Nicotine & Tobacco Research最新文献

{"title":"The Effect of Adult Smoking Behavior on Children's Exposure to Secondhand Smoke. An Analysis Based on Salivary Cotinine Levels Among Children in Dhaka and Karachi.","authors":"Kamran Siddiqi, Charlie Welch, Rumana Huque, Romania Iqbal, Mona Kanaan, Masuma Pervin Mishu, Mariam Ahmad Khokhar, Sean Semple","doi":"10.1093/ntr/ntae130","DOIUrl":"10.1093/ntr/ntae130","url":null,"abstract":"<p><strong>Introduction: </strong>Exposure to secondhand smoke (SHS) risks children's health. However, biomarkers are rarely used to study SHS exposure among children in low- and middle-income countries.</p><p><strong>Aims and methods: </strong>We analyzed cross-sectional data collected between March and November 2022 for a cluster-randomized controlled trial investigating a Smoke-Free Intervention in 2769 children aged 9-15 in 74 schools (34 in Dhaka, Bangladesh, and 40 in Karachi, Pakistan). Children's saliva was tested for the concentration of cotinine-a highly sensitive and specific biomarker for SHS exposure. Based on their reports, children's homes were categorized as Nonsmoking Homes (NSH) when residents were nonsmokers; Smoke-free Homes (SFH) when residents and visitors smoked outdoors only; and Smoke-permitted Homes (SPH) when either residents or visitors smoked indoors. We compared cotinine concentrations across these home types and the two cities using a proportional odds model.</p><p><strong>Results: </strong>Overall, 95.7% of children (92% in Dhaka; and 99.4% in Karachi) had cotinine levels between 0.1 and 12 ng/mL, indicating SHS exposure. Median cotinine levels were higher in Karachi (0.58 ng/mL, IQR 0.37 to 0.93) than in Dhaka (0.27 ng/mL, IQR 0.16 to 0.49). Median cotinine concentration was also higher among children living in SPH than those in either NSH or SFH; with absolute differences of approximately 0.1-0.3 and 0.05 ng/mL, respectively.</p><p><strong>Conclusions: </strong>The level of SHS exposure in Dhaka and Karachi indicates widespread and unrestricted smoking. Smoking restrictions in households and enforcement of smoking bans are urgently needed.</p><p><strong>Implications: </strong>The high levels of SHS exposure in children living in SFH suggest parental behavior to hide their smoking and/or exposure in private vehicles or public spaces. It is important to advocate for SFH and cars to protect children from SHS exposure. However, these initiatives alone may not be enough. There is a need to enforce smoking bans in enclosed public places and transportation, as well as extend these bans to playgrounds, parks, fairgrounds, and other public spaces that children frequently visit. It is essential to complement smoking restrictions with tobacco cessation advice and support in these settings.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1512-1520"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420085","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":"\"It's the Wild West Out There\": A Qualitative Study of the Views and Preparedness of Health Professionals in Helping Young Adult E-cigarette Users to Quit.","authors":"Nicola Rahman, Bernadette Sebar, Ernesta Sofija","doi":"10.1093/ntr/ntae117","DOIUrl":"10.1093/ntr/ntae117","url":null,"abstract":"<p><strong>Introduction: </strong>Young adults (YA) are attempting to quit vaping, with many accessing smoking cessation programs with a lack of reported efficacy, highlighting the need for targeted vaping cessation support. Young people report seeing health professionals (HPs) as potential sources of support in the quitting process. Additionally, the current changing regulatory landscape around vaping in Australia potentially increases the number of those seeking health professional help for cessation. However, limited research exists on HPs' views and preparedness to assist YA with their vaping cessation; thus, this exploratory study aimed to gain insights into their readiness to support YA in quitting vaping.</p><p><strong>Aims and methods: </strong>Data were gathered via eight co-design workshops (two groups each of two hours duration and six semi-structured interviews of 1-hour duration), facilitated online with 12 HPs. Data underwent thematic analysis.</p><p><strong>Results: </strong>HPs expressed a need for more information in supporting YA to quit vaping, with them presently relying on informal pathways of support and information for their practice. Participants reported a lack of evidence-based guidelines and a reluctance to prescribe nicotine vapes, expressing conflict with the changing regulatory landscape in Australia.