Tobacco Control最新文献

{"title":"Transitions in tobacco product use involving combustible cigarettes, heated tobacco products and electronic cigarettes among 7 million South Korean adults: a prospective cohort study.","authors":"Youn Huh, Hae Rim Kim, Jung Ah Lee, Hong-Jun Cho","doi":"10.1136/tc-2026-060187","DOIUrl":"https://doi.org/10.1136/tc-2026-060187","url":null,"abstract":"<p><strong>Background: </strong>We investigated the roles of heated tobacco products (HTPs) and electronic cigarettes (ECs) in combustible cigarette (CCs) smoking initiation, relapse and cessation, as well as in all tobacco product discontinuation and transition of dual and triple use of CCs, HTPs and ECs.</p><p><strong>Method: </strong>Researchers analysed data from Korea National Health Insurance Service including 7 260 125 Korean adults who participated in three biennial health screenings between 2019 and 2023. Multivariable logistic regression analyses were performed to investigate the associations of HTPs and ECs use with initiation, relapse and cessation of CCs smoking and discontinuing all tobacco products, and transition probabilities were estimated to characterise changes in tobacco-use patterns.</p><p><strong>Results: </strong>Compared with participants who reported never using, those who reported current HTPs and ECs use had higher odds of initiation, relapse and cessation of CCs smoking, but lower odds of discontinuing all tobacco products. Among participants who reported dual use of CCs and HTPs, more than 70% transitioned to CCs' use. Complete cessation of all tobacco products was less common among dual and triple users of HTPs, ECs and CCs than among exclusive CC users.</p><p><strong>Conclusion: </strong>Although HTPs and ECs use was associated with increased CCs smoking cessation, these products drive higher rates of CC initiation and relapse and lower rates of complete tobacco cessation. Most users of multiple tobacco products revert to CCs smoking and are less likely to successfully quit all tobacco use. The net public health impact of these evolving tobacco use patterns in Korea remains uncertain.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115406","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":"Subsidising tobacco growing in North Macedonia: policy at a crossroads.","authors":"Biljana Tashevska, Tamara Mijovic Spasova, Bojana Mijovic Hristovska, Marija Trpkova-Nestorovska, Kristijan Kozheski, Borce Trenovski","doi":"10.1136/tc-2025-059680","DOIUrl":"https://doi.org/10.1136/tc-2025-059680","url":null,"abstract":"<p><strong>Background: </strong>North Macedonia consistently provides substantial direct subsidies for tobacco cultivation despite its commitments under the WHO Framework Convention on Tobacco Control and aspirations to align with the European Union's Common Agricultural Policy. This study examines tobacco subsidies and their implications on production trends, farmer behaviour and policy alignment.</p><p><strong>Methods: </strong>This study applies descriptive analysis to assess the economic significance of tobacco farming and subsidies and correlation analysis and Interrupted Time Series Analysis to estimate the relationship between production and financial incentives (price and subsidies). The study also draws on survey results to understand farmer attitudes towards tobacco growing and subsidies.</p><p><strong>Results: </strong>Tobacco remains North Macedonia's most subsidised crop, receiving around 40% of crop-related support. While subsidies appear to sustain production and significantly supplement farmer income, cultivated area and farmer participation are declining. Survey results provide further support that subsidies influence farmer behaviour and that without them most farmers would quit tobacco farming.</p><p><strong>Conclusion: </strong>North Macedonia allocates substantial public funds to tobacco subsidies aimed to support rural households and promote its valuable agricultural export, but this may not be the most economically prudent use of national resources. A strategic transition plan is essential to align agricultural policy with international commitments and health and sustainability goals. This includes measures for diversification and transition towards viable alternatives along with phased decoupling of subsidies. Successful implementation of reforms would be facilitated with farmer support for alternative livelihoods, a clear timeline of measures, stronger institutional capacity and investment in sustainable rural development.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115360","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":"Trends and predictors of tobacco product purchasing source in Australia.","authors":"Sisay Derso Mengesha, Cheneal Puljević, Dominique de Andrade, Coral E Gartner","doi":"10.1136/tc-2026-060347","DOIUrl":"https://doi.org/10.1136/tc-2026-060347","url":null,"abstract":"<p><strong>Background: </strong>This study examines trends in categories of tobacco suppliers to inform policy such as restricting the type of retailer permitted to sell tobacco.