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Consumers' response to mass media can be difficult to assess because individuals choose for themselves the amount of media they consume, and that choice may be correlated with their other consumption decisions. To avoid this selection problem, this article examines the introduction of television to the US, during which some cities gained access to television years before others. This natural experiment makes it possible to estimate the causal impact of television on the decision to start smoking, a consumer behavior with important public health implications. Difference-in-differences analyses of television's introduction indicate that (1) television did cause people to start smoking, (2) 16- to 21-year-olds were particularly affected by television, and (3) much of the response to television occurred within a couple of years of its introduction. Our preferred estimates suggest that television increased the share of smokers in the population by 5–15 percentage points, generating roughly 11 million additional smokers between 1946 and 1970. More broadly, these results offer causal evidence that (1) mass media can have a large influence on consumers, potentially affecting their health, (2) media exerts an especially strong influence on teens, and (3) mass media can influence consumers more than typical changes in prices. [ABSTRACT FROM AUTHOR]

Background and aims: We aimed to create a basic set of definitions and relationships for identity‐related constructs, as part of the Addiction Ontology and E‐Cigarette Ontology projects, that could be used by researchers with diverse theoretical positions and so facilitate evidence synthesis and interoperability. Methods: We reviewed the use of identity‐related constructs in psychological and social sciences and how these have been applied to addiction with a focus on nicotine and tobacco research. We, then, used an iterative process of adaptation and review to arrive at a basic set of identity‐related classes with labels, definitions and relationships that could provide a common framework for research. Results: We propose that 'identity' be used to refer to 'a cognitive representation by a person or group of themselves', with 'self‐identity' referring to an individual's identity and 'group identity' referring to an identity held by a social group. Identities can then be classified at any level of granularity based on the content of the representations (e.g. 'tobacco smoker identity', 'cigarette smoker identity' and 'vaper identity'). We propose distinguishing identity from 'self‐appraisal' to capture the distinction between the representation of oneself (e.g. as an 'ex‐smoker') and (i) the importance and (ii) the positive or negative evaluation that we attach to what is represented. We label an identity that is appraised as enduring as a 'core identity', related to 'strong identity' because of the appraisal as important. Identities that are appraised positively or negatively involve 'positive self‐appraisal' and 'negative self‐appraisal' respectively. This allows us to create 'logically defined classes' of identity by combining them (e.g. 'positive core cigarette smoker identity' to refer to a cigarette smoker self‐identity that is both positive and important). We refer to the totality of self‐identities of a person as a 'composite self‐identity'. Conclusions: An ontology of identity constructs may assist in improving clarity when discussing theories and evidence relating to this construct in addiction research. [ABSTRACT FROM AUTHOR]

INTRODUCTION Significant changes occurred in the way people socialize and interact with each other since China reported its first COVID-19 cases. However, little is known about how smoking behaviors may have changed due to the COVID-19 pandemic in China. The aim of this study was to assess changes in smoking behavior and intention to quit during the early stage of the COVID-19 pandemic in China and to investigate the associated factors. METHODS An online cross-sectional survey was conducted among Chinese adult smokers. Participants were recruited through snowball sampling from 19 March to 2 April 2020. RESULTS A total of 1388 smokers participated in this study. Of those, 1014 (73.0%) reported not changing their cigarette consumption, 104 (7.5%) reported smoking more and 268 (19.3%) reported smoking less due to the pandemic. Average daily cigarette consumption among all participants decreased from 15.0 (IQR: 10.0--20.0) to 13.0 (IQR: 8.0-20.0) (W=6.919, p<0.001). For intention to quit, 270 (19.5%) respondents reported becoming more willing to quit, and 91 (6.6%) reported becoming less willing to quit. Multivariate analyses showed that tobacco addiction, overall knowledge about the relationship between smoking and COVID-19, level of attention devoted to COVID-19, anxiety, living alone, and number of smokers in the family were significantly correlated with cigarette consumption and intention to quit, and living alone was the strongest factor associated with increased cigarette consumption (AOR=5.29; 95% CI: 1.51-18.56). CONCLUSIONS The COVID-19 pandemic led to a slight decrease in cigarette consumption and an increase in quitting intention among Chinese smokers. During the early stages of the pandemic, it was important to focus on the anxiety of smokers, dispel smokers' misunderstandings of smoking and COVID-19 and create a supporting environment in the family to help smokers quit. [ABSTRACT FROM AUTHOR]

The smoking addiction of patients with severe mental disorders has consequences not only for the patients but also for the people around them. This is qualitative research on family and friends of patients with Schizophrenia spectrum disorders to investigate their perception and vision of smoking, its impact on the patients' physical and mental health, and the possible attempts to combat addiction. The research also investigates the participants' views on electronic cigarettes as a means of replacing traditional cigarettes and helping the patient to quit smoking. The survey method used was a semi-structured interview. The answers were recorded, transcribed and analyzed with the technique of thematic analysis. The results of this study show that the view of most participants on smoking is negative (83.3%), although not all of them consider smoking cessation treatments for these patients of primary importance (33.3%). Nevertheless, a good number of them have tried to intervene spontaneously with their own resources and strategies (66.6%). Finally, low-risk products, and in particular electronic cigarettes, are considered by many participants as a useful alternative to traditional cigarettes in patients with schizophrenia spectrum disorders. About the meaning that cigarettes can assume for the patient, recurring themes emerge: they are considered as a way to manage nervousness and tension or as a means to contrast daily monotony and boredom or repeat usual gestures and habits. [ABSTRACT FROM AUTHOR]