</p><p><strong>Conclusions: </strong>Our findings identify a significant gap in health professional preparedness in supporting vaping cessation. HPs are working within a rapidly evolving regulatory environment and are feeling unprepared to address the widely spread issue of vaping, especially among young people. We demonstrate the critical need for guidelines and training of HPs to enable them to better support young people in quitting vaping.</p><p><strong>Implications: </strong>This qualitative study offers unique insights into the views and readiness of Australian HPs to support young people to quit vaping, specifically in the context of recent regulatory reforms. The results highlight the need for evidence-based guidance and training for HPs to inform their vaping cessation support practice.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1538-1544"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087860","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":"A Qualitative Study of Barriers and Motivators to Prevent Secondhand Smoke Exposure Among Pregnant Women and Children in Egypt: Identifying Appropriate Approaches for Change.","authors":"Zeinab M Hassanein, Gamze Nalbant, Ilze Bogdanovica, Tessa Langley, Rachael L Murray","doi":"10.1093/ntr/ntae051","DOIUrl":"10.1093/ntr/ntae051","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of daily secondhand smoke (SHS) exposure among pregnant nonsmoking women and children in Egypt is estimated to be about 50% and 55%, respectively. This study aimed to explore barriers to preventing SHS exposure among pregnant women/children and smoking in the home in Egypt.</p><p><strong>Aims and methods: </strong>Six focus group discussions with pregnant women or mothers of children residing in urban-rural areas (n = 61) were conducted. Data were managed and analyzed using the Framework Method.</p><p><strong>Results: </strong>Sixty-one participants aged 18-49 were recruited. They reported being never smokers and SHS exposure for themselves and their children was mainly at home. Pregnant women or mothers had some general knowledge of the dangers of SHS, but their knowledge appeared incomplete. The most commonly reported barriers to preventing SHS exposure/adopting a smoke-free home or workplace were social acceptance of smoking and SHS exposure, masculinity and gender norms of accepting smoking among men as a normative behavior, fear among women of damaging a relationship with family or even divorce, women resigning themselves to SHS exposure, and doctors not being supportive of smoking cessation. The majority of interviewees' families were reported to allow smoking anywhere in the home. Others implemented some measures to prevent SHS; however, these tended to be inconsistently implemented.</p><p><strong>Conclusions: </strong>Changing the norm of accepting smoking among men as a normative behavior within Egyptian society and better enforcement of smoke-free policies, will help to protect pregnant women and children from SHS.</p><p><strong>Implications: </strong>This study suggests promising approaches to support the promotion of smoke-free homes and the prevention of SHS exposure among pregnant women and children in public places in Egypt. Better enforcement of smoke-free policies is needed. Healthcare professionals should support smoking cessation services in primary health centers. SHS policy, practice, and research should focus on husbands/fathers as they are the main source of SHS. There is a need for denormalization of SHS exposure in Egyptian society.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1545-1552"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081894","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":"A Pilot Study to Evaluate the Use of Automated Nicotine Metabolite Ratio Reporting Within Primary Care as an Implementation Strategy to Increase the Use of Tobacco Treatments.","authors":"Robert Schnoll, Frank T Leone, Anna-Marika Bauer, E Paul Wileyto, Colin Wollack, Nathaniel Stevens, Daniel Blumenthal, Casey Foster, Fodie Koita, Julia Villasenor, Brian P Jenssen","doi":"10.1093/ntr/ntae124","DOIUrl":"10.1093/ntr/ntae124","url":null,"abstract":"<p><strong>Introduction: </strong>Concerns about safety and effectiveness of tobacco treatments reduce their use. We explored integrating the nicotine metabolite ratio (NMR), and messaging about its potential for improving safety and effectiveness, as a strategy to increase the use of tobacco treatments within primary care.