</p><p><strong>Methods: </strong>We analysed four waves of national cross-sectional survey data from 10 940 individuals who smoked tobacco from 2013 to 2022/2023. We report the proportion who obtained tobacco from informal sources, supermarkets, tobacconists, convenience stores and hospitality venues. Multinomial logistic regression examined factors associated with source relative to supermarkets.</p><p><strong>Result: </strong>Purchasing from supermarkets declined from 51% in 2013 to 35% in 2022/2023; convenience stores remained steady; hospitality venues stayed minimal; while obtaining from tobacconists (17-33%) and informal sources (10-14%) increased. Purchasing from tobacconists was associated with being male (adjusted relative risk ratios (aRRR)=1.15, 95% CIs 1.04 to 1.27) versus female, of low socio-economic status (aRRR=1.24, 95% CI 1.09 to 1.41) versus high metropolitan residence (aRRR=1.54, 95% CI 1.38 to 1.72) versus other and being retired from work (aRRR=1.20, 95% CI 1.04 to 1.38) versus employed. Informal sourcing was associated with younger age (18-24 years aRRR=1.69, 95% CI 1.16 to 2.0) versus older (65+ years) and smoking weekly (aRRR=2.94, 95% CI 2.28 to 3.78) or less than weekly (aRRR=11.57, 95% CI 9.27 to 14.45) versus daily. Informal sourcing (aRRR=1.44, 95% CI 1.20 to 1.74) and purchasing from tobacconists (aRRR=1.31, 95% CI 1.16 to 1.49) were associated with using illicitly traded tobacco.</p><p><strong>Conclusion: </strong>Tobacconists have become a major supplier of tobacco in Australia. Purchasing from tobacconists is associated with sociodemographic, behavioural factors and use of illicitly traded tobacco. Informal sources are increasing as a tobacco supply channel for young people and persons who smoke infrequently. Understanding these patterns may inform policies to reduce tobacco supply and availability.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115394","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":"Fast-moving consumer goods, slow-moving policy: structures and strategies of China's e-cigarette industry and global regulatory challenges.","authors":"Steve Shaowei Xu, Anne C K Quah, Geoffrey T Fong","doi":"10.1136/tc-2026-060270","DOIUrl":"https://doi.org/10.1136/tc-2026-060270","url":null,"abstract":"<p><strong>Background: </strong>China is the global centre for e-cigarette (EC) manufacturing. While regulatory responses have increasingly incorporated supply-side enforcement measures, research examining the supply-side dynamics of the global EC market remains limited.</p><p><strong>Methods: </strong>Using the tobacco industry globalisation framework of Lee and Eckhardt, we examined the globalisation of the Chinese EC industry across three domains: current status, globalisation strategies and structural organisation. Analyses drew on publicly available industry reports, government documents, academic literature, corporate records and media sources in English and Chinese.</p><p><strong>Results: </strong>China dominates the global EC market, producing over 90% of the world's ECs, including those that are sold by transnational tobacco companies (TTCs) (eg, Vuse, Njoy) and those that are sold by Chinese companies, notably high-volume disposable ECs (eg, Elf Bar, Puff Bar) and exports these products to more than 160 countries. Chinese EC firms operate under a fast-moving consumer goods (FMCG) model characterised by rapid product turnover, extensive flavour and design variation and short innovation cycles, in many respects the inverse of the TTC business model. A vertically integrated manufacturing ecosystem centred in Shenzhen enables low-cost production and rapid regulatory adaptation. Domestic regulations imposed on Chinese ECs in 2022 appear to have further accelerated global expansion, while complex corporate structures obscure accountability. We present examples illustrating how regulations premised on the assumption that ECs behave like cigarettes have failed to keep pace with this industry.</p><p><strong>Conclusions: </strong>The globalisation of Chinese EC companies challenges prevailing tobacco control paradigms. FMCG-style production, rapid product iteration and effective supply chains enable circumvention of regulations. More effective responses require coordinated, supply-side-informed approaches that strengthen oversight of manufacturing, distribution and cross-border trade.