Tobacco Use Insights最新文献

{"title":"Preferred Sources of Health-Risk Information About Cigarettes, e-Cigarettes, and Waterpipes Among Adolescents in Germany: A Cross-Sectional Analysis of a Large School-Based Survey.","authors":"Stephanie Klosterhalfen, Cynthia Fedler, Reiner Hanewinkel, Clemens Neumann, Julia Hansen","doi":"10.1177/1179173X261473915","DOIUrl":"10.1177/1179173X261473915","url":null,"abstract":"<p><strong>Background: </strong>Adolescent nicotine use remains a major public health concern, particularly in the context of increasing e-cigarette uptake and gaps in tobacco-control communication. Effective prevention requires evidence on the information channels through which adolescents prefer to receive risk information about tobacco and nicotine products.</p><p><strong>Objectives: </strong>This study examined adolescents' preferred sources for receiving information about the health risks of cigarettes, e-cigarettes, and waterpipes in Germany, and assessed differences by age, gender, school type, and nicotine-use status.</p><p><strong>Design: </strong>Cross-sectional analysis of a large nationwide school-based survey across 14 of 16 German federal states.</p><p><strong>Methods: </strong>Data were drawn from the 2024/2025 wave of the Präventionsradar study and included 21,841 adolescents aged 9-17 years from 116 schools and 1,712 classes across 14 German federal states. Weighted descriptive analyses and multilevel logistic regression models were used to examine preferred information sources and information refusal. Models were adjusted for age, gender, school type, and current nicotine-product use, with random intercepts at the class level.</p><p><strong>Results: </strong>Parents (30.2%), social media (21.5%), and physicians (18.6%) were the most frequently selected information sources. Younger adolescents more often selected parents, whereas older adolescents more often selected social media and peers. Adolescents currently using at least one tobacco or nicotine product were more likely to select friends and less likely to select parents, teachers, or physicians. They were also more likely to report not wanting health information. Information refusal was additionally associated with male gender and lower academic track.</p><p><strong>Conclusion: </strong>Adolescents' preferred sources of tobacco- and nicotine-related health information differ substantially by sociodemographic characteristics and nicotine-use status. These findings may inform the development of differentiated and multimodal communication strategies.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261473915"},"PeriodicalIF":1.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697972","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":"Technology Access, Pattern of Use, Interest in Digital Health, and Barriers to Tobacco Treatment Among HIV-Infected Smokers From Under-Resourced Communities: A Cross-Sectional Study.","authors":"Olusanya J Oluwole, Tulay Koru-Sengul, Deborah L Jones, Maria L Alcaide, David J Lee, Adam Carrico, Taghrid Asfar","doi":"10.1177/1179173X261473918","DOIUrl":"10.1177/1179173X261473918","url":null,"abstract":"<p><strong>Background: </strong>Cigarette smoking remains a major public health concern among people living with HIV (PLWH), particularly those from under-resourced communities. Digital health may improve access to cessation support, yet its potential among this population remains understudied.</p><p><strong>Objective: </strong>This study explored barriers to quitting smoking and evaluated the potential of digital health for tobacco treatment among PWLH smokers.</p><p><strong>Methods: </strong>We surveyed 205 PLWH who smoked cigarettes (45.4% female; mean age 51.2 years; response rate 92.3%) to examine smoking behaviors, cessation barriers, technology access, use pattern, and interest in digital health for tobacco treatment. Multivariable logistic regression models were employed to assess how demographics and smoking behaviors influence interest in using digital health (phone calls, text messages, smartphone applications, or combinations) for tobacco treatment.</p><p><strong>Results: </strong>Participants were primarily racial and ethnic minorities, including 55.1% non-Hispanic Black and 34.2% Hispanic individuals, with 74.4% earning less than $10,000 annually. Most participants reported previous quit attempts (76.5%). Common barriers to quitting included difficulty managing cravings (45.4%), cost of treatment (28.8%), and limited access to care (25.9%), while depression (58.9%) and risky alcohol use (39.6%) were also prevalent. Access to technology was high: 91.7% owned a cell phone, 61.0% owned a smartphone, and 63.9% reported internet access. Among smartphone owners, 74.0% used mobile applications. Phone calls were the most preferred single digital health modality for tobacco treatment (51.7%), followed by text messaging (43.9%), smartphone applications (39.0%), and video conferencing (38.5%). Preferred intervention methods included mindfulness strategies (73.0%), nicotine replacement therapy (71.1%), and counseling (63-65%). Non-Hispanic Black and non-heterosexual participants showed significantly higher interest in digital health for tobacco treatment, with aOR 5.49 (1.44 - 20.90) and 6.02 (1.46 - 24.82), respectively.