INTRODUCTION Several factors associated with susceptibility to cigarette smoking have been identified, yet there is little evidence on the possible effects of waterpipe use. With this systematic review and meta-analysis, we aimed to investigate the relationship between waterpipe use and cigarette smoking susceptibility among adolescents and young adults who never smoked. METHODS Eligible studies were searched in PubMed, Springer Link, ScienceDirect and Cochrane Library up to August 2022. The pooled odds ratio (OR) and 95% confidence intervals (CI) of cigarette smoking susceptibility with waterpipe use were estimated using a random-effects model. Publication bias was assessed by Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. RESULTS A total of 59710 participants, including 3559 waterpipe users from six studies, were identified in this analysis. Results showed that the odds of susceptibility to cigarette smoking were nearly two times (OR=1.90; 95% CI: 1.59-2.26) greater for never smoker adolescents and young adults who used waterpipe tobacco, compared to those who were never users. In subgroup analyses, the pooled OR was 2.19 (95% CI: 1.52-3.14) and 1.70 (95% CI: 1.51-1.92) for current and ever use of waterpipe, while the pooled OR was 1.99 (95% CI: 1.35-2.95) and 1.87 (95% CI: 1.45-2.39) in Arab and non-Arab nations, respectively. CONCLUSIONS Our findings suggest that waterpipe use was associated with greater odds of susceptibility to cigarette smoking among adolescents and young adults who never smoked. Tailored public health policies and regulations on waterpipe smoking may help to protect youth never smokers from initiation of cigarette smoking. [ABSTRACT FROM AUTHOR]

Objective: The world is struggling with the damage caused by the coronavirus disease 2019 pandemic. Most countries have applied quarantines to combat the spread of coronavirus disease 2019. The aim of this study was to determine the mental health of smoking adolescents and the change in smoking behavior compared to their peers during the coronavirus disease 2019 quarantine. Materials and Methods: This study was conducted with adolescents registered in the adolescent outpatient clinic with no record of psychiatric illness. The mental health of smoking (n = 50) and non-smoking (n = 121) adolescents was evaluated using the Brief Symptom Inventory. Smoking adolescents have been questioned about the change in smoking behavior since quarantine began. Results: The rates of depression and hostility symptoms were significantly higher in smoking than in nonsmoking adolescents. Male smokers had significantly higher depression and hostility symptoms than male non-smokers. However, no significant difference was observed between the rates of female smokers and non-smokers. It was determined that 54% (27) of the smokers reduced their smoking, while 14% (7) smoked more than before and 3.5% of former smokers stated that they quit smoking during quarantine and these people were included in the non-smoker group. Conclusion: It is not surprising that the mental health of adolescents was affected by the coronavirus disease 2019 quarantine. Our findings revealed the necessity to closely monitor the mental health of smoking adolescents, especially males smokers. The results of our study suggest that encouraging adolescents who smoke to quit during the coronavirus disease 2019 pandemic may be more effective than before quarantine. [ABSTRACT FROM AUTHOR]

Background and aims: Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio‐economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. Design: Secondary analysis of survey data. Setting: A cross‐sectional nation‐wide exhaustive 12‐day survey in March 2017 of French youth aged 17–18.5 years participating in the national mandatory civic information day. Participants: A total of 13 314 adolescents answering a pen‐and‐paper questionnaire about their own tobacco consumption and the smoking of their parents. Measurements Risk ratios (RRs) were computed using modified Poisson regressions, and population‐attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. Findings Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50–1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99–2.36) when both parents smoked, compared with non‐smoking parents; the risk associated with living in a non‐intact family was 1.35 (95% CI = 1.26–1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10–1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68–1.98) and RR = 2.10, 95% CI = 1.92–2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. Conclusion: In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio‐economic status is small in comparison. [ABSTRACT FROM AUTHOR]

INTRODUCTION Direct and indirect smoking exposure is highly related to mental health in children. This study aimed to identify the association between exposure to smoking or secondhand smoke (SHS) and attention deficit hyperactivity disorder (ADHD). METHODS We used data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2019, including variables such as diagnosed ADHD, smoking status, SHS, and urine cotinine levels among children and adolescents. We estimated the risk of ADHD according to smoking or SHS exposure in various exposure groups using adjusted logistic or linear regression models. RESULTS Among 16434 participants, 133 children were diagnosed with ADHD (0.8%). Of these, 58 (43.6%) were aged <12 years and 75 (56.3%) were aged ≥12 years. Smoking was significantly associated with ADHD (crude odds ratio, OR=1.48; 95% CI: 1.14-3.26 and adjusted odds ratio, AOR=1.22; 95% CI: 1.02-1.64). SHS exposure and ADHD were attenuated after adjustment (OR=2.42; 95% CI: 1.08-4.02; AOR=1.42; 95% CI: 0.86-2.64) in the logistic regression model. Smoking history was statistically associated with a younger age of ADHD diagnosis in the linear regression model. CONCLUSIONS Smoking and the amount of smoking among children and adolescents was associated with ADHD. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia. METHODS This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020. RESULTS This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively. CONCLUSIONS Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate. [ABSTRACT FROM AUTHOR]

