Samantha Johnstone, Robert K Cooper, Jennifer M Wray, Sarah Tonkin, Kyler S Knapp, Craig R Colder, Eugene Maguin, Martin C Mahoney, Stephen T Tiffany, Thomas H Brandon, Rebecca L Ashare, Larry W Hawk
{"title":"Sex-Specific Mediation of Pre-Quit Smoking Reduction: Secondary Analysis of a Randomized Controlled Trial Extending Varenicline Preloading.","authors":"Samantha Johnstone, Robert K Cooper, Jennifer M Wray, Sarah Tonkin, Kyler S Knapp, Craig R Colder, Eugene Maguin, Martin C Mahoney, Stephen T Tiffany, Thomas H Brandon, Rebecca L Ashare, Larry W Hawk","doi":"10.1093/ntr/ntaf100","DOIUrl":"https://doi.org/10.1093/ntr/ntaf100","url":null,"abstract":"<p><strong>Introduction: </strong>Relative to other pharmacotherapies for smoking cessation, varenicline has significantly greater efficacy in females; however, sex-specific mechanisms have not yet been investigated. We conducted a secondary analysis of ecological momentary assessment (EMA) data to assess whether reductions in craving, negative affect, and smoking satisfaction/reward/aversion mediate effects of varenicline on next-day smoking to a greater degree in females (n=179) relative to males (n=141).</p><p><strong>Methods: </strong>Data were from a 3-week medication manipulation period during the pre-quit phase of a double-blind randomized placebo-controlled trial investigating extended preloading (4 weeks) vs. standard preloading varenicline (1 week, preceded by 3 weeks of placebo, NCT03262662). Time-invariant multilevel moderated mediation models and time-varying mediation models were utilized.</p><p><strong>Results: </strong>A significant time-varying indirect effect through craving that increased in magnitude over the pre-quit period was identified only in females. Exploratory analysis found that decreases in psychological reward and smoking satisfaction mediated the relationship between varenicline and reductions in craving only in females. Time-invariant multi-level models did not evidence a significant indirect effect through candidate mediators in males or females; the index of moderated mediation was not significant in any of the models.</p><p><strong>Conclusions: </strong>Our findings suggest that the efficacy of varenicline on reductions in pre-quit smoking in females operates through reductions in craving. Furthermore, reductions in craving may be due to decreases in positive subjective experiences of smoking. Augmenting craving coping strategies as well as reducing smoking reward and satisfaction may be a beneficial approach in females.</p><p><strong>Implications: </strong>This is the first study to investigate sex-specific mediation of varenicline on reductions in pre-quit smoking. Further investigation into varenicline-induced changes in smoking reinforcement and craving is warranted, particularly in females. For example, experimentally manipulating these mediators may inform them as mechanisms for smoking reduction.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ketki Pawaskar, Sophia M Scott, Shaydel Engel, Sarah M Mulloy, Anna M Lee
{"title":"Flavor compounds found in electronic cigarette liquids differentially enhance voluntary nicotine consumption and preference in mice.","authors":"Ketki Pawaskar, Sophia M Scott, Shaydel Engel, Sarah M Mulloy, Anna M Lee","doi":"10.1093/ntr/ntaf106","DOIUrl":"https://doi.org/10.1093/ntr/ntaf106","url":null,"abstract":"<p><strong>Introduction: </strong>Beta-damascone is a flavor compound found only in tobacco-flavored e-cigarette products, trans-2-hexenal is found only in fruit-flavored products, and isoamyl acetate is found in multiple flavor categories such as fruit, candy and dessert. We investigated the effect of these compounds on nicotine consumption and preference in mice to determine how these compounds modulate nicotine intake.</p><p><strong>Methods: </strong>Adult, male C57BL/6J mice underwent a voluntary, 24 hour two-bottle choice test where they were presented with 75 μg/mL nicotine, the flavor compounds only (0.1-100 μg/mL), or the flavor compounds plus nicotine over a 5-week period.