Preventive medicine最新文献

{"title":"Secondary analysis of a randomized clinical trial of very low nicotine cigarettes: Outcomes across social and demographic groups.","authors":"Ridwan J Said, Dana Mowls Carroll, Xianghua Luo, Jiayi Hu, Qing Cao, Katelyn M Tessier, Lorna Bittencourt, Dorothy K Hatsukami","doi":"10.1016/j.ypmed.2025.108362","DOIUrl":"https://doi.org/10.1016/j.ypmed.2025.108362","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether the impact of a nicotine reduction standard (NRS) varies by socio-demographics.</p><p><strong>Methods: </strong>Secondary analysis of a 12-week trial (2018-2022) with 438 people who smoke (PWS) comparing very low nicotine content (VLNC) vs. normal nicotine content (NNC) cigarettes. Moderation by education, race, and age on cigarettes per day (CPD), smoke-free days, and biomarkers (CEMA, NNAL) was assessed using interaction models.</p><p><strong>Results: </strong>For race and education, interaction tests for moderation were not significant (ps > 0.05). In subgroup analyses, VLNC condition reduced CPD and biomarkers and increased smoke-free days with the following exception: no difference in CEMA was observed by condition among those of lower education (Geometric mean ratio [GMR] = 0.72, 95 % confidence interval [CI] = 0.39, 1.33). For age, multiple interaction tests were significant. In subgroup analyses, older but not younger adults, had no VLNC vs. NNC differences for CEMA (GMR: 0.85 [CI = 0.51, 1.41] vs 0.47 [CI = 0.35, 0.62]) or smoke-free days (rate ratio: 1.85 [CI = 0.63, 5.55] vs 5.85 [CI = 3.12, 10.89]).</p><p><strong>Conclusion: </strong>Age and potentially education moderate NRS effects among PWS.</p><p><strong>Policy implications: </strong>Targeted support for older adults and those with lower education may maximize NRS benefits.</p><p><strong>Trial registration: </strong>NCT03272685.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108362"},"PeriodicalIF":4.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699257","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":"Associations between behavior cognition–social influence and pregnancy planning behavior in China: An integrated individual-couple analysis","authors":"Ruyu Sun ,&nbsp;Tingzhong Yang ,&nbsp;Menmen Wang ,&nbsp;Xinxin Ying ,&nbsp;Lu Li ,&nbsp;Weifang Zhang","doi":"10.1016/j.ypmed.2025.108363","DOIUrl":"10.1016/j.ypmed.2025.108363","url":null,"abstract":"<div><h3>Objective</h3><div>Pregnancy planning is a critical opportunity to enhance preconception health. “Beiyun,” a culturally rooted concept in China, encompasses traditional and modern practices for preparing for pregnancy. This study used the comprehensive idea of “Beiyun” to examine the mechanisms of pregnancy planning behavior among women and men through an integrated individual-couple analysis based on the Behavior Cognition – Social Influence Theory.</div></div><div><h3>Methods</h3><div>Using multistage stratified sampling, we recruited reproductive-aged individuals in Zhejiang, China between July and September 2023. A cross-sectional survey collected data on pregnancy planning behavior. Analyses were conducted at both individual (Study 1, all participants) and couple levels (Study 2, coupled participants) using path analysis, specifically employing the actor-partner interdependence model in Study 2.</div></div><div><h3>Results</h3><div>Study 1 included 1086 women and 905 men, with 57.6 % and 67.7 % reporting pregnancy planning, respectively. Study 2 comprised 458 heterosexual couples. At the individual level, perceived susceptibility (women: <em>β</em> = 0.09, <em>p</em> = 0.01; men: <em>β</em> = 0.09, <em>p</em> = 0.04) and behavioral norms (women: <em>β</em> = 0.37, <em>p</em> &lt; 0.01; men: <em>β</em> = 0.45, <em>p</em> &lt; 0.01) were significantly associated with planning behavior. Couple-level analysis revealed that women's pregnancy planning was associated with their perceived susceptibility (<em>β</em> = 0.13, <em>p</em> = 0.02), behavioral norms (<em>β</em> = 0.29, <em>p</em> &lt; 0.01), and their partner's behavioral norms (<em>β</em> = 0.30, <em>p</em> &lt; 0.01), while men's behavior was associated with their norms (<em>β</em> = 0.35, <em>p</em> &lt; 0.01) and partner's perceived susceptibility (<em>β</em> = 0.13, <em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>This study yielded new insights into pregnancy planning behavior, highlighting the role of individual factors and partner dynamics. Future interventions should enhance risk awareness among women and shape behavioral norms in men, considering partner dynamics in public health campaigns.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"199 ","pages":"Article 108363"},"PeriodicalIF":4.