</p><p><strong>Practice implications: </strong>Despite barriers, PLWH smokers are interested in digital health for tobacco treatment. Incorporating digital tools could improve access and reduce disparities in this population.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261473918"},"PeriodicalIF":1.8,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608443","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":"Strengthening Adolescent E-CIGARETTE Prevention Through Digital Literacy and Responsible Artificial Intelligence.","authors":"Darin Jan Tindowen, Djovi Durante, Richster John Macaballug, Flordeliza Gecobe, Joven Jacinto","doi":"10.1177/1179173X261473916","DOIUrl":"10.1177/1179173X261473916","url":null,"abstract":"","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261473916"},"PeriodicalIF":1.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563244","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: Ethnic Identity, Tobacco and Nicotine Product Use, and Health Among Arab Americans.","authors":"Sarah Alnahari, Arturo Durazo, Paul Brown, Anna Epperson","doi":"10.1177/1179173X261470168","DOIUrl":"10.1177/1179173X261470168","url":null,"abstract":"<p><strong>Background: </strong>Arab Americans are one of the fastest-growing immigrant populations in the United States, yet they remain largely invisible in tobacco surveillance and prevention efforts due to their classification as \"White\" in national data. Despite evidence of elevated tobacco use and chronic disease burden, limited research has examined how cultural, psychological, and social factors shape tobacco-related health risks in this community.</p><p><strong>Objectives: </strong>This study examined associations between ethnic identity, tobacco use, and health outcomes (self-rated health, chronic disease diagnosis) among Arab American adults, and tested whether ethnic identity moderated the association between tobacco use and health outcomes.</p><p><strong>Methods: </strong>In a cross-sectional study, a convenience sample of 112 Arab American adults residing in Central California completed a survey assessing ethnic identity, tobacco use, and health. Ethnic identity was measured using an abbreviated, Arabic-translated adaptation of Phinney's Multigroup Ethnic Identity Measure. Tobacco use was categorized as non-use, single-product use, or multi-product use. Multivariable regression models assessed associations and potential moderating effects of ethnic identity on health outcomes.</p><p><strong>Results: </strong>Over 48% of study participants reported current use, defined as at least some use or more, of at least one tobacco or nicotine product, including cigarettes, e-cigarettes (which may contain synthetic rather than tobacco-derived nicotine), and hookah. Higher ethnic identity scores were associated with significantly lower odds of tobacco use (adjusted OR = 0.35, 95% CI: 0.15-0.83). Single-product users had 75% lower odds of reporting better self-rated health compared to non-users (OR = 0.25, 95% CI: 0.07-0.96). No significant associations were found for multi-product use or chronic disease in adjusted models, and ethnic identity did not significantly moderate associations with health outcomes.</p><p><strong>Conclusion: </strong>Ethnic identity is associated with lower tobacco use among Arab Americans, though its protective effects on health outcomes remain less clear. These findings underscore the need to move beyond acculturation-based frameworks and incorporate identity-informed, culturally responsive approaches to tobacco control in marginalized immigrant communities.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261470168"},"PeriodicalIF":1.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521053","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":"A Meta-Analysis of Urinary Cotinine Cut-Off Concentrations in Children Under Five Years for Assessing Environmental Tobacco Smoke Exposure.","authors":"Sharifah Mazrah Sayed Mohamed Zain, Nadia Mohamad, Zurahanim Fasha Anual, Imanul Hassan Abdul Shukor, Wan Nurul Farah Wan Azmi","doi":"10.1177/1179173X261459432","DOIUrl":"10.1177/1179173X261459432","url":null,"abstract":"<p><strong>Background: </strong>Environmental tobacco smoke (ETS) exposure is a preventable risk factor for adverse health outcomes in early childhood. Urinary cotinine is widely used as a non-invasive biomarker of ETS exposure; however, variation in reported cut-off concentrations limits comparability across studies. No prior systematic review has quantitatively synthesised urinary cotinine cut-off values for children under five years. This review aimed to systematically summarise and evaluate these cut-off concentrations in early childhood.