Nicotine & Tobacco Research最新文献

{"title":"Creating and Testing the Acceptability and Feasibility of a Novel Video-Based Smoking Cessation Intervention Tailored for Individuals with Cancer: Results for Alliance for Clinical Trials in Oncology Trial A21_Pilot 12.","authors":"Kinsey Pebley, Kathryn Moody, Amanda M Palmer, Alana M Rojewski","doi":"10.1093/ntr/ntag220","DOIUrl":"https://doi.org/10.1093/ntr/ntag220","url":null,"abstract":"<p><strong>Introduction: </strong>Cigarette smoking poses unique risks for cancer survivors, but challenges remain with reach and efficacy of current interventions. The current randomized controlled pilot study created a video-based smoking cessation intervention for cancer survivors and tested acceptability/feasibility.</p><p><strong>Methods: </strong>Participants were cancer survivors ages 21+ reporting current smoking, could read/understand English, and did not have medical/psychiatric conditions impairing ability to consent. Three videos were created and shown to survivors (N = 10) and refined based on feedback. Four additional videos were then created. Participants (N = 40) were randomized to a video (n=20, received 7 video links) or control (n=20, received link to NCI's \"Clearing the Air\" online booklet) group. Primary outcomes were acceptability/feasibility, assessed using the Acceptability and Feasibility of Intervention measures (scores ≥4 considered acceptable/feasible). Secondary outcomes included quit attempts, abstinence, cigarettes per day, and cessation resource use. Surveys were completed at baseline and 1-week, 1-month, and-3 months post-randomization.</p><p><strong>Results: </strong>Mean acceptability scores for video and control groups were 4.2 and 3.9, respectively. Mean feasibility scores for video and control groups were 4.0 and 3.8, respectively. Video participants saw decreases in cigarettes per day that were sustained from baseline (Mean [M]=16.2) through final follow-ups (M=7.7), and had numerically higher use of all nine cessation resources assessed. More video participants reported quit attempts at 1-week (55.0%), 1-month (50.0%), and 3-months (60.0%) than the control group (40.0% at 1-week and 1-month, 52.6% at 3-months).</p><p><strong>Conclusion: </strong>The video intervention was acceptable/feasible among a diverse sample. Larger studies assessing intervention efficacy are needed.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112708","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":"Does Adding Modified Risk Statements to E-Cigarette Advertisements and Packages Change Risk Beliefs? A Systematic Review and Meta-Analysis.","authors":"Youjin Jang, Jessica Shaw, Olivia A Wackowski, Seth M Noar","doi":"10.1093/ntr/ntag216","DOIUrl":"https://doi.org/10.1093/ntr/ntag216","url":null,"abstract":"<p><strong>Introduction: </strong>Modified risk statements (MRS), claiming e-cigarettes are less harmful than cigarettes, attempt to alter tobacco risk beliefs but may conflict with warning messages. Absolute risk beliefs reflect the perceived likelihood of harm from e-cigarettes, while relative risk beliefs reflect the likelihood of harm from e-cigarettes versus cigarettes. This systematic review and meta-analysis examined whether adding MRS to e-cigarette advertisements and packages containing warnings affects risk beliefs and intentions to vape.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, PsycInfo, and Business Source Premier, and supplemental sources, identifying 10 eligible experimental studies (N = 11,025). Studies compared e-cigarette advertisement or packages containing warnings with versus without MRS. Random-effects meta-analyses estimated effect sizes (d), heterogeneity, and three moderators. Databases were last searched in May 2025. Risk of bias was assessed using a modified JBI tool for randomized controlled trials.</p><p><strong>Results: </strong>Compared with no MRS, advertisements and packages containing MRS reduced absolute risk beliefs of e-cigarettes (d = - 0.08, p = .003). No significant effects emerged for relative risk beliefs (d = - 0.05, p = .108) or intentions to vape (d = 0.03, p = .173). Smoking status moderated effects on relative risk beliefs (p = .03); MRS reduced relative risk beliefs that e-cigarettes are more harmful than cigarettes among non-smokers only (d = -0.12).</p><p><strong>Conclusions: </strong>MRS lowered absolute risk beliefs, but the effect was very small and MRS did not affect overall relative risk beliefs or intentions to vape. Given the modest number of studies available for this review, additional work is needed on communicating about the continuum of tobacco product risk.