Smoking adversely affects tuberculosis (TB) outcomes and may be associated with depression and anxiety among people diagnosed with TB in Botswana. We conducted a cross-sectional study among patients newly diagnosed with TB in Gaborone, Botswana, evaluating factors associated with self-reported cigarette smoking. We performed Poisson regression analyses with robust variance to examine whether depressive and anxiety symptoms were associated with smoking. Among 180 participants with TB enrolled from primary health clinics, depressive symptoms were reported in 47 (26.1%) participants and anxiety symptoms were reported in 85 (47.2%) participants. Overall, 45 (25.0%) participants reported current smoking. Depressive symptoms were associated with a higher prevalence of smoking (adjusted prevalence ratio [aPR]: 2.04; 95% confidence interval [CI]: 1.29–3.25) in the adjusted analysis. The association between anxiety symptoms and smoking did not reach statistical significance (aPR: 1.26; 95% CI: 0.77–2.05). Future studies should further investigate these associations when addressing TB care. [ABSTRACT FROM AUTHOR]

While the cigarette smoking prevalence in the United States has decreased, smoking disparities persist for individuals with psychiatric disorders and individuals who identify as racial/ethnic minorities. These groups also experience higher levels of psychosocial stress. This study was the first to examine the relationship between psychosocial and psychiatric-related stressors and cigarette smoking status in a sample of Black and Latinx adults with psychiatric illness. Stress associated with friend strain, lifetime discrimination, and attending appointments for psychotropic medication management were associated with cigarette smoking. The present results have implications for integrating smoking cessation interventions into mental health treatment settings. [ABSTRACT FROM AUTHOR]

Background: Alcohol and tobacco use could cause health problems in older adults. Older adults who become in need of 24/7 care due to physical and/or neurological disabilities may need to move to a Residential Care Facility (RCF). RCFs aim to provide person‐centred care (PCC) to enhance quality of life (QoL) of residents. Objectives: This study aims to explore perspectives of residents on alcohol and tobacco use, which is essential to provide PCC. Methods: A qualitative research design was chosen, and semi‐structured interviews were conducted. Residents who use alcohol and/or tobacco and those who do not use these substances were purposively selected in two organisations on two types of units: psychogeriatric units and units providing care for residents with mainly physical disabilities. The results were analysed using thematic analysis. Results: Thematic analysis resulted in five themes: Current use and self‐reflection, knowledge and attitudes, addiction or habit, policies and availability, dependency versus autonomy. Conclusion: Residents in this study value their autonomy regarding alcohol and tobacco use. They experience dependency on their (in)formal caregivers to use these substances and acknowledge that their use could cause a nuisance to others, challenging the ability of caregivers to implement PCC. Future research could assess how to integrate providing PCC to residents by offering choices and autonomy, while considering the addictive component of these substances, health and safety risks for all. Implications for practice: This study could help care professionals to become aware of the habits and wishes of residents regarding alcohol and tobacco use and to discuss the possibilities and limitations within RCFs. [ABSTRACT FROM AUTHOR]

Home smoking bans reduce exposure to second-hand smoke. Understanding how psychosocial factors are related to having a home smoking ban may lead to better interventions for populations less likely to have home smoking bans, including low-income smokers. In this study, we used baseline data from 1,944 participants in a randomized trial of low-income smokers in Missouri to explore psychosocial correlates of a total home smoking ban. Using logistic regression, we examined associations between psychosocial variables (social support, unmet social needs [e.g., food, housing], perceived stress, and depressive symptoms) and a total home smoking ban. 72% of participants were female, and 58% were Black/African American; 26% reported a home smoking ban. In unadjusted and adjusted models, greater social support was associated with greater likelihood of a home smoking ban. Stress was negatively associated with a ban in adjusted models only. The fact that most participants did not have a home smoking ban highlights the need for further intervention in this population. Results suggest links between social support and having a home smoking ban, although effect sizes were small. Smoke-free home interventions that increase social connectedness or leverage existing support may be especially effective. Tobacco control planners may also consider partnering with agencies addressing social isolation. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the development of tolerance, using a population modeling approach, in recreational marijuana users after acute pulmonary administration of tetrahydrocannabinol (THC), a primary ingredient in marijuana. A total of 85 subjects in 3 separate studies smoked marijuana cigarettes (dose = 13–49 mg) under controlled conditions. Each study was designed as a randomized, crossover, double‐blind, and placebo‐controlled study. Up to 5 THC plasma samples and corresponding user‐reported psychological highness were pooled for population modeling analyses. Age, sex, user status, and body mass index were evaluated as covariates. Population pharmacokinetic (PK) parameters were estimated in the 2‐compartment PK model. PK parameters were fixed in the effect compartment model to describe the relationship between THC plasma concentration–psychological highness. The distribution rate constant in the effect compartment was estimated to be 0.988 (95%CI 0.964–1.010)/h. The population mean half‐maximal effective concentration (EC50) was 23.8 (95%CI 22.7–24.9) ng/mL. Covariate analysis revealed that user status was a significant covariate, and that chronic users appear to need higher plasma concentrations compared with occasional users to achieve a similar degree of highness. The modeling results conclude that chronic users develop tolerance to euphoria, which is the primary central nervous system effect of smoking marijuana. [ABSTRACT FROM AUTHOR]