</p><p><strong>Results: </strong>Beta-damascone resulted in increased nicotine consumption (mg/kg) and % preference when added to nicotine at 1 μg/mL, whereas trans-2-hexenal had no enhancing effect on nicotine consumption and preference compared with mice that were given nicotine alone. Isoamyl acetate resulted in increased consumption but not preference when added to nicotine at 1 μg/mL. The preference for the three flavor compounds alone was similar and did not differ from water between 0.1 - 50 μg/mL. At 100 μg/mL, the preference for the flavor compounds was significantly less compared with water.</p><p><strong>Conclusion: </strong>We find that flavor compounds have distinct modulatory effects on nicotine consumption and preference that are not due to increased preference for the flavor itself. Moreover, flavor compounds in the same flavor category (e.g. trans-2-hexenal and isoamyl acetate) do not have the same effects, indicating that the modulatory effect of flavor compounds cannot be generalized based on their category.</p><p><strong>Implications: </strong>This study examines the effect of individual flavor compounds on nicotine consumption and preference in a preclinical mouse model. We find that flavor compounds have distinct effects in modulating nicotine consumption and preference in mice, with flavor compounds of the same flavor category having differential modulatory effects. These data suggest that the effect of flavor compound cannot be generalized to the flavor category.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olanrewaju Onigbogi, Rebekah Pratt, Xianghua Luo, Susan A Everson-Rose, Ned L Cooney, Sheila Specker, Janet Thomas, Kolawole Okuyemi
{"title":"Combined smoking cessation and alcohol abstinence treatment for people experiencing homelessness: a randomized trial.","authors":"Olanrewaju Onigbogi, Rebekah Pratt, Xianghua Luo, Susan A Everson-Rose, Ned L Cooney, Sheila Specker, Janet Thomas, Kolawole Okuyemi","doi":"10.1093/ntr/ntaf085","DOIUrl":"https://doi.org/10.1093/ntr/ntaf085","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, 80% of adults experiencing homelessness smoke combustible cigarettes. Power to Quit 2 (PTQ2) was a randomized clinical trial to test the efficacy of a combined smoking cessation and alcohol abstinence biobehavioral intervention, Intensive Smoking plus Alcohol (IS+A), versus Usual Care (UC) for adults experiencing homelessness.</p><p><strong>Methods: </strong>PTQ2 was conducted in 2 urban homeless shelters in the Upper Midwest (2014-2018). People who smoked and reported hazardous alcohol use (N=344) were randomized to IS+A (10 sessions of cognitive behavioral therapy for smoking and alcohol cessation plus nicotine replacement therapy [NRT], n=168) or UC (educational session on smoking and alcohol cessation plus NRT, n=176). The primary hypothesis was that the intervention would result in greater biochemically verified 7-day point-prevalent smoking abstinence 26 weeks post-intervention compared with UC. Our secondary hypothesis was that the intervention would result in greater 30-day alcohol abstinence 26 weeks post-intervention compared with UC.</p><p><strong>Results: </strong>At week 26, the IS+A intervention group did not differ from the UC group in expired carbon monoxide-verified 7-day point-prevalent smoking abstinence (16.6% vs. 12.8%, P=0.47) or rate of self-reported 30-day alcohol abstinence (91.1% vs. 90.2%, P=0.75).</p><p><strong>Conclusions: </strong>The IS+A intervention did not result in significantly better smoking or alcohol cessation outcomes than UC. Nonetheless, trends in the smoking outcome data favored the intervention group, underscoring the importance of continued research into bio-behavioral interventions that address smoking and alcohol use among adults experiencing homelessness.</p><p><strong>Implications: </strong>The study highlights the difficulty in observing changes in smoking outcomes in interventions tailored to concurrently address smoking and alcohol use among persons experiencing homelessness. The findings add to existing knowledge by providing evidence about the real-world complexities facing people who use tobacco and alcohol while experiencing homelessness.