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696730","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":"Compliance with smoke-free policies in outdoor settings: a realist review","authors":"Sophie J.A. Jooren ,&nbsp;Heike H. Garritsen ,&nbsp;Sigrid Troelstra ,&nbsp;Willeke van Dijk ,&nbsp;Maria W.J. Jansen ,&nbsp;Marc C. Willemsen ,&nbsp;Jeroen Bommelé","doi":"10.1016/j.ypmed.2025.108361","DOIUrl":"10.1016/j.ypmed.2025.108361","url":null,"abstract":"<div><h3>Objective</h3><div>Although smoke-free outdoor environments are increasingly implemented to reduce adolescent smoking and de-normalize the behaviour, compliance is often low. To better understand compliance of people who smoke, we conducted a realist review.</div></div><div><h3>Methods</h3><div>A realist review, a type of literature review, uses existing evidence to make a program theory, outlining mechanisms and contexts, that provides an explanatory analysis of compliance of people who smoke with outdoor smoke-free environments. The search was conducted in PubMed, Web of Science, Embase, and PsycINFO. Studies were included that had been published from January 1, 2000, to September 1, 2023. Twenty-five peer-reviewed English-language articles were included. Evidence was extracted about contexts and mechanisms that influence the compliance of smokers.</div></div><div><h3>Results</h3><div>Compliance with smoke-free outdoor environments increases if people who smoke accept the policy, have sufficient knowledge and when the policy affects their motivation to quit smoking. However, these mechanisms may be hindered by feelings of people who smoke, such as low confidence in the policy's effectiveness and enforcement, feelings of stigma, and a lack of understanding. The context in which these environments are implemented, such as communication about the smoke-free policy, the stop-smoking facilities, the presence of ashtrays and designated smoking areas, and the size of the environment, influences mechanisms and compliance.</div></div><div><h3>Conclusions</h3><div>To increase acceptance and clarity of smoke-free policies, we recommend implementing smoke-free outdoor policies without designated smoking areas or ashtrays while actively promoting public awareness. To avoid stigmatisation, accessible cessation support is key. Lastly, proper enforcement training is essential.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"199 ","pages":"Article 108361"},"PeriodicalIF":4.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691326","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 association between life's essential 8 health behavior component score and all-cause and cardiovascular mortality among U.S. adults with cardiovascular-kidney-metabolic syndrome stages 0-3.","authors":"Yifei Wang, Tianshan Dong, Bin Wang, Ping Zhang","doi":"10.1016/j.ypmed.2025.108360","DOIUrl":"10.1016/j.ypmed.2025.108360","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between Life's Essential 8 (LE8) health behavior component score and mortality outcomes among individuals with Cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3.</p><p><strong>Methods: </strong>8067 U.S. adults from the National Health and Nutrition Examination Survey 2005-2018, aged 30-79 years with CKM syndrome stages 0-3, were analyzed. Mortality status was obtained via linkage to the National Death Index through December 31, 2019. Kaplan-Meier analysis, multivariable Cox regression, and restricted cubic splines (RCS) were used to examine associations between LE8 health behavior component score and mortality outcomes.</p><p><strong>Results: </strong>CKM stages were distributed as follows: 7.8 % (stage 0), 21.0 % (stage 1), 64.0 % (stage 2), and 7.3 % (stage 3). Higher LE8 total score and health behavior component score were linked to reduction in all-cause mortality and cardiovascular mortality risk. RCS analysis showed a linear relationship between LE8 total score, health behavior component score and mortality outcomes. Interaction between health behavior component score and CKM syndrome stages was identified for all-cause mortality.</p><p><strong>Conclusions: </strong>Higher LE8 health behavior component score is associated with reduced all-cause and cardiovascular mortality among population with CKM syndrome stages 0-3. These findings support the potential value of behavior-targeted interventions tailored to CKM syndrome stages.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108360"},"PeriodicalIF":4.