Criterion Validity of Measures of Perceived Relative Harm of E-Cigarettes and Smokeless Tobacco Compared to Cigarettes

PubMed Central

Persoskie, Alexander; Nguyen, Anh B.; Kaufman, Annette R.; Tworek, Cindy

2017-01-01

Beliefs about the relative harmfulness of one product compared to another (perceived relative harm) are central to research and regulation concerning tobacco and nicotine-containing products, but techniques for measuring such beliefs vary widely. We compared the validity of direct and indirect measures of perceived harm of e-cigarettes and smokeless tobacco (SLT) compared to cigarettes. On direct measures, participants explicitly compare the harmfulness of each product. On indirect measures, participants rate the harmfulness of each product separately, and ratings are compared. The U.S. Health Information National Trends Survey (HINTS-FDA-2015; N=3738) included direct measures of perceived harm of e-cigarettes and SLT compared to cigarettes. Indirect measures were created by comparing ratings of harm from e-cigarettes, SLT, and cigarettes on 3-point scales. Logistic regressions tested validity by assessing whether direct and indirect measures were associated with criterion variables including: ever-trying e-cigarettes, ever-trying snus, and SLT use status. Compared to the indirect measures, the direct measures of harm were more consistently associated with criterion variables. On direct measures, 26% of adults rated e-cigarettes as less harmful than cigarettes, and 11% rated SLT as less harmful than cigarettes. Direct measures appear to provide valid information about individuals’ harm beliefs, which may be used to inform research and tobacco control policy. Further validation research is encouraged. PMID:28073035

Correlates of adolescents' use of smokeless tobacco.

PubMed

Colborn, J W; Cummings, K M; Michalek, A M

1989-01-01

Data are presented on the prevalence and correlates of smokeless tobacco use among a group of 568 adolescents from five public schools located in western New York State. Two of the five schools were located in rural communities, two were located in suburbs of Buffalo, and one school was located in the city of Buffalo. Nineteen percent of males reported current use of smokeless tobacco. There was very little regular use among girls, although 18% reported having tried it. Sharp regional differences in the use of smokeless tobacco were observed with the highest percentage of users among students from rural communities. Experimentation with cigarette smoking was associated with use of smokeless tobacco, however, few regular users of smokeless tobacco were current smokers. As is the case with cigarette smoking, social influences, especially those of peers and family members, were important factors associated with use of smokeless tobacco. Study findings suggest that programs that attempt to prepare students to cope with social pressures for using and stress the immediate negative consequences of use (i.e., stained teeth, bad breath) are more likely to be successful in discouraging adolescents from using smokeless tobacco than programs that only educate about the detrimental health effects of chewing and/or dipping tobacco.

Consumption of Combustible and Smokeless Tobacco - United States, 2000-2015.

PubMed

Wang, Teresa W; Kenemer, Brandon; Tynan, Michael A; Singh, Tushar; King, Brian

2016-12-09

Combustible and smokeless tobacco use causes adverse health outcomes, including cardiovascular disease and multiple types of cancer (1,2). Standard approaches for measuring tobacco use include self-reported surveys of use and consumption estimates based on tobacco excise tax data (3,4). To provide the most recently available tobacco consumption estimates in the United States, CDC used federal excise tax data to estimate total and per capita consumption during 2000-2015 for combustible tobacco (cigarettes, roll-your-own tobacco, pipe tobacco, small cigars, and large cigars) and smokeless tobacco (chewing tobacco and dry snuff). During this period, total combustible tobacco consumption decreased 33.5%, or 43.7% per capita. Although total cigarette consumption decreased 38.7%, cigarettes remained the most commonly used combustible tobacco product. Total noncigarette combustible tobacco (i.e., cigars, roll-your-own, and pipe tobacco) consumption increased 117.1%, or 83.8% per capita during 2000-2015. Total consumption of smokeless tobacco increased 23.1%, or 4.2% per capita. Notably, total cigarette consumption was 267.0 billion cigarettes in 2015 compared with 262.7 billion in 2014. These findings indicate that although cigarette smoking declined overall during 2000-2015, and each year from 2000 to 2014, the number of cigarettes consumed in 2015 was higher than in 2014, and the first time annual cigarette consumption was higher than the previous year since 1973. Moreover, the consumption of other combustible and smokeless tobacco products remains substantial. Implementation of proven tobacco prevention interventions (5) is warranted to further reduce tobacco use in the United States.

Using alcohol to sell cigarettes to young adults: a content analysis of cigarette advertisements.

PubMed

Belstock, Sarah A; Connolly, Gregory N; Carpenter, Carrie M; Tucker, Lindsey

2008-01-01

Advertising influences the health-related behaviors of college-aged individuals. Cigarette manufacturers aggressively market to young adults and may exploit their affinity for alcohol when creating advertisements designed to increase cigarettes' appeal. Internal tobacco industry documents reveal that cigarette manufacturers understood the popularity of alcohol among young adults and sought to produce pertinent marketing strategies. The authors conducted a content analysis of cigarette and alcohol advertisements in young adult-oriented magazines to investigate portrayed associations between cigarettes and alcohol. The content analysis revealed that 32 of 114 cigarette advertisements referenced alcohol and that those advertisements were more likely than others to portray active smoking. Conversely, 0 of 317 alcohol advertisements referenced cigarettes, and alcohol advertisements were only slightly more likely than cigarette advertisements to feature alcohol-related settings. Such advertising may detrimentally affect smoking patterns of college students. An understanding of these strategies can benefit on-campus tobacco control efforts.

Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA.

PubMed

Mejia, Adrienne B; Ling, Pamela M; Glantz, Stanton A

2010-08-01

Snus (a form of smokeless tobacco) is less dangerous than cigarettes. Some health professionals argue that snus should be promoted as a component of a harm reduction strategy, while others oppose this approach. Major US tobacco companies (RJ Reynolds and Philip Morris) are marketing snus products as cigarette brand line extensions. The population effects of smokeless tobacco promotion will depend on the combined effects of changes in individual risk with population changes in tobacco use patterns. To quantitatively evaluate the health impact of smokeless tobacco promotion as part of a harm reduction strategy in the US. A Monte Carlo simulation of a decision tree model of tobacco initiation and use was used to estimate the health effects associated with five different patterns of increased smokeless tobacco use. With cigarette smoking having a health effect of 100, the base case scenario (based on current US prevalence rates) yields a total health effect of 24.2 (5% to 95% interval 21.7 to 26.5) and the aggressive smokeless promotion (less cigarette use and increased smokeless, health-concerned smokers switching to snus, smokers in smokefree environments switching to snus) was associated with a health effect of 30.4 (5% to 95% interval 25.9 to 35.2). The anticipated health effects for additional scenarios with lower rates of smokeless uptake also overlapped with the base case. Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.

Current use of smokeless tobacco among adolescents in the Republic of Congo.

PubMed

Rudatsikira, Emmanuel; Muula, Adamson S; Siziya, Seter

2010-01-14

Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT). Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations. Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]). Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and

Trends in annual sales and current use of cigarettes, cigars, roll-your-own tobacco, pipes, and smokeless tobacco among US adults, 2002-2012.

PubMed

Agaku, Israel T; Alpert, Hillel R

2016-07-01

Regulatory imbalances exist in the treatment of cigarettes and non-cigarette tobacco products in the USA. We assessed whether declines in cigarette consumption during 2002-2012 were offset by increased use of non-cigarette tobacco products-cigars, pipes, roll-your-own (RYO) and smokeless tobacco. Industry-reported taxable removals (actual sales) were converted into packs for cigarettes and cigarette pack equivalents (CPEs) for loose tobacco (RYO plus pipe tobacco) and moist snuff. Cigars were not converted to CPEs because of their heterogeneity in size/tobacco content. Per capita sales were calculated for the US adult population aged ≥18 years based on the US Census Bureau data. Self-reported data on current (past 30-day) tobacco use among US adults aged ≥18 years were from the National Survey on Drug Use and Health (NSDUH). Joinpoint and logistic regression were used to assess linear trends during 2002-2012. During 2002-2012, cigarette sales declined from 96.91 to 59.85 cigarette packs per capita; increases occurred for sale of cigars (30.51-57.42 cigars per capita), loose tobacco (2.50-5.63 CPEs per capita) and moist snuff (10.64-14.58 CPEs per capita; all p<0.05 for trend). Self-reported current cigarette smoking declined during 2002-2012 (27.4-23.6%); increases were noted for current RYO (2.6-3.6%) and smokeless tobacco use (3.5-3.7%; all p<0.05 for trend). The increase in non-cigarette tobacco consumption is a public health concern because all tobacco products are harmful. Eliminating imbalances in tax structure and regulations between cigarettes and non-cigarette tobacco products may help reduce aggregate tobacco consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Interactions between cigarette and alcohol consumption in rural China.

PubMed

Yu, Xiaohua; Abler, David

2010-04-01

The objective of this paper is to analyze interdependencies between cigarette and alcohol consumption in rural China, using panel data for 10 years (1994-2003) for rural areas of 26 Chinese provinces. There have been many studies in which cigarette and alcohol consumption have been considered separately but few to date for China on interactions between the consumption of these two products. Taxes are often recommended as a tool to reduce alcohol and cigarette consumption. If cigarettes and alcohol are complements, taxing one will reduce the consumption of both and thus achieve a double public health dividend. However, if they are substitutes, taxing one will induce consumers to increase consumption of the other, offsetting the public health benefits of the tax. Our results indicate that the demands for both cigarettes and alcohol are very sensitive to the price of alcohol, but not to the price of cigarettes or to income. This suggests that taxes on alcohol can have a double dividend. On the other hand, an increase in cigarette taxes may not be effective in curbing cigarette or alcohol consumption in rural China.

Multiple tobacco product use among adults in the United States: cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus.

PubMed

Lee, Youn O; Hebert, Christine J; Nonnemaker, James M; Kim, Annice E

2014-05-01

Noncigarette tobacco products are increasingly popular. Researchers need to understand multiple tobacco product use to assess the effects of these products on population health. We estimate national prevalence and examine risk factors for multiple product use. We calculated prevalence estimates of current use patterns involving cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus using data from the 2012 RTI National Adult Tobacco Survey (N=3627), a random-digit-dial telephone survey of adults aged 18 and over. Associations between use patterns (exclusive single product and multiple products) and demographic characteristics were examined using Pearson chi-square tests and logistic regression. 32.1% of adults currently use 1 or more tobacco products; 14.9% use cigarettes exclusively, and 6.6% use one noncigarette product exclusively, 6.9% use cigarettes with another product (dual use), 1.3% use two noncigarette products, and 2.4% use three or more products (polytobacco use). Smokers who are young adult, male, never married, reside in the West, and made prior quit attempts were at risk for multiple product use. Over 10% of U.S. adults use multiple tobacco products. A better understanding of multiple product use involving combustible products, like cigars and hookah, is needed. Multiple product use may be associated with past quit attempts. Copyright © 2014 Elsevier Inc. All rights reserved.

The Self-Report Habit Index: Assessing habitual marijuana, alcohol, e-cigarette, and cigarette use.

PubMed

Morean, Meghan E; DeMartini, Kelly S; Foster, Dawn; Patock-Peckham, Julie; Garrison, Kathleen A; Corlett, Philip R; Krystal, John H; Krishan-Sarin, Suchitra; O'Malley, Stephanie S

2018-05-01

Substance use is partially driven by habitual processes that occur automatically in response to environmental cues and may be central to users' identities. This study was designed to validate the Self-Report Habit Index (SRHI) for assessing habitual marijuana, alcohol, cigarette, and e-cigarette use. We examined the SRHI's psychometrics in separate samples of adult marijuana (Ns = 189;170), alcohol (Ns = 100;133), cigarette (Ns = 58;371), and e-cigarette (N = 239) users. A 6-item, single-factor solution evidenced good fit across substances (CFI marijuana/alcohol/cigarettes/e-cigarettes = 0.996/0.997/0.996/0.994, RMSEA = 0.046/0.047/0.067/0.068, SRMR = 0.017/0.017/0.010/0.015) and internal consistency (α = 0.88/0.94/0.95/0.91). The SRHI was scalar invariant for sex and race. However, independent-samples t-tests indicated only that women endorsed stronger habitual e-cigarette use and that men endorsed stronger habitual marijuana use. The SRHI also was scalar invariant by product type in dual-users (cigarettes/e-cigarettes[N = 371]; alcohol/cigarettes [n = 58]), although differences in habit strength only were observed for cigarettes versus e-cigarettes, with dual-users reporting stronger habitual cigarette use. Finally, the SRHI predicted frequency of marijuana, alcohol, cigarette, and e-cigarette use (n p 2 [marijuana/alcohol/cigarettes/e-cigarettes] = 0.37/0.48/0.31/0.17) and quantity of alcohol and cigarette use (n p 2  = 0.43/0.33). The SRHI is a psychometrically sound measure of adults' habitual substance use. The SRHI detected mean differences by sex and substance type and predicted the frequency of using each substance. Future research should determine if the SRHI is appropriate for use with other substances or age groups (e.g., adolescents), how it relates to task-based, behavioral measures of habit strength, and the degree to which habit predicts the development or maintenance of addiction. Copyright © 2018

Tobacco industry use of flavourings to promote smokeless tobacco products

PubMed Central

Kostygina, Ganna; Ling, Pamela M

2017-01-01

Background While fruit, candy and alcohol characterising flavours are not allowed in cigarettes in the USA, other flavoured tobacco products such as smokeless tobacco (ST) continue to be sold. We investigated tobacco manufacturers’ use of flavoured additives in ST products, the target audience(s) for flavoured products, and marketing strategies promoting products by emphasising their flavour. Methods Qualitative analysis of internal tobacco industry documents triangulated with data from national newspaper articles, trade press and internet. Results Internally, flavoured products have been consistently associated with young and inexperienced tobacco users. Internal studies confirmed that candy-like sweeter milder flavours (eg, mint, fruit) could increase appeal to starters by evoking a perception of mildness, blinding the strong tobacco taste and unpleasant mouth feel; or by modifying nicotine delivery by affecting product pH. Discussion Similar to cigarettes, flavoured ST is likely to encourage novices to start using tobacco, and regulations limiting or eliminating flavours in cigarettes should be extended to include flavoured ST products. PMID:27856998

The synergistic effect of cigarette taxes on the consumption of cigarettes, alcohol and betel nuts

PubMed Central

Lee, Jie-Min

2007-01-01

Background Consumption of cigarettes and alcoholic beverages creates serious health consequences for individuals and overwhelming financial burdens for governments around the world. In Asia, a third stimulant – betel nuts – increases this burden exponentially. For example, individuals who simultaneously smoke, chew betel nuts and drink alcohol are approximately 123 times more likely to develop oral, pharyngeal and laryngeal cancer than are those who do not. To discourage consumption of cigarettes, the government of Taiwan has imposed three taxes over the last two decades. It now wishes to lower consumption of betel nuts. To assist in this effort, our study poses two questions: 1) Will the imposition of an NT$10 Health Tax on cigarettes effectively reduce cigarette consumption? and 2) Will this cigarette tax also reduce consumption of alcoholic beverages and betel nuts? To answer these questions, we analyze the effect of the NT$10 tax on overall cigarette consumption as well as the cross price elasticities of cigarettes, betel nuts, and alcoholic beverages. Methods To establish the Central Bureau of Statistics demand function, we used cigarette, betel nut, and alcoholic beverage price and sales volume data for the years 1972–2002. To estimate the overall demand price elasticity of cigarettes, betel nuts, and alcoholic beverages, we used a seemingly unrelated regression analysis. Results We find that the NT$10 health tax on cigarettes will reduce cigarette consumption by a significant 27.22%. We also find that cigarettes, betel nuts, and alcoholic beverages have similar inherent price elasticities of -0.6571, -0.5871, and -0.6261 respectively. Because of this complementary relationship, the NT$10 health tax on cigarettes will reduce betel nut consumption by 20.07% and alcohol consumption by 7.5%. Conclusion The assessment of a health tax on cigarettes as a smoking control policy tool yields a win-win outcome for both government and consumers because it not only

The impact of product information and trials on demand for smokeless tobacco and cigarettes: Evidence from experimental auctions

PubMed Central

Rousu, Matthew C.; O'Connor, Richard; Thrasher, James F; June, Kristie; Bansal-Travers, Maansi; Pitcavage, James

2014-01-01

Introduction Epidemiological and toxicological evidence suggests lower risk of smokeless tobacco (ST) products compared to cigarettes. Less is known, however, about consumer perceptions and use of novel forms of ST, including snus and dissolvable tobacco. Methods In this study, we conducted in-person experimental auctions in Buffalo, NY, Columbia, SC, and Selinsgrove, PA with 571 smokers to test the impact of information and product trials on smokers’ preferences. Auctions were conducted between November 2010-November 2011. Results We found no evidence of an impact of product trials on demand in our auctions. Anti-ST information increased demand for cigarettes when presented alone, but when presented with Pro-ST information it decreased demand for cigarettes. It did not decrease demand for ST products. Anti-smoking information increased demand for ST products, but did not affect cigarette demand. Conclusions These findings suggest that credible and effective communications about tobacco harm reduction should reinforce the negative effects of smoking. PMID:24321456

The impact of product information and trials on demand for smokeless tobacco and cigarettes: evidence from experimental auctions.

PubMed

Rousu, Matthew C; O'Connor, Richard J; Thrasher, James F; June, Kristie M; Bansal-Travers, Maansi; Pitcavage, James

2014-03-01

Epidemiological and toxicological evidence suggests lower risk of smokeless tobacco (ST) products compared to cigarettes. Less is known, however, about consumer perceptions and use of novel forms of ST, including snus and dissolvable tobacco. In this study, we conducted in-person experimental auctions in Buffalo, NY, Columbia, SC, and Selinsgrove, PA with 571 smokers to test the impact of information and product trials on smokers' preferences. Auctions were conducted between November 2010-November 2011. We found no evidence of an impact of product trials on demand in our auctions. Anti-ST information increased demand for cigarettes when presented alone, but when presented with pro-ST information it decreased demand for cigarettes. It did not decrease demand for ST products. Anti-smoking information increased demand for ST products, but did not affect cigarette demand. These findings suggest that credible and effective communications about tobacco harm reduction should reinforce the negative effects of smoking. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence and Patterns of Smokeless Tobacco Use in a Southeastern University.

ERIC Educational Resources Information Center

Glover, Elbert D.; And Others

1987-01-01

Investigated prevalence and patterns of use for tobacco products, especially smokeless tobacco, among 632 college students. Smokeless tobacco use was considerably more prevalent among males than among females; the reverse was true for cigarette smoking. Implications for health education programs are discussed. (Author/NB)

The Case for Requiring Graphic Warning Labels on Smokeless Tobacco Product Packages.

PubMed

Pakhale, Smita; Samet, Jonathan; Folan, Patricia; Leone, Frank; White, Alexander

2016-03-01

On November 10, 2015, the U.S. Food and Drug Administration approved, for the first time, the sale of smokeless tobacco products authorized under the new premarket tobacco application pathway. This Food and Drug Administration regulatory decision draws attention to the growing worldwide use of smokeless tobacco products in general. Use of these tobacco products is particularly popular in low- and middle-income countries of Asia. Due to aggressive and strategic marketing to children, young adults, and current smokers, rates of smokeless tobacco use in men of all ages are on the rise in United States and elsewhere. The tobacco industry also continues to market these products to current cigarette smokers for use in the growing number of "smoke-free environments." Smokeless tobacco products are associated with cancers of the upper aerodigestive tract, particularly the oral cavity, esophagus, and pancreas; cardiovascular diseases; small-for-gestational-age infants; premature births; increased risk of apnea; and stillbirth. There is no convincing evidence regarding the efficacy of smokeless tobacco, including snus, to promote smoking cessation. Rather, studies from Europe and the United States demonstrate that smokeless tobacco use may facilitate regular cigarette smoking by acting as a gateway drug, especially for children. Caution is warranted before proposing smokeless tobacco as a harm-reduction strategy, in part because of the potential for further promoting smokeless tobacco in low- and middle-income countries where use is already widespread. Continued vigilance through comprehensive surveillance is warranted. We strongly recommend the use of graphic warning labels as a "no regrets" strategy for all smokeless tobacco products marketed globally.

Smokeless tobacco: challenges, products and, cessation.

PubMed

Rankin, K Vendrell; Jones, Daniel L; Benton, Elain

2010-06-01

Tobacco companies continue to develop and aggressively market new products for oral use. Most new products are intended to dissolve in the mouth and swallow rather than spit out the juices. These products effectively circumvent smoke-free policies, decrease tobacco cessation efforts, and create individuals who use both smokeless tobacco (ST) and cigarettes. All ST products contain nicotine, carcinogens, and pose multiple health risks. The cancer and health risks associated with ST use extend well beyond the changes in the oral cavity and the risk of oral cancer. Unlike cigarettes, the contents of ST vary widely by brand and product posing difficulty in the use of the available pharmacotherapy for cessation. Although no uniform guidelines exist for the use of pharmacotherapy for smokeless tobacco cessation, research suggests that use of these drugs is effective. The most important motivator for quitting ST cessation remains in the hands of the dentist.

Nicotine and Toxicant Exposure Among US Smokeless Tobacco Users: Results from 1999-2012 National Health and Nutrition Examination Survey Data

PubMed Central

Rostron, Brian L.; Chang, Cindy M.; van Bemmel, Dana M.; Xia, Yang; Blount, Benjamin C.

2016-01-01

Background It has been suggested that smokeless tobacco users have high levels of exposure to nicotine and some toxic substances as measured by biomarker concentrations, but studies with nationally representative data have been limited. Methods We analyzed biomarkers of tobacco exposure for 23,684 adult participants from the National Health and Nutrition and Examination Survey (NHANES) from 1999-2012. The biomarkers analyzed were serum cotinine, urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), blood lead, blood cadmium, blood mercury, urinary arsenic, and urinary N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA). We calculated geometric mean concentrations for each biomarker by tobacco use category (exclusive smokeless tobacco use, exclusive cigarette smoking, dual cigarette and smokeless tobacco use, and non-cigarette and smokeless tobacco use) and geometric mean ratios adjusting for demographic factors. Results Exclusive smokeless tobacco users had higher geometric mean concentrations of cotinine (178.9 ng/mL, 95% CI = 145.5, 220.0) and NNAL (583.0 pg/mg creatinine, 95% CI = 445.2, 763.5) than exclusive cigarette smokers, (130.6 ng/mL, 95% CI = 122.3, 139.6 and 217.6 pg/mg creatinine, 95% CI = 193.0, 245.2, respectively). Smokeless tobacco users also had higher concentrations of blood lead compared with non-tobacco users (adjusted geometric mean ratio = 1.30, 95% CI = 1.21, 1.38). Differences in concentrations of cadmium, mercury, and CYMA between smokeless tobacco users and non-tobacco users were not observed. Based on limited sample sizes, NNAL concentrations for smokeless tobacco users appear to have declined from 2007-2008 (geometric mean = 1013.7 pg/mg creatinine, 95% CI = 738.9, 1390.8) to 2011-2012 (geometric mean = 325.7 pg/mg creatinine, 95% CI = 159.6, 664.9). Conclusions Smokeless tobacco users have higher observed levels of exposure to nicotine and carcinogenic tobacco-specific nitrosamines, as measured by cotinine and NNAL biomarker

Exploring the Predictive Validity of the Susceptibility to Smoking Construct for Tobacco Cigarettes, Alternative Tobacco Products, and E-Cigarettes.

PubMed

Cole, Adam G; Kennedy, Ryan David; Chaurasia, Ashok; Leatherdale, Scott T

2017-12-06

Within tobacco prevention programming, it is useful to identify youth that are at risk for experimenting with various tobacco products and e-cigarettes. The susceptibility to smoking construct is a simple method to identify never-smoking students that are less committed to remaining smoke-free. However, the predictive validity of this construct has not been tested within the Canadian context or for the use of other tobacco products and e-cigarettes. This study used a large, longitudinal sample of secondary school students that reported never using tobacco cigarettes and non-current use of alternative tobacco products or e-cigarettes at baseline in Ontario, Canada. The sensitivity, specificity, and positive and negative predictive values of the susceptibility construct for predicting tobacco cigarette, e-cigarette, cigarillo or little cigar, cigar, hookah, and smokeless tobacco use one and two years after baseline measurement were calculated. At baseline, 29.4% of the sample was susceptible to future tobacco product or e-cigarette use. The sensitivity of the construct ranged from 43.2% (smokeless tobacco) to 59.5% (tobacco cigarettes), the specificity ranged from 70.9% (smokeless tobacco) to 75.9% (tobacco cigarettes), and the positive predictive value ranged from 2.6% (smokeless tobacco) to 32.2% (tobacco cigarettes). Similar values were calculated for each measure of the susceptibility construct. A significant number of youth that did not currently use tobacco products or e-cigarettes at baseline reported using tobacco products and e-cigarettes over a two-year follow-up period. The predictive validity of the susceptibility construct was high and the construct can be used to predict other tobacco product and e-cigarette use among youth. This study presents the predictive validity of the susceptibility construct for the use of tobacco cigarettes among secondary school students in Ontario, Canada. It also presents a novel use of the susceptibility construct for

Comparative risk assessment and cessation information seeking among smokeless tobacco users.

PubMed

Jun, Jungmi; Nan, Xiaoli

2018-05-01

This research examined (1) smokeless tobacco users' comparative optimism in assessing the health and addiction risks of their own product in comparison with cigarettes, and (2) the effects of comparative optimism on cessation information-seeking. A nationally-representative sample from the 2015 Health Information National Trends Survey (HINTS)-FDA was employed. The analyses revealed the presence of comparative optimism in assessing both health and addiction risks among smokeless tobacco users. Comparative optimism was negatively correlated with most cessation information-seeking variables. Health bias (the health risk rating gap between the subject's own tobacco product and cigarettes) was associated with decreased intent to use cessation support. However, the health bias and addiction bias (the addiction risk rating gap between the subject's own tobacco product and cigarettes) were not consistent predictors of all cessation information-seeking variables, when covariates of socio-demographics and tobacco use status were included. In addition, positive correlations between health bias and past/recent cessation-information searches were observed. Optimisic biases may negatively influence cessation behaviors not only directly but also indirectly by influencing an important moderator, cessation information-seeking. Future interventions should prioritize dispelling the comparative optimism in perceiving risks of smokeless tobacco use, as well as provide more reliable cessation information specific to smokeless tobacco users. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of smokeless tobacco product marketing and use on population harm from tobacco use policy perspective for tobacco-risk reduction.

PubMed

Kozlowski, Lynn T

2007-12-01

This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.

Cigarette Smoking and Risk of Alcohol Use Relapse Among Adults in Recovery from Alcohol Use Disorders.

PubMed

Weinberger, Andrea H; Platt, Jonathan; Jiang, Bianca; Goodwin, Renee D

2015-10-01

Individuals in recovery from alcohol use disorders (AUDs) frequently continue to smoke cigarettes. The purpose of this study was to examine the relationship between cigarette smoking status and risk of AUD relapse in adults with remitted AUDs among adults in the United States. Data were drawn from Wave 1 (2001 to 2002) and Wave 2 (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Analyses included the subsample of respondents who completed both waves of data collection reported a history of alcohol abuse and/or dependence prior to Wave 1 (N = 9,134). Relationships between Wave 1 cigarette smoking status (nonsmoker, daily cigarette smoker, and nondaily cigarette smoker) and Wave 2 alcohol use, abuse, and dependence were examined using logistic regression analyses. Analyses were adjusted for Wave 1 demographics; mood, anxiety, and substance use disorders; nicotine dependence; and AUD severity. Both daily and nondaily cigarette smoking at Wave 1 were significantly associated with a lower likelihood of alcohol use and a greater likelihood of alcohol abuse and dependence at Wave 2 compared to Wave 1 nonsmoking. These relationships remained significant after adjusting for demographics, psychiatric disorders, substance use disorders, AUD severity, and nicotine dependence. Among adults with remitted AUDs, daily and nondaily use of cigarettes was associated with significantly decreased likelihood of alcohol use and increased likelihood of alcohol abuse and alcohol dependence 3 years later. Concurrent treatment of cigarette smoking when treating AUDs may help improve long-term alcohol outcomes and reduce the negative consequences of both substances. Copyright © 2015 by the Research Society on Alcoholism.

Impact of tobacco control policies on adolescent smokeless tobacco and cigar use: a difference-in-differences approach.

PubMed

Hawkins, Summer Sherburne; Bach, Nicoline; Baum, Christopher F

2018-02-15

While increasing cigarette taxes has been a major policy driver to decrease smoking, taxes on other tobacco products have received less attention. Our aims were to evaluate the impact of chewing tobacco/cigar taxes, cigarette taxes, and smoke-free legislation on adolescent male and female use of smokeless tobacco and cigars. We analyzed data on 499,381 adolescents age 14-18 years from 36 US states in the Youth Risk Behavior Surveys (1999-2013) linked to state-level tobacco control policies. We conducted difference-in-differences regression models to assess whether changes in taxes and the enactment of smoke-free legislation were associated with smokeless tobacco use and, separately, cigar use. Models were stratified by adolescent sex. We found that chewing tobacco taxes had no effect on smokeless tobacco use and cigar taxes had no effect on cigar use. In contrast, among males a 10% increase in cigarette taxes was associated with a 1.0 percentage point increase (0.0010, 95% CI 0.0003-0.0017) in smokeless tobacco use. A 10% increase in cigarette taxes was also associated with a 1.5 percentage point increase (0.0015, 95% CI 0.0006-0.0024) in cigar use among males and a 0.7 percentage point increase (0.0007, 95% CI 0.0001-0.0013) in cigar use among females. There was some evidence that smoke-free legislation was associated with an 1.1 percentage point increase (0.0105, 95% CI 0.0015-0.0194) in smokeless tobacco use among males only, but no effect of smoke-free legislation on cigar use for males or females. Higher state cigarette taxes are associated with adolescents' use of cheaper, alternative tobacco products such as smokeless tobacco and cigars. Reducing tobacco use will require comprehensive tobacco control policies that are applied equally to and inclusive of all tobacco products.

Advertising Receptivity and Youth Initiation of Smokeless Tobacco.

PubMed

Timberlake, David S

2016-07-28

Cross-sectional data suggests that adolescents' receptivity to the advertising of smokeless tobacco is correlated with use of chewing tobacco or snuff. Lack of longitudinal data has precluded determination of whether advertising receptivity precedes or follows initiation of smokeless tobacco. The objective of this study was to test for the association between advertising receptivity and subsequent initiation of smokeless tobacco among adolescent males. Adolescent males from the 1993-1999 Teen Longitudinal California Tobacco Survey were selected at the baseline survey for never having used smokeless tobacco. Separate longitudinal analyses corresponded to two dependent variables, ever use of smokeless tobacco (1993-1996; N = 1,388) and use on 20 or more occasions (1993-1999; N = 1,014). Models were adjusted for demographic variables, risk factors for smokeless tobacco use, and exposure to users of smokeless tobacco. Advertising receptivity at baseline was predictive of ever use by late adolescence (RR(95% CI) = 2.0 (1.5, 2.8)) and regular use by young adulthood (RR(95% CI) = 3.7 (2.1, 6.7)) in models that were adjusted for covariates. Conclusions/ Importance: The findings challenge the tobacco industry's assertion that tobacco marketing does not impact youth initiation. This is particularly relevant to tobacco control in the United States because the 2009 Tobacco Control Act places fewer restrictions on smokeless tobacco products compared to cigarettes.

Smokeless tobacco product prices and taxation in Bangladesh: Findings from the ITC survey

PubMed Central

Nargis, N; Hussain, AKMG; Fong, GT

2015-01-01

Context Smokeless tobacco use is well-recognized as occupying a significant portion of overall tobacco consumption in Bangladesh. Yet very little is known about the effectiveness of tax and price policy in controlling the use of smokeless tobacco use in the country. Aims The aims of this paper are to examine the price distribution of various smoked and smokeless tobacco products and estimate the effects of changes in the prices of tobacco products on the consumption of smokeless tobacco. Settings and Design The data for this paper came from the Wave 3 ITC Bangladesh (ITC BD) Survey conducted between November 2011 and May 2012. It is a cohort survey of a nationally representative sample of adult tobacco users and non-users in Bangladesh selected using a stratified multistage cluster sampling design. Two measures of smokeless tobacco use are used in the analysis—prevalence of smokeless tobacco use indicating the decision to use smokeless tobacco products, and the frequency of using smokeless tobacco per day indicating intensity of smokeless tobacco use. Methods and Material The regression analysis involves estimation of the demand function for the most widely used smokeless tobacco product in Bangladesh, zarda. Statistical analysis used The descriptive analysis looks at the characteristics of the price distribution of cigarette, bidi, zarda, and gul using the univariate Epanechnikov kernel density estimation. Results It estimates the price elasticity of lower price brands of zarda (the most commonly used smokeless tobacco product in Bangladesh) at -0.64 and of higher-priced brands at -0.39, and the cross-price elasticity of zarda with respect to cigarettes at 0.35. Conclusions The tax increase on smokeless tobacco products needs to be greater than the tax increase on smoked tobacco products to bridge the wide price differential between the two types of products that currently encourages downward substitution and discourages quitting behaviour. Finally, a specific

The Cigarette and Smokeless Tobacco Markets in Texas Relative to the United States.

PubMed

Miller Lo, Erin J; Giovenco, Daniel P; Wackowski, Olivia A; Harrell, Melissa B; Perry, Cheryl L; Delnevo, Cristine D

2017-04-01

This study compares the cigarette and smokeless tobacco (SLT) markets in Texas and the United States (US) as a whole. Nielsen convenience store sales data from 2014 were obtained for Dallas, Houston, San Antonio/Austin, and the total US. Descriptive statistics highlighted market share differences in Texas compared to the US overall. Marlboro and Copenhagen dominated the cigarette (58.9%) and SLT markets (44.8%) in Texas and had substantially higher relative market shares in Texas than nationally (46.7% and 29.8%, respectively). Camel, with sales driven largely by its Camel Crush variety, held second place in Texas (9.8%), outselling Newport (6.6%), despite Newport's status as second best-selling brand in the US (11.5%). Copenhagen led the SLT market in Texas, outselling Grizzly 2 to 1, yet the brands hold roughly equivalent shares nationally. Whereas flavored SLT products made up nearly 60% of the US SLT market, unflavored SLT (58.6%) dominated in Texas markets. Finally, sales of fine-cut SLT in Texas were more than triple their national market share. Regional tobacco market share differences are likely influenced by multiple factors such as marketing, population demographics, culture, and neighboring communities. Policymakers are encouraged to develop local tobacco control policies and programs within the context of this knowledge.

Effects of prenatal alcohol and cigarette exposure on offspring substance use in multiplex, alcohol-dependent families.

PubMed

O'Brien, Jessica W; Hill, Shirley Y

2014-12-01

Prenatal exposures to alcohol, cigarettes, and other drugs of abuse are associated with numerous adverse consequences for affected offspring, including increased risk for substance use and abuse. However, maternal substance use during pregnancy appears to occur more often in those with a family history of alcohol dependence. Utilizing a sample that is enriched for familial alcohol dependence and includes controls selected for virtual absence of familial alcohol dependence could provide important information on the relative contribution of familial risk and prenatal exposures to offspring substance use. A sample of multigenerational families specifically ascertained to be at either high or low risk for developing alcohol dependence (AD) provided biological offspring for a longitudinal prospective study. High-risk families were selected based on the presence of 2 alcohol-dependent sisters. Low-risk families were selected on the basis of minimal first and second-degree relatives with AD. High-risk (HR = 99) and Low-risk offspring (LR = 110) were assessed annually during childhood and biennially in young adulthood regarding their alcohol, drug, and cigarette use. At the first childhood visit, mothers were interviewed concerning their prenatal use of substances. High-risk mothers were more likely to use alcohol, cigarettes, and other drugs during pregnancy than low-risk control mothers, and to consume these substances in greater quantities. Across the sample, prenatal exposure to alcohol was associated with increased risk for both offspring cigarette use and substance use disorders (SUD), and prenatal cigarette exposure was associated with increased risk for offspring cigarette use. Controlling for risk status by examining patterns within the HR sample, prenatal cigarette exposure remained a specific predictor of offspring cigarette use, and prenatal alcohol exposure was specifically associated with increased risk for offspring SUD. Women with a family history of

Adverse Childhood Experiences and Use of Cigarettes and Smokeless Tobacco Products.

PubMed

Alcalá, Héctor E; von Ehrenstein, Ondine S; Tomiyama, A Janet

2016-10-01

Adverse childhood experiences (ACEs) have been linked to increased use of tobacco products later in life. However, studies to date have ignored smokeless tobacco products. To address this, data from the 2011 Behavioral Risk Factor Surveillance System, which interviewed adults 18 years and over (N = 102,716) were analyzed. Logistic regression models were fit to estimate odds ratios of ever smoking, current smoking and current smokeless tobacco use in relation to ACEs. Results showed that less than 4 % of respondents currently used smokeless tobacco products, while 44.95 and 18.57 % reported ever and current smoking, respectively. Physical abuse (OR 1.40; 95 % CI 1.14, 1.72), emotional abuse (OR 1.41; 95 % CI 1.19, 1.67), sexual abuse (OR 0.70; 95 % CI 0.51, 0.95), living with a drug user (OR 1.50; 95 % CI 1.17, 1.93), living with someone who was jailed (OR 1.50; 95 % CI 1.11, 2.02) and having parents who were separated or divorced (OR 1.31; 95 % CI 1.09, 1.57) were associated with smokeless tobacco use in unadjusted models. After accounting for confounders, physical abuse (OR 1.43; 95 % CI 1.16, 1.78), emotional abuse (OR 1.32; 95 % CI 1.10, 1.57), living with a problem drinker (OR 1.30; 95 % CI 1.08, 1.58), living with a drug user (OR 1.31; 95 % CI 1.00, 1.72) and living with adults who treated each other violently (OR 1.30; 95 % CI 1.05, 1.62) were associated with smokeless tobacco use. Living with someone who was mentally ill (OR 0.70; 95 % CI 0.53, 0.92) was associated with smokeless tobacco use after accounting for confounders and all ACEs. Results indicated that some childhood adversities are associated with use of smokeless tobacco products. Special attention is needed to prevent tobacco use of different types among those experiencing ACEs.

Aggression among male alcohol-dependent inpatients who smoke cigarettes.

PubMed

Saatcioglu, Omer; Erim, Rahsan

2009-12-01

The authors aimed to explore the relation between nicotine dependence and the severity of aggression among Turkish male alcohol-dependent inpatients who smoked cigarettes, as well as the effect of aggression in these groups. Participants were 126 male alcohol-dependent inpatients who were given the Structured Clinical Interview for DSM-IV, Substance Use Disorder Module (A. Corapcioglu, O. Aydemir, & M. Yildiz, 1999; M. B. First, R. L. Spitzer, & J. B. W. Williams, 1997), the Fagerstrom Test for Nicotine Dependence (K. O. Fagerstrom, 1978), and the Overt Aggression Scale (OAS; S. C. Yudofsky, J. M. Silver, W. Jackson, J. Endicott, & D. Williams, 1986). The authors found differences between male alcohol-dependent inpatients with nicotine dependence (n = 94) and those with nondependence (n = 32) in OAS subtypes. The authors' findings showed that smoking cigarettes-an addiction frequently observed with alcoholism-was positively correlated with aggressive behaviors. The authors suggest that smoking cigarettes may cause aggression or aggression may cause smoking. Observing and evaluating how aggression and smoking cigarettes are associated with alcohol dependence may help relapse prevention and improve effectiveness of treatment interventions in alcoholism.

Tobacco industry use of flavourings to promote smokeless tobacco products.

PubMed

Kostygina, Ganna; Ling, Pamela M

2016-11-01

While fruit, candy and alcohol characterising flavours are not allowed in cigarettes in the USA, other flavoured tobacco products such as smokeless tobacco (ST) continue to be sold. We investigated tobacco manufacturers' use of flavoured additives in ST products, the target audience(s) for flavoured products, and marketing strategies promoting products by emphasising their flavour. Qualitative analysis of internal tobacco industry documents triangulated with data from national newspaper articles, trade press and internet. Internally, flavoured products have been consistently associated with young and inexperienced tobacco users. Internal studies confirmed that candy-like sweeter milder flavours (eg, mint, fruit) could increase appeal to starters by evoking a perception of mildness, blinding the strong tobacco taste and unpleasant mouth feel; or by modifying nicotine delivery by affecting product pH. Similar to cigarettes, flavoured ST is likely to encourage novices to start using tobacco, and regulations limiting or eliminating flavours in cigarettes should be extended to include flavoured ST products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Usual Source of Cigarettes and Alcohol among US High School Students

ERIC Educational Resources Information Center

Jones, Sherry Everett; Caraballo, Ralph S.

2014-01-01

Background: Cigarette and alcohol use are common among youth. We examined sources of cigarettes and alcohol among youth who were current cigarette and alcohol users. Methods: We analyzed nationally representative data from the 2009 and 2011 national Youth Risk Behavior Surveys--biennial, school-based surveys of high school students in the United…

Advertising receptivity and youth initiation of smokeless tobacco

PubMed Central

2016-01-01

Background Cross-sectional data suggests that adolescents’ receptivity to the advertising of smokeless tobacco is correlated with use of chewing tobacco or snuff. Lack of longitudinal data has precluded determination of whether advertising receptivity precedes or follows initiation of smokeless tobacco. Objectives The objective of this study was to test for the association between advertising receptivity and subsequent initiation of smokeless tobacco among adolescent males. Methods Adolescent males from the 1993–1999 Teen Longitudinal California Tobacco Survey were selected at the baseline survey for never having used smokeless tobacco. Separate longitudinal analyses corresponded to two dependent variables, ever use of smokeless tobacco (1993–1996; n=1,388) and use on 20 or more occasions (1993–1999; n=1,014). Models were adjusted for demographic variables, risk factors for smokeless tobacco use, and exposure to users of smokeless tobacco. Results Advertising receptivity at baseline was predictive of ever use by late adolescence (RR(95% CI)=2.0 (1.3, 3.1)) and regular use by young adulthood (RR(95% CI)=3.7 (2.0, 7.0)) in models that were adjusted for covariates. Conclusions/Importance The findings challenge the tobacco industry’s assertion that tobacco marketing does not impact youth initiation. This is particularly relevant to tobacco control in the United States because the 2009 Tobacco Control Act places fewer restrictions on smokeless tobacco products compared to cigarettes. PMID:27159627

Developing smokeless tobacco products for smokers: an examination of tobacco industry documents.

PubMed

Carpenter, C M; Connolly, G N; Ayo-Yusuf, O A; Wayne, G Ferris

2009-02-01

To investigate whether development of smokeless tobacco products (SLT) is intended to target current smokers. This study analysed internal tobacco industry documents to describe research related to the smokeless tobacco market. Relevant documents included those detailing the development and targeting of SLT products with a particular emphasis on moist snuff. Cigarette and SLT manufacturers recognised that shifting demographics of SLT users, as well as indoor smoking restrictions, health concerns and reduced social acceptability of smoking could impact the growth of the SLT market. Manufacturers developed new SLT products to target cigarette smokers promoting dual cigarette and SLT use. Heavy marketing of new SLT products may encourage dual use and result in unknown public health effects. SLT products have been designed to augment cigarette use and offset regulatory strategies such as clean indoor air laws. In the United States, the SLT strategy may provide cigarette companies with a diversified range of products under the prospect of federal regulation. These products may pose significant challenges to efforts by federal agencies to reduce harm caused by tobacco use.

Smokeless tobacco product prices and taxation in Bangladesh: findings from the International Tobacco Control Survey.

PubMed

Nargis, N; Hussain, A K M G; Fong, G T

2014-12-01

Smokeless tobacco use occupies a significant portion of overall tobacco consumption in Bangladesh. Yet very little is known about the effectiveness of tax and price policy in controlling the use of smokeless tobacco use in the country. The paper examines the price distribution of various smoked (cigarette, bidi) and smokeless tobacco products (zarda, gul) using the univariate Epanechnikov kernel density function. It estimates the own and cross price elasticity of demand for the most widely used smokeless tobacco product zarda using two-step regression analysis. The analysis is based on data from the ITC Bangladesh Wave 3 Survey which is a nationally representative cohort survey of tobacco users and nonusers conducted in in Bangladesh during 2011-12. The price elasticity of lower price brands of zarda is estimated at -0.64 and of higher priced brands at -0.39, and the cross price elasticity of zarda with respect to cigarette price at 0.35. The tax increase on smokeless tobacco needs to be greater than the tax increase on smoked tobacco to bridge the wide price differential between the two types of products that currently encourages downward substitution from smoked to smokeless tobacco and discourages quitting behavior. This paper argues that increasing tax on smokeless tobacco simultaneously with the tax increase on smoked tobacco can have significant negative impact on the prevalence of smokeless tobacco use in Bangladesh. Finally, a specific excise system replacing the existing ad valorem excise tax can substantially contribute to the revenue collection performance from smokeless tobacco products.

Perceptions of e-Cigarettes and Noncigarette Tobacco Products Among US Youth.