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is it time to update clinical care guidelines to address sex and gender differences in smoking cessation medication efficacy?","authors":"Sherry A McKee","doi":"10.1093/ntr/ntaf107","DOIUrl":"https://doi.org/10.1093/ntr/ntaf107","url":null,"abstract":"","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can Religious Fasting Nudge People to Smoke Less? Evidence from Ramadan.","authors":"Zeynep B Uğur, Abdullah Doğan","doi":"10.1093/ntr/ntaf101","DOIUrl":"https://doi.org/10.1093/ntr/ntaf101","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we examine whether religiosity affects people's levels of smoking. We use the month of Ramadan, a sacred month for Muslims, as an exogenous change for religiosity. In this month, there is less opportunity to smoke for fasters.</p><p><strong>Methods: </strong>First, we conducted a survey at different times: once before Ramadan, four times during Ramadan (one survey per week), and once after Ramadan. Secondly, we utilized monthly administrative cigarette sales data between 2009-2020.</p><p><strong>Results: </strong>Individual level data from the survey shows that full fasters reduce their smoking by 53% drop during Ramadan compared to the pre-Ramadan sample. Cigarette sales drop as much as 14% in the month of Ramadan in Turkey overall. A regular Ramadan day lowers cigarette sales around 0.8%. Reduction in Ramadan is much higher in more religious provinces.</p><p><strong>Conclusion: </strong>This study demonstrates that limiting the opportunity to smoke can be an effective way to reduce smoking.</p><p><strong>Implications: </strong>Based on two complementary studies-a six-wave survey of 769 individuals and an analysis of provincial-level cigarette sales from 2009 to 2020-this research shows that Ramadan significantly reduces smoking intensity and cigarette sales. Full fasters decreased smoking by 53%, and national cigarette sales fell by 14%. The effect was more pronounced in more religious provinces. These findings suggest that even short-term restrictions on smoking opportunities can lead to substantial behavioral changes, despite the addictive nature of tobacco use. These findings offer valuable insights for public health policies aiming to reduce smoking through culturally sensitive and opportunity-limiting interventions.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koen Smit, Rowan Dowling, Robin Room, Anne-Marie Laslett, Ron Borland, Charles Livingstone, Heng Jiang
{"title":"Financial Stress and Tobacco Expenditure in Australian Households: A Cross-Sectional Analysis of Prevalence and Association Across Wealth and Income Levels.","authors":"Koen Smit, Rowan Dowling, Robin Room, Anne-Marie Laslett, Ron Borland, Charles Livingstone, Heng Jiang","doi":"10.1093/ntr/ntaf102","DOIUrl":"https://doi.org/10.1093/ntr/ntaf102","url":null,"abstract":"<p><strong>Introduction: </strong>Despite successful public health campaigns, tobacco use persists as a major cause of preventable illness and death. While tobacco taxation is recognized as an effective control strategy, concerns remain about potential financial strain on lower socioeconomic groups. This study investigates the relationship between household tobacco expenditure and financial stress in Australia, a country with high tobacco taxes and declining smoking rates.</p><p><strong>Methods: </strong>Household data from the 2015-16 Australian Household Expenditure Survey were analysed (N=10,036). Financial stress was measured using a scale based on nine self-reported indicators. Respondents were asked to report if their household had experienced any of these difficulties, e.g. inability to pay utility bills or going without meals. Negative binomial regression models assessed the association between tobacco expenditure share and financial stress, adjusting for sociodemographic factors, household wealth, and other expenditures.</p><p><strong>Results: </strong>Financial stress was more prevalent among households that did (45.0%; (95% CI: 42.5, 47.5)) versus did not (25.4%) purchase tobacco. All levels of tobacco expenditure were significantly associated with higher financial stress bivariably, after controlling for covariates. For instance, households in the second-lowest tobacco expenditure share quintile had a higher mean financial stress score than non-purchasing households (RR=1.59, CI, 1.36, 1.85, p<0.001).