E-cigarettes are believed to be less harmful than combustible tobacco. However, e-cigarettes have created divisions in public health: within and between academia, policy and practice. As e-cigarettes proliferate, and public health debates intensify, the best interests of those most at risk of smoking related illness can be lost in the furore. This article draws on 183 open-ended responses to a 2019–2020 questionnaire posted to various online vaping discussion forums to argue that emotion needs to become part of this discussion – particularly the emotional perspectives of vapers. The findings indicated that for many vapers, e-cigarettes are not just another potential harm reduction or alternative nicotine product. For many of the respondents, vaping is a social practice, but also more than this: an affective economy. In this economy, emotions do things, specifically they indicate the boundaries of a vaping community. This community is based on shared experiences of e-cigarettes creating positive new lifeworlds and changes to everyday life. However, it is also based on fears that these new lifeworlds are under threat. The aim of this article is to encourage more acknowledgment of this affective economy in the interests of reducing division and increasing reflexivity. [ABSTRACT FROM AUTHOR]

Background despite the well-known adverse health effects of smoking, evidence of these effects on frail individuals is still scarce. Aims to assess whether frailty influences the association between smoking and mortality. Methods individuals ≥50 years from the Mexican Health and Aging Study were analysed. Mortality rates from a 17-year follow-up were compared between smoking status groups (never, previous and current) and other smoking behaviour-related characteristics (pack-years, age commenced and cessation). Baseline variables were included to adjust the Cox regression models. First, models were adjusted for the whole sample, including an interaction term between the frailty index (FI) and smoking variables. A second set of models were stratified by FI levels: 0.00–0.10, 0.11–0.20, 0.21–0.30 and ≥ 0.31. Results from a total 14,025 individuals, mean age was 62.4 (95% confidence interval [95% CI]: 62.1–62.8) and 53.9% were women (95% CI: 52.4–55.6). Main results from the survival analyses showed that when including FI interaction term with smoking status, comparing current to never smoking, the hazard ratio (HR) was 2.03 (95% CI: 1.07–3.85, P  = 0.029), and comparing current to previous smoking, the HR was 2.13 (95% CI: 1.06–4.26, P  = 0.032). Models stratified by FI levels showed a significant HR only for the two highest level groups. Similar results were found for the smoking behaviour-related characteristics. Discussion our results suggest that frailty could modify smoking mortality risk. Other smoking characteristics were impacted by frailty, in particular, cessation. It was noteworthy that having ≥10 years of tobacco cessation was beneficial for frail individuals. Conclusions smoking has a higher toll on frail individuals, but ceasing is still beneficial for this group. [ABSTRACT FROM AUTHOR]

Background: Smoking and depression are closely related and form a vicious cycle. Yokukansan (YiganSan) is a polyherbal remedy that has the effect of calming neuropsychiatric symptoms such as anger and irritation. To examine the efficacy of Yokukansan during smoking cessation (SC) therapy in smokers with depressive tendencies but without major depressive disorders requiring pharmacotherapy. Methods: A multicenter, double-blind, randomized, placebo-controlled, parallel-group comparison trial was conducted between June 2016 and May 2020 at 12 centers of the National Hospital Organization, Japan. This trial targeted smokers who first visited the SC outpatient clinics, did not receive any pharmacological treatment at the psychiatric or psychosomatic department, and scored 39 or more on the self-rating depression scale (SDS). Participants (n = 198) were randomly assigned to either the Yokukansan or placebo groups. The trial drug was initiated with the start of the SC treatment and continued for 12 weeks. The primary outcome was the high success rate of the SC treatment, and the secondary outcomes included changes in scores of the SDS and the Profile of Mood States (POMS) instrument. Results: The success rate of the SC treatment was similar between the placebo (63%) and Yokukansan (67%) groups (P =.649). The SDS scores (placebo: mean difference [MD] = -3.5, 95% confidence interval [CI][-5.8, -1.2], d = 0.42; Yokukansan: MD = -4.6, 95%CI[-6.8, -2.3], d = 0.55), and the "tension-anxiety" POMS-subscale scores (placebo: MD = -1.6, 95%CI[-2.5, -0.7], d = 0.52; Yokukansan: MD = -1.6, 95%CI[-2.9, -0.3], d = 0.36) showed significant improvement in both groups after the SC treatment. However, "depression-dejection" improved in the Yokukansan group (MD = -1.9, 95%CI[-3.1, -0.7], d = 0.44) but not in the placebo group (MD = -0.1, 95%CI[-1.0, 0.7], d = 0.04). Significant improvement in "fatigue" was noted in the Yokukansan group (MD = -2.1, 95%CI[-3.4, -0.9], d = 0.47) but not in the placebo group (MD = -0.5, 95%CI[-1.8, 0.8], d = 0.11). The time × group interaction on the improvement in "depression-dejection" was significant (P =.019). Conclusions: Yokukansan does not increase the SC treatment's success rate but has additional positive effects on the psychological states due to the SC treatment in smokers with depressive tendencies but without apparent mental disorders. Trial registration: ID: UMIN000027036. Retrospectively registered at UMIN on April 18, 2017. [ABSTRACT FROM AUTHOR]

The widespread exchange of tobacco cigarettes as a gift in some societies normalises the symbolic desirability of tobacco products and promotes smoking. Little is known about how and why people exchange toxic substances as gifts. This study argues two key factors involved in social exchange processes – reciprocity and social capital – can explain gift cigarette circulation. We conducted a multistage survey among household heads from China and measured the quantity and monetary values of outgoing and incoming gift cigarettes circulated by each household and measured social capital in three dimensions: collective participation, social ties, and trust. Ordinary Least Square regressions showed that reciprocity is strongly and significantly associated with both the value and quantity of gift cigarettes. All three dimensions of social capital are varyingly associated with gifting cigarettes. Income and higher classes are also associated with greater quantity and value of received cigarettes. This study broadens the phenomenon of gifting cigarettes to the more universal patterns of reciprocity and social capital, wherein better social capital and socioeconomic position ironically lead to a higher risk of tobacco use and endanger health. We suggest policymakers target the endemic social need for gift exchange in China's informal economy. [ABSTRACT FROM AUTHOR]

