-day flavor; assessed in 2015/16) was categorized into Only tobacco; Only menthol/mint; Only non-tobacco, non-menthol/mint; and Any combination of tobacco, menthol/mint, other flavor(s). The key outcome, evaluated at follow-up in 2016/17, was frequent e-cigarette use, which was defined as use on 20+ of past 30 days. Logistic regression was used to evaluate associations between e-cigarette flavor use in 2015/16 and frequent e-cigarette use at follow-up in 2016/17. Dual users who attempted to quit smoking had greater odds of frequent e-cigarette use at follow-up when they used only non-tobacco, non-menthol/mint flavor than when they used only tobacco flavor as their regular/last e-cigarette flavor (OR = 1.9, 95% CI: 1.1–3.4); findings were no longer significant when adjusted for factors including e-cigarette device type (AOR = 1.4, 95% CI: 0.7–2.8). Past 30-day e-cigarette flavor use results were generally similar, although frequent e-cigarette use at follow-up was highest among those who used any combination of tobacco, menthol/mint, or other flavors. Findings indicate that e-cigarette flavor use among dual users who attempt to quit smoking may be related to e-cigarette use frequency overall, which may indicate a mechanism underlying findings for e-cigarette use and smoking cessation. Further longitudinal research may help to disentangle how e-cigarette characteristics uniquely impact e-cigarette use frequency and smoking cessation/sustained use.


VASA ◽  
2000 ◽  
Vol 29 (2) ◽  
pp. 103-105 ◽  
Author(s):  
Oguogho ◽  
Lupattelli ◽  
Palumbo ◽  
Helmut Sinzinger

Background: Isoprostanes and in particular 8-epi-PGF2alpha have been claimed as a useful measure for in-vivo oxidation injury. While smokers show elevated 8-epi-PGF2alpha, the behaviour during quitting smoking is unknown. Methods and results: We determined 8-epi-PGF2alpha in 7 healthy adults ready to quit smoking in plasma, serum and urine by means of an enzyme immunoassay after extraction and purification before quitting smoking and during a follow-up period of 4 weeks. After quitting smoking, 8-epi-PGF2alpha shows a rapid decline within a few days almost completely normalizing within 4 weeks. Conclusion: The cigarette-smoking associated in-vivo oxidation injury almost completely disappears within 4 weeks of quitting smoking.


Author(s):  
Adam M Leventhal ◽  
Hongying Dai

Abstract Background Evidence of US adult flavored e-cigarette use prevalence stratified by age, smoking status, and purpose for vaping (ie, quitting smoking, to use when or where smoking is not allowed) can inform policies that reduce the tobacco-related cancer burden. Methods Current flavored e-cigarette use (use 1 or more nontobacco flavors) prevalence estimates were compared across subpopulation groups using 2-sided statistical significance tests in the July 2018 Current Population Survey Tobacco Use Supplement, a nationally representative cross-sectional adult survey (n = 46 759). Results Current flavored e-cigarette use was reported by 1.6% (95% confidence interval [CI] = 1.47% to 1.69%) of all respondents. Among current vapers, the percentage of those who used flavored e-cigarettes was higher for adults aged 18-24 years (89.6%), 25-34 years (86.7%), and 35-44 years (76.0%) than for adults aged 45 years and older (60.4%, Ps < .001); was higher in never smokers (89.8%) than current (72.9%), long-term former (73.9%), and recent former (80.4%) smokers (Ps ≤ .009); was higher in smokers who reportedly did (78.9%) vs did not (71.1%) use e-cigarettes to vape where or when smoking is not allowed (P = .005); and did not differ between smokers who reportedly did (75.0%) vs did not (73.9%) vape to quit smoking (P = .71). Individuals who vaped to quit smoking and currently used flavored e-cigarettes constituted 0.9% (95% CI = 0.82% to 0.99%) of all adults (weighted N = 2 251 000, 95% CI = 2 046 000 to 2 476 000) and 57.2% of current flavored e-cigarette users. Conclusions Flavored e-cigarette use prevalence was low among US adults overall but common for current vapers. Flavored e-cigarette use was disproportionately prevalent among never smokers and other subpopulations that might experience harm from vaping.


2020 ◽  
Vol 47 (2) ◽  
pp. 284-292 ◽  
Author(s):  
Allison M. Glasser ◽  
Alexis Barton ◽  
Jessica Rath ◽  
Bethany Simard ◽  
Shyanika W. Rose ◽  
...  