PubMed

Amrock, Stephen M; Lee, Lily; Weitzman, Michael

2016-11-01

Electronic cigarettes (e-cigarettes) are now the most commonly used tobacco product among US youth. The extent to which perceptions of e-cigarettes' harm and addictiveness differ from those of other products remains unknown, as does whether these perceptions have changed over time. Data from the 2012 and 2014 National Youth Tobacco Survey, a repeated cross-sectional survey of grade 6 to 12 students, were used. Cross-tabulations and logistic regression models were used to describe correlates of perceptions of harm and addictiveness of e-cigarettes, cigars, and smokeless tobacco compared with cigarettes. Trends in perceptions of e-cigarettes' harm among different demographic groups were also assessed. In 2014, 73.0% believed that e-cigarettes were less harmful than cigarettes, compared with 20.2% for smokeless tobacco and 25.8% for cigars. By comparison, 47.1% believed that e-cigarettes were less addictive than cigarettes, compared with only 14.0% for smokeless tobacco and 31.5% for cigars. Use of each product was associated with a perception of decreased harm and addictiveness in adjusted analyses, as was being male, being a non-Hispanic white, and residing with a household member who used that product. Between 2012 and 2014, increasing numbers of US youth thought they were able to assess the relative harm of e-cigarettes and increasingly believed that e-cigarettes are less harmful than cigarettes. Most US youth view e-cigarettes as less harmful and addictive than cigarettes. Far fewer think similarly about cigars and smokeless tobacco. Increases in e-cigarettes' perceived safety mirrors rapid increases observed in their use. Perceived safety correlates with use of each tobacco product. Copyright © 2016 by the American Academy of Pediatrics.

Using Alcohol to Sell Cigarettes to Young Adults: A Content Analysis of Cigarette Advertisements

ERIC Educational Resources Information Center

Belstock, Sarah A.; Connolly, Gregory N.; Carpenter, Carrie M.; Tucker, Lindsey

2008-01-01

Objective: Advertising influences the health-related behaviors of college-aged individuals. Cigarette manufacturers aggressively market to young adults and may exploit their affinity for alcohol when creating advertisements designed to increase cigarettes' appeal. Internal tobacco industry documents reveal that cigarette manufacturers understood…

The Cigarette and Smokeless Tobacco Markets in Texas Relative to the United States

PubMed Central

Miller Lo, Erin J.; Giovenco, Daniel P.; Wackowski, Olivia A.; Harrell, Melissa B.; Perry, Cheryl L.; Delnevo, Cristine D.

2017-01-01

Objective This study compares the cigarette and smokeless tobacco (SLT) markets in Texas and the United States (US) as a whole. Methods Nielsen convenience store sales data from 2014 were obtained for Dallas, Houston, San Antonio/Austin, and the total US. Descriptive statistics highlighted market share differences in Texas compared to the US overall. Results Marlboro and Copenhagen dominated the cigarette (58.9%) and SLT markets (44.8%) in Texas and had substantially higher relative market shares in Texas than nationally (46.7% and 29.8%, respectively). Camel, with sales driven largely by its Camel Crush variety, held second place in Texas (9.8%), outselling Newport (6.6%), despite Newport’s status as second best-selling brand in the US (11.5%). Copenhagen led the SLT market in Texas, outselling Grizzly 2 to 1, yet the brands hold roughly equivalent shares nationally. Whereas flavored SLT products made up nearly 60% of the US SLT market, unflavored SLT (58.6%) dominated in Texas markets. Finally, sales of fine-cut SLT in Texas were more than triple their national market share. Conclusions Regional tobacco market share differences are likely influenced by multiple factors such as marketing, population demographics, culture, and neighboring communities. Policymakers are encouraged to develop local tobacco control policies and programs within the context of this knowledge. PMID:28345014

Childhood Cigarette and Alcohol Use: Negative Links with Adjustment

PubMed Central

Staff, Jeremy; Maggs, Jennifer; Cundiff, Kelsey; Evans-Polce, Rebecca J.

2016-01-01

Children who initiate cigarette or alcohol use early—during childhood or early adolescence—experience a heightened risk of nicotine and alcohol dependence in later life as well as school failure, crime, injury, and mortality. Using prospective intergenerational data from the Millennium Cohort Study (MCS), we investigate the association between early substance use initiation (cigarettes or alcohol) and age 11 school engagement, academic achievement, and wellbeing. The ongoing MCS tracks the development of a nationally representative sample of children in the United Kingdom (born 2000–2002) from infancy through adolescence. At age 11, MCS children (n=13,221) indicated whether they had ever used cigarettes or alcohol; at age 7 and 11 they reported on school engagement and wellbeing and completed investigator-assessed tests of academic achievement. Using propensity score methods, children who had initiated cigarette or alcohol use by age 11 were matched to abstaining children with similar risks (or propensities) of early substance use, based on numerous early life risk and protective factors assessed from infancy to age 7. We then examined whether early initiators differed from non-initiators in age 11 adjustment and achievement. Results show that substance use by age 11 was uncommon (3% cigarettes; 13% alcohol). After matching for propensity for early initiation, school engagement and wellbeing were significantly lower among initiators compared to non-initiators. Academic achievement was not consistently related to early initiation. We conclude that initiation of smoking and drinking in childhood is associated with poorer adjustment. PMID:27347653

The effects of alcohol-containing e-cigarettes on young adult smokers.

PubMed

Valentine, Gerald W; Jatlow, Peter I; Coffman, Marcedes; Nadim, Haleh; Gueorguieva, Ralitza; Sofuoglu, Mehmet

2016-02-01

The liquids (e-liquids) used in an electronic cigarette (e-cigarette) contain myriad chemicals without adequate human inhalation safety data. Furthermore, the absence of e-liquid labeling requirements poses a formidable challenge to understanding how e-liquid constituents may promote nicotine addiction and/or have independent or synergistic biological effects when combined with nicotine. Ethyl alcohol is such a constituent, but has received little scientific interest in this context. Using a randomized, double blind, crossover design, acute changes in subjective drug effects, motor performance and biochemical measures of alcohol and nicotine intake were evaluated after directed and ad lib puffing from two commercially available e-liquids containing nicotine (8 mg/ml), vanilla flavor and either 23.5% (high) or 0.4% (trace) alcohol. While no differences in subjective drug effects were observed between alcohol conditions, performance on the Purdue Pegboard Dexterity Test (PPDT) improved under the trace, but not under the 23.5% alcohol condition. Although plasma alcohol levels remained undetectable during testing, urine ethyl glucuronide (EtG), an alcohol metabolite, became measurable in three participants after puffing from the 23.5% alcohol e-cigarette. Brief use of a widely available type of e-cigarette containing an e-liquid purchased from an internet vendor can negatively impact psychomotor performance and in some instances, produce detectable levels of a urine alcohol metabolite. Given the widespread and unregulated use of e-cigarettes, especially by youth and other vulnerable populations, further studies are needed to evaluate both the acute safety and long-term health risks of using alcohol-containing e-cigarettes. Published by Elsevier Ireland Ltd.

Smokers who are also using smokeless tobacco products in the US: a national assessment of characteristics, behaviours and beliefs of 'dual users'.

PubMed

McClave-Regan, Annette K; Berkowitz, Judy

2011-05-01

Marketing and advertising of smokeless tobacco products towards cigarette smokers has increased recently. Because the use of multiple tobacco products is a growing public health concern, the present work assesses the use of smokeless tobacco among cigarette smokers, a behaviour termed as 'dual use', as well as attitudes and beliefs on their 'dual use' of tobacco. Data were used from the 2008 Consumer Styles survey, a nationally representative, mail-in survey of consumers in the USA (n=10,108). 'Dual use' was more common among cigarette smokers who were young, white men living in the Midwest or South. The majority of 'dual users' reported using smokeless tobacco in places where they could not smoke (67.7%) and did not believe smokeless tobacco would help in quitting smoking (75.1%). 'Dual users' reported planning to quit within the next 6 months less often than adults who smoke cigarettes exclusively and close to half (42.3%) never plan to quit smoking. Tobacco use is attributed to a number of diseases and deaths worldwide, and cessation of tobacco use can reduce these health risks. The prevalent use of smokeless tobacco in places with smoking restrictions and lack of planning to quit by 'dual users' suggest the need to promote cessation among these users.

Perceptions of e-Cigarettes and Noncigarette Tobacco Products Among US Youth

PubMed Central

Lee, Lily; Weitzman, Michael

2016-01-01

BACKGROUND: Electronic cigarettes (e-cigarettes) are now the most commonly used tobacco product among US youth. The extent to which perceptions of e-cigarettes’ harm and addictiveness differ from those of other products remains unknown, as does whether these perceptions have changed over time. METHODS: Data from the 2012 and 2014 National Youth Tobacco Survey, a repeated cross-sectional survey of grade 6 to 12 students, were used. Cross-tabulations and logistic regression models were used to describe correlates of perceptions of harm and addictiveness of e-cigarettes, cigars, and smokeless tobacco compared with cigarettes. Trends in perceptions of e-cigarettes’ harm among different demographic groups were also assessed. RESULTS: In 2014, 73.0% believed that e-cigarettes were less harmful than cigarettes, compared with 20.2% for smokeless tobacco and 25.8% for cigars. By comparison, 47.1% believed that e-cigarettes were less addictive than cigarettes, compared with only 14.0% for smokeless tobacco and 31.5% for cigars. Use of each product was associated with a perception of decreased harm and addictiveness in adjusted analyses, as was being male, being a non-Hispanic white, and residing with a household member who used that product. Between 2012 and 2014, increasing numbers of US youth thought they were able to assess the relative harm of e-cigarettes and increasingly believed that e-cigarettes are less harmful than cigarettes. CONCLUSIONS: Most US youth view e-cigarettes as less harmful and addictive than cigarettes. Far fewer think similarly about cigars and smokeless tobacco. Increases in e-cigarettes’ perceived safety mirrors rapid increases observed in their use. Perceived safety correlates with use of each tobacco product. PMID:27940754

Hazards of cigarettes, smokeless tobacco and waterpipe in a Middle Eastern Population: a Cohort Study of 50 000 individuals from Iran.

PubMed

Etemadi, Arash; Khademi, Hooman; Kamangar, Farin; Freedman, Neal D; Abnet, Christian C; Brennan, Paul; Malekzadeh, Reza

2017-11-01

There is limited information about the hazards of cigarettes, smokeless tobacco and waterpipe in the Middle East. The aim of this study was to determine the association between different types of tobacco use and earlier death in the Golestan Cohort Study. The Study includes 50 045 adults (aged 40-75 years) from north eastern Iran. The baseline questionnaire (2004-2008) assessed information about use of cigarettes, chewing tobacco (nass) and waterpipe. To assess the use of each type of tobacco compared with never tobacco users, we used Cox regression models adjusted for age, socioeconomic status, area of residence, education and other tobacco used, and stratified by sex, ethnicity and opium use. 17% of participants reported a history of cigarette smoking, 7.5% chewing tobacco (nass) and 1.1% smoking waterpipe, and these figures declined in the later birth cohorts. During a median follow-up of 8 years, 4524 deaths occurred (mean age 64.8+9.9 years). Current (HR=1.44; 95% CI 1.28 to 1.61) and former (HR=1.35; 95% CI 1.16 to 1.56) cigarette smokers had higher overall mortality relative to never tobacco users. The highest cigarette-associated risk was for cancer death among current heavy smokers (HR=2.32; 95% CI 1.66 to 3.24). Current nass chewing was associated with overall mortality (HR=1.16; 95% CI 1.01 to 1.34), and there was a 61% higher risk of cancer death in people chewing nass more than five times a day. We observed an association between the cumulative lifetime waterpipe use (waterpipe-years≥28) and both overall (HR=1.66; 95% CI 1.11 to 2.47), and cancer mortality (HR=2.82; 95% CI 1.30 to 6.11). Regular use of cigarettes, smokeless tobacco and waterpipe were associated with the risk of earlier death (particularly from cancer) in our cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relationship of nicotine deprivation and indices of alcohol use behavior to implicit alcohol and cigarette approach cognitions in smokers.

PubMed

Cohn, Amy; Ehlke, Sarah; Cobb, Caroline O

2017-04-01

Alcohol and smoking frequently co-occur and alcohol is a primary trigger for smoking behavior and relapse back to smoking. This study examined whether several indices of alcohol use behavior and consequences of use would be associated with changes in implicit alcohol-approach versus implicit cigarette-approach cognitions under cigarette deprived and non-deprived cognitions in 109 smokers who drank at risky or non-risky levels. An Implicit Association Task (IAT) measured how quickly respondents paired alcohol and cigarette pictures with approach and avoid words. Regression analyses examined the associations of quantity/frequency, proportion heavy drinking days, number of DSM-IV alcohol use disorder (AUD) symptoms, and risky drinking status to IAT scores under deprived conditions, controlling for IAT order effects, non-deprived IAT score, and deprived cigarette craving and withdrawal. Interactions with craving and withdrawal intensity were also examined. Results showed a significant positive association between proportion of heavy drinking days and stronger alcohol-approach than cigarette-approach motivations when deprived. There was also a conditional association of AUD symptoms to alcohol-approach motivations among respondents reporting more intense withdrawal when deprived. Alcohol quantity and frequency, as well as risky drinking status were unrelated to change in IAT scores. Findings suggest that cigarette deprivation may magnify motivation to drink, rather than smoke, among smokers who engage in more frequent bouts of heavy drinking and who report more alcohol-related problems. Results also show relative momentary and unconscious "preference" or choice for alcohol over cigarettes in some high-risk smokers, when cigarette craving and withdrawal are high. Copyright © 2016 Elsevier Ltd. All rights reserved.

Young adults report increased pleasure from smoking cigarettes when drinking alcohol but not when using marijuana.

PubMed

Gubner, Noah R; Thrul, Johannes; Kelly, Oona A; Ramo, Danielle E

2018-01-01

Among young adults, cigarette smoking is strongly associated with alcohol and marijuana use. The present study compared self-reported co-use of cigarettes and alcohol versus cigarettes and marijuana among young adults using cross-sectional survey data. Participants were young adult cigarette smokers (age 18 to 25) who also reported past month alcohol or marijuana use enrolled in a randomized trial testing a smoking cessation intervention on Facebook. Participants self-reported extent of cigarette smoking under the influence of alcohol or marijuana and differences in perceived pleasure from cigarette smoking when drinking alcohol compared to using marijuana. Among cigarette smokers who drank alcohol and used marijuana in the past month (n=200), a similar percentage of cigarettes were smoked under the influence of alcohol (42.4%±31.2%) and marijuana (43.1% ±30.0%). Among alcohol + marijuana users, perceived pleasure from smoking cigarettes was significantly greater when drinking alcohol versus when using marijuana (t (199) =7.05, p<0.001). There was, on average, an increase in perceived pleasure from smoking cigarettes when drinking alcohol, though perceived pleasure did not differ by binge drinking frequency. In contrast, there was on average no change in perceived pleasure from smoking cigarettes when using marijuana. Results from the cigarette smokers who used alcohol + marijuana were similar to cigarette smokers who only used alcohol (n=158) or only used marijuana (n=54). Findings highlight greater perceived reward from smoking cigarettes when drinking alcohol compared to when using marijuana, informing smoking cessation interventions that target users of multiple substances.

Cigarette Users’ Interest in Using or Switching to Electronic Nicotine Delivery Systems for Smokeless Tobacco for Harm Reduction, Cessation, or Novelty: A Cross-Sectional Survey of US Adults

PubMed Central

Haardoerfer, Regine; Escoffery, Cam; Zheng, Pinpin; Kegler, Michelle

2015-01-01

Introduction: We examined: (a) current (past 30-day) smokers’ interest in using or switching to electronic nicotine delivery systems (ENDS) or smokeless tobacco for various reasons; (b) correlates of interest in these products; and (c) subgroups of current smokers in relation to interest in these products. Methods: We conducted a cross-sectional survey assessing sociodemographics, tobacco use, interest in ENDS and smokeless tobacco among smokers, and knowledge about ENDS among 2,501US adults recruited through an online consumer panel. We oversampled tobacco users (36.7% current cigarette smokers), ethnic minorities, and southeastern US state residents. Results: On average, participants were more interested in ENDS than smokeless tobacco across all reasons provided. Additionally, they were less interested in either product because of their potential use in places prohibiting smoking or due to curiosity and more interested in reducing health risk or cigarette consumption or to aid in cessation. We documented high rates (27.9%) of misbeliefs about Food and Drug Administration approval of ENDS for cessation, particularly among current smokers (38.5%). Also, 27.2% of current smokers had talked with a health care provider about ENDS, with 18.0% reporting that their provider endorsed ENDS use for cessation. Furthermore, cluster analyses revealed 3 groups distinct in their interest in the products, sociodemographics, and smoking-related characteristics. Conclusions: This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions. Developing educational campaigns and informing practitioners about caveats around ENDS as cessation or harm reduction aids are critical. PMID:24951496

Smokeless tobacco, sport and the heart.

PubMed

Chagué, Frédéric; Guenancia, Charles; Gudjoncik, Aurélie; Moreau, Daniel; Cottin, Yves; Zeller, Marianne

2015-01-01

Smokeless tobacco (snuff) is a finely ground or shredded tobacco that is sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek. Smokeless tobacco is widely used by young athletes to enhance performance because nicotine improves some aspects of physiology. However, smokeless tobacco has harmful health effects, including cardiovascular disorders, linked to nicotine physiological effects, mainly through catecholamine release. Nicotine decreases heart rate variability and the ventricular fibrillation threshold, and promotes the occurrence of various arrhythmias; it also impairs endothelial-dependent vasodilation and could therefore promote premature atherogenesis. At rest, heart rate, blood pressure, inotropism, cardiac output and myocardial oxygen consumption are increased by nicotine, leading to an imbalance between myocardial oxygen demand and supply. The same occurs at submaximal levels of exercise. These increases are accompanied by a rise in systemic resistances. At maximal exercise, heart rate, cardiac output and maximal oxygen uptake (V˙O2max) are unaffected by nicotine. Because endothelial dysfunction is promoted by nicotine, paradoxical coronary vasoconstriction may occur during exercise and recovery. Nicotine induces a decrease in muscular strength and impairs anaerobic performance. However, nicotine is used in sports as it diminishes anxiety, enhances concentration and agility, improves aerobic performance and favours weight control. Importantly, smokeless tobacco, similar to cigarette smoking, leads to nicotine dependence through dopaminergic pathways. Smokeless tobacco has harmful cardiovascular effects and is addictive: it fulfils all the criteria for inclusion in the World Anti-Doping Agency prohibited list as a doping product. Smokeless tobacco use in sporting activities must be discouraged. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Neurobiological and neurocognitive effects of chronic cigarette smoking and alcoholism.

PubMed

Durazzo, Timothy C; Meyerhoff, Dieter J

2007-05-01

Chronic cigarette smoking is associated with adverse effects on cardiac, pulmonary, and vascular function as well as the increased risk for various forms of cancer. However, little is known about the effects of chronic smoking on human brain function. Although smoking rates have decreased in the developed world, they remain high in individuals with alcohol use disorders (AUD) and other neuropsychiatric conditions. Despite the high prevalence of chronic smoking in AUD, few studies have addressed the potential neurobiological or neurocognitive consequences of chronic smoking in alcohol use disorders. Here, we review the the neurobiological and neurocognitive findings in both AUD and chronic cigarette smoking, followed by a review of the effects of comorbid cigarette smoking on neurobiology and neurocognition in AUD. Recent research suggests that comorbid chronic cigarette smoking modulates magnetic resonance-detectable brain injury and neurocognition in alcohol use disorders and adversely affects neurobiological and neurocognitive recovery in abstinent alcoholics.. Consideration of the potential separate and interactive effects of chronic smoking and alcohol use disorders may have significant implications for pharmacological and behavioral treatment interventions.

Cigarette Smoking Predicts Differential Benefit from Naltrexone for Alcohol Dependence

PubMed Central

Fucito, Lisa M.; Park, Aesoon; Gulliver, Suzy Bird; Mattson, Margaret E.; Gueorguieva, Ralitza V.; O’Malley, Stephanie S.

2012-01-01

Background Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism. Methods We examined the association between cigarette smoking and drinking outcomes in the COMBINE study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management (MM), combined behavioral therapy (CBI)) in 1383 alcohol dependent individuals. Results Smokers (i.e., more than half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received CBI or MM and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment. Conclusions These results suggest that naltrexone may be particularly beneficial for improving alcohol use outcomes in alcohol dependent smokers. Trial Registration The COMBINE Study, NCT000626, http://www.cscc.unc.edu/combine/. PMID:22541040

Cigarette users' interest in using or switching to electronic nicotine delivery systems for smokeless tobacco for harm reduction, cessation, or novelty: a cross-sectional survey of US adults.

PubMed

Berg, Carla J; Haardoerfer, Regine; Escoffery, Cam; Zheng, Pinpin; Kegler, Michelle

2015-02-01

We examined: (a) current (past 30-day) smokers' interest in using or switching to electronic nicotine delivery systems (ENDS) or smokeless tobacco for various reasons; (b) correlates of interest in these products; and (c) subgroups of current smokers in relation to interest in these products. We conducted a cross-sectional survey assessing sociodemographics, tobacco use, interest in ENDS and smokeless tobacco among smokers, and knowledge about ENDS among 2,501 US adults recruited through an online consumer panel. We oversampled tobacco users (36.7% current cigarette smokers), ethnic minorities, and southeastern US state residents. On average, participants were more interested in ENDS than smokeless tobacco across all reasons provided. Additionally, they were less interested in either product because of their potential use in places prohibiting smoking or due to curiosity and more interested in reducing health risk or cigarette consumption or to aid in cessation. We documented high rates (27.9%) of misbeliefs about Food and Drug Administration approval of ENDS for cessation, particularly among current smokers (38.5%). Also, 27.2% of current smokers had talked with a health care provider about ENDS, with 18.0% reporting that their provider endorsed ENDS use for cessation. Furthermore, cluster analyses revealed 3 groups distinct in their interest in the products, sociodemographics, and smoking-related characteristics. This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions. Developing educational campaigns and informing practitioners about caveats around ENDS as cessation or harm reduction aids are critical. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Increased cigarette tax is associated with reductions in alcohol consumption in a longitudinal U.S. sample.

PubMed

Young-Wolff, Kelly C; Kasza, Karin A; Hyland, Andrew J; McKee, Sherry A

2014-01-01

Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and

INCREASED CIGARETTE TAX IS ASSOCIATED WITH REDUCTIONS IN ALCOHOL CONSUMPTION IN A LONGITUDINAL U.S. SAMPLE

PubMed Central

Young-Wolff, Kelly C.; Kasza, Karin A.; Hyland, Andrew J.; McKee, Sherry A.

2013-01-01

Background Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample. Method Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves I (2001–2002) and II (2004–2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group. Results Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among non-smokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category. Conclusions Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette

The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep.

PubMed

Sabanayagam, Charumathi; Shankar, Anoop

2011-01-01

Studies have shown that cigarette smoking is associated with sleep disorders in the general population. But studies examining the association between smokeless tobacco use, second-hand smoke exposure and insufficient rest/sleep are limited. We examined the association between smoking, smokeless tobacco use (n=83,072), second-hand smoke exposure (n=28,557) and insufficient rest/sleep among adults aged ≥20 years in the state-based 2008 Behavioral Risk Factor Surveillance System. Exposure to second-hand smoke was defined as >1 day of exposure to cigarette smoking either at home or in the workplace in the preceding 7 days. Insufficient rest/sleep was defined as not getting enough rest/sleep everyday in the preceding 30 days. Compared to never smokeless tobacco users, the odds ratio (OR; 95% confidence interval [CI]) of insufficient rest/sleep was 1.16 (1.00-1.36) and 1.74 (1.37-2.22) among former and current users. Compared to non-smokers/non-smokeless tobacco users, the OR (95% CI) of insufficient rest/sleep for those who were both current smokers and current smokeless tobacco users was 2.21 (1.66-2.94). Regarding second-hand smoke exposure among non-smokers, those with second-hand smoke exposure had higher odds for insufficient rest/sleep than those without. In contrast, the odds of insufficient rest/sleep were similar among current smokers with or without second-hand smoke exposure. In a multiethnic sample of US adults, compared to non-smokers/non-smokeless tobacco users, those who were both current smokers and current smokeless tobacco users had twice the odds of insufficient sleep. Second-hand smoke exposure was associated with insufficient rest/sleep among non-smokers. Copyright © 2010 Elsevier B.V. All rights reserved.

Lifetime risk of distinct upper aerodigestive tract cancers and consumption of alcohol, betel and cigarette.

PubMed

Hsu, Wan-Lun; Chien, Yin-Chu; Chiang, Chun-Ju; Yang, Hwai-I; Lou, Pei-Jen; Wang, Cheng-Ping; Yu, Kelly J; You, San-Lin; Wang, Li-Yu; Chen, Shu-Yuan; Yang, Czau-Siung; Chen, Chien-Jen

2014-09-15

The cancer of upper aerodigestive tract (UADT) is a common cancers in the world. However, its lifetime risk by consumption of alcohol, betel and cigarettes remain to be elucidated. This study aimed to estimate lifetime risk of distinct UADT cancers and assess their associations with alcohol, betel and cigarette consumption. Three cohorts of 25,611 men were enrolled in 1982-1992 in Taiwan. The history of alcohol, betel and cigarette consumption was enquired through questionnaire interview. Newly developed UADT cancers were ascertained through computerized linkage with national cancer registry profile. Lifetime (30-80 years old) risk and multivariate-adjusted hazard ratio (HRadj) of distinct UADT cancers by alcohol, betel and cigarette consumption were estimated. A total of 269 pathologically confirmed cases of UADT cancers were newly-diagnosed during 472,096 person-years of follow-up. The lifetime risk of UADT cancer was 9.42 and 1.65% for betel chewers and nonchewers, 3.22 and 1.21% for cigarette smokers and nonsmokers and 4.77 and 1.85% for alcohol drinkers and nondrinkers. The HRadj (95% confidence interval) of developing UADT cancer was 3.36 (2.51-4.49), 2.02 (1.43-2.84), 1.90 (1.46-2.49), respectively, for the consumption of betel, cigarette and alcohol. Alcohol, betel and cigarette had different effect on cancers at various anatomical sites of UADT. The cancer risk from the mouth, pharynx, esophagus to larynx increased for alcohol and cigarette consumption, but decreased for betel consumption. Alcohol, betel and cigarette consumption are independent risk predictors for distinct UADT cancers. © 2014 UICC.

Other tobacco product and electronic cigarette use among homeless cigarette smokers

PubMed Central

Baggett, Travis P.; Campbell, Eric G.; Chang, Yuchiao; Rigotti, Nancy A.

2016-01-01

Objective We determined the prevalence and correlates of other tobacco product and electronic cigarette (e-cigarette) use in a clinic-based sample of homeless cigarette smokers. Methods In April-July 2014, we used time-location sampling to conduct a cross-sectional, in-person survey of 306 currently homeless adult cigarette smokers recruited from 5 clinical sites at Boston Health Care for the Homeless Program. We assessed past-month use of large cigars, little cigars, smokeless tobacco, and e-cigarettes. Among those who had used e-cigarettes, we assessed the reasons for doing so. We used logistic regression analysis to identify the participant characteristics associated with the use of each product. Results Eighty-six percent of eligible individuals participated in the survey. In the past month, 37% of respondents used large cigars, 44% used little cigars, 8% used smokeless tobacco, 24% used an e-cigarette, and 68% used any of these products. Reasons for e-cigarette use included curiosity (85%) and to help quit conventional cigarettes (69%). In multivariable regression analyses, homeless smokers with greater subsistence difficulties were more likely to use little cigars (p=0.01) and less likely to use e-cigarettes (p=0.001). Non-Hispanic black (p=0.01), Hispanic (p<0.001), and rough-sleeping (p=0.04) participants were more likely to use large cigars. Readiness to quit was not associated with other tobacco product use but was significantly associated with e-cigarette use to help quit smoking (p=0.02). Conclusions Health care providers who serve homeless people should consider routine screening for the use of other tobacco products and e-cigarettes to help guide smoking cessation discussions and tobacco treatment planning. PMID:27128808

Other tobacco product and electronic cigarette use among homeless cigarette smokers.

PubMed

Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Rigotti, Nancy A

2016-09-01

We determined the prevalence and correlates of other tobacco product and electronic cigarette (e-cigarette) use in a clinic-based sample of homeless cigarette smokers. In April-July 2014, we used time-location sampling to conduct a cross-sectional, in-person survey of 306 currently homeless adult cigarette smokers recruited from 5 clinical sites at Boston Health Care for the Homeless Program. We assessed past-month use of large cigars, little cigars, smokeless tobacco, and e-cigarettes. Among those who had used e-cigarettes, we assessed the reasons for doing so. We used logistic regression analysis to identify the participant characteristics associated with the use of each product. Eighty-six percent of eligible individuals participated in the survey. In the past month, 37% of respondents used large cigars, 44% used little cigars, 8% used smokeless tobacco, 24% used an e-cigarette, and 68% used any of these products. Reasons for e-cigarette use included curiosity (85%) and to help quit conventional cigarettes (69%). In multivariable regression analyses, homeless smokers with greater subsistence difficulties were more likely to use little cigars (p=0.01) and less likely to use e-cigarettes (p=0.001). Non-Hispanic black (p=0.01), Hispanic (p<0.001), and rough-sleeping (p=0.04) participants were more likely to use large cigars. Readiness to quit was not associated with other tobacco product use but was significantly associated with e-cigarette use to help quit smoking (p=0.02). Health care providers who serve homeless people should consider routine screening for the use of other tobacco products and e-cigarettes to help guide smoking cessation discussions and tobacco treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparative In Vitro Toxicity Profile of Electronic and Tobacco Cigarettes, Smokeless Tobacco and Nicotine Replacement Therapy Products: E-Liquids, Extracts and Collected Aerosols

PubMed Central

Misra, Manoj; Leverette, Robert D.; Cooper, Bethany T.; Bennett, Melanee B.; Brown, Steven E.

2014-01-01

The use of electronic cigarettes (e-cigs) continues to increase worldwide in parallel with accumulating information on their potential toxicity and safety. In this study, an in vitro battery of established assays was used to examine the cytotoxicity, mutagenicity, genotoxicity and inflammatory responses of certain commercial e-cigs and compared to tobacco burning cigarettes, smokeless tobacco (SLT) products and a nicotine replacement therapy (NRT) product. The toxicity evaluation was performed on e-liquids and pad-collected aerosols of e-cigs, pad-collected smoke condensates of tobacco cigarettes and extracts of SLT and NRT products. In all assays, exposures with e-cig liquids and collected aerosols, at the doses tested, showed no significant activity when compared to tobacco burning cigarettes. Results for the e-cigs, with and without nicotine in two evaluated flavor variants, were very similar in all assays, indicating that the presence of nicotine and flavors, at the levels tested, did not induce any cytotoxic, genotoxic or inflammatory effects. The present findings indicate that neither the e-cig liquids and collected aerosols, nor the extracts of the SLT and NRT products produce any meaningful toxic effects in four widely-applied in vitro test systems, in which the conventional cigarette smoke preparations, at comparable exposures, are markedly cytotoxic and genotoxic. PMID:25361047

Flavoured non-cigarette tobacco product use among US adults: 2013–2014

PubMed Central

Bonhomme, Michèle G; Holder-Hayes, Enver; Ambrose, Bridget K; Tworek, Cindy; Feirman, Shari P; King, Brian A; Apelberg, Benjamin J

2017-01-01

Introduction Limited data exist on flavoured non-cigarette tobacco product (NCTP) use among US adults. Methods Data from the 2013 to 2014 National Adult Tobacco Survey (N=75 233), a landline and cellular telephone survey of US adults aged ≥18, were assessed to estimate past 30-day NCTP use, flavoured NCTP use and flavour types using bivariate analyses. Results During 2013–2014, 14.4% of US adults were past 30-day NCTP users. Nationally, an estimated 10.2 million e-cigarette users (68.2%), 6.1 million hookah users (82.3%), 4.1 million cigar smokers (36.2%) and 4.0 million smokeless tobacco users (50.6%) used flavoured products in the past 30 days. The most prevalent flavours reported were menthol/mint (76.9%) for smokeless tobacco; fruit (74.0%) for hookah; fruit (52.4%), candy/chocolate/other sweet flavours (22.0%) and alcohol (14.5%) for cigars/cigarillos/filtered little cigars; fruit (44.9%), menthol/mint (43.9%) and candy/chocolate/other sweet flavours (25.7%) for e-cigarettes and fruit (56.6%), candy/chocolate/other sweet flavours (26.5%) and menthol/mint (24.8%) for pipes. Except for hookah and pipes, past 30-day flavoured product use was highest among 18–24-year olds. By cigarette smoking, never smoking e-cigarette users (84.8%) were more likely to report flavoured e-cigarette use, followed by recent former smokers (78.1%), long-term former smokers (70.4%) and current smokers (63.2%). Conclusions Flavoured NCTP use is prominent among US adult tobacco users, particularly among e-cigarette, hookah and cigar users. Flavoured product use, especially fruit and sweet-flavoured products, was higher among younger adults. It is important for tobacco prevention and control strategies to address all forms of tobacco use, including flavoured tobacco products. PMID:27794065

Beyond the brotherhood: Skoal Bandits' role in the evolution of marketing moist smokeless tobacco pouches.

PubMed

Hendlin, Yogi H; Veffer, Jessica R; Lewis, M Jane; Ling, Pamela M

2017-01-01

Since 2006, "snus" smokeless tobacco has been sold in the U.S.. However, U.S. Smokeless Tobacco (USST) and Swedish Match developed and marketed pouched moist snuff tobacco (MST) since 1973. Analysis of previously secret tobacco documents, advertisements and trade press. USST partnered with Swedish Match, forming United Scandia International to develop pouch products as part of the "Lotus Project." Pouched MST was not commonly used, either in Sweden or the U.S. prior to the Lotus Project's innovation in 1973. The project aimed to transform smokeless tobacco from being perceived as an "unsightly habit of old men" into a relevant, socially acceptable urban activity, targeting 15-35 year-old men. While USST's initial pouched product "Good Luck," never gained mainstream traction, Skoal Bandits captured significant market share after its 1983 introduction. Internal market research found that smokers generally used Skoal Bandits in smokefree environments, yet continued to smoke cigarettes in other contexts. Over time, pouch products increasingly featured increased flavor, size, nicotine strength and user imagery variation. Marlboro and Camel Snus advertising mirrors historical advertising for Skoal Bandits, designed to recruit new users and smokers subjected to smokefree places. Despite serious efforts, pouched MST marketing has been unable to dispel its association with traditional smokeless tobacco stereotypes as macho and rural. Public education efforts to discourage new users and dual use of MST and cigarettes should emphasize that "new" pouch products are simply repackaging "old" smokeless tobacco.

Smokeless tobacco use and perceptions of risk among students in Mumbai municipal schools.

PubMed

Rose, M L; Chadha, D; Bhutia, T D

2016-01-01

Nearly 15% of youth in India use tobacco. However, few studies have explored the use, knowledge, and attitudes of smokeless tobacco use among youth. To determine the patterns of use as well as knowledge and perceptions of smokeless tobacco among youth in Mumbai attending municipal schools. A cross-sectional survey was performed among 1053 students in the 8th and 9th grades in 16 municipal schools in Mumbai to determine the knowledge and perceptions about smokeless tobacco products as well as the patterns of use. Ever use of smokeless tobacco was reported by 47 (4.7%) students in the survey. Twenty-nine (2.9%) students reported ever using smoked tobacco. Students were more likely to identify cigarettes and bidis as tobacco products compared to smokeless tobacco products such as gutkha, mishri, and khaini. Betel nut products were used by 178 (17.9%) students. The high rate of smokeless tobacco and betel nut use coupled with low levels of knowledge about their contents and harms suggests that tobacco control programs targeting youth should ensure that these products are adequately explained and understood by students.

The Use of E-cigarettes among school-going adolescents in a predominantly rural environment of Central Appalachia

PubMed Central

Owusu, Daniel; Aibangbee, Jocelyn; Collins, Candice; Robertson, Crystal; Wang, Liang; Littleton, Mary A.; Rafie, Boghozian; Casenburg, Vicki; Mamudu, Hadii M.

2017-01-01

Introduction E-cigarette use among youth in the United States (U.S.) continues to increase. In the rural Northeast Tennessee, where prevalence of tobacco use is higher than national and state averages, there is no literature on e-cigarette use to inform policies and programs. This study aimed to estimate the prevalence of e-cigarette use and examine association of e-cigarette use with two tobacco products among school-going adolescents. Method Data from 894 participants of a school-based survey conducted in 2016 in Northeast Tennessee were analyzed. Descriptive statistics and logistic regression analyses were conducted to estimate the prevalence and delineate the associations between e-cigarette use and other tobacco products. Results Approximately 11% of the participants currently used e-cigarettes, and 35% had ever used e-cigarettes. About 6% of the participants were current users of both e-cigarettes and cigarettes; 4% were current users of e-cigarettes and smokeless tobacco; 3% were current users of all the three products, and 15% had ever tried all the three products. More than one-half of current e-cigarette users (52%) also smoked cigarette. Adjusting for covariates, current e-cigarette use was positively associated with cigarette smoking [Odds Ratio (OR)=27.32, 95% confidence interval (CI)=14.4–51.7] and smokeless tobacco use [OR=7.92, 95% CI=3.8–16.5]. Conclusion E-cigarette use was more common among the high school students than cigarette and smokeless tobacco use, and a significant proportion of users either smoked cigarettes, used smokeless tobacco, or both. Thus, there is a critical need for preventive policies and programs to address dual and poly-use of these products. PMID:27868166

Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, TN

PubMed Central

Reich, Michael S.; Dietrich, Mary S.; Finlayson, A.J. Reid; Fischer, Edward F.; Martin, Peter R.

2008-01-01

Background Alcoholics Anonymous (AA) members represent an important and relatively understudied population for improving our understanding of alcohol dependence recovery since over one million Americans participate in the program. Further insight into coffee and cigarette use by these individuals is necessary given AA members’ apparent widespread consumption and the recognized health consequences and psychopharmacological actions of these substances. Methods Volunteers were sought from all open-AA meetings in Nashville, TN during the summer of 2007 to complete a questionnaire (n=289, completion rate=94.1%) including timeline followback for coffee, cigarette, and alcohol consumption; the Alcoholics Anonymous Affiliation Scale; coffee consumption and effects questions; the Fagerstrom Test for Nicotine Dependence (FTND); and the Smoking Effects Questionnaire. Results Mean (±SD) age of onset of alcohol consumption was 15.4±4.2 years and mean lifetime alcohol consumption was 1026.0±772.8 kg ethanol. Median declared alcohol abstinence was 2.1 years (range: 0 days–41.1 years) and median lifetime AA attendance was 1000.0 meetings (range: 4–44209 meetings); average AA affiliation score was 7.6±1.5. Most (88.5%) individuals consumed coffee and approximately 33% of coffee consumers drank more than four cups per day (M=3.9±3.9). The most common self-reported reasons for coffee consumption and coffee-associated behavioral changes were related to stimulatory effects. More than half (56.9%) of individuals in AA smoked cigarettes. Of those who smoked, 78.7% consumed at least half a pack of cigarettes per day (M=21.8±12.3). Smokers’ FTND scores were 5.8±2.4; over 60% of smokers were highly or very highly dependent. Reduced negative affect was the most important subjective effect of smoking. Conclusions A greater proportion of AA participants drink coffee and smoke cigarettes in larger per capita amounts than observed in general US populations. The effects of these

Concurrent and Prospective Associations Between Substance-Specific Parenting Practices and Child Cigarette, Alcohol, and Marijuana Use.

PubMed

Bailey, Jennifer A; Epstein, Marina; Steeger, Christine M; Hill, Karl G

2018-06-01

The current study aimed to understand whether substance-specific parenting practices predicted the probability of child alcohol, cigarette, or marijuana use beyond known family factors like family management and parental substance use and norms. Data were drawn from the Intergenerational Project, which used an accelerated longitudinal design and included 383 families surveyed seven times between 2002 and 2011. Analyses included 224 families with children ages 10-18 years (49% female). Multilevel models tested both concurrent and lagged (predictors at time t - 1, outcomes at time t) associations between child past year use of alcohol, cigarettes, and marijuana and time-varying measures of substance-specific parenting practices, including permitting child use of alcohol or cigarettes; family rules about alcohol, cigarette, and drug use; and child involvement in family member alcohol or cigarette use (getting, opening, or pouring alcoholic drinks; getting or lighting cigarettes for family members). Demographic controls were included. Child involvement in family member substance use predicted an increased probability of child substance use both concurrently and 1 year later, even when controlling parent substance use, pro-substance norms, and family management. Family rules about substance use and parent provision of alcohol or cigarettes were not consistently related to child alcohol, cigarette, or marijuana use. Family-based preventive interventions to reduce youth substance use should continue to focus on family management and include messaging discouraging parents from allowing children to get, open, or pour drinks or get or light cigarettes for family members. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Are Australian smokers interested in using low-nitrosamine smokeless tobacco for harm reduction?

PubMed

Gartner, C E; Jimenez-Soto, E V; Borland, R; O'Connor, R J; Hall, W D

2010-12-01

To determine (1) whether Australian smokers are aware of low-nitrosamine smokeless tobacco (LNSLT) products and (2) whether they would be interested in using LNSLT either as a long-term substitute for smoking or as an aid to quitting, if these products were to become legally available. 401 daily smokers were recruited by a market research company to complete an internet questionnaire about their smoking history, knowledge of smokeless tobacco and intentions to purchase LNSLT under different scenarios. Just under half (48%) indicated they were willing to buy an LNSLT product. Predictors of an interest in purchasing LNSLT were low income, poorer health, prior SLT use, belief that SLT is less harmful than cigarettes, switching to a lower tar cigarette in the past year, ever using nicotine replacement therapy products for quitting or other reasons, having made a failed cessation attempt in the previous year and not planning to quit smoking. Analysis of quitting and LNSLT purchasing intentions under different scenarios suggest that making LNSLT available at a much lower cost than smoked cigarettes while increasing taxes on cigarettes could provide a greater reduction in the number of smokers than the same tax increase alone. These results support further examination of the potential for LNSLT to reduce smoking-related harm in Australia.

Cigarette Smoking, Alcohol Use and Adenomatous Polyps of the Sigmoid Colon

PubMed Central

Kono, Suminori; Shinchi, Koichi; Imanishi, Koji; Hirohata, Tomio

1992-01-01

The relationship of adenomatous polyps of the sigmoid colon with cigarette smoking and alcohol use was investigated in male self‐defense officials in Japan. In the comparison between 116 cases and 930 controls, total ethanol intake was not at all associated with the risk of adenomatous polyps, but cigarette smoking was strongly related to adenomatous polyps. After adjustment for total ethanol intake, body mass index and rank, odds ratios (and 95% confidence interval) for the categories of 0, 1–399, 400–799, and 800 or more cigarette‐years were 1.0 (referent), 2.3 (1.1–4.6), 2.9 (1.5–5.4) and 3.2 (1.6–6.5), respectively. Among five alcoholic beverages (sake, shochu, beer, whiskey including brandy, and wine), only whiskey consumption was weakly related to the risk of adenomatous polyps. Because the present findings disagree with an earlier observation on self‐defense officials, we examined the association with smoking and alcohol use separately for small (<5 mm) and large (≥5 mm) adenomas, combining data from these two studies. Cigarette smoking was more strongly associated with small adenomas while the positive association with certain alcoholic beverages were largely confined to large adenomas. These findings suggest that cigarette smoking and alcohol use may be linked with the development of adenoma at different stages of colon tumorigenesis. PMID:1399817

Attitudes toward Tobacco, Alcohol, and Non-Alcoholic Beverage Advertisement Themes among Adolescent Boys.

PubMed

Friedman, Katherine L; Roberts, Megan E; Keller-Hamilton, Brittney; Yates, Katherine A; Paskett, Electra D; Berman, Micah L; Slater, Michael D; Lu, Bo; Ferketich, Amy K

2018-02-13

Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys.

Ethnic Pride, Traditional Family Values, and Acculturation in Early Cigarette and Alcohol Use Among Latino Adolescents

PubMed Central

Stein, Judith A.; Bentler, Peter M.

2010-01-01

A structural equations model examined the influence of three cultural variables of ethnic pride, traditional family values and acculturation, along with the mediating variables of avoidance self-efficacy and perceptions of the “benefits” of cigarette smoking, on cigarette and alcohol use in a sample of Latino middle school students in the Southwest. Girls (N = 585) and boys (N = 360) were analyzed separately. In both groups, higher ethnic pride and traditional family values exerted indirect effects on less cigarette smoking and alcohol use when mediated through greater self-efficacy and less endorsement of the “benefits” of cigarette smoking. Among the girls, greater ethnic pride also had a direct effect on less cigarette and alcohol use. Also, greater acculturation directly predicted more cigarette and alcohol use among the girls, but not among the boys. However, differences between the boys and girls were generally nonsignificant as revealed by multiple group latent variable models. These results offer implications for incorporating cultural variables into the design of culturally relevant prevention interventions that discourage cigarette and alcohol use among Latino adolescents. PMID:19415497

Smokeless tobacco: a major public health problem in the SEA region: a review.

PubMed

Gupta, Prakash C; Ray, Cecily S; Sinha, Dhirendra N; Singh, Poonam K

2011-01-01

Smokeless tobacco use is on the upswing in some parts of the world, including parts of SEAR. It is therefore important to monitor this problem and understand the possible consequences on public health. Material for this review was obtained from documents and data of the World Health Organization, co-authors, colleagues, and searches on key words in PubMed and on Google. Smokeless tobacco use in SEAR, as betel quid with tobacco, declined with increased marketing of cigarettes from the early twentieth century. Smokeless tobacco use began to increase in the 1970s in South Asia, with the marketing of new products made from areca nut and tobacco and convenient packaging. As a consequence, oral precancerous conditions and cancer incidence in young adults have increased significantly. Thailand's successful policies in reducing betel quid use through school health education from the 1920s and in preventing imports of smokeless tobacco products from 1992 are worth emulating by many SEAR countries. India, the largest manufacturing country of smokeless tobacco in the Region, is considering ways to regulate its production. Best practices require the simultaneous control of smokeless and smoking forms of tobacco. Governments in SEAR would do well to adopt strong measures now to control this problem.

Flavoured non-cigarette tobacco product use among US adults: 2013-2014.