Introduction The Pain and Smoking Inventory (PSI) measures patients' perceived interrelations of their pain and smoking behavior, and it comprises three conceptually distinct domains: smoking to cope with pain (PSI-Cope), pain as a motivator of smoking (PSI-Motivate), and pain as a barrier to cessation (PSI-Barrier). Associations between PSI scores and pain interference and self-efficacy to quit smoking, two measures that can affect cessation outcomes, remain unclear. Methods We conducted a secondary analysis of baseline data from 371 veterans with chronic pain (88% male, Median age =60) enrolled in a randomized smoking cessation trial. We used sequential multivariate regression models to examine associations between the three PSI domains and pain interference / self-efficacy. Results Of 371 veterans who completed baseline surveys, 88% were male, with a median age of 60 years. PSI-Motivate scores were positively associated with pain interference (beta [B]: 0.18, 95% confidence interval [CI]: 0.02 to 0.34). PSI-Barrier subscores were negatively associated with self-efficacy (B: –0.23, 95% CI: –0.36 to –0.10). Conclusion Findings suggest that individuals who hold maladaptive perceptions of pain–smoking interrelations could be more likely to endorse higher pain interference and lower self-efficacy—two established predictors of cessation outcomes. Moreover, each PSI subscale demonstrated unique relationships with the dependent variables, and our results provided support for a three-factor structure. These findings further demonstrate that the PSI comprises three conceptually and empirically distinct domains; future research should evaluate the clinical utility of assessing each domain in relation to cessation outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to explore E-cigarette (EC) accounts from a small sample of UK adults with varied smoking/EC experiences. This was to contribute to existing knowledge of adult perceptions and understand the factors that encourage or deter use to inform health messaging aimed at professionals, policy makers and the general public. Twelve participants, five men and seven women aged 23–55 years (mean age 32.43) with mixed smoking/EC backgrounds took part in face-to-face interviews, analysed using semantic-level inductive thematic analysis. The analysis identified three key themes. Social influence (1) relates to the understanding of the social representations of ECs. Representation and knowledge (2) captures the impact of varied EC related communication on perception. Aspects of addiction (3) conveys aspects of nicotine addiction and how this influences EC use. ECs were generally perceived as more socially acceptable than cigarettes by non-smokers, although there were varying levels of acceptability depending on the type of EC device used. There was also unanimity concerning uncertainty surrounding the devices. Behavioural/sensory elements and personal enjoyment of ECs were consistent elements that encouraged or deterred use. Although non-smokers/vapers did not use the devices, they expressed similar apprehensions to those who did. [ABSTRACT FROM AUTHOR]

While smoking is a crucial health risk, it adversely affects oral health, particularly becoming riskier for older adults who have smoked for a long time. This study identifies the patterns of smoking behavior changes in older adults aged 65 years and older and examines how the smoking behavior changes affect their oral health. Longitudinal data were derived from Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2018, targeting the older adults 65 years and older in South Korea. The independent variable was the amount of smoking, and the dependent variable was oral health. For data analysis, SPSS 25.0 and M-plus 8.0 programs were utilized. As a result, the patterns of changes in smoking behavior of the older adults finally derived were 'non-smoking,' 'decreasing,' 'high-level maintenance,' and 'decreasing after increasing.' Furthermore, the relationship between the smoking behavior change pattern of the older adults and oral health was revealed. Specifically, as for the smoking behavior change pattern of the older adults, it was confirmed that the oral health was better in the 'non-smoking' pattern compared to the 'high-level maintenance' pattern. On the other hand, it was confirmed that the 'decreasing' pattern and the 'decreasing after rising' pattern did not significantly affect oral health. The findings imply that even if older adults smoked a lot in the past, if they quit smoking at some point, it can positively affect their oral health. Furthermore, it is suggested to allow public officials, medical professionals, and welfare experts to actively intervene for older adults to stop smoking for their oral health. [ABSTRACT FROM AUTHOR]

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Tobacco use among youth in the South-East Asian region is quite prevalent. This study aims to examine if psychosocial factors (perceived loneliness, peer, and parental relationships) were associated with adolescent smoking, and whether the effects were different according to sex and age. Data came from the Global School-based Student Health Surveys collected between 2012 and 2015 in Brunei, Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand, Timor-Leste, and Vietnam. 64 578 (males = 48.5%) adolescents aged 13-18 completed the survey. Prevalence of past-month cigarette use was 10.6%. Adolescent smoking was associated with loneliness (OR = 1.75), lack of close friends (OR = 1.43), and lack of parental understanding (OR = 1.35). There was significant interactions between sex with loneliness, close friends, and parental understanding (p <.001). Interactions indicated having no close friends is associated with smoking and is stronger for females than males. Conversely, loneliness was associated with smoking more strongly in males than females. Results indicate that psychosocial factors are linked to adolescent smoking in South-East Asia, suggesting a further need for research on the relation of psychosocial factors with smoking, and their underlying factors. [ABSTRACT FROM AUTHOR]

