Nicotine & Tobacco Research最新文献

{"title":"The Systematic Development of a Mobile Phone Delivered Text-Messaging Tobacco Cessation Intervention in India.","authors":"Miriam Sequeira, Felix Naughton, Richard Velleman, Leena Gaikwad, Pratima Murthy, Marimilha Grace Pacheco, Joseline D'souza, Ganga Nair, Rachit Shah, Seema Sambari, Urvita Bhatia, Abhijit Nadkarni","doi":"10.1093/ntr/ntae306","DOIUrl":"10.1093/ntr/ntae306","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco consumption is a leading cause of mortality globally. Eighty percent of these deaths occur in low- and middle-income countries. Despite this, there is a large treatment gap due to both demand and supply-side barriers. Digital interventions are an innovative solution to bridge this gap. We describe the systematic development of ToQuit, a text-messaging intervention for tobacco cessation in India.</p><p><strong>Aims and methods: </strong>ToQuit was developed in sequential steps: (1) Identifying Behaviour Change Techniques (BCTs) from evidence-based tobacco cessation interventions; (2) Identifying additional BCTs through in-depth interviews; (3) Online expert survey to rate BCTs on feasibility, acceptability, and perceived effectiveness when delivered via text messaging; and (4) A consultation workshop with practitioners.</p><p><strong>Results: </strong>Thirty BCTs were identified from steps 1 and 2. Three were excluded in step 3. The final intervention included 27 BCTs delivered over three phases: phase 1-orientation (information about antecedents and consequences of tobacco consumption, goal setting, reattribution, pros and cons of quitting); phase 2-skill building (self-monitoring, avoidance of cues for behavior, behavior substitution, distraction, stress management, handling urges, restructuring physical and social environments, instructions on how to perform a behavior, prompts and cues, problem-solving, social support, and referrals among others); and phase 3-relapse prevention (psychoeducation about lapse and relapse, review goals, action planning, and feedback on behavior). The intervention is delivered via text messages over 8 weeks with 2-3 messages a day, 2-3 days a week.</p><p><strong>Conclusions: </strong>ToQuit is a contextually relevant and potentially scalable text-messaging intervention for tobacco cessation in resource-constrained settings.</p><p><strong>Implications: </strong>This manuscript is an important piece in the development of contextually relevant digital interventions for the cessation of both smoked and smokeless forms of tobacco. The detailed description of the steps followed in developing the ToQuit intervention will help others replicate these procedures while developing similar interventions responsive to their contexts; particularly in low- and middle-income countries.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1616-1625"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872579","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":"The Impact of Cigarette Package Tar Yield Displays, Tar Warning Statement, and Plain Packaging on Low-Tar Cigarette Misperceptions Among South Koreans Who Smoke.","authors":"Stella Juhyun Lee","doi":"10.1093/ntr/ntaf041","DOIUrl":"10.1093/ntr/ntaf041","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined whether different cigarette package features such as tar yield display, tar warning statement, and plain packaging affect beliefs about tar intake, smoothness, and safety of low-tar cigarettes among South Koreans who smoke.</p><p><strong>Aims and methods: </strong>An online randomized between-subjects experiment was carried out (n = 500) on a panel of South Koreans who smoke. Participants were exposed to either a mock cigarette package that (1) displayed tar yield, (2) did not display tar yield, (3) showed a tar warning statement, or (4) was plain packaged. Beliefs about tar intake, smoothness, and safety were measured post-exposure. Beliefs were compared across conditions, and mediation analysis was conducted.</p><p><strong>Results: </strong>Participants exposed to the tar warning statement believed the mock cigarette would deliver lesser tar compared to those only exposed to the package that displayed tar yield. Those who viewed the cigarette package with no tar yield number were less likely to agree that the cigarette would be smoother compared to those who viewed the package with a visible tar yield number. The effect of viewing the tar warning statement on safety beliefs was fully mediated by tar intake beliefs. The effect of exposure to tar yield display on safety beliefs was fully mediated by smoothness beliefs.