Tobacco Use Insights最新文献

{"title":"Equity Promoting Features of Smoking Cessation Interventions Delivered in Pregnancy: An Intervention Component Analysis of a Systematic Review.","authors":"Claire Tatton, G J Melendez-Torres","doi":"10.1177/1179173X261477246","DOIUrl":"10.1177/1179173X261477246","url":null,"abstract":"<p><strong>Objective: </strong>Despite reductions in rates of smoking in pregnancy in most high-income countries, disparities persist between those from different socioeconomic backgrounds and ethnic groups. Our recent systematic review that sought to understand the equity impacts of psychosocial interventions indicated effectiveness of tailored interventions for prenatal smoking cessation and postnatal abstinence, but with significant unexplained heterogeneity. We conducted this review to explore how interventions were tailored and why some may work better than others.</p><p><strong>Methods: </strong>We used intervention component analysis to characterise the features of tailored interventions. We conducted meta-analyses for prenatal smoking cessation (second or third trimester) and postnatal abstinence (<12 months from childbirth) and ran meta-regressions to explore how components may relate to effectiveness.</p><p><strong>Results: </strong>We included 70 papers related to 54 randomised controlled trials. We identified 39 components common to both tailored and universal interventions and 26 components unique to tailored interventions. Equity focussed components sought to improve the relevance of the intervention, and to improve accessibility through intervention position. Meta-analyses indicated effectiveness for both prenatal smoking cessation and postnatal abstinence (odds ratio [OR] 1.47, 95% CI 1.32 - 1.63 and OR 1.30, 95% CI 1.13 - 1.49). However, meta-regressions showed no conclusive evidence that any individual tailored intervention component produced differential effectiveness. This may be due to insufficient statistical power resulting from the limited number of trials containing some of the components reported.</p><p><strong>Conclusion: </strong>Our analysis provides a framework to understand what options could be used to tailor interventions to underserved groups. These include offering adapted communication, habit building approaches and social network support, improving relationships with providers, and reducing practical barriers to engagement. Further testing is warranted to more accurately assess how approaches may relate to effectiveness, and for who.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261477246"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Drivers, Modes of Use, and Perceived Harms of Traditional and Non-Traditional Smokeless Tobacco Use in South Africa: A Qualitative Study.","authors":"Senamile P Ngobese, Olalekan A Ayo-Yusuf, Catherine O Egbe","doi":"10.1177/1179173X261480537","DOIUrl":"10.1177/1179173X261480537","url":null,"abstract":"<p><strong>Introduction: </strong>Smokeless tobacco (SLT) is used not only for recreation, but also for traditional healing, spiritual practices, and medicinal purposes. Understanding the motivations and lived experiences underlying these diverse forms of use is important for developing culturally-appropriate tobacco control interventions. This study explored the drivers, mode of use, perceived harms and lived experiences associated with traditional and non-traditional SLT use among adults in KwaZulu-Natal, South Africa.</p><p><strong>Methods: </strong>A qualitative phenomenological design was used. In-depth interviews were conducted with 25 adults who used SLT primarily for traditional purposes (traditional health practitioners [THPs] and trainees/initiates [n=12]) or non-traditional purposes (n=13). Participants were recruited using convenience, purposive and snowball sampling. All interviews were audio-recorded, transcribed verbatim, translated where necessary, and analysed thematically using Braun and Clarke's six-phase framework aided by NVivo v12.</p><p><strong>Results: </strong>Four key themes emerged: motivations for SLT use, modes and practices of use, experienced harms, and perceptions of harmfulness. Traditional users described SLT use as part of ancestral communication, initiation into traditional healing, ritual practices, and traditional treatment. Non-traditional users reported using SLT for stress relief, perceived medicinal benefits, sexual enhancement, affordability compared with smoking, and social influence. Multiple modes of use were reported, including oral, nasal, intravaginal, and external ritual use. Participants described health-related, social, and financial harms associated with SLT use. However, some traditional users perceived SLT used within traditional healing contexts as protected from harm through ancestral or spiritual authority.</p><p><strong>Conclusion: </strong>SLT use in KwaZulu-Natal is shaped by cultural, spiritual, medicinal, psychological, sexual, and economic motivations. Although participants reported multiple harms, cultural beliefs and perceptions of spiritual protection may influence risk perceptions and continued use. Public health interventions should address both the health risks of SLT and the cultural meanings attached to its use while engaging THPs and communities in developing culturally-acceptable prevention and cessation approaches.