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659997","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":"Disparities in willingness to call the police in a 2023 survey of US adults: Implications for alternative crisis response programs","authors":"Saba Rouhani ,&nbsp;Eteri Machavariani ,&nbsp;Anna-Michelle McSorley ,&nbsp;Therese L. Todd ,&nbsp;Jonathan Purtle","doi":"10.1016/j.ypmed.2025.108358","DOIUrl":"10.1016/j.ypmed.2025.108358","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate willingness to call the police in an emergency among US adults to inform policies addressing emergency response and help-seeking.</div></div><div><h3>Methods</h3><div>We utilized cross-sectional data from a web-based 2023 Survey of Racism and Health of (<em>N</em> = 5059) adults in 12 Northeastern and Mid-Atlantic states and D.C. We estimated odds of willingness to call the police as a function of gender, race/ethnicity, and lifetime diagnosis with a behavioral health (substance use or mental health) condition using unadjusted and adjusted logistic regression.</div></div><div><h3>Results</h3><div>Most of the sample (80 %) reported willingness to call the police in an emergency. Dds were observed among Black (aOR 0.33; 95 % CI 0.27–0.41), American Indian/Native American (aOR 0.43; 95 % CI 0.27, 0.70), and Multiracial (aOR 0.36; 95 % CI 0.25–0.52) compared to White respondents, and those with behavioral health diagnoses (aOR 0.73; 95 % CI 0.61, 0.88). Women (aOR 1.23; 95 % CI 1.05, 1.43) and older adults (Age 55+: aOR 4.62; 95 % CI 3.70, 5.80) reported higher willingness to call the police.</div></div><div><h3>Conclusions</h3><div>Findings highlight subpopulations for whom the police may not be a viable source of emergency response, particularly individuals who are racially minoritized and/or have behavioral health conditions. This has implications for alternative response programs which rely on 911 dispatch to triage calls and highlights a need for targeted messaging and alternative mechanisms to call for service in communities with police mistrust.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108358"},"PeriodicalIF":4.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623794","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":"Examining rural disparities in cigarette smoking among U.S. women by chronological age: 2002-2022.","authors":"Stephen T Higgins, Tyler G Erath, Fang Fang Chen, Michael J DeSarno","doi":"10.1016/j.ypmed.2025.108359","DOIUrl":"10.1016/j.ypmed.2025.108359","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated rural disparities in cigarette smoking among U.S. women by age (18-65+ years) across survey years (2002-2022).</p><p><strong>Methods, data source: </strong>Data came from the National Survey on Drug Use and Health. Women were categorized by rural-urban residence and age. We examined associations between residence, age, and time on current-smoking prevalence and quit ratios in two-year bins using weighted logistic-regression adjusting for race/ethnicity, education, annual income.</p><p><strong>Results: </strong>Effects of residence on current-smoking prevalence interacted with time (t[df = 430,180] = 4.51, P < .001), with reductions over time among urban (AOR = 0.95, 95 %CI: 0.94-0.96, P < .001) but not rural residents (AOR = 0.99, 95 %CI: 0.98-1.01, P = .66). Residence interacted with age (t[df = 430,180] = -4.90, P < .001), with greater smoking among rural women in younger (AORs≥1.23, 95 %CI: 1.01-1.44, Ps ≤ 0.008), but not older age brackets (AORs ≤1.04, 95 %CI: 0.74-1.35, Ps ≥ 0.688). Rural residence predicted lower odds of quitting smoking (AOR = 0.80, 95 %CI: 0.71-0.91, P < .001).</p><p><strong>Conclusions: </strong>There is a growing disparity in smoking prevalence that disproportionately impacts rural women ages 18-49 years raising concerns about multigenerational adverse effects as this demographic is most likely to be pregnant or parenting young children. There is also a rural disparity in quitting smoking across age groups underscoring a need for greater access to smoking-cessation services among rural women.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108359"},"PeriodicalIF":4.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626968","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":"Sustainable chronic disease prevention at scale: Evaluation of the Get Healthy Service, a telephone and online coaching service","authors":"Zoë Szewczyk ,&nbsp;Bronwyn McGill ,&nbsp;Philip Clare ,&nbsp;Karen Lee ,&nbsp;Sandra Davidson ,&nbsp;Sarah Yeun-Sim Jeong ,&nbsp;Adrian Bauman ,&nbsp;Blythe J. O'Hara","doi":"10.1016/j.ypmed.2025.108357","DOIUrl":"10.1016/j.ypmed.2025.108357","url":null,"abstract":"<div><h3>Objective</h3><div>The Get Healthy Service (GHS) is a free telephone and online health coaching service for adults delivered across New South Wales, Australia, since 2009. The GHS was first evaluated over 10 years ago and was shown to be effective. Using recent data, we investigated characteristics conducive to program completion and whether program impact has been sustained at scale.