Despite declines in overall cigarette smoking in the United States, menthol cigarette smoking prevalence has increased among young adults (18-25 years) and remains constant among older adults (26 years and older). Disparities in menthol cigarette use exist, with higher prevalence among younger adult smokers and among racial/ethnic minority populations. Menthol in cigarettes has been shown to play a role in increasing smoking initiation and making it more difficult to quit smoking. Little research focuses on perceptions of the addictive potential and health consequences of menthol cigarette use. This analysis uses data from a national panel of U.S. adults ( n = 1,303) surveyed in 2016. Participants were asked to what extent they agreed with various statements regarding menthol use among demographic and tobacco use subgroups. These data reveal disparities in perceptions of the impact of menthol use, with Black, non-Hispanic, and Hispanic adults and adults with lower income and less education misperceiving the health effects and addiction potential of menthol in cigarettes. Determining how and to what extent population subgroups understand the effect of menthol cigarette use can inform public education strategies and, in turn, policy efforts to ban or restrict menthol cigarette availability.


2021 ◽  
Vol 8 ◽  
pp. 205435812199724
Author(s):  
Ann Bugeja ◽  
Ieta Shams ◽  
Sophie Harris ◽  
Edward G. Clark ◽  
Kevin D. Burns ◽  
...  

Background: It is unclear whether kidney donation leads to lifestyle changes in terms of cannabis and cigarette use. Objective: To describe cigarette and cannabis use before and after kidney donation and to determine their associations with lifestyle and clinical factors. Design: Retrospective cohort study. Setting: The Living Kidney Donor program in the Champlain Local Health Integration Network at The Ottawa Hospital in Ottawa, Canada. Patients: The study included 178 living kidney donors who donated between January 2009 and December 2018. Measurements: Donors were screened for cannabis and cigarette use by telephone interview. Their clinical characteristics and changes in kidney function before and after donation were recorded. Methods: Cannabis and cigarette use before and after kidney donation were compared using chi-square test. Risk factors associated with their use was examined by univariate and multivariate logistic regression. Wilcoxon rank sum test was used to examine the association of cannabis and Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) estimated glomerular filtration rate (eGFR) at donation and at last follow-up. T-test was used to examine the association of cigarette smoking and CKD-EPI eGFR at donation and at last follow-up. Results: Among 305 donors, 262 met inclusion criteria and 178 participated (mean of 4.7 ± 2.9 years from kidney donation). Cannabis and cigarette use were reported by 5% (9 of 178) and 13% (23 of 178) at donation. After donation, 8% (14 of 178) and 5% (9 of 178) started cannabis and cigarettes, respectively; 74% (17 of 23) of smokers remained smokers after donation and 88% (53 of 60) who quit smoking before donation did not restart after donation. In multivariate analysis, non-married/common-in-law status was associated with cannabis use (odds ratio, 2.73; 95% confidence interval, 1.05-7.11; P = .04). There was no difference in eGFR pre- or post-donation among cannabis or cigarette users. Limitations: The single-center study design limits generalizability. Social desirability bias may have affected survey responses and cigarette smoking was not quantified. Conclusions: Cannabis and cigarette use was uncommon in the studied population and was not associated with remaining kidney function. Cannabis use increased post-donation. Most smokers remained smokers after donation and most donors who quit smoking before donation did not restart after donation. This warrants education and support for potential donors who smoke, to quit smoking prior to donation to reduce risks of cardiovascular and end-stage kidney disease. Trial Registration: Not applicable as this is not a clinical trial.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Nor Azlida Mohd Nor ◽  
Marvin Costher Repen ◽  
Zakuan Zakaria ◽  
Norintan Ab-Murat ◽  
Roslan Saub ◽  
...  

Introduction: This study assesses dental students’ and patients’ perceptions on the role of dental students as smoking cessation counsellors as well as the patient’s quit rate at the University of XX. Materials and methods: Self-administered questionnaires were distributed to all senior dental students (n=154) in XX University and telephone call interviews were conducted on their patients (n=169) who received smoking cessation counselling from September 2010 to June 2013. Results: Response rates for dental students and patients were 68.2% and 67.3% respectively. Most of the dental students in this study were females (72.3%) whereas the majority of patients were males (97.6%). An average of six months follow up indicated that 22.5% of patients had quit smoking, 65.3% reduced the number of cigarettes smoked and 6.5% had relapsed. About a third of patients surveyed (33.1%) believed that smoking cessation counselling was extremely helpful compared to what students perceived (5.7%, p<0.01). A higher percentage of patients (89.9%) rated the smoking cessation counselling performance as “excellent”, as compared to students’ rating (58.1%, p<0.01). The majority of the dental students and patients agreed that students should enquire about patients tobacco usage, information regarding the effects of smoking on oral health should be transmitted to patients and that quit smoking assistance should be offered. Conclusion: Smoking cessation counselling conducted by dental students seemed to be effective in assisting patients to reduce the number of cigarettes smoked and in quitting smoking. To some extent, both patients and students had positive attitudes towards smoking cessation counselling.


Author(s):  
Jennifer L Pearson ◽  
Yitong Zhou ◽  
Sabrina L Smiley ◽  
Leslie F Rubin ◽  
Emily Harvey ◽  
...  