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines and a prospectively published protocol (PROSPERO CRD42024556969). PubMed, Embase, Scopus, and the Cochrane Library were searched from inception to February 2025. Observational and experimental studies reporting urinary cotinine cut-off concentrations to classify ETS exposure among children under five years were included. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed to estimate pooled urinary cotinine cut-off concentrations for ETS exposure classification, stratified by unit of measurement (ng/mL vs ng/mg creatinine).</p><p><strong>Results: </strong>Twelve studies were included. Reported urinary cotinine cut-off concentrations ranged from 0.05 to 30 ng/mL for unadjusted values and from 2.47 to 120 ng/mg creatinine for creatinine-adjusted values. Meta-analysis yielded pooled reference values of 5.90 ng/mL (95% CI: 5.53-6.27) and 50.36 ng/mg creatinine (95% CI: 47.53-53.20), respectively.</p><p><strong>Conclusion: </strong>Urinary cotinine is a valid biomarker for assessing ETS in young children, but inconsistent cut-off values limit comparability. The pooled estimates may aid interpretation in surveillance and research but should not be used as universal thresholds. Standardized, age-appropriate cut-offs are needed to strengthen exposure assessment and inform child-focused tobacco control policies.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261459432"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391497","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":"Advanced Readiness to Quit Smoking Among People Living With HIV Enrolled in a Smoking Cessation Trial in Hanoi, Vietnam: Associations With Risk Perception, Self-Efficacy, and Social Norms.","authors":"Thanh Ha-Lan Hoang, Gloria Guevara Alvarez, Nam Nguyen, Louise Adermark, Qinyun Lin","doi":"10.1177/1179173X261466277","DOIUrl":"10.1177/1179173X261466277","url":null,"abstract":"<p><strong>Background: </strong>In Vietnam, smoking remains highly prevalent among people living with HIV (PLWH), posing significant health risks. As PLWH receiving HIV care represent a selected population that may differ from the general smoking population, evidence on the psychosocial factors shaping readiness to quit in this group remains limited. This study examines the associations between tobacco-related risk perception, self-efficacy, and social norms with advanced readiness to quit among PLWH who smoke and were enrolled in a smoking cessation trial in Vietnam.</p><p><strong>Methods: </strong>We conducted a secondary cross-sectional analysis of baseline data from the VQUIT randomized controlled trial, including 672 PLWH who currently smoked cigarettes some days or every day, recruited from 13 HIV outpatient clinics in Hanoi, Vietnam. Advanced readiness to quit was defined as currently trying to quit or planning to quit within 30 days; all other responses were classified as lower or no readiness. Multivariable logistic regression models with robust standard errors, clustered at the clinic level, were fitted to examine associations between risk perception, self-efficacy, four social norm constructs, and advanced readiness to quit.</p><p><strong>Results: </strong>Overall, 76.6% of participants reported advanced readiness to quit. Higher risk perception was consistently associated with increased odds of advanced readiness to quit (aORs ranged 1.10 to 1.13 across models). Injunctive norms (aOR=1.11, 95% CI: 1.03-1.20) and internalized norms (aOR=1.40, 95% CI: 1.02-1.94) were positively associated with advanced readiness to quit, while descriptive and subjective norms were not. Self-efficacy showed no significant association.</p><p><strong>Conclusion: </strong>Among PLWH enrolled in a smoking cessation trial in Vietnam, higher risk perception and stronger injunctive and internalized norms were associated with advanced readiness to quit. Cessation interventions integrated into HIV care may benefit from addressing both perceived smoking-related risks and norm-based motivations to quit.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261466277"},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391469","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":"Sex-Specific Associations Between Smokeless Tobacco Use and <i>Staphylococcus aureus</i> Carriage in Norwegian Adolescents.","authors":"Dina B Stensen, Anna Karlsen, Gunnar Skov Simonsen, Anne-Sofie Furberg","doi":"10.1177/1179173X261461691","DOIUrl":"10.1177/1179173X261461691","url":null,"abstract":"<p><strong>Background/objectives: </strong><i>Staphylococcus aureus</i> (<i>S. aureus</i>) can cause life-threatening infections, with colonization often preceding infection. Understanding the determinants of <i>S. aureus</i> carriage may improve infection prevention. While smoking has been associated with <i>S. aureus</i> carriage, studies on smokeless tobacco products remain scarce. This study aimed to investigate whether the use of snuff (Swedish snus), a smokeless tobacco product, is associated with <i>S. aureus</i> carriage in adolescents.