There is a close relationship between taboo, marketing and consumption. Taboos place limits on our ability to access and make use of certain objects, services, ideas and experiences. Similarly, researching taboo topics comes with its own limitations and proscriptions and needs to be handled with care and empathy. [ABSTRACT FROM AUTHOR]

Purpose. Smoking has a negative effect on health and ocular tear film. The purpose of the current study is to investigate the correlation between the TearLab and I-Pen osmolarity scores in smokers and compare them with those of non-smoking healthy males. Methods. Thirty male smokers (25.3 ± 2.2 years) participated in the study. An age-matched (22.9 ± 2.0 years) control group of non-smoking healthy males (N = 30) was also recruited for comparison purposes. The ocular surface disease index (OSDI) was completed first, followed by the TearLab and I-Pen osmolarity measurements. Results. The median TearLab osmolarity score was lower (P < 0.001) than that obtained using the I-Pen in both the study and the control groups. The OSDI scores and osmolality measurements were higher (P < 0.001) in smokers than in the control subjects. In the smoker group, there were moderate correlations between the OSDI scores and the measurements obtained using the TearLab (Spearman's correlation coefficient, r = 0.463; P = 0.010) and I-Pen (r = 0.449; P = 0.013) systems. In addition, there was a strong correlation between the osmolarity scores obtained from the TearLab and I-Pen systems in smokers (r = 0.911; P < 0.001). Conclusion. The I-Pen scores in smokers were significantly higher than those obtained using TearLab. The TearLab scores showed small variations compared with those obtained using I-Pen. A strong correlation was found between the TearLab and I-Pen scores in smokers. The osmolarity TearLab and I-Pen scores were significantly higher in smokers compared with normal eye subjects. [ABSTRACT FROM AUTHOR]

Evidence supports the use of graphic warnings to educate the public about the health harms of smoking and suggests warnings eliciting negative emotional responses may be more effective. This study aimed to replicate a preliminary theory-based model whereby perceived new knowledge promotes discouragement from smoking through its impact on worry about smoking with a different sample and using a new set of cigarette graphic warnings. We explored if the pattern extended to encouragement to use e-cigarettes, and if age and user group moderated the indirect effects of these models. Exclusive smokers, dual/e-cigarette users and nonusers (N = 412) evaluated graphic cigarette warnings on perceived new knowledge and worry about health harms of smoking, discouragement to smoke, and encouragement to use e-cigarettes. Perceived new knowledge was both directly and indirectly associated with discouragement to smoke through worry about health harms of smoking, and did not vary as a function of age or user group. In contrast, perceived new knowledge was not directly or indirectly associated with encouragement to use e-cigarettes, and this pattern largely did not vary as a function of age or user group. Graphic cigarette warnings that enhance knowledge may discourage smoking both directly and indirectly through worry elicited by them, and may have less impact on encouraging e-cigarette use. These findings replicate prior work and generalize to different user groups and new warnings planned for implementation in the U.S. [ABSTRACT FROM AUTHOR]

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Objective: Smoking stigmatization has been shown to hinder cigarette smoking cessation, especially among individuals with a strong smoker identity. Self-affirmation, a psychological threat-management coping strategy, can promote smoking cessation, and may mitigate the adverse consequences of stigmatization. Design: Data from an online sample of 1,020 U.S. adult smokers were analyzed using multiple linear regression. Main Outcome Measures: Participants completed a self-affirmation (or no-affirmation control) writing task before viewing a smoking stigma (or non-stigma control) anti-smoking public service announcement video. Participants then reported smoking-related cognitions and behavioral intentions. Results: Among participants with strong--but not weak--ties to a smoker identity (smoking self-concept), self-affirming led to higher quit intentions compared to the control condition. Among participants with weak--but not strong--smoking self-concepts, those who self-affirmed had lower intentions to switch completely to e-cigarettes relative to the control condition. Exposure to stigmatization reduced intentions to seek cessation counseling, particularly among those with weak smoking self-concepts. Conclusion: Findings demonstrate the critical role that smoking identity centrality plays in moderating reactions to both affirming and stigmatizing stimuli. Additional research is needed to better understand how self-affirmation and stigma-reduction interventions can be tailored and implemented in natural contexts. [ABSTRACT FROM AUTHOR]

Objective: Vaping rates among college students have been increasing significantly in recent years, due in large part to the diffusion of pod vaping devices (i.e., JUUL, Suorin) on American college campuses. In this study, we explore the ecological system of knowledge, attitudes, and practices in regards to this trend. Participants: Participants were 26 undergraduate students at the University of Minnesota. Method: Following a KAP (knowledge, attitudes, practices) approach, 8 focus groups were conducted in April/ May 2019. Results: Knowledge themes include awareness of the addictiveness of the devices and uncertainty regarding the health risks. Attitudinal themes include a dual perspective, wherein social use is acceptable, but everyday use is stigmatized. Practice themes included three evident stages: social connection, wherein the devices were used to achieve social advantage with peers; addiction, characterized by solitary, habitual use; and detachment, sometimes marked by a dramatic, public action filmed for social media. Conclusions: As we consider intervention points on college campuses, an understanding of knowledge, attitude, and practice themes can guide our approach. Recommendations for college vaping campaigns are discussed. [ABSTRACT FROM AUTHOR]