PubMed

Bonhomme, Michèle G; Holder-Hayes, Enver; Ambrose, Bridget K; Tworek, Cindy; Feirman, Shari P; King, Brian A; Apelberg, Benjamin J

2016-11-01

Limited data exist on flavoured non-cigarette tobacco product (NCTP) use among US adults. Data from the 2013 to 2014 National Adult Tobacco Survey (N=75 233), a landline and cellular telephone survey of US adults aged ≥18, were assessed to estimate past 30-day NCTP use, flavoured NCTP use and flavour types using bivariate analyses. During 2013-2014, 14.4% of US adults were past 30-day NCTP users. Nationally, an estimated 10.2 million e-cigarette users (68.2%), 6.1 million hookah users (82.3%), 4.1 million cigar smokers (36.2%) and 4.0 million smokeless tobacco users (50.6%) used flavoured products in the past 30 days. The most prevalent flavours reported were menthol/mint (76.9%) for smokeless tobacco; fruit (74.0%) for hookah; fruit (52.4%), candy/chocolate/other sweet flavours (22.0%) and alcohol (14.5%) for cigars/cigarillos/filtered little cigars; fruit (44.9%), menthol/mint (43.9%) and candy/chocolate/other sweet flavours (25.7%) for e-cigarettes and fruit (56.6%), candy/chocolate/other sweet flavours (26.5%) and menthol/mint (24.8%) for pipes. Except for hookah and pipes, past 30-day flavoured product use was highest among 18-24-year olds. By cigarette smoking, never smoking e-cigarette users (84.8%) were more likely to report flavoured e-cigarette use, followed by recent former smokers (78.1%), long-term former smokers (70.4%) and current smokers (63.2%). Flavoured NCTP use is prominent among US adult tobacco users, particularly among e-cigarette, hookah and cigar users. Flavoured product use, especially fruit and sweet-flavoured products, was higher among younger adults. It is important for tobacco prevention and control strategies to address all forms of tobacco use, including flavoured tobacco products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Negative affect is associated with alcohol, but not cigarette use in heavy drinking smokers.

PubMed

Bujarski, Spencer; Ray, Lara A

2014-12-01

Co-use of alcohol and cigarettes is highly prevalent, and heavy drinking smokers represent a large and difficult-to-treat subgroup of smokers. Negative affect, including anxiety and depressive symptomatology, has been associated with both cigarette and alcohol use independently, but less is known about the role of negative affect in heavy drinking smokers. Furthermore, while some studies have shown negative affect to precede substance use, a precise biobehavioral mechanism has not been established. The aims of the present study were twofold. First, to test whether negative affect is associated with alcohol and cigarette use in a large community sample of heavy drinking smokers (n=461). And second, to examine craving as a plausible statistical mediator of the association between negative affect and alcohol and/or cigarette use. Hypothesis testing was conducted using a structural equation modeling approach with cross-sectional data. Analysis revealed a significant main effect of negative affect on alcohol use (β=0.210, p<0.05), but not cigarette use (β=0.131, p>0.10) in this sample. Mediational analysis revealed that alcohol craving was a full statistical mediator of this association (p<0.05), such that there was no direct association between negative affect and alcohol use after accounting for alcohol craving. These results are consistent with a negative reinforcement and relief craving models of alcohol use insofar as the experience of negative affect was associated with increased alcohol use, and the relationship was statistically mediated by alcohol craving, presumably to alleviate negative affect. Further longitudinal or experimental studies are warranted to enhance the causal inferences of this mediated effect. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Price elasticity of demand for cigarettes and alcohol in Ecuador, based on household data].

PubMed

Chávez, Ricardo

2016-10-01

Estimate price elasticity of demand for cigarettes and alcohol in Ecuador using cross-sectional data from the National Survey of Urban and Rural Household Income and Expenditures (ENIGHUR is the acronym in Spanish) 2011-2012. ENIGHUR 2011-2012 data were used with Deaton's (1, 2) methodology to estimate price elasticity of demand for cigarettes and alcohol with expenditure and quantity information. Household socioeconomic variables were also included. Price elasticity of demand for cigarettes is -0.87, meaning that a 10% price increase could lead to an 8.7% decrease in consumption. Results for cross-price elasticities of alcohol on cigarette demand are negative, as expected, indicating that they are complementary goods; however, the results are not statistically significant. Furthermore, it was found that price elasticity of demand for alcohol is -0.44, meaning that a 10% increase in the price of alcohol would produce a 4.4% decrease in consumption. A policy of price increases, for example, with a tax increase, applied to both cigarettes and alcohol, could have a positive effect on public health through reductions in consumption of both goods. However, this measure would not be sufficient to bridge gaps in prevalence measures and health outcomes between sex and other population groups, given the observed difference in the sensitivity of consumption to price variations.

Combustible Tobacco and Smokeless Tobacco Use Among Working Adults-United States, 2012 to 2014.

PubMed

Syamlal, Girija; Jamal, Ahmed; Mazurek, Jacek M

2016-12-01

The aim of this study was to examine tobacco use among working adults at least 18 years of age. The 2012 to 2014 National Health Interview Survey (n = 105,779) was used to estimate prevalences for cigarette smoking, other combustible tobacco use, and smokeless tobacco use and prevalence odds ratios (PORs) for any tobacco product use among working adults at least 18 years of age, by industry and occupation. Of the estimated 144 million currently employed adults, 17% were cigarette smokers, 7.0% other noncigarette combustible tobacco users, and 3.4% smokeless tobacco users. Odds of using tobacco varied by sociodemographic characteristics and by industry and occupations. Disparities in tobacco use exist among working adults. Continued implementation of proven interventions to prevent and reduce all forms of tobacco use among U.S. workers is warranted, particularly among those workers with a higher burden of use.

Alcohol and cigarette use among Warsaw adolescents: Factors associated with risk and resilience

PubMed Central

Pisarska, Agnieszka; Eisman, Andria; Ostaszewski, Krzysztof; Zimmerman, Marc A.

2016-01-01

Background Youth in Poland are at notable risk for substance use. Guided by resiliency theory, we examine if developmental risk and promotive factors are associated with substance abuse risk. Objectives We examined the association between adolescent cigarette and alcohol use and related risk and promotive factors including maternal support, neighbours’ informal social control, friends’ acceptance of substance use, and alcohol and cigarette use by nonparental adults. Method Data were collected from a random sample of 13–14-year old students attending Warsaw middle schools (N=3029). We used hierarchical regression models and examined compensatory and protective models of resilience, controlling for sociodemograhic factors. Results Our results indicated that friends’ acceptance of substance use and perceived drug use among nonparental adults was associated with increased risk cigarette and alcohol use among youth. We found that maternal support moderated the relationship between friends’ acceptance of substance use and cigarette use (protective model of resilience). Thus, maternal support buffered the negative effects of friends’ acceptance of use on youths’ cigarette use. Neighbor’s informal social control and maternal support were associated with reduced risk of alcohol use (compensatory model of resilience). Conclusion Collectively, results of the study support compensatory and protective models of resilience in a large representative sample of Warsaw adolescents. PMID:27223142

Responses to Alcohol and Cigarette Use During Ecologically Assessed Drinking Episodes

PubMed Central

Piasecki, Thomas M.; Wood, Phillip K.; Shiffman, Saul; Sher, Kenneth J.; Heath, Andrew C.

2012-01-01

Rationale Tobacco and alcohol are frequently used together, and this may be partly explained by a distinct profile of subjective effects associated with co-administration. Ecological Momentary Assessment studies have examined effects of naturally occurring co-use, but, to date, have not assessed differing effects as alcohol levels rise and fall. Objectives To describe subjective states and appraisals of cigarette and alcohol effects reported during the entirety of real-world drinking episodes. Methods Currently-smoking frequent drinkers (N = 255) carried electronic diaries for 21 days. Analyses focused on reports made during 2,046 drinking episodes. Signaled prompts intensively oversampled moments in the hours following consumption of the first drink in an episode. Multilevel regression analyses were used to predict ratings of buzz, dizziness, excitement, and sluggishness as a function of person-level and contextual covariates, estimated blood alcohol concentration (eBAC) level, ascending vs. descending eBAC, smoking, and their interactions. Appraisals of cigarette and alcohol effects were also examined within this framework. Results Buzz, excitement, and pleasure from alcohol and cigarettes were prominent features of real-world drinking episodes. Smoking was associated with enhanced buzz and excitement when eBAC was high and descending. Smoking slightly accentuated the relation between eBAC and ratings of drinking pleasure among women, but this relation was somewhat weakened by smoking among men. Conclusions Smoking during drinking episodes may be partly be explained by a persistence of stimulant alcohol effects beyond the BAC peak. Acute effects of nicotine and tobacco use on the descending limb deserve further scrutiny in experimental alcohol challenge research. PMID:22538731

The consumption of cigarettes, coffee and sweets in detoxified alcoholics and its association with relapse and a family history of alcoholism.

PubMed

Junghanns, Klaus; Backhaus, Jutta; Tietz, Ulrike; Lange, Wolfgang; Rink, Lothar; Wetterling, Tilman; Driessen, Martin

2005-08-01

Thirty male alcohol dependent inpatients without concurrent depressive disorder, 13 of them with a positive family history of alcohol dependence in a first degree relative (PFH), were questioned about their desire and consumption habits with respect to cigarettes, coffee, and sweets while on a three-week inpatient treatment after detoxification from alcohol. Six weeks after discharge from hospital, the patients were reassessed for relapse. Eleven patients (36.6%) had relapsed at follow-up. Relapsers were younger than abstainers. The days until relapse correlated negatively with intensity of desire to drink alcohol, desire to smoke cigarettes, and with a higher consumption of cigarettes. PFH patients did not relapse earlier but they had a stronger desire to drink coffee and eat sweets and had a higher coffee consumption.

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products—A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland

PubMed Central

Kaleta, Dorota; Polanska, Kinga; Bak-Romaniszyn, Leokadia; Wojtysiak, Piotr

2016-01-01

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13–19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products. PMID:27608034

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

PubMed

Kaleta, Dorota; Polanska, Kinga; Bak-Romaniszyn, Leokadia; Wojtysiak, Piotr

2016-09-06

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13-19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.

Effects of personality on use of medications, alcohol, and cigarettes during pregnancy.

PubMed

Ystrom, Eivind; Vollrath, Margarete E; Nordeng, Hedvig

2012-05-01

The aim of the study was to examine the role of personality in a pregnant woman's consumption of medications, cigarettes, and alcohol. The study included 835 pregnant women in Norway who responded to an electronic questionnaire posted on websites for pregnant women. On the questionnaire, the women reported their use of medications, cigarettes, and alcohol during pregnancy. They also filled out a personality assessment questionnaire, the Big Five Inventory. Use of medications, alcohol, and cigarettes was significantly associated with different personality traits. Women with high scores for conscientiousness were less likely to use an over-the-counter medication such as paracetamol than other women (odds ratio (OR) 0.74; 95% confidence interval (CI) 0.55-0.99). Women who scored high for neuroticism were four- to sixfold more likely to use prescription medications such as sedatives/anxiolytics (OR 4.07; 95% CI 1.48-11.20) or antidepressants (OR 5.73, 95% CI 2.33-14.09). Women with high scores for openness to experience were more likely to use herbal remedies (OR 1.59; 95% CI 1.00-2.52). Women who continued consuming alcohol during pregnancy were more likely to score high on extraversion and low on conscientiousness than women who quit alcohol use. Scoring high on neuroticism increased the likelihood of quitting smoking during pregnancy. This study shows that a woman's personality traits are associated with use of medications, cigarettes, and alcohol during pregnancy. This knowledge could be of clinical importance to health care personnel providing prenatal care.

Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size.

PubMed

England, Lucinda J; Kim, Shin Y; Shapiro-Mendoza, Carrie K; Wilson, Hoyt G; Kendrick, Juliette S; Satten, Glen A; Lewis, Claire A; Whittern, Persenia; Tucker, Myra J; Callaghan, William M

2012-01-01

To examine the effects of maternal prenatal smokeless tobacco use on infant birth size. A retrospective medical record review of 502 randomly selected deliveries. Singleton deliveries to Alaska Native women residing in a defined geographical region in western Alaska, 1997-2005. A regional medical center's electronic records were used to identify singleton deliveries. Data on maternal tobacco exposure and pregnancy outcomes were abstracted from medical records. Logistic models were used to estimate adjusted mean birthweight, length and head circumference for deliveries to women who used no tobacco (n=121), used smokeless tobacco (n=237) or smoked cigarettes (n=59). Differences in mean birthweight, length and head circumference, 95% confidence intervals and p-values were calculated using non-users as the reference group. Infant birthweight, crown-heel length and head circumference. After adjustment for gestational age and other potential confounders, the mean birthweight of infants of smokeless tobacco users was reduced by 78 g compared with that of infants of non-users (p=0.18) and by 331 g in infants of smokers (p<0.01). No association was found between maternal smokeless tobacco use and infant length or infant head circumference. We found a modest but non-significant reduction in the birthweight of infants of smokeless tobacco users compared with infants of tobacco non-users. Because smokeless tobacco contains many toxic compounds that could affect other pregnancy outcomes, results of this study should not be construed to mean that smokeless tobacco use is safe during pregnancy. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology No claim to original US government works.

Diet, cigarettes and alcohol in laryngeal cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Freudenheim, J.L.; Graham, S.; Byers, T.E.

Diet and other risk factors for cancer of the larynx were examined in a case-control study among white males in Western New York, conducted in 1975-1985. Incident, pathologically-confirmed cases and age- and neighborhood-matched controls were interviewed to determine usual diet, and lifetime use of tobacco and alcohol. Because response rates were low for both cases and controls, this cannot be considered a population-based study. A strong association of risk with cigarette but not pipe and cigar smoking was found. Beer and hard liquor but not wine were associated with increased risk. After control for cigarettes, alcohol and education, the uppermore » quartile odds ratio for fat was 2.40, while the odds ratio for high intake of carotenoids was 0.51. There was effect modification by smoking. Carotenoids were most negatively associated with risk among lighter smokers; dietary fat was most positively associated with risk among heavier smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamins C and E or carbohydrate. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high fat may increase risk.« less

Low Alcohol and Cigarette Use Is Associated to the Risk of Developing Chronic Pancreatitis.

PubMed

Di Leo, Milena; Leandro, Gioacchino; Singh, Satish K; Mariani, Alberto; Bianco, Margherita; Zuppardo, Raffaella Alessia; Goni, Elisabetta; Rogger, Teresa Marzia; Di Mario, Francesco; Guslandi, Mario; De Cobelli, Francesco; Del Maschio, Alessandro; Testoni, Pier Alberto; Cavestro, Giulia Martina

2017-02-01

The aim of this study was to investigate the contribution of smoking and alcohol intake and pancreas divisum on the risk of developing chronic pancreatitis (CP). Consecutive patients with CP who underwent secretin-enhanced magnetic resonance cholangiopancreatography were compared with consecutive patients without pancreatic disease who underwent secretin-enhanced magnetic resonance cholangiopancreatography for irritable bowel syndrome. We enrolled 145 consecutive CP patients and 103 irritable bowel syndrome patients from 2010 to 2014. In a univariate analysis, statistically significant differences in sex, mean age, and the duration and amount of cigarette and alcohol use were found. Per a receiver operating characteristic curve analysis, thresholds for cigarette and alcohol consumption were, respectively, 5.5 cigarettes and 13.5 g daily. In a multivariate analysis, independent risk factors for CP were male sex (odds ratio [OR], 2.05), smoking more than 5.5 cigarettes per day (OR, 2.72), and drinking more than 13.5 g/d (OR, 6.35). In an Italian population, we confirmed smoking and alcohol as cofactors in the development of CP. This study shows that alcohol intake and smoking habits are 2 of the most important risk factors for the development of CP.

Smokeless tobacco use in India: Role of prices and advertising.

PubMed

Kostova, Deliana; Dave, Dhaval

2015-08-01

Although the primary form of tobacco use worldwide is cigarette smoking, the large majority of users in India consume smokeless forms of tobacco. There is little evidence on the role of policy-related factors in shaping the demand for smokeless tobacco (ST) in India. This study evaluates the relationship between two such factors, prices and advertising, and ST use in India, using data on 67,737 individuals from the Global Adult Tobacco Survey (GATS) India 2009. We find that ST advertising is more likely to influence ST consumption in women than men, while men are more likely to respond to changes in ST price. We estimate that among adult males in India, the total price elasticity of ST demand is -0.212, which is close to estimates reported for males in the U.S. We do not find strong direct evidence on the economic substitutability or complementarity of smoked and smokeless products. However, the positive association between former smoking and current smokeless use may point to temporal substitutability at the individual level. The findings have implications on the relative effectiveness of policy tools across genders in India - increasing the prices of ST products may discourage ST use particularly among men, and advertising restrictions may play a relatively larger role in the consumption behavior of women in India. Published by Elsevier Ltd.

Worries about others' substance use-Differences between alcohol, cigarettes and illegal drugs?

PubMed

Moan, Inger Synnøve; Storvoll, Elisabet E; Lund, Ingunn Olea

2017-10-01

While it is well documented that many experience harm from others' substance use, little is known about the psychological strain associated with others' use. The aims were: (1) to describe the prevalence of worries about others' alcohol, cigarette and illegal drug use, (2) whose substance use people worry about, (3) the overlap in worries, and (4) to examine how worries about others' use of each substance vary according to demographics, own substance use and experience of harm from others' use. A population survey was conducted among 16-64year old Norwegians (N=1667). Respondents' reported on worries about others' alcohol, cigarette and illegal drug use, measures of experiences of harm from others' use of the three substances, and own substance use. Worries about others' drinking were most prevalent. Among those who worried, others' cigarette and illegal drug use caused more frequent worry. While worry about cigarette use was mostly associated with family members' use, worry about others' alcohol and illegal drug use more often concerned friends'/acquaintances' use. About half worried about others' use of at least one substance. Across all three substances, experience of harm from others' substance use was most strongly related to worries. Worries about others' substance use are common and reflect the prevalence of use of the substances in the population. In sum, the findings suggest that worry about others' alcohol and illegal drug use is primarily related to acute harm while worry about others' cigarette smoking is more related to chronic harm. Copyright © 2017 Elsevier B.V. All rights reserved.

Cross sectional survey on association between alcohol, betel- nut, cigarette consumption and health promoting behavior of industrial workers in Ghaziabad.

PubMed

Arora, Dimple; Marya, Charu Mohan; Menon, Ipseeta; Oberoi, Sukhvinder Singh; Dhingra, Chandan; Anand, Richa

2015-01-01

The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers. A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant. Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise. This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.

Testing messages to reduce smokers’ openness to using novel smokeless tobacco products

PubMed Central

Popova, Lucy; Neilands, Torsten B.; Ling, Pamela M.

2013-01-01

Introduction Tobacco manufacturers’ aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential counter-marketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. Methods In a pretest – post-test experiment, 1,836 adult current and recently former smokers from a national sample were randomized to view one of six anti-smokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Results Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with anti-tobacco industry themes significantly decreased favorable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Conclusions Measures of perceived effectiveness of anti-tobacco ads need to be augmented with measures of actual effectiveness to assess counter-marketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. PMID:23467655

The assessment of tobacco dependence in young users of smokeless tobacco.

PubMed

DiFranza, Joseph R; Sweet, Michael; Savageau, Judith A; Ursprung, W W Sanouri

2012-09-01

As all published measures of dependence for users of smokeless tobacco (dippers) have poor reliability, in the present work the Hooked on Nicotine Checklist (HONC) and the Autonomy Over Smoking Scale (AUTOS) were evaluated for use with this population. Dippers and smokers were also compared in relation to dependence, the pleasure derived from using tobacco and the latency to the onset of withdrawal. In 2010, an anonymous self-completed paper survey was administered to 1541 students of mixed race and ethnicity in grades 9-12 (mean age 15.9 years) in a Florida high school where students used cigarettes and smokeless tobacco. The reliability (Cronbach's α) for the HONC was 0.90 for smokers (n = 139) and 0.91 for dippers (n = 85), and for the AUTOS was 0.94 for smokers and dippers. Dippers and smokers did not differ significantly in relation to scores on the HONC, AUTOS, latency to withdrawal onset or pleasure derived from smoking. One or more symptoms on the HONC were reported by 56% of dippers and 57% of smokers with <100 lifetime uses of their favoured tobacco product, and by 91% of dippers and 91% of smokers with ≥ 100 lifetime uses (not significant). Greater lifetime use was associated with a significantly shorter latency to withdrawal for smokers and dippers. The HONC and AUTOS are highly reliable measures of dependence for adolescent users of cigarettes and smokeless tobacco. Using these measures and other indicators, no meaningful differences in dependence were found between dippers and smokers at comparable levels of lifetime use.

Personal Network Correlates of Alcohol, Cigarette, and Marijuana Use Among Homeless Youth

PubMed Central

Wenzel, Suzanne L.; Tucker, Joan S.; Golinelli, Daniela; Green, Harold D.; Zhou, Annie

2013-01-01

Background Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Methods Homeless youth aged 13–24 were randomly sampled from 41 service and street sites in Los Angeles County (N = 419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomal regression analysis (for frequency of past month marijuana use). Results Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Conclusions Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. PMID:20656423

Personal network correlates of alcohol, cigarette, and marijuana use among homeless youth.

PubMed

Wenzel, Suzanne L; Tucker, Joan S; Golinelli, Daniela; Green, Harold D; Zhou, Annie

2010-11-01

Youth who are homeless and on their own are among the most marginalized individuals in the United States and face multiple risks, including use of substances. This study investigates how the use of alcohol, cigarettes, and marijuana among homeless youth may be influenced by characteristics of their social networks. Homeless youth aged 13-24 were randomly sampled from 41 service and street sites in Los Angeles County (N=419). Predictors of substance use were examined using linear regression analysis (for average number of drinks and average number of cigarettes per day) and negative binomial regression analysis (for frequency of past month marijuana use). Youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. Marijuana use was more frequent for youth who met more network members through homeless settings, but less frequent among those who met more network members through treatment or AA/NA. Greater alcohol use occurred among youth who met more network members through substance use-related activities. Youth having more adults in positions of responsibility in their networks consumed less alcohol, and those with more school attendees in their networks consumed less alcohol and cigarettes. Findings highlight the importance of social context in understanding substance use among homeless youth. Results also support the relevance of network-based interventions to change social context for substance-using youth, in terms of both enhancing pro-social influences and reducing exposure to substance use. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Stimulus selectivity of drug purchase tasks: A preliminary study evaluating alcohol and cigarette demand.

PubMed

Strickland, Justin C; Stoops, William W

2017-06-01

The use of drug purchase tasks to measure drug demand in human behavioral pharmacology and addiction research has proliferated in recent years. Few studies have systematically evaluated the stimulus selectivity of drug purchase tasks to demonstrate that demand metrics are specific to valuation of or demand for the commodity under study. Stimulus selectivity is broadly defined for this purpose as a condition under which a specific stimulus input or target (e.g., alcohol, cigarettes) is the primary determinant of behavior (e.g., demand). The overall goal of the present study was to evaluate the stimulus selectivity of drug purchase tasks. Participants were sampled from the Amazon.com's crowdsourcing platform Mechanical Turk. Participants completed either alcohol and soda purchase tasks (Experiment 1; N = 139) or cigarette and chocolate purchase tasks (Experiment 2; N = 46), and demand metrics were compared to self-reported use behaviors. Demand metrics for alcohol and soda were closely associated with commodity-similar (e.g., alcohol demand and weekly alcohol use) but not commodity-different (e.g., alcohol demand and weekly soda use) variables. A similar pattern was observed for cigarette and chocolate demand, but selectivity was not as consistent as for alcohol and soda. Collectively, we observed robust selectivity for alcohol and soda purchase tasks and modest selectivity for cigarette and chocolate purchase tasks. These preliminary outcomes suggest that demand metrics adequately reflect the specific commodity under study and support the continued use of purchase tasks in substance use research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Combustible and Smokeless Tobacco Use Among High School Athletes - United States, 2001-2013.

PubMed

Agaku, Israel T; Singh, Tushar; Jones, Sherry Everett; King, Brian A; Jamal, Ahmed; Neff, Linda; Caraballo, Ralph S

2015-09-04

Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 National Youth Risk Behavior Surveys. Current use of any tobacco (combustible or smokeless tobacco) significantly declined from 33.9% in 2001 to 22.4% in 2013; however, current smokeless tobacco use significantly increased from 10.0% to 11.1% among athletes, and did not change (5.9%) among nonathletes. Furthermore, in 2013, compared with nonathletes, athletes had significantly higher odds of being current smokeless tobacco users (adjusted odds ratio [AOR] = 1.77, p<0.05), but significantly lower odds of being current combustible tobacco users (AOR = 0.80, p<0.05). These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.

Patterns of Use and Perceptions of Harm of Smokeless Tobacco in Navi Mumbai, India and Dhaka, Bangladesh.

PubMed

Mutti, Seema; Reid, Jessica L; Gupta, Prakash C; Pednekar, Mangesh S; Dhumal, Gauri; Nargis, Nigar; Hussain, Akm Ghulam; Hammond, David

2016-01-01

Globally, smokeless tobacco use is disproportionately concentrated in low-income and middle-income countries like India and Bangladesh. The current study examined comparative patterns of use and perceptions of harm for different smokeless tobacco products among adults and youth in Navi Mumbai, India, and Dhaka, Bangladesh. Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16-18 years) users and non-users in Navi Mumbai ( n = 1002), and Dhaka ( n = 1081). A majority (88.9%) of smokeless tobacco users reported daily use. Approximately one-fifth (20.4%) of the sample were mixed-users (used both smoked and smokeless tobacco), of which about half (54.4%) reported that they primarily used smokeless over smoked forms like cigarettes or bidis. The proportion of users planning to quit was higher in India than in Bangladesh (75.7% vs. 49.8%, p < 0.001). Gutkha was the most commonly used smokeless product in India, and pan masala in Bangladesh. Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was "less harmful" than other types. Perceptions of harm also differed with respect to a respondent's usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents. The findings highlight the high daily use of smokeless tobacco, and the high prevalence of false beliefs about its harms. This set of findings reinforces the need to implement effective tobacco control strategies in low and middle-income countries like India and Bangladesh.

To sell or not to sell: cigarette sales in alcohol-licenced premises.

PubMed

Burton, Suzan; Ludbrooke, Mark; Williams, Kelly; Walsberger, Scott C; Egger, Sam

2017-11-27

To obtain insight into tobacco retailing by alcohol-licenced premises, in order to understand the financial importance of tobacco sales for such retailers. Data were collected by a telephone survey of 1042 clubs, hotels and packaged liquor outlets in New South Wales, Australia. The response rate was 86.1%. Qualitative and quantitative data were obtained. Logistic and linear regression were used to determine factors associated with the probability of selling and stopping selling and the importance of cigarette sales. More than a third (36.4%) of premises contacted did not sell cigarettes. 147 (an estimated 18.1% of those who had ever sold) had stopped selling. There were significant differences in the probability of selling, in the reported importance of cigarette sales and in the probability of stopping selling, between different outlet types and other outlet characteristics (number of gaming machines, proximity of nearest alternative tobacco retailer and remoteness). Outlets where alcohol can be consumed were more likely to rate cigarette sales as 'not important' than 'important'. Despite claims by tobacco companies that tobacco sales are important for many Australian retailers, tobacco sales appear to be of limited importance for alcohol-licenced premises. This means that opposition to stopping tobacco sales where alcohol is consumed and/or sold may be less than expected. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Adolescent internet use and its relationship to cigarette smoking and alcohol use: a prospective cohort study.

PubMed

Chiao, Chi; Yi, Chin-Chun; Ksobiech, Kate

2014-01-01

The present study aims to investigate the longitudinal impact of situational Internet use on future cigarette smoking and alcohol use among male and female adolescents. A Northern Taiwanese cohort sample of adolescents with no prior use of cigarettes (n=1445) or alcohol (n=1468) was surveyed at age 16 and again 4 years later. Information regarding where, why, and length of time spent using the Internet was gathered from the 16-year-old participants. Outcome information regarding cigarette/alcohol use was gathered via a follow-up questionnaire at age 20. Multivariate regressions were used to incorporate peer, individual and family characteristics as measured at age 16 and create models of future cigarette and alcohol use at age 20. The analyses demonstrated that adolescent Internet use, particularly where such use took place, has a significant impact on future cigarette smoking and alcohol use, adjusted for conventional factors, and its relationship differs significantly by gender. Female adolescents with Internet café use appear to be especially likely to develop these two risky behaviors. The why of Internet use is also a predictor of future cigarette smoking. Finally, time spent using the Internet is significantly related to alcohol use; greater use of the Internet is associated with higher levels of drinking. The results revealed that different risky behaviors are differentially influenced by separate components of adolescent Internet use. These findings suggest that programs aimed at promoting adolescent health could potentially benefit Taiwanese adolescents by including components related to situational Internet use and taking gender into consideration. © 2013.

Smokeless tobacco: a gateway to smoking or a way away from smoking.

PubMed

Melikian, Assieh A; Hoffmann, Dietrich

2009-07-01

Recently, tobacco companies have been marketing moist smokeless tobacco products that are 'spitless'. These products have lower concentrations of tobacco-specific nitrosamines and of other harmful chemicals than other tobacco products, but can deliver relatively high doses of nicotine. They are packaged in small sachets, similar to tea bags that are placed between cheek and gum. Global promotion of smokeless tobacco products is hotly debated among tobacco control and public health experts. Proponents point to the Swedish experience where snus (Swedish moist snuff) is widely used as an alternative to cigarette smoking among men. Meanwhile, Sweden has low rates of smoking and a lower rate of respiratory diseases and lung cancers by comparison to other developed countries. The opponents argue that snus has its own risks, that no form of tobacco should ever be promoted; and that 'snus is culture-bound and not transferable to other settings'. Critics also suspect that the tobacco industry will use snus marketing as a 'gateway' to promote cigarettes among young people. Research on the effects of marketing snus to smokers is too limited to support using snus as a harm-reduction tool, and the epidemiological data are not conclusive.

Predicting Alcohol, Cigarette, and Marijuana Use From Preferential Music Consumption.

PubMed

Oberle, Crystal D; Garcia, Javier A

2015-01-01

This study investigated whether use of alcohol, cigarettes, and marijuana may be predicted from preferential consumption of particular music genres. Undergraduates (257 women and 78 men) completed a questionnaire assessing these variables. Partial correlation analyses, controlling for sensation-seeking tendencies and behaviors, revealed that listening to conventional music (pop, country, and religious genres) was negatively correlated with cigarette smoking (p=.001) and marijuana use (p<.001). Additionally, listening to energetic music (rap or hip-hop and soul or funk genres) was positively correlated with marijuana use (p=.004). The only significant predictor of alcohol use was country music, with which it was positively correlated (p=.04). This research suggests an especially harmful influence of energetic music on marijuana use. © The Author(s) 2015.

How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes.

PubMed

Czoli, Christine D; Fong, Geoffrey T; Mays, Darren; Hammond, David

2017-03-01

To systematically review the literature regarding relative risk perceptions (RRPs) across non-combustible nicotine products. MEDLINE and PsycINFO databases were searched for articles published up to October 2014. Of the 5266 records identified, articles not published in English that did not quantitatively assess RRPs across categories of non-combustible nicotine products were excluded, yielding 55 records. One reviewer extracted measures and findings of RRPs for product comparisons of smokeless tobacco (SLT), e-cigarettes (ECs) and nicotine replacement therapy (NRT) to one another, and to combustible cigarettes (CCs). A total of 157 samples from 54 studies were included in the analyses. The accuracy of RRPs differed based on the products being compared: although the accuracy of RRPs was variable across studies, substantial proportions of respondents reported inaccurate beliefs about the relative harmfulness of SLT versus CCs, as well as of ECs versus NRT. In addition, in most studies, respondents did not know the relative harmfulness of SLT versus NRT. In contrast, respondents in many studies correctly perceived NRT and ECs as less harmful than CCs. Cigarette smokers and users of non-combustible nicotine products tended to correctly perceive the relative harmfulness of products more often than non-users. Measures used to assess RRPs varied across studies, with different approaches characterised by certain strengths and limitations. The highly variable and context-specific nature of non-combustible nicotine product RRPs have direct implications for researchers and present several challenges for policymakers working with modified risk products, including issues of measurement, health risk communication and behaviour change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Patterns of Use and Perceptions of Harm of Smokeless Tobacco in Navi Mumbai, India and Dhaka, Bangladesh

PubMed Central

Mutti, Seema; Reid, Jessica L.; Gupta, Prakash C.; Pednekar, Mangesh S.; Dhumal, Gauri; Nargis, Nigar; Hussain, AKM Ghulam; Hammond, David

2016-01-01

Background: Globally, smokeless tobacco use is disproportionately concentrated in low-income and middle-income countries like India and Bangladesh. Objectives: The current study examined comparative patterns of use and perceptions of harm for different smokeless tobacco products among adults and youth in Navi Mumbai, India, and Dhaka, Bangladesh. Methods: Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16–18 years) users and non-users in Navi Mumbai (n = 1002), and Dhaka (n = 1081). Results: A majority (88.9%) of smokeless tobacco users reported daily use. Approximately one-fifth (20.4%) of the sample were mixed-users (used both smoked and smokeless tobacco), of which about half (54.4%) reported that they primarily used smokeless over smoked forms like cigarettes or bidis. The proportion of users planning to quit was higher in India than in Bangladesh (75.7% vs. 49.8%, p < 0.001). Gutkha was the most commonly used smokeless product in India, and pan masala in Bangladesh. Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was “less harmful” than other types. Perceptions of harm also differed with respect to a respondent's usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents. Conclusions: The findings highlight the high daily use of smokeless tobacco, and the high prevalence of false beliefs about its harms. This set of findings reinforces the need to implement effective tobacco control strategies in low and middle-income countries like India and Bangladesh. PMID:27890978

E-cigarettes and cardiovascular risk: beyond science and mysticism.

PubMed

Lippi, Giuseppe; Favaloro, Emmanuel J; Meschi, Tiziana; Mattiuzzi, Camilla; Borghi, Loris; Cervellin, Gianfranco

2014-02-01

Cigarette smoking is the most important cause of premature death, and it is currently listed as a major independent risk factor for cardiovascular disease. Because of restrictive measures and widespread control policies, tobacco companies are now using aggressive marketing strategies in favor of smokeless tobacco, including electronic nicotine delivery systems, which are also known as electronic cigarettes or e-cigarettes. Although the regular use of these devices appears less hazardous than traditional cigarettes or other forms of smokeless tobacco, recent studies have shown that various potentially harmful substances, especially nicotine, ultraparticles, and volatile organic compounds, may be effectively inhaled or liberated in exhaled air during repeated e-cigarette puffing. This would enhance the risk of cardiac arrhythmias and hypertension, which may predispose some users to increased risk of cardiovascular events, which may be further magnified by other potential adverse effects such as arrhythmias, increased respiratory, and flow respiratory resistance. Some cases of intoxication have also been described, wherein large amounts of nicotine and other harmful compounds may be effectively absorbed. As the use of e-cigarettes is continuously rising, and it is also considered a potentially effective method for smoking cessation, more focused research is urgently needed to definitely establish the cardiovascular safeness of these devices. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cigarette Smoke, Bacteria, Mold, Microbial Toxins, and Chronic Lung Inflammation

PubMed Central

Pauly, John L.; Paszkiewicz, Geraldine

2011-01-01

Chronic inflammation associated with cigarette smoke fosters malignant transformation and tumor cell proliferation and promotes certain nonneoplastic pulmonary diseases. The question arises as to whether chronic inflammation and/or colonization of the airway can be attributed, at least in part, to tobacco-associated microbes (bacteria, fungi, and spores) and/or microbial toxins (endotoxins and mycotoxins) in tobacco. To address this question, a literature search of documents in various databases was performed. The databases included PubMed, Legacy Tobacco Documents Library, and US Patents. This investigation documents that tobacco companies have identified and quantified bacteria, fungi, and microbial toxins at harvest, throughout fermentation, and during storage. Also characterized was the microbial flora of diverse smoking and smokeless tobacco articles. Evidence-based health concerns expressed in investigations of microbes and microbial toxins in cigarettes, cigarette smoke, and smokeless tobacco products are reasonable; they warrant review by regulatory authorities and, if necessary, additional investigation to address scientific gaps. PMID:21772847

Factors Associated with Smokeless Tobacco Use among Pregnant Women in Rural Areas of the Southern Terai, Nepal.

PubMed

Singh, J K; Acharya, D; Kadel, R; Adhikari, S; Lombard, D; Koirala, S; Paudel, R

2017-01-01

Tobacco use among women during pregnancy leading to poor maternal and child health outcomes has been well documented. However, factors influencing use of smokeless tobacco in Nepal has not yet been well established. This study aims at exploring the factors related to smokeless tobacco use among pregnant women in rural southern Terai of Nepal. A community-based cross-sectional study was performed at 52 wards within 6 Village Development Committee in Dhanusha district of Nepal. A total of 426 expectant mothers in their second trimester were selected using a multistage cluster sampling method. Descriptive and regression analyses were done to explore the factors that influence smokeless tobacco use. In a total of 426 pregnant mothers, one in five used tobacco in any form. Among the users, 13.4% used smokeless tobacco. Pregnant mothers who were smoking tobacco (AOR 6.01; 95% CI (1.88-19.23), having alcohol consumption (AOR 3.86; 95% CI (1.23-12.08), stressed (AOR 5.04; 95% CI (1.81-14.03), non-vegetarian (AOR 3.31;(1.84-13.03), not attending regular mothers' group meetings (AOR 4.63; (1.41-15.19), and not-exposed to mass media (AOR 5.02; (1.89-13.33) were significantly associated with smokeless tobacco use. Similarly, mothers of age group 20-34 years, dalit, aadibasi and janajati, hill origin, no education and primary education were more likely to use smokeless tobacco than their counterparts. Factors such as smoking tobacco, alcohol consumption, stress, and poor education were found to be significantly associated with smokeless tobacco use among pregnant women in southern Terai of Nepal. This requires an immediate attention develop an effective strategy to prevent and control smokeless tobacco use among pregnant women in southern Terai of Nepal.

Cardiovascular toxicity of nicotine: Implications for electronic cigarette use.

PubMed

Benowitz, Neal L; Burbank, Andrea D

2016-08-01

The cardiovascular safety of nicotine is an important question in the current debate on the benefits vs. risks of electronic cigarettes and related public health policy. Nicotine exerts pharmacologic effects that could contribute to acute cardiovascular events and accelerated atherogenesis experienced by cigarette smokers. Studies of nicotine medications and smokeless tobacco indicate that the risks of nicotine without tobacco combustion products (cigarette smoke) are low compared to cigarette smoking, but are still of concern in people with cardiovascular disease. Electronic cigarettes deliver nicotine without combustion of tobacco and appear to pose low-cardiovascular risk, at least with short-term use, in healthy users. Copyright © 2016 Elsevier Inc. All rights reserved.

Measurement of multiple nicotine dependence domains among cigarette, non-cigarette and poly-tobacco users: Insights from item response theory.

PubMed

Strong, David R; Messer, Karen; Hartman, Sheri J; Conway, Kevin P; Hoffman, Allison C; Pharris-Ciurej, Nikolas; White, Martha; Green, Victoria R; Compton, Wilson M; Pierce, John

2015-07-01

Nicotine dependence (ND) is a key construct that organizes physiological and behavioral symptoms associated with persistent nicotine intake. Measurement of ND has focused primarily on cigarette smokers. Thus, validation of brief instruments that apply to a broad spectrum of tobacco product users is needed. We examined multiple domains of ND in a longitudinal national study of the United States population, the United States National Epidemiological Survey of Alcohol and Related Conditions (NESARC). We used methods based in item response theory to identify and validate increasingly brief measures of ND that included symptoms to assess ND similarly among cigarette, cigar, smokeless, and poly tobacco users. Confirmatory factor analytic models supported a single, primary dimension underlying symptoms of ND across tobacco use groups. Differential Item Functioning (DIF) analysis generated little support for systematic differences in response to symptoms of ND across tobacco use groups. We established significant concurrent and predictive validity of brief 3- and 5-symptom indices for measuring ND. Measuring ND across tobacco use groups with a common set of symptoms facilitates evaluation of tobacco use in an evolving marketplace of tobacco and nicotine products. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Influence of Family Relations on Trajectories of Cigarette and Alcohol Use from Early to Late Adolescence

ERIC Educational Resources Information Center

Gutman, Leslie Morrison; Eccles, Jacquelynne S.; Peck, Stephen; Malanchuk, Oksana

2011-01-01

The present study examines growth curve trajectories of cigarette and alcohol use from 13 to 19 years, and investigates how family relations (i.e., decision-making opportunities, negative family interactions, and positive identification with parents) relate to contemporaneous and predictive alcohol and cigarette use during adolescence. Data came…

Postural stability in cigarette smokers and during abstinence from alcohol.

PubMed

Schmidt, Thomas P; Pennington, David L; Durazzo, Timothy C; Meyerhoff, Dieter J

2014-06-01

Static postural instability is common in alcohol-dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and nonsmoking ALC (nsALC) and to 71 smoking (sCON) and nonsmoking light/nondrinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (TPs; approximately 1, 5, 34 weeks of abstinence from alcohol); a subset of nsCON was retested at 40 weeks. We tested whether cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across TPs within ALC. Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all 3 TPs and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks were nonsignificant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. Copyright © 2014 by the Research Society on Alcoholism.

Sporting activity and drug use: Alcohol, cigarette and cannabis use among elite student athletes.

PubMed

Peretti-Watel, Patrick; Guagliardo, Valérie; Verger, Pierre; Pruvost, Jacques; Mignon, Patrick; Obadia, Yolande

2003-09-01

To study the relationship between sporting activity and alcohol, cigarette and cannabis use among adolescents and young adults, by focusing on elite student athletes (ESAs). Cross-sectional survey (Spring 2002), in a sample of 460 ESAs (ages 16-24 years) recruited at 40 public centres gathering the young sporting elite from 30 different sports in South-Eastern France, comparison with samples of the general population of adolescents in South-Eastern France. Respondents were asked confidentially by a self-administered questionnaire about their use of licit and illicit drugs, their sporting activity and other aspects of their life-style. Prevalences of cigarette, alcohol and cannabis use were markedly lower for ESAs than for other adolescents (generally twice or three times as low). Among ESAs, when compared with the practice of an individual sport, the practice of a team sport was correlated positively with alcohol use (OR = 2.7 for girls, OR = 1.8 for boys), and the practice of a sliding sport was correlated positively with cannabis use (for girls: OR = 2.3) and with alcohol use (for boys: 4.3). Girls who entered competition at international level were more prone to smoke cigarettes and cannabis (OR = 6.1 and 2.4, respectively). As a whole, practising sports as an elite student-athlete can be considered as correlated negatively with cigarette, alcohol and cannabis use. Nevertheless, this relationship depends on the kind of sport practised as well as the level of competition, and further research is needed to understand specific elite athletes' motives for use.

Parental divorce and adolescent cigarette smoking and alcohol use: assessing the importance of family conflict.

PubMed

Kristjansson, Alfgeir Logi; Sigfusdottir, Inga Dora; Allegrante, John P; Helgason, Asgeir R

2009-03-01

To investigate how family conflict contributes to the relationship between parental divorce and adolescent cigarette smoking and alcohol use. Population-based cross-sectional survey. School classrooms in Iceland in which an anonymous questionnaire was administered to respondents by supervising teachers. Participants were 7430 (81.4%) of 9124 14- to 16-year-old adolescents. Cigarette smoking and alcohol use during the last 30 days were assessed by self-report. Parental divorce was related to adolescent cigarette smoking during the last 30 days (OR = 2.12, 95% CI 1.84-2.44) when controlling for gender only, but was insignificant (OR = 1.18 95%, CI 0.99-1.44) when controlling for relationship with parents, disruptive social changes and family conflict. There was a significant relationship between parental divorce and adolescent alcohol use during last 30 days (OR = 1.66, 95% CI 1.48-1.87), controlling only for gender; however, the relationship disappeared (OR = 1.04, 95% CI 0.91-1.20) when controlling for other variables. Family conflicts are important contributors to the relationship between parental divorce and adolescent cigarette smoking and alcohol use. Conflict between parents and adolescents, but not inter-parental conflict, appears to be the most important factor in the relationship between family conflict and adolescent substance use.

Use of cigarettes and alcohol by preschoolers while role-playing as adults: "Honey, have some smokes".

PubMed

Dalton, Madeline A; Bernhardt, Amy M; Gibson, Jennifer J; Sargent, James D; Beach, Michael L; Adachi-Mejia, Anna M; Titus-Ernstoff, Linda T; Heatherton, Todd F

2005-09-01

To examine preschoolers' attitudes, expectations, and perceptions of tobacco and alcohol use. Structured observational study. Children used props and dolls to act out a social evening for adults. As part of the role play, each child selected items from a miniature grocery store stocked with 73 different products, including beer, wine, and cigarettes, for an evening with friends. A behavioral laboratory at the Department of Psychological and Brain Sciences, Dartmouth College. One hundred twenty children, 2 to 6 years old, participated individually in the role-playing. Whether or not a child purchased cigarettes or alcohol at the store. Children purchased a mean of 17 of the 73 products in the store. Thirty-four children (28.3%) bought cigarettes and 74 (61.7%) bought alcohol. Children were more likely to buy cigarettes if their parents smoked (adjusted odds ratio [OR], 3.90; 95% confidence interval [CI], 1.20-12.63). Children were more likely to buy beer or wine if their parents drank alcohol at least monthly (adjusted OR, 3.04; 95% CI, 1.02-9.10) or if they viewed PG-13- or R-rated movies (adjusted OR, 5.10; 95% CI, 1.14-22.90). Children's play behavior suggests that they are highly attentive to the use and enjoyment of alcohol and tobacco and have well-established expectations about how cigarettes and alcohol fit into social settings. The data suggest that observation of adult behavior, especially parental behavior, may influence preschool children to view smoking and drinking as appropriate or normative in social situations. These perceptions may relate to behaviors adopted later in life.