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261480537"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Tobacco Product Use and Cessation Behaviors Among People Who Use Opioids: Implications for Integrated Harm Reduction Services.","authors":"Sandesh Bhusal, Kiran Paudel, Jeffrey A Wickersham, Kamal Gautam, Md Safaet Hossain Sujan, Reyusha Chalise, Toan Ha, Tara Ballav Adhikari, Roman Shrestha","doi":"10.1177/1179173X261483910","DOIUrl":"10.1177/1179173X261483910","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco use, particularly cigarette smoking, is disproportionately high among people who use opioids (PWUO). Although harm reduction programs provide trusted, low-barrier, and repeated contact with PWUO, tobacco cessation support is not routinely integrated into these settings. We assessed current use of different forms of tobacco products and smoking cessation behaviors among PWUO and considered implications for integrating tobacco cessation into harm reduction services.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among PWUO attending a syringe service program (SSP) in New Haven, Connecticut (N=200) between November 2025 and March 2026. We used questionnaires adopted from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) to assess current tobacco product use (i.e., cigarettes, e-cigarettes, cigars, smokeless tobacco, and pipes). We used descriptive statistics to report current tobacco product use, cessation-related behaviors, and other participant characteristics.</p><p><strong>Results: </strong>Participants had a mean age of 46.9 (± 10.9) years, 66.5% (n=133) were male, and 65.5% (n=131) were currently homeless. Most participants screened positive for opioid dependence (92.0%, n=184), and 65.0% (n=130) were currently receiving prescribed medication for opioid addiction. Nearly all participants [97.5% (n=195)] reported current use of any tobacco product. Prevalence of current use of each tobacco product was as follows: cigarettes (96.0%, n=192), e-cigarettes (73.5%, n=147), cigars (29.5%, n=59), smokeless tobacco (18.5%, n=37), and pipes (16.5%, n=33). Among current smokers, 87.5% (n=168/192) reported interest in quitting, and 37.5% (n=72/192) reported a past-year quit attempt.</p><p><strong>Conclusions: </strong>This study demonstrated a high prevalence of tobacco use among PWUO, while most current smokers reported interest in quitting. Integrating tobacco cessation support into harm reduction programs, such as SSP and addiction treatment settings, represents a critical, yet underutilized, opportunity to address this unmet need and improve health outcomes in this vulnerable population.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261483910"},"PeriodicalIF":1.8,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beliefs About e-Cigarette Regulation Among a Cohort of Long-Term Adult Users: A Thematic Analysis.","authors":"Gail C D'Souza-Rushton, Candace R Bordner, Sophia I Allen, Nicolle M Krebs, Andrea Hobkirk, Jonathan Foulds, Jessica M Yingst","doi":"10.1177/1179173X261476227","DOIUrl":"10.1177/1179173X261476227","url":null,"abstract":"<p><strong>Introduction: </strong>The United States Food and Drug Administration (FDA) is a regulatory authority with the ability to regulate tobacco products, including electronic cigarettes (e-cigarettes). Few studies have investigated the beliefs and attitudes about e-cigarette regulation, from the perspective of long-term users of e-cigarettes. The purpose of the current study was to understand the beliefs about e-cigarette regulation among former and current users of e-cigarettes using a qualitative approach.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among a cohort of former and current users of e-cigarettes in 2022 which contained open-ended questions about perceptions of e-cigarette regulation. Participants were asked about their e-cigarette use, whether the FDA should regulate e-cigarettes (yes/no), and responded to an open-ended question about their opinions of FDA regulation/non-regulation of e-cigarettes. Means and frequencies were used to describe the sample, and all open-ended responses were imported into MAXQDA software. Open-ended responses were analyzed using thematic analysis.</p><p><strong>Results: </strong>Participants (n=172) were 93.0% White, 66.3% male, and 73.3% were people who currently use e-cigarettes. More than half (51.7%) of participants reported they do not believe the FDA should regulate e-cigarettes, while 48.3% of participants reported they believe that the FDA should regulate e-cigarettes. Opponents of e-cigarette regulation felt it would lead to over-regulation and politicization. On the other hand, those with supportive views felt that FDA regulation would ensure the safety of e-cigarette products.</p><p><strong>Conclusion: </strong>Our findings suggest that this cohort of long -term users of e-cigarettes believe FDA regulation will affect the availability of e-cigarette products, making it harder to quit smoking or to avoid relapsing to traditional cigarettes. User perceptions highlighted that the FDA should assess the health impact of e-cigarette products and their influence on smoking cessation efforts among smokers who had otherwise been unable to quit.