</p><p><strong>Conclusions: </strong>Study results indicate that the current tar warning statement could increase misperceptions. Removing tar yield numbers may reduce smoothness beliefs about low-tar cigarettes. Health communication efforts should address beliefs about tar intake and smoothness when trying to correct low-tar cigarette misperceptions about safety.</p><p><strong>Implications: </strong>Previous research has found that tar yield numbers displayed on the front of South Korean low-tar cigarette packages may mislead people to perceive lesser harm. However, studies have not yet examined whether other package elements such as the current tar warning statement or plain packaging could reduce misperceptions. Study results indicated that viewing the current tar warning statement backfires by increasing belief in lesser tar intake. Viewing tar yield numbers also led to an increased perception that the cigarette would feel smoother. Plain packaging did not exert any effects on beliefs about tar intake, safety, or smoothness. Findings can inform tobacco packaging policies and health communication efforts to reduce misperceptions about low-tar cigarettes.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1600-1606"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449580","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":"Nicotine and Toxicant Exposure among Individuals using both Combustible Cigarettes and E-cigarettes Based on Level of Product Use.","authors":"Zheng Xue, Eva Orr-Souza, Nigar Nargis, Minal Patel, Tyler Nighbor","doi":"10.1093/ntr/ntaf053","DOIUrl":"10.1093/ntr/ntaf053","url":null,"abstract":"<p><strong>Introduction: </strong>Dual use of combustible cigarettes and e-cigarettes is the most common multiple tobacco-use behavior in the United States, but its long-term health impact remains unclear. Biomarkers of exposure (BOE) can help identify potential health risks of dual use.</p><p><strong>Methods: </strong>We analyzed data from 2,679 adult participants from Wave 5 of the Population Assessment on Tobacco and Health Study, a U.S. nationally representative study, including individuals reporting current exclusive cigarette use (n = 1,913), exclusive e-cigarette use (n = 316), and dual use (n = 450). Eight subgroups were created based on self-reported high/low (above/below mean) cigarettes per day (CPD) and days of e-cigarette use in past the 30 days (ECIG). Adjusted geometric mean concentrations were compared for total nicotine equivalents, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), three volatile organic compounds (VOCs), and heavy metals (lead and cadmium).</p><p><strong>Results: </strong>Individuals reporting dual use did not differ from those reporting exclusive cigarette use on CPD (13.1 vs. 11.8, respectively). Dual-use groups with high CPD had higher levels of NNAL and VOCs compared to those with low CPD (eg, NNAL for high CPD/high ECIG: 257.07 ng/mg creatinine vs. low CPD/high ECIG: 64.57 ng/mg creatinine, p < .001; high CPD/low ECIG: 312.02 ng/mg creatinine vs. low CPD/low ECIG: 144.11 ng/mg creatinine, p < .001). Cigarette use (dual or exclusive use) was generally associated with higher BOE than exclusive e-cigarette use, though metal exposure did not differ between groups.</p><p><strong>Conclusions: </strong>Dual use and exclusive cigarette use are associated with higher toxicant exposure compared to exclusive e-cigarette use.</p><p><strong>Implications: </strong>In this population-based cross-sectional study, individuals reporting dual use appear to have nicotine and toxicant exposure at least at the same level as those using cigarettes alone and higher than exclusive e-cigarette use (except for metals). Given the adverse health consequences of dual use, including potential cancer risk, our findings highlight the need for clinicians and public health practitioners to increase awareness of the potential risks associated with dual use.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1591-1599"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012763","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":"Joint Effect of Sleep Patterns and Secondhand Smoke Exposure with Mortality Among Non-smoking Adults.","authors":"Chen Chen, Hongyu Jin, Zhiping Jiang, Wang Wei, Wen-Yang Li","doi":"10.1093/ntr/ntaf035","DOIUrl":"10.1093/ntr/ntaf035","url":null,"abstract":"<p><strong>Introduction: </strong>Unhealthy sleep and secondhand smoke (SHS) exposure are independent risk factors for death. Their joint association with all-cause and cardiovascular disease (CVD) mortality (ACDM) deserves to be investigated in a nationally representative population.