Testing messages to reduce smokers' openness to using novel smokeless tobacco products.

PubMed

Popova, Lucy; Neilands, Torsten B; Ling, Pamela M

2014-07-01

Tobacco manufacturers' aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential countermarketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. In a pretest-post-test experiment, 1836 adult current and recently former smokers from a national sample were randomised to view one of six antismokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with antitobacco industry themes significantly decreased favourable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Measures of perceived effectiveness of antitobacco ads need to be augmented with measures of actual effectiveness to assess countermarketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

E-cigarette Use of Young Adults: Motivations and Associations with Combustible Cigarette, Alcohol, Marijuana, and Other Illicit Drugs

PubMed Central

Temple, Jeff R.; Shorey, Ryan C.; Lu, Yu; Torres, Elizabeth; Stuart, Gregory L.; Le, Vi D.

2017-01-01

Background and Objectives Although the prevalence of e-cigarette use among adolescents and young adults has caught up to or eclipsed that of combustible cigarette use, there is relatively little known about (a) the link between e-cigarettes and other substances and (b) the reasons underlying this increase in e-cigarette use. To address this gap in knowledge, the current study examined associations between e-cigarette use and other substances and identified motives for e-cigarette use among young adults. Methods Participants included an ethnically diverse sample of African American, White, and Hispanic young adults (N=662; 61% female) who were participating in an ongoing survey-based longitudinal study of health and risky behaviors. Results Hispanic, White, and male young adults reported significantly greater past year e-cigarette use compared to their African American and female counterparts. Bivariate correlations showed that use of e-cigarettes was positively associated with use of combustible cigarettes, alcohol, marijuana, cocaine, amphetamines, inhalants, hallucinogens, ecstasy, and misuse of over-the-counter and prescription medications. Furthermore, e-cigarette users reported a higher prevalence of substance use relative to those who did not use e-cigarettes. The taste of e-cigarettes was identified as an important motive for use. Conclusions and Significance Although the potential harm associated with e-cigarettes remains largely unknown, e-cigarettes appear to be a risk marker for the use of substances that are known to pose substantial health problems. Health care providers should screen for e-cigarette use, and youth substance use prevention programs should target the reduction of e-cigarette use with particular attention to addressing their taste appeal. PMID:28370717

E-cigarette use of young adults motivations and associations with combustible cigarette alcohol, marijuana, and other illicit drugs.

PubMed

Temple, Jeff R; Shorey, Ryan C; Lu, Yu; Torres, Elizabeth; Stuart, Gregory L; Le, Vi D

2017-06-01

Although the prevalence of e-cigarette use among adolescents and young adults has caught up to or eclipsed that of combustible cigarette use, there is relatively little known about (a) the link between e-cigarettes and other substances and (b) the reasons underlying this increase in e-cigarette use. To address this gap in knowledge, the current study examined associations between e-cigarette use and other substances and identified motives for e-cigarette use among young adults. Participants included an ethnically diverse sample of African American, White, and Hispanic young adults (N = 662; 61% female) who were participating in an ongoing survey-based longitudinal study of health and risky behaviors. Hispanic, White, and male young adults reported significantly greater past year e-cigarette use compared to their African American and female counterparts. Bivariate correlations showed that use of e-cigarettes was positively associated with use of combustible cigarettes, alcohol, marijuana, cocaine, amphetamines, inhalants, hallucinogens, ecstasy, and misuse of over-the-counter and prescription medications. Furthermore, e-cigarette users reported a higher prevalence of substance use relative to those who did not use e-cigarettes. The taste of e-cigarettes was identified as an important motive for use. Although the potential harm associated with e-cigarettes remains largely unknown, e-cigarettes appear to be a risk marker for the use of substances that are known to pose substantial health problems. Health care providers should screen for e-cigarette use, and youth substance use prevention programs should target the reduction of e-cigarette use with particular attention to addressing their taste appeal. (Am J Addict 2017;26:343-348). © 2017 American Academy of Addiction Psychiatry.

The Associations Between E-Cigarettes and Binge Drinking, Marijuana Use, and Energy Drinks Mixed With Alcohol.

PubMed

Milicic, Sandra; Leatherdale, Scott T

2017-03-01

Use of e-cigarettes by youth is proliferating worldwide, but little is known about the behavioral profile of youth e-cigarette users and the association of e-cigarette use with other health-risky behaviors. This study examines the associations between e-cigarette use and tobacco, marijuana, and alcohol use among a large sample of Canadian youth. Using Canadian data from 39,837 grade 9 to 12 students who participated in year 3 (2014-2015) of the COMPASS study, logistic regression models were used to examine how current use of e-cigarettes were associated with tobacco, marijuana, binge drinking, and energy drinks mixed with alcohol. Pearson's chi-square tests were used to examine subgroup differences by sex. Overall, 9.75% of respondents were current e-cigarette users. Current cigarette smokers (odds ratio [OR] = 3.009), current marijuana users (OR = 5.549), and noncurrent marijuana users (OR = 3.653) were more likely to report using e-cigarettes than noncigarette smokers and nonmarijuana users. Gender differences among males and females showed higher risk of e-cigarette use among female current marijuana users (OR = 7.029) relative to males (OR = 4.931) and female current smokers (OR = 3.284) compared to males (OR = 2.862). Compared to nonbinge drinkers, weekly (OR = 3.253), monthly (OR = 3.113), and occasional (OR = 2.333) binge drinkers were more likely to use e-cigarettes. Similarly, students who consume energy drinks mixed with alcohol (OR = 1.650) were more likely to use e-cigarettes compared to students who do not consume them. We identify that youth who binge drink or use marijuana have a greater increased risk for using e-cigarettes compared to cigarette smokers. These data suggest that efforts to prevent e-cigarette use should not only be discussed in the domain of tobacco control. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Availability, price and promotions for cigarettes and non-cigarette tobacco products: an observational comparison of US Air Force bases with nearby tobacco retailers, 2016.

PubMed

Kong, Amanda Y; Golden, Shelley D; Myers, Allison E; Little, Melissa A; Klesges, Robert; Talcott, Wayne; Vandegrift, Sara M; Cassidy, Daniel G; Ribisl, Kurt M

2018-04-28

Active duty military personnel have higher cigarette and smokeless tobacco use rates than civilian populations. Although US Airmen (called Airmen regardless of gender or rank) are required to be tobacco-free during initial training, many resume use once this period ends, perhaps as a result of easy access to cheap tobacco products. Between July and September 2016, we collected tobacco product, price and promotion information by visiting on-base (n=28) and off-base (n=80) tobacco retailers near the eight technical training bases where approximately 99% of Airmen attend training. We conducted mixed linear effects models to examine on-base versus off-base differences. Cigarette packs were 11%-12% cheaper at on-base retailers compared with off-base retailers. Newport Menthol and Marlboro Red cigarette packs were $0.87 and $0.80 lower on-base (p<0.001) while the cheapest pack available was $0.54 lower on-base (p<0.01). Copenhagen smokeless tobacco was also significantly cheaper on-base (B=-0.65, p<0.01). Interior price promotions were more common on-base. Retail stores located on Air Force bases sell cigarettes and smokeless tobacco products at prices well below those in nearby off-base retailers: the vast majority of these retailers feature interior price promotions for these products. Federal policies regulating prices of on-base tobacco sales, if implemented more effectively, have the potential to protect the health of Airmen by helping them remain tobacco-free after technical training. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethnic and sex differences in E-cigarette use and relation to alcohol use in California adolescents: the California Health Interview Survey.

PubMed

Wong, D N; Fan, W

2018-04-01

E-cigarette use is not only prevalent among adolescents but is growing at an alarming rate. This study sought to determine e-cigarette use prevalence and its relation to alcohol use as a potential gateway drug, and how this may differ by sex and ethnicity in a multi-ethnic sample of California adolescents. Cross-sectional survey. We included data from 1806 adolescents (weighted to 3.0 million) aged 12-17 in the 2014 and 2015 California Health Interview Survey (CHIS) cycles. The prevalence of e-cigarette use was calculated within sex and ethnic groups and the prevalence of alcohol use according to e-cigarette use was also examined with sample weighting providing population estimates. Multiple logistic regression models were built to predict the odds of using alcohol from e-cigarette use status adjusted for sociodemographic and other characteristics. The prevalence of e-cigarette use was 9.1% (projected to 0.3 million) overall in California adolescents but highest in boys among non-Hispanic Whites (15.1%) and in Asian girls (13.3%). Among e-cigarette users, 61.3% of boys and 71.0% of girls reported using alcohol as well. The logistic regression odds of alcohol use, adjusted for age, ethnicity, body mass index, cigarette smoking status, socioeconomic status, parents' education level, and insurance status among e-cigarettes users (compared with non-users) was 9.2 in girls and 3.1 in boys (both P < 0.01). Asians/others, non-Hispanic whites and Hispanics were similarly at increased odds: 17.8, 5.4, and 3.0, respectively (P < 0.01 for Asians/others and for whites) of using alcohol compared with their non-e-cigarette using counterparts, respectively. Attention needs to be paid to the high prevalence of e-cigarette smoking as well as its potential as a gateway drug for alcohol drinking in adolescents, especially among girls and Asians. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Postural Stability in Cigarette Smokers and During Abstinence from Alcohol

PubMed Central

Schmidt, Thomas Paul; Pennington, David Louis; Durazzo, Timothy Craig; Meyerhoff, Dieter Johannes

2014-01-01

Background Static postural instability is common in alcohol dependent individuals (ALC). Chronic alcohol consumption has deleterious effects on the neural and perceptual systems subserving postural stability. However, little is known about the effects of chronic cigarette smoking on postural stability and its changes during abstinence from alcohol. Methods A modified Fregly ataxia battery was administered to a total of 115 smoking (sALC) and non-smoking ALC (nsALC) and to 74 smoking (sCON) and non-smoking light/non-drinking controls (nsCON). Subgroups of abstinent ALC were assessed at 3 time points (approximately 1 week, 5 weeks, 34 weeks of abstinence from alcohol); a subset of nsCON was re-tested at 40 weeks. We tested if cigarette smoking affects postural stability in CON and in ALC during extended abstinence from alcohol, and we used linear mixed effects modeling to measure change across time points within ALC. Results Chronic smoking was associated with reduced performance on the Sharpened Romberg eyes-closed task in abstinent ALC at all three time points and in CON. The test performance of nsALC increased significantly between 1 and 32 weeks of abstinence, whereas the corresponding increases for sALC between 1 and 35 weeks was non-significant. With long-term abstinence from alcohol, nsALC recovered into the range of nsCON and sALC recovered into the range of sCON. Static postural stability decreased with age and correlated with smoking variables but not with drinking measures. Conclusions Chronic smoking was associated with reduced static postural stability with eyes closed and with lower increases of postural stability during abstinence from alcohol. Smoking cessation in alcohol dependence treatment may facilitate recovery from static postural instability during abstinence. PMID:24721012

[Cigarette and alcohol advertising in the Swiss free press].

PubMed

Olivier, Jacques

2014-11-26

Tobacco and alcohol are ordinary consumer goods that are still two overriding preventable causes of death in Switzerland. Massive advertising supports their selling and contributes to maintain a major public health problem up to date. The widely read free press represents an interesting advertising mean. The study of tobacco and alcohol advertisements published in the free newspaper 20 minutes through the year 2012 gives us a good idea of these products' advertising strategies. Compared to those for alcohol, the cigarette advertisements are more numerous, more suggestive and dealing with emotions. The themes proposed respond to young people's expectations in order to incline them to smoke, whereas positive images encourage to keep on smoking.

A comparison of memory for and attitudes about alcohol, cigarette, and other product advertisements in college students.

PubMed

Zinser, O; Freeman, J E; Ginnings, D K

1999-01-01

The purpose of this study was to compare the attitude ratings and recall scores of cigarette, alcohol, automobile, deodorant, jeans, soft drink, athletic shoe, breakfast cereal, and fast food restaurant advertisements. Male and female college students rated the advertisements of these product groups on a number of traits--adventurous, eye-catching, appealing, informative, believable, good times, recreational, effectiveness, romantic, athletic, buy product, and honesty. Drawing on their everyday experience, the students also were asked to recall as much about the advertisements from these product groups as they could. The results revealed that the rating and recall scores of the alcohol advertisements were significantly higher than those for the cigarette advertisements and among the highest of all of the advertisement groups. The female recall scores generally were significantly higher than the male recall scores. In contrast to the cigarette advertisements, the high scores of the alcohol advertisements were interpreted to be due in part to the wider distribution alcohol advertising has had. That alcohol advertising ranked among the highest of all of the advertising groups indicates that college students view alcohol advertising very favorably.

Predicting Alcohol, Cigarette, and Marijuana Use from Preferential Music Consumption

ERIC Educational Resources Information Center

Oberle, Crystal D.; Garcia, Javier A.

2015-01-01

This study investigated whether use of alcohol, cigarettes, and marijuana may be predicted from preferential consumption of particular music genres. Undergraduates (257 women and 78 men) completed a questionnaire assessing these variables. Partial correlation analyses, controlling for sensation-seeking tendencies and behaviors, revealed that…

Alcohol and Cigarette Use and Misuse among Hurricane Katrina Survivors: Psychosocial Risk and Protective Factors

PubMed Central

Flory, Kate; Hankin, Benjamin L.; Kloos, Bret; Cheely, Catherine; Turecki, Gustavo

2008-01-01

The present study examined survivors’ use and misuse of cigarettes and alcohol following Hurricane Katrina. We also examined several psychosocial factors that we expected would be associated with higher or lower rates of substance use following the Hurricane. Participants were 209 adult survivors of Hurricane Katrina interviewed in Columbia, SC or New Orleans, LA between October 31, 2005 and May 13, 2006. Results revealed that survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol-related problems at a substantially higher rate than expected based on pre-Hurricane prevalence data. Results also suggested that certain psychosocial factors were associated with participants’ substance use and misuse following the Hurricane. PMID:19895302

Transitional Life Events and Trajectories of Cigarette and Alcohol Use During Emerging Adulthood: Latent Class Analysis and Growth Mixture Modeling

PubMed Central

Huh, Jimi; Huang, Zhaoqing; Liao, Yue; Pentz, Maryann; Chou, Chih-Ping

2013-01-01

Objective: Emerging adulthood (ages 18–25 years) has been associated with elevated substance use. Transitional life events (TLEs) during emerging adulthood in relation to substance use are usually examined separately, rather than as a constellation. The purposes of this study were (a) to explore distinct subgroups experiencing various TLEs during emerging adulthood, (b) to identify heterogeneous trajectories of cigarette and alcohol use during emerging adulthood, and (c) to examine the association of TLEs with cigarette and alcohol use trajectories. Method: Five waves of longitudinal data (mean age range: 19.5–26.0 years) were used from a community-based drug prevention program (n = 946, 49.9% female). Distinct subgroups of emerging adults who experienced various TLEs were identified using latent class analysis. Cigarette and alcohol use were examined using a latent growth mixture model. Results: A three-class model fit the data best in identifying TLE subgroups (new family, college attenders [NFCA]; uncommitted relationships, college attenders [URCA]; hibernators [HBN]). Three-trajectory models fit the data best for cigarette and alcohol use during emerging adulthood. The TLE categories were significantly associated with the cigarette (p < .05) and alcohol use groups (p < .001); specifically, the URCA and HBN groups were significantly more likely to be classified as accelerating cigarette users, relative to NFCA (ps < .05). The NFCA and HBN groups were significantly more likely to be classified as accelerating alcohol users, relative to URCA (ps < .01). Conclusions: To characterize an “at-risk” emerging adult group for cigarette and alcohol use over time, a range of life events during emerging adulthood should be considered. Interventions tailored to young adulthood may benefit from targeting the absence of these life events typifying “independence” as a potential marker for underlying substance use problems and provide supplemental screening methods

Association of socioeconomic status with consumption of cigarettes, illicit drugs, and alcohol.

PubMed

Marzban, Maryam; Hadji, Maryam; Gholipour, Mahin; Rashidian, Hamideh; Rezaianzadeh, Abbas; Hasanzadeh, Jafar; Haghdoost, Ali Akbar; Rahimi-Movaghar, Afarin; Ghiasvand, Reza; Moradi, Abdolvahab; Khavari-Daneshvar, Hossein; Weiderpass, Elisabete; Kamangar, Farin; Zendehdel, Kazem

2017-08-18

Socioeconomic Status (SES) is considered as one of the important factors associated with use of various drugs. The present study aimed to investigate the effect of SES on cigarette smoking, alcohol use, drug use, and passive exposure to opium and cigarette smoke. In this study, which is part of a multicenter case-control study, the research hypothesis was checked among controls who had referred to hospitals. Data were collected through a questionnaire and laboratory tests to determine the actual consumers of opium and other illicit drugs. Then, the data were analyzed using STATA 13. This study was performed on 364 individuals within the age range of 30 to 75 years. More than 55% of the participants had a history of life-time consumption of cigarettes and hookah as well as alcohol and drugs. The results revealed an inverse relationship between SES and life-time consumption of hookah and alcohol. Furthermore, individuals with higher SES were more likely to deny their drug use. The results revealed little robust evidence supporting the assumption that SES level can have an important effect on illicit drug use. On the other hand, the participants' characteristics could have a prominent effect on precise evaluation of the relationship between SES and drug use. Further multicenter studies are needed with samples diversified in terms of age and ethnicity to identify these confounding relationships.

The influence of electronic cigarette age purchasing restrictions on adolescent tobacco and marijuana use.

PubMed

Pesko, Michael F; Hughes, Jenna M; Faisal, Fatima S

2016-06-01

In the United States, many states have established minimum legal purchase ages for electronic nicotine delivery systems (ENDS) to ban adolescent purchases, but these policies may also affect other related substance use. We explore whether ENDS are substitutes or complements for cigarettes, cigars, smokeless tobacco, and marijuana among adolescents by using variation in state-level implementation of ENDS age purchasing restrictions. We linked data on ENDS age purchasing restrictions to state- and year-specific rates of adolescent tobacco and marijuana use in 2007-2013 from the Youth Risk Behavior Surveillance System. This data provides a nationally representative sample of adolescents who attend public and private schools. We performed a fixed effect regression analysis exploring the influence of ENDS age purchasing restrictions on outcomes of tobacco use and marijuana use, controlling for state and year fixed characteristics, age-race cohorts, cigarette excise taxes, and cigarette indoor use restrictions. For cigarette use, we separate our results into cigarette use frequency. We found causal evidence that ENDS age purchasing restrictions increased adolescent regular cigarette use by 0.8 percentage points. ENDS age purchasing restrictions were not associated with cigar use, smokeless tobacco use, or marijuana use. We document a concerning trend of cigarette smoking among adolescents increasing when ENDS become more difficult to purchase. Copyright © 2016 Elsevier Inc. All rights reserved.

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections

PubMed Central

2012-01-01

Background Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. Methods The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Results Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Conclusions Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy. PMID:22784412

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections.

PubMed

McLellan, Deborah L; Hodgkin, Dominic; Fagan, Pebbles; Reif, Sharon; Horgan, Constance M

2012-07-11

Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy.

Tobacco Alkaloids and Tobacco-specific Nitrosamines in Dust from Homes of Smokeless Tobacco Users, Active Smokers, and Non-tobacco Users

PubMed Central

Whitehead, Todd P.; Havel, Christopher; Metayer, Catherine; Benowitz, Neal L.; Jacob, Peyton

2016-01-01

Smokeless tobacco products, such as moist snuff or chewing tobacco, contain many of the same carcinogens as tobacco smoke; however the impact on children of indirect exposure to tobacco constituents via parental smokeless tobacco use is unknown. As part of the California Childhood Leukemia Study, dust samples were collected from 6 homes occupied by smokeless tobacco users, 6 homes occupied by active smokers, and 20 tobacco-free homes. To assess children’s potential for exposure to tobacco constituents, vacuum-dust concentrations of five tobacco-specific nitrosamines, including N′-nitrosonornicotine [NNN] and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone [NNK], as well as six tobacco alkaloids, including nicotine and myosmine were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). We used generalized estimating equations derived from a multivariable marginal model to compare levels of tobacco constituents between groups, after adjusting for a history of parental smoking, income, home construction date, and mother’s age and race/ethnicity. The ratio of myosmine:nicotine was used as a novel indicator of the source of tobacco contamination, distinguishing between smokeless tobacco products and tobacco smoke. Median dust concentrations of NNN and NNK were significantly greater in homes with smokeless tobacco users compared to tobacco-free homes. In multivariable models, concentrations of NNN and NNK were 4.8-fold and 6.9-fold higher in homes with smokeless tobacco users compared to tobacco-free homes. Median myosmine:nicotine ratios were lower in homes with smokeless tobacco users (1.8%) compared to homes of active smokers (7.7%), confirming that cigarette smoke was not the predominant source of tobacco constituents in homes with smokeless tobacco users. Children living with smokeless tobacco users may be exposed to carcinogenic tobacco-specific nitrosamines via contact with contaminated dust and household surfaces. PMID:25794360

Recall of Point-of-Sale Marketing Predicts Cigar and E-Cigarette Use among Texas Youth.

PubMed

Pasch, Keryn E; Nicksic, Nicole E; Opara, Samuel C; Jackson, Christian; Harrell, Melissa B; Perry, Cheryl L

2017-10-23

While research has documented associations between recall of point-of sale tobacco marketing and youth tobacco use, much of the research is cross-sectional and focused on cigarettes. The present longitudinal study examined recall of tobacco marketing at the point-of-sale and multiple types of tobacco use six months later. The Texas Adolescent Tobacco Advertising and Marketing Surveillance System (TATAMS) is a large-scale, representative study of 6th, 8th, and 10th graders in 79 middle and high schools in five counties in Texas. Weighted logistic regression examined associations between recall of tobacco advertisements and products on display at baseline and ever use, current use, and susceptibility to use for cigarette, e-cigarette, cigar, and smokeless products six months later. Students' recall of signs marketing e-cigarettes at baseline predicted ever e-cigarette use and increased susceptibility to use e-cigarettes at follow-up across all store types. Recall of e-cigarette displays only predicted susceptibility to use e-cigarettes at follow-up, across all store types. Both recall of signs marketing cigars and cigar product displays predicted current and ever cigar smoking and increased susceptibility to smoking cigars at follow-up, across all store types. Recall of cigarette and smokeless product marketing and displays was not associated with tobacco use measures. The point-of-sale environment continues to be an important influence on youth tobacco use. Restrictions on point-of-sale marketing, particularly around schools, are warranted. Cross-sectional studies have shown that exposure to point-of-sale cigarette marketing is associated with use of cigarettes among youth, though longitudinal evidence of the same is sparse and mixed. Cross-sectional studies have found that recall of cigars, smokeless product, and e-cigarette tobacco marketing at point-of-sale is associated with curiosity about tobacco use or intentions to use tobacco among youth, but limited

E-cigarette Use and Beliefs Among Urban Public High School Students in North Carolina.

PubMed

Anand, Vivek; McGinty, Kaye L; O'Brien, Kevin; Guenthner, Gregory; Hahn, Ellen; Martin, Catherine A

2015-07-01

The aim of this study was to examine the prevalence, attitudes, and risk factors associated with electronic cigarette (e-cigarette) use among high school students in tobacco growing state. A 47-item e-cigarette questionnaire modeled after Monitoring the Future with additional information about demographics, adolescent and family nicotine use, and school and health care interventions was designed, piloted, and administered to public high school students (N = 3,298) in May 2013, in an urban county in North Carolina. Completers (2,769/3,298) were aged 16.4 years (standard deviation ± 1.4) with 48.9% males and 43.9% African-American, 38% white, and 4.6% Hispanics. The majority (77.3%) knew about e-cigarettes; 15.2% reported that they had tried an e-cigarette, and 60% reported that e-cigarettes were safe or had minimal health hazards. Only 5.4% reported that schools had offered information about e-cigarette use. One quarter (24.9%) reported ever cigarette smoking, and 13.3% reported ever using smokeless tobacco. E-cigarette use was positively associated with older age, tobacco use, male gender, Caucasian race, mother's e-cigarette use, biological parents' tobacco use, and lower academic performance, whereas negatively associated with having a mother who never used e-cigarettes, not knowing any e-cigarette users, and living with mother (p < .05). E-cigarette use and awareness is evident among high school students in North Carolina. A high number of smokers and smokeless tobacco users are using e-cigarettes simultaneously, and many perceive e-cigarettes as healthy and with minimal health hazards. Also, there is limited school-based education about e-cigarettes. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Availability, accessibility and promotion of smokeless tobacco in a low-income area of Mumbai

PubMed Central

Schensul, Jean J; Nair, Saritha; Bilgi, Sameena; Cromley, Ellen; Kadam, Vaishali; Mello, Sunitha D; Donta, Balaiah

2015-01-01

Objective To examine the role of accessibility, product availability, promotions and social norms promotion, factors contributing to the use of smokeless tobacco (ST) products in a typical low-income community of Mumbai community using Geographic Information System (GIS), observational and interview methodologies and to assess implementation of Cigarettes and other Tobacco Products Act (COTPA) legislation. Rationale In India, the third largest producer of tobacco in the world, smokeless tobacco products are used by men, women and children. New forms of highly addictive packaged smokeless tobacco products such as gutkha are inexpensive and rates of use are higher in low-income urban communities. These products are known to increase rates of oral cancer and to affect reproductive health and fetal development. Methods The study used a mixed methods approach combining ethnographic and GIS mapping, observation and key informant interviews. Accessibility was defined as density, clustering and distance of residents and schools to tobacco outlets. Observation and interview data with shop owners and community residents produced an archive of products, information on shop histories and income and normative statements. Results Spatial analysis showed high density of outlets with variations across subcommunities. All residents can reach tobacco outlets within 30–100 feet of their homes. Normative statements from 55 respondents indicate acceptance of men’s, women’s and children’s use, and selling smokeless tobacco is reported to be an important form of income generation for some households. Multilevel tobacco control and prevention strategies including tobacco education, community norms change, licensing and surveillance and alternative income generation strategies are needed to reduce accessibility and availability of smokeless tobacco use. PMID:22387521

DECOY: Documenting Experiences with Cigarettes and Other Tobacco in Young Adults

PubMed Central

Berg, Carla J.; Haardörfer, Regine; Lewis, Michael; Getachew, Betelihem; Lloyd, Steven A.; Thomas, Sarah Fretti; Lanier, Angela; Trepanier, Kelleigh; Johnston, Teresa; Grimsley, Linda; Foster, Bruce; Benson, Stephanie; Smith, Alicia; Barr, Dana Boyd; Windle, Michael

2016-01-01

Objectives We examined psychographic characteristics associated with tobacco use among Project DECOY participants. Methods Project DECOY is a 2-year longitudinal mixed-methods study examining risk for tobacco use among 3418 young adults across 7 Georgia colleges/universities. Baseline measures included sociodemographics, tobacco use, and psychographics using the Values, Attitudes, and Lifestyle Scale. Bivariate and multivariable analyses were conducted to identify correlates of tobacco use. Results Past 30-day use prevalence was: 13.3% cigarettes; 11.3% little cigars/cigarillos (LCCs); 3.6% smokeless tobacco; 10.9% e-cigarettes; and 12.2% hookah. Controlling for sociodemographics, correlates of cigarette use included greater novelty seeking (p < .001) and intellectual curiosity (p = .010) and less interest in tangible creation (p = .002) and social conservatism (p < .001). Correlates of LCC use included greater novelty seeking (p < .001) and greater fashion orientation (p = .007). Correlates of smokeless tobacco use included greater novelty seeking (p = .006) and less intellectual curiosity (p < .001). Correlates of e-cigarette use included greater novelty seeking (p < .001) and less social conservatism (p = .002). Correlates of hookah use included greater novelty seeking (p < .001), fashion orientation (p = .044), and self-focused thinking (p = .002), and less social conservatism (p < .001). Conclusions Psychographic characteristics distinguish users of different tobacco products. PMID:27103410

Cigarette smoking, alcohol intake, and risk of glioma in the NIH-AARP Diet and Health Study.

PubMed

Braganza, M Z; Rajaraman, P; Park, Y; Inskip, P D; Freedman, N D; Hollenbeck, A R; de González, A Berrington; Kitahara, C M

2014-01-07

Although cigarette smoking and alcohol drinking increase the risk of several cancers and certain components of cigarette smoke and alcohol can penetrate the blood-brain barrier, it remains unclear whether these exposures influence the risk of glioma. We examined the associations between cigarette smoking, alcohol intake, and risk of glioma in the National Institutes of Health-AARP Diet and Health Study, a prospective study of 477,095 US men and women ages 50-71 years at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using models with age as the time metric and adjusted for sex, race/ethnicity, education, and marital status. During a median 10.5 person-years of follow-up, 492 men and 212 women were diagnosed with first primary glioma. Among men, current, heavier smoking was associated with a reduced risk of glioma compared with never smoking, but this was based on only nine cases. No associations were observed between smoking behaviours and glioma risk in women. Greater alcohol consumption was associated with a decreased risk of glioma, particularly among men (>2 drinks per day vs <1 drink per week: HR=0.67, 95% CI=0.51-0.90). Smoking and alcohol drinking do not appear to increase the risk of glioma.

Smokeless tobacco use in Sri Lanka.

PubMed

Somatunga, L C; Sinha, D N; Sumanasekera, P; Galapatti, K; Rinchen, S; Kahandaliyanage, A; Mehta, F R; Nishirani Lanka, J D

2012-01-01

To comprehensively review the issues of smokeless tobacco use in Sri Lanka . This review paper is based on a variety of sources including Medline, WHO documents, Ministry of Health and Nutrition, Colombo and from other sources. The prevalence of smokeless tobacco (SLT) use in Sri Lanka has been reported high, especially among rural and disadvantaged groups. Different smokeless tobacco products were not only widely available but also very affordable. An increasing popularity of SLT use among the youth and adolescents is a cause for concern in Sri Lanka. There were evidences of diverse benign, premalignant, and malignant oral diseases due to smokeless tobacco use in the country. The level of awareness about health risks related to the consumption of smokeless tobacco products was low, particularly among the people with low socio-economic status. In Sri Lanka various forms of smokeless tobacco products, some of them imported, are used. At the national level, 15.8% used smokeless tobacco products and its use is three-fold higher among men compared to women. Betel quid is by far the traditional form in which tobacco is a general component. Other manufactured tobacco products include pan parag/pan masala, Mawa, Red tooth powder, Khaini, tobacco powder, and Zarda. Some 8.6% of the youth are current users of smokeless tobacco. There are studies demonstrating the harmful effects of smokeless tobacco use, especially on the oral mucosa, however, the level of awareness of this aspect is low. The highest mean expenditure on betel quid alone in rural areas for those earning Rs. 5,000/month was Rs. 952. The core issue is the easy availability of these products. To combat the smokeless tobacco problem, public health programs need to be intensified and targeted to vulnerable younger age groups. Another vital approach should be to levy higher taxation.

Changes in use of cigarettes and non-cigarette alternative products among college students.

PubMed

Loukas, Alexandra; Batanova, Milena; Fernandez, Alejandra; Agarwal, Deepti

2015-10-01

The present study examined change in use of various smoked and smokeless non-cigarette alternative products in a sample of college students, stratified by current, or past 30-day, cigarette smoking status. Participants were 698 students from seven four-year colleges in Texas. Participants completed two waves of online surveys regarding tobacco use, knowledge, and attitudes, with 14 months between each wave. The most prevalent products used by the entire sample at Wave 1 were cigarettes, followed by hookah, cigars/cigarillos/little cigars, and electronic cigarettes (e-cigarettes). At Wave 2, prevalence of e-cigarette use surpassed use of cigars/cigarillos/little cigars. Snus and chew/snuff/dip were relatively uncommon at both waves. Examination of change in use indicated that e-cigarette use increased across time among both current cigarette smokers and non-cigarette smokers. Prevalence of current e-cigarette use doubled across the 14-month period to 25% among current smokers and tripled to 3% among non-cigarette smokers. Hookah use also increased across time, but only among non-cigarette smokers, whereas it decreased among current cigarette smokers. Use of all other non-cigarette alternatives remained unchanged across time. Logistic regression analysis was used to examine the socio-demographic predictors of Wave 2 e-cigarette use, the only product that increased in use among both current cigarette smokers and non-cigarette smokers. Results indicated that Wave 1 current cigarette use and Wave 1 current e-cigarette use, but not gender, age, or race/ethnicity, were significantly associated with Wave 2 e-cigarette use. Findings underscore the need to track changes in the use of non-cigarette alternatives and call for additional research examining the factors contributing to change in use. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Test of Biosocial Models of Adolescent Cigarette and Alcohol Involvement

ERIC Educational Resources Information Center

Foshee, Vangie A.; Ennett, Susan T.; Bauman, Karl E.; Granger, Douglas A.; Benefield, Thad; Suchindran, Chirayath; Hussong, Andrea M.; Karriker-Jaffe, Katherine J.; DuRant, Robert H.

2007-01-01

The authors test biosocial models that posit interactions between biological variables (testosterone, estradiol, pubertal status, and pubertal timing) and social context variables (family, peer, school, and neighborhood) in predicting adolescent involvement with cigarettes and alcohol in a sample of 409 adolescents in Grades 6 and 8. Models…

Smokeless Tobacco: Health Effects

MedlinePlus

... the mouth 1,3 Can increase risks for early delivery and stillbirth when used during pregnancy 2 Can cause nicotine poisoning in children 4 ... Reproductive and Developmental Risks Using smokeless tobacco during ... risk for early delivery and stillbirth. 2 Nicotine in smokeless tobacco ...

The role of smokeless tobacco use in smoking persistence among male college students

PubMed Central

Wolfson, Mark; Suerken, Cynthia K.; Egan, Kathleen L.; Sutfin, Erin L.; Reboussin, Beth A.; Wagoner, Kimberly G.; Spangler, John

2015-01-01

Background Significant changes in the tobacco industry have led to heightened concern about co-use of cigarettes and smokeless tobacco (SLT) products. Objectives The aim of this study was to assess whether male cigarette smokers who also used SLT products, in the first semester of their first year of college, were more or less likely than male cigarette smokers who did not use SLT products to still be smoking by the first semester of their senior year. Methods Using a longitudinal, observational study, we followed a cohort of undergraduate students from 11 four-year universities in North Carolina and Virginia through their college career. Mixed-effects logistic regression analysis was conducted to estimate the likelihood of being a current smoker fall of senior year for male students who used both cigarettes and SLT at baseline, compared to those who only smoked cigarettes, after adjustment for potential confounders (n = 274). Results At baseline, 67.2% of participants were smoking cigarettes only (no SLT use) and 32.8% were dual users (cigarettes and SLT). A total of 62% were still smoking at senior year. Dual users were 30% more likely to be current smokers senior year compared to cigarette only users, although this difference was not statistically significant. Having at least one friend who smoked cigarettes and heavier cigarette smoking at baseline were significantly related to senior year smoking. Conclusions Our findings do not support the argument that SLT use may help male college smokers discontinue their smoking habit. In fact, it may contribute to smoking persistence. PMID:26375618

Risk of spina bifida and maternal cigarette, alcohol, and coffee use during the first month of pregnancy.

PubMed

Benedum, Corey M; Yazdy, Mahsa M; Mitchell, Allen A; Werler, Martha M

2013-08-02

This study was conducted to assess the association between the risks of spina bifida (SB) in relation to cigarette, alcohol, and caffeine consumption by women during the first month of pregnancy. Between 1988-2012, this multi-center case-control study interviewed mothers of 776 SB cases and 8,756 controls about pregnancy events and exposures. We evaluated cigarette smoking, frequency of alcohol drinking, and caffeine intake during the first lunar month of pregnancy in relation to SB risk. Logistic regression models were used to calculate adjusted odds ratios and 95% confidence intervals. Levels of cigarette smoking (1-9 and ≥10/day), alcohol intake (average ≥4 drinks/day) and caffeine intake (<1, 1, and ≥2 cups/day) were not likely to be associated with increased risk of SB. Further, results were similar among women who ingested less than the recommended amount of folic acid (400 μg/day).

Association Between Electronic Cigarette Use and Openness to Cigarette Smoking Among US Young Adults

PubMed Central

Apelberg, Benjamin J.; Ambrose, Bridget K.; Green, Kerry M.; Choiniere, Conrad J.; Bunnell, Rebecca; King, Brian A.

2015-01-01

Introduction: Use of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes), is increasing. One concern is the appeal of these products to youth and young adults and the potential to influence perceptions and use of conventional cigarettes. Methods: Using data from the 2012–2013 National Adult Tobacco Survey, characteristics of adults aged 18–29 years who had never established cigarette smoking behavior were examined by ever use of e-cigarettes, demographics, and ever use of other tobacco products (smokeless tobacco, cigars, hookah, and cigarettes). Multivariate logistic regression was used to examine the relationship between e-cigarette use and openness to cigarette smoking among young adults, defined as the lack of a firm intention not to smoke soon or in the next year. Results: Among young adults who had never established cigarette smoking behavior (unweighted n = 4,310), 7.9% reported having ever tried e-cigarettes, and 14.6% of those who reported having ever tried e-cigarettes also reported current use of the product. Ever e-cigarette use was associated with being open to cigarette smoking (adjusted odds ratio = 2.4; 95% confidence interval = 1.7, 3.3), as was being male, aged 18–24 years, less educated, and having ever used hookah or experimented with conventional cigarettes. Conclusions: Ever use of e-cigarettes and other tobacco products was associated with being open to cigarette smoking. This study does not allow us to assess the directionality of this association, so future longitudinal research is needed to illuminate tobacco use behaviors over time as well as provide additional insight on the relationship between ENDS use and conventional cigarette use among young adult populations. PMID:25378683

Parental attitudes about cigarette smoking and alcohol use in the Motion Picture Association of America rating system.

PubMed

Longacre, Meghan R; Adachi-Mejia, Anna M; Titus-Ernstoff, Linda; Gibson, Jennifer J; Beach, Michael L; Dalton, Madeline A

2009-03-01

To evaluate whether parents want smoking and alcohol use to be considered in movie ratings. Data were collected as part of a longitudinal study of adolescent health behavior involving 2564 parent/child dyads from northern New England. Parents (n = 2401) were surveyed at wave 2 about movie ratings. Qualitative interviews were conducted with a subset of parents (n = 62) 15 months later. Participants were surveyed by telephone. Most parents (94.9%; n = 2279) were mothers, 52.5% were younger than 40 years, and 90.6% were white, and children were aged 9 to 15 years. Whether cigarette and alcohol use should be included as movie ratings criteria and if movies with cigarette or alcohol use should be rated R. About 52% (n = 1242) and 66% (n = 1579) of parents believed cigarette or alcohol use, respectively, should be used as movie ratings criteria; 28.9% (n = 693) supported an R rating for movies with smoking and 41.9% (n = 1003) supported R ratings for alcohol. In adjusted models, parents were more likely to support adding cigarette and alcohol use as ratings criteria if they believed the current ratings were not useful, they restricted their children from watching R-rated movies, and they were nondrinkers. Nonsmoking parents were more likely to support an R rating for smoking. Interviews revealed that parents may underestimate the impact of movie smoking and drinking. Although a majority of parents supported including smoking or drinking in ratings criteria, fewer favored R ratings. Parental support could be a key factor in determining the impact of modifications to the Motion Picture Association of America rating system.

Parental Attitudes About Cigarette Smoking and Alcohol Use in the Motion Picture Association of America Rating System

PubMed Central

Longacre, Meghan R.; Adachi-Mejia, Anna M.; Titus-Ernstoff, Linda; Gibson, Jennifer J.; Beach, Michael L.; Dalton, Madeline A.

2013-01-01

Objective To evaluate whether parents want smoking and alcohol use to be considered in movie ratings. Design Data were collected as part of a longitudinal study of adolescent health behavior involving 2564 parent/child dyads from northern New England. Parents (n=2401) were surveyed at wave 2 about movie ratings. Qualitative interviews were conducted with a subset of parents (n=62) 15 months later. Setting Participants were surveyed by telephone. Participants Most parents (94.9%; n=2279) were mothers, 52.5% were younger than 40 years, and 90.6% were white, and children were aged 9 to 15 years. Main Outcome Measures Whether cigarette and alcohol use should be included as movie ratings criteria and if movies with cigarette or alcohol use should be rated R. Results About 52% (n=1242) and 66% (n=1579) of parents believed cigarette or alcohol use, respectively, should be used as movie ratings criteria; 28.9% (n=693) supported an R rating for movies with smoking and 41.9% (n=1003) supported R ratings for alcohol. In adjusted models, parents were more likely to support adding cigarette and alcohol use as ratings criteria if they believed the current ratings were not useful, they restricted their children from watching R-rated movies, and they were nondrinkers. Nonsmoking parents were more likely to support an R rating for smoking. Interviews revealed that parents may underestimate the impact of movie smoking and drinking. Conclusions Although a majority of parents supported including smoking or drinking in ratings criteria, fewer favored R ratings. Parental support could be a key factor in determining the impact of modifications to the Motion Picture Association of America rating system. PMID:19255388

Adolescent cigarette smokers' and non-cigarette smokers' use of alternative tobacco products.

PubMed

Saunders, Charles; Geletko, Karen

2012-08-01

This study uses the most recent data from the nationally representative National Youth Tobacco Survey (NYTS) to examine the use of alternative tobacco products among U.S. cigarette smokers and non-cigarette smokers aged 14-17. Alternative tobacco product use is defined as use of one or more of the following products: smokeless tobacco, cigars, pipes, bidis, or kreteks. Using the results from the 2004, 2006, and 2009 NYTS, multivariate logistic regressions were used to investigate separately the extent of alternative tobacco product use in current cigarette smokers and in those who reported not smoking cigarettes controlling for demographic and other independent influences. The results indicate that for adolescent smokers and nonsmokers, the use of one type of alternative tobacco product made it much more likely the individual would use one or more of the other alternative tobacco products. Non-cigarette smokers using these tobacco products appeared to exhibit symptoms of nicotine dependence comparable to those of cigarette smokers. More information on adolescent use of alternative tobacco products is needed. Current cigarette use declined 3.4% annually over 2004-2009 for the NYTS 14- to 17-year-old population, but this cohort's use of alternative tobacco products was unchanged. The number of adolescents aged 14-17 who did not smoke cigarettes but used alternative tobacco products increased 5.9% per year over the same period. Current surveillance measures need to be expanded in order to gain a more comprehensive understanding of adolescent alternative tobacco use.

Patterns of Alternative Tobacco Product Use: Emergence of Hookah and E-cigarettes as Preferred Products Amongst Youth.

PubMed

Gilreath, Tamika D; Leventhal, Adam; Barrington-Trimis, Jessica L; Unger, Jennifer B; Cruz, Tess Boley; Berhane, Kiros; Huh, Jimi; Urman, Robert; Wang, Kejia; Howland, Steve; Pentz, Mary Ann; Chou, Chih Ping; McConnell, Rob

2016-02-01

There is a growing public health concern related to the rapid increase in the use of multiple tobacco products among adolescents. This study examined patterns of adolescent use of cigarettes, e-cigarettes, cigars/cigarillo, hookah/waterpipe, and smokeless/dip/chewing tobacco in a population of southern California adolescents. Data from 2,097 11th- and 12th-grade participants in the Southern California Children's Health Study were collected via self-report in 2014. Study participants were asked about lifetime and current (past 30 days) use of cigarettes, cigars/cigarillos/little cigars, e-cigarettes, hookah/waterpipe, and smokeless/dip/chewing tobacco. Latent class analysis (LCA) was used to identify patterns of tobacco use. Hookah/waterpipe tobacco use had the highest current prevalence (10.7%) followed by e-cigarettes (9.6%). The prevalence of use of smokeless/dip/chewing tobacco was lowest, with 2.2% of adolescents reporting current use. The LCA suggested four distinct classes, comprising nonusers (72.3% of the sample), polytobacco experimenters (13.9%), e-cigarette/hookah users (8.2%), and polytobacco users (5.6%). Multinomial logistic regression based on these four classes found that males had double the odds to be polytobacco users relative to nonusers compared to females (odds ratio, 2.3; 95% confidence interval, 1.26-4.25). By identifying naturally occurring configurations of tobacco product use in teens, these findings may be useful to practitioners and policymakers to identify the need for tobacco control interventions that address specific tobacco products and particular combinations of polytobacco use. LCA can be used to identify segments of the population overrepresented among certain tobacco use classes (e.g., boys) that may benefit most from targeted polyproduct intervention approaches. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Association of Noncigarette Tobacco Product Use With Future Cigarette Smoking Among Youth in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2015.