</p><p><strong>Funding: </strong>NIH/NIDA (R01DA049155) and NCI (R37CA222002).</p><p><strong>Registration: </strong>OSF(https://osf.io/8t9hz).</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112636","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":"Correction to: The impact of Shanghai's comprehensive smoke-free legislation on hospital admission and mortality rates for chronic obstructive pulmonary disease: an interrupted time series analysis.","authors":"","doi":"10.1093/ntr/ntag209","DOIUrl":"https://doi.org/10.1093/ntr/ntag209","url":null,"abstract":"","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070050","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":"Prenatal Tobacco-Cannabis Co-Use: A Mixed-Methods, Convergent Parallel Study.","authors":"Kristine Alaniz, Emmanuel Ngui, Young Cho, Linnea Laestadius, Tessa Vance","doi":"10.1093/ntr/ntaf251","DOIUrl":"10.1093/ntr/ntaf251","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco-cannabis co-use among vulnerable populations, particularly pregnant people, is a growing public health concern. While prenatal tobacco use has been declining, rates of prenatal cannabis use have more than doubled in recent years. Although there is growing evidence around the health effects of prenatal co-use, little is known about reasons for co-use or cessation behaviors during pregnancy.</p><p><strong>Methods: </strong>This descriptive, mixed-methods study aimed to discern reasons for co-use and cessation patterns among birthing people. Surveys and interviews were conducted with adults who reported tobacco-cannabis co-use during pregnancy and were enrolled in a community-based program in Wisconsin between 2022 and 2023. Quantitative data were analyzed using Fisher's Exact Tests and logistic regression. Qualitative data were analyzed using reflexive thematic analysis. A mixed methods convergent parallel design integrated the findings.</p><p><strong>Results: </strong>Findings from 46 surveys and 19 interviews revealed key differences in cannabis and tobacco use intentions and cessation during pregnancy. Results also indicated that individuals tend to view tobacco and cannabis use as distinct behaviors, contrary to previous research. Findings underscore the interconnectedness of mental health, stress, and co-use.</p><p><strong>Conclusions: </strong>Future efforts should partner with communities to identify strategies that empower pregnant people to make informed decisions about co-use during pregnancy.</p><p><strong>Implications: </strong>The development of tailored, evidence-based tobacco-cannabis-co-use interventions is crucial, as the study highlights divergent experiences and intentions in quitting tobacco versus cannabis. A better understanding of tobacco and cannabis co-use mechanisms during pregnancy is also needed. Furthermore, the study emphasizes the necessity of integrating mental health and substance use in both research and clinical practice to more effectively support pregnant individuals. Centering the experiences of birthing people in this work will ensure that efforts align with the needs and priorities of community members.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1722-1729"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669304","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":"Tobacco cessation treatment in pregnancy: insights from Florida Medicaid claims data.","authors":"Lindsay T Olson, Leah Sussman, Margaret Moakley, Diana Poehler, Benjamin T Allaire, Kay Roussos-Ross, Jaclyn M Hall","doi":"10.1093/ntr/ntag140","DOIUrl":"10.1093/ntr/ntag140","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco use increases risk for serious pregnancy complications, increasing infant and maternal morbidity and mortality. Cessation treatments are safe during pregnancy, increase the likelihood of successfully quitting, and decrease risk of negative neonatal health outcomes. All Florida Medicaid plans cover evidence-based cessation treatments. This study analyzed Medicaid claims to better understand cessation treatment utilization for pregnant people enrolled in Florida Medicaid.</p><p><strong>Methods: </strong>We analyzed Florida Medicaid claims from 2018 to 2021 to assess utilization of tobacco cessation services among Medicaid beneficiaries with a delivery during the study period. We identified tobacco use status and perinatal episodes using diagnostic and procedural codes; we identified treatment utilization (counseling, pharmacotherapy) using procedural and prescription drug claims.