</p><p><strong>Methods: </strong>Data from 15175 adults from the National Health and Nutrition Examination Survey database (2005-2014) were analyzed. The study endpoints were all-cause and CVD mortality. Sleep patterns (healthy, intermediate, and poor) were classified based on self-reported questionnaires, including sleep duration, self-reported trouble sleeping, and doctor-diagnosed sleep disorders. SHS exposure among nonsmokers was defined according to cotinine levels in serum. Multivariate Cox hazards regression models were conducted to assess the association between sleep patterns and SHS exposure, alone and in combination, with ACDM.</p><p><strong>Results: </strong>During 15 years of follow-up, 2016 all-cause deaths and 678 CVD deaths were recorded. In multivariable models, poor sleep was independently associated with higher risk of all-cause (hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.15-1.51) and CVD mortality (HR = 1.31; 95% CI: 1.02-1.68). Exposure to SHS was associated with higher risk of all-cause (HR, 1.21; 95% CI, 1.08-1.36) and CVD mortality (HR, 1.25; 95% CI, 1.04-1.50). In the joint analyses, participants with both unhealthy sleep patterns (intermediate and poor) and SHS exposure had a significantly higher risk of all-cause (HR, 1.48; 95% CI: 1.26-1.74) and CVD mortality (HR, 1.51; 95% CI, 1.15-1.97) than those with neither risk factor.</p><p><strong>Conclusions: </strong>The coexistence of SHS exposure and unhealthy sleep patterns was associated with an increased risk of death from all causes and CVD.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1574-1582"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374365","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":"Behavioral Activation for Smoking Cessation in Veterans with Posttraumatic Stress Disorder: A Randomized Clinical Trial.","authors":"Jesse T Kaye, Jennifer M Betts, Elana Brubaker, Kirsten Webster, Jean C Beckham, Timothy B Baker, Jessica W Cook","doi":"10.1093/ntr/ntaf054","DOIUrl":"10.1093/ntr/ntaf054","url":null,"abstract":"<p><strong>Introduction: </strong>Certain psychiatric populations have especially low smoking cessation rates. This highlights the need to identify smoking treatments that increase cessation rates by addressing factors thought to impede their success. Behavioral activation (BA) targets anhedonia (ie, reward insensitivity), which is linked with difficulties in quitting smoking and that is especially common and severe amongst mental health populations, including those with posttraumatic stress disorder (PTSD). Thus, BA has the potential to increment the effectiveness of standard smoking cessation treatment for people with PTSD.</p><p><strong>Methods: </strong>A randomized clinical trial for US military veterans with PTSD evaluated 8-weeks of behavioral activation versus health-smoking education counseling (contact-control) when each was used as an adjuvant to standard smoking cessation counseling and combination nicotine replacement therapy (nicotine patch + nicotine lozenge or nicotine gum). The primary outcome was biochemically confirmed 7-day point-prevalence abstinence 26 weeks after the target quit day.</p><p><strong>Results: </strong>Of 124 participants randomized (mean [SD] age 49 years [12.6], 109 male [88%]), 68 (54.8%) provided final follow-up data. Intent-to-treat analyses showed that 17 participants (13.7%) had biochemically confirmed abstinence at 26 weeks (16.1% self-reported abstinence). There was no significant main effect of BA (15.9%, 10/63) vs. control adjuvant counseling (11.5%, 7/61) on biochemically confirmed abstinence at 26 weeks, nor on self-reported abstinence at 4, 12, 20, or 26 weeks.</p><p><strong>Conclusions: </strong>BA intervention did not improve smoking cessation rates more than an attention-control condition when each was paired with standard cessation counseling and medication and delivered to US veterans with PTSD. Smoking treatment was not associated with psychiatric symptom exacerbation.</p><p><strong>Implications: </strong>Behavioral activation therapy has proven effective in treating people with mental health disorders and may be effective as a smoking treatment. This randomized clinical trial compared behavioral activation with intensity-matched attention-control therapy when each was used as an adjuvant to standard smoking cessation treatment (counseling + nicotine patch and lozenge or gum) among US military veterans with PTSD. Behavioral activation therapy did not produce higher smoking abstinence rates than an attention-contact control therapy when each was paired with standard smoking cessation treatment delivered to patients with PTSD. Smoking treatment was not associated with worsening of psychiatric symptoms.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT01995123.