Nicotine & Tobacco Research最新文献

{"title":"Taiwan's E-Cigarette and Heat-Not-Burn Bans: A Beacon for Global Tobacco Control.","authors":"Sharon Wei, Chao-Chun Wu, Y Tony Yang","doi":"10.1093/ntr/ntae288","DOIUrl":"10.1093/ntr/ntae288","url":null,"abstract":"","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"945-947"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822336","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":"Renal Hyperfiltration as a New Mechanism of Smoking-Related Mortality.","authors":"Mohamed Smail Aissani, Leo Niskanen, Tomi-Pekka Tuomainen, Mounir Ould Setti","doi":"10.1093/ntr/ntae136","DOIUrl":"10.1093/ntr/ntae136","url":null,"abstract":"<p><strong>Introduction: </strong>Renal hyperfiltration (RHF), an established risk factor for mortality, is prevalent among tobacco smokers. The aim of this study was to assess the mediating role of RHF in the association between smoking and mortality.</p><p><strong>Aims and methods: </strong>Data of this study were retrieved from the cohort of the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), including 2064 males from Finland. Study participants were followed over a 35-year period. Using classic and counterfactual mediation analysis approaches, we estimated the mediative effect of RHF in the association between smoking and each of the following outcomes: All-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality.</p><p><strong>Results: </strong>The risk of all-cause mortality in smokers was twice that in nonsmokers (hazard ratio [HR], 2.06; 95% confidence interval [CI]: 1.84 to 2.31). Under the counterfactual framework the direct effect of smoking on all-cause mortality, controlled for RHF, corresponded to an HR of 2.00 (95% CI: 1.78 to 2.30). Of the effect of smoking on mortality, 5% (p-value = .016) was mediated by RHF. This finding concerned particularly non-CVD mortality.</p><p><strong>Conclusions: </strong>RHF mediated the effect of smoking on non-CVD and all-cause mortality, but not on CVD mortality. The generalizability of our study results is however limited by its focus on a Finnish male cohort, underscoring the need for further investigation into RHF's broader implications across diverse populations.</p><p><strong>Implications: </strong>This study elucidates the complex interplay between smoking, renal hyperfiltration (RHF), and mortality, offering novel insights into the mediating role of RHF. Our findings demonstrate that RHF significantly mediates the relationship between smoking and non-cardiovascular disease (non-CVD), but not CVD mortality. This distinction underscores the multifaceted role of RHF beyond its established association with cardiovascular events. By highlighting the specific pathways through which RHF mediates some of the smoking-attributed mortality, this research contributes to our understanding of the mechanisms linking smoking to mortality.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"903-908"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420083","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":"Impact of Heating Conventional Cigarettes With a Novel Device on Health-Related Biomarkers and Cigarette Use Patterns Among Chinese Adult Smokers Unwilling to Quit: A Pilot Randomized Controlled Trial.","authors":"Shuilian Chu, Xiaobo Li, Di Zhang, Hang Jing, Lin Feng, Yingting Zuo, Jiachen Li, Haomiao Ma, Zhaohui Tong, Lirong Liang","doi":"10.1093/ntr/ntae177","DOIUrl":"10.1093/ntr/ntae177","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the impact of heating conventional cigarettes with a novel heated tobacco product (HTP) device on biomarkers and cigarette use patterns in Chinese adult smokers unwilling to quit smoking.</p><p><strong>Aims and methods: </strong>In this pilot randomized controlled trial, 50 eligible participants were allocated to either control group (smoking conventional cigarettes) or HTP device group (switching to using heated conventional cigarettes by the HTP device). Participants in the HTP device group went through a 2-day run-in period and then used heated conventional cigarettes exclusively for 5 days, followed by flexible use for 14 days. Five biomarkers of exposure (BoEs) were measured at baseline and on day 7. Thirteen biomarkers of biological effect (BoBEs) were measured at baseline and on day 21. Safety, daily cigarette consumption, craving, withdrawal symptoms, and device acceptability, were assessed.</p><p><strong>Results: </strong>BoE levels decreased by 26.4 % to 71.4% from baseline in the HTP device group, while BoBE levels did not significantly change in either group. In the HTP group, 56% exclusively used heated conventional cigarettes during the flexible use period, experiencing reduced cravings and withdrawal symptoms, while dual users consumed more cigarettes. Mild to moderate device-related reactions were reported in 36% of users. Satisfaction, taste, and harm reduction belief scores averaged 7.4, 6.6, and 8.7 (out of 10), respectively.