PubMed

Watkins, Shannon Lea; Glantz, Stanton A; Chaffee, Benjamin W

2018-02-01

Approximately 90% of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking. Noncigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths. To estimate the longitudinal association between noncigarette tobacco use and subsequent cigarette smoking initiation among US youth. In this prospective cohort study of the Population Assessment of Tobacco and Health (PATH) waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youths who never smoked a conventional cigarette at baseline and completed wave 2 follow-up (N = 10 384) was studied. PATH retention at follow-up was 87.9%. Ever use and past 30-day use of electronic cigarettes (e-cigarettes), hookah, noncigarette combustible tobacco, or smokeless tobacco at baseline. Ever use and past 30-day use of cigarettes at follow-up. The present analysis was based on the 10 384 PATH youth respondents who reported never having smoked a cigarette in wave 1 and whose cigarette ever or past 30-day use was reported in wave 2 (mean [SD] age, 14.3 [1.7] years; age range, 12-17 years; 5087 [49.1%] female; 4829 [52.5%] white). At 1-year follow-up, 469 (4.6%) of all baseline never-smoking youths had tried a cigarette and 219 (2.1%) had smoked a cigarette within the past 30 days. Cigarette ever use at follow-up was higher among youths who had ever used e-cigarettes (78 [19.1%]), hookah (60 [18.3%]), noncigarette combustible tobacco (45 [19.2%]), or smokeless tobacco (29 [18.8%]) at baseline. After adjusting for sociodemographic, environmental, and behavioral smoking risk factors and for baseline ever use of other tobacco products, the odds of past 30-day cigarette use at follow-up were approximately twice as high among baseline ever users of e-cigarettes (odds ratio [OR], 1.87; 95% CI, 1.15-3.05), hookah (OR, 1

Risk for oral cancer from smokeless tobacco

PubMed Central

Janbaz, Khalid Hussain; Basser, Hibba Tul; Bokhari, Tanveer Hussain; Ahmad, Bashir

2014-01-01

Tobacco products which are used in a way other than smoking are known as smokeless tobacco. The most common smokeless tobaccos are chewing tobacco, naswar, snuff, snus, gutka, and topical tobacco paste. Any product which contains tobacco is not safe for human health. There are more than twenty-five compounds in smokeless tobacco which have cancer causing activity. Use of smokeless tobacco has been linked with risk of oral cancer. Smokeless tobacco contains tobacco-specific nitrosamines (TSNAs), polonium, formaldehyde, cadmium, lead, and benzo[a]pyrene, which are carcinogenic agents. Although there is presence of some compounds, carotenoids and phenolic compounds, that have cancer inhibiting properties, they are in low concentrations. Dry snuff use is linked with higher relative risks, while the use of other smokeless tobacco is of intermediate risk. Moist snuff and chewing tobacco have a very low risk for oral cancer. Therefore, from this review article, it was concluded that smokeless tobacco has risk for oral cancer – either low, medium or high depending on the balance between cancer causing agents and cancer inhibiting agents. PMID:25520574

Association between electronic cigarette use and openness to cigarette smoking among US young adults.

PubMed

Coleman, Blair N; Apelberg, Benjamin J; Ambrose, Bridget K; Green, Kerry M; Choiniere, Conrad J; Bunnell, Rebecca; King, Brian A

2015-02-01

Use of electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes), is increasing. One concern is the appeal of these products to youth and young adults and the potential to influence perceptions and use of conventional cigarettes. Using data from the 2012-2013 National Adult Tobacco Survey, characteristics of adults aged 18-29 years who had never established cigarette smoking behavior were examined by ever use of e-cigarettes, demographics, and ever use of other tobacco products (smokeless tobacco, cigars, hookah, and cigarettes). Multivariate logistic regression was used to examine the relationship between e-cigarette use and openness to cigarette smoking among young adults, defined as the lack of a firm intention not to smoke soon or in the next year. Among young adults who had never established cigarette smoking behavior (unweighted n = 4,310), 7.9% reported having ever tried e-cigarettes, and 14.6% of those who reported having ever tried e-cigarettes also reported current use of the product. Ever e-cigarette use was associated with being open to cigarette smoking (adjusted odds ratio = 2.4; 95% confidence interval = 1.7, 3.3), as was being male, aged 18-24 years, less educated, and having ever used hookah or experimented with conventional cigarettes. Ever use of e-cigarettes and other tobacco products was associated with being open to cigarette smoking. This study does not allow us to assess the directionality of this association, so future longitudinal research is needed to illuminate tobacco use behaviors over time as well as provide additional insight on the relationship between ENDS use and conventional cigarette use among young adult populations. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Smokeless tobacco in Canada: deterring market development

PubMed Central

Wyckham, R.

1999-01-01

DATA SOURCES—A review of the literature identified demographic, cultural, and marketing variables related to the uptake and continuation of smokeless tobacco use. Government and industry data on production, marketing, and consumption of smokeless tobacco products are presented.
METHODS—The Canadian and American markets are compared in terms of prevalence, consumption per capita, and marketing practices. Lessons to be learned from the well-orchestrated development of the American market in the past 30 years are examined. Canadian tobacco regulations are described. Strategies by which the increased exploitation of the Canadian smokeless tobacco market can be deterred are discussed.
CONCLUSIONS—A long-term, independently financed strategy built around a national smokeless tobacco de-marketing organisation with a constellation of private local institutions is suggested as a means of combating smokeless tobacco marketing efforts.


Keywords: smokeless tobacco; marketing; Canada PMID:10629248

Differences in cigarette and smokeless tobacco use among American Indian and Alaska Native people living in Alaska and the Southwest United States

PubMed Central

Lanier, Anne P.; Renner, Caroline; Smith, Julia; Tom-Orme, Lillian; Slattery, Martha L.

2010-01-01

Introduction: This study analyzed self-reported tobacco use among American Indian and Alaska Native (AI/AN) people enrolled in the Education and Research Towards Health Study in Alaska (n = 3,821) and the Southwest United States (n = 7,505) from 2004 to 2006. Methods: Participants (7,060 women and 4,266 men) completed a computer-assisted self-administered questionnaire on cigarette and smokeless tobacco (ST) use. Results: Current use of cigarettes was considerably higher in Alaska than in the Southwest United States (32% vs. 8%). Current ST use was also more common in Alaska than in the Southwest United States (18% vs. 8%). Additionally, smoking was more common among men, younger age, those who were not married, and who only spoke English at home, while ST use was more common among men, those with lower educational attainment and those who spoke an AI/AN language at home (p < .01). Compared with the U.S. general population, AI/AN people living in Alaska were more likely and those living in the Southwest United States were less likely to be current smokers. Rates of ST use, including homemade ST, in both regions were much higher than the U.S. general population. Discussion: Tobacco use among AI/AN people in the Southwest United States, who have a tradition of ceremonial tobacco use, was far lower than among Alaska Native people, who do not have a tribal tradition. Tobacco use is a key risk factor for multiple diseases. Reduction of tobacco use is a critical prevention measure to improve the health of AI/AN people. PMID:20525781

Differences in cigarette and smokeless tobacco use among American Indian and Alaska Native people living in Alaska and the Southwest United States.

PubMed

Redwood, Diana; Lanier, Anne P; Renner, Caroline; Smith, Julia; Tom-Orme, Lillian; Slattery, Martha L

2010-07-01

This study analyzed self-reported tobacco use among American Indian and Alaska Native (AI/AN) people enrolled in the Education and Research Towards Health Study in Alaska (n = 3,821) and the Southwest United States (n = 7,505) from 2004 to 2006. Participants (7,060 women and 4,266 men) completed a computer-assisted self-administered questionnaire on cigarette and smokeless tobacco (ST) use. Current use of cigarettes was considerably higher in Alaska than in the Southwest United States (32% vs. 8%). Current ST use was also more common in Alaska than in the Southwest United States (18% vs. 8%). Additionally, smoking was more common among men, younger age, those who were not married, and who only spoke English at home, while ST use was more common among men, those with lower educational attainment and those who spoke an AI/AN language at home (p < .01). Compared with the U.S. general population, AI/AN people living in Alaska were more likely and those living in the Southwest United States were less likely to be current smokers. Rates of ST use, including homemade ST, in both regions were much higher than the U.S. general population. Tobacco use among AI/AN people in the Southwest United States, who have a tradition of ceremonial tobacco use, was far lower than among Alaska Native people, who do not have a tribal tradition. Tobacco use is a key risk factor for multiple diseases. Reduction of tobacco use is a critical prevention measure to improve the health of AI/AN people.

Developmental Changes in Friendship Alliance and its Impact on Early Adolescent Cigarette and Alcohol Expectancies and Use. PSC CUNY 34 Final Report

ERIC Educational Resources Information Center

Malow-Iroff, Micheline S.

2005-01-01

The purpose of this grant funded investigation was to examine the impact of friendship alliance in an early adolescent population on cigarette and alcohol variables. Sixth, seventh and eighth grade students from two urban areas completed a survey that addressed cigarette and alcohol attitudes, practices, expectancies and intentions. Only those…

Concurrent alcohol and tobacco use among a middle-aged and elderly population in Mumbai.

PubMed

Gupta, Prakash C; Maulik, Pallab K; Pednekar, Mangesh S; Saxena, Shekhar

2005-01-01

The concurrent use of alcohol and tobacco and its deleterious effects have been reported in the western literature. However, studies on the relationship between concurrent alcohol and tobacco use in India are limited. This study outlines the association between concurrent alcohol and tobacco use among a middle-aged and elderly population in a western Indian cohort after controlling for various sociodemographic factors. A total of 35 102 men, 45 years of age and above were interviewed for concurrent alcohol and tobacco use. The sample was part of an earlier cohort drawn from the general population. The data were analysed after controlling for age, education, religion and mother-tongue. Among alcohol users, 51.1% smoked tobacco and 35.6% used smokeless tobacco. The relative risk of alcohol use was highest among those smoking cigarettes or beedis and among those using mishri with betel quid and tobacco. The risk of alcohol use increased with the frequency of tobacco use. The risk also increased with higher amounts of alcohol consumption, but peaked at around 100-150 ml of absolute alcohol use. The study highlights the association between concurrent alcohol and tobacco use among the Indian population. This has important public health implications since concurrent use of these is synergistic for increased risk of oropharyngeal cancers.

Cigarette smokers' use of unconventional tobacco products and associations with quitting activity: findings from the ITC-4 U.S. cohort.

PubMed

Kasza, Karin A; Bansal-Travers, Maansi; O'Connor, Richard J; Compton, Wilson M; Kettermann, Anna; Borek, Nicolette; Fong, Geoffrey T; Cummings, K Michael; Hyland, Andrew J

2014-06-01

The purpose of this study was to evaluate the prevalence and correlates of use of nicotine-containing tobacco products such as cigars, pipe tobacco, and cigarettes that promise less exposure to toxins; e-cigarettes; and smokeless tobacco products among a cohort of conventional cigarette smokers followed over the past decade. We also evaluated associations between use of such products and cigarette quitting. Participants were 6,110 adult smokers in the United States, who were interviewed as part of the International Tobacco Control Four Country Survey between 2002 and 2011. Respondents reported their concurrent use of other smoked tobacco products (including cigars, pipe tobacco, and cigarillos), smokeless tobacco products (including chewing tobacco, snus, and snuff), unconventional cigarettes (including Omni, Accord, and Eclipse), and electronic cigarettes. Prevalence and correlates of use and associations between use and cigarette quitting were assessed using regression analyses via generalized estimating equations. Most cigarette smokers did not use unconventional tobacco products, although use of any of these products started to rise at the end of the study period (2011). For each type of tobacco product evaluated, use was most prevalent among those aged 18-24 years. Smokers who did use unconventional tobacco products did not experience a clear cessation advantage. During the past decade, relatively few cigarette smokers reported also using other tobacco products. Those that did use such products were no more likely to stop using conventional cigarettes compared with those who did not use such products.

Cigarette smoking, physical activity, and alcohol consumption: relationship to blood lipids and lipoproteins in premenopausal females.

PubMed

Stamford, B A; Matter, S; Fell, R D; Sady, S; Cresanta, M K; Papanek, P

1984-07-01

A total of 164 premenopausal female subjects were randomly selected for evaluation from a much larger pool of volunteers. The relationships between blood lipid and lipoprotein levels as dependent variables and cigarette smoking, physical activity, and alcohol consumption were determined from partial regression coefficients. A lower HDL-C level (10.1 mg/dL) was seen in smokers v nonsmokers. For each ounce of alcohol consumed, HDL-C level was higher by 2.8 mg/dL, and greater physical activity was associated with a higher HDL-C level of 8.6 mg/dL. An analysis of covariance with covariance adjustments for age and body fat revealed that smokers who regularly exercise or consume alcohol had significantly lower HDL-C levels than nonsmokers with similar habits. Subjects who both exercise and consume alcohol demonstrated higher HDL-C levels than those who indulge in one or the other separately. Results suggest that cigarette smoking may attenuate the effects of chronic exercise or alcohol consumption, or of both, to raise HDL-C levels. Also, chronic exercise and alcohol consumption may exert an additive effect, raising HDL-C level.

Frequency of Youth E-Cigarette and Tobacco Use Patterns in the United States: Measurement Precision Is Critical to Inform Public Health.

PubMed

Villanti, Andrea C; Pearson, Jennifer L; Glasser, Allison M; Johnson, Amanda L; Collins, Lauren K; Niaura, Raymond S; Abrams, David B

2017-11-01

E-cigarette use occurs with tobacco product use in youth. Using the 2014 National Youth Tobacco Survey (NYTS), we examined past 30-day frequency of cigarette, cigar, smokeless, and e-cigarette use in the context of past 30-day and ever tobacco product use in US middle and high school students (N = 22 007). Frequency of product-specific use was examined by exclusive versus concurrent use with another product in the past 30 days (poly-use). In 2014, the majority (83%) of US middle and high school students had not used tobacco or e-cigarettes in the past 30 days. In the 9.3% of youth reporting any past 30-day e-cigarette use, 63% also reported using a tobacco product; among the 3.3% past 30-day exclusive e-cigarette users, about two-thirds (2.1%) had ever used combustible or non-combustible tobacco products and one-third (1.2%) had not. Few never tobacco users had used e-cigarettes on 10 or more days in the past month (absolute percent < 0.1%). Among past 30-day cigarette and smokeless users, the two highest frequency categories were 1-2 days and daily use; among past 30-day e-cigarette and cigar users, prevalence decreased with increasing frequency of use. The majority of past 30-day cigarette, cigar, smokeless, and e-cigarette users reported poly-use. Prevalence estimates for a single product mask the complex patterns of frequency, temporality, and poly-use in youth. Two-thirds of past 30-day exclusive e-cigarette users have ever used tobacco. Poly-use is the dominant pattern of tobacco and e-cigarette use among US middle and high school students. Our study highlights the complexity of tobacco use patterns in US middle and high school students. Future studies addressing the full public health impact of movement into or out of combustible tobacco use will require longitudinal data with appropriate measures of tobacco and e-cigarette product-specific use (eg, frequency and intensity), as well as adequate sample size and a sufficient number of waves to determine how

Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh; Mir, Imtiyaz Ali; Sin, Shwe

2014-01-01

In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command. Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.

Effects of state cigarette excise taxes and smoke-free air policies on state per capita alcohol consumption in the U.S., 1980–2009

PubMed Central

Krauss, Melissa J.; Cavazos-Rehg, Patricia A.; Plunk, Andrew D.; Bierut, Laura J.; Grucza, Richard A.

2014-01-01

Background Increasing state cigarette excise taxes and strengthening smoke-free air laws are known to reduce smoking prevalence. Some studies suggest that such policies may also reduce alcohol use, but results for cigarette taxes have been mixed and associations with smoke-free air policies have been limited to some demographic subgroups. To shed further light on the potential secondary effects of tobacco control policy, we examined whether increases in cigarette taxes and strengthening of smoke-free air laws were associated with reductions of per capita alcohol consumption and whether any reductions were specific to certain beverage types. Methods State per capita alcohol consumption from 1980–2009 was modeled as a function of state price per pack of cigarettes and smoke-free air policy scores while controlling for secular trends and salient state covariates. Both policy measures also accounted for local policies. Total alcohol, beer, wine, and spirits consumption per capita were modeled separately. For each type of beverage, we used a nested models approach to determine whether the two policies together were associated with reduced consumption. Results For total alcohol consumption, and for beer or spirits (but not wine), one or both tobacco policies were associated with reductions in consumption. A one percent increase in cigarette price per pack was associated with a 0.083% decrease in per capita total alcohol consumption (95% confidence interval [CI] 0.0002% to 0.166%, p=.0495), and a one point increase in SFA policy score, measured on a 6-point scale, was associated with a 1.1% decrease in per capita total alcohol consumption (95% CI 0.4% to 1.7%, p=.001; p<.001 for the hypothesis that the two policies are jointly associated with reduced alcohol consumption). Conclusions The public health benefits of increasing cigarette taxes and smoke-free policies may go beyond the reduction of smoking and extend to alcohol consumption, specifically beer and spirits

75 FR 24534 - Treatment of Cigarettes and Smokeless Tobacco as Nonmailable Matter

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... photocopy all written comments at USPS Headquarters Library, 475 L'Enfant Plaza, SW., 11th Floor North... benchmarking purposes of cigarette brands or sub-brands among existing adult smokers.'' 18 U.S.C. 1716E(b)(5)(D... of evaluating the product for quality assurance and benchmarking purposes of cigarette brands or sub...

Cigarette Smokers’ Use of Unconventional Tobacco Products and Associations With Quitting Activity: Findings From the ITC-4 U.S. Cohort

PubMed Central

2014-01-01

Introduction: The purpose of this study was to evaluate the prevalence and correlates of use of nicotine-containing tobacco products such as cigars, pipe tobacco, and cigarettes that promise less exposure to toxins; e-cigarettes; and smokeless tobacco products among a cohort of conventional cigarette smokers followed over the past decade. We also evaluated associations between use of such products and cigarette quitting. Methods: Participants were 6,110 adult smokers in the United States, who were interviewed as part of the International Tobacco Control Four Country Survey between 2002 and 2011. Respondents reported their concurrent use of other smoked tobacco products (including cigars, pipe tobacco, and cigarillos), smokeless tobacco products (including chewing tobacco, snus, and snuff), unconventional cigarettes (including Omni, Accord, and Eclipse), and electronic cigarettes. Prevalence and correlates of use and associations between use and cigarette quitting were assessed using regression analyses via generalized estimating equations. Results: Most cigarette smokers did not use unconventional tobacco products, although use of any of these products started to rise at the end of the study period (2011). For each type of tobacco product evaluated, use was most prevalent among those aged 18–24 years. Smokers who did use unconventional tobacco products did not experience a clear cessation advantage. Conclusions: During the past decade, relatively few cigarette smokers reported also using other tobacco products. Those that did use such products were no more likely to stop using conventional cigarettes compared with those who did not use such products. PMID:24376276

Co-occurrent use of cigarettes, alcohol, and caffeine in a retired military population.

PubMed

Talcott, G W; Poston, W S; Haddock, C K

1998-03-01

Previous studies have linked the use of caffeine, nicotine, and alcohol to health complications and have also found that the use of these substances significantly covary. Given the prevalence of health problems of older adults, it is surprising that no studies to date have examined the co-occurrent use of alcohol, caffeine, and nicotine in a senior population. This investigation evaluated the co-occurrent use of cigarettes, caffeine, and alcohol in a community sample of older Americans. Respondents (1,095 women and 1,371 men) completed a questionnaire examining their use of caffeine, nicotine, and alcohol. This study replicated earlier findings that tobacco, caffeine, and alcohol use co-occur and that there are consistent use patterns for these substances. The results suggest that health organizations could better target services by prescreening for smoking, alcohol, and caffeine use and possibly targeting smokers and ex-smokers for potentially problematic use patterns of caffeine and alcohol.

Join the Campaign against Smokeless Tobacco.

ERIC Educational Resources Information Center

Koop, C. Everett

1987-01-01

The Surgeon General explains the health risks associated with smokeless tobacco use, analyzes the appeal of tobacco chewing to young males, and looks at what various levels of government and parents can do to discourage the use of smokeless tobacco. (MT)

Evidence supporting product standards for carcinogens in smokeless tobacco products.

PubMed

Hatsukami, Dorothy K; Stepanov, Irina; Severson, Herb; Jensen, Joni A; Lindgren, Bruce R; Horn, Kimberly; Khariwala, Samir S; Martin, Julia; Carmella, Steven G; Murphy, Sharon E; Hecht, Stephen S

2015-01-01

Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer. ©2014 American Association for Cancer Research.

27 CFR 40.24 - Classification of cigarettes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... cigarettes. 40.24 Section 40.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.24 Classification of cigarettes. For tax purposes, small...

27 CFR 40.24 - Classification of cigarettes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... cigarettes. 40.24 Section 40.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.24 Classification of cigarettes. For tax purposes, small...

27 CFR 40.24 - Classification of cigarettes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... cigarettes. 40.24 Section 40.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.24 Classification of cigarettes. For tax purposes, small...

27 CFR 40.24 - Classification of cigarettes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... cigarettes. 40.24 Section 40.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.24 Classification of cigarettes. For tax purposes, small...

27 CFR 40.24 - Classification of cigarettes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... cigarettes. 40.24 Section 40.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.24 Classification of cigarettes. For tax purposes, small...

Smokeless Tobacco Education for College Athletes.

ERIC Educational Resources Information Center

Burak, Lydia J.

2001-01-01

Chewing tobacco and taking snuff are common practices among college athletes. This article describes one college's smokeless tobacco education program for students athletes in the health, physical education, and recreation department. Research on the multiple-strategy intervention indicated decreases in student athletes' smokeless tobacco use and…

Risk perceptions of smokeless tobacco among adolescents and adult users and nonusers

PubMed Central

Liu, Sherry T.; Nemeth, Julianna M.; Klein, Elizabeth G.; Ferketich, Amy K.; Kwan, Mei-Po; Wewers, Mary Ellen

2015-01-01

The recent growth in smokeless tobacco (ST) consumption has raised questions about consumer risk perceptions of ST products, especially in high-risk vulnerable populations. This qualitative study examined risk perceptions of ST among adolescent and adult users and non-users in Ohio Appalachia. Focus groups and interviews were held with adolescents (n=53; mean age of 17 years) and adults (n=63; mean age of 34 years) from four Ohio Appalachian counties. Participants were asked about their perceptions of ST-related health risks, ST safety, and the relative safety of ST compared to cigarettes. Transcriptions were coded independently by two individuals. Overall, participants were knowledgeable about health problems from ST use (e.g., oral cancers, periodontal disease). Nearly all participants stated that ST use is not safe; however, there was disagreement about its relative safety. Some perceived all tobacco products as equally harmful; others believed that ST is safer than cigarettes for either the user or those around the user. Disagreements about ST relative safety may reflect mixed public health messages concerning the safety of ST. Comprehensive consumer messages about the relative safety of ST compared to cigarettes are needed. Messages should address the effect of ST on the health of the user as well as those exposed to the user. PMID:25832126

The association of sexual orientation with self-rated health, and cigarette and alcohol use in Mexican adolescents and youths.

PubMed

Ortiz-Hernández, Luis; Tello, Blanca Lilia Gómez; Valdés, Jesús

2009-07-01

Evidence of health inequities associated with sexual orientation has been gathered for industrialized countries. The situation for lesbians, gay males, and bisexuals (LGB) from middle- or low-income countries may be worse than those in industrialized nations. Here, we analyze the relationship of sexual orientation with self-rated health and cigarette and alcohol use among a representative sample of Mexican adolescents and youths between the ages of 12 and 29 years, in order to explore whether this association is mediated by discrimination and violence. Three dimensions of sexual orientation (affective attraction, sexual behavior, and identity) were assessed. The outcomes were self-rated health and cigarette and alcohol use. Compared to heterosexuals, LGB youths more frequently smoked >or=6 cigarettes per day, reported having experienced family violence, having crimes perpetrated against them, and having experienced violations of their rights. Among males, gays and bisexuals exhibited a higher risk of poor health than heterosexuals. Compared to heterosexual women, lesbians and bisexual women were more likely to consume alcohol. Many differences in self-rated health and substance use according to sexual orientation were explained by having experienced discrimination and violence. We concluded that lesbian and bisexual females have a higher prevalence of cigarette and alcohol use. It is necessary to develop policies and programs aimed at the reduction of substance abuse among LGB youths (focusing on females who engage in sexual contact with persons of the same gender) and to work against discrimination and violence experienced by LGB people, particularly against non-heterosexual males.

77 FR 20030 - Draft Guidance for Industry: Reporting Harmful and Potentially Harmful Constituents in Tobacco...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... products for consumer use--cigarettes, smokeless tobacco, and roll-your-own tobacco--and not with respect...: Cigarette smoke, smokeless tobacco products, and roll-your- own tobacco and cigarette filler. To facilitate... for cigarette smoke and filler, smokeless tobacco, and roll-your-own tobacco. FDA has created forms to...

Smokeless tobacco use among operating engineers.

PubMed

Noonan, Devon; Duffy, Sonia A

2012-05-01

Workers in blue collar occupations have been shown to have higher rates of smokeless tobacco (ST) use compared to other occupational groups. Guided by the Health Promotion Model, the purpose of this study was to understand various factors that predict ST use in Operating Engineers. A cross-sectional design was used to determine variables related to ST use among Operating Engineers. Engineers (N = 498) were recruited during their 3-day apprentice certification course to participate in the study. Logistic regression was used to assess the associations between personal, psychological and behavioral characteristics associated with ST use. Past month ST use was reported among 13% of operating engineers surveyed. Multivariate analysis showed that younger age and lower rates of past month cigarette use were significantly associated with ST use, while higher rates of problem drinking were marginally associated with ST use. Operating Engineers are at high risk for using ST products with rates in this sample well over the national average. Work site interventions, which have shown promise in other studies, may be useful in decreasing ST use among this population.

Tobacco Marketing and Subsequent Use of Cigarettes, E-cigarettes and Hookah in Adolescents.

PubMed

Cruz, Tess Boley; McConnell, Rob; Low, Brittany Wagman; Unger, Jennifer B; Pentz, Mary Ann; Urman, Robert; Berhane, Kiros; Chou, Chih Ping; Liu, Fei; Barrington-Trimis, Jessica

2018-05-28

Tobacco marketing has expanded from cigarettes to other tobacco products through many promotional channels. Marketing exposure is associated with use of that tobacco product. However, it's unclear if marketing for one product leads to subsequent use of other tobacco products. This prospective cohort study assessed self-reported marketing exposure for six tobacco products across five marketing channels in 11th/12th grade students in 2014. Approximately 16 months later a follow-up survey was conducted online (N=1553) to assess initiation of cigarettes, e-cigarettes and hookah. Adolescent never smokers with frequent exposure to cigarette marketing on the Internet and in stores are more than two times as likely to begin smoking as young adults (Internet OR 2.98 [95% CI, 1.56-5.66); Stores OR, 2.83 [95% CI, 1.23-6.50]). Never users of e-cigarettes were significantly more likely to initiate use, if exposed to Internet, store and outdoor e-cigarette marketing. Never users of hookah were more likely to use hookah after seeing it marketed in stores. Youth exposed to marketing of e-cigarettes, hookah, cigars, smokeless and pipe tobacco in stores were two to three times more likely to begin smoking cigarettes even though the marketed products were not cigarettes. Adolescent exposure to marketing of tobacco products is associated with initiation of those products as young adults. Exposure to marketing for non-cigarette tobacco products is associated with subsequent cigarette smoking, even when the promoted products are not cigarettes. Future research and interventions should consider the influence of marketing from multiple tobacco products on adolescent tobacco use. Adolescents grow up in a rich media environment with exposure to tobacco marketing in both their homes (e.g., through the Internet and television) and their communities (e.g., stores and billboards). This prospective study provides evidence that adolescents exposed to tobacco marketing for multiple tobacco

27 CFR 41.38 - Cigarettes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarettes. 41.38 Section... THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Classification of Large Cigars and Cigarettes § 41.38 Cigarettes. For internal...

27 CFR 41.38 - Cigarettes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarettes. 41.38 Section... THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Classification of Large Cigars and Cigarettes § 41.38 Cigarettes. For internal...

27 CFR 41.38 - Cigarettes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarettes. 41.38 Section... THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Classification of Large Cigars and Cigarettes § 41.38 Cigarettes. For internal...

27 CFR 41.38 - Cigarettes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarettes. 41.38 Section... THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Classification of Large Cigars and Cigarettes § 41.38 Cigarettes. For internal...

27 CFR 41.38 - Cigarettes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarettes. 41.38 Section... THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Classification of Large Cigars and Cigarettes § 41.38 Cigarettes. For internal...

The reemergence of smokeless tobacco.

PubMed

Connolly, G N; Winn, D M; Hecht, S S; Henningfield, J E; Walker, B; Hoffmann, D

1986-04-17

Smokeless tobacco (snuff and chewing tobacco) is reemerging as a popular form of tobacco, particularly among male adolescents. In different regions of the United States, from 8 to 36 percent of male high-school students are regular users. The use of smokeless tobacco has been shown to cause oral-pharyngeal cancer. The strongest link is with cancers of the cheek and gum. White mucosal lesions (leukoplakia) are found in 18 to 64 percent of users, often at the site where the tobacco was held. Other associations have been suggested for cancers of the esophagus, larynx, and pancreas. Nitrosamines, found in high concentrations in smokeless tobacco, most likely have a role in its carcinogenicity. Other health problems include periodontal disease, acute elevations of blood pressure, and dependence. In early 1986, after action at the state level, Congress enacted a federal law requiring health-warning labels on packages of smokeless tobacco and a ban on electronic advertising. Other regulatory measures under consideration include raising state and federal excise taxes, tightening controls on advertising, and prohibiting sales to minors. In view of the recent growth of this problem, policy makers are taking the opportunity to intervene with preventive measures to protect a new generation of tobacco users.

European Union policy on smokeless tobacco: a statement in favour of evidence based regulation for public health

PubMed Central

Bates, C; Fagerstrom, K; Jarvis, M; Kunze, M; McNeill, A; Ramstrom, L

2003-01-01

Rationale: This statement is an updated version of one released by the same authors in February 2003. The statement was produced to follow up the Royal College of Physicians (RCP) Tobacco Advisory Group report "Protecting smokers, saving lives: the case for a tobacco and nicotine regulatory authority",1 which argued for an evidence based regulatory approach to smokeless tobacco and harm reduction and posed a series of questions that regulators must address in relation to smokeless tobacco. The purpose of this statement is to provide arguments of fact and principle to follow the RCP's report and to outline the public health case for changing existing European Union (EU) regulation in this area. A review of regulation in relation to harm reduction and regulation of tobacco products other than cigarettes is required in Article 11 of EU directive 2001/37/EC,2 and this is a contribution towards forming a consensus in the European public health community about what policy the EU should adopt in the light of this review, or following ongoing legal action that may potentially strike out the existing regulation altogether. Public health case: We believe that the partial ban applied to some forms of smokeless tobacco in the EU should be replaced by regulation of the toxicity of all smokeless tobacco. We hold this view for public health reasons: smokeless tobacco is substantially less harmful than smoking and evidence from Sweden suggests it is used as a substitute for smoking and for smoking cessation. To the extent there is a "gateway" it appears not to lead to smoking, but away from it and is an important reason why Sweden has the lowest rates of tobacco related disease in Europe. We think it is wrong to deny other Europeans this option for risk reduction and that the current ban violates rights of smokers to control their own risks. For smokers that are addicted to nicotine and cannot or will not stop, it is important that they can take advantage of much less hazardous

The Effects of Maternal Alcohol Consumption and Cigarette Smoking during Pregnancy on Acoustic Cry Analysis.

ERIC Educational Resources Information Center

Nugent, J. Kevin; And Others

1996-01-01

Measured the neurobehavioral integrity of Irish infants and maternal alcohol consumption and cigarette smoking. Subjects were 127 primiparous mothers. Results demonstrated significant cry effects on infants of heavily drinking mothers, supporting the conclusion that newborn infants show functional disturbances in the nervous system resulting from…

Food, alcohol and cigarette availability and consumption in Almaty, Kazakstan: results and appraisal of a rapid assessment.

PubMed

Yim, Andrew; Humphries, Debbie; Abuova, Gaukhar

2003-12-01

(1) To develop a useful tool to measure food, alcohol and tobacco items; (2) to document the availability of these items in Almaty, Kazakstan; (3) to describe the relationship between consumption and availability; and (4) to identify possible relationships between availability and health outcomes in the city and region. A survey of 648 vendors in Almaty, Kazakstan was conducted over one month from December 1999 to January 2000. Vendors identified which items they sold from a list of 61 food, alcohol and tobacco items. Vendors were approached in three of the six regions of Almaty, Kazakstan. Regions canvassed included Auzov, one of the three 'sleeping regions'; Medeo, one of the two downtown regions; and Turksib, a more suburban/rural area of the city. There was a significant correlation between alcohol and cigarette consumption and availability. The relative availability of items was numerically and spatially consistent throughout the city. Fruits and vegetables occurred infrequently (<20% of sites) and in relative isolation from the rest of the system, while candy and cigarettes occurred with a higher relative frequency (75-80% of sites). Maps of vendors showed clusters around geographical features such as major roads and intersections. Combining a checklist and mapping tools provides a model of consumer item availability that can help identify priorities for public health and urban planning professionals. The wide availability of cigarettes, alcohol, candy, coffee and tea, and limited availability of fruits, vegetables and whole grains, is likely to support increasing rates of chronic disease in Almaty.

76 FR 16424 - Draft Guidance for Industry: Compliance With Regulations Restricting the Sale and Distribution of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Cigarettes and Smokeless Tobacco To Protect Children and Adolescents; Availability AGENCY: Food and Drug... Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and... the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents...

27 CFR 40.351 - Cigarette papers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette papers. 40.351... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.351 Cigarette papers. Cigarette...

27 CFR 40.351 - Cigarette papers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette papers. 40.351... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.351 Cigarette papers. Cigarette...

27 CFR 40.351 - Cigarette papers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette papers. 40.351... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.351 Cigarette papers. Cigarette...

27 CFR 40.351 - Cigarette papers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette papers. 40.351... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.351 Cigarette papers. Cigarette...

27 CFR 40.351 - Cigarette papers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette papers. 40.351... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.351 Cigarette papers. Cigarette...

Childhood adversity, serotonin transporter (5-HTTLPR) genotype, and risk for cigarette smoking and nicotine dependence in alcohol dependent adults.

PubMed

Mingione, Carolyn J; Heffner, Jaimee L; Blom, Thomas J; Anthenelli, Robert M

2012-06-01

This study examined the extent to which cigarette smoking and nicotine dependence in adults with alcohol dependence (AD) are associated with adverse childhood experiences. Gender, social support, and an allelic variant in the gene encoding the serotonin transporter (5-HTTLPR) were examined as moderators of this relationship. The Semi-Structured Assessment for the Genetics of Alcoholism - Version II (SSAGA-II) was used to assess DSM-IV diagnoses and cigarette smoking characteristics as well as traumatic life events and social support during childhood in 256 AD men (n=149) and women (n=107). An increase in number of adverse childhood events was associated with heightened risk of cigarette use and nicotine dependence. 5-HTTLPR genotype, gender, and social support did not significantly moderate the relationships among childhood adversity and ever-smoking or nicotine dependence. Results extend previous findings to suggest that childhood adversity is strongly related to risk for ever-smoking and nicotine dependence in AD individuals. Additional research is needed to examine other potential genetic and environmental moderators and mediators of the relationships among smoking, alcohol use, and childhood trauma. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Childhood Adversity, Serotonin Transporter (5-HTTLPR) Genotype, and Risk for Cigarette Smoking and Nicotine Dependence in Alcohol Dependent Adults

PubMed Central

Mingione, Carolyn J.; Heffner, Jaimee L.; Blom, Thomas J.; Anthenelli, Robert M.

2011-01-01

Background This study examined the extent to which cigarette smoking and nicotine dependence in adults with alcohol dependence (AD) are associated with adverse childhood experiences. Gender, social support, and an allelic variant in the gene encoding the serotonin transporter (5-HTTLPR) were examined as moderators of this relationship. Methods The Semi-Structured Assessment for the Genetics of Alcoholism- Version II (SSAGA-II) was used to assess DSM-IV diagnoses and cigarette smoking characteristics as well as traumatic life events and social support during childhood in 256 AD men (n=149) and women (n=107). Results An increase in number of adverse childhood events was associated with heightened risk of cigarette use and nicotine dependence. 5-HTTLPR genotype, gender, and social support did not significantly moderate the relationships among childhood adversity and ever-smoking or nicotine dependence. Conclusions Results extend previous findings to suggest that childhood adversity is strongly related to risk for ever-smoking and nicotine dependence in AD individuals. Additional research is needed to examine other potential genetic and environmental moderators and mediators of the relationships among smoking, alcohol use, and childhood trauma. PMID:22172222

Past Year Quit Attempts and Use of Cessation Resources Among Cigarette-Only Smokers and Cigarette Smokers Who Use Other Tobacco Products.

PubMed

Schauer, Gillian L; Pederson, Linda L; Malarcher, Ann M

2016-01-01

It is unclear how use of other tobacco products impacts cigarette-smoking cessation. We assessed differences in past year cigarette smoking quit attempts and use of counseling and medication among current cigarette-only users, cigarette and cigar users, and cigarette and smokeless tobacco (SLT) users. Data came from 24 448 current cigarette-only, 1064 cigarette and cigar only, and 508 cigarette and SLT only users who responded to the 2010-2011 Tobacco Use Supplement to the Current Population Survey. Demographic, smoking, and cessation characteristics were computed by group. Bivariate and multivariable logistic regression models assessed the relationship of tobacco use group to making a past year quit attempt, and use of counseling or medication during the last quit attempt. Dual users of cigarettes and cigars or SLT had similar interest in quitting and prevalence of reported past year quit attempts compared to cigarette-only users. In unadjusted analyses, cigarette and SLT users had higher odds of trying to quit in the past year compared to cigarette-only users (odds ratio [OR] = 1.31, 95% confidence interval [CI] = 1.05, 1.64); no differences were found for cigarette and cigar users. However, adjusting for demographic and cigarette smoking variables, both groups of dual users had similar odds as cigarette-only users for having made a past year cigarette smoking quit attempt, and to have used counseling or medication during the last quit attempt. Dual tobacco use was not associated with decreased attempts to quit smoking cigarettes; however, use of evidence-based treatment was sub-optimal among cigarette-only and dual users, and should be increased. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

21 CFR 1140.34 - Sale and distribution of nontobacco items and services, gifts, and sponsorship of events.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS..., and sponsorship of events. (a) No manufacturer and no distributor of imported cigarettes or smokeless... item (other than cigarettes or smokeless tobacco or roll-your-own paper) or service, which bears the...

78 FR 44955 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

...; Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco To Protect Children and... and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents'' has been... ``Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and...

21 CFR 1140.34 - Sale and distribution of nontobacco items and services, gifts, and sponsorship of events.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS..., and sponsorship of events. (a) No manufacturer and no distributor of imported cigarettes or smokeless... item (other than cigarettes or smokeless tobacco or roll-your-own paper) or service, which bears the...

75 FR 32791 - Draft Guidance for Industry: Compliance With Regulations Restricting the Sale and Distribution of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-09

... Cigarettes and Smokeless Tobacco to Protect Children and Adolescents; Availability AGENCY: Food and Drug... Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco To Protect Children and... restricting the sale and distribution of cigarettes and smokeless tobacco in order to protect children and...

Physical Activity, Body Mass Index, Alcohol Consumption and Cigarette Smoking among East Asian College Students

ERIC Educational Resources Information Center

Seo, Dong-Chul; Torabi, Mohammad R.; Chin, Ming-Kai; Lee, Chung Gun; Kim, Nayoung; Huang, Sen-Fang; Chen, Chee Keong; Mok, Magdalena Mo Ching; Wong, Patricia; Chia, Michael; Park, Bock-Hee

2014-01-01

Objective: To identify levels of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) in a representative sample of college students in six East Asian economies and examine their relationship with weight, alcohol consumption and cigarette smoking. Design: Cross-sectional survey. Setting: College students…

Periodontal effects and dental caries associated with smokeless tobacco use.

PubMed Central

Weintraub, J A; Burt, B A

1987-01-01

The prevalence of smokeless tobacco use has been increasing in the United States with concomitant social, medical, legal, and regulatory ramifications. This paper examines the association between the use of smokeless tobacco and the occurrence of periodontal disease and dental caries. Existing literature consists primarily of case reports and cross-sectional studies among teenagers. The limited evidence suggests an association between smokeless tobacco use and gingival recession. There is insufficient evidence to support any associations between smokeless tobacco use and gingivitis, periodontitis, or dental caries. Methods to improve future epidemiologic research to examine possible associations between smokeless tobacco use and periodontal effects or dental caries are discussed. PMID:3101120

21 CFR 1140.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.1 Scope. (a) This part sets out the restrictions... cigarettes and smokeless tobacco that contain nicotine. (b) The failure to comply with any applicable provision in this part in the sale, distribution, and use of cigarettes and smokeless tobacco renders the...

21 CFR 1140.1 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.1 Scope. (a) This part sets out the restrictions... cigarettes and smokeless tobacco that contain nicotine. (b) The failure to comply with any applicable provision in this part in the sale, distribution, and use of cigarettes and smokeless tobacco renders the...

21 CFR 1140.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.1 Scope. (a) This part sets out the restrictions... cigarettes and smokeless tobacco that contain nicotine. (b) The failure to comply with any applicable provision in this part in the sale, distribution, and use of cigarettes and smokeless tobacco renders the...

Associations between e-cigarette access and smoking and drinking behaviours in teenagers.

PubMed

Hughes, Karen; Bellis, Mark A; Hardcastle, Katherine A; McHale, Philip; Bennett, Andrew; Ireland, Robin; Pike, Kate

2015-03-31

Public health concerns regarding e-cigarettes and debate on appropriate regulatory responses are focusing on the need to prevent child access to these devices. However, little is currently known about the characteristics of those young people that are accessing e-cigarettes. Using a cross-sectional survey of 14-17 year old school students in North West England (n = 16,193) we examined associations between e-cigarette access and demographics, conventional smoking behaviours, alcohol consumption, and methods of accessing cigarettes and alcohol. Access to e-cigarettes was identified through a question asking students if they had ever tried or purchased e-cigarettes. One in five participants reported having accessed e-cigarettes (19.2%). Prevalence was highest among smokers (rising to 75.8% in those smoking >5 per day), although 15.8% of teenagers that had accessed e-cigarettes had never smoked conventional cigarettes (v.13.6% being ex-smokers). E-cigarette access was independently associated with male gender, having parents/guardians that smoke and students' alcohol use. Compared with non-drinkers, teenagers that drank alcohol at least weekly and binge drank were more likely to have accessed e-cigarettes (adjusted odds ratio [AOR] 1.89, P < 0.001), with this association particularly strong among never-smokers (AOR 4.59, P < 0.001). Among drinkers, e-cigarette access was related to: drinking to get drunk, alcohol-related violence, consumption of spirits; self-purchase of alcohol from shops or supermarkets; and accessing alcohol by recruiting adult proxy purchasers outside shops. There is an urgent need for controls on the promotion and sale of e-cigarettes to children. Findings suggest that e-cigarettes are being accessed by teenagers more for experimentation than smoking cessation. Those most likely to access e-cigarettes may already be familiar with illicit methods of accessing age-restricted substances.

Use of Conventional and Novel Smokeless Tobacco Products Among US Adolescents

PubMed Central

Ayo-Yusuf, Olalekan A.; Vardavas, Constantine I.; Alpert, Hillel R.; Connolly, Gregory N.

2013-01-01

OBJECTIVES: To assess the prevalence and correlates of use of conventional and novel smokeless tobacco products among a national sample of US middle and high school students. METHODS: Data from the 2011 National Youth Tobacco Survey were analyzed to determine national estimates of current use of conventional (“chewing tobacco”, “snuff,” or “dip”), novel (“snus” and “dissolvable tobacco products”), and any smokeless tobacco products (novel and/or conventional products) within the past 30 days. RESULTS: The overall prevalence of current use of any smokeless tobacco product was 5.6% (n = 960). Among all students, 5.0% used chewing tobacco, snuff, or dip; 1.9% used snus; and 0.3% used dissolvable tobacco products. Among users of any smokeless tobacco, 64.0% used only conventional products, 26.8% were concurrent users of novel plus conventional products, whereas 9.2% exclusively used novel products. Approximately 72.1% of current any smokeless tobacco users concurrently smoked combustible tobacco products, and only 40.1% expressed an intention to quit all tobacco use. Regression analyses indicated that peer (adjusted odds ratio [aOR]: 9.56; 95% confidence interval [CI]: 7.14–12.80) and household (aOR: 3.32; 95% CI: 2.23–4.95) smokeless tobacco use were associated with smokeless tobacco use, whereas believing that all forms of tobacco are harmful was protective (aOR: 0.55; 95% CI: 0.38–0.79). CONCLUSIONS: Conventional smokeless tobacco products remain the predominant form of smokeless tobacco use. Most users of novel smokeless tobacco products also concurrently smoked combustible tobacco products. Smokeless tobacco use was associated with lower perception of harm from all tobacco products and protobacco social influences, indicating the need to change youth perceptions about the use of all tobacco products and to engage pediatricians in tobacco use prevention and cessation interventions. PMID:23918889

27 CFR 41.34 - Cigarette papers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette papers. 41.34... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.34 Cigarette papers. Cigarette papers are taxed at the following...

27 CFR 41.34 - Cigarette papers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette papers. 41.34... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.34 Cigarette papers. Cigarette papers are taxed at the following...

27 CFR 41.34 - Cigarette papers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette papers. 41.34... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.34 Cigarette papers. Cigarette papers are taxed at the following...

27 CFR 41.34 - Cigarette papers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette papers. 41.34... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.34 Cigarette papers. Cigarette papers are taxed at the following...

27 CFR 41.34 - Cigarette papers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette papers. 41.34... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.34 Cigarette papers. Cigarette papers are taxed at the following...

Perceived Harm, Addictiveness, and Social Acceptability of Tobacco Products and Marijuana Among Young Adults: Marijuana, Hookah, and Electronic Cigarettes Win

PubMed Central

Berg, Carla J.; Stratton, Erin; Schauer, Gillian L.; Lewis, Michael; Wang, Yanwen; Windle, Michael; Kegler, Michelle

2015-01-01

Background There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. Objectives This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. Methods In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. Results Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth. PMID:25268294

Perceived harm, addictiveness, and social acceptability of tobacco products and marijuana among young adults: marijuana, hookah, and electronic cigarettes win.

PubMed

Berg, Carla J; Stratton, Erin; Schauer, Gillian L; Lewis, Michael; Wang, Yanwen; Windle, Michael; Kegler, Michelle

2015-01-01

There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance: Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.