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1524-1533"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605834","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":"The Impact of Cigarillo Text Warning Presence and Size on Young Adults' Cigarillo Risk Beliefs, Knowledge, Appeal, and Use Intentions.","authors":"Olivia A Wackowski, Stefanie K Gratale, Michelle Jeong, Kevin R J Schroth, Melissa Mercincavage, Andrew A Strasser, Cristine D Delnevo","doi":"10.1093/ntr/ntaf074","DOIUrl":"10.1093/ntr/ntaf074","url":null,"abstract":"<p><strong>Introduction: </strong>Cigar warning labels can serve as health communication tools; yet current cigar warnings in the United States can be small or absent, and efforts to standardize them have met industry resistance, partly because of limited research.</p><p><strong>Aims and methods: </strong>In 2021, we conducted an online 3 × 2 × 2 factorial experiment with 1352 young adults (aged 18-34) past 12-month cigar users. Participants viewed a cigarillo pack image that varied by: text-only warning size (none; small 15%-of-pack label; larger 30%-of-pack label); warning color (White; Black); and brand (Swisher Sweets; White Owl). We compared group means on risk perceptions, knowledge, and intentions.</p><p><strong>Results: </strong>Packs with any warning label (vs. none) elicited higher endorsement that the packs made participants think about the health risks of smoking cigarillos (p < .001), as did packs with larger 30%-of-pack versus 15%-of-pack warnings (p < .001). Packs with a warning label (vs. without) elicited greater absolute perceptions of cigarillo harm (p < .001), as did 30%-of-pack versus 15%-of-pack warnings (p < .001). Risks referenced in the stimuli warning (mouth and throat cancer) were more frequently mentioned in an open-ended knowledge item by participants in conditions with a warning label versus the no-warning condition (p < .05). Packs with 30%-of-pack warnings were also rated as less attractive and elicited lower use intentions than packs without a warning or with the 15%-of-pack warning (p < .05).</p><p><strong>Conclusions: </strong>Results provide evidence that cigar text-only warning labels, particularly larger ones, can facilitate some cigar risk knowledge and beliefs, reduce pack appeal, and discourage product interest, supporting policy efforts to strengthen cigar warning requirements.</p><p><strong>Implications: </strong>Our results suggest that the use of the small text warnings on cigarillo packs (~15% of pack size), as currently still found in the United States based on existing Federal Trade Commission agreement guidelines, is better than having no warnings at all, but that larger warnings sized at 30% of the pack (as proposed by the U.S. Food and Drug Administration (FDA) and voluntarily used by some brands/manufacturers) could have significant benefits across a range of outcomes. Study findings lend support for the cigar warning requirements proposed by the U.S. FDA through the Deeming Rule.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1607-1615"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772756","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":"Examining E-cigarette Flavor Use and Preference by Menthol Cigarette Status and Quit Duration Among U.S. Adults Using E-cigarettes in a Smoking Cessation Attempt.","authors":"Melina Joseph, Meghan E Morean, Ran Wu, Suchitra Krishnan-Sarin, Stephanie S O'Malley, Krysten W Bold","doi":"10.1093/ntr/ntaf059","DOIUrl":"10.1093/ntr/ntaf059","url":null,"abstract":"<p><strong>Introduction: </strong>Switching to e-cigarettes may help some adults quit smoking. More research is needed to understand the role of flavors in e-cigarettes among adults who smoke menthol and non-menthol cigarettes to inform policy and efforts to reduce cigarette use.</p><p><strong>Aims and methods: </strong>Cross-sectional survey data from adults who used e-cigarettes to quit smoking (N = 857) were used to examine e-cigarette flavors used and preferred during the smoking cessation attempt and differences by cigarette type (menthol vs. non-menthol). A general linear model was used to examine the main effects and interaction of cigarette type (menthol vs. non-menthol) and preferred e-cigarette flavor for quitting on the duration of smoking abstinence.</p><p><strong>Results: </strong>Adults who smoked menthol cigarettes were more likely to prefer menthol/mint versus tobacco (AOR = 12.29, 95% CI = 7.42 to 20.34) or other e-cigarette flavors (AOR = 7.55, 95% CI = 4.22 to 13.50). However, there was a significant interaction between cigarette type and preferred e-cigarette flavor (p = .01). Adults smoking non-menthol cigarettes who preferred to use menthol/mint flavored e-cigarettes to quit smoking had longer durations of abstinence compared to those preferring tobacco flavor (LSmean difference = 0.92, CI: 0.39 to 1.46) or other flavors (LSmean difference = 0.81, CI: 0.15 to 1.46). Among participants who typically smoked menthol cigarettes, e-cigarette flavor preference was not associated significantly with duration of abstinence (F 3,834 = 1.36, p = .25).