People who are incarcerated have limited resources to help them quit tobacco smoking. This study assessed the association between baseline attitudes and expectations of the program with final smoking status as the outcome. A 6-week group-based counseling with nicotine patches was provided to incarcerated individuals to quit smoking. A cross-sectional survey was given at the first session. Questions surrounding attitudes such as interest, confidence, motivation, and expectations were used to assess associations with smoking cessation. Exhaled carbon monoxide (CO) levels were taken at each sessions. Participants were categorized as nonsmoking or continued smoking at a 6.0 parts per million (ppm) CO at their final session attended. Overall, 123 participants had a CO higher than 6.0 ppm or missed more than two sessions at their final session, and 54 had a CO under 6.0 ppm. A total of 102 participants completed the 6-week program. Differences among the two groups in exhaled CO began at Session 3 and continued throughout the study. [ABSTRACT FROM AUTHOR]

Introduction: depression and anxiety is one of the most relevant public health problems. The link between smoking and depression has been demonstrated. Regular physical activity (PA) could act as a protector against mental health diseases. Objectives: (1) to explore the prevalence of depression and anxiety in relation to sex and to the condition of smoker and ex-smoker, (2) to study the differences in prevalence proportions according to the frequency and level of PA, and (3) to calculate the probability of presenting depression or anxiety according to the frequency and level of PA. Methods: a cross-sectional study was conducted, based on data extracted from the 2014 and 2020 Spanish European Health Survey and the 2017 Spanish National Health Survey. The sample included 9524, 7813, and 9079 participants, respectively. Descriptive analysis was performed (comparisons using a Chi-square test and z-test for independent proportions). Probability odds ratios of anxiety and depression were calculated according to PA. Results: women had a higher prevalence of depression and anxiety than men (p < 0.001–0.003). Higher levels of prevalence were observed in inactive people versus very active or active people (p < 0.001). Inactive people had a higher risk of depression and anxiety compared to very active people. Conclusion: inactive smokers and ex-smokers had higher levels of prevalence of depression and anxiety than active and very active people. Physical inactivity could increase the risk of suffering these mental disorders in this population. This could affect women more than men. [ABSTRACT FROM AUTHOR]

We hypothesized (1) perceived harm beliefs and intention to use e-cigarette attitudes will become more negative post-exposure to the intervention (2) this change will generalize to more negative beliefs and intention toward regular cigarettes and marijuana. MANOVAs of students' perceptions of harm beliefs and intention toward the use of e-cigarettes and regular cigarettes, and marijuana were performed to ascertain change in harm beliefs before (t1) to after the intervention (t2) for 188 nonwhite Hispanic and White college students who viewed educational material (informational text + video), the intervention, during an online experimental survey. The first MANOVA yielded main effect with significant differences for substances, Wilks' Lambda (Λ) = 0.254, F = 234.920 (2, 160), p < 0.001, ηp2 =0.746 and by time (Λ = 0.740, F = 56.684 (1, 161), p < 0.001, ηp2 = 0.260). E-cigarettes, regular cigarettes, and marijuana were perceived more harmful for one's health and for the health of others at t2. The MANOVA on peer influence and intention to use (Λ = 0.277, F = 222.890 (2, 171), p < 0.001), ηp2 = 0.723) and by time (Λ = 0.922, F = 14.514 (1, 172), p < 0.001), ηp2 = 0.078) was significant. Respondents were less likely to use any of the substances if their best friend offered at t2. Intent for future use was also reduced at t2. A brief intervention potentiated favorable change in harm beliefs and intention to focal object (e-cigarettes) and lateral objects (regular cigarettes and marijuana). [ABSTRACT FROM AUTHOR]

Aims: Our aim was to synthesize current evidence on the association between parental smoking and incidence of type 1 diabetes and islet autoantibody positivity (IA) in the offspring by conducting a systematic review and meta‐analysis. Methods: We searched Medline, Embase, and Cochrane Library until January 21, 2021, for human studies with parental tobacco use as exposure, type 1 diabetes or IA as outcome, and hazard, risk, or odds ratios as effect estimates. Summary relative risks (RR) and 95% confidence intervals (CI) were estimated with random‐effects models. Heterogeneity was quantified with the I2 statistic, bias with the ROBINS‐I tool, and the certainty of evidence with the GRADE tool. Results: We identified 535 records of which 23 were eligible including 25 927 cases of type 1 diabetes. Maternal smoking during pregnancy was associated with a reduced risk of type 1 diabetes (n = 22, RR 0.78, CI 0.71–0.86, I2=69%). Including only studies with low to moderate risk of bias indicated similar results with less heterogeneity (n = 14, RR 0.73, CI 0.68–0.79, I2 = 44%). The certainty of evidence was graded as high. There was no clear association between type 1 diabetes and neither maternal (n = 6, RR 0.95, CI 0.78–1.14, I2 = 0%) nor paternal (n = 6, RR 0.90, 0.70–1.17, I2 = 68%) smoking during childhood. Furthermore, the association between maternal smoking during pregnancy and IA was weak (n = 4, RR 0.86, CI 0.44–1.65, I2 = 71%). Conclusions: Maternal smoking during pregnancy may reduce the risk of type 1 diabetes in the offspring. Further studies are needed to elucidate potential mechanisms underlying this association. Registration: Prospero CRD42021236717. [ABSTRACT FROM AUTHOR]