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261476227"},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Cigarette Affordability and Demographic Determinants of Cigarette Consumption in Vietnam From 2020 to 2024.","authors":"Hoang Van Minh, Tran Tuan Anh, Tran Thi Tuyet Hanh, Dao The Son, Phan Thi Hai, Duong Tu Anh, Vu Duc Loi, Le Tu Hoang, Nguyen Thi Minh Thanh, Phan Van Can","doi":"10.1177/1179173X261460130","DOIUrl":"https://doi.org/10.1177/1179173X261460130","url":null,"abstract":"<p><strong>Background: </strong>Despite various tobacco control efforts, cigarette affordability remains a significant challenge in Vietnam as rapid economic growth outpaces static excise tax rates. This study examined the determinants of smoking intensity, focusing on the comparative impact of absolute expenditure versus relative affordability.</p><p><strong>Methods: </strong>Data from two waves of the Provincial Global Adult Tobacco Survey (PGATS 2020 and PGATS 2024) were analysed using multivariable linear regression and validated via Negative Binominal models to assess the association of the Relative Income Price (RIP), monthly cigarette expenditure, and sociodemographic characteristics with daily cigarette consumption.</p><p><strong>Results: </strong>Between 2020 and 2024, the median price per pack of cigarettes rose slightly from 7,407 VND to 8,667 VND, yet the median RIP decreased from 0.90% to 0.75%, indicating increased affordability. Rural smokers reported higher daily consumption (13 vs. 10 sticks) despite paying lower prices than urban smokers. Regression analysis showed that RIP was a powerful predictor of consumption; a 1% increase in RIP was associated with a reduction of 0.68 cigarettes per day (p < 0.01). The affordability model demonstrated greater explanatory power than the expenditure model (R² = 0.08 vs. 0.02). Demographic findings revealed that smoking intensity peaked among those aged 45-64 and was significantly lower among women and university graduates (p < 0.01).</p><p><strong>Conclusion: </strong>Relative affordability, rather than absolute price, was the primary economic determinant of smoking intensity in Vietnam. The continuous 15-year decline in RIP highlights a systemic failure of the current ad valorem tax structure to keep pace with sustained economic growth. Findings highlight an urgent need to transition to a hybrid tax system to ensure that price increases consistently outpace income growth.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261460130"},"PeriodicalIF":1.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic Identity or Religiosity? Unpacking Protective Association With Tobacco Use Among Arab Americans.","authors":"Queenne Kimverlee C Landingin","doi":"10.1177/1179173X261480539","DOIUrl":"https://doi.org/10.1177/1179173X261480539","url":null,"abstract":"","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261480539"},"PeriodicalIF":1.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Structure and Peer Influences as Correlates of Lifetime Smokeless Tobacco Use Among Undergraduate Students at The University For Development Studies, Ghana: An Analytical Cross-Sectional Study.","authors":"Yula Salifu, Torjim Salifu, Amidu Alhassan, Frank Odonkor Offei, Joseph Lasong","doi":"10.1177/1179173X261478963","DOIUrl":"10.1177/1179173X261478963","url":null,"abstract":"<p><strong>Background: </strong>Smokeless tobacco (SLT) use is a growing public health concern among young adults in sub-Saharan Africa. Evidence on family-level factors associated with lifetime SLT use among university students in Ghana is lacking. This study estimated the lifetime prevalence of SLT use and identified associated factors, focusing on family structure, among undergraduates at the University for Development Studies (UDS), Tamale, Ghana.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted (January-March 2023) among 600 undergraduate students at UDS (response rate 85.7%). Data were collected using a locally adapted WHO student drug-use survey. Subgroup prevalence was calculated with 95% Wilson score confidence intervals. Between-group differences were assessed using the chi-square test or Fisher's exact test where the corresponding expected cell count was fewer than five. Factors associated with lifetime SLT use were identified using Firth penalised logistic regression, with standard logistic and modified Poisson regression as sensitivity analyses.</p><p><strong>Results: </strong>Lifetime SLT prevalence was 9.67% (95% CI: 7.54-12.31%). In the primary multivariable analysis, having friends who used drugs during upbringing (aOR = 1.84; 95% CI: 1.02-3.32; p = 0.043) and having relatives who used drugs during upbringing (aOR = 1.82; 95% CI: 1.01-3.27; p = 0.045) were independently associated with lifetime SLT use. Associations were consistent across all three regression models.</p><p><strong>Conclusions: </strong>Early-life exposure to drug use within peer and family networks is independently associated with lifetime SLT use among university students at UDS, Ghana. Family-based and peer-focused prevention strategies may be useful in reducing SLT use in this context.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261478963"},"PeriodicalIF":1.