Abstract Introduction This study examined the association between the introduction of an e-cigarette and subsequent change in cigarette smoking among smokers who were not immediately interested in quitting. Aims and Methods The Moment Study was a 21-day intensive longitudinal study with an online follow-up survey at 30 days. After observing baseline cigarette smoking for 1 week, participants received 10 cigalike e-cigarettes on study days 6 and 13. Participants reported cigarettes per day, e-cigarette puffs per day, and e-cigarette satisfaction using text-message-based surveys. Results The sample of 96 daily smokers was majority female (53.1%), African American (67.7%), and non-Hispanic (95.8%). When e-cigarettes were provided (day 6), average cigarettes per day dropped by 1.82 cigarettes (p &lt; .0001). The within-person e-cigarette puff effect on daily cigarette smoking was significantly negative (β = −0.023; p = .005); a participant who consumed 100 more e-cigarette puffs in a day than usual for that person was expected to smoke 2.3 fewer cigarettes that day, but this was only true for non-menthol smokers (p = .006). Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps &lt; .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up. Conclusions Giving e-cigarettes to smokers who did not intend to quit reduced their cigarette smoking on days when they used e-cigarette more frequently, but this relationship did not hold for menthol smokers. Satisfaction with e-cigarette use was predictive of continued use 30 days later. Implications A greater amount of cigalike e-cigarette use resulted in less smoking among adult daily smokers without immediate plans to quit, but a lack of nicotine delivery and satisfaction for these devices may have limited their utility as a replacement for cigarette smoking, especially among menthol smokers. The global concept of “satisfaction” may be an important driver of e-cigarette use among adult smokers.


Perfusion ◽  
2021 ◽  
pp. 026765912199599
Author(s):  
Esther Dreier ◽  
Maximilian Valentin Malfertheiner ◽  
Thomas Dienemann ◽  
Christoph Fisser ◽  
Maik Foltan ◽  
...  

Background: The role of venovenous extracorporeal membrane oxygenation (VV ECMO) in patients with COVID-19-induced acute respiratory distress syndrome (ARDS) still remains unclear. Our aim was to investigate the clinical course and outcome of those patients and to identify factors associated with the need for prolonged ECMO therapy. Methods: A retrospective single-center study on patients with VV ECMO for COVID-19-associated ARDS was performed. Baseline characteristics, ventilatory and ECMO parameters, and laboratory and virological results were evaluated over time. Six months follow-up was assessed. Results: Eleven of 16 patients (68.8%) survived to 6 months follow-up with four patients requiring short-term (<28 days) and seven requiring prolonged (⩾28 days) ECMO support. Lung compliance before ECMO was higher in the prolonged than in the short-term group (28.1 (28.8–32.1) ml/cmH2O vs 18.7 (17.7–25.0) ml/cmH2O, p = 0.030). Mechanical ventilation before ECMO was longer (19 (16–23) days vs 5 (5–9) days, p = 0.002) and SOFA score was higher (12.0 (10.5–17.0) vs 10.0 (9.0–10.0), p = 0.002) in non-survivors compared to survivors. Low viral load during the first days on ECMO tended to indicate worse outcomes. Seroconversion against SARS-CoV-2 occurred in all patients, but did not affect outcome. Conclusions: VV ECMO support for COVID-19-induced ARDS is justified if initiated early and at an experienced ECMO center. Prolonged ECMO therapy might be required in those patients. Although no relevant predictive factors for the duration of ECMO support were found, the decision to stop therapy should not be made dependent of the length of ECMO treatment.


Author(s):  
Zongshuan Duan ◽  
Yu Wang ◽  
Jidong Huang

E-cigarettes are the most-used tobacco products among U.S. adolescents. Emerging evidence suggests that adolescents using e-cigarettes are at elevated risk for initiating cigarette smoking. However, whether this risk may differ by sex remains unknown. This study analyzed data from Wave 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal survey. Generalized estimation equations (GEE) were performed to estimate the associations between baseline e-cigarette use and subsequent cigarette smoking, controlling for sociodemographic characteristics, mental health conditions, and other tobacco use. Effect modifications by sex were examined. Multivariate analyses showed that, among baseline never cigarette smokers, past-30-day e-cigarette use at baseline waves was significantly associated with past-30-day cigarette smoking at follow-up waves (aOR = 3.90, 95% CI: 2.51–6.08). This association was significantly stronger for boys (aOR = 6.17, 95% CI: 2.43–15.68) than for girls (aOR = 1.10, 95% CI: 0.14–8.33). Additionally, using other tobacco products, older age, and having severe externalizing mental health problems at baseline were significantly associated with an increased likelihood of cigarette smoking at follow-up. The prospective association between e-cigarette use and cigarette smoking differs by sex among U.S. adolescents. Sex-specific tobacco control interventions may be warranted to curb the youth tobacco use epidemic.


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