Did You Know? Waterpipe Tobacco Smoking More Common Among Black And White Latinos Compared To Non-Hispanic Whites


A recently published study examined intra-ethnic racial differences in waterpipe tobacco smoking (WTS) among Latinos using a nationally representative sample. Researchers analyzed pooled data from the National Adult Tobacco Survey, 2012-2014.

 Findings included:

·         Black Latinos and White Latinos exhibited an increased prevalence of lifetime WTS compared to their non-Hispanic white counterparts.

·         Black Latino men exhibited increased prevalence of lifetime WTS compared to their non-Hispanic white men counterparts. 

·         Black Latinas and white Latinas exhibited increased prevalence of WTS compared to their non-Hispanic white women counterparts.

 The researchers concluded that among the U.S. general adult population, intra-ethnic racial differences in WTS behaviors exist among Latinos; and is shaped by gender. Future efforts to eliminate racial disparities in WTS should be attentive to intra-ethnic racial differences among Latinos.

Source: Ortiz et al. (2018). Intra-Ethnic Racial Differences in Waterpipe Tobacco Smoking among Latinos? Substance Use & Misuse, Jul 20, 1-10. [Epub ahead of print]

Did You Know? How to Tailor Technology-Based Cessation Programs for Socioeconomically Disadvantaged African American Smokers

unnamed (3)

Communication technology-based interventions are increasingly being employed to help smokers quit. Understanding preferences for such strategies among socioeconomically disadvantaged smokers can inform targeted intervention planning. A newly published study examined socioeconomically disadvantaged smokers’ use of and access to communication technology and elucidated preferences for receiving quitting information and support via email and text message. A self-administered survey and focus groups were conducted with a sample of 15 predominantly African American, socioeconomically disadvantaged smokers aged 21-64 years.

Findings included:

·         Smartphone ownership was high, although use of communication-based cessation resources such as web sites and smartphone apps was low.

·         Four themes emerged relevant to preferences for receiving quitting information and support via email and text message: access, appropriateness, intended use, and satisfaction.

·         Although initially participants were mixed in their preferences for receiving emails vs texts, 80% preferred emails over texts when presented with sample emails and text messages containing cessation information.

The researchers concluded that although email and text message strategies may be acceptable to socioeconomically disadvantaged smokers generally, issues such as access and intended use should be considered to inform specific disparity-reducing intervention approaches.

Source: Alcaraz et al. (2018). To Text or Not to Text? Technology-based Cessation Communication Preferences among Urban, Socioeconomically Disadvantaged Smokers. Ethnicity & Disease, Jul 12, 28(3), 161-168.

Cultural Smokeless Tobacco Use Among Asian Indians

Asian Indians (AIs) in the United States exhibit disproportionate burdens of oral cancer and cardiovascular disease, which are potentially linked to smokeless tobacco. However, little is known about the use of cultural smokeless tobacco (CST) products in this population. A recently published study utilized California Asian Indian Tobacco Use Survey data from 2004 (n = 1,618) to investigate CST prevalence among California’s AIs. CST products included paan, paan masala, and gutka. 
Findings included: 
·         The current CST prevalence was 13% (14% for men and 12% for women). 
·         The prevalence of current cigarette use was 6% (9% for men and 2% for women), and the prevalence was lower for cultural smoked tobacco (0.1% for bidis and 0.5% for hookahs).
·         Factors associated with CST use included being male, being 50 years old or older, being an immigrant, speaking an AI language at home, having a higher level of education, having a higher income, identifying as non-Sikh and disagreeing that spiritual beliefs are the foundation of life.
The researchers concluded that acculturation and religious affiliation are important factors associated with current use. 
Source: Mukherjea et al. (2018). Moving toward a true depiction of tobacco behavior among Asian Indians in California: Prevalence and factors associated with cultural smokeless tobacco product use. CancerApr 1;124 Suppl 7:1607-1613.

What Is The Loop?

We are excited to launch our new LOOP Overview Video called “What Is The LOOP?”designed to provide a brief highlight of who we are, how we have evolved, what we do and the services we provide to CTCP grantees.
Look out for more videos coming out in this series on our Tailored Assistance Services and Leadership Development Program in the coming weeks!
The LOOP Team

Did You Know? Urban Residents Are More Likely To Self-Impose Indoor Household Tobacco Restrictions


A newly published study examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. Researchers analyzed data from a cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users.

