A recently published study examined the relationships between flavored tobacco use and single, dual, and poly tobacco product use, among adolescents. Data were obtained from the 2017 National Youth Tobacco Survey. Participants were 2,329 adolescent past 30-day tobacco users.
· Approximately half of all adolescent tobacco users (49%) reported use of more than one product.
· The majority of adolescent tobacco users reported using flavors (73%).
· Flavored tobacco use was significantly correlated with a greater risk of dual and poly tobacco use, relative to single product use.
· Similarly, flavored tobacco use was significantly correlated with a greater risk of poly tobacco use, relative to dual tobacco use.
The researchers concluded that there is a positive relationship between flavored tobacco use and multiple tobacco product use. Recommendations included stronger regulations of flavored tobacco products and the need to emphasize flavored tobacco use in prevention and education programs.
Source: Mantey et al. (2018). Flavored tobacco use is associated with dual and poly tobacco use among adolescents. Addictive Behaviors, Dec 27;92:84-88. doi: 10.1016/j.addbeh.2018.12.028. [Epub ahead of print]
A recently published study assessed whether tobacco policy, program, and communication evidence-based practice implementation is associated with employee tobacco outcomes (current smoking; quit attempt; smokeless tobacco (SLT) use; and perceived worksite support for cessation) at small low-wage worksites. The study found that communication practice implementation was associated with better perceived worksite support for cessation. Policy and program implementation were associated with increased odds of being a current SLT user.
Tobacco communication evidence-based practice implementation was associated with favorable perceptions of worksite support for cessation; more may be needed to change tobacco use behavior.
Source: Kava et al. (2019). Tobacco Evidence-Based Practice Implementation and Employee Tobacco-Related Outcomes at Small Low-Wage Worksites. Journal of Occupational and Environmental Medicine, Apr 19. doi: 10.1097/JOM.0000000000001618. [Epub ahead of print]
A recently published study examined changes in cigarette prevalence and quit ratios over 15 years by racial/ethnic group (Non-Hispanic (NH) White, NH Black, Hispanic, NH Other). Data were drawn from the 2002-2016 National Survey on Drug Use and Health (NSDUH) public use data files.
- 19% of NH White persons were daily smokers in 2016; this prevalence was significantly higher than all other groups (NH Black 11%, Hispanic 7%, NH Other 9%).
- Menthol use was significantly more common among NH Black individuals than all other groups in every year from 2002 to 2016 (2016: NH Black 23%, NH White 15%, Hispanic 10%, NH Other 9%).
- From 2002 to 2016, daily and nondaily smoking decreased significantly among all groups.
- The rate of decline of nondaily smoking was more rapid among Hispanic than NH White individuals while the rate of menthol smoking decline was more rapid among NH White than among Hispanic individuals.
- The quit ratio did not change significantly from 2002 to 2016 among NH Black individuals (31% to 35%) in contrast to a significant increase among NH White (2002, 45%; 2016, 50%) and Hispanic (2002, 33%; 2016, 41%) individuals.
Source: Weinberger et al. (2019). Racial/ethnic differences in daily, nondaily, and menthol cigarette use and smoking quit ratios in the United States: 2002 to 2016. Preventive Medicine, Apr 17. pii: S0091-7435(19)30133-1. doi: 10.1016/j.ypmed.2019.04.009. [Epub ahead of print]
In a recently published study heterogeneity in tobacco-use behaviors among U.S. blacks by global region of origin and age at immigration was examined. Self-identified black participants from the 2006-2015 Tobacco Use Supplement to the Current Population Survey were included (n = 47,857). Countries of origin were classified by global regions (U.S., Africa, Europe, West Indies).
- Prevalence of current cigarette smoking among U.S. blacks varied significantly by global region of origin (U.S.-born = 17%, Europe-born = 18%, Africa-born = 5%, West-Indies-born = 5%).
- Foreign-born blacks were less likely than U.S.-born blacks to smoke menthol flavored cigarettes.
- Participants who immigrated to the U.S. at ≥ 13 years old were less likely than U.S.-born blacks to start regular smoking as minor.
Source: Saint-Fort & Choi (2019). Heterogeneity in Tobacco-Use Behaviors Among U.S. Blacks per Global Region of Origin. Journal of Immigrant and Minority Health, Apr 19. doi: 10.1007/s10903-019-00865-x. [Epub ahead of print]
Tobacco studies often combine data for Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) subgroups, masking subgroup differences. A newly published study describes tobacco use (ever use and past 30-day use) among some disaggregated AANHOPI subgroups. Data from Wave 1 of the 2013-2014 Population Assessment of Tobacco and Health (PATH) Study were analyzed. The dataset contains a sample of 32,320 adults, of which 1623 identified as being of AANHOPI origin. Asian Americans further identified as being Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian. Those who identified as Native Hawaiian, Guamanian or Chamarro, Samoan, and Other Pacific Islander were combined into an NHOPI group.
· Asian Indians and Chinese had the lowest and NHOPI had the highest tobacco use prevalence compared to other AANHOPI subgroups.
· Males generally had higher prevalence compared to females.
· Prevalence varied by AANHOPI membership and tobacco product.
Tobacco use varies by AANHOPI subgroup and product type. Tobacco use differences in AANHOPI subgroups may be attributed to socio-economic status differences. The researcher concluded that treating these distinct subgroups as a monolithic group may contribute to reliance on tobacco prevention and control strategies that may have limited impact on specific subgroups.