Health Implications of Smokeless Tobacco Use. Volume 6, Number 1.

ERIC Educational Resources Information Center

National Institutes of Health (DHHS), Bethesda, MD. Office of Medical Applications of Research.

Concerned with the increase in use of chewing tobacco and snuff, this brochure looks at the health risks of using smokeless tobacco. It presents five questions about smokeless tobacco use and provides answers to the questions developed by a consensus development conference on health implications of smokeless tobacco use convened by the National…

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

Under the radar: smokeless tobacco advertising in magazines with substantial youth readership.

PubMed

Morrison, Margaret A; Krugman, Dean M; Park, Pumsoon

2008-03-01

In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents' exposure to smokeless tobacco advertising. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA.

How risky is it to use e-cigarettes? Smokers’ beliefs about their health risks from using novel and traditional tobacco products

PubMed Central

Emery, Sherry L.; Ribisl, Kurt M.; Rini, Christine M.; Brewer, Noel T.

2015-01-01

We sought to understand smokers’ perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use. PMID:25348584

How risky is it to use e-cigarettes? Smokers' beliefs about their health risks from using novel and traditional tobacco products.

PubMed

Pepper, Jessica K; Emery, Sherry L; Ribisl, Kurt M; Rini, Christine M; Brewer, Noel T

2015-04-01

We sought to understand smokers' perceived likelihood of health problems from using cigarettes and four non-cigarette tobacco products (NCTPs: e-cigarettes, snus, dissolvable tobacco, and smokeless tobacco). A US national sample of 6,607 adult smokers completed an online survey in March 2013. Participants viewed e-cigarette use as less likely to cause lung cancer, oral cancer, or heart disease compared to smoking regular cigarettes (all p < .001). This finding was robust for all demographic groups. Participants viewed using NCTPs other than e-cigarettes as more likely to cause oral cancer than smoking cigarettes but less likely to cause lung cancer. The dramatic increase in e-cigarette use may be due in part to the belief that they are less risky to use than cigarettes, unlike the other NCTPs. Future research should examine trajectories in perceived likelihood of harm from e-cigarette use and whether they affect regular and electronic cigarette use.

Influence of the Flavored Cigarette Ban on Adolescent Tobacco Use.

PubMed

Courtemanche, Charles J; Palmer, Makayla K; Pesko, Michael F

2017-05-01

This paper estimated the association between the U.S. Food and Drug Administration's 2009 ban on flavored cigarettes (which did not apply to menthol cigarettes or tobacco products besides cigarettes) and adolescents' tobacco use. Regression modeling was used to evaluate tobacco use before and after the ban. The analyses controlled for a quadratic time trend, demographic variables, prices of cigarettes and other tobacco products, and teenage unemployment rate. Data from the 1999-2013 National Youth Tobacco Surveys were collected and analyzed in 2016. The sample included 197,834 middle and high schoolers. Outcomes were past 30-day cigarette use; cigarettes smoked in the past 30 days among smokers; rate of menthol cigarette use among smokers; and past 30-day use of cigars, smokeless tobacco, pipes, any tobacco products besides cigarettes, and any tobacco products including cigarettes. Banning flavored cigarettes was associated with reductions in the probability of being a cigarette smoker (17%, p<0.001) and cigarettes smoked by smokers (58%, p=0.005). However, the ban was positively associated with the use by smokers of menthol cigarettes (45%, p<0.001), cigars (34%, p<0.001), and pipes (55%, p<0.001), implying substitution toward the remaining legal flavored tobacco products. Despite increases in some forms of tobacco, overall there was a 6% (p<0.001) reduction in the probability of using any tobacco. The results suggest the 2009 flavored cigarette ban did achieve its objective of reducing adolescent tobacco use, but effects were likely diminished by the continued availability of menthol cigarettes and other flavored tobacco products. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Thai Parenting Practices, Family Rituals and Risky Adolescent Behaviors: Alcohol Use, Cigarette Use and Delinquency

PubMed Central

Miller, Brenda A.; Byrnes, Hilary F.; Cupp, Pamela K.; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Fongkaew, Warunee; Rosati, Michael J.; Chookhare, Warunee; Zimmerman, Rick S.

2011-01-01

Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics. PMID:24511362

Thai Parenting Practices, Family Rituals and Risky Adolescent Behaviors: Alcohol Use, Cigarette Use and Delinquency.

PubMed

Miller, Brenda A; Byrnes, Hilary F; Cupp, Pamela K; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Fongkaew, Warunee; Rosati, Michael J; Chookhare, Warunee; Zimmerman, Rick S

2011-10-01

Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics.

Serotonergic dysfunction in addiction: effects of alcohol, cigarette smoking and heroin on platelet 5-HT content.

PubMed

Schmidt, L G; Dufeu, P; Heinz, A; Kuhn, S; Rommelspacher, H

1997-10-10

The impact of ethanol, cigarette smoking and heroin on serotonin function was evaluated, first in alcoholics during chronic ethanol intoxication and in opiate addicts after long-term heroin consumption, and secondly in both patient groups after detoxification treatment (i.e. a short-term abstinence of 8 days). Our results showed that the 5-hydroxytryptamine (5-HT) content in platelets was: (1) increased in the subgroup of anti-social alcoholics; (2) transiently and differently altered in alcoholics compared to opiate addicts; and (3) lowered in drinking alcoholics and normal in alcoholics who were drinking as well as smoking (that may occur via MAO-B inhibition by smoke). The findings indicate that alterations of the peripheral and possibly the central serotonin system may occur as predisposing factors for alcoholism in individuals with anti-social traits; they may also have some impact on the progression of alcoholism due to its lowered function during chronic ethanol intoxication that is substantially modified by smoking.

The Effect of Comparatively-Framed versus Similarity-Framed E-Cigarette and Snus Print Ads on Young Adults' Ad and Product Perceptions.

PubMed

Banerjee, Smita C; Greene, Kathryn; Li, Yuelin; Ostroff, Jamie S

2016-07-01

This study examined the effects of comparative-framing [C-F; ads highlighting differences between the advertised product and conventional cigarettes and/or smokeless tobacco products] versus similarity-framing (S-F; ads highlighting congruence with conventional cigarettes and/or smokeless tobacco products) in e-cigarette and snus ads on young adult smokers' and non-smokers' ad- and product-related perceptions. One thousand fifty one (1,051) young adults (18-24 years; 76% women; 50% smokers) from existing consumer panels were recruited in a within-subjects quasi-experiment. Each participant viewed 4 online advertisements, varied by tobacco product type (e-cigarette or snus) and ad framing (C-F or S-F). The dependent measures for this study were ad-related (ad perceptions, ad credibility) and product-related perceptions (absolute and comparative risk perceptions, product appeal, and product use intentions). Former and current smokers rated C-F ads as more persuasive than S-F ads, as evidenced by favorable ad perceptions and high product use intentions. Former and current smokers also rated e-cigarette ads with more favorable ad perceptions, low absolute and comparative risk perceptions, high product appeal, and high product use intentions as compared to snus ads. However, the effect sizes of the significant differences are less than.2, indicating small magnitude of difference between the study variables. Unless FDA regulates e-cig and snus advertising, there is a potential of decreasing risk perceptions and increasing use of e-cigs among young adults. Further research on implicit/explicit comparative claims in e-cigarettes and snus advertisements that encourage risk misperceptions is recommended.

Under the Radar: Smokeless Tobacco Advertising in Magazines With Substantial Youth Readership

PubMed Central

Morrison, Margaret A.; Krugman, Dean M.; Park, Pumsoon

2008-01-01

Objectives. In light of the Smokeless Tobacco Master Settlement Agreement (STMSA) and the fact that smokeless tobacco advertising has received little attention, we examined industry data to assess smokeless tobacco advertising in popular magazines. Of particular interest was the level of advertising in magazines with high youth readership and the amount of reach and frequency that was generated among readers aged 12 to 17 years. Methods. We used readership data from Mediamark Research Inc, advertising expenditure data from TNS Media Intelligence, and Adplus, a media planning program from Telmar to document the composition of adult and youth readership of magazines in which smokeless tobacco products were advertised, industry expenditures on advertising, and adolescents’ exposure to smokeless tobacco advertising. Results. The STMSA appears to have had a limited effect on the advertising of smokeless tobacco products to youth; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Conclusions. Popular magazines with smokeless tobacco advertising reach a large number of adolescents through a combination of both youth-oriented and adult magazines. These exposure levels have generally increased since the STMSA. PMID:17600263

27 CFR 40.215 - Notice for cigarettes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Notice for cigarettes. 40..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES... cigarettes. Every package of cigarettes shall, before removal subject to tax, have adequately imprinted...

27 CFR 40.215 - Notice for cigarettes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Notice for cigarettes. 40..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES... cigarettes. Every package of cigarettes shall, before removal subject to tax, have adequately imprinted...

27 CFR 40.215 - Notice for cigarettes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for cigarettes. 40..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES... cigarettes. Every package of cigarettes shall, before removal subject to tax, have adequately imprinted...

27 CFR 40.215 - Notice for cigarettes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Notice for cigarettes. 40..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES... cigarettes. Every package of cigarettes shall, before removal subject to tax, have adequately imprinted...

27 CFR 40.215 - Notice for cigarettes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Notice for cigarettes. 40..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES... cigarettes. Every package of cigarettes shall, before removal subject to tax, have adequately imprinted...

Brief, Instructional Smokeless Tobacco Use Among Cigarette Smokers Who Do Not Intend to Quit: A Pilot Randomized Clinical Trial

PubMed Central

2014-01-01

Introduction: Low-nitrosamine smokeless tobacco (SLT) may have efficacy for smoking reduction and cessation, but its public health impact depends on how smokers use it. Methods: This pilot study explored brief, instructional low-nitrosamine SLT use among smokers unmotivated to quit. Participants (N = 57) were randomized to either a free 2-week supply of Camel Snus group or a no-supply group. Of those randomized to use Camel Snus, half were told to use it to cope with smoking restrictions (Snus to Cope), and the remaining half were advised to use it to reduce smoking (Snus to Reduce). Participants were assessed before, during, and immediately after the intervention. Results: Many Snus to Cope and Snus to Reduce participants reported daily use of Camel Snus, although the amount of use was low. Snus to Cope (18.4%) and Snus to Reduce (37.6%) participants reported a decline in number of cigarettes used per day, which was not reported by the control participants (p < .001). Intention to quit smoking and intention to quit all tobacco use (ps < .001) increased to a greater extent among Snus to Cope and Snus to Reduce participants than among control participants. Conclusions: This study replicates previous work that shows that low-nitrosamine SLT use can lead to reduced smoking and increased intention to quit, and it adds direct evidence to suggest that the function of low-nitrosamine SLT use—either to cope with smoking restrictions or to reduce smoking—can have a differential impact on smoking behavior. Overall, the results highlight the importance of messaging and, more specifically, marketing of low-nitrosamine SLT to smokers. PMID:24130144

Was it the drink? The conditioned association of alcohol and desire to quit smoking on the dual use of little cigars/cigarillos and cigarettes among men and women.

PubMed

Ehlke, Sarah J; Cohn, Amy M

2016-08-01

Dual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women. Data utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected. Dual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit. Alcohol use may be a risk factor for men's dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed. Copyright © 2016. Published by Elsevier Ltd.

Alcohol consumption, cigarette smoking and incidence of aortic valve stenosis.

PubMed

Larsson, S C; Wolk, A; Bäck, M

2017-10-01

Alcohol consumption and cigarette smoking are modifiable lifestyle factors with important impact on public health. It is unclear whether these factors influence the risk of aortic valve stenosis (AVS). To investigate the associations of alcohol consumption and smoking, including smoking intensity and time since cessation, with AVS incidence in two prospective cohorts. This analysis was based on data from the Swedish Mammography Cohort and the Cohort of Swedish Men, comprising 69 365 adults without cardiovascular disease at baseline. Participants were followed for AVS incidence and death by linkage to the Swedish National Patient and Causes of Death Registers. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox proportional hazards regression. Over a mean follow-up of 15.3 years, 1249 cases of AVS (494 in women and 755 in men) were recorded. Compared with never drinkers of alcohol (lifelong abstainers), the risk of AVS was significantly lower in current light drinkers (1-6 drinks per week [1 drink = 12 g alcohol]; multivariable HR 0.82; 95% CI: 0.68-0.99). The risk of AVS increased with increasing smoking intensity. Compared with never smokers, the HR was 1.46 (95% CI: 1.16-1.85) in current smokers of ≥30 pack-years. Former smokers who had quit smoking 10 or more years previously had similar risk for AVS as never smokers. This study suggests that current light alcohol consumption is associated with a lower risk of AVS, and indicates that the association between smoking and AVS risk is reversible. © 2017 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

27 CFR 41.74 - Notice for cigarettes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Notice for cigarettes. 41..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Packages § 41.74 Notice for cigarettes. Every package of cigarettes, except as...

27 CFR 41.74 - Notice for cigarettes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Notice for cigarettes. 41..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Packages § 41.74 Notice for cigarettes. Every package of cigarettes, except as...

27 CFR 41.74 - Notice for cigarettes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Notice for cigarettes. 41..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Packages § 41.74 Notice for cigarettes. Every package of cigarettes, except as...

27 CFR 41.74 - Notice for cigarettes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Notice for cigarettes. 41..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Packages § 41.74 Notice for cigarettes. Every package of cigarettes, except as...

27 CFR 41.74 - Notice for cigarettes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for cigarettes. 41..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Packages § 41.74 Notice for cigarettes. Every package of cigarettes, except as...

Prenatal exposure to cigarette smoke or alcohol and cerebellum volume in attention-deficit/hyperactivity disorder and typical development

PubMed Central

de Zeeuw, P; Zwart, F; Schrama, R; van Engeland, H; Durston, S

2012-01-01

Prenatal exposure to teratogenic substances, such as nicotine or alcohol, increases the risk of developing attention-deficit/hyperactivity disorder (ADHD). To date, studies examining this relationship have used symptom scales as outcome measures to assess the effect of prenatal exposure, and have not investigated the neurobiological pathways involved. This study explores the effect of prenatal exposure to cigarettes or alcohol on brain volume in children with ADHD and typically developing controls. Children with ADHD who had been exposed prenatally to either substance were individually matched to children with and without ADHD who had not been. Controls who had been exposed prenatally were also individually matched to controls who had not been. For prenatal exposure to both smoking and alcohol, we found a pattern where subjects with ADHD who had been exposed had the smallest brain volumes and unexposed controls had the largest, with intermediate volumes for unexposed subjects with ADHD. This effect was most pronounced for cerebellum. A similar reduction fell short of significance for controls who had been exposed to cigarettes, but not alcohol. Our results are consistent with an additive effect of prenatal exposure and ADHD on brain volume, with the effects most pronounced for cerebellum. PMID:22832850

Non-cigarette tobacco products: what have we learnt and where are we headed?

PubMed

O'Connor, Richard J

2012-03-01

A wide variety of non-cigarette forms of tobacco and nicotine exist, and their use varies regionally and globally. Smoked forms of tobacco such as cigars, bidis, kreteks and waterpipes have high popularity and are often perceived erroneously as less hazardous than cigarettes, when in fact their health burden is similar. Smokeless tobacco products vary widely around the world in form and the health hazards they present, with some clearly toxic forms (eg, in South Asia) and some forms with far fewer hazards (eg, in Sweden). Nicotine delivery systems not directly reliant on tobacco are also emerging (eg, electronic nicotine delivery systems). The presence of such products presents challenges and opportunities for public health. Future regulatory actions such as expansion of smoke-free environments, product health warnings and taxation may serve to increase or decrease the use of non-cigarette forms of tobacco. These regulations may also bring about changes in non-cigarette tobacco products themselves that could impact public health by affecting attractiveness and/or toxicity.

Smoking and smokeless tobacco use among adolescents: trends and intervention results.

PubMed

Schinke, S P; Gilchrist, L D; Schilling, R F; Senechal, V A

1986-01-01

Data from a 2-year study describe tobacco use trends, perceptions, and prevention effects for 1,281 5th and 6th graders enrolled in 12 randomly selected Washington State elementary schools. Youths were pretested, then randomly divided by school into skills, discussion, and control groups. Preventive intervention curriculums for the skills and discussion groups included age-relevant information on smoked and smokeless tobacco use, peer testimonials, debates, games, and homework. Youths in the skills group also learned communication and problem-solving methods for handling difficult situations around tobacco use. Following intervention, youths were posttested, then retested semiannually for 2 years. During the 2-year study, three-quarters of all smokers and nonusers and half of all smokeless tobacco users maintained their statuses. Only 10 percent of all smokers and 3 percent of all smokeless users quit their habits. One in six reported new tobacco use, one-third of smokers began using smokeless tobacco, and two-thirds of all smokeless users began smoking during the study. Most youths at final measurement perceived smokeless tobacco as less of a health risk than smoking. Nearly one in two of all smokeless users intended to smoke, and two-thirds were actually smoking at 24-month followup. Both smoked and smokeless tobacco use rates increased in all groups, and youths in the skills intervention group consistently showed the lowest rates relative to the other groups. These findings demonstrate the potential of skills intervention methods for lowering tobacco use rates among adolescents.

Acceptability of electronic cigarettes as an option to replace tobacco smoking for alcoholics admitted to hospital for detoxification.

PubMed

Truman, Penelope; Gilmour, Moira; Robinson, Geoffrey

2018-02-23

A feasibility/acceptability trial was undertaken at Ward 5, Kenepuru Hospital, Porirua, to ascertain whether electronic cigarettes (e-cigarettes) were a useful option to replace or reduce smoking in the detoxification ward. Two groups of patients were studied. Tobacco use and dependency data were collected for each. The first group was surveyed on the usefulness of standard nicotine replacement therapy (NRT). The second group were offered e-cigarettes with the option of standard NRT as well. All were asked to record their use of cigarettes, e-cigarettes and NRT during their stay on the ward, and to comment on their experiences. Outcomes monitored were self-reported use of NRT and of tobacco. Informal impressions of the nursing staff were also collected, where offered. For the e-cigarette group, a blood sample was taken on day 3 or 4 of their stay in hospital for nicotine/cotinine analysis, to confirm nicotine intake status. E-cigarettes were well tolerated as a form of nicotine replacement, eliciting positive comments, though they were not effective for all. The average reduction in median cigarettes per day was very similar between the group given standard NRT and the e-cigarette group, at 80% and 86% respectively. There were no adverse effects reported. The study showed that e-cigarettes were an acceptable form of nicotine replacement for these alcohol-dependent patients during their time in the ward. For heavily tobacco-dependent smokers, e-cigarettes may provide a useful aid to patient management within a hospital setting.

Cigarette graphic warning labels increase both risk perceptions and smoking myth endorsement.

PubMed

Evans, Abigail T; Peters, Ellen; Shoben, Abigail B; Meilleur, Louise R; Klein, Elizabeth G; Tompkins, Mary Kate; Tusler, Martin

2018-02-01

Cigarette graphic warning labels elicit negative emotion, which increases risk perceptions through multiple processes. We examined whether this emotion simultaneously affects motivated cognitions like smoking myth endorsement (e.g. 'exercise can undo the negative effects of smoking') and perceptions of cigarette danger versus other products. 736 adult and 469 teen smokers/vulnerable smokers viewed one of three warning label types (text-only, low emotion graphic or high emotion graphic) four times over two weeks. Emotional reactions to the warnings were reported during the first and fourth exposures. Participants reported how often they considered the warnings, smoking myth endorsement, risk perceptions and perceptions of cigarette danger relative to smokeless tobacco and electronic cigarettes. In structural equation models, emotional reactions influenced risk perceptions and smoking myth endorsement through two processes. Emotion acted as information about risk, directly increasing smoking risk perceptions and decreasing smoking myth endorsement. Emotion also acted as a spotlight, motivating consideration of the warning information. Warning consideration increased risk perceptions, but also increased smoking myth endorsement. Emotional reactions to warnings decreased perceptions of cigarette danger relative to other products. Emotional reactions to cigarette warnings increase smoking risk perceptions, but also smoking myth endorsement and misperceptions that cigarettes are less dangerous than potentially harm-reducing tobacco products.

27 CFR 41.32 - Cigarette tax rates.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tax rates. 41.32... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.32 Cigarette tax rates. Cigarettes are taxed at the following rates...

27 CFR 41.32 - Cigarette tax rates.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tax rates. 41.32... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.32 Cigarette tax rates. Cigarettes are taxed at the following rates...

27 CFR 41.32 - Cigarette tax rates.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tax rates. 41.32... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.32 Cigarette tax rates. Cigarettes are taxed at the following rates...

27 CFR 41.32 - Cigarette tax rates.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tax rates. 41.32... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.32 Cigarette tax rates. Cigarettes are taxed at the following rates...

27 CFR 41.32 - Cigarette tax rates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tax rates. 41.32... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.32 Cigarette tax rates. Cigarettes are taxed at the following rates...

The development of tobacco use in adolescence among "snus starters" and "cigarette starters": an analysis of the Swedish "BROMS" cohort.

PubMed

Galanti, Maria Rosaria; Rosendahl, Ingvar; Wickholm, Seppo

2008-02-01

Whether the use of smokeless tobacco can facilitate the transition to cigarette smoking and/or to prolonged tobacco use in adolescence is unclear. We analyzed data from a cohort of 2,938 Swedish adolescents, with six follow-up assessments of tobacco use between the ages of 11 and 18 years. The majority of tobacco users (70%) started by smoking cigarettes, 11% took up snus before smoking, and 19% used both tobacco types close in time. Ever users of tobacco at baseline had a higher risk of being current smokers and/or smokeless tobacco users at the end of follow-up compared with never users, with the highest excess relative risk for "mixed users." Adolescents who initiated tobacco use with cigarettes had a non-significantly increased probability to end up as current smokers compared with snus starters (adjusted OR=1.42; 95% CI 0.98-2.10) The OR of smoking for "mixed starters" was 2.54 (95% CI 1.68-3.91). The risk of becoming current user of any tobacco was also significantly enhanced for "mixed starters." Marked sex differences were observed in these associations, as initiation with cigarettes rather than with snus predicted current smoking or tobacco use only among females. Progression of tobacco use in adolescence is not predicted by onset with snus or cigarettes, but rather by initiation with both tobacco types close in time and/or at young age. The proportion of adolescent smoking prevalence attributable to a potential induction effect of snus is likely small.

27 CFR 40.23 - Cigarette tax rates.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tax rates. 40.23... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.23 Cigarette tax rates. Cigarettes are taxed at the following rates under 26 U...

27 CFR 40.23 - Cigarette tax rates.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tax rates. 40.23... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.23 Cigarette tax rates. Cigarettes are taxed at the following rates under 26 U...

27 CFR 40.23 - Cigarette tax rates.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tax rates. 40.23... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.23 Cigarette tax rates. Cigarettes are taxed at the following rates under 26 U...

27 CFR 40.23 - Cigarette tax rates.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tax rates. 40.23... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.23 Cigarette tax rates. Cigarettes are taxed at the following rates under 26 U...

27 CFR 40.23 - Cigarette tax rates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tax rates. 40.23... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes § 40.23 Cigarette tax rates. Cigarettes are taxed at the following rates under 26 U...

Smoking and smokeless tobacco use among adolescents: trends and intervention results.

PubMed Central

Schinke, S P; Gilchrist, L D; Schilling, R F; Senechal, V A

1986-01-01

Data from a 2-year study describe tobacco use trends, perceptions, and prevention effects for 1,281 5th and 6th graders enrolled in 12 randomly selected Washington State elementary schools. Youths were pretested, then randomly divided by school into skills, discussion, and control groups. Preventive intervention curriculums for the skills and discussion groups included age-relevant information on smoked and smokeless tobacco use, peer testimonials, debates, games, and homework. Youths in the skills group also learned communication and problem-solving methods for handling difficult situations around tobacco use. Following intervention, youths were posttested, then retested semiannually for 2 years. During the 2-year study, three-quarters of all smokers and nonusers and half of all smokeless tobacco users maintained their statuses. Only 10 percent of all smokers and 3 percent of all smokeless users quit their habits. One in six reported new tobacco use, one-third of smokers began using smokeless tobacco, and two-thirds of all smokeless users began smoking during the study. Most youths at final measurement perceived smokeless tobacco as less of a health risk than smoking. Nearly one in two of all smokeless users intended to smoke, and two-thirds were actually smoking at 24-month followup. Both smoked and smokeless tobacco use rates increased in all groups, and youths in the skills intervention group consistently showed the lowest rates relative to the other groups. These findings demonstrate the potential of skills intervention methods for lowering tobacco use rates among adolescents. PMID:3090603

Adolescent elite athletes' cigarette smoking, use of snus, and alcohol.

PubMed

Martinsen, M; Sundgot-Borgen, J

2014-04-01

The purpose was to examine cigarette smoking, use of snus, alcohol, and performance-enhancing illicit drugs among adolescent elite athletes and controls, and possible gender and sport group differences. First-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. Totally, 602 athletes (89%) and 354 (84%) controls completed the questionnaire. More controls than athletes were smoking, using snus, and drinking alcohol. Competing in team sports was associated with use of snus [odds ratio = 2.8, 95% confidence interval (CI) 1.6 to 4.7] and a similar percentage of male and female handball (22.2% vs 18.8%) and soccer players (15.7% vs 15.0%) reported using snus. For controls, not participating in organized sport was a predictor for smoking (odds ratio = 4.9, 95% CI 2.2 to 10.9). Female athletes were more prone to drink alcohol than males (46.3% vs 31.0%, P < 0.001). Only, 1.2% athletes and 2.8% controls reported use of performance-enhancing illicit drugs. In conclusion, use of legal drugs is less common among athletes, but this relationship depends on type of sport and competition level. The association between team sports and use of snus suggests that sport subcultures play a role. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Physiological Response to Reward and Extinction Predicts Alcohol, Marijuana, and Cigarette Use Two Years Later

PubMed Central

Derefinko, Karen J.; Eisenlohr-Moul, Tory A.; Peters, Jessica R.; Roberts, Walter; Walsh, Erin C.; Milich, Richard; Lynam, Donald R.

2017-01-01

Background Physiological responses to reward and extinction are believed to represent the Behavioral Activation System (BAS) and Behavioral Inhibition System (BIS) constructs of Reinforcement Sensitivity Theory and underlie externalizing behaviors, including substance use. However, little research has examined these relations directly. Methods We assessed individuals’ cardiac pre-ejection periods (PEP) and electrodermal responses (EDR) during reward and extinction trials through the “Number Elimination Game” paradigm. Responses represented BAS and BIS, respectively. We then examined whether these responses provided incremental utility in the prediction of future alcohol, marijuana, and cigarette use. Results Zero-inflated Poisson (ZIP) regression models were used to examine the predictive utility of physiological BAS and BIS responses above and beyond previous substance use. Physiological responses accounted for incremental variance over previous use. Low BAS responses during reward predicted frequency of alcohol use at year 3. Low BAS responses during reward and extinction and high BIS responses during extinction predicted frequency of marijuana use at year 3. For cigarette use, low BAS response during extinction predicted use at year 3. Conclusions These findings suggest that the constructs of Reinforcement Sensitivity Theory, as assessed through physiology, contribute to the longitudinal maintenance of substance use. PMID:27306728

The Effect of Comparatively-Framed versus Similarity-Framed E-Cigarette and Snus Print Ads on Young Adults’ Ad and Product Perceptions

PubMed Central

Banerjee, Smita C.; Greene, Kathryn; Li, Yuelin; Ostroff, Jamie S.

2016-01-01

Objectives This study examined the effects of comparative-framing [C-F; ads highlighting differences between the advertised product and conventional cigarettes and/or smokeless tobacco products] versus similarity-framing (S-F; ads highlighting congruence with conventional cigarettes and/or smokeless tobacco products) in e-cigarette and snus ads on young adult smokers’ and non-smokers’ ad- and product-related perceptions. Methods One thousand fifty one (1,051) young adults (18–24 years; 76% women; 50% smokers) from existing consumer panels were recruited in a within-subjects quasi-experiment. Each participant viewed 4 online advertisements, varied by tobacco product type (e-cigarette or snus) and ad framing (C-F or S-F). The dependent measures for this study were ad-related (ad perceptions, ad credibility) and product-related perceptions (absolute and comparative risk perceptions, product appeal, and product use intentions). Results Former and current smokers rated C-F ads as more persuasive than S-F ads, as evidenced by favorable ad perceptions and high product use intentions. Former and current smokers also rated e-cigarette ads with more favorable ad perceptions, low absolute and comparative risk perceptions, high product appeal, and high product use intentions as compared to snus ads. However, the effect sizes of the significant differences are less than.2, indicating small magnitude of difference between the study variables. Conclusions Unless FDA regulates e-cig and snus advertising, there is a potential of decreasing risk perceptions and increasing use of e-cigs among young adults. Further research on implicit/explicit comparative claims in e-cigarettes and snus advertisements that encourage risk misperceptions is recommended. PMID:28042597

Drug and Alcohol Use by Canadian University Athletes: A National Survey.

ERIC Educational Resources Information Center

Spence, John C.; Gauvin, Lise

1996-01-01

Using a stratified random sampling procedure, 754 student athletes were surveyed regarding drug and alcohol use in eight different sports from eight universities across Canada. Provides statistics of substances athletes reported using, including pain medications, weight loss products, anabolic steroids, smokeless tobacco products, alcohol,…

Naturalistic assessment of demand for cigarettes, snus, and nicotine gum.

PubMed

Stein, Jeffrey S; Wilson, A George; Koffarnus, Mikhail N; Judd, Michael C; Bickel, Warren K

2017-01-01

Behavioral economic measures of demand provide estimates of tobacco product abuse liability and may predict effects of policy-related price regulation on consumption of existing and emerging tobacco products. In the present study, we examined demand for snus, a smokeless tobacco product, in comparison to both cigarettes and medicinal nicotine. We used both a naturalistic method in which participants purchased these products for use outside the laboratory, as well as laboratory-based self-administration procedures. Cigarette smokers (N = 42) used an experimental income to purchase their usual brand of cigarettes and either snus or gum (only one product available per session) across a range of prices, while receiving all products they purchased from one randomly selected price. In a separate portion of the study, participants self-administered these products during laboratory-based, progressive ratio sessions. Demand elasticity (sensitivity of purchasing to price) was significantly greater for snus than cigarettes. Elasticity for gum was intermediate between snus and cigarettes but was not significantly different than either. Demand intensity (purchasing unconstrained by price) was significantly lower for gum compared to cigarettes, with no significant difference observed between snus and cigarettes. Results of the laboratory-based, progressive ratio sessions were generally discordant with measures of demand elasticity, with significantly higher "breakpoints" for cigarettes compared to gum and no significant differences between other study products. Moreover, breakpoints and product purchasing were generally uncorrelated across tasks. Under naturalistic conditions, snus appears more sensitive to price manipulation than either cigarettes or nicotine gum in existing smokers.

Naturalistic assessment of demand for cigarettes, snus, and nicotine gum

PubMed Central

Stein, Jeffrey S.; Wilson, A. George; Koffarnus, Mikhail N.; Judd, Michael C.

2017-01-01

Rationale Behavioral economic measures of demand provide estimates of tobacco product abuse liability and may predict effects of policy-related price regulation on consumption of existing and emerging tobacco products. Objective In the present study, we examined demand for snus, a smokeless tobacco product, in comparison to both cigarettes and medicinal nicotine. We used both a naturalistic method in which participants purchased these products for use outside the laboratory, as well as laboratory-based self-administration procedures. Methods Cigarette smokers (N = 42) used an experimental income to purchase their usual brand of cigarettes and either snus or gum (only one product available per session) across a range of prices, while receiving all products they purchased from one randomly selected price. In a separate portion of the study, participants self-administered these products during laboratory-based, progressive ratio sessions. Result Demand elasticity (sensitivity of purchasing to price) was significantly greater for snus than cigarettes. Elasticity for gum was intermediate between snus and cigarettes but was not significantly different than either. Demand intensity (purchasing unconstrained by price) was significantly lower for gum compared to cigarettes, with no significant difference observed between snus and cigarettes. Results of the laboratory-based, progressive ratio sessions were generally discordant with measures of demand elasticity, with significantly higher “breakpoints” for cigarettes compared to gum and no significant differences between other study products. Moreover, breakpoints and product purchasing were generally uncorrelated across tasks. Conclusions Under naturalistic conditions, snus appears more sensitive to price manipulation than either cigarettes or nicotine gum in existing smokers. PMID:27730273

The role of early childhood ADHD and subsequent CD in the initiation and escalation of adolescent cigarette, alcohol, and marijuana use.

PubMed

Sibley, Margaret H; Pelham, William E; Molina, Brooke S G; Coxe, Stefany; Kipp, Heidi; Gnagy, Elizabeth M; Meinzer, Michael; Ross, J Megan; Lahey, Benjamin B

2014-05-01

Adolescents with attention deficit/hyperactivity disorder (ADHD) are at an increased risk for substance use but the pathways through which this risk emerges are insufficiently understood. Tobacco, alcohol, and marijuana outcomes were compared between adolescents diagnosed with ADHD in early childhood (N = 113) and demographically similar controls (N = 65). Participants were assessed from age 5 until age 18. A comprehensive history of adolescent substance use was compiled for each participant and growth in ADHD and conduct disorder (CD) were modeled as they related to substance use outcomes. Results indicated that when compared with controls, adolescents with ADHD were more likely to try cigarettes, initiate alcohol use at early ages, and smoke marijuana more frequently. Furthermore, adolescents with ADHD were 4 to 5 times more likely than controls to escalate to heavy cigarette and marijuana use after trying these substances once. Adolescents with ADHD who escalated to heavy use patterns were more likely to display early cigarette use and marked problems with family members, but displayed fewer peer problems. There was evidence of baseline effects (latent intercept, measured at age 5) for both ADHD and CD on substance use outcomes. Furthermore, growth in ADHD symptoms accounted for much of the growth in CD symptoms, and consequently, escalating CD symptoms in childhood (latent slope) were viewed as a mediator of the relationship between ADHD and cigarette and marijuana use. Maternal drinking in early childhood was the strongest predictor of early adolescent alcohol use. These findings are discussed with respect to the role of ADHD in the development of adolescent risk outcomes.

27 CFR 72.65 - Sale of forfeited tobacco products and cigarette papers and tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Sale of forfeited tobacco products and cigarette papers and tubes. 72.65 Section 72.65 Alcohol, Tobacco Products and Firearms ALCOHOL... of forfeited tobacco products and cigarette papers and tubes. All tobacco products and cigarette...

27 CFR 72.65 - Sale of forfeited tobacco products and cigarette papers and tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Sale of forfeited tobacco products and cigarette papers and tubes. 72.65 Section 72.65 Alcohol, Tobacco Products and Firearms ALCOHOL... of forfeited tobacco products and cigarette papers and tubes. All tobacco products and cigarette...

27 CFR 72.65 - Sale of forfeited tobacco products and cigarette papers and tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Sale of forfeited tobacco products and cigarette papers and tubes. 72.65 Section 72.65 Alcohol, Tobacco Products and Firearms ALCOHOL... of forfeited tobacco products and cigarette papers and tubes. All tobacco products and cigarette...

27 CFR 72.65 - Sale of forfeited tobacco products and cigarette papers and tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Sale of forfeited tobacco products and cigarette papers and tubes. 72.65 Section 72.65 Alcohol, Tobacco Products and Firearms ALCOHOL... of forfeited tobacco products and cigarette papers and tubes. All tobacco products and cigarette...

27 CFR 72.65 - Sale of forfeited tobacco products and cigarette papers and tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Sale of forfeited tobacco products and cigarette papers and tubes. 72.65 Section 72.65 Alcohol, Tobacco Products and Firearms ALCOHOL... of forfeited tobacco products and cigarette papers and tubes. All tobacco products and cigarette...

Biochemical Validation of Self-Reported Smokeless Tobacco Abstinence among Smokeless Tobacco Users: Results from a Clinical Trial of Varenicline in India.

PubMed

Jain, Raka; Jhanjee, Sonali; Jain, Veena; Gupta, Tina; Mittal, Swati; Chauhan, Prashant; Raghav, Rahul; Goelz, Patricia; Schnoll, Robert A

2015-01-01

The validity of self-reported tobacco use is often questioned given the potential for underestimation of use. This study used data from a double-blind, placebo-controlled clinical trial of varenicline for smokeless tobacco dependence in India to evaluate the accuracy of self-reported smokeless tobacco cessation using biochemical validation procedures and to evaluate correlates of reporting inaccuracy. Smokeless tobacco users attending a dental clinic at AIIMS were randomized to placebo or varenicline; all participants received counseling. Detailed smokeless tobacco use was recorded and abstinence was defined as cotinine-verified 7-day point prevalence cessation (cotinine < 50 ng/ml) and breath CO > 10 ppm at the end of 12 weeks of treatment. One-half of study completers (82/165) self-reported abstinence. Biochemical verification confirmed that (65.9%) subjects provided accurate self-reports while (34.1%) participants underreported tobacco use. These data indicate poor agreement between self-reported and biochemically confirmed abstinence (κ = -0.191). Underreporters of tobacco use had significantly higher baseline cotinine (p < 0.05), total craving (p < 0.012), and negative reinforcement craving (p < 0.001) vs. those whose self-reports were correctly verified. These findings provide evidence to support the need for biochemical validation of self-reported abstinence outcomes among smokeless tobacco users in cessation programs in India and identify high levels of pretreatment cotinine and craving levels as potential correlates of false reporting.

78 FR 52203 - Guidance for Industry on Compliance With Regulations Restricting the Sale and Distribution of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

...] Guidance for Industry on Compliance With Regulations Restricting the Sale and Distribution of Cigarettes... Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents.'' This guidance is... and distribution of cigarettes and smokeless tobacco to protect children and adolescents. DATES...

78 FR 20923 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... Request; Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco To Protect... Sale and Distribution of Cigarettes and Smokeless Tobacco To Protect Children and Adolescents--21 CFR... of the information collection requirements contained in FDA's regulations for cigarettes and...

The Effects of Social Anxiety on Alcohol and Cigarette Use across Adolescence: Results from a Longitudinal Twin Study in Finland

PubMed Central

Savage, Jeanne E.; Kaprio, Jaakko; Korhonen, Tellervo; Pulkkinen, Lea; Rose, Richard J.; Verhulst, Brad; Dick, Danielle M.

2016-01-01

Conflicting reports exist on the direction of the relationship between social anxiety (SA) and alcohol/cigarette use (AU/CU) and alcohol/nicotine dependence (AD/ND), with both positive and negative associations reported. A prospective, longitudinal sample of Finnish twins (n=1906) was used to test potential explanations for these discrepancies. Specifically, this study used peer, parent, and teacher ratings of SA, and a clinical interview screening item for Social Anxiety Disorder (SAD-Sc) to examine associations between SA and AU/CU and AD/ND from early adolescence into young adulthood. Peer-rated SA was negatively associated with AU, CU, and AD from age 14 through age 22, implying a protective effect (β=−0.01 to −.03). Teacher- and parent-rated SA associations were in the same directions but weaker or non-significant, indicating that aspects of SA that are recognizable by peers may be most relevant to AU/CU. Self-reported SAD-Sc was also negatively associated with AU, but positively associated with AD symptoms in young adulthood (β=0.38). Our findings partially support the existence of different associations between SA and AU versus AD, but only in the context of SAD-Sc rather than trait SA. Neither trait SA nor SAD-Sc significantly predicted ND symptoms, although SAD-Sc was associated with both cigarette abstinence and daily smoking. These findings suggest that adolescent SA is modestly associated with lower AU/CU, although there may be some individuals with more severe SA who develop alcohol problems later in life. There was little evidence of a common underlying liability contributing to both SA and alcohol/cigarette use. PMID:27322804

Maternal prenatal cigarette, alcohol and illicit drug use and risk of infant leukaemia: a report from the Children's Oncology Group.

PubMed

Slater, Megan E; Linabery, Amy M; Blair, Cindy K; Spector, Logan G; Heerema, Nyla A; Robison, Leslie L; Ross, Julie A

2011-11-01

Several case-control studies have evaluated associations between maternal smoking, alcohol consumption and illicit drug use during pregnancy and risk of childhood leukaemia. Few studies have specifically focused on infants (<1 year) with leukaemia, a group that is biologically and clinically distinct from older children. We present data from a Children's Oncology Group case-control study of 443 infants diagnosed with acute leukaemia [including acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML)] between 1996 and 2006 and 324 population controls. Mothers were queried about their cigarette, alcohol and illicit drug use 1 year before and throughout pregnancy. Odds ratios (ORs) and 95% confidence intervals [CI] were calculated using adjusted unconditional logistic regression models. Maternal smoking (>1 cigarette/day) and illicit drug use (any amount) before and/or during pregnancy were not significantly associated with infant leukaemia. Alcohol use (>1 drink/week) during pregnancy was inversely associated with infant leukaemia overall [OR = 0.64; 95% CI 0.43, 0.94], AML [OR = 0.49; 95% CI 0.28, 0.87], and leukaemia with mixed lineage leukaemia gene rearrangements ('MLL+') [OR = 0.59; 95% CI 0.36, 0.97]. While our results agree with the fairly consistent evidence that maternal cigarette smoking is not associated with childhood leukaemia, the data regarding alcohol and illicit drug use are not consistent with prior reports and are difficult to interpret. It is possible that unhealthy maternal behaviours during pregnancy, some of which carry potential legal consequences, may not be adequately measured using only self-report. Future case-control studies of childhood leukaemia that pursue these exposures may benefit from incorporation of validated instruments and/or biomarkers when feasible. © 2011 Blackwell Publishing Ltd.

Exposure to Terrorism and Israeli Youths’ Cigarette, Alcohol, and Cannabis Use

PubMed Central

Schiff, Miriam; Zweig, Hillah Haim; Benbenishty, Rami; Hasin, Deborah S.

2007-01-01

Objectives. We investigated the consequences of exposure to acts of terrorism among Israeli adolescents. We examined whether exposure to terrorism predicted adolescents’ use of cigarettes, alcohol (including binge drinking), and cannabis after we controlled for posttraumatic stress and depressive symptoms and background variables. Methods. Anonymous self-administered questionnaires were given to a random sample of 960 10th and 11th grade students (51.6% boys, 48.4% girls) in a large city in northern Israel. Results. Close physical exposure to acts of terrorism predicted higher levels of alcohol consumption (including binge drinking among drinkers) and cannabis use. These relationships remained even after we controlled for posttraumatic stress and depressive symptoms. Conclusions. In addition to posttraumatic stress symptoms, negative consequences of terrorism exposure among adolescents included substance abuse. The similarity between our findings among Israeli adolescents and previous findings among US adults suggests cross-cultural generalizability. Given the risks for later problems from early-onset substance abuse, the consequences of terrorism exposure among adolescents merit greater research and clinical attention. PMID:17761574

[Qualitative analysis among electronic cigarette users: practices, use, representations].

PubMed

Fontaine, Astrid; Artigas, Fernanda

2017-01-01

Electronic cigarettes are smokeless devices that simulate the act of tobacco smoking by spraying an ?e-liquid? and diffusing an aerosol that is inhaled by the user. Although the initial enthusiasm observed in 2012-2013 has tended to flag, electronic cigarettes are now part of the landscape of smokers seeking an alternative to smoking and abstinence. Smoking cessation professionals need to meet a growing demand from smokers and must adopt a clear position in relation to this device. The results presented here were derived from a qualitative study conducted with the financial support of the French Directorate of Health, part of the Ministry of Social Affairs and Health from September 2014 to January 2016. The study was based on classical field-work ethnology: observations were made during events involving electronic cigarette users and 25 semi-structured interviews with diverse profiles to clarify a poorly known field. This study contributes to the observation and understanding of an emerging phenomenon, likely to induce a lasting change in our relationship to tobacco. The study revealed a wide variety of profiles among smokers interested by electronic cigarettes. Men and women, young and old, or former smokers, adopt various attitudes when trying this device, and their patterns of use often change over the months following initiation.

The Role of Early Childhood ADHD and Subsequent CD in the Initiation and Escalation of Adolescent Cigarette, Alcohol, and Marijuana Use

PubMed Central

Sibley, Margaret H.; Pelham, William E.; Molina, Brooke S.G.; Coxe, Stefany; Kipp, Heidi; Gnagy, Elizabeth M.; Meinzer, Michael; Ross, J. Megan; Lahey, Benjamin B.

2014-01-01

Objective Adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) are at an increased risk for substance use but the pathways through which this risk emerges are insufficiently understood. Method Tobacco, alcohol, and marijuana outcomes were compared between adolescents diagnosed with ADHD in early childhood (N=113) and demographically similar controls (N=65). Participants were assessed from age 5 until age 18. A comprehensive history of adolescent substance use was compiled for each participant and growth in ADHD and Conduct Disorder (CD) were modeled as they related to substance use outcomes. Results Results indicated that when compared to controls, adolescents with ADHD were more likely to try cigarettes, initiate alcohol use at early ages, and smoke marijuana more frequently. Furthermore, adolescents with ADHD were four to five times more likely than controls to escalate to heavy cigarette and marijuana use after trying these substances once. Adolescents with ADHD who escalated to heavy use patterns were more likely to display early cigarette use and marked problems with family members, but displayed fewer peer problems. There was evidence of baseline effects (latent intercept, measured at age five) for both ADHD and CD on substance use outcomes. Furthermore, growth in ADHD symptoms accounted for much of the growth in CD symptoms, and consequently, escalating CD symptoms in childhood (latent slope) were viewed as a mediator of the relationship between ADHD and cigarette and marijuana use. Maternal drinking in early childhood was the strongest predictor of early adolescent alcohol use. Conclusions These findings are discussed with respect to the role of ADHD in the development of adolescent risk outcomes. PMID:24886010

Motivational Interviewing versus Brief Advice for Cigarette Smokers in Residential Alcohol Treatment

PubMed Central

Rohsenow, Damaris J.; Martin, Rosemarie A.; Monti, Peter M.; Colby, Suzanne M.; Day, Anne M.; Abrams, David B.; Sirota, Alan D.; Swift, Robert M.