</p><p><strong>Conclusions: </strong>Switching to heated conventional cigarettes with the HTP device may reduce short-term exposure to smoke toxicants. However, it can lead to increased tobacco use among dual users. Further investigation is needed to confirm these preliminary findings.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (http://www.chictr.org.cn/), ChiCTR2200065055, October 26, 2022.</p><p><strong>Implications: </strong>This study is the first to evaluate the impact of heating conventional cigarettes with a novel HTP device on health-related biomarkers and cigarette use patterns among Chinese adult smokers. This novel HTP device can directly heat conventional cigarettes without the necessity for specifically designed tobacco products, avoiding the potential additive risks of traditional HTPs. If the results of this study could be further verified by randomized controlled clinical trials with larger sample sizes, this novel HTP device could serve as a short-term harm reduction alternative for smokers unwilling to quit.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"873-883"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634091","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":"Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial.","authors":"Irene Pericot-Valverde, Moonseong Heo, Shadi Nahvi, Justin Barron, Sarah Voss, Erik G Ortiz, Diann Gaalema, James F Thrasher, Abigail W Batchelder, Kaileigh A Byrne, Deborah Kunkel, Alain H Litwin","doi":"10.1093/ntr/ntae260","DOIUrl":"10.1093/ntr/ntae260","url":null,"abstract":"<p><strong>Introduction: </strong>People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.</p><p><strong>Aims and methods: </strong>A pilot study assessed the feasibility, acceptability, and preliminary effectiveness of EC as a harm reduction tool among CC smokers with OUD on buprenorphine (N = 30). Participants were provided with an EC and freebase nicotine liquid (6 mg/mL) with a choice of flavor and a brief training session. Research visits were scheduled in person at baseline, week 4, and week 8 (follow-up). Daily diary assessments were completed during the 4-week EC period.</p><p><strong>Results: </strong>Most visits (>74%) and 61.4% of daily diary assessments were completed. During the 4-week study period, 90% of participants used the EC at least one day, 66.7% used the EC for at least 16 days, and 43.3% used the EC every day. Significant reductions were observed between baseline and both weeks 4 and 8 in cigarettes smoked per day (CPDbaseline = 16.2[8.3], CPDweek4 = 9.6[9.3], CPDweek8 = 8.4[8.3]) carbon monoxide (CO) levels (CObaseline = 21.5[15.0], COweek4 = 16.9[9.6], COweek8 = 15.7[10.0]), and nicotine dependence measured using the Fagerström Test for Nicotine Dependence (FTNDbaseline = 5.4[2.5], FTNDweek4 = 4.2[2.6], FTNDweek8 = 4.4[2.6]), with all p-values < .05.</p><p><strong>Conclusions: </strong>Implementing an EC protocol in outpatient maintenance treatment programs is feasible and acceptable. Preliminary results suggest that ECs may facilitate reductions in cigarettes per day, CO levels, and nicotine dependence. Future research should explore the effect of prolonged EC use on harm reduction and cessation milestones.</p><p><strong>Implications: </strong>EC are a potentially promising harm reduction strategy for adult CC smokers with OUD on buprenorphine who are unable to quit using evidence-based medications. However, previous studies have largely overlooked people with OUD on buprenorphine with recent drug use. This study addresses this gap through a pilot trial investigating the feasibility, acceptability, and preliminary effects of EC on CC behavior. The brief and standardized nature of the protocol and its implementation in outpatient settings highlights its potential for widespread implementation in facilities providing care to people with OUD on buprenorphine.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"856-863"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558364","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":"Understanding Use of E-cigarettes for Smoking Cessation Among a Sample of U.S. Adults.","authors":"Akshika Sharma, Meghan E Morean, Suchitra Krishnan-Sarin, Stephanie S O'Malley, Krysten W Bold","doi":"10.1093/ntr/ntae251","DOIUrl":"10.1093/ntr/ntae251","url":null,"abstract":"<p><strong>Introduction: </strong>Many adults who smoke cigarettes report trying e-cigarettes to quit smoking. Understanding the use of e-cigarettes for smoking cessation and the type of support that adults desire when trying to quit smoking is important for supporting cessation attempts and maximizing smoking abstinence.