Objectives: Dual use of cigarettes and electronic nicotine delivery systems (ENDS) is increasingly common in adult smokers, who often report using ENDS to quit smoking. Elevated negative affect is an established predictor of increased difficulty quitting smoking combustible cigarettes but has not yet been examined in the context of cigarette cessation for dual users. Method: This study examined whether mood-related factors predict cigarette smoking cessation among dual users (N = 364) over 12-months. Self-reported cigarette smoking at 12 months, with abstinence defined as no smoking for the past 7 days, was the primary outcome variable. Logistic regression included baseline levels of depression symptoms (CES-D), anxiety symptoms (MASQ), and negative affect expectancies for smoking, with baseline nicotine dependence for cigarettes (NDSS), motivation to quit, age, race/ethnicity, rate of cigarette smoking at baseline, and ENDS usage at baseline and 12 months as covariates. Interactions between CES-D, MASQ, and negative affect expectancies were examined. We predicted that negative affect, especially for smokers who had high negative affect expectancies for smoking, would be negatively associated with quitting. Results: Contrary to expectations, negative affect constructs did not predict quitting. Baseline nicotine dependence for cigarettes, gender, and race/ethnicity significantly predicted the likelihood of cigarette cessation. Higher rates of ENDS use, higher motivation, and lower negative affect smoking expectancies were significantly correlated with quitting cigarettes. Conclusion: In this non-treatment seeking sample of dual users, negative affect did not predict cigarette cessation over and above nicotine dependence for cigarettes, gender, and race/ethnicity. [ABSTRACT FROM AUTHOR]

INTRODUCTION Greater understanding is required of how smokers with smoking-related diseases respond to smoking cessation medications. This post hoc analysis of EAGLES data compared continuous abstinence rates (CARs) in smokers with/without smoking-related diseases and assessed participant demographic and baseline characteristics that may serve as predictors of continuous abstinence (CA). METHODS EAGLES was a 24-week (12-week treatment, 12-week follow-up), double-blind, active- (nicotine replacement therapy; patch) and placebo-controlled study in motivated-to-quit smokers with/without psychiatric disorders. This analysis assessed CARs at weeks 9-12 (CAR9-12) and 9-24 (CAR9-24) in participants with smoking-related diseases [asthma, chronic obstructive pulmonary disease (COPD), diabetes, and/or cardiovascular disease (n=1372)] versus controls without these comorbidities (n=6039). Participants received varenicline 1 mg twice daily, bupropion 150 mg twice daily, nicotine patches 21 mg/day with taper, or placebo for 12 weeks. Stepwise logistic modeling was also performed to analyze odds ratio (OR) for predictors of CA at weeks 9-12 (CA9-12) and 9-24 (CA9-24). RESULTS Smokers with smoking-related diseases were older, had a longer smoking history, more quit attempts, and were more likely to have a psychiatric disorder and reside in the US versus smokers without comorbidities. Fagerström Test for Cigarette Dependence scores and treatment adherence were comparable between cohorts. Smokers with smoking-related diseases had lower CARs versus controls (CAR9-12: 20.8% vs 24.0%; CAR9-24: 13.0% vs 16.9%). Use of smoking cessation medication was the strongest predictor of CA after control for demographics, smoking characteristics, and psychiatric disorder. By treatment, OR and CI were: varenicline CA9-12 (OR=3.82; 95% CI: 3.21-4.54) and CA9-24 (OR=2.92; 95% CI: 2.40-3.54); bupropion CA9-12 (OR=2.17; 95% CI: 1.81-2.60) and CA9-24 (OR=1.99; 95% CI: 1.63-2.44); nicotine patches CA9-12 (OR=2.23; 95% CI: 1.87-2.67) and CA9-24 (OR=1.86; 95% CI: 1.52-2.28). CONCLUSIONS Smokers with smoking-related diseases had lower quit rates than controls. Of the active treatments compared, varenicline was most effective in smokers with asthma, COPD, diabetes, or cardiovascular disease. TRIAL REGISTRATION: NCT01456936 (https://clinicaltrials.gov/ct2/show/NCT01456936). [ABSTRACT FROM AUTHOR]

Objective To examine whether policies prohibiting smoking on college campuses contribute to greater decreases in smoking. Participants: This study compares smoking prevalence and perceptions of prevalence pre/post a smoking ban enacted in 2015 by using repeated cross-sectional surveys administered at a university in 2011 (n = 1.548), 2013 (n = 3.657), 2015 (n = 3.456), 2016 (n = 2.575), and 2018 (n = 4.600). Methods: Regression models evaluated trends in prevalence with a spline term to evaluate differences after the smoking ban. Results: Before the ban, the prevalence of any past 30-day smoking decreased each survey period (AOR = 0.89, 95%CI: 0.85, 0.97); after the ban, a significantly greater decrease was observed (AOR = 0.78, 95%CI: 0.74, 0.83). Similar patterns were observed specifically for cigarette use as well as students' perceptions of the proportion of the student body who use tobacco and nicotine products. Stratified analysis identified that pre/post declines were largest in the youngest age category. Conclusions: Results support the effectiveness of campus-based antismoking policies. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to examine the effects of primary social factors on the smoking behaviors according to the smoking stages—initiation and continuation—among Korean adolescents. Subject and methods: We used the clustered logistic regression method to examine whether the primary social factors significantly influence smoking behaviors among Korean adolescents at two different stages with a cross-sectional study for 9 years. Results: We found that primary social factors significantly influenced adolescent smoking in both stages, and peer effects for adolescent smoking were much clearer in the smoking continuation stage. In addition, adolescents initiating smoking early tend to continue their smoking with high probability. Conclusion: The impacts of primary social factors are robust on adolescent smoking, particularly in the smoking continuation stage. [ABSTRACT FROM AUTHOR]