2013-01-01

Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) Motivational Interviewing (MI) to Brief Advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1 month, 2% at 3, 6 and 12 months. However, patients with more drug use pretreatment (>22 days in 6 months) given BA had more abstinence at 12 months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation. PMID:24210533

27 CFR 45.45 - Notice for cigarettes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for cigarettes. 45..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES, WITHOUT PAYMENT OF TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.45 Notice for cigarettes...

27 CFR 45.45 - Notice for cigarettes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Notice for cigarettes. 45..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES, WITHOUT PAYMENT OF TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.45 Notice for cigarettes...

27 CFR 45.45 - Notice for cigarettes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Notice for cigarettes. 45..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES, WITHOUT PAYMENT OF TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.45 Notice for cigarettes...

27 CFR 45.45 - Notice for cigarettes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Notice for cigarettes. 45..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES, WITHOUT PAYMENT OF TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.45 Notice for cigarettes...

27 CFR 45.45 - Notice for cigarettes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Notice for cigarettes. 45..., DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES, WITHOUT PAYMENT OF TAX, FOR USE OF THE UNITED STATES Packaging Requirements § 45.45 Notice for cigarettes...

Non-cigarette tobacco products: What have we learned and where are we headed?

PubMed Central

O'Connor, Richard J.

2013-01-01

A wide variety of non-cigarette forms of tobacco and nicotine exists and their use varies regionally and globally. Smoked forms of tobacco such as cigars, bidis, kreteks, and waterpipes have high popularity and are often perceived erroneously as less hazardous than cigarettes, when in fact their health burden is similar. Smokeless tobacco products vary widely around the world in both form and health hazards, with some clearly toxic forms (e.g. South Asia), and some forms with far fewer hazards (e.g., Sweden). There are also emerging nicotine delivery systems not directly reliant on tobacco (e.g. electronic nicotine delivery systems [ENDS]). The presence of such products presents both challenges and opportunities for public health. Future regulatory actions such as expansion of smokefree environments, product health warnings, and taxation may serve to increase or decrease the use of non-cigarette forms of tobacco. These regulations may also bring about changes in non-cigarette tobacco products themselves that could impact public health by affecting attractiveness and/or toxicity. PMID:22345243

The changing marketing of smokeless tobacco in magazine advertisements.

PubMed

Curry, Laurel E; Pederson, Linda L; Stryker, Jo Ellen

2011-07-01

Concerns about secondhand smoke, increasing indoor smoking bans, and health concerns regarding cigarettes are contributing to the development of new smokeless tobacco (ST) products by the tobacco industry and the repositioning of traditional ST products. The objective of this research was to systematically document the changing advertising strategies and themes of the ST industry. Using descriptive content analysis, this study analyzed 17 nationally circulated magazines for ST advertisements (ads) from 1998-1999 and 2005-2006, recording both magazine and advertisement characteristics (e.g., themes, selling proposition, people portrayed, and setting/surroundings.) Ninety-five unique ads were found during the two time periods-occurring with total frequency of 290 ad placements in 816 issues. One hundred ninety-one ads were found in the 2005-2006 sample, while 99 were found in the 1998-1999 magazines. Significant differences in ST ads were identified between time periods and magazine types. A greater percentage of ads were found in the latter time period, and the average number of ads per issue increased (0.24 in 1998-1999 and 0.49 in 2005-2006, p < .001). More recent magazines and general adult magazines contained a greater proportion of flavored products, "alternative to cigarette" messages, and indoor settings when compared with earlier magazines and men's magazines, respectively. While continuing to advertise in men's magazines with themes appealing to men and "traditional" ST users, the ST industry appears to be simultaneously changing its message placement and content in order to include readers of general adult magazines who may not currently use ST.

Epidemiologic perspectives on smokeless tobacco marketing and population harm.

PubMed

Tomar, Scott L

2007-12-01

Moist snuff is the most popular form of orally-used smokeless tobacco in North America and parts of Europe. Because moist snuff use conveys lower risks for morbidity or mortality than does cigarette smoking, its use has been proposed as a tobacco harm-reduction strategy. This article critically reviews new and published epidemiologic evidence on health effects of moist snuff and its patterns of use relative to smoking in the United States, Sweden, and Norway. The available evidence suggests that: (1) moist snuff is a human carcinogen and toxin, (2) increased promotion of moist snuff has led to increased sales in those countries, (3) the uptake of moist snuff in these three countries during the past several decades has occurred primarily among adolescent and young adult men, (4) increased prevalence of snuff use has not been associated consistently with a reduction in smoking initiation or prevalence, (5) moist snuff use apparently plays a very minor role in smoking cessation in the U.S. and an inconsistent role in Sweden, (6) U.S. states with the lowest smoking prevalence also tend to have the lowest prevalence of snuff use, (7) there are no data on the efficacy of snuff as a smoking-cessation method, (8) the prevalence of cigarette smoking is relatively high among people who use snuff, and (9) snuff use is more consistently associated with partial substitution for smoking than with complete substitution. The evidence base for promotion of snuff use as a public health strategy is weak and inconsistent.

Smokeless tobacco cessation: report of a preliminary trial using nicotine chewing gum.

PubMed

Sinusas, K; Coroso, J G

1993-09-01

Smokeless tobacco use is a major public health hazard whose incidence is increasing, particularly among male adolescents. Little research has been done on cessation programs designed to assist smokeless tobacco users in ending their habit. There have been no studies on the use of nicotine polacrilex chewing gum as an adjunct to cessation. Fourteen of 88 male smokeless tobacco users in a professional baseball organization enrolled in a cessation program and were followed for up to 12 months. The program consisted of two support group sessions at the spring training camp followed by adjunctive use of nicotine polacrilex chewing gum during the baseball season as monitored by the athletic trainers. At 2 to 4 months, only 3 of 14 participants were completely abstinent from smokeless tobacco. Follow-up data at 6 to 12 months revealed that only one participant was abstinent. The 14 ballplayers experienced various side effects of nicotine chewing gum: bad taste (6), nausea (4), headache (4), jaw discomfort (3), and dizziness (1). Despite these side effects, 11 of the 14 participants replied that they would recommend the gum to others trying to quit. Most participants (10) felt that quitting the smokeless tobacco habit was "very difficult." We conclude that nicotine chewing gum as an adjunct to smokeless tobacco cessation had limited effectiveness. Further study on smokeless tobacco cessation methods is needed.

Tobacco industry consumer research on smokeless tobacco users and product development.

PubMed

Mejia, Adrienne B; Ling, Pamela M

2010-01-01

Since 2006, RJ Reynolds (RJR) and Philip Morris have both introduced new smokeless "snus" tobacco products. We analyzed previously secret tobacco industry documents describing the history of RJR and Philip Morris's consumer research, smokeless product development, and marketing strategies. We found that RJR had invested in smokeless research, development, and marketing since 1968. RJR first targeted low-income males through sampling and sponsorship at fishing, rodeo, and baseball events, and through advertising portraying the user as "hard working." In the early 1990s, Philip Morris and RJR hoped to attract more urban, female smokeless users. The current "snus" campaigns appear to appeal to these targeted consumers and smokers in smoke-free environments. These efforts may expand the tobacco market and undermine smoking cessation.

[Smokeless tobacco].

PubMed

Underner, M; Perriot, J

2011-10-01

Use of smokeless tobacco (ST) (chewing tobacco and snuff) can lead to a number of consequences detrimental to health. ST rapidly delivers high doses of nicotine, which can lead to dependence and is also a source of carcinogenic nitrosamines. Changes usually develop in the mouth area where the ST is most often placed. Non-malignant oral lesions include leuko-oedema, hyperkeratotic lesions of the oral mucosa and localised periodontal disease. Oral premalignant lesions are leukoplakia, erythroplakia, submucosal fibrosis and lichen planus. Betel chewing, with or without tobacco, may increase the incidence of oral cancer. There is conflicting evidence with regard to snuff users about the risk of oral and gastro-oesophageal cancer. ST use is a risk factor for pancreatic cancer and may increase the risk of fatal myocardial infarction and ischemic stroke. During pregnancy, ST is associated with an increase in pre-eclampsia, preterm delivery and stillbirth. Nicotine replacement therapy and bupropion reduce withdrawal symptoms and tobacco craving during ST cessation. However, they have not been shown to help long-term abstinence. Information concerning the potential hazards of ST products should be incorporated into educational programmes to discourage its use and to help users to quit. Smokeless tobacco is not recommended to help smoking cessation. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

21 CFR 1140.16 - Conditions of manufacture, sale, and distribution.

Code of Federal Regulations, 2011 CFR

2011-04-01

... SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution... product as the trade or brand name for a cigarette or smokeless tobacco product, except for a tobacco... the United States on January 1, 1995. (b) Minimum cigarette package size. Except as otherwise provided...

21 CFR 1140.14 - Additional responsibilities of retailers.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution to Persons... requirements under this part, each retailer is responsible for ensuring that all sales of cigarettes or smokeless tobacco to any person comply with the following requirements: (a) No retailer may sell cigarettes...

21 CFR 1140.14 - Additional responsibilities of retailers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution to Persons... requirements under this part, each retailer is responsible for ensuring that all sales of cigarettes or smokeless tobacco to any person comply with the following requirements: (a) No retailer may sell cigarettes...

21 CFR 1140.16 - Conditions of manufacture, sale, and distribution.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution... product as the trade or brand name for a cigarette or smokeless tobacco product, except for a tobacco... the United States on January 1, 1995. (b) Minimum cigarette package size. Except as otherwise provided...

21 CFR 1140.16 - Conditions of manufacture, sale, and distribution.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution... product as the trade or brand name for a cigarette or smokeless tobacco product, except for a tobacco... the United States on January 1, 1995. (b) Minimum cigarette package size. Except as otherwise provided...

21 CFR 1140.16 - Conditions of manufacture, sale, and distribution.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SERVICES (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution... product as the trade or brand name for a cigarette or smokeless tobacco product, except for a tobacco... the United States on January 1, 1995. (b) Minimum cigarette package size. Except as otherwise provided...

21 CFR 1140.14 - Additional responsibilities of retailers.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution to Persons... requirements under this part, each retailer is responsible for ensuring that all sales of cigarettes or smokeless tobacco to any person comply with the following requirements: (a) No retailer may sell cigarettes...

21 CFR 1140.14 - Additional responsibilities of retailers.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) TOBACCO PRODUCTS CIGARETTES AND SMOKELESS TOBACCO Prohibition of Sale and Distribution to Persons... requirements under this part, each retailer is responsible for ensuring that all sales of cigarettes or smokeless tobacco to any person comply with the following requirements: (a) No retailer may sell cigarettes...

Tobacco use harm reduction, elimination, and escalation in a large military cohort.

PubMed

Klesges, Robert C; Sherrill-Mittleman, Deborah; Ebbert, Jon O; Talcott, G Wayne; Debon, Margaret

2010-12-01

We evaluated changing patterns of tobacco use following a period of forced tobacco abstinence in a US military cohort to determine rates of harm elimination (e.g., tobacco cessation), harm reduction (e.g., from smoking to smokeless tobacco use), and harm escalation (e.g., from smoking to dual use or from smokeless tobacco use to smoking or dual use). Participants were 5225 Air Force airmen assigned to the health education control condition in a smoking cessation and prevention trial. Tobacco use was assessed by self-report at baseline and 12 months. Among 114 baseline smokers initiating smokeless tobacco use after basic military training, most demonstrated harm escalation (87%), which was 5.4 times more likely to occur than was harm reduction (e.g., smoking to smokeless tobacco use). Harm reduction was predicted, in part, by higher family income and belief that switching from cigarettes to smokeless tobacco is beneficial to health. Harm escalation predictors included younger age, alcohol use, longer smoking history, and risk-taking. When considering a harm reduction strategy with smokeless tobacco, the tobacco control community should balance anticipated benefits of harm reduction with the risk of harm escalation and the potential for adversely affecting public health.

77 FR 71008 - Guidance for Industry: Enforcement Policy Concerning Rotational Warning Plans for Smokeless...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

...] Guidance for Industry: Enforcement Policy Concerning Rotational Warning Plans for Smokeless Tobacco... ``Enforcement Policy Concerning Rotational Warning Plans for Smokeless Tobacco Products,'' that was announced in... Concerning Rotational Warning Plans for Smokeless Tobacco Products.'' This guidance provided information to...

Tobacco Industry Consumer Research on Smokeless Tobacco Users and Product Development

PubMed Central

Mejia, Adrienne B.

2010-01-01

Since 2006, RJ Reynolds (RJR) and Philip Morris have both introduced new smokeless “snus” tobacco products. We analyzed previously secret tobacco industry documents describing the history of RJR and Philip Morris's consumer research, smokeless product development, and marketing strategies. We found that RJR had invested in smokeless research, development, and marketing since 1968. RJR first targeted low-income males through sampling and sponsorship at fishing, rodeo, and baseball events, and through advertising portraying the user as “hard working.” In the early 1990s, Philip Morris and RJR hoped to attract more urban, female smokeless users. The current “snus” campaigns appear to appeal to these targeted consumers and smokers in smoke-free environments. These efforts may expand the tobacco market and undermine smoking cessation. PMID:19910355

21 CFR 1140.2 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.2 Purpose. The purpose of this part is to establish restrictions on the sale, distribution, and use of cigarettes and smokeless tobacco in order to...

21 CFR 1140.2 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.2 Purpose. The purpose of this part is to establish restrictions on the sale, distribution, and use of cigarettes and smokeless tobacco in order to...

21 CFR 1140.2 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.2 Purpose. The purpose of this part is to establish restrictions on the sale, distribution, and use of cigarettes and smokeless tobacco in order to...

Nicotine quantity and packaging disclosure in smoked and smokeless tobacco products in India.

PubMed

Sharma, Priyamvada; Murthy, Pratima; Shivhare, Parul

2015-01-01

A variety of smoked and smokeless tobacco products with varying nicotine content are accessible in India. Nicotine quantity in tobacco products has direct bearing on tobacco dependence. Our objective was to estimate nicotine content in various types of smoked and smokeless products. Disclosure for essential health warning was also checked. Liquid-liquid extraction was used for nicotine extraction and high-performance thin layer chromatography technique was applied for quantification of nicotine in seventy-one smoked and smokeless tobacco products. Significant variation in nicotine content was observed across products. In smoked tobacco, nicotine content varied from 1.01 to 13.0 mg/rod, while in smokeless tobacco products it ranged from 0.8 mg/g to 50.0 mg/g. Moisture content varied from 9% to 21%. This work lists a range of smoked and smokeless tobacco products available in this region. We report a wide variability in nicotine quantity across smoked and smokeless tobacco products. Such variation in nicotine content may have important implications for tobacco cessation interventions and policies.

Social and generalized anxiety symptoms and alcohol and cigarette use in early adolescence: The moderating role of perceived peer norms☆

PubMed Central

Zehe, Jennifer M.; Colder, Craig R.; Read, Jennifer P.; Wieczorek, William F.; Lengua, Liliana J.

2013-01-01

This study prospectively examines the association between social and generalized anxiety symptoms and alcohol and cigarette use in early adolescence and how injunctive (perceived peer approval of use) and descriptive (perceived peer use) norms may moderate the association. Sex differences were also examined. Data were taken from a longitudinal study investigating problem behavior and adolescent substance use. The community sample (N=387) was assessed annually, and data from the first two waves of assessment were used for this study. Early adolescents were between the ages of 11 and 13 at the first assessment (mean age=11.05, SD=0.55, 55% female). Peer norms moderated the association between both social and generalized anxiety symptoms and the likelihood of alcohol and cigarette use for girls, but not for boys. Specifically, girls with elevated levels of generalized anxiety symptoms were at risk for use when perceived peer use was low, and protected from use when perceived peer use was high. Girls with elevated levels of social anxiety symptoms were at risk for use when perceived peer approval of use was high, and protected from use when perceived peer approval of use was low. Past studies have found inconsistent support for an association between anxiety and adolescent substance use, and our findings provide some clarity regarding for whom and when anxiety operates as a risk/protective factor. Social context and sex are critical for understanding the role of different forms of anxiety in the etiology of adolescent alcohol and cigarette use. PMID:23380488

21 CFR 1140.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., fabricates, assembles, processes, or labels a finished cigarette or smokeless tobacco product. (e) Nicotine... CIGARETTES AND SMOKELESS TOBACCO General Provisions § 1140.3 Definitions. (a) Cigarette. (1) Means a product that: (i) Is a tobacco product; and (ii) Meets the definition of the term “cigarette” in section 3(1...

Contexts of cigarette and e-cigarette use among dual users: a qualitative study.

PubMed

Pokhrel, Pallav; Herzog, Thaddeus A; Muranaka, Nicholas; Regmi, Sakshi; Fagan, Pebbles

2015-09-04

Not much is currently understood regarding the contexts of cigarette and e-cigarette use among dual users. Proper application of e-cigarettes to smoking cessation or tobacco harm reduction would require an understanding of when and why dual users use cigarettes versus e-cigarettes. This study sought to elucidate the contexts of cigarette versus e-cigarette use among dual users. Twelve focus group discussions were conducted with 62 young adult current daily e-cigarette users [63% men; mean age = 25.1 (Standard Deviation = 5.5)]. Almost all participants either concurrently smoked cigarettes or had been recent dual users. Data were analyzed following principles of inductive deduction. Results indicated that dual users' use of cigarettes is influenced by particular activities (e.g., before/after eating), strong craving or need for stimulation (e.g., in response to stress), places/situations (e.g., when cigarette smokers are nearby; outdoors), use of other substances (alcohol, coffee), and unavailability of an e-cigarette when needed. In addition to particular activities and places/situations that are conducive to e-cigarette use, use of e-cigarette when cigarette is not available or where cigarette smoking is not permitted emerged as contexts specific to e-cigarette use. For habitual cigarette smokers wanting to quit tobacco smoking, switching over completely to e-cigarettes may require skills of cognitive-behavioral management. Future research needs to ascertain the characteristics of dual users who use e-cigarettes as cessation aids versus as cigarette alternative when cigarette is unavailable or smoking is not permitted.

You might as well smoke; the misleading and harmful public message about smokeless tobacco.

PubMed

Phillips, Carl V; Wang, Constance; Guenzel, Brian

2005-04-05

Compared to smoking cigarettes, use of Western smokeless tobacco (ST) products is associated with a very small risk of life-threatening disease (with estimates in the range of a few percent of the risk from smoking, or even less). This means that smokers can realize substantial health benefits by switching to ST, an obvious substitute. But consumers and policy makers have little chance of learning that ST is much less dangerous than smoking because popular information provided by experts and advocates overstates the health risks from ST relative to cigarettes. To examine the extent of this overstatement in one medium, we conducted a systematic review of websites containing information about ST and health risks. We examined the content of 316 relevant websites identified by a Google search. We found that when any substantive information about the risk from ST is given, the risk is almost universally conflated with the risk from cigarettes. Accurate comparative risk information was quite rare, provided by only a handful of websites, all appearing low in our search results (i.e., of low popularity and thus unlikely to be found by someone searching for information). About 1/3 of the websites, including various authoritative entities, explicitly claimed that ST is as bad as or worse than cigarettes. Most of the other sites made statements that imply the risks are comparable. Through these websites, and presumably other information provided by the same government, advocacy, and educational organizations, ST users are told, in effect, that they might as well switch to smoking if they like it a bit more. Smokers and policy makers are told there is no potential for harm reduction. These messages are clearly false and likely harmful, representing violations of ethical standards.

Lung cancer specialist physicians’ attitudes towards e-cigarettes: A nationwide survey

PubMed Central

Kim, Seung Joon; Kim, Jung Soo; Chong, SeMin; Park, Young Sik; Song, Sang-Yun; Lee, Jin Han; Ahn, Hee Kyung; Kim, Eun Young; Yang, Sei Hoon; Lee, Myoung Kyu; Cho, Deog Gon; Jang, Tae Won; Son, Ji Woong; Cho, Moon-June

2017-01-01

Objectives Despite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists’ attitudes toward e-cigarettes and its regulation. Methods We undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients. Results Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients. Conclusion Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on

Lung cancer specialist physicians' attitudes towards e-cigarettes: A nationwide survey.

PubMed

Shin, Dong Wook; Kim, Young Il; Kim, Seung Joon; Kim, Jung Soo; Chong, SeMin; Park, Young Sik; Song, Sang-Yun; Lee, Jin Han; Ahn, Hee Kyung; Kim, Eun Young; Yang, Sei Hoon; Lee, Myoung Kyu; Cho, Deog Gon; Jang, Tae Won; Son, Ji Woong; Ryu, Jeong-Seon; Cho, Moon-June

2017-01-01

Despite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists' attitudes toward e-cigarettes and its regulation. We undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients. Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients. Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on scientific evidence, suggesting the need for

Socio-demographic characteristics associated with cigarettes smoking, drug abuse and alcohol drinking among male medical university students in Iran.

PubMed

Jalilian, Farzad; Karami Matin, Behzad; Ahmadpanah, Mohammad; Ataee, Mari; Ahmadi Jouybari, Touraj; Eslami, Ahmad Ali; Mirzaei Alavijeh, Mehdi

2015-01-01

Substance abuse is one of the most complicated social problems. Understanding socio-demographic characteristics of those who abuse substances could help deal with this problem more efficiently. The main objective of this study was to determine socio-demographic characteristics associated with alcohol drinking, cigarettes smoking and drug abuse among a sample of male medical university students in Iran. This cross-sectional study was conducted in 2014 among 425 male medical college students randomly selected with the proportional to size among different faculties in Isfahan and Kermanshah medical universities in Iran. A self-report written questionnaire was applied to collect data. Data were analyzed by the SPSS-20. Mean age of the respondents was 19.9 yr (ranging from 18 to 22 yr). About 19.4%, 3.9%, and 10.1% of the respondents had history of cigarette smoking, drug use, and alcohol drinking during the past three months, respectively. Logistic regression showed that mother's educational level, living place, economic status, and parents' divorce were the most influential predictive factors on substance abuse. Considering the high prevalence of substance abuse (especially smoking and alcohol drinking), it seems essential to design educational interventions to prevent substance abuse, paying attention to predictive factors mentioned above, among college students.

Chemical and toxicological characterization of commercial smokeless tobacco products available on the Canadian market.

PubMed

Rickert, W S; Joza, P J; Trivedi, A H; Momin, R A; Wagstaff, W G; Lauterbach, J H

2009-03-01

Some health experts are recommending that smokers who refuse to quit or refuse to use nicotine replacement therapy (NRT) such as nicotine-containing chewing gum switch to certain types of smokeless tobacco products (STP) such as Swedish snus. Other health experts disagree citing the uncertainty in the composition of commercially available STP, the lack of governmental regulations to ensure that STP advertised to meet certain standards (i.e., GothiaTek) do actually meet such standards, and the uncertainty that any STP can provide as safe as alternative to smoking as NRT. One reason for uncertainty is the dearth of detailed chemical and toxicological information on contemporary STP. Unlike the situation with cigarettes, there are few standardized methods for analytical and toxicological studies of STP. Consequently, the objective for this work was to characterize several types of STP available on the Canadian market using the modifications of the Official Health Canada chemical and toxicological methods developed for cigarettes. Moist snuff samples tested had TSNA and B[a]P levels somewhat above the GothiaTek standard while samples of Swedish snus, low-moisture snuff, and US-style chewing tobacco did not. Use of in vitro assays to assess STP toxicity was of limited utility in distinguishing product types.

Extent to Which Selected Factors Contribute to Alcohol and Cigarette Use among Public Day Secondary Schools Male Students: A Case of Nakuru Municipality, Kenya

ERIC Educational Resources Information Center

Oteyo, John; Kariuki, Mary

2009-01-01

The increase in alcohol and cigarettes use among young people than any population strata is of great concern. The use of alcohol that began in African traditional society as an activity for political, religious, cultural and social relations has evolved over time into a problem of dependence and addiction. Despite concerted prevention efforts,…

Preferring more e-cigarette flavors is associated with e-cigarette use frequency among adolescents but not adults

PubMed Central

Butler, Ellyn R.; Bold, Krysten W.; Kong, Grace; Camenga, Deepa R.; Cavallo, Dana A.; Simon, Patricia; O’Malley, Stephanie S.; Krishnan-Sarin, Suchitra

2018-01-01

Introduction Many e-cigarette users find the variety of e-cigarette flavors appealing. We examined whether preferences for e-liquid flavors and the total number of flavors preferred differed between samples of adolescent and adult e-cigarette users. We also examined whether these preferences were associated with e-cigarette use frequency for adolescents or adults, respectively. Materials and methods The analytic samples comprised 1) 396 adolescent, past-month e-cigarette users from 5 Connecticut high schools who completed an anonymous, school-based survey in Fall 2014 (56.1% male; 16.18 [1.18] years; 42.2% past-month smokers), and 2) 590 adult, past-month e-cigarette users who completed an anonymous, MTurk survey in Fall 2014 (53.7% male; 34.25 [9.89] years; 51.2% past-month smokers). Results Compared to adults, a larger proportion of adolescents preferred fruit, alcohol, and “other”-flavored e-liquids, whereas adults disproportionately preferred tobacco, menthol, mint, coffee, and spice-flavored e-liquids (p-values < .05). Adults also preferred a greater total number of flavors compared to adolescents and used e-cigarettes more frequently (p-values < .001). Flavor preferences uniquely were associated with frequency of e-cigarette use within the adolescent sample; the total number of flavors preferred was associated with more days of e-cigarette use (ηp2 = 0.04), as were preferences for fruit (ηp2 = 0.02), dessert (ηp2 = 0.02), and alcohol-flavored (ηp2 = 0.02) e-liquids. Conclusions Flavor preferences differed between adolescent and adult samples. While youth reported less frequent e-cigarette use overall, their preferences for specific flavors and the total number of flavors preferred were associated with more days of e-cigarette use, indicating that flavor preferences may play an important role in adolescent e-cigarette use. PMID:29300749

The case against smokeless tobacco: five facts for the health professional to consider.

PubMed

Christen, A G

1980-09-01

Snuff dipping and tobacco chewing are rapidly gaining popularity in the United States. They are being heavily promoted through mass media advertising. Advertising spots on radio, television, and in the printed media use well-known sports personalities and entertainers to act as spokesmen for smokeless tobacco. Despite the esthetic drawbacks of these social acceptance. This is being accomplished, at least in part, through a skillful manipulation of the public by the tobacco industry. Use of smokeless tobacco is rapidly increasing, especially among young male athletes and students in high school and college. Advertising implies that smokeless tobacco habits are innocuous and safe. They are not. Smokeless tobacco products have shown that potential for causing cancer of the oral cavity, pharynx, larynx, and eophagus. A review of the medical and dental literature has shown 646 cases of cancer associated directly with smokeless tobacco. Smokeless tobacco can produce significant effects on the soft and hard tissues of the mouth, including bad breath, discolored teeth and restorations, excessive wear (abrasion) of the incisal and occlusal surfaces of the teeth, decreased ability to taste and small, gingival recession, advanced periodontal destruction of the soft and hard tissues, erythema of the soft tissues, leukoplakia, and cancer. Health professionals are urged to advise their patients concerning the hazards of using smokeless tobacco and to take a strong public stance in opposition to the current advertising campaigns aimed at youth. The professions should demand that smokeless tobacco products print health warning labels on the packages and in advertising copy. Finally, patients should be taught how to recognize signs of breakdown of the soft and hard tissues.

Maternal prenatal cigarette, alcohol and illicit drug use and risk of infant leukaemia: a report from the Children’s Oncology Group

PubMed Central

Slater, Megan E.; Linabery, Amy M.; Blair, Cindy K.; Spector, Logan G.; Heerema, Nyla A.; Robison, Leslie L.; Ross, Julie A.

2012-01-01

Summary Several case–control studies have evaluated associations between maternal smoking, alcohol consumption and illicit drug use during pregnancy and risk of childhood leukaemia. Few studies have specifically focused on infants (<1 year) with leukaemia, a group that is biologically and clinically distinct from older children. We present data from a Children’s Oncology Group case–control study of 443 infants diagnosed with acute leukaemia [including acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML)] between 1996 and 2006 and 324 population controls. Mothers were queried about their cigarette, alcohol and illicit drug use 1 year before and throughout pregnancy. Odds ratios (ORs) and 95% confidence intervals [CI] were calculated using adjusted unconditional logistic regression models. Maternal smoking (>1 cigarette/day) and illicit drug use (any amount) before and/or during pregnancy were not significantly associated with infant leukaemia. Alcohol use (>1 drink/week) during pregnancy was inversely associated with infant leukaemia overall [OR = 0.64; 95% CI 0.43, 0.94], AML [OR = 0.49; 95% CI 0.28, 0.87], and leukaemia with mixed lineage leukaemia gene rearrangements (‘MLL+’) [OR = 0.59; 95% CI 0.36, 0.97]. While our results agree with the fairly consistent evidence that maternal cigarette smoking is not associated with childhood leukaemia, the data regarding alcohol and illicit drug use are not consistent with prior reports and are difficult to interpret. It is possible that unhealthy maternal behaviours during pregnancy, some of which carry potential legal consequences, may not be adequately measured using only self-report. Future case–control studies of childhood leukaemia that pursue these exposures may benefit from incorporation of validated instruments and/or biomarkers when feasible. PMID:21980945

Effects of alcohol consumption, cigarette smoking, and betel quid chewing on upper digestive diseases: a large cross-sectional study and meta-analysis.

PubMed

Chuang, Yun-Shiuan; Wu, Meng-Chieh; Yu, Fang-Jung; Wang, Yao-Kuang; Lu, Chien-Yu; Wu, Deng-Chyang; Kuo, Chie-Tong; Wu, Ming-Tsang; Wu, I-Chen

2017-09-29

Cigarette smoking is a well-known risk factor of upper digestive diseases. Findings on alcohol's effect on these diseases are inconsistent and with the exception of its association with esophageal cancer, little is known about betel quid chewing. This study investigated the association between use of these three substances and upper digestive diseases. We collected data from 9,275 patients receiving upper endoscopies between April 2008 and December 2013. Polynomial regressions were used to analyze the association between risk factors and diseases of the esophagus, stomach and duodenum. Meta-analysis for use of these substances and esophageal diseases was also performed. Participants who simultaneously consumed cigarettes, alcohol and betel quid had a 17.28-fold risk of esophageal cancer (95% CI = 7.59-39.33), 2.99-fold risk of Barrette's esophagus (95% CI = 2.40-4.39), 1.60-fold risk of grade A-B erosive esophagitis (95% CI = 1.29-2.00), 2.00-fold risk of gastric ulcer (95% CI = 1.52-2.63), 2.12-fold risk of duodenitis (95% CI = 1.55-2.89) and 1.29-fold risk of duodenal ulcer (95% CI = 1.01-1.65). Concurrent consumption of more substances was associated with significantly higher risk of developing these diseases. Meta-analysis also revealed use of the three substances came with a high risk of esophageal diseases. In conclusions, cigarette smoking, alcohol drinking and betel quid chewing were associated with upper digestive tract diseases.

16 CFR 307.12 - Rotation, display, and dissemination of warning statements in smokeless tobacco advertising.

Code of Federal Regulations, 2010 CFR

2010-01-01

... warning statements in smokeless tobacco advertising. 307.12 Section 307.12 Commercial Practices FEDERAL... warning statements in smokeless tobacco advertising. (a) In the case of advertising for a smokeless... account practical constraints on the production and distribution of advertising. (b) Each manufacturer...

Brief Report: Disposable Income, and Spending on Fast Food, Alcohol, Cigarettes, and Gambling by New Zealand Secondary School Students

ERIC Educational Resources Information Center

Darling, Helen; Reeder, Anthony I.; McGee, Rob; Williams, Sheila

2006-01-01

We describe self-reported sources of income and expenditure, and the association between part-time employment and spending on fast food, alcohol, cigarettes, and gambling for a sample of 3434 New Zealand (NZ) secondary school students (mean age 15.0 years). Disposable income was usually received from parents and guardians, but nearly 40% of…

A propensity scoring approach to characterizing the effects of maternal smoking during pregnancy on offspring's initial responses to cigarettes and alcohol

PubMed Central

Bidwell, L. Cinnamon; Palmer, Rohan H.C.; Brick, Leslie; Madden, Pamela A.F.; Heath, Andrew C.; Knopik, Valerie S.

2016-01-01

When examining the effects of prenatal exposure to maternal smoking during pregnancy (MSDP) on later offspring substance use, it is critical to consider familial environments confounded with MSDP. The purpose of this study was to examine the effect of MSDP on offspring's initial reactions to cigarettes and alcohol, which are indicators of future substance-use related problems. We tested these effects using two propensity score approaches (1) by controlling for confounding using the MSDP propensity score and 2) examining effects of MSDP across the MSDP risk distribution by grouping individuals into quantiles based on their MSDP propensity score. This study used data from 829 unrelated mothers with a reported lifetime history of smoking to determine the propensity for smoking only during their first trimester (MSDP-E) or throughout their entire pregnancy (MSDP-T). Propensity score analyses focused on the offspring (N=1616 female twins) of a large subset of these mothers. We examined the effects of levels of MSDP-E/T on offspring initial reactions to their first experiences with alcohol and cigarettes, across the distribution of liability for MSDP-E/T. MSDP-E/T emerged as significant predictors of offspring reactions to alcohol and cigarettes, but the effects were confounded by the familial liability for MSDP. Further, the unique MSDP effects that emerged were not uniform across the MSDP familial risk distribution. Our findings underscore the importance of properly accounting for correlated familial risk factors when examining the effects of MSDP on substance related outcomes. PMID:27098899

No sisyphean task: how the FDA can regulate electronic cigarettes.

PubMed

Paradise, Jordan

2013-01-01

The adverse effects of smoking have fostered a natural market for smoking cessation and smoking reduction products. Smokers attempting to quit or reduce consumption have tried everything: "low" or "light" cigarettes; nicotine-infused chewing gum, lozenges, and lollipops; dermal patches; and even hypnosis. The latest craze in the quest to find a safer source of nicotine is the electronic cigarette. Electronic cigarettes (e-cigarettes) have swept the market, reaching a rapidly expanding international consumer base. Boasting nicotine delivery and the tactile feel of a traditional cigarette without the dozens of other chemical constituents that contribute to carcinogenicity, e-cigarettes are often portrayed as less risky, as a smoking reduction or even a complete smoking cessation product, and perhaps most troubling for its appeal to youth, as a flavorful, trendy, and convenient accessory. The sensationalism associated with e-cigarettes has spurred outcry from health and medical professional groups, as well as the Food and Drug Administration (FDA), because of the unknown effects on public health. Inhabiting a realm of products deemed "tobacco products" under recent 2009 legislation, e-cigarettes pose new challenges to FDA regulation because of their novel method of nicotine delivery, various mechanical and electrical parts, and nearly nonexistent safety data. Consumer use, marketing and promotional claims, and technological characteristics of e-cigarettes have also raised decades old questions of when the FDA can assert authority over products as drugs or medical devices. Recent case law restricting FDA enforcement efforts against e-cigarettes further confounds the distinction among drugs and medical devices, emerging e-cigarette products, and traditional tobacco products such as cigarettes, cigars, and smokeless tobacco. This Article investigates the e-cigarette phenomenon in the wake of the recently enacted Family Smoking Prevention and Tobacco Control Act of 2009

Alcohol-flavoured tobacco products.

PubMed

Jackler, Robert K; VanWinkle, Callie K; Bumanlag, Isabela M; Ramamurthi, Divya

2018-05-01

In 2009, the Food and Drug Administration (FDA) banned characterising flavours in cigarettes (except for menthol) due to their appeal to teen starter smokers. In August 2016, the agency deemed all tobacco products to be under its authority and a more comprehensive flavour ban is under consideration. To determine the scope and scale of alcohol-flavoured tobacco products among cigars & cigarillos, hookahs and electronic cigarettes (e-cigarettes). Alcohol-flavoured tobacco products were identified by online search of tobacco purveyors' product lines and via Google search cross-referencing the various tobacco product types versus a list of alcoholic beverage flavours (eg, wine, beer, appletini, margarita). 48 types of alcohol-flavoured tobacco products marketed by 409 tobacco brands were identified. Alcohol flavours included mixed drinks (n=25), spirits (11), liqueurs (7) and wine/beer (5). Sweet and fruity tropical mixed drink flavours were marketed by the most brands: piña colada (96), mojito (66) and margarita (50). Wine flavours were common with 104 brands. Among the tobacco product categories, brands offering alcohol-flavoured e-cigarettes (280) were most numerous, but alcohol-flavoured products were also marketed by cigars & cigarillos (88) and hookah brands (41). Brands by major tobacco companies (eg, Philip Morris, Imperial Tobacco) were well represented among alcohol-flavoured cigars & cigarillos with five companies offering a total of 17 brands. The widespread availability of alcohol-flavoured tobacco products illustrates the need to regulate characterising flavours on all tobacco products. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Tobacco Use among Minnesota Adults, 2014.

PubMed

Boyle, Raymond G; Amato, Michael S; Rode, Peter; Kinney, Ann M; St Claire, Ann W; Taylor, Kristie

2015-09-01

The changing landscape of tobacco including the introduction of new products such as smokeless tobaccos and electronic delivery devices has highlighted the need for continued surveillance of tobacco use. Minnesota has conducted an in-depth surveillance of adult tobacco use since 1999. For the fifth in the series, conducted in 2014, 9304 telephone interviews were completed. The 2014 prevalence of cigarette smoking (14.4%) continues a downward trend that remains lower than the national smoking prevalence (17.3%). Among all Minnesota adults, use prevalence of other tobacco products was as follows: e-cigarettes 5.9%, all smokeless tobaccos 3.6%, cigars 3.0%, water pipe 1.4%, and regular pipe 0.7%. Among individuals who have never smoked cigarettes, smokeless tobacco was the most common product used (2.0%), nearly twice the prevalence of e-cigarette use (1.2%). Former smokers were equally likely to use smokeless tobacco (4.9%) or e-cigarettes (4.8%). Among smokers, 27.3% reported current use of e-cigarettes. In the past 15 years, cigarette smoking prevalence in Minnesota has dropped by an average of 0.51 percentage points annually, and prevalence could drop to less than 5% by 2034.

Smokeless tobacco use among American Indian women--southeastern North Carolina, 1991.

PubMed

1995-02-17

Rates of smokeless tobacco use among U.S. adults are highest for young males, American Indians/Alaskan Natives, persons residing in the South or rural areas of the country, and those of low socioeconomic status (1). In addition, the prevalence of smokeless tobacco use has been reported to be high in tobacco-producing regions, including rural North Carolina and Kentucky (2,3). In southeastern North Carolina, reports from physicians and dentists suggested a high prevalence of smokeless tobacco use in the local American Indian population, the Lumbee--particularly among women and children. In response to these reports, the Department of Family and Community Medicine at the Bowman Gray School of Medicine of Wake Forest University analyzed data from a National Cancer Institute-sponsored cervical cancer prevention program to estimate the prevalence of smokeless tobacco use during 1991 among Lumbee women aged > or = 18 years residing in Robeson County, North Carolina (1990 population: 105,179).(ABSTRACT TRUNCATED AT 250 WORDS)

Electronic Cigarette Use Among Adolescents in the Russian Federation.

PubMed

Kong, Grace; Idrisov, Bulat; Galimov, Artur; Masagutov, Radik; Sussman, Steve

2017-02-23

Information on e-cigarettes among youth in the Russian Federation is lacking. We examined prevalence of and factors associated with youth e-cigarette use in the Russian Federation. A cross-sectional, anonymous survey, conducted among 716 (females 51.5%) high school students in three cities (i.e., Ufa, Sterlitamak, Karagaevo) within the Republic of Bashkortostan, Russian Federation in 2015, assessed e-cigarette use and its correlates (i.e., sex, age, ethnicity, family structure, parents' highest degrees, antisocial behaviors, stress coping strategies, lifetime cigarette, hookah, alcohol, and marijuana use). Lifetime use of e-cigarettes was 28.6% and past-30-day use was 2.2%. Multilevel modeling showed that belonging to Tatar/Bashkir ethnicity relative to Russian ethnicity (OR = 1.60) and lifetime use of cigarettes (OR = 21.64), hookah (OR = 4.21), and alcohol (OR = 1.90) was associated with greater odds of lifetime use of e-cigarettes. Furthermore, use of social support coping strategies (i.e., utilizing parents for support) were associated with lower odds of lifetime use of e-cigarettes (OR = 0.94). Despite high lifetime e-cigarette use, past-30-day use was low. Greater knowledge of the reasons for e-cigarette discontinuation through continued surveillance is needed in the Russian Federation. Social coping strategies involving parents may inform e-cigarette use prevention.

Results of a national mass media campaign in India to warn against the dangers of smokeless tobacco consumption.

PubMed

Murukutla, Nandita; Turk, Tahir; Prasad, C V S; Saradhi, Ranjana; Kaur, Jagdish; Gupta, Shefali; Mullin, Sandra; Ram, Faujdar; Gupta, Prakash C; Wakefield, Melanie

2012-01-01

Smokeless tobacco consumption in India is a significant source of morbidity and mortality. In order to educate smokeless tobacco users about the health harms of smokeless tobacco and to denormalise tobacco usage and encourage quitting, a national television and radio mass media campaign targeted at smokeless tobacco users was aired for 6 weeks during November and December 2009. The campaign was evaluated with a nationally representative household survey of smokeless tobacco users (n = 2898). The effect of campaign awareness was assessed with logistic regression analysis. The campaign affected smokeless tobacco users as intended: 63% of smokeless-only users and 72% of dual users (ie, those who consumed both smoking and smokeless forms) recalled the campaign advertisement, primarily through television delivery. The vast majority (over 70%) of those aware of the campaign said that it made them stop and think, was relevant to their lives and provided new information. 75% of smokeless-only users and 77% of dual users said that it made them feel concerned about their habit. Campaign awareness was associated with better knowledge, more negative attitudes towards smokeless tobacco and greater cessation-oriented intentions and behaviours among smokeless tobacco users. Social marketing campaigns that utilise mass media are feasible and efficacious interventions for tobacco control in India. Implications for future mass media tobacco control programming in India are discussed.

Predictors of Smokeless Tobacco Abstinence

ERIC Educational Resources Information Center

Ebbert, Jon O.; Glover, Elbert D.; Shinozaki, Eri; Schroeder, Darrell R.; Dale, Lowell C.

2008-01-01

Objectives: To investigate predictors of tobacco abstinence among smokeless tobacco (ST) users. Methods: Logistic regression analyses assessed characteristics associated with tobacco abstinence among ST users receiving bupropion SR. Results: Older age was associated with increased tobacco abstinence in both placebo and bupropion SR groups at end…

Reinforcement of smoking and drinking: tobacco marketing strategies linked with alcohol in the United States.

PubMed

Jiang, Nan; Ling, Pamela M

2011-10-01

We investigated tobacco companies' knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities. We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results. Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use. Tobacco companies' numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.

Detection and characterization of smokeless powders with ion mobility spectrometry

NASA Astrophysics Data System (ADS)

Hernandez, Neiza M.; Rosario, Santa V.; Hernandez, Samuel P.; Mina, Nairmen

2005-05-01

Smokeless Powders are a class of propellants that were developed in the late 19th century to replace black powder; it has been used as an explosive in shotguns, rifles, firearms and many other larger caliber weapons. These propellants can be placed into one of three different classes according to the chemical composition of their primary energetic ingredients. Advance equipment have been designed and used for the detection of explosives devices and compounds potentially energetic. In this research we are developing an analytical methodology to detect different formulation of smokeless powders: Alliant-American Select, Alliant-Bullseye, and Alliant-Red Dot using the ion mobility spectrometry (IMS) technique. We used different surfaces like computer diskettes, CD"s, book covers and plastics to study their adsorption/desorption process. Using micropipettes, we delivered solutions with different amounts of Smokeless Powders from a 1000 ppm solution and deposit it on various types of filters to make a calibration curve. Several amounts of Smokeless Powder were deposited to the different surfaces and collected with filter paper. The samples were desorbed directly from the filter to the instrument inlet port. Subsequently, the percentage of explosive recovered was calculated.

Tobacco use and cancer risk in the Agricultural Health Study

PubMed Central

Andreotti, Gabriella; Freedman, Neal D.; Silverman, Debra T.; Lerro, Catherine C.; Koutros, Stella; Hartge, Patricia; Alavanja, Michael C.; Sandler, Dale P.; Freeman, Laura Beane

2017-01-01

Background Cigarettes are well known to cause cancer, but less is known about the risks of other tobacco products and use of more than one product. Methods We examined cancer incidence in relation to exclusive use of six tobacco products (cigarettes, other combustibles (pipe, cigar, cigarillo), and smokeless tobacco (chewing tobacco, snuff)) in the Agricultural Health Study. We also examined the added cancer risks associated with use of cigarettes and other tobacco products. Results In our study population of 84,015, ever use of smokeless tobacco was higher than the general United States population, while cigarette use was lower and other combustible product use was about the same. The strongest associations for exclusive ever use were for lung cancer (cigarettes hazard ratio (HR)=15.48, 95% confidence interval (CI): 11.95, 20.06; other combustible tobacco HR=3.44, 95% CI: 1.53, 7.71; smokeless tobacco HR=2.21, 95% CI: 1.11, 4.42). Compared to exclusive cigarette smokers, cigarette smokers who additionally ever-used another combustible product had higher risks of smoking related cancers (HR=1.16, 95% CI: 1.04, 1.30), especially among those who smoked cigarettes for more than 15 years. Conclusion and Impact Cigarette smokers who additionally ever used smokeless tobacco had cancer risks similar to exclusive cigarette smokers. Users of cigarettes and other combustible tobacco may have higher risks of certain cancers than exclusive cigarette users. PMID:28035020

Health consequences of using smokeless tobacco: summary of the Advisory Committee's report to the Surgeon General.