</p><p><strong>Discussion: </strong>In Australia, financial stress is prevalent among tobacco-purchasing households and household tobacco expenditure is significantly associated with increased financial stress even at modest levels of spending, i.e. the lower quintiles of tobacco expenditure. These findings underscore the need for targeted policies to mitigate financial strain and support smoking cessation among vulnerable populations.</p><p><strong>Implications: </strong>This study found that the prevalence of financial stress is higher in Australian households that purchase tobacco, regardless of their spending on tobacco. Although tobacco price increases reduce overall tobacco use, our study shows that increased prices exacerbate strain among financially disadvantaged smokers. Further research into associations between financial well-being and tobacco use is needed, both nationally and internationally. Longitudinal research should also examine the longer-term health and economic impacts mediated by financial stress.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary Freedman, Andrew Kim, Nicholas Graziane, Matthew Silvis, Elise N Marino, Brandon Fross, Ducel Jean-Berluche, Curtis Bone
{"title":"Nicotine use is associated with elevated risk of opioid use disorder following total/hemi hip arthroplasty procedures.","authors":"Zachary Freedman, Andrew Kim, Nicholas Graziane, Matthew Silvis, Elise N Marino, Brandon Fross, Ducel Jean-Berluche, Curtis Bone","doi":"10.1093/ntr/ntaf098","DOIUrl":"https://doi.org/10.1093/ntr/ntaf098","url":null,"abstract":"<p><strong>Introduction: </strong>Opioids are often necessary for pain control after surgery; however, it is challenging to predict risk of developing opioid use disorder (OUD) after surgical interventions. Nicotine impacts opioid metabolism, which is associated with risk of opioid use disorder (OUD). We aimed to determine whether peri-operative nicotine use is associated with incident OUD following hip arthroplasties.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using a national de-identified database to identify subjects who underwent total/hemi hip arthroplasty in the United States from 2013-2018 and received post-operative opioid treatment within two weeks of the procedure. The matched cohorts consisted of nicotine dependent (N=10,464) versus non-nicotine dependent individuals (N=10,464). Subjects were matched on known confounders: age, sex, race, ethnicity, alcohol use disorder, sedative-hypnotic/anxiolytic disorders, congestive heart failure, chronic obstructive pulmonary disease, depressive disorders, and anxiety disorders. We assessed for development of OUD, and though IVDU was not directly measured due to data limitations, we assessed for secondary outcomes of OUD associated with IVDU: Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV), and Hepatitis B Virus (HBV) at multiple timepoints (1 month, 3 months, 6 months, 1 year, 3 years) after surgery utilizing logistic regression analysis.</p><p><strong>Results: </strong>Nicotine dependence was associated with increased risk of developing OUD at 3 months post-surgery (OR 2.36 p<0.001) and thereafter (OR 2.37-2.42 p<0.001). Peri-operative nicotine dependence was also associated with HIV (OR 1.26-1.92 p<0.05) and HCV (OR 1.47-1.60 p<0.02) at all timepoints.</p><p><strong>Conclusions: </strong>Considering nicotine use when determining OUD risk following total/hemi hip arthroplasty procedures is warranted.</p><p><strong>Implications: </strong>Orthopedic surgeons should monitor individuals who use nicotine products with vigilance for signs and symptoms of OUD post-operatively. The opioid risk tool should be evaluated to determine if inclusion of nicotine products enhances the predictive model. Future research efforts may focus on the impact of pre-surgical smoking cessation on development of OUD.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hongying Daisy Dai, Yi Hao, Mona Periera, Tzeyu Michaud