 Findings included:

  • 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors.
  • Urban location, younger age, male sex, college education, household income of more than $15,000, and being married were associated with a higher likelihood of banning combustible products indoors.
  • SLT and e-cigarette users were more likely to have indoor bans compared to combustible users.
  • Children in the household, older age, and nonwhite race were associated with a higher likelihood of banning noncombustible products indoors.
  • Combustible and e-cigarette users were more likely than SLT users to have indoor bans.


The researchers concluded that indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Recommendations included targeting modifiable risk factors for in-home secondhand smoke exposure through public policy.

Source: Kopp et al. (2018). Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users. Academic Pediatrics, Apr 10. pii: S1876-2859(18)30165-7. doi: 10.1016/j.acap.2018.04.002. [Epub ahead of print]

Newly Published: Literature Review of Hookah Use among Youth

unnamed (2)

This systematic review summarizes and assesses the literature related to hookah use among adolescents (11 to 18 years of age) in the U.S. from 2009 to 2017. Authors reviewed 461 articles for inclusion and included 55 articles which were coded for study themes, study quality and their relevance to FDA’s research priorities.

Findings included:

·         The following themes were identified: (1) prevalence of hookah use (n=42); (2) tobacco use transitions (n=7); (3) sociodemographic correlates (n=35); (4) psychosocial risk factors (n=21); (5) concurrent use of other tobacco products (n=31); (6) concurrent use of other substances (n=9); and (7) other (n=15) which includes low prevalence themes.

·         Older age, male gender, positive social normative beliefs, higher peer use as well as lower perceived risk were associated with hookah use.

·         Longitudinal studies of youth hookah use showed bidirectional relationships between use of hookah and other tobacco products.

·         All articles fell within FDA’s research priority related to “behavior.” Three priorities (“impact analysis,” “health effects,” and “toxicity”) have not been explored for hookah use among U.S. youth since 2009.

The researchers concluded that the prevalence of hookah use among youth in the U.S. is increasing, thus more research is needed to inform policies targeted to protect this vulnerable population.

Source: Cooper et al. (2018). Hookah Use among U.S. Youth: A Systematic Review of the Literature from 2009-2017. Nicotine & Tobacco Research, Jun 28. doi: 10.1093/ntr/nty135. [Epub ahead of print].

unnamed (1)

Who Is More Likely To Initiate Tobacco Product Use: Youth or Young Adults?

A recently published study examined the initiation of tobacco product use, including cigarettes, e-cigarettes, cigar products, and hookah, among contemporary youth and young adults, to determine whether the developmental timing (youth vs. young adulthood) of initiation has changed. Researchers analyzed data from the national Population Assessment of Tobacco and Health Study, and two Texas cohort studies, the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS), and the Marketing and Promotions Across Colleges in Texas (M-PACT) project. Findings indicate that young adults who were never users began to ever and currently use all tobacco products more than youth in these samples, a marked departure from prior decades of research.

Source:  Perry et al. (2018). Youth or Young Adults: Which Group Is at Highest Risk for Tobacco Use Onset? The Journal of Adolescent Health, Jul 7. pii: S1054-139X(18)30188-5. doi: 10.1016/j.jadohealth.2018.04.011. [Epub ahead of print]

Did You Know? Cigars, Cigarillos and Little Cigars Used Primarily By Male, Black Youth


A recently published study examined the association between risk perceptions of youths’ personal and parental attitudes toward smoking cigarettes, cigars, and marijuana with current use of cigars, cigarillos or little cigars (CCLCs) or modified CCLCs (i.e., freaking or blunting). Researchers analyzed data from the 2013 Cuyahoga County Youth Risk Behavior Survey.

Findings included:

  • 23.5% of youth reported current use of CCLCs in some way; 11.0% reported current freaking and 18.5% reported current blunt use.
  • CCLC users tended to be male and Black.
  • Perceiving all smoking behaviors as risky, wrong, or wrong by parents reduced odds of youth using CCLCs.
  • Blacks had increased odds of using CCLCs if they perceived smoking cigarettes as harmful, which was not found among other race/ethnicity categories.
  • Having parents who believed that smoking CCLCs is wrong increased the odds of youth freaking or blunting among all CCLC users.
  • Odds of blunting were greater for those who believed CCLCs were more risky among all CCLC users.