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Tobacco Cessation Counselling in Primary Care: A Mixed-Methods Evaluation of the Shared Decision-Making Model.","authors":"Ines Habfast-Robertson, Anne Boesch, Christina Hempel-Bruder, Marie-Anne Durand, Hubert Maisonneuve, Michael Amiguet, Ivan Berlin, Kevin Selby","doi":"10.1177/1179173X261477253","DOIUrl":"10.1177/1179173X261477253","url":null,"abstract":"<p><strong>Background: </strong>Smoking cessation aids are under-prescribed in primary care. General practitioners (GPs) might prescribe more smoking cessation aids if they focused on the choice between treatments as the default, rather than using motivational interviewing that focuses on whether to make a quit attempt.</p><p><strong>Objectives: </strong>Explore the self-reported adoption and impressions of shared-decision making (SDM) for smoking cessation treatments using a decision aid amongst GPs who received intervention or control trainings.</p><p><strong>Design: </strong>Mixed quantitative-qualitative convergent analysis of self-reported behaviours from GPs in a pragmatic, cluster-randomized trial conducted between 2021-2023 in Switzerland and France.</p><p><strong>Methods: </strong>The intervention training encouraged GPs to offer a choice of smoking cessation aids as the default choice using a decision aid (sustained intervention). The control training presented cessation aids without encouraging GPs to change how they discuss smoking cessation. Implementation was measured using questionnaires before and after the trainings, then at 6- and 12-month follow-up. Self-reported behaviours were quantitatively analysed using logistic regression adjusting for baseline responses. Experiences using SDM and default choice were explored through semi-structured interviews.</p><p><strong>Results: </strong>A total of 43 GPs completed questionnaires (26 women (60%), age range 30-59 years) and 12 an interview. The intervention group reported more sustained interventions (OR 8.2 (CI 1.9-50)), use of the decision aid (OR 19.7 (CI 4.1-135)), and offer of treatments as the default choice than the control group (OR 6.4 (CI 1.4-40)) at 12-month follow-up. Small sample size bias was addressed by using Firth's methodology. In interviews, GPs in the intervention group highlighted the utility of the decision aid and the importance of adapting the default approach to the context of individual patients.</p><p><strong>Conclusion: </strong>GPs in the intervention group reported more often initiating treatment discussions with patients who smoke using a decision aid, but not more prescriptions. The default approach was not appropriate for all patients.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261477253"},"PeriodicalIF":1.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Acculturation: Reinterpreting Ethnic Identity as an Identity-Mediated Pathway in Tobacco-use Behavior Among Arab Americans.","authors":"Jomel M Mabborang","doi":"10.1177/1179173X261478435","DOIUrl":"10.1177/1179173X261478435","url":null,"abstract":"","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261478435"},"PeriodicalIF":1.8,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quitting Shisha Smoking Among Young Adults in Germany: Insights From an Online Survey on Sociodemographic, Perceptual and Behavioural Economic Factors Associated With Quit Attempts.","authors":"Cynthia Fedler, Daniel Kotz, Markus Vomhof, Stephanie Klosterhalfen","doi":"10.1177/1179173X261454173","DOIUrl":"10.1177/1179173X261454173","url":null,"abstract":"<p><strong>Introduction: </strong>Shisha smoking is common among young adults despite well-documented health risks. Evidence on factors linked to quit attempts among shisha smokers is limited. We examined sociodemographic, consumption-related, harm-perception, and behavioural-economic correlates of quit attempts in Germany.</p><p><strong>Methods: </strong>We analysed baseline data from the SHISHA study (01/2024-12/2025), a pilot online survey of adults aged 18-40 years in Germany. Participants were recruited via social media, schools, and flyers. Associations with quit attempts were examined using univariable logistic regressions.</p><p><strong>Results: </strong>Of 1,134 respondents, 570 identified themselves as current shisha smokers, and 504 provided valid data on quit attempts. The median age was 24 years; 68.3% were male and 30.2% female. Overall, 14.6% (95% CI = 11.9-17.8) of current shisha smokers reported having ever attempted to quit. Perceived dependence was the only variable significantly associated with quit attempts: those rating it unlikely to be or become addicted had higher odds of having attempted to quit than those rating it likely (OR = 2.05, 95% CI: 1.26-3.32). No significant associations were observed for sociodemographic characteristics, consumption patterns, perceived health risk, or behavioural-economic measures; descriptively, quit attempters showed more risk-averse choices.</p><p><strong>Discussion: </strong>In Germany, people who smoke shisha are typically young adults and have never attempted to quit. The observed association between low perceived dependence and the absence of quit attempts leaves open whether perceived dependence drives cessation behaviour or whether previous quit attempts shape individuals' perception of their own dependence.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261454173"},"PeriodicalIF":1.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}