</p><p><strong>Design: </strong>We used data from Fit Futures 1, a population-based cross-sectional study including 1,038 participants (93% attendance).</p><p><strong>Methods: </strong>A total of 457 boys and 443 girls had data on snuff use and two nasal and throat swab cultures for <i>S. aureus</i> carriage assessment. Snuff use was defined as occasional or daily use. Logistic regression analysis was used to examine the association between snuff use and <i>S. aureus</i> carriage, with odds ratios (ORs) adjusted for known risk factors.</p><p><strong>Results: </strong>Snuff use was associated with a 64% higher odds of nasal carriage (95% CI = 1.18-2.26; carriage defined as one or two positive nasal cultures) compared to non-use. In sex-stratified analyses, this association was observed only among girls, with an adjusted OR of 1.62 (95% CI = 1.03-2.55; carriage defined as two positive nasal cultures) and an adjusted OR of 1.99 (95% CI = 1.25-3.16; carriage defined as one or two positive nasal cultures). Among girls using snuff, the adjusted OR for <i>S. aureus</i> throat carriage was 1.66 (95% CI 1.06-2.59; carriage defined as two positive throat cultures) compared to non-users.</p><p><strong>Conclusion: </strong>We identified an association between snuff use and <i>S. aureus</i> nasal and throat carriage among adolescent girls. Girls who used snuff had higher odds of <i>S. aureus</i> nasal (62%) and throat (66%) carriage compared to female non-users. Futures longitudinal studies are needed to clarify whether the observed associations reflect casual relationships.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261461691"},"PeriodicalIF":1.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346804","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":"Social Media Engagement, Youth E-Cigarette Use, and the Moderating Potential of Harm Perceptions.","authors":"Emily Jackman, Jason J Burrow-Sánchez, Allison Cohen","doi":"10.1177/1179173X261460121","DOIUrl":"10.1177/1179173X261460121","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent electronic cigarette use is a significant public health concern due to its potential for negative health effects and prevalence among youth. The primary aim of the current study is to examine the moderation effect of perceived harm (i.e., low versus high) on the relation between passive and active social media use and past 30-day adolescent e-cigarette use. We hypothesized that the relation between type of social media use and e-cigarette use would be contingent on the level of perceived harm.</p><p><strong>Aims and method: </strong>This study was conducted via secondary data analysis with the public use files from the 2023 National Youth Tobacco Survey that provides a nationally representative sample (N = 22,069) of youth in the United States. The primary analysis consisted of logistic regression that accounted for complex survey sampling and missing data; primarily testing for a moderation effect.</p><p><strong>Results: </strong>We found a significant omnibus interaction, F(2,37) = 3.83, <i>p</i> = 0.0307, confirming that high versus low perceived harm moderated the relationship between social media use type and past 30-day e-cigarette use. The difference in probabilities between levels of perceived harm for using e-cigarettes was significantly larger for those reporting high active social media use (i.e., Pr = 0.214) compared to those reporting passive social media use (i.e., Pr = 0.084).</p><p><strong>Conclusions: </strong>We found that high versus low perceived harm moderated the relationship between passive and active engagement with e-cigarette-related social media content and past 30-day e-cigarette use for a nationally representative sample of adolescents in the U.S. Based on these findings, prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known effects of using e-cigarettes on one's health.</p><p><strong>Implications: </strong>Examining the moderating effects of variables provides a greater understanding of the ways multiple factors interplay and influence adolescent e-cigarette use. The results of the current study demonstrated that differences between perceived levels of harm occurred at each category of social media use, while these differences were most pronounced between the passive use and the high active use social media categories. Prevention strategies targeting adolescent e-cigarette use may be enhanced through tailoring educational messaging and teaching strategies that focus on the potential effects of exposure to e-cigarette related social media content in conjunction with the known biological effects of using e-cigarettes on one's health.