The findings suggest that CCLC users may think cigars are safer than cigarettes, and that modifiers may think their use is safer and more in line with their parents’ views than non-modified CCLCs.

Source: Trapl et al. (2018). Attitudes and Risk Perceptions Toward Smoking Among Adolescents Who Modify Cigar Products. Ethnicity & Disease, Jul 12, 28(3), 135-144.

Did You Know? Tobacco Use More Prevalent Among Bisexual Adults And Sexual Identity-Attraction Discordant Women

A newly published study examined tobacco use among U.S. adults and variations by age, race/ethnicity, and sexual identity-attraction concordance/discordance. Data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions were analyzed.
Findings included:
  • Tobacco use was more prevalent among sexual minority-identified adults compared with heterosexual-identified adults.
  • Tobacco use among sexual minorities was most prevalent among younger lesbian women and gay men, and all age groups of bisexual men and women.
  • Tobacco use was significantly greater among sexual identity-attraction discordant women and significantly lower among sexual identity-attraction discordant men.
The researchers concluded that self-identified bisexual adults and sexual identity-attraction discordant women appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking.
Source: McCabe et al. (2018). Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity-Attraction Differences. American Journal of Preventive Medicine, Apr 9. pii: S0749-3797(18)31636-2. doi: 10.1016/j.amepre.2018.03.009. [Epub ahead of print]

Did You Know? Study Highlights Smoking Patterns Among Adults Receiving Housing Assistance


A recently published study examined patterns of cigarette smoking (current, former, never) by sociodemographic, household, and chronic disease characteristics and correlates among US adults receiving housing assistance from the US Department of Housing and Urban Development (HUD) during 2007-2012. 

Findings included:

  • Overall, 48% of HUD-assisted adults were never smokers, 33% were current smokers, and 19% were former smokers.
  • The percentage of never smokers was significantly higher among adults aged 18 to 44 (54%) or 65 years or older (50%) than among adults aged 45 to 64 (38%).
  • The percentage of never smokers was significantly higher among women (51%) than men (41%).
  • The percentage of never smokers was significantly higher among Hispanic adults (59%) and non-Hispanic black adults (55%) than non-Hispanic white adults (37%)


Source: Wang et al. (2018). Characteristics and Correlates of Cigarette Smoking Status Among US Adults Receiving Federal Housing Assistance. Preventing Chronic Disease, Mar 22;15:E48. doi: 10.5888/pcd15.170395.


Did You Know? African American And Low SES Children With Asthma Have More Exposure To Passive Tobacco Smoke


A newly published study examined the risk of asthma in children exposed to passive tobacco smoke. Researchers analyzed National Health and Nutrition Examination Survey (NHANES) data collected from 2003 to 2014 (n = 8064).

Findings included:

  • The proportion of children living with household smokers decreased from 24.9% in the 2003-2004 cycle to 11.4% in the 2013-2014 cycle.
  • Highly exposed asthmatic children were primarily Non-Hispanic Black and whose family incomes were below poverty guidelines.
  • Overall results reveal passive smoke exposure level among children ages 3-11 in the US decreased over the study period.
  • Nevertheless, higher exposure to passive smoke is still associated with higher odds of childhood asthma.

 The researchers concluded that targeted smoking cessation interventions in clinical practices are needed to reduce tobacco smoke exposure and related asthma risk in children, particularly in low-income and minority groups.


Source: Zhang et al. (2018). Decreasing trend in passive tobacco smoke exposure and association with asthma in U.S. children. Environmental Research, May 31;166:35-41. doi: 10.1016/j.envres.2018.05.022. [Epub ahead of print]

We’re Thinking of Those Who Are Battling Wildfires


Due to the current high volume of fires in California, we know this is a difficult time. We want you to know that we are thinking about you and it is our hope that you are safe and well.

According to CA.GOV CAL FIRE, current fires are in the following counties:








San Bernardino




The residents of these counties are in our thoughts,

The LOOP Team