PubMed Central

Cullen, J W; Blot, W; Henningfield, J; Boyd, G; Mecklenburg, R; Massey, M M

1986-01-01

On March 25, 1986, the Surgeon General of the Public Health Service released a report that detailed the results of the first comprehensive, indepth review of the relationship between smokeless tobacco use and health. This review, prepared under the auspices of the Surgeon General's Advisory Committee on the Health Consequences of Using Smokeless Tobacco, is summarized in this article. In the United States, smokeless tobacco is used predominantly in the forms of chewing tobacco and snuff. During the past 20 years, the production and consumption of these products have risen significantly in marked contrast to the decline in smokeless tobacco use during the first half of the century. National estimates indicate that more than 12 million persons age 12 and older in the United States used some form of smokeless tobacco in 1985, and half of these were regular users. The highest rates of smokeless tobacco use occurred among adolescent and young adult males. Examination of the relevant epidemiologic, experimental, and clinical data revealed that oral use of smokeless tobacco is a significant health risk. This behavior can cause cancer in humans, and the evidence is strongest for cancer of the oral cavity, particularly at the site of tobacco placement. Smokeless tobacco use can also lead to the development of noncancerous oral conditions, particularly, oral leukoplakias and gingival recession. Further, the levels of nicotine in the body resulting from smokeless tobacco can lead to nicotine addiction and dependence. PMID:3090602

Use of smokeless tobacco among male students of Zahedan universities in Iran: a cross sectional study.

PubMed

Honarmand, Marieh; Farhadmollashahi, Leila; Bekyghasemi, Mahmoud

2013-01-01

Smokeless tobacco consumption is one of the causes of oral cancer. The aim of this study was to determine the prevalence of smokeless tobacco consumption among male students of Zahedan universities and associated factors in 2012. In this cross-sectional study, 431 students were selected from the universities of Zahedan using multi-stage random cluster sampling. The data collection tool was a questionnaire including questions about demographic information, history of smokeless tobacco consumption, and awareness of smokeless tobacco hazards. Data were analyzed by SPSS19 using Chi-square test and multinomial logistic regression, with p<0.05 considered significant. At the time of conducting this study, 102 students (23.7%) had already consumed smokeless tobacco and 49 students (11.4%) were current users (consuming at least once in 30 days before the study). There was a significant relationship between history of smokeless tobacco consumption, university/college, place of living, mean GPA, and mother's education level (p<0.05). Also there was a significant association between knowledge and prevalence of smokeless tobacco use (p<0.001). There is a relatively high prevalence of smokeless tobacco consumption among the male students of universities of Zahedan, which shows the need to emphasize the provision and implementation of prevention programs in universities.

A report of two smokeless tobacco surveys and associated intervention strategies among Utah adolescents.

PubMed

Leopardi, E A; Poulson, T C; Neiger, B L; Lindenmuth, J E; Greer, R O

1989-01-01

Smokeless tobacco is an increasingly popular substance, especially among male adolescents. We determined the prevalence of smokeless tobacco use and evaluated selected factors associated with it among 8,902 students in grades 7 through 12 in the Davis County, Utah, School District. The students responded anonymously in their classrooms to a 16-item self-reporting questionnaire. Results indicated that smokeless tobacco usage was predominately a male phenomenon in all grades and schools, as illustrated by prevalence rates "within the past week" for junior high school students (male: 15.0%; female: 1.1%). Modal responses regarding users' source of supply revealed "friends" as the leading source for junior high students (43.1%) and direct purchase for senior high students (62.2%). Peer usage or nonusage of smokeless tobacco was found to be directly and proportionately correlated with smokeless tobacco users' participation in the school activity designated "sports" for both junior high (39%) and senior high school students (36.2%). Subsequently, clinical evaluation of high school male athletes was undertaken. To our surprise, the rate of lesion detection among members of this group, previously judged to be the subjects most likely to use smokeless tobacco, fell far short of the anticipated rate. We believe the reason for the low rate may be the result of numerous efforts to educate students and coaches, the reinforcement of existing tobacco use policies by the Davis County School District, and the reiteration to smokeless tobacco vendors of the terms of the Utah laws relative to smokeless tobacco sales. This health-endangering behavior deserves a concerted educational thrust by health professional, parents, and teachers, with emphasis on prevention.

Smokeless Tobacco Use in the United States Military: A Systematic Review

PubMed Central

Hunt, Yvonne M.; Augustson, Erik

2012-01-01

Introduction: Smokeless tobacco (ST) use represents an important target for intervention in the U.S. military population because it impairs “military readiness” and harms the health of the military. This paper aims to provide a systematic review of ST studies conducted in the U.S. military population in order to assess the content of existing ST research in this population, provide estimates of prevalence and clinically relevant use patterns, and discuss how these findings might be used to guide future ST research among this population. Methods: We reviewed articles published through December 2010 using PubMed and PsycINFO databases, Google Scholar, and any relevant articles’ reference lists. Inclusion criteria included focus on a U.S. military sample, English language, measured tobacco use, and ST prevalence was reported or could be calculated. To the extent possible, each article was coded for demographics, socioeconomic status, prevalence, amount, frequency, and length of use, and quit intentions/attempts. Results: Thirty-nine articles met criteria for inclusion. Less than half focused primarily on ST use among military personnel. The remaining studies measured ST use in the context of other behaviors. Findings related to clinically relevant behaviors included a need for more cohort and intervention studies, a better understanding of ST use in combination with cigarettes (i.e., concurrent use), and identifying risk factors for ST initiation and use. Discussion: ST use is prevalent among military personnel, as is concurrent use of cigarettes and ST. We provide a number of recommendations to guide future research in this important, yet understudied, area. PMID:22123789

The effect of computer usage in internet café on cigarette smoking and alcohol use among chinese adolescents and youth: a longitudinal study.

PubMed

Wu, Liyun; Delva, Jorge

2012-02-01

We used longitudinal data to investigate the relationship between computer use in internet cafés and smoking/drinking behavior among Chinese adolescents and young adults. Data are from two waves of the China Health and Nutrition Survey (2004 and 2006). Fixed effects models were used to examine if changes in internet café use were associated with changes in cigarette smoking and drinking of alcohol. Male café users spent on average 17.3 hours in front of the computer/week. This was associated with an increase in the probability of being a current smoker by 13.3% and with smoking 1.7 more cigarettes. Female café users spent on average 11 hours on the computer/week. This was associated with an increase in the probability of drinking wine and/or liquor by 14.74% and was not associated with smoking. Internet cafés are an important venue by which adolescent and young adults in China are exposed to smoking and drinking. Multi-component interventions are needed ranging from policies regulating cigarette and alcohol availability in these venues to anti-tobacco campaigns aimed at the general population but also at individuals who frequent these establishments.

What Factors are Associated with Electronic Cigarette, Shisha-Tobacco and Conventional Cigarette Use? Findings from a Cross-Sectional Survey of Australian Adolescents?

PubMed

Williams, Tahlia; White, Victoria

2018-01-16

Adolescents' use of electronic cigarettes and shisha-tobacco increased in several countries during the 2000s, including in the United States, United Kingdom and Canada. Few studies have examined the factors associated with exclusive e-cigarette or shisha-tobacco use and whether adolescents using these substances exclusively differ from those using traditional cigarettes. To examine the socio-demographic and behavioural correlates of exclusive e-cigarette and exclusive shisha-tobacco use to those found for users of tobacco cigarettes and multiple nicotine products in Australian adolescents. Cross-sectional survey of smoking behaviours of a random sample of 4,576 students in the Australian state of Victoria aged 12-17 conducted between June 2014 and December 2014. Overall, 14% of students had used an e-cigarette with 3% using e-cigarettes exclusively. 13% had used shisha-tobacco, with 2% using shisha-tobacco exclusively. Most students (65%) using e-cigarette and shisha-tobacco (67%) had also used tobacco cigarettes. After adjusting for demographic factors, students using e-cigarettes only were more likely to have never used cannabis or drink alcohol in the past year compared to tobacco cigarette users. Compared to tobacco cigarette users, students using only shisha-tobacco were younger, less likely to use cannabis or alcohol or have friends or parents who smoke. Most Australian adolescents who use alternative nicotine and tobacco-related products do so in conjunction with tobacco cigarettes. Students using e-cigarettes or shisha-tobacco exclusively were less likely to use other substances. Australian longitudinal studies are needed to determine whether this group of students are on a pathway to traditional tobacco use.

27 CFR 40.478 - Disposition of cigarette papers and tubes and schedule.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Disposition of cigarette... PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.478 Disposition of cigarette papers and tubes and schedule. When so...

27 CFR 40.478 - Disposition of cigarette papers and tubes and schedule.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Disposition of cigarette... PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.478 Disposition of cigarette papers and tubes and schedule. When so...

27 CFR 40.478 - Disposition of cigarette papers and tubes and schedule.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Disposition of cigarette... PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.478 Disposition of cigarette papers and tubes and schedule. When so...

27 CFR 40.478 - Disposition of cigarette papers and tubes and schedule.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Disposition of cigarette... PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.478 Disposition of cigarette papers and tubes and schedule. When so...

27 CFR 40.478 - Disposition of cigarette papers and tubes and schedule.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Disposition of cigarette... PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Claims by Manufacturers § 40.478 Disposition of cigarette papers and tubes and schedule. When so...

Youth access, creation, and content of smokeless tobacco ("dip") videos in social media.

PubMed

Seidenberg, Andrew B; Rodgers, Elizabeth J; Rees, Vaughan W; Connolly, Gregory N

2012-04-01

Smokeless tobacco (SLT) use among white adolescent males has increased in recent years, and prevalence of SLT use among adolescent males exceeds that for smoking in several U.S. states. Recent reports have described the presence of cigarette-related content on social media Web sites popular among youth; however, little has been reported on SLT content. The YouTube video search engine was searched for the popular SLT brand Skoal, and the first 50 search results were downloaded. Video statistics data were collected for and content analysis was performed on all videos featuring smokeless use (82%). Access to SLT YouTube videos by youth was also determined by assessing whether YouTube permits youth viewing and creation of SLT videos. Mean number of views for videos analyzed was 15,422, and the most watched video had 124,276 views. Descriptions of SLT flavor/smell and social references/interactions were found in 48.8% and 63.4% of videos, respectively. By contrast, references to drug (nicotine) effects (12.2%) and public health messaging (9.8%) were less common. None of the SLT videos in the sample had restrictions that would block youth viewing. In addition, evidence of self-identified youth creating SLT videos was found for 13% of unique users in the sample. YouTube does not restrict youth from creating or viewing "dip videos." Proactive efforts are needed to ensure that YouTube and other online media do not become influential vehicles for tobacco promotion to youth. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

An Epidemiological Study of ADHD Symptoms among Young Persons and the Relationship with Cigarette Smoking, Alcohol Consumption and Illicit Drug Use

ERIC Educational Resources Information Center

Gudjonsson, Gisli H.; Sigurdsson, Jon Fridrik; Sigfusdottir, Inga Dora; Young, Susan

2012-01-01

Background: This study investigates the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and cigarette smoking, alcohol use and illicit drug use. Method: The participants were 10,987 pupils in the final three years of their compulsory education in Iceland (ages 14-16 years). The participants completed questionnaires in…

Changes in cigarette use and nicotine dependence in the United States: evidence from the 2001-2002 wave of the national epidemiologic survey of alcoholism and related conditions.

PubMed

Goodwin, Renee D; Keyes, Katherine M; Hasin, Deborah S

2009-08-01

We examined the roles of gender and poverty in cigarette use and nicotine dependence among adults in the United States. Our data were drawn from the 2001-2002 National Epidemiological Survey of Alcoholism and Related Conditions, a nationally representative sample of US adults 18 years and older. The overall rate of cigarette use declined between 1964 and 2002. Nicotine dependence does not appear to have declined overall, and there is evidence that nicotine dependence has increased among women in recent cohorts. The odds of nicotine dependence among cigarette users appear to have increased significantly in recent cohorts. Despite recent declines in cigarette use, the prevalence of nicotine dependence has increased among some groups and has remained steady overall, which may be hampering public health initiatives to reduce cigarette use. Efforts to study or curb cigarette use should therefore take nicotine dependence into account.

Susceptibility to cigarette smoking among middle and high school e-cigarette users in Canada.

PubMed

Azagba, Sunday; Baskerville, Neill Bruce; Foley, Kristie

2017-10-01

There is a growing concern that the historic reductions in tobacco consumption witnessed in the past decades may be undermined by the rapid increase in e-cigarette use. This study examined the association between e-cigarette use and future intention to smoke cigarettes among middle and high school students who had never smoked cigarettes. Data were drawn from the 2014-2015 Canadian Student Tobacco, Alcohol and Drugs Survey (n=25,637). A multivariable logistic regression model was used to examine the association between e-cigarette use and susceptibility to cigarette smoking. In addition, an inverse probability of treatment weighted regression adjustment method (doubly robust estimator), which models both the susceptibility to smoking and the probability of e-cigarette use, was conducted. About 10% of the students had ever tried an e-cigarette. There were higher rates of ever e-cigarette use among students in grades 10-12 (12.5%) than those in grades 7-9 (7.3%). Students who had ever tried an e-cigarette had higher odds of susceptibility to cigarette smoking (adjusted odds ratio=2.16, 95% confidence interval=1.80-2.58) compared to those that had never tried an e-cigarette. Current use of an e-cigarette was associated with higher odds of smoking susceptibility (adjusted odds ratio=2.02, 95% confidence interval=1.43-2.84). Similar results were obtained from the doubly robust estimation. Among students who had never smoked cigarettes, e-cigarette use was associated with a higher susceptibility to cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

Snuffing Out Smokeless Tobacco Use.

ERIC Educational Resources Information Center

Wichmann, Susan; Martin, D. R.

1994-01-01

Major League Baseball's ban on players using tobacco during minor league games may provide physicians with a timely excuse to discuss smokeless tobacco with young patients. Chewing and dipping remain a significant health problem, especially among young men, many of whom view it as a secret ingredient in sports success. (SM)

210Po in Human Saliva of Smokeless Tobacco Users.

PubMed

Meli, Maria Assunta; Desideri, Donatella; Roselli, Carla; Feduzi, Laura

2017-01-01

The occurrence and mobility of Po in oral smokeless tobacco products (STPs) were determined because its effects on human health must be taken into account. This research was subdivided into two parts: determination by alpha spectrometry of the Po activity concentration in 16 oral smokeless tobacco products of different brands purchased in local specialty stores in Europe and evaluation of its percent extraction into an artificial salivary gland during sucking or chewing operations. Polonium-210 was detected in all samples, and its concentrations ranged from 3.46 to 14.8 Bq kg (mean value of 7.45 ± 3.82 Bq kg). The highest concentration was found in chewing tobacco. The samples showed no significant difference in the content of Po level. The data obtained in this study show that the polonium, although poorly extracted (12.8 ± 8.96%) by artificial saliva, is not totally retained within the smokeless tobacco products, with a consequent potential health hazard associated with oral use of these products.

The appeal of smokeless tobacco products among young Canadian smokers: the impact of pictorial health warnings and relative risk messages.

PubMed

Callery, William E; Hammond, David; O'Connor, Richard J; Fong, Geoffrey T

2011-05-01

Although the health risks from smokeless tobacco (ST) are lower than cigarettes, it remains unclear how smokers might use ST products, including as a substitute, a cessation aid, or concurrently with cigarette use, if at all. Additionally, there is little evidence examining the impact of health warning labels (HWL) on ST use and perceptions. The current study investigated perceptions of ST products with and without HWL and a relative health risk (RHR) message. The study consisted of a full-factorial "between-subjects" experiment in which 3 HWL and a RHR message were systematically varied. Canadian smokers aged 18-30 years (N = 611) completed an online survey where they viewed four brands of ST packages altered according to the experimental conditions. Approximately half of the smokers indicated that they were willing to try ST as a substitute and to help quit smoking. More than one quarter (28%) of smokers were unaware that using ST is less harmful than smoking. Pictorial HWL increased false beliefs about the RHR of ST and decreased smokers' willingness to try ST, whereas text warnings did not. Adding a RHR message communicating the lower risk of ST compared with cigarettes increased willingness to try ST when added to text HWL but decreased willingness to try ST even further when added to pictorial HWL. The findings indicate relatively high levels of appeal for ST among young adult Canadian cigarette smokers. Pictorial HWL reduced the appeal of ST products and increased perceived risks, including the false belief that ST is equally harmful as cigarettes. Further research could consider evaluating designs of HWL on ST products that better balance absolute and RHR.

Reinforcement of Smoking and Drinking: Tobacco Marketing Strategies Linked With Alcohol in the United States

PubMed Central

Jiang, Nan

2011-01-01

Objectives. We investigated tobacco companies’ knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities. Methods. We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results. Results. Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use. Conclusions. Tobacco companies’ numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use. PMID:21852637

U.S. Demand for Tobacco Products in a System Framework.

PubMed

Zheng, Yuqing; Zhen, Chen; Dench, Daniel; Nonnemaker, James M

2017-08-01

This study estimated a system of demand for cigarettes, little cigars/cigarillos, large cigars, e-cigarettes, smokeless tobacco, and loose smoking tobacco using market-level scanner data for convenience stores. We found that the unconditional own-price elasticities for the six categories are -1.188, -1.428, -1.501, -2.054, -0.532, and -1.678, respectively. Several price substitute (e.g., cigarettes and e-cigarettes) and complement (e.g., cigarettes and smokeless tobacco) relationships were identified. Magazine and television advertising increased demand for e-cigarettes, and magazine advertising increased demand for smokeless tobacco and had spillover effects on demand for other tobacco products. We also reported the elasticities by U.S. census regions and market size. These results may have important policy implications, especially viewed in the context of the rise of electronic cigarettes and the potential for harm reduction if combustible tobacco users switch to non-combustible tobacco products. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A Brief Alcohol Preventive Intervention for Student Athletes

ERIC Educational Resources Information Center

Werch, Chudley E.; Carlson, Joan M.; Pappas, Deborah M.; Edgemon, Patricia; DiClemente, Carlo C.

2002-01-01

Studies of athletes suggest that they are at increased risk for using alcohol, smokeless tobacco, steroids, and marijuana. They are also a readily available audience during annual preparticiaption physical examinations. In this article, Dr. Werch and colleagues report on the results from their pilot study, using a modified version of STARS (Start…

Adolescents' interest in trying flavoured e-cigarettes.

PubMed

Pepper, J K; Ribisl, K M; Brewer, N T

2016-11-01

More US adolescents use e-cigarettes than smoke cigarettes. Research suggests flavoured e-cigarettes appeal to youth, but little is known about perceptions of and reasons for attraction to specific flavours. A national sample of adolescents (n=1125) ages 13-17 participated in a phone survey from November 2014 to June 2015. We randomly assigned adolescents to respond to survey items about 1 of 5 e-cigarette flavours (tobacco, alcohol, menthol, candy or fruit) and used regression analysis to examine the impact of flavour on interest in trying e-cigarettes and harm beliefs. Adolescents were more likely to report interest in trying an e-cigarette offered by a friend if it were flavoured like menthol (OR=4.00, 95% CI 1.46 to 10.97), candy (OR=4.53, 95% CI 1.67 to 12.31) or fruit (OR=6.49, 95% CI 2.48 to 17.01) compared with tobacco. Adolescents believed that fruit-flavoured e-cigarettes were less harmful to health than tobacco-flavoured e-cigarettes (p<0.05). Perceived harm mediated the relationship between some flavours and interest in trying e-cigarettes. A minority of adolescents believed that e-cigarettes did not have nicotine (14.6%) or did not know whether they had nicotine (3.6%); these beliefs did not vary by flavour. Candy-flavoured, fruit-flavoured and menthol-flavoured e-cigarettes appeal to adolescents more than tobacco-flavoured or alcohol-flavoured e-cigarettes. This appeal is only partially explained by beliefs about reduced harm. Given adolescents' interest in trying e-cigarettes with certain flavours, policymakers should consider restricting advertisements promoting flavoured products in media that reach large numbers of young people. Future research should examine other reasons for the appeal of individual flavours, such as novelty and perceived luxury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

E-cigarette openness, curiosity, harm perceptions and advertising exposure among U.S. middle and high school students.

PubMed

Margolis, Katherine A; Donaldson, Elisabeth A; Portnoy, David B; Robinson, Joelle; Neff, Linda J; Jamal, Ahmed

2018-07-01

Understanding factors associated with youth e-cigarette openness and curiosity are important for assessing probability of future use. We examined how e-cigarette harm perceptions and advertising exposure are associated with openness and curiosity among tobacco naive youth. Findings from the 2015 National Youth Tobacco Survey (NYTS) were analyzed. The 2015 NYTS is a nationally representative survey of 17,711 U.S. middle and high school students. We calculated weighted prevalence estimates of never users of tobacco products (cigarettes, cigars/cigarillos/little cigars, waterpipe/hookah, smokeless tobacco, bidis, pipes, dissolvables, e-cigarettes) who were open to or curious about e-cigarette use, by demographics. Weighted regression models examined how e-cigarette harm perceptions and advertising exposure were associated with openness using e-cigarettes and curiosity about trying e-cigarettes. Among respondents who never used tobacco products, 23.8% were open to using e-cigarettes and 25.4% were curious. Respondents that perceived e-cigarettes cause a lot of harm had lower odds of both openness (OR = 0.10, 95% CI = 0.07, 0.15) and curiosity about e-cigarettes (OR = 0.10, 95% CI = 0.07, 0.13) compared to those with lower harm perception. Respondents who reported high exposure to e-cigarette advertising in stores had greater odds of being open to e-cigarette use (OR = 1.22, 95% CI = 1.03, 1.44) and highly curious (OR = 1.25, 95% CI = 1.01, 1.53) compared to those not highly exposed. These findings demonstrate that youth exposed to e-cigarette advertising are open and curious to e-cigarette use. These findings could help public health practitioners better understand the interplay of advertising exposure and harm perceptions with curiosity and openness to e-cigarette use in a rapidly changing marketplace. Published by Elsevier Inc.

Smokeless tobacco and oral cancer: a review of the risks and determinants.

PubMed

Rodu, Brad; Jansson, Christer

2004-09-01

Smokeless tobacco has been associated with oral cancer for many decades. The purpose of this article is to review research relevant to this association, including epidemiologic studies, studies of putative carcinogens such as tobacco-specific nitrosamines (TSNAs) and other contaminants, and possible cancer inhibitors. Epidemiologic studies addressing this issue primarily consist of case-control studies. They show that the use of chewing tobacco and moist snuff is associated with very low risks for cancers of the oral cavity and related structures (relative risks [RR] from 0.6 to 1.7). The use of dry snuff is associated with higher RRs, ranging from 4 to 13, while the RRs from smokeless tobacco, unspecified as to type, are intermediate (RR = 1.5 to 2.8). With regard to TSNAs, historical levels in American moist snuff products were higher than those in their Swedish counterparts, but levels in contemporary products are uniformly low. TSNA levels in chewing tobacco have always been low, but levels in dry snuff have been higher, including some very high levels in current products. In general, smokeless tobacco users are not exposed to significant levels of cadmium, lead, benzo(a)pyrene, polonium-210, and formaldehyde, when compared with concentrations of these compounds in foods. Finally, low oral cancer risk from smokeless tobacco use may be influenced by the presence of cancer inhibitors, mainly anti-oxidants, in smokeless tobacco products.

Smokeless tobacco use among rural Kadazan women in Sabah, Malaysia.

PubMed

Gan, C Y

1995-06-01

A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.

The Effect of Computer Usage in Internet Café on Cigarette Smoking and Alcohol Use among Chinese Adolescents and Youth: A Longitudinal Study

PubMed Central

Wu, Liyun; Delva, Jorge

2012-01-01

We used longitudinal data to investigate the relationship between computer use in internet cafés and smoking/drinking behavior among Chinese adolescents and young adults. Data are from two waves of the China Health and Nutrition Survey (2004 and 2006). Fixed effects models were used to examine if changes in internet café use were associated with changes in cigarette smoking and drinking of alcohol. Male café users spent on average 17.3 hours in front of the computer/week. This was associated with an increase in the probability of being a current smoker by 13.3% and with smoking 1.7 more cigarettes. Female café users spent on average 11 hours on the computer/week. This was associated with an increase in the probability of drinking wine and/or liquor by 14.74% and was not associated with smoking. Internet cafés are an important venue by which adolescent and young adults in China are exposed to smoking and drinking. Multi-component interventions are needed ranging from policies regulating cigarette and alcohol availability in these venues to anti-tobacco campaigns aimed at the general population but also at individuals who frequent these establishments. PMID:22470305

Examining market trends in the United States smokeless tobacco use: 2005-2011.

PubMed

Delnevo, Cristine D; Wackowski, Olivia A; Giovenco, Daniel P; Manderski, Michelle T Bover; Hrywna, Mary; Ling, Pamela M

2014-03-01

While cigarette consumption in the USA continues to decline, promotion for and consumption of smokeless tobacco (SLT) is growing. However, little research has explored what product features are driving SLT growth, despite awareness that product-level factors may be important in SLT use. This study analyses national sales data to better understand the impact of product features on SLT sales. Data on sales of SLT in US convenience stores from 2005 to 2011 were obtained from Nielsen Research Company. Each listed product was coded for attributes such as type, brand, flavouring and form to calculate their respective total sales, market share and contribution to overall SLT growth. Sales of moist snuff products (including snus) increased by 65.6% between 2005 and 2011. Sales of pouched and flavoured forms of moist snuff increased by 333.8% and 72.1%, respectively, and contributed to 28% and 59.4% of the total growth in the moist snuff category, respectively. Value/discount brands accounted for 42% of moist snuff sales in 2011 among the top 10 selling brands, largely driven by Grizzly. After 2 years on the national market, Camel Snus was also one of the top 10 selling moist snuff brands. Sales of moist snuff, both overall and for particular styles, are increasing. Growing pouch use may be attributed to new SLT users, which may include cigarette smokers using them as starter SLT products. Increased sales of flavoured and discounted snuff raise concerns about use and appeal to youth. Continued surveillance of SLT sales trends is warranted.

Smokeless tobacco advertising at the point of sale: prevalence, placement, and demographic correlates.

PubMed

Widome, Rachel; Brock, Betsy; Klein, Elizabeth G; Forster, Jean L

2012-02-01

We aimed to describe the prevalence, in-store location, and neighborhood predictors of point-of-sale smokeless tobacco advertising. In 2007, we conducted assessments of smokeless tobacco advertising at the point of sale in 484 establishments, which held tobacco licenses and sold tobacco products in a Midwest metropolitan area. Associations between store characteristics, neighborhood characteristics (based on U.S. 2000 census block groups), and smokeless tobacco advertising were calculated. Advertisements for smokeless tobacco were found in 21% (n = 103) of stores. Approximately, 12% (n = 58) of stores had ads within 6 feet of the counter, 3% (n = 14) had ads less than 3 feet from the ground, and 2% (n = 9) had advertisement less than 1 foot from candy or snacks. The racial/ethnic composition and number of households on public assistance within the block group in which a store was situated were related to the amount of smokeless advertising in stores. For instance, having a higher proportion of the population identifying as White was associated with more advertising. Gas stations/convenience stores had more advertising than any other store types. Chain stores had double the amount of advertising as independent stores (p < .05) even after adjustment for other factors. Smokeless tobacco advertising is not uncommon even in an urban metropolitan community. These products are being advertised in a way that youth, especially those living in neighborhoods with certain demographic characteristics, can encounter. With Food and Drug Administration regulation, there are new opportunities to regulate advertising at the point of sale.

Association of smokeless tobacco use and smoking in adolescents in the US: Youth Risk Behavior Survey, 2011

PubMed Central

Wiener, R. Constance

2014-01-01

Background Using smokeless tobacco and smoking are risk behaviors for oral cancer, soft tissue lesions, caries, periodontal disease and other oral conditions. The purpose of this study was to examine adolescent smokeless tobacco use and smoking. Methods The study was a cross-sectional analysis of participants with complete data on smoking, smokeless tobacco use, and other variables of interest in the 2011 Youth Risk Behavior Survey (n=9655). Descriptive analysis and multivariable logistic regression analyses were performed. Results The unadjusted odds ratio for smokeless tobacco use and smoking was 9.68 (95% CI: 7.72, 12.13, p<.0001); the adjusted odds ratio was 3.92 (95%CI: 2.89, 5.31, p<.0001). Adolescents using smokeless tobacco were more likely to be male, to smoke, and to have engaged in binge drinking. Conclusions Adolescents who are using smokeless tobacco are more likely to also be engaging in concomitant smoking and are participating in other risk-taking behaviors. Practice implications Dentists are involved in helping patients in tobacco cessation. The strong association of smoking with smokeless tobacco needs to be considered in designing cessation programs for adolescents. PMID:23904581

Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study

PubMed Central

Rossie, Karen; Stokes, Katie; Tallman, Christina; Tanner, Bradley

2018-01-01

Background New technologies such as virtual reality, augmented reality, and video games hold promise to support and enhance individuals in addiction treatment and recovery. Quitting or decreasing cigarette or alcohol use can lead to significant health improvements for individuals, decreasing heart disease risk and cancer risks (for both nicotine and alcohol use), among others. However, remaining in recovery from use is a significant challenge for most individuals. Objective We developed and assessed the Take Control game, a partially immersive Kinect for Windows platform game that allows users to counter substance cues through active movements (hitting, kicking, etc). Methods Formative analysis during phase I and phase II guided development. We conducted a small wait-list control trial using a quasi-random sampling technique (systematic) with 61 participants in recovery from addiction to alcohol or tobacco. Participants used the game 3 times and reported on substance use, cravings, satisfaction with the game experience, self-efficacy related to recovery, and side effects from exposure to a virtual reality intervention and substance cues. Results Participants found the game engaging and fun and felt playing the game would support recovery efforts. On average, reported substance use decreased for participants during the intervention period. Participants in recovery for alcohol use saw more benefit than those in recovery for tobacco use, with a statistically significant increase in self-efficacy, attitude, and behavior during the intervention. Side effects from the use of a virtual reality intervention were minor and decreased over time; cravings and side effects also decreased during the study. Conclusions The preliminary results suggest the intervention holds promise as an adjunct to standard treatment for those in recovery, particularly from alcohol use. PMID:29661748

Perception of health risks among adolescents due to consumption of cigarettes, alcohol and psychoactive substances in the Federation of Bosnia and Herzegovina.

PubMed

Pilav, A; Rudić, A; Branković, S; Djido, V

2015-07-01

This article describes the perception of health risks in adolescents due to the consumption of cigarettes, alcohol and psychoactive substances in the Federation of Bosnia and Herzegovina (FBIH), as well as their observation of the behavior of their peers related to addictive behaviors. For the analysis was used a database from the European School Survey Project on Alcohol and Other Drugs (ESPAD) survey which was conducted in FBIH in 2011. The target population were students in the second grade of secondary schools in FBIH born in 1995 according to the ESPAD protocol. The total number of respondents from the cohort born in 1995 was 3813 students. The research results showed that the prevalence of risk perception due to the consumption of cigarettes, alcohol and psychoactive substances among adolescents in the FBIH is lower than the mean prevalence in countries which have implemented the ESPAD survey of 2011. PPreventive activities should be aimed at adolescent risk behaviours and empower them to make the right decisions that can have far reaching significance. Attention has to be paid to selective prevention that is directed towards individuals or subgroup of population where the risk of developing disorder is much higher than average. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Dependence on Smokeless Tobacco in the South Asian Communities in East London.

PubMed

Khaja, Amjad Hussain; Ali Zwiad, Abdulsalam; Tarakji, Bassel; Gazal, Giath; Albaba, Feras; KalajI, Nader; Petro, Waleed

2015-05-17

The purpose of the study was to understand the dependency on smokeless tobacco. The major aspect of the interview was to study the type of chewing tobacco used, frequency of purchase of chewing tobacco, change in attitude and behavior after the use of chewing tobacco. This study was done in 2005 in London. Of the 110 respondents interviewed 88 were used for the data analysis. An exploratory study was conducted in East London, United Kingdom. The selected sample was interviewed through a questionnaire, based on the Severson Smokeless Tobacco Dependence Scale. Cross tabulations report that in a sample of 88 South Asian UK resident men 46.6% used leaf (paan), 43.2% used processed form of chewing tobacco and 10.2% used gutka. Older age (67%) respondents were more likely than the younger age (30%) respondents to chew tobacco. The frequency of purchase of chewing tobacco is reported high (67.2%) in the older age group than the younger age group (50%). This current study used an amended form of the Severson Smokeless Tobacco Scale questionnaire to study the dependency on smokeless tobacco. The study could be developed in the selection of the sample, which would include both males and females to study the dependency on smokeless tobacco.

Adult Product Advertising to the Adolescent Audience: The Case of Smokeless Tobacco.

ERIC Educational Resources Information Center

McDermott, Steven T.; And Others

Prior to the 1986 advertising ban, a study measured the effects of smokeless tobacco advertising on young people. A questionnaire was administered in the spring of 1985 to 133 sixth, eighth, and tenth grade students in rural Georgia. The probability of exposure to smokeless tobacco ads was measured by: (1) the number of hours per week the student…

Alcohol and Cigarette Use From Ages 23 to 55: Links With Health and Well-Being in the Long-Term National Child Development Study

PubMed Central

Staff, Jeremy; Maggs, Jennifer

2017-01-01

Objective: Using longitudinal data from the National Child Development Study, an ongoing study of a nationally representative British cohort born in 1958 (n = 9,137; 51% female), we examined how patterns of alcohol and cigarette use from young adulthood (age 23) to midlife (age 55) are associated with health and well-being. Method: We first used a nonparametric multilevel latent class specification to identify eight unique paths of alcohol and cigarette use from ages 23 to 55, and then assessed how these long-term latent paths related to overall health, heart problems, chronic illness, and quality of life at midlife. Results: Results show that adults who consistently drank within current U.K. low-risk guidelines (i.e., not exceeding 14 units of alcohol per week) and abstained from smoking from young adulthood to midlife reported the best overall health and well-being compared with latent paths involving steady, light to moderate drinking and both current and prior smoking, increasing drinking and smoking, and infrequent drinking/abstention. Conclusions: British adults who consistently drank within new lower risk guidelines and abstained from smoking from young adulthood to midlife reported the best overall health and well-being across numerous indicators. However, apparent observed health benefits of stable low-dose alcohol use (vs. abstention) are weakened by the fact that by age 55 almost all alcohol “abstainers” in the National Child Development Study sample were former drinkers, and that respondents who followed infrequent drinking/abstention paths were the mostly likely to report poor health, psychological distress, and low educational qualifications in early adulthood. (J Stud. Alcohol Drugs, 78, 394–403, 2017) PMID:28499106

Early initiation of alcohol drinking, cigarette smoking, and sexual intercourse linked to suicidal ideation and attempts: findings from the 2006 Korean Youth Risk Behavior Survey.

PubMed

Kim, Dong-Sik; Kim, Hyun-Sun

2010-01-01

This study examined the association between early initiation of problem behaviors (alcohol drinking, cigarette smoking, and sexual intercourse) and suicidal behaviors (suicidal ideation and suicide attempts), and explored the effect of concurrent participation in these problem behaviors on suicidal behaviors among Korean adolescent males and females. Data were obtained from the 2006 Korean Youth Risk Behavior Survey, a nationally representative sample of middle and high school students (32,417 males and 31,467 females) in grades seven through twelve. Bivariate and multivariate logistic analyses were conducted. Several important covariates, such as age, family living structure, household economic status, academic performance, current alcohol drinking, current cigarette smoking, current butane gas or glue sniffing, perceived body weight, unhealthy weight control behaviors, subjective sleep evaluation, and depressed mood were included in the analyses. Both male and female preteen initiators of each problem behavior were at greater risk for suicidal behaviors than non-initiators, even after controlling for covariates. More numerous concurrent problematic behaviors were correlated with greater likelihood of seriously considering or attempting suicide among both males and females. This pattern was more clearly observed in preteen than in teen initiators although the former and latter were engaged in the same frequency of problem behavior. Early initiation of alcohol drinking, cigarette smoking, and sexual intercourse, particularly among preteens, represented an important predictor of later suicidal ideation and suicide attempts in both genders. Thus, early preventive intervention programs should be developed and may reduce the potential risks for subsequent suicidal behaviors.

Examining vulnerability to smokeless tobacco use among adolescents and adults meeting diagnostic criteria for major depressive disorder.

PubMed

Redner, Ryan; White, Thomas J; Harder, Valerie S; Higgins, Stephen T

2014-08-01

Smoking prevalence is unevenly distributed in the U.S. population, with those with mental illness, other substance use disorders, and lower socioeconomic status being especially vulnerable. Less research has been conducted on the association between these same vulnerabilities and smokeless tobacco (ST) use. The present study examined cigarette and ST use among adolescents and adults who met diagnostic criteria for major depressive disorder in the National Survey on Drug Use and Health (NSDUH). Utilizing the most recent (2011) NSDUH, we compared odds for current cigarette smoking and ST use among adolescents and adults meeting criteria for past-year major depressive disorder to the general population, after adjusting for potential confounding influences of sociodemographic and other substance use characteristics. Analyses were conducted to examine sex as a moderator of the relation between major depressive disorder and tobacco use. Odds for current cigarette smoking among those classified with major depressive disorder were increased among adolescents (OR = 1.33, 95% CI [1.05, 1.69], p = .021) and adults (OR = 1.70, 95% CI [1.47, 1.97], p < .0005), and odds for current ST use did not differ among adolescents (OR = 0.90, 95% CI [0.54, 1.49], p = .678) and were lower among adults (OR = 0.68, 95% CI [0.51, 0.91], p = .010). Sex was not a significant moderator in adolescents or adults. Major depressive disorder is associated with increased risk for smoking but not ST use among adolescents and adults further demonstrating heterogeneity in predictors of vulnerability to use of different tobacco products.

27 CFR 40.384 - Disposal of forfeited, condemned, and abandoned cigarette papers and tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., condemned, and abandoned cigarette papers and tubes. 40.384 Section 40.384 Alcohol, Tobacco Products and... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes General § 40.384 Disposal of forfeited, condemned, and abandoned cigarette papers and...

27 CFR 40.384 - Disposal of forfeited, condemned, and abandoned cigarette papers and tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., condemned, and abandoned cigarette papers and tubes. 40.384 Section 40.384 Alcohol, Tobacco Products and... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes General § 40.384 Disposal of forfeited, condemned, and abandoned cigarette papers and...

27 CFR 40.384 - Disposal of forfeited, condemned, and abandoned cigarette papers and tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., condemned, and abandoned cigarette papers and tubes. 40.384 Section 40.384 Alcohol, Tobacco Products and... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes General § 40.384 Disposal of forfeited, condemned, and abandoned cigarette papers and...

27 CFR 40.384 - Disposal of forfeited, condemned, and abandoned cigarette papers and tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., condemned, and abandoned cigarette papers and tubes. 40.384 Section 40.384 Alcohol, Tobacco Products and... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes General § 40.384 Disposal of forfeited, condemned, and abandoned cigarette papers and...

27 CFR 40.384 - Disposal of forfeited, condemned, and abandoned cigarette papers and tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., condemned, and abandoned cigarette papers and tubes. 40.384 Section 40.384 Alcohol, Tobacco Products and... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes General § 40.384 Disposal of forfeited, condemned, and abandoned cigarette papers and...

Obsolete tobacco control themes can be hazardous to public health: the need for updating views on absolute product risks and harm reduction.

PubMed

Kozlowski, Lynn T; Abrams, David B

2016-05-24

Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1) how bad is the problem (i.e., absolute risk) and 2) what can be done to reduce the risk without cessation (i.e., prospects for harm reduction). Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that "cigarettes are hazardous to health" and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes). In the 1980s there was the creation of the seminal theme that "Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined." By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as "unsafe" or "not a safe alternative to cigarettes." The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS) had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus), and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control are proposed as an important next step. A new reframing can align

Waterpipes and e-cigarettes: Impact of alternative smoking techniques on indoor air quality and health

NASA Astrophysics Data System (ADS)

Fromme, Hermann; Schober, Wolfgang

2015-04-01

Waterpipe (WP) smoking is growing as an alternative to cigarette smoking, especially in younger age groups. E-cigarette use has also increased in recent years. A majority of smokers mistakenly believe that WP smoking is a social entertainment practice that leads to more social behavior and relaxation and that this type of smoking is safe or less harmful and less addictive than cigarette smoking. In reality, WP smokers are exposed to hundreds of toxic substances that include known carcinogens. High exposures to carbon monoxide and nicotine are major health threats. Persons exposed to secondhand WP smoke are also at risk. There is growing evidence that WP smoke causes adverse effects on the pulmonary and cardiovascular systems and is responsible for cancer. E-cigarettes are marketed as a smokeless and safe way to inhale nicotine without being exposed to the many toxic components of tobacco cigarettes, and as an aid to smoking cessation. In fact, consumers (vapers) and secondhand vapers can be exposed to substantial amounts of VOC, PAH or other potentially harmful substances. Of major health concern is the inhalation of fine and ultrafine particles formed from supersaturated 1,2-propanediol vapor. Such particles can be deposited in the deeper parts of the lung and may harm the respiratory system or increase the risk of acquiring asthma. More research on the safety of e-cigarettes needs to be conducted to ensure a high level of public health protection in the long-term.

Smokeless Tobacco Use in Adolescents: The Cardiovascular Health in Children (CHIC II) Study.

ERIC Educational Resources Information Center

Lewis, Paul C.; Harrell, Joanne S.; Deng, Shibing; Bradley, Chyrise

1999-01-01

Examined age, gender, ethnicity, self-esteem, physical activity, parental smoking, and socioeconomic status as predictors of smokeless tobacco use among middle-school students. Student surveys indicated that males, Hispanics, and older students were more likely to be current smokeless-tobacco users. Other influential factors were low self-esteem…

Study on the short-term effects of increased alcohol and cigarette consumption in healthy young men’s seminal quality

PubMed Central

Silva, Joana Vieira; Cruz, Daniel; Gomes, Mariana; Correia, Bárbara Regadas; Freitas, Maria João; Sousa, Luís; Silva, Vladimiro; Fardilha, Margarida

2017-01-01

Many studies have reported a negative impact of lifestyle factors on testicular function, spermatozoa parameters and pituitary-gonadal axis. However, conclusions are difficult to draw, since studies in the general population are rare. In this study we intended to address the early and late short-term impact of acute lifestyle alterations on young men’s reproductive function. Thirty-six healthy male students, who attended the Portuguese academic festivities, provided semen samples and answered questionnaires at three time-points. The consumption of alcohol and cigarette increased more than 8 and 2 times, respectively, during the academic festivities and resulted in deleterious effects on semen quality: one week after the festivities, a decrease on semen volume, spermatozoa motility and normal morphology was observed, in parallel with an increase on immotile spermatozoa, head and midpiece defects and spermatozoa oxidative stress. Additionally, three months after the academic festivities, besides the detrimental effect on volume, motility and morphology, a negative impact on spermatozoa concentration was observed, along with a decrease on epididymal, seminal vesicles and prostate function. This study contributed to understanding the pathophysiology underlying semen quality degradation induced by acute lifestyle alterations, suggesting that high alcohol and cigarette consumption are associated with decreased semen quality in healthy young men. PMID:28367956

Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents.

PubMed

Wills, Thomas A; Knight, Rebecca; Williams, Rebecca J; Pagano, Ian; Sargent, James D

2015-01-01

To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories. School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product). Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers. This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use. Copyright © 2015 by the American Academy of Pediatrics.

Risk Factors for Exclusive E-Cigarette Use and Dual E-Cigarette Use and Tobacco Use in Adolescents

PubMed Central

Knight, Rebecca; Williams, Rebecca J.; Pagano, Ian; Sargent, James D.

2015-01-01

OBJECTIVE: To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories. METHODS: School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product). RESULTS: Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers. CONCLUSIONS: This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use. PMID:25511118

Risky behaviors, e-cigarette use and susceptibility of use among college students.

PubMed

Saddleson, M L; Kozlowski, L T; Giovino, G A; Hawk, L W; Murphy, J M; MacLean, M G; Goniewicz, M L; Homish, G G; Wrotniak, B H; Mahoney, M C

2015-04-01

Since 2007, there has been a rise in the use of electronic cigarettes (e-cigarettes). The present study uses cross-sectional data (2013) to examine prevalence, correlates and susceptibility to e-cigarettes among young adults. Data were collected using an Internet survey from a convenience sample of 1437, 18-23 year olds attending four colleges/universities in Upstate New York. Results were summarized using descriptive statistics; logistic regression models were analyzed to identify correlates of e-cigarette use and susceptibility to using e-cigarettes. Nearly all respondents (95.5%) reported awareness of e-cigarettes; 29.9% were ever users and 14.9% were current users. Younger students, males, non-Hispanic Whites, respondents reporting average/below average school ability, ever smokers and experimenters of tobacco cigarettes, and those with lower perceptions of harm regarding e-cigarettes demonstrated higher odds of ever use or current use. Risky behaviors (i.e., tobacco, marijuana or alcohol use) were associated with using e-cigarettes. Among never e-cigarette users, individuals involved in risky behaviors or, with lower harm perceptions for e-cigarettes, were more susceptible to future e-cigarette use. More e-cigarette users report use of another nicotine product besides e-cigarettes as the first nicotine product used; this should be considered when examining whether e-cigarette use is related to cigarette susceptibility. Involvement in risky behaviors is related to e-cigarette use and susceptibility to e-cigarette use. Among college students, e-cigarette use is more likely to occur in those who have also used other tobacco products, marijuana, and/or alcohol. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.