</p><p><strong>Aims and methods: </strong>Through a prospective cohort design, we explored the effects of integrating NMR testing within primary care on the provision of tobacco treatment; 65 patients completed assessments including NMR before a clinic visit. At the clinic visit, patients' clinicians received an electronic health record (EHR) alert about the patient's NMR and personalized treatment recommendations to improve effectiveness and safety. Being asked about smoking and advised to quit, and a referral for tobacco treatment or medication prescription, were assessed within 30 days of the appointment and were compared to a usual care cohort (N = 85).</p><p><strong>Results: </strong>The NMR and usual care cohorts reported similar rates of being asked about smoking (92.3% vs. 92.9%, p = 1.0), being advised to quit (72.3% vs. 74.1%, p = .85), being referred for tobacco treatment (23.1% vs. 36.5%, p = .11), and receiving tobacco use medications (20% vs. 27.1%, p = .34). In the NMR cohort, fast versus slow metabolizers were more likely to receive medication (26% vs. 0%, p = .003) and all patients who received varenicline (n = 8) were fast metabolizers.</p><p><strong>Conclusions: </strong>NMR results and treatment recommendations did not increase tobacco treatment rates in primary care, although it may increase treatment rates and the use of varenicline for fast metabolizers. Future studies could test ways to use the NMR to increase tobacco treatment rates in clinical settings.</p><p><strong>Implications: </strong>This study generated a novel implementation strategy, namely an EHR alert about patients' NMR and personalized treatment recommendations, in an effort to increase tobacco treatment rates in primary care. While the strategy did not increase tobacco treatment rates, it may have boosted the rate of varenicline prescription for patients who metabolize nicotine faster, aligning with evidence-based practice.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1570-1575"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081961","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":"Pleasure and Satisfaction as Predictors of Future Cigarette and E-cigarette Use: A Novel Two-Stage Modeling Approach.","authors":"Donald Hedeker, Julia Brooks, Kathleen Diviak, Nancy Jao, Robin J Mermelstein","doi":"10.1093/ntr/ntae121","DOIUrl":"10.1093/ntr/ntae121","url":null,"abstract":"<p><strong>Introduction: </strong>Subjective experience of e-cigarettes may be an important factor in helping people who use combustible cigarettes switch completely to e-cigarettes to reduce harm from smoking. This paper describes a novel two-stage analysis using pleasure and satisfaction responses from ecological momentary assessments (EMA) of both cigarette and e-cigarette use to predict future cigarette and e-cigarette tobacco use.</p><p><strong>Aims and methods: </strong>This observational study included adult users of cigarettes and e-cigarettes who provided 7 days of EMA, capturing cigarette and e-cigarette use, followed by biweekly reports of cigarette and e-cigarette use over 1 year. Participants were 279 adults who provided both cigarette and e-cigarette responses during the EMA. We employed a two-stage analytic approach in which EMA data were used to predict subsequent levels of cigarette and e-cigarette use. In the first stage, EMA responses to cigarette and e-cigarette events were modeled via a mixed-effects location scale model to yield summaries of participants' means and variability on event-related ratings of pleasure and satisfaction. These EMA summaries served as predictors in the second stage analysis of the biweekly post-EMA longitudinal cigarette and e-cigarette use data.</p><p><strong>Results: </strong>EMA pleasure and satisfaction ratings were similar for both products and predicted both longitudinal cigarette and e-cigarette use, even after controlling for baseline cigarette and e-cigarette dependence. Relatively higher levels of satisfaction with e-cigarettes were associated with greater decreases in cigarette use over time.</p><p><strong>Conclusions: </strong>Pleasure and satisfaction are important predictors of subsequent cigarette and e-cigarette use.