</div></div><div><h3>Methods</h3><div>This evaluation used data collected during program delivery between December 2017 and May 2023. Descriptive and inferential analysis was used to measure program completion, and pre-post health risk behaviour change.</div></div><div><h3>Results</h3><div>Of 53,566 participants enrolled in the GHS, 34 % completed the program. Multivariable analyses showed that men, people aged 50+ years, and those who did not identify as Aboriginal were more likely to complete the program. Program completers showed increased physical activity (43.5 mins/week; 95 % CI 40.55, 46.49), fruit intake (IRR 1.011; 95 % CI 1.08, 1.14) and vegetable intake (IRR 1.3; 95 % CI 1.27, 1.32); improvements in their BMI score (−0.51 kg/m²; 95 % CI -0.56, −0.45) and waist circumference (−2.74 cm; 95 % CI -2.96, −2.52); and improvements in sweet drink and takeaway food consumption. Compared to earlier evaluations, the impact of the GHS on health risk behaviours had decreased.</div></div><div><h3>Conclusions</h3><div>Since its launch almost 15 years ago, GHS continues to confer improved anthropometric and lifestyle risk factors in adults, however the magnitude of effect has decreased since earlier evaluations. Efforts to sustain and improve the impact of the program, particularly amongst participants from most disadvantaged backgrounds, is needed.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108357"},"PeriodicalIF":4.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611546","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":"Barriers to healthcare utilization among adults engaging in heavy drinking: Results from the all of us research program","authors":"Melissa Pearman Fenton ,&nbsp;Kaitlyn Swacil ,&nbsp;Catherine Woodstock Striley ,&nbsp;Linda Bauer Cottler ,&nbsp;Milton Eder ,&nbsp;Irvin PeDro Cohen ,&nbsp;Catalina Lopez-Quintero","doi":"10.1016/j.ypmed.2025.108356","DOIUrl":"10.1016/j.ypmed.2025.108356","url":null,"abstract":"<div><h3>Objective</h3><div>We examined sociodemographic factors associated with barriers to healthcare utilization (HCU) among a national sample of adults engaging in heavy drinking behavior (HDB).</div></div><div><h3>Methods</h3><div>A sample of 3257 participants from the <em>All of Us</em> program (2018–2022 Controlled Tier Dataset-v7) who reported HDB (i.e., six or more drinks on one occasion, at least weekly) was selected to examine the associations between socio-demographic factors and barriers to HCU (i.e., structural, competing social roles, attitudinal, and financial barriers). Multiple logistic regressions estimated adjusted Odds Ratios (aOR) for the associations of interest.</div></div><div><h3>Results</h3><div>Financial barriers (23.64 %) were the most common of the four barriers, followed by attitudinal (18.27 %), competing social roles (15.66 %), and structural (13.36 %) barriers. Females were more likely than males to report competing social roles (or = 1.56, 95 %CI = 1.28,1.90), attitudinal (aOR = 1.41, 95 %CI = 1.17,1.70), and financial (or = 1.41, 95 %CI = 1.19,1.68) barriers. Lower income (aOR = 6.71, 95 %CI = 4.77,9.56), and Non-Hispanic Black/African Americans (aOR = 1.39, 95 %CI = 1.04,1.85) showed higher odds of reporting structural barriers.</div></div><div><h3>Conclusions</h3><div>As many as one in four individuals who engage in HDB experience at least one HCU barrier, particularly women, those with low-incomes, and Non-Hispanic Black/African Americans. The findings highlight the need for implementation of evidence-based strategies among the identified populations to reduce HCU barriers, and ultimately, alcohol-related disparities.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108356"},"PeriodicalIF":4.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604233","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":"Travel distance to the general practitioner and women's participation in cervical cancer screening in Denmark – A population-based cohort study, 2017","authors":"Rikke Bjerring Plenborg,&nbsp;Annette Kjær Ersbøll,&nbsp;Kristine Bihrmann","doi":"10.1016/j.ypmed.2025.108355","DOIUrl":"10.1016/j.ypmed.2025.108355","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies found disparities in utilization of cervical cancer screening programs. Geographical distance to the screening location may affect women's participation. The aim of this study was to investigate the association between travel distance from residence to general practitioner, and invited women's participation in a national screening program for cervical cancer.