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075825","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":"Global analysis of regulatory definitions of tobacco and nicotine-containing products.","authors":"Ahmad Abbadi, Tamam Alnaimat, Jawad Al Nahar, Larissa Al-Uar, Randa K Saad, E Ulysses Dorotheo, Nour Obeidat, Raouf Alebshehy","doi":"10.1136/tc-2026-060170","DOIUrl":"https://doi.org/10.1136/tc-2026-060170","url":null,"abstract":"<p><strong>Introduction: </strong>The proliferation of nicotine-containing products challenges global tobacco control progress. National regulations often rely on product definitions to enforce restrictions or prohibitions. Incomplete legal definitions can leave certain products unregulated, undermining public health efforts. We analysed how countries define tobacco and nicotine-containing products in national laws to map current regulatory coverage.</p><p><strong>Methods: </strong>We reviewed tobacco control-related national laws of the 189 Signatories and Parties to the WHO Framework Convention on Tobacco Control (FCTC), assessing the presence of specific definitions of tobacco products, nicotine, nicotine-containing products and the subcomponents of these definitions. Up-to-date national laws published until 31 December 2024 were collected using online search engines and publicly available information, primarily from https://www.tobaccocontrollaws.org/, published in English, existing translations or translated into English from local languages. We employed a qualitative aggregation of the legal definitions to map the central categories and divergent approaches across countries.</p><p><strong>Results: </strong>In the analysis, 231 laws from 189 countries were included. Of these countries, 169 (89%) had an explicit definition of tobacco products, while 76 (40%) defined nicotine, 18 (10%) defined nicotine-containing products and 91 (48%) defined specific nicotine-containing products. Only 56 (30%) had a definition of tobacco products covering all components mentioned in the FCTC's definition, 68 (36%) named specific products within the definition, 24 (13%) included electronic nicotine delivery systems, 13 (7%) included any nicotine-containing product and 5 (3%) included electronic non-nicotine delivery systems. The most commonly defined nicotine-containing product group was electronic-cigarettes or their liquids: 61 (32%).</p><p><strong>Conclusions: </strong>This study reveals heterogeneity in how countries define tobacco and nicotine-containing products. While the 2003 FCTC definition provides a foundational baseline, the rapid proliferation of nicotine-containing products may have prompted countries to expand their legal definitions in divergent ways. These discrepancies may create loopholes that could be exploited by the nicotine and tobacco industry to undermine and avoid regulations.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017956","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":"Association of early-stage COVID-19 policy changes with smoking cessation outcomes: secondary analysis of two randomised trials in Hong Kong.","authors":"Aaron Wan Jia He, Nga Ting Wong, Man Ping Wang, Sophia Siu Chee Chan, Yee Tak Derek Cheung","doi":"10.1136/tc-2025-059954","DOIUrl":"https://doi.org/10.1136/tc-2025-059954","url":null,"abstract":"<p><strong>Aim: </strong>To examine whether smoking cessation outcomes among Chinese-speaking adults who smoked and used community-based smoking cessation services in Hong Kong differed before and after early-stage COVID-19 policy changes.</p><p><strong>Design: </strong>Secondary analysis of two randomised controlled trials, comprising one individually randomised trial and one cluster randomised trial, conducted in Hong Kong between 2018 and 2021.</p><p><strong>Setting: </strong>Participants who used a community-based smoking cessation service were recruited.</p><p><strong>Participants: </strong>1762 Chinese-speaking adults who smoke or recently quit smoking (80.5% male).</p><p><strong>Measures: </strong>The primary outcome was the 6-month biochemically validated abstinence rate before and after the first major policy change on 25 January 2020, when the COVID-19 emergency response level was raised. Secondary outcomes were self-reported 7-day point prevalence abstinence at 3-month and 6-month follow-ups. Sensitivity analyses were conducted for subsequent policy changes on 8 February and 28 March 2020. Modified Poisson regression models with cluster-robust SEs, adjusted for group allocation, trial, age, gender, baseline smoking intensity and intervention type, were used.</p><p><strong>Findings: </strong>After the 25 January 2020 policy cut-off, the 6-month biochemically validated abstinence rate significantly decreased from 12.3% before the cut-off to 6.8% (risk ratio (RR) (95% CI) 0.55 (0.40 to 0.76), p<0.001) after the cut-off. Self-reported 7-day abstinence rates were also lower after the policy change at the 3-month (49.1% vs 31.3%, 0.60 (0.51 to 0.71), p<0.001) and 6-month (41.0% vs 32.2%, 0.78 (0.69 to 0.88), p<0.001) follow-ups. Sensitivity analyses using the 8 February and 28 March cut-off points showed generally consistent reductions in abstinence outcomes.