</p><p><strong>Results: </strong>We identified 46 512 deliveries for people who use tobacco during the study period, making up 17.5% of all deliveries; among them, 6.3% received Medicaid covered tobacco cessation treatment during pregnancy and 2.4% postpartum. Among those treated, counseling was the most prevalent treatment during pregnancy (61.2%) and pharmacotherapy (nicotine replacement therapy and cessation medication) was the most prevalent treatment (75.8%) postpartum.</p><p><strong>Conclusion: </strong>Best practices indicate that clinicians should ask pregnant patients about tobacco use at every visit, document their status, and offer brief counseling and cessation treatment. Despite cessation treatment coverage by Medicaid, our analysis indicates that few clinicians and beneficiaries are using Medicaid coverage for cessation treatment during the perinatal period. These findings suggest an opportunity to increase utilization of covered cessation services for individuals who use tobacco who are pregnant/postpartum, reducing risk factors for morbidity and mortality.</p><p><strong>Implications: </strong>This study highlights the gap between tobacco use and the use of Medicaid coverage for tobacco cessation aids among pregnant and postpartum individuals enrolled in Medicaid. Efforts to periodically identify and address barriers to accessing covered cessation services can inform resource allocation to increase cessation support and reduce tobacco use in this population.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1730-1734"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352754","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":"Thinking outside the box to reduce health inequities in prenatal nicotine and tobacco exposure.","authors":"Natacha M De Genna, Laura R Stroud, Yael Bar-Zeev","doi":"10.1093/ntr/ntag158","DOIUrl":"10.1093/ntr/ntag158","url":null,"abstract":"","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1631-1634"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422854","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":"Impact of prepregnancy menthol cigarette use on smoking cessation across pregnancy and postpartum: a longitudinal analysis of the Population Assessment of Tobacco and Health (PATH) Study.","authors":"Eva Sharma, Jessica M Powers, Sarah Maloney, Laura R Stroud","doi":"10.1093/ntr/ntag089","DOIUrl":"10.1093/ntr/ntag089","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to characterize smoking cessation at pregnancy and postpartum return to use as a function of prepregnancy menthol vs non-menthol cigarette use.</p><p><strong>Methods: </strong>Data were drawn from waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study, using 3 longitudinal time-points indicating prepregnancy, pregnancy, and postpartum in 179 participants who reported exclusive cigarette smoking at prepregnancy and were currently pregnant during the middle interval. Outcomes included (1) quit attempts and successful quitting within 12 months of pregnancy, (2) change in past 30-day smoking frequency at pregnancy, and (3) postpartum return to use. Generalized estimating equations were conducted adjusting for sociodemographic and smoking characteristics.</p><p><strong>Results: </strong>Approximately 47% of pregnant persons who smoked reported use of menthol cigarettes at prepregnancy, almost 80% attempted to quit or cut down during pregnancy, and 43.6% successfully quit. Approximately 56% of those who reported being quit at pregnancy returned to use in postpartum. Menthol use was associated with smoking on 1.13 fewer days among those who continued to smoke at pregnancy. Although prepregnancy menthol cigarette use was associated with greater nicotine dependence (fewer minutes to first cigarette; P < .05), menthol cigarette use was not significantly associated with quit attempts, successful cessation or changes in smoking frequency at pregnancy, or postpartum return to use (Ps > .05).</p><p><strong>Conclusions: </strong>Our study did not find an impact of prepregnancy menthol cigarette use on quit attempts, cessation, or postpartum return to use. Findings suggest cessation efforts should focus on behavioral and contextual factors beyond cigarette mentholation alone.</p><p><strong>Implications: </strong>Use of menthol vs non-menthol cigarettes in prepregnancy did not impact quit attempts, successful quitting, frequency of cigarette use at pregnancy assessment, or postpartum return to use among pregnant respondents who exclusively smoked cigarettes. Results indicate cessation outcomes during or after pregnancy may be influenced by behavioral and contextual factors beyond menthol cigarette use.