</p><p><strong>Implications: </strong>Experienced subjective pleasure and satisfaction from e-cigarettes relative to cigarettes may be an important factor in helping individuals who smoke to switch completely to e-cigarettes as a harm reduction approach. In order to help sustain complete product switching and reduce dual use or relapse to smoking, e-cigarettes may need to deliver more satisfaction to the user compared to that experienced from cigarettes.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1472-1479"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076358","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":"Attitudes and Exposure to Illicit Tobacco in England, 2022.","authors":"Nathan Davies, Tessa Langley, Leah Jayes, Manpreet Bains, Jamie Brown, Deborah Arnott, Ilze Bogdanovica","doi":"10.1093/ntr/ntae118","DOIUrl":"10.1093/ntr/ntae118","url":null,"abstract":"<p><strong>Introduction: </strong>The United Kingdom has achieved reductions in illicit tobacco (IT) market size and share. However, there remains a 17.7% tobacco duty gap, contributing to health inequalities. In January 2024, the UK government announced a new strategy to control IT, along with provision of new funding.</p><p><strong>Methods: </strong>A representative cross-sectional survey of adults in England ran in April 2022 to evaluate attitudes and exposure to IT. Tobacco smokers were asked questions about encounters with IT, while all participants answered questions on knowledge and perspectives on IT.</p><p><strong>Results: </strong>Of 262 tobacco smokers, 18.3% (95% CI 13.8% to 23.6%) had come across IT in the past year. Men had four times the odds of encountering IT recently than women. Among 1767 adults responding to questions on IT, two-thirds agreed IT harmed children, and more than half agreed IT was linked to organized crime. Younger adults, smokers, and those in lower socioeconomic groups were less likely to agree IT was harmful.</p><p><strong>Conclusions: </strong>Exposure to IT, especially among younger males, remains a concern. While most of the public acknowledge its harm, this is not universal, and some population groups are less likely to do so.</p><p><strong>Implications: </strong>The study highlights persistent exposure to IT in England, especially among younger males, and varying perceptions of IT harm across socioeconomic groups. Tackling IT requires collaboration between health and enforcement agencies, independent of the tobacco industry's influence. Strategies should include components that shift demand for IT and denormalize its presence in communities, particularly in lower socioeconomic areas with higher smoking prevalence.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1591-1594"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945509","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":"Changes in Compliance With Bans on Tobacco Product Display and Advertising at Traditional and Modern Point-of-Sale Retailers in Depok, Indonesia, 2019-2021.","authors":"Qinghua Nian, Ryan David Kennedy, Dina Ariani, Kathy Wright, Jennifer L Brown, Tara Singh Bam, Made Kerta Duana, Diah Setyawati Dewanti","doi":"10.1093/ntr/ntae099","DOIUrl":"10.1093/ntr/ntae099","url":null,"abstract":"<p><strong>Introduction: </strong>Banning Point-of-Sale (POS) advertising and product display is an important tobacco control strategy. Depok, Indonesia enacted some regional tobacco control policies regulating the POS environment in 2021. This study examined changes in compliance before and after the implementation of these policies as of 2021.</p><p><strong>Methods: </strong>Data collectors visited 180 modern retailers (hyper/supermarkets/convenience stores) and 147 traditional retailers (warungs) in 2019. The same retailers were revisited in 2021. Data collectors assessed compliance with tobacco product display, and advertising regulations at POS, including if products were displayed in spaces to target minors (near candy or at a child's eye level). Data were analyzed using McNemar and Mann-Whitney U tests.</p><p><strong>Results: </strong>From 2019 to 2021, in modern retailers, tobacco product display (95.6% vs. 52.2%) and product advertising (36.1% vs. 3.9%) were significantly reduced (p < .001). In traditional retailers, tobacco product display (94.6% in 2019, 91.2% in 2021, p > .05) and product advertising (87.1% in 2019, 87.8% in 2021, p > .05) remained common during both data collection periods. Tobacco products were commonly displayed in spaces to target minors in both modern retailers (43.3% in 2019, 34.4% in 2021, p > .05) and traditional retailers (90.5% in 2019, 83.0% in 2021, p > .05).