</p><p><strong>Conclusions: </strong>Menthol/mint e-cigarettes are more often preferred by adults who smoke menthol cigarettes, yet preferring menthol/mint e-cigarettes was associated with longer abstinence durations for those who smoke non-menthol (vs. menthol) cigarettes.</p><p><strong>Implications: </strong>This study provides new information about the types of e-cigarette flavors used and preferred by adults who smoke menthol versus non-menthol cigarettes when using e-cigarettes to try to quit. The association between e-cigarette flavors and abstinence duration varies by cigarette type. While menthol/mint e-cigarette flavors are preferred by adults who smoke menthol cigarettes, menthol/mint e-cigarettes are associated with longer quitting success for those who smoke non-menthol (vs. menthol) cigarettes. More research is needed to understand the impact of e-cigarette flavor by cigarette type. These results may help inform tobacco policy and efforts to maximize reductions in cigarette use.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":"1657-1661"},"PeriodicalIF":3.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582347","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":"Urinary tobacco and nicotine exposure biomarkers as predictors of transitions between cigarette and e-cigarette use in the Exhale longitudinal cohort study.","authors":"Andrew F Brouwer, Fatema Shafie-Khorassani, Neal Benowitz, Nan Shi, Timothy B Baker, Todd Hayes-Birchler, Megan E Piper","doi":"10.1093/ntr/ntaf173","DOIUrl":"10.1093/ntr/ntaf173","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary tobacco and nicotine exposure biomarkers may be predictive of subsequent transitions in product use.</p><p><strong>Methods: </strong>We used data from an observational study of 371 adults who smoked cigarettes daily, some of whom also used e-cigarettes, and who were followed every two months for up to two years (Wisconsin, US, 2015-19). Using a multistate transition model, we assessed continuous associations between transition propensities and urinary tobacco biomarker concentrations, namely 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) (NNAL) and NE-2 (cotinine + trans-3'-hydroxycotinine), the nicotine metabolite ratio (NMR; trans-3'-hydroxycotinine:cotinine), and NNAL:NE-2, measured every 4 months.</p><p><strong>Results: </strong>The biomarkers were generally more predictive of transitions from dual use, but not from cigarette-only use, than self-reported product use was. Propensity to stop smoking cigarettes decreased with increasing concentrations of NNAL and NE-2, for both participants who smoked only cigarettes and those who used both cigarettes and e-cigarettes. For example, we estimated that, at 20 pg NNAL per mg creatinine, 30.2% (95%CI, 14.6%, 47.0%) of those who only smoke cigarettes and 26.6% (95% CI, 11.3%, 42.5%) who dual use would transition to non-current cigarette use and e-cigarette use in one year, while at the 200 pg/ng, we estimate these probabilities to be 3.2% (95%CI, 1.7%, 5.8%) and 3.9% (95% CI, 1.9%, 8.5%), respectively. The ratio NNAL:NE-2 was predictive of transitions from dual use to cigarette-only (higher ratio) or e-cigarette-only (lower ratio) use.</p><p><strong>Conclusions: </strong>Urinary tobacco biomarkers were non-linearly associated with transitions in tobacco product use and may guide the development of clinical interventions to promote harm-reducing product use transitions.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963019","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":"\"Stealth Vaping Is Everywhere\": The Narratives of Young Māori Adults in New Zealand.","authors":"Robin Quigg, Louise Marsh, Sade Gilbert-Perenise","doi":"10.1093/ntr/ntaf135","DOIUrl":"https://doi.org/10.1093/ntr/ntaf135","url":null,"abstract":"<p><strong>Introduction: </strong>Vape use is increasing, particularly among young people who have never been cigarette smokers. Stealth vaping, that is, discrete use in places where it is prohibited, is also reported to be increasing. Regular vape use is high among those who identify as Māori, with the Tobacco Industry reported to be targeting Indigenous communities, thus continuing long-running harmful, colonial practices.</p><p><strong>Aims and methods: </strong>This qualitative study, using group interviews within a kaupapa Māori framework, explored stealth vaping with 19 young adults, of whom 18 identified as Māori in the Indigenous context in New Zealand.