</p><p><strong>Aims and methods: </strong>In the summer of 2021, an online survey of 857 adults who reported a history of regular cigarette smoking and endorsed using e-cigarettes in a recent smoking cessation attempt was conducted. Survey items assessed reasons for using e-cigarettes to quit smoking, what was helpful about e-cigarettes, and what information participants desired when using e-cigarettes to quit smoking.</p><p><strong>Results: </strong>Common reasons for using e-cigarettes to quit smoking included beliefs that vaping would be helpful for quitting (53.6%), vaping is safer than smoking (50.5%), and favorable comparisons relative to other nicotine replacement treatments like nicotine patches and gum (24.7%). 23.8% selected e-cigarettes because they were cheaper than other smoking cessation aids. 89% of participants reported still smoking cigarettes at the time of the survey. The most common information people wanted when quitting was advice on how to gradually reduce nicotine over time to become nicotine-free (46.3%), how different vaping devices work (39.7%), and what nicotine concentration to start with (37.7%).</p><p><strong>Conclusions: </strong>Findings identified common beliefs about e-cigarettes as a smoking cessation aid and how they compare to other treatments including nicotine replacement treatment. Understanding factors that support cessation is critical especially due to high relapse rates. Results may help to inform support programs, especially for individuals who are interested in using e-cigarettes to quit smoking.</p><p><strong>Implications: </strong>Despite greater reporting, there is a limited understanding of e-cigarette use for quitting among those who smoke cigarettes. Our study highlights the reasons for using e-cigarettes among those who have recently tried e-cigarettes for quitting smoking, and the components of e-cigarettes that were helpful. We also examined the desired support in a program designed to use e-cigarettes for quitting smoking. The majority of participants who attempted to quit smoking using an e-cigarette relapsed to smoking, indicating the gap in cessation support that can be filled with a greater understanding of the desired support.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"926-931"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546544","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":"Can We Predict Who Will Experience Adverse Events While Using Smoking Cessation Pharmacotherapy? A Secondary Analysis of the EAGLES Clinical Trial.","authors":"Bethany J Wolf, Kevin M Gray, Jennifer R Dahne, Daniel Hashemi, Rachel L Tomko","doi":"10.1093/ntr/ntae290","DOIUrl":"10.1093/ntr/ntae290","url":null,"abstract":"<p><strong>Introduction: </strong>Concerns about potential side effects remain a barrier to uptake of Food and Drug Administration-approved smoking cessation pharmacotherapy (ie, varenicline, bupropion, nicotine replacement therapy [NRT]). However, use of pharmacotherapy can double the odds of successful quitting. Knowledge of an individual's likelihood of side effects while taking smoking cessation pharmacotherapy could influence treatment planning discussions and monitoring.</p><p><strong>Methods: </strong>We conducted a secondary, post hoc analysis to predict an individual's likelihood of adverse events (AEs) using the Evaluating Adverse Events in a Global Smoking Cessation Study data from 4209 adults in the United States who smoked. Participants were randomized to receive 12 weeks of treatment with varenicline, bupropion, NRT patch, or placebo. Our models predicted the likelihood of moderate to severe psychiatric and nonpsychiatric AEs during treatment.</p><p><strong>Results: </strong>Using pretreatment demographic and clinical data, multivariable logistic regression models yielded acceptable areas under the receiver operating characteristic curve for an individual's likelihood of moderate to severe (1) psychiatric AEs for bupropion and NRT and (2) nonpsychiatric AEs for varenicline and bupropion. Once we adjusted for demographic and baseline characteristics, medication was not associated with psychiatric AEs. Varenicline differed from placebo with regards to nonpsychiatric AEs.</p><p><strong>Conclusions: </strong>It is possible to predict person-specific likelihood of moderate to severe psychiatric and nonpsychiatric AEs during smoking cessation treatment, though the probability of psychiatric AEs did not differ by medication. Future work should consider factors related to implementation in clinical settings, including determining whether lower burden assessment protocols can be equally accurate for AE prediction.