{"title":"Biomarkers of Exposure to Tobacco-Related Toxicants and Oxidative Stress among Cancer Survivors.","authors":"Hongying Daisy Dai, Yi Hao, Mona Periera, Tzeyu Michaud","doi":"10.1093/ntr/ntaf099","DOIUrl":"https://doi.org/10.1093/ntr/ntaf099","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer survivors who continue to use tobacco products may have negative impacts on their long-term health outcomes.</p><p><strong>Methods: </strong>Data were drawn from the Population Assessment of Tobacco and Health Study Wave 5 (n=6946). Geometric mean concentrations of biomarkers from four classes of harmful and potentially harmful constituents, along with a biomarker of oxidative stress, were compared between cancer survivors and non-cancer adults using weighted linear regressions adjusted for demographic factors. Among cancer survivors, comparisons were also made across current cigarette smoking and e-cigarette use statuses.</p><p><strong>Results: </strong>Compared to non-cancer adults (n=6441), cancer survivors (n=505) exhibited higher mean concentrations of 4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanol (NNAL, 10.9 vs. 6.7 pg/mg creatinine), cadmium (0.3 vs. 0.2 ng/mg creatinine), lead (0.4 vs. 0.3 ng/mg creatinine), N-Acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA), 156.6 vs. 128.3 ng/mg creatinine), and 8-isoprostane (521.6 vs. 441.5 pg/mg creatinine) in the unadjusted analyses. Among cancer survivors, both exclusive cigarette smokers and dual users had higher mean concentrations of urine nicotine metabolites (i.e., nicotine equivalents [TNE2], and cotinine), NNAL, cadmium, volatile organic compounds (VOCs), and 8-isoprostane than non-tobacco users. Exclusive e-cigarette users also had higher mean concentrations of nicotine metabolites (TNE2, 4.1 vs. 0.01, p<.0001; cotinine, 288.1 vs. 0.4, p<.0001), NNAL (5.6 vs. 1.7, p=.03), cadmium (0.4 vs. 0.3, p=.01), and 8-isoprostane (594.2 vs. 482.5, p=.03) than non-tobacco users.</p><p><strong>Conclusions: </strong>Both exclusive smoking and dual use pose elevated risks of exposure to tobacco-related toxicants to cancer survivors. Exclusive e-cigarette use also increases the risk of nicotine addiction and oxidative stress. Abstinence of all tobacco use among cancer survivors is needed to improve health outcomes.</p><p><strong>Implications: </strong>Cancer survivors represent a high-risk group for tobacco use. This study offers important insights into differences in biomarkers of tobacco-related toxicant exposure between cancer survivors and non-cancer adults and provides evidence of the health impacts associated with cigarette smoking and e-cigarette use. The findings emphasize the need for clinical monitoring and targeted public health interventions to encourage tobacco cessation, including addressing dual use of cigarettes and e-cigarettes, in order to enhance long-term health outcomes and quality of life for cancer survivors.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring Factors Shaping Tobacco and Marijuana Use Among Sexual Minority Adolescents.","authors":"Meng-Yun Lin, Darcy Lockhart, Rachel Denlinger-Apte","doi":"10.1093/ntr/ntaf097","DOIUrl":"https://doi.org/10.1093/ntr/ntaf097","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to identify the predominant factors associated with tobacco and marijuana/cannabis use among adolescents according to their sexual identity.</p><p><strong>Methods: </strong>Using the 2023 National Youth Tobacco Survey, we examined current use of e-cigarettes, cigarettes, and marijuana/cannabis vaping among adolescents. We used dominance analyses and logistic regression models to assess the relative importance of factors linked to tobacco and marijuana/cannabis use. The analyses were stratified by sexual identity (straight, sexual minorities, unsure) and grade levels (middle-school versus high-school).</p><p><strong>Results: </strong>The study sample includes 6,654 middle-school and 8,274 high-school students. Three themes emerge from the dominance analysis. First, exposure to e-cigarette or cigarette use at home or in vehicles consistently ranked as the leading factor associated with smoking and vaping across school levels and sexual identity, explaining up to 44% of the predicted variance. Second, the perception of occasional e-cigarette or cigarette use as little to no harm was a top factor, linked to e-cigarette use among sexual minority students and straight high-school students, as well as cigarette use among straight students and sexual minority high-school students. It explained up to 21.6% and 26.5% of the variance in current e-cigarette and cigarette use, respectively. Third, mental stress was a dominant factor associated with tobacco and marijuana/cannabis use among sexual minority middle-school students, explaining up to 21% of the variance.