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1764-1770"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Not Smoking and Ceasing Smoking During Pregnancy Among Aboriginal and Torres Strait Islander Women.","authors":"Jamie Bryant, Rita Hitching, Matthew Clapham, Sandra Eades, Kristy Fakes, Bob Davis, Jennifer Rumbel, Emilie Cameron","doi":"10.1093/ntr/ntaf126","DOIUrl":"10.1093/ntr/ntaf126","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking during pregnancy has been linked to serious adverse health outcomes for mother and baby.</p><p><strong>Aims and methods: </strong>This study aims to examine the individual and pregnancy characteristics associated with not smoking or ceasing smoking during pregnancy among Aboriginal and Torres Strait Islander women in Australia. A cross-sectional secondary analysis of data was conducted. Records were included if the mother was Aboriginal and/or Torres Strait Islander and had smoking status recorded. The individual and pregnancy characteristics associated with not smoking or ceasing smoking during pregnancy were assessed using mixed model logistic regressions.</p><p><strong>Results: </strong>A total of 49 651 women with a median age of 25 years were included. Overall, 56% (n = 27 782) reported not smoking during pregnancy and 13% reported ceasing smoking during pregnancy. The odds of not smoking were increased for those who were older, had fewer previous pregnancies, were married or in a de facto relationship, were private patients, had higher body mass index, were diagnosed with hypertension, attended more antenatal care visits, and began antenatal care earlier in pregnancy. The odds of ceasing smoking were higher for those who were married or in a de facto relationship, were private patients, began antenatal care earlier in pregnancy, had a lower number of pregnancies, and were diagnosed with hypertension.</p><p><strong>Conclusions: </strong>A variety of sociodemographic, health, and antenatal care factors were associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women. These findings inform targeted interventions and policies to enhance efforts to promote smoke-free pregnancies among Aboriginal and Torres Strait Islander women.</p><p><strong>Implications: </strong>Understanding the factors associated with not smoking among pregnant Aboriginal and Torres Strait Islander woman can inform the development of strategies to address the harmful effects of smoking during pregnancy. This secondary analysis found that considering strategies such as tailoring supports to those who are younger or not married, evaluating programs run by different jurisdictions, and addressing barriers to receiving early and consistent antenatal care may be useful for informing the development of targeted interventions and policies and tailoring cessation support approaches.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1650-1658"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Quit Attempts and Successful Smoking Abstinence in Pregnancy: An Exploratory Analysis of a Pooled Clinical Trial Dataset.","authors":"Hannah Igoe, Joanne Emery, Felix Naughton, Jaspal Taggar, Jo Leonardi-Bee, Tim Coleman","doi":"10.1093/ntr/ntaf262","DOIUrl":"10.1093/ntr/ntaf262","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking in pregnancy is a preventable cause of detrimental effects on mother and baby, exacerbating socioeconomic health disparities. This study investigates predictors of making a quit attempt and smoking abstinence in pregnancy.</p><p><strong>Methods: </strong>This study used pooled data from two large UK multicenter smoking cessation intervention trials in pregnancy (N = 1409). Baseline predictor variables included demographic, smoking behavior, and quitting belief measures. Percentage of cigarettes cut down in early pregnancy was a novel variable. Outcomes (36 weeks' gestation) were having made a quit attempt (>24 hours) and smoking abstinence (both self-reported). Exploratory logistic regression analyses, with missing smoking outcomes imputed as non-abstinent, involved univariate then multivariable analyses. Sensitivity analyses included complete case analyses and biochemically validated abstinence.</p><p><strong>Results: </strong>A total of 1409 women were included in study analyses. In multivariable analyses, for making a quit attempt, higher intention to quit (OR = 1.50, 95% CI = 1.26% to 1.79%) and higher combined self-efficacy score (OR = 1.60, 95% CI = 1.30% to 1.96%) were statistically significant predictors. For smoking abstinence, higher percentage reduction in number of cigarettes smoked in early pregnancy (OR = 1.02, 95% CI = 1.01% to 1.02%) and longer previous quit attempt (omnibus p = .001) were statistically significant predictors.