</p><p><strong>Implications: </strong>Using data from a large dataset people who smoke in the United States, it is possible to predict an individual's likelihood of psychiatric and nonpsychiatric AEs during smoking cessation treatment prior to initiating treatment. These predictive models provide a starting point for future work addressing how best to modify and integrate such clinical decision support algorithms into treatment for smoking cessation.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"839-848"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807400","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":"Prize-Based Incentives for Smoking Cessation Among People With HIV: A Sequential Multiple Assignment Randomized Trial.","authors":"David M Ledgerwood, Leslie H Lundahl, Mark K Greenwald, Jonathan Cohn, Cynthia L Arfken","doi":"10.1093/ntr/ntae243","DOIUrl":"10.1093/ntr/ntae243","url":null,"abstract":"<p><strong>Introduction: </strong>Contingency management (CM) is an incentive-based approach that has demonstrated efficacy for smoking cessation in various populations. There is an unmet need for feasible and effective smoking cessation interventions in people with HIV (PWH). The purpose of this study was to assess the efficacy of prize-based CM for smoking cessation in PWH using a Sequential Multiple Assignment Randomization Trial (SMART) design selected to tailor intervention intensity based on early treatment response.</p><p><strong>Methods: </strong>During phase I, 129 participants were randomly assigned to high-magnitude prize CM (HM-CM) or standard of care (SoC) for 4 weeks. Participants who did not reduce smoking were randomized in phase II to continued counseling with HM-CM plus monitoring support or only continued monitoring support for 8 weeks. Participants who reduced smoking were randomized to booster monitoring with low-magnitude CM or no additional care. Outcomes were biochemically verified smoking reduction and 7-day abstinence prevalence at posttreatment, 6-month, and 12-month follow-up.</p><p><strong>Results: </strong>Phase I responders (based on biochemical indicators of smoking reduction) were significantly less likely to return to smoking (during treatment and at 6 and 12 months) if they received low-magnitude incentives. Notably, initial exposure to CM versus SoC did not increase the rate of phase I response, and high-magnitude incentives later in treatment did not lead to greater smoking cessation for early-treatment nonresponders.</p><p><strong>Conclusions: </strong>Weekly CM sessions in the first 4 weeks of smoking cessation intervention did not perform significantly better than SoC. However, brief booster CM sessions aimed at maintaining early smoking cessation hold clinical promise and warrant further investigation.</p><p><strong>Implications: </strong>This represents the first trial to examine the use of CM for smoking cessation among PWH within the context of a SMART design. Clinical Trial Registration: NCT01965405 (https://clinicaltrials.gov/study/NCT01965405).</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"893-902"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471028","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 Industry-Backed Third Parties Sow Confusion and Doubt Amongst the Public Health Community.","authors":"Sophie Braznell, Louis Laurence, Anna B Gilmore","doi":"10.1093/ntr/ntae279","DOIUrl":"10.1093/ntr/ntae279","url":null,"abstract":"","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"943-944"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716675","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":"Longitudinal Electronic Cigarette Exposures Impair Respiratory Function and Structure in the Female Apoe/- Mouse.","authors":"Héctor Millán Cotto, Yasmeen M Farra, Alexandra G Sorenson, Sanika Shingwekar, Ye Chen, Paola Sebastiani, Chiara Bellini, Jessica M Oakes","doi":"10.1093/ntr/ntaf084","DOIUrl":"https://doi.org/10.1093/ntr/ntaf084","url":null,"abstract":"<p><strong>Introduction: </strong>Electronic cigarette (EC) usage amongst naïve users in the U.S. has been rising for the last decade. The effects of inhaling e-cig aerosols on respiratory health are not fully understood. The goal of this study was to longitudinally track changes in inflammation alongside abnormalities in lung structure and function following 8, 16, and 24 weeks of EC exposure.</p><p><strong>Methods: </strong>Female Apoe-/- mice were nose-only exposed to either EC aerosols (JUULTM, 3% nicotine, tobacco flavored, 2 puffs/min, particle concentration of 300 mg/m3) or room air for 95 mins, 5 days/week, for 8, 16, or 24 weeks.