</p><p><strong>Conclusions: </strong>This study identifies modifiable factors linked to adolescent tobacco and marijuana use. Public health initiatives targeting these factors may reduce smoking and vaping, especially among sexual minority adolescents.</p><p><strong>Implications: </strong>Adolescents in the LGBTQ+ community use tobacco and marijuana at higher rates than their straight peers. This study offers insight into the relative importance of a variety of sociodemographic and environmental factors contributing to increased use. The most dominant factors, identified as immediate environmental exposure, e-cigarette risk perceptions, and mental stress should be prioritized when developing targeted interventions to reduce smoking and vaping in this priority population.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elise E DeVito, Esther Stern, Marc Szpilzinger, Nicole Petersen, Raina D Pang, Andrea H Weinberger
{"title":"Sex and gender in relation to use of e-cigarette product characteristics in united states datasets: a systematic review.","authors":"Elise E DeVito, Esther Stern, Marc Szpilzinger, Nicole Petersen, Raina D Pang, Andrea H Weinberger","doi":"10.1093/ntr/ntaf092","DOIUrl":"https://doi.org/10.1093/ntr/ntaf092","url":null,"abstract":"<p><strong>Introduction: </strong>Electronic cigarette (e-cigarette) product characteristics impact appeal, addictive potential, toxicity, and/or harm reduction potential. We conducted a systematic review to characterize sex and gender differences in e-cigarette product characteristics used in the United States (US).</p><p><strong>Methods: </strong>Included studies used US population representative datasets to assess sex/gender differences, sex-specific findings, or differences by sexual or gender minority (SGM) status in relation to e-cigarette product characteristics (e.g., flavors, nicotine (i.e., nicotine in e-liquid), cannabis vaping (i.e., cannabis in e-liquid), device types, other). Additionally, articles had to be written in English and published in peer-reviewed journals. Searches were conducted in PubMed on March 9, 2024 and in PsycInfo and Medline on February 23, 2025.</p><p><strong>Results: </strong>The 52 included papers used 7 datasets and addressed flavor (N=28), nicotine (N=14), cannabis vaping (N=15), device (N=6), and other characteristics (N=3; 1 package size; 2 other toxicant exposure). Samples included youth (N=23) and/or adults (N=32). Although data are somewhat mixed, taken together findings indicate that while prevalence of e-cigarette use is higher in males, within those who use e-cigarettes, prevalence of flavor use is higher in females, prevalence of nicotine and cannabis vaping and open (adjustable) device type use is higher in males.</p><p><strong>Conclusions: </strong>E-cigarette product characteristics are a tractable target for regulation. Understanding e-cigarette product characteristics used by males and females in the US could shed light on sex and gender differences in the course of e-cigarette use and the addictive potential, appeal, or harm reduction potential of e-cigarette products.</p><p><strong>Implications: </strong>There are sex and gender differences in the use and cessation of tobacco products like combustible cigarettes. E-cigarettes have become more popular and characteristics such as flavors, nicotine, cannabis vaping (i.e., cannabis in e-liquid), and device types impact appeal and addiction potential. This review is the first to synthesize the literature on sex and gender in relation to e-cigarette characteristics among United States youth and adults and highlight gaps where more research is needed. This information can help guide that regulation and other efforts related to e-cigarette so they are as effective as possible across sex and gender groups.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}