</div></div><div><h3>Methods</h3><div>Data were obtained from Danish national registers including all women invited to the screening program in 2017 (<em>n</em> = 341,708). Travel distance from residence to the general practitioner was calculated based on geocoded addresses and the road network. Multilevel logistic regression was used to calculate odds ratios (ORs) of participation with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Based on 271,959 women with complete information, screening participation decreased from 67.7 % among women with a travel distance of 1.0–4.9 km to 61.1 % among women with ≥15.0 km. Adjusted for ethnicity, education, and age, women with ≥15.0 km to the general practitioner had 22 % lower odds of participation compared to those living 1.0–4.9 km away (OR = 0.78, 95 %CI [0.75;0.81]). Women with &lt;1.0 km to the general practitioner had 10 % lower odds of participation (OR = 0.90, 95 %CI [0.88;0.93]). Sensitivity analysis indicated an exposure-response relationship when distance was ≥5 km, implying lower odds of participation with increasing distance above 5 km.</div></div><div><h3>Conclusion</h3><div>Travel distance to the general practitioner was associated with participation in screening. Future initiatives should promote equal access to preventive health services focusing on women having a long travel distance to their general practitioner, as well as those living very close to their general practitioner.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"198 ","pages":"Article 108355"},"PeriodicalIF":4.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596779","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":"E-cigarette use frequency mediates effects in three randomized controlled trials of reduced nicotine cigarettes with tobacco vs preferred flavor E-cigarettes in high-risk populations in the U.S.","authors":"Elias M Klemperer, Michael J DeSarno, Jennifer W Tidey, Diann E Gaalema, Katya A Nolder, Marc Jerome P Feinstein, Rhiannon C Wiley, Stephen T Higgins","doi":"10.1016/j.ypmed.2025.108353","DOIUrl":"10.1016/j.ypmed.2025.108353","url":null,"abstract":"<p><strong>Objectives: </strong>The U.S. Food and Drug Administration is authorized to implement a nicotine-reducing standard to decrease smoking. Three recent trials found switching to very low nicotine content (VLNC) cigarettes produced the greatest reduction in cigarettes/day and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a tobacco-specific carcinogen) among adults from high-risk populations when participants also received preferred- vs tobacco-flavored e-cigarettes. This pooled secondary analysis investigates e-cigarette use frequency as a mechanism driving these effects.</p><p><strong>Methods: </strong>Participants (U.S. adults with affective disorders, adults with opioid use disorder, and reproductive-age females with ≤high-school education) were randomized to 16 weeks of VLNC cigarettes with preferred-flavored e-cigarettes selected from eight options (VLNC+PF; n = 84) or VLNC cigarettes with tobacco-flavored e-cigarettes (VLNC+TF; n = 74) from October 2020-November 2023. General linear models explored whether e-cigarette use frequency (days/week) between Weeks 1-15 mediated effects on Week-16 cigarettes/day and NNAL.</p><p><strong>Results: </strong>Participants were 40.4 (mean) years old (SD = 11.5), 69.0 % female, 81.0 % white, and smoked 17.3 (mean) cigarettes/day (SD = 9.0) at baseline. The VLNC+PF condition reported more e-cigarette use days/week (LSmean[SEM]): 4.3[±0.4]) than the VLNC+TF condition (LSMean[SEM]: 3.4[±0.5]; F[1151] = 3.9, p < .05) across weeks 1-15. More e-cigarette use days/week predicted greater reductions in mean cigarettes/day (β[SE]: -0.32[±0.05)]; F[1106] = 50.5, p < .01) and NNAL (β[SE]: -0.14[±0.04]; F[1,92] = 12.2, p < .01) at Week-16. E-cigarette use frequency fully mediated the effects of condition on cigarettes/day and partially mediated effects on NNAL.</p><p><strong>Conclusions: </strong>Greater frequency of e-cigarette use was a mechanism by which preferred-flavor e-cigarettes led to reductions in smoking and tobacco-toxicant exposure, demonstrating the potential for appealing e-cigarettes to reduce harm among high-risk populations who smoke.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108353"},"PeriodicalIF":4.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592024","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}