</p><p><strong>Results: </strong>Cytokines, measured from bronchioalveolar lavage fluid supernatant, were elevated at either 16 weeks of exposure (IL-4, IL-10, INF-α) or at the 16- and 24- week time point (IL-6, IL-17). Newtonian resistance, coefficient of respiratory elastance and resistances were larger in EC exposed, compared to air control mice, only at the 16-week time point. Mice at the 8-week and 16-week time point positively responded to methacholine, indicating hyper-reactive airways. Linear mean intercept (LM) was smaller in EC exposed mice, compared to controls, at the 8-week time point and larger at the 24-week time point. No change in LM was observed at the 16-week time point.</p><p><strong>Conclusion: </strong>It is evident that EC aerosol inhalation caused pathological changes in the function respiratory system after 16 weeks of exposure. Evolution of structural changes including larger LM and increases in tissue thickness compensated each other, resulting in a return to functional normality at the 24-week time point.</p><p><strong>Implications: </strong>Electronic cigarette use is on the rise, making it necessary to understand the long-term health implications of their use. This study provides the first assessment of structural and functional changes in the lung following prolonged exposure to electronic cigarettes. We find that 16 weeks, but not 8 weeks, of exposure leads to increases in resistances and tissue stiffness, due to an increase in cytoplasm and thickened alveolar septa. At 24 weeks, functional changes appear to reverse while structural abnormalities worsened. This study suggests that electronic cigarettes pose a significant health risk and regulation of them should be considered.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005793","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":"Addressing Tobacco Screening and Treatment Among Racially and Ethnically Minoritized Parents in Pediatric Clinics: Barriers and Facilitators.","authors":"April K Wilhelm, Karen Bauer, Michele L Allen, Steven S Fu, Junia N de Brito, Rebekah J Pratt","doi":"10.1093/ntr/ntae264","DOIUrl":"10.1093/ntr/ntae264","url":null,"abstract":"<p><strong>Introduction: </strong>Household secondhand smoke (SHS) exposure remains a significant health issue for racially and ethnically minoritized children in the United States. Delivering parental tobacco treatment during pediatric primary care visits can reduce children's SHS exposure. This study examined current tobacco screening practices and health system stakeholder perceptions of facilitators and barriers to addressing tobacco use during pediatric visits among racially and ethnically minoritized parents.</p><p><strong>Methods: </strong>We conducted 25 semistructured interviews with clinicians, staff, and health system leaders from five pediatric primary care clinics in Minneapolis-St. Paul, Minnesota. The study was informed by the Health Equity Implementation Framework. Interviews were analyzed using both directed content and thematic analysis.</p><p><strong>Results: </strong>Participants identified multilevel facilitators and barriers to addressing parental tobacco use in minoritized families. Within the clinical encounter, barriers included linguistic and cultural barriers, health system navigational challenges, medical mistrust, low levels of clinician and staff knowledge, skills, and confidence, time constraints, and lack of alignment with external metrics. Facilitators centered on leveraging interpreters' cultural knowledge and the presence of culturally congruent clinicians and staff to reduce medical mistrust and stigma, developing linguistically and culturally relevant resources, and integrating prompts and resources into the electronic health record. Participants described how lessons from previous system change mechanisms would facilitate this work.</p><p><strong>Conclusions: </strong>Addressing health system, training and resources, and linguistic and cultural barriers among clinicians and staff is essential to strengthen their capacity to address household SHS exposure among racially and ethnically minoritized populations as a component of pediatric preventive care.</p><p><strong>Implications: </strong>Clinicians and health system staff perceive unique barriers to identifying and addressing parental tobacco use among racially and ethnically minoritized parents during pediatric primary care visits. Solutions to expand tobacco treatment access to minoritized parents in pediatric settings must attend to clinician training needs on tobacco treatment, embedding clinical encounter resources and reminders that match the linguistic and cultural needs and preferences of their patient populations, and increasing access to high-quality interpreting services and culturally congruent staff.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"822-829"},"PeriodicalIF":3.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624970","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}