</p><p><strong>Conclusions: </strong>Compliance with bans on tobacco product advertising and display at modern retailers improved significantly from 2019 to 2021; however, most modern retailers continue to display tobacco products in 2021. Traditional retailers remain largely noncompliant. Tobacco products are commonly displayed in areas that target minors. The enforcement of regional regulations should be strengthened, particularly among traditional retailers.</p><p><strong>Implications: </strong>In Depok, Indonesia, tobacco advertising and product display bans have been implemented; however, more work is needed to support compliance. Enforcement efforts, such as those carried out by civil police, can focus on tobacco product display bans in traditional and modern retailers, and traditional retailers need additional support to remove tobacco product advertising. Retailers may receive money from the tobacco industry for these advertisements. Creative solutions may include supporting retailers in finding alternative advertising revenue.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1497-1503"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868543","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":"Mendelian Randomization Analysis of the Causal Effect of Cigarette Smoking on Hospital Costs.","authors":"Padraig Dixon, Hannah Sallis, Marcus Munafò, George Davey Smith, Laura Howe","doi":"10.1093/ntr/ntae089","DOIUrl":"10.1093/ntr/ntae089","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge of the impact of smoking on health care costs is important for establishing the external effects of smoking and for evaluating policies intended to modify this behavior. Conventional analysis of this association is difficult because of omitted variable bias, reverse causality, and measurement error.</p><p><strong>Aims and methods: </strong>We approached these challenges using a Mendelian Randomization study design; genetic variants associated with smoking behaviors were used in instrumental variables models with inpatient hospital costs (calculated from electronic health records) as the outcome. We undertook genome-wide association studies to identify genetic variants associated with smoking initiation and a composite smoking index (reflecting cumulative health impacts of smoking) on up to 300 045 individuals (mean age: 57 years at baseline, range 39-72 years) in the UK Biobank. We followed individuals up for a mean of 6 years.</p><p><strong>Results: </strong>Genetic liability to initiate smoking (ever vs. never smoking) was estimated to increase mean per-patient annual inpatient hospital costs by £477 (95% confidence interval (CI): £187 to £766). A one-unit change in genetic liability to the composite smoking index (range: 0-4.0) increased inpatient hospital costs by £204 (95% CI: £105 to £303) per unit increase in this index. There was some evidence that the composite smoking index causal models violated the instrumental variable assumptions, and all Mendelian Randomization models were estimated with considerable uncertainty. Models conditioning on risk tolerance were not robust to weak instrument bias.</p><p><strong>Conclusions: </strong>Our findings have implications for the potential cost-effectiveness of smoking interventions.</p><p><strong>Implications: </strong>We report the first Mendelian Randomization analysis of the causal effect of smoking on health care costs. Using two smoking phenotypes, we identified substantial impacts of smoking on inpatient hospital costs, although the causal models were associated with considerable uncertainty. These results could be used alongside other evidence on the impact of smoking to evaluate the cost-effectiveness of antismoking interventions and to understand the scale of externalities associated with this behavior.