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261460121"},"PeriodicalIF":1.8,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228598","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":"Predictors of Tobacco Use Behaviors Among Syrian Americans.","authors":"Isabel Nakoud, Cyrene Arputhasamy, Catherine M Crespi, Jovana F Mahho, Mellissa Withers, Burton O Cowgill","doi":"10.1177/1179173X261423430","DOIUrl":"10.1177/1179173X261423430","url":null,"abstract":"<p><strong>Background: </strong>This study examines the prevalence and predictors of cigarette and hookah smoking among Syrian Americans, a growing U.S. immigrant population with historically high tobacco use.</p><p><strong>Objectives: </strong>To assess tobacco use behaviors and identify demographic and behavioral predictors of cigarette and hookah use, as well as key motivators for tobacco use, among Syrian American adults.</p><p><strong>Design: </strong>A cross-sectional survey study of Syrian American adults in 2 U.S. states.</p><p><strong>Methods: </strong>Data were collected from 919 Syrian American adults in Southern California and Florida between 2018 and 2019. Multinomial regression analyses were used to identify demographic and behavioral predictors of cigarette and hookah use.</p><p><strong>Results: </strong>Among participants, 16% were current cigarette users, and 37% were current hookah users, both exceeding U.S. national averages. Social occasions and flavored tobacco were key motivators for hookah use, with most participants perceiving hookah as equally or more harmful than cigarettes. Male gender, older age, longer U.S. residency among females, alcohol use, and lower education levels predicted cigarette smoking. Hookah use was associated with younger age, alcohol consumption, and the perception that hookah is less harmful than cigarettes, while health insurance and higher education were protective factors. Cigarette users were less likely to use hookah, whereas former cigarette users had a higher likelihood of hookah use. Education was a key factor in quitting both cigarettes and hookah. Individuals with health insurance were more likely to quit hookah, while those who perceived hookah as less harmful were less likely to quit.</p><p><strong>Conclusion: </strong>These findings emphasize the need for culturally tailored tobacco prevention and cessation programs for Syrian Americans, addressing misperceptions of hookah harms and leveraging community-specific motivators to develop effective interventions.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261423430"},"PeriodicalIF":1.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200517","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":"Gender-Specific Associations Between Tobacco and Tobacco-Free Nicotine Use and Symptoms of Anxiety and Depression in Swedish Adolescents.","authors":"Johanna Andersson, Malin Hansson, Mia Ericson, Louise Adermark","doi":"10.1177/1179173X261455075","DOIUrl":"10.1177/1179173X261455075","url":null,"abstract":"<p><strong>Background: </strong>The use of non-combustible tobacco-free nicotine (TFN) products has increased markedly among adolescents. Although often perceived as less harmful than traditional tobacco products, nicotine use has been associated with psychological distress.</p><p><strong>Aim: </strong>This study examined whether TFN use is associated with symptoms of anxiety and depression in adolescents, whether these associations differ from those of traditional tobacco products, and whether gender identity affects the outcome.</p><p><strong>Methods: </strong>Adolescents aged 17 to 19 years were invited to complete an online questionnaire assessing nicotine use and psychological distress, measured using the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using chi-square tests and logistic regression models.</p><p><strong>Results: </strong>A total of 3730 adolescents participated, of whom 30% reported nicotine use. TFN use was more common than tobacco use, while dual use was more prevalent among boys. Both TFN and tobacco use were associated with increased odds of anxiety or depression symptoms, with similar effect sizes across product types. However, association were partly gender-dependent. Among girls using nicotine, 80% reported anxiety symptoms, with higher frequency of use associated with greater risk. Among boys, nicotine use was associated with depressive symptoms, and dual product use was associated with an increased risk of psychological distress.</p><p><strong>Conclusion: </strong>Nicotine use is associated with psychological distress regardless of product type. Girls may be particularly vulnerable to anxiety-related symptoms, while dual use appears especially risky among boys. These findings highlight the need for gender-sensitive prevention strategies targeting dual use and the progression to regular nicotine use.</p>","PeriodicalId":43361,"journal":{"name":"Tobacco Use Insights","volume":"19 ","pages":"1179173X261455075"},"PeriodicalIF":1.8,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018069","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}