</p><p><strong>Conclusion: </strong>Early-stage COVID-19 policy changes in Hong Kong were associated with significantly lower tobacco abstinence rates among adults using or being referred to community-based smoking cessation services. Rapidly adaptable cessation support, including telehealth counselling and continuity of pharmacotherapy, is needed to sustain quit attempts during public health emergencies.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002466","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":"Mexican illicit cigarette market in 2023: a follow-up study.","authors":"Belen Saenz-de-Miera, Luz Myriam Reynales-Shigematsu, Ignacio Mendez Gomez-Humaran, Graziele Grilo, Kevin Welding","doi":"10.1136/tc-2026-060107","DOIUrl":"https://doi.org/10.1136/tc-2026-060107","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, research on illicit tobacco trade in low- and middle-income countries has expanded considerably. In Latin America, independent studies have been conducted in at least seven countries, including Mexico, where the illicit cigarette market was estimated at 8.5% in 2017, with wide variation across cities. However, longitudinal evidence remains scarce because collecting comparable data over time is challenging. This follow-up study, conducted in 2023, provides one of the few longitudinal assessments available in the region.</p><p><strong>Methods: </strong>Discarded cigarette packs were collected between January and March 2023 across 126 randomly selected Basic Geostatistical Areas (AGEB, <i>Área Geoestadística Básica</i>) in 11 Mexican cities (the 8 surveyed in 2017 plus 3 additional cities). A total of 12 607 packs were classified according to compliance with national packaging requirements, brand legality and the presence of the tax code. Statistical tests adjusted for the sampling design were used to compare proportions.</p><p><strong>Results: </strong>In 2023, the estimated share of illicit cigarettes across the study cities was 18.2%, ranging from <1% to 43.4%. Among the eight cities with follow-up data, illicit trade increased from 8.5% in 2017 to 20.4% (p<0.001). Estimates were consistent across the three legality definitions, except in one city where a local legal brand frequently lacked the tax code.</p><p><strong>Conclusion: </strong>The substantial variation in both magnitude and evolution across cities suggests that factors beyond taxation influence illicit trade. Mexico should implement a comprehensive strategy to combat illicit trade, including the ratification of the Protocol to Eliminate Illicit Trade in Tobacco Products.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002556","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":"Your rights versus my rights: Australian media representation of smoking and secondhand smoke in homes.","authors":"Germaine Lai, Coral E Gartner, Kylie Morphett","doi":"10.1136/tc-2026-060152","DOIUrl":"https://doi.org/10.1136/tc-2026-060152","url":null,"abstract":"<p><strong>Background: </strong>Internationally, there has been growing interest in expanding smoke-free environments to include residential settings. Historically, smoke-free policies have been framed as a controversial social issue in the media and this framing can deter policy action in advancing smoke-free homes. Previous studies have examined the media discourse on smoke-free policies in public or semiprivate settings but none in residential settings. We explored how the Australian media has framed smoking and secondhand smoke drift issues in residential settings over a 10-year period.</p><p><strong>Methods: </strong>We searched the Factiva database and used Google News search engine to identify relevant Australian news articles that reported on smoking or smoke-drift-related issues in housing contexts, published between 2015 and 2024. We conducted a content analysis of all included articles to determine temporal trends in article characteristics and used thematic analysis on a subset of articles to explore the news frames used.</p><p><strong>Results: </strong>We identified 220 relevant news articles and the majority were published between 2015 and 2017 (57%). Most articles contained supportive views about policy change to address smoke-drift in homes (61%) and discussed smoke-drift in multiunit housing contexts (72%). The articles predominantly cited spokespersons from non-governmental health organisations (44%). In a subsample of articles (n=89), we identified three dominant news frames: moral contention between individual rights, power imbalances and the realities of smoke-drift and government responsibility to protect public health.</p><p><strong>Conclusions: </strong>Our findings suggest that the media portrayed smoke-drift in homes as fundamentally conflictual and primarily a 'rights-based' conflict between individuals. This framing may deter policy action to provide comprehensive protection from residential smoke-drift.