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1521-1529"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862069","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":"A Review of the Toxicity of Ingredients in e-Cigarettes, Including Those Ingredients Having the FDA's \"Generally Recognized as Safe (GRAS)\" Regulatory Status for Use in Food.","authors":"Nada O F Kassem, Robert M Strongin, Andrea M Stroup, Marielle C Brinkman, Ahmad El-Hellani, Hanno C Erythropel, Arash Etemadi, Vernat Exil, Maciej L Goniewicz, Noura O Kassem, Theodore P Klupinski, Sandy Liles, Thivanka Muthumalage, Alexandra Noël, David H Peyton, Qixin Wang, Irfan Rahman, Luis G Valerio","doi":"10.1093/ntr/ntae123","DOIUrl":"10.1093/ntr/ntae123","url":null,"abstract":"<p><p>Some firms and marketers of electronic cigarettes (e-cigarettes; a type of electronic nicotine delivery system (ENDS)) and refill liquids (e-liquids) have made claims about the safety of ingredients used in their products based on the term \"GRAS or Generally Recognized As Safe\" (GRAS). However, GRAS is a provision within the definition of a food additive under section 201(s) (21 U.S.C. 321(s)) of the U.S. Federal Food Drug and Cosmetic Act (FD&C Act). Food additives and GRAS substances are by the FD&C Act definition intended for use in food, thus safety is based on oral consumption; the term GRAS cannot serve as an indicator of the toxicity of e-cigarette ingredients when aerosolized and inhaled (ie, vaped). There is no legal or scientific support for labeling e-cigarette product ingredients as \"GRAS.\" This review discusses our concerns with the GRAS provision being applied to e-cigarette products and provides examples of chemical compounds that have been used as food ingredients but have been shown to lead to adverse health effects when inhaled. The review provides scientific insight into the toxicological evaluation of e-liquid ingredients and their aerosols to help determine the potential respiratory risks associated with their use in e-cigarettes.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1445-1454"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087796","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":"Comparing the Fagerström Test and Heaviness of Smoking Index in Predicting Smoking Abstinence in Cancer Patients.","authors":"Rubén Rodríguez-Cano, George Kypriotakis, Jason D Robinson, Maher Karam-Hage, Janice A Blalock, Jennifer A Minnix, Diane Beneventi, Paul M Cinciripini","doi":"10.1093/ntr/ntae120","DOIUrl":"10.1093/ntr/ntae120","url":null,"abstract":"<p><strong>Introduction: </strong>People with cancer who smoke exhibit greater cigarette dependence than people without cancer who smoke, a crucial factor in smoking cessation. Research is limited on the predictive potential of the Fagerström Test for Cigarette Dependence (FTCD) and the Heaviness of Smoking Index (HSI) on smoking abstinence in cancer patients undergoing smoking cessation treatment.</p><p><strong>Aims and methods: </strong>We analyzed data from 5934 cancer patients seeking smoking cessation treatment at The University of Texas MD Anderson Cancer Center (female 52.08%; Mean age = 55.52, SD = 11.17). We evaluated the predictive accuracy of FTCD and HSI on abstinence at 3, 6, and 9 months from the first consultation, and assessed the concordance between these tools in measuring cigarette dependence using Cohen's kappa test and different correlation and regression models. We also analyzed variations across sex at birth and race/ethnicity.</p><p><strong>Results: </strong>Both the FTCD and the HSI demonstrated comparable predictive accuracy for smoking cessation at all follow-ups, with neither showing high accuracy (Areas Under the Curve scores around 0.6). Concordance analysis revealed substantial agreement between FTCD and HSI scores (Cohen's kappa ~ 0.7), particularly at lower levels of dependence. However, this agreement varied by race, with reduced concordance observed in non-Hispanic Blacks.</p><p><strong>Conclusions: </strong>Our results indicate that both the FTCD and HSI are effective tools for predicting smoking cessation in cancer patients, with the HSI offering a less burdensome assessment option. Nevertheless, the findings suggest the need for tailored approaches in assessing cigarette dependence that could predict smoking cessation more accurately, considering racial differences.</p><p><strong>Implications: </strong>The burden of assessing cigarette dependence in cancer care settings can be reduced by using the HSI instead of the FTCD. In addition, both instruments could be substantially interchanged and used for meta-analytic studies examining dependence and abstinence, but race/ethnicity should be considered.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1576-1581"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087858","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}