</p><p><strong>Conclusions: </strong>Smoking beliefs, including motivational factors, were statistically significant predictors of making a quit attempt. However, smoking behaviors relating to cutting down the number of cigarettes in early pregnancy and having had a previous period of smoking abstinence >6 weeks were predictors of successful smoking abstinence.</p><p><strong>Implications: </strong>This study adds to the evidence that motivational factors are important in initiating a quit attempt, whereas positive behavioral changes are associated with smoking abstinence in pregnant women. This information could be used by clinicians designing smoking abstinence support for pregnant women. Women who reduce the number of cigarettes they smoke very early in pregnancy might be more receptive to smoking abstinence support offered at that point.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1735-1743"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifying effects of pregnancy on the association of heavy alcohol consumption with e-cigarette, cigarette, and dual use among females of reproductive age.","authors":"Olatokunbo Osibogun, Rime Jebai, Wei Li, Saurya Dhungel, Ebbie Kalan","doi":"10.1093/ntr/ntag055","DOIUrl":"10.1093/ntr/ntag055","url":null,"abstract":"<p><strong>Introduction: </strong>We examined the association of heavy alcohol consumption with e-cigarette, cigarette, or dual use among females of reproductive age and stratified by pregnancy status.</p><p><strong>Methods: </strong>Cross-sectional data from 2021 (n = 13 744), 2022 (n = 38 021), and 2023 (n = 38 765) Behavioral Risk Factor Surveillance System were analyzed for females aged 18-44 years. Heavy alcohol consumption (>7 drinks/week) was categorized as Yes or No (reference). Current nicotine/tobacco product use (everyday/somedays) was categorized as nonuse of either cigarette or e-cigarette (reference), e-cigarette-only, cigarette-only, or dual use. Weighted multinomial logistic regression was used to examine the association between alcohol consumption and tobacco use, adjusting for sociodemographic factors, self-rated health, current smokeless tobacco use, pregnancy status, and survey year. Interaction effects between pregnancy status and alcohol consumption were analyzed.</p><p><strong>Results: </strong>Findings showed that heavy alcohol consumption was associated with a higher likelihood of e-cigarette (aRRR: 5.57, [95% CI, 4.70-6.61]), cigarette (aRRR: 4.88, [95% CI, 4.03-5.91]), or dual (aRRR: 6.95, [95% CI, 5.59-8.64]) use. Pregnancy significantly modified the association for dual use (P = .002) only. Stratified analysis indicated that pregnant (vs non-pregnant) females with heavy alcohol consumption had much higher likelihood of e-cigarette (aRRR: 10.35, [95% CI, 2.59-41.33] vs aRRR: 5.52, [95% CI, 4.65-6.55]), cigarette (aRRR: 6.56, [95% CI, 1.16-37.05] vs aRRR: 4.88, [95% CI, 4.02-5.92]), and dual aRRR: 15.82, [95% CI, 4.56-54.84] vs aRRR: 6.81, [95% CI, 5.45-8.50]) use.</p><p><strong>Conclusion: </strong>Heavy alcohol consumption is strongly associated with a higher likelihood of e-cigarette, cigarette, or dual use among reproductive-age females, with pregnancy significantly amplifying this relationship. Comprehensive substance use screening and tailored cessation support are essential for pregnant females and those of reproductive age.</p><p><strong>Implications: </strong>Females who are pregnant with heavy alcohol consumption form a vulnerable subgroup, underscoring the need for integrated substance use interventions in prenatal care. Tailored programs addressing alcohol and nicotine/tobacco product use may reduce the compounded risks of adverse maternal and fetal outcomes. Additionally, early screening protocols and culturally sensitive public health messaging could enhance identification and support for high-risk pregnant females. Prioritizing holistic approaches in healthcare policies may improve overall maternal and child health and foster better long-term outcomes for families affected by dual substance use. Comprehensive substance use screening and tailored cessation support are needed for all females of reproductive age.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1704-1712"},"PeriodicalIF":2.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474439","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}