</p><p><strong>Results: </strong>The results showed that hiding vape use is enhanced by the features of devices, while the nicotine content drives the need to vape nearly anywhere.</p><p><strong>Conclusions: </strong>The tobacco and nicotine endgame approach is favored by Māori leaders, meaning stricter regulation on vaping devices alone does not adequately protect young people. Instead, stronger measures must be implemented to reduce the appeal of vaping. Vaping does not align with Māori worldviews. Addiction and their easy concealment sustain their use, highlighting the tension between alternative nicotine products that benefit the Tobacco Industry, with the goals of Māori and other Indigenous peoples to eradicate nicotine entirely.</p><p><strong>Implications: </strong>The study results reinforce that priority must be given to culturally led and culturally safe regulatory and policy changes and advocacy for both smoke- and vape-free environments. Regulating the features of devices to negate their stealth use, as their invisibility was facilitated by their manipulability, should enable the existing smoke-free environment spaces to again deter vape use. Advocates must understand Māori history and context to extend the spaces where the strength that comes from being Māori will overcome the need to vape.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835867","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":"Exposure, access, susceptibility to and use of nicotine and tobacco products among 10-16 year-olds: National cross-sectional survey of 14,232 in-school and out-of-school children in Pakistan.","authors":"Midhat Farzeen, Saeed Ansari, Amina Khan, Crawford Moodie, Aziz Sheikh, Catherine Hewitt, Sheraz Ahmad Khan, Zohaib Khan, Hana Ross, Linda Bauld, Kamran Siddiqi","doi":"10.1093/ntr/ntaf171","DOIUrl":"https://doi.org/10.1093/ntr/ntaf171","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco and newer nicotine products pose significant risks to children. Data is needed on tobacco and nicotine use among children in Pakistan, given the evolving market and lack of regular surveillance.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 10-16-year-olds in Pakistan. Using a multistage stratified random sampling strategy, we planned to recruit 9,000 school children from 180 schools and 4,320 out-of-school children from 72 enumeration blocks. We gathered data on their tobacco/nicotine use, exposure, access, and susceptibility. Descriptive analyses were performed to estimate frequencies and usage patterns.</p><p><strong>Results: </strong>Between December 2023 and May 2024, 14,232 children were surveyed; one-third were out-of-school, with one-third girls. Overall, 9.1% (95%CI:8.5-9.6) of boys and 7.1% (95%CI:6.3-7.7) of girls reported using nicotine and/or tobacco products. Their use did not differ between school-going (8.3%; 95%CI:7.7-8.9) and out-of-school (8.5%; 95%CI:7.7-9.2) children. Reported use of e-cigarettes (boys=4.3%; girls=3.2%) and nicotine pouches (boys=3.4%; girls=2.7%) appeared higher than smoking (boys=2.1%; girls=0.7%) and smokeless tobacco use (boys=2.7%; girls=2.0%), though no statistical comparisons were conducted. More children stated that they would accept cigarettes (27%) and nicotine pouches (23.4%) than smokeless tobacco (18.5%) and electronic cigarettes (16.7%) when offered by a friend. A significant proportion could access tobacco shops near their schools (55.4%) and homes (43.1%); and 33.3% indicated they could buy these easily.</p><p><strong>Conclusions: </strong>In Pakistan, more children reported using e-cigarettes and nicotine pouches than smoking cigarettes, although these differences were not tested for statistical significance. Nonetheless, the observed prevalence underscores the need to regulate these products.</p><p><strong>Implications: </strong>The findings underscore the need for targeted regulatory actions to address youth use of tobacco and nicotine products in Pakistan. Comprehensive policies should consider restrictions on sales near schools, enforcement of smoke-free laws, and public awareness campaigns to prevent youth uptake and continued use of tobacco and nicotine products. Future research should build on these findings by exploring the social and behavioural drivers of children's nicotine use and evaluating interventions aimed at curbing product accessibility and appeal. This study sets a benchmark for future surveillance efforts and policy evaluations in Pakistan and similar settings.</p>","PeriodicalId":19241,"journal":{"name":"Nicotine & Tobacco Research","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835871","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}