Nguyen (2019). Disaggregating Asian American and Native Hawaiian and Other Pacific Islander (AANHOPI) Adult Tobacco Use: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, 2013-2014. Journal of Racial and Ethnic Health Disparities, Jan 4. doi: 10.1007/s40615-018-00532-1. [Epub ahead of print]
Water pipe with smoke
A newly published study assessed the contribution of substance use and stress/traumatic events to hookah use among African American college students (n = 1,402).
· Lifetime hookah use was 25%, with 34% of lifetime users having done so in the past 30 days.
· Compared to nonusers, hookah users had significantly higher use rates of alcohol, marijuana, other tobacco, and other drugs.
· Hookah use was more likely among those with cumulative stress, yet less likely among older students.
The researchers concluded that prevention messages may need to be tailored for African American college students and particularly target younger students, substance users, and those with cumulative stress.
Source: Cunningham-Williams et al. (2018). Stress, stressors, and substance use: Differential risk for hookah use among African American college students. Journal of Ethnicity in Substance Abuse, Oct 22:1-22. doi: 10.1080/15332640.2018.1511492. [Epub ahead of print]
Smoking cessation may promote long-term recovery in patients with substance use disorders (SUD). Yet smoking rates remain alarmingly high in this population. A recently published study examined smoking rates among hospitalized patients with SUD at a large safety-net hospital, and then characterized factors associated with smoking behaviors. Researchers analyzed data from all hospital admissions (7/2016-6/2017) and conducted semi-structured qualitative interviews with 20 hospitalized SUD smokers.
- Prevalence of cigarette smoking among hospitalized smokers with SUD was three times higher than those without SUD.
- Qualitative analyses showed that patients perceived that smoking cigarettes was a less serious concern than other substances.
- Some patients feared that quitting cigarettes could negatively impact their recovery and perceived that clinicians do not prioritize treating tobacco dependence.
- Almost all patients with heroin use disorder described how cigarette use potentiated their heroin high.
- Many SUD patients are turning to vaping and e-cigarettes to quit smoking.
The researchers concluded that hospitalized patients with SUD have disproportionately high smoking rates and perceive multiple barriers to quitting cigarettes. Smoking cessation interventions with this population should take into account how patients with SUD perceive smoking-related health risks and how that influences their decision to quit smoking.
Source: Kathuria et al. (2019). Perceived barriers to quitting cigarettes among hospitalized smokers with substance use disorders: A mixed methods study. Addictive Behaviors, Feb 18;95:41-48. doi: 10.1016/j.addbeh.2019.02.017. [Epub ahead of print]
A newly published study examined the characteristics and risk factors for preterm birth in Hawaiian and Pacific Islander women. Data from 10,470 women of Hawaiian or Pacific Islander descent in California were analyzed. Hawaiian/Pacific Islander women were at higher risk for preterm birth when they had fewer than three prenatal visits; were underweight, reported tobacco, alcohol, or illicit drugs use in pregnancy; had a diagnosis of anemia, gestational diabetes, preexisting diabetes, or hypertension with or without pre-eclampsia; or had a history of previous preterm birth.
Source: Altman et al. (2018). Patterns of Preterm Birth among Women of Native Hawaiian and Pacific Islander Descent. American Journal of Perinatology, Dec 21. doi: 10.1055/s-0038-1676487. [Epub ahead of print]
Young adults have high smoking rates and low utilization of evidence-based smoking cessation strategies. A recently published study investigated smoking cessation intentions, strategy use, and socioeconomic predictors of strategy use among young adult smokers (age 18-24) and compared patterns to those of older adults (age 25-64).
· Young adults planned to quit on a longer time frame, expressed lower interest in quitting, and were more confident they would be successful, compared to older adults.
· Young adults were significantly less likely to use pharmacotherapy.
· Both groups reported using product substitution, primarily with e-cigarettes, more than any evidence-based cessation strategy.
· Socioeconomic predictors of cessation strategy use did not differ between age groups.
The researchers concluded that more research on why young adult smokers underutilize evidence-based cessation support is needed, as are innovative efforts to increase intentions to quit and utilization of cessation assistance.
Source: Watkins et al. (2018). Cold Turkey and Hot Vapes? A national study of young adult cigarette cessation strategies. Nicotine & Tobacco Research, Dec 26. doi: 10.1093/ntr/nty270. [Epub ahead of print]
A recently published study explored the effect of tobacco retailer density, neighborhood poverty, and housing type (multiunit and public) on smoking in a large urban environment (New York City). Researchers analyzed data on smoking prevalence and individual sociodemographic characteristics from the 2011-2013 New York City Community Health Survey, data on tobacco retailers from the 2012 New York City Department of Consumer Affairs, data on neighborhood sociodemographic characteristics and population density from the 2009-2013 American Community Survey, and data on multiunit and public housing from the 2012 New York City Primary Land Use Tax Lot Output data set.
- Neighborhood poverty positively and significantly modified the association between tobacco retailer density and prevalence of neighborhood smoking.
- Neighborhood poverty was positively associated with the prevalence of individual smoking.
Source: Farley et al. (2019). The Influence of Tobacco Retailer Density and Poverty on Tobacco Use in a Densely Populated Urban Environment. Public Health Reports, Mar/Apr;134(2):164-171. doi: 10.1177/0033354918824330. Epub 2019 Feb 14.