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888443","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":"MPOWER policy intensity and the global burden of smoking-attributable respiratory cancers: lag-aligned inequality regressions with Bayesian age-period-cohort projections (1990-2050).","authors":"Anqi Guan, Xianyao Wang, Xi Chen","doi":"10.1136/tc-2025-059983","DOIUrl":"https://doi.org/10.1136/tc-2025-059983","url":null,"abstract":"<p><strong>Background: </strong>Smoking-related respiratory cancers, including lung, laryngeal and nasopharyngeal cancers, remain a major global public health challenge. The WHO MPOWER framework has guided international tobacco control, but most evaluations have focused on smoking prevalence and cessation rather than disease-specific burden. The present study introduces an ecological, lag-aligned inequality regression framework, linking MPOWER policy scores with age-standardised disability-adjusted life-years (DALYs) of smoking-related respiratory diseases derived from the Global Burden of Disease (GBD) study.</p><p><strong>Materials and methods: </strong>We quantified the global burden of smoking-attributable respiratory cancers from 1990 to 2021 using GBD 2021 estimates, the WHO MPOWER policy database and World Bank ageing statistics. We analysed age-standardised mortality rates (ASMRs) and age-standardised DALY rates (ASDRs) by sex and region and projected trends to 2050 with a BAPC model. For the policy analysis, we ran associational, ecological, lag-aligned global inequality regressions, regressing the annual cross-country 90-10 ASDR gap (Δq_t) on the global-mean MPOWER score and global-mean ageing aligned by lags.</p><p><strong>Results: </strong>Smoking-attributable ASDRs and ASMRs declined from 2008 to 2021, although disparities by sex and region persisted. BAPC projections suggest continued decline through 2050, particularly among women. Countries with higher MPOWER scores, especially for Monitor, Protect and Enforce measures, were associated with narrower ASDR gaps with slower progress among men.</p><p><strong>Conclusion: </strong>Our findings suggest that robust MPOWER implementation is associated with reduced inequality in smoking-related cancer burden. Prioritising monitoring, protective measures and enforcement, while tailoring strategies by sex and age, may further accelerate the reductions. Future studies with unit-level data are needed to strengthen causal inference.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881459","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":"Role of e-cigarette nicotine concentration in longitudinal transitions between cigarette, e-cigarette and dual use.","authors":"Hongying Daisy Dai, Abraham Degarege, Paula R Guastello","doi":"10.1136/tc-2026-060086","DOIUrl":"10.1136/tc-2026-060086","url":null,"abstract":"<p><strong>Objective: </strong>E-cigarette nicotine concentration level is critical to tobacco regulation. This study seeks to examine whether nicotine level is associated with transitions in tobacco use status such as exclusive cigarette, exclusive electronic (e-)cigarette, dual and no use.</p><p><strong>Methods: </strong>Using a large, nationally representative cohort from the Population Assessment of Tobacco and Health (PATH) study in the USA, we compared changes in the prevalence of tobacco use status at 1-year follow-up (Wave 7) based on level of e-cigarette nicotine exposure at baseline (Wave 6). Self-reported nicotine concentration was categorised into high (5.0% or more), moderate (1.8-4.9%), low (0.1-1.7%), 0% and 'I don't know'.</p><p><strong>Results: </strong>Among those using e-cigarettes at baseline, those using products containing nicotine (≥0.1%) were more likely to continue exclusive e-cigarette use at follow-up than those using 0% or unknown nicotine content. Among those reporting dual use at baseline, nearly half continued dual use at follow-up regardless of nicotine concentration. However, those using higher nicotine concentrations (≥1.8%) were more likely to either switch to exclusive e-cigarettes or quit entirely indicating greater harm reduction than those using low-nicotine or no-nicotine products. In contrast, nearly half with baseline dual use and 0% nicotine transitioned to exclusive cigarette smoking.</p><p><strong>Conclusion: </strong>These findings highlight the complex relationship between e-cigarette nicotine concentration and tobacco use transitions. Regulatory and public health approaches may benefit from balancing the potential harm reduction role of nicotine-containing e-cigarettes for adults who smoke with concerns regarding sustained nicotine dependence and long-term e-cigarette use.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353686","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}