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Introduction: Tobacco harm perceptions are associated with tobacco use for both youth and adults, but it is unknown how these harm perceptions have changed over time in a changing tobacco product landscape., Methods: Data from Waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study were analyzed to examine perceptions of harm of eight non-cigarette tobacco products compared to cigarettes. Perceptions of harm were assessed with the questions, "Is smoking/using [product] less harmful, about the same, or more harmful than smoking cigarettes?"., Results: The share of participants who perceived non-cigarette combustible products as posing similar harm to cigarettes increased over time, while the share of participants who perceived non-combustible products as less harmful than cigarettes decreased over time., Conclusions: Tobacco harm perceptions are changing over time, along with the tobacco product marketplace and regulatory environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: In guidance published in February 2020, the FDA described their intent to prioritize enforcement against the sale of flavored cartridge-based Electronic Nicotine Delivery Systems (ENDS) except tobacco and menthol flavors. This guidance was specific to cartridge-based ENDS and did not apply to other ENDS types or e-liquids sold in the U.S.. It remains unknown if use of certain types of ENDS devices and flavors changed following the publication of this guidance., Methods: This analysis includes PATH Study data from Wave 5 (W5, 2018-2019) and Wave 6 (W6, 2021) and examines cross-sectional estimates of (1) use of flavored ENDS and (2) use of different device types. All analyses in this study were stratified by self-reported age (youth-aged 12-17 years at W5 and aged 14-17 years at W6, and adults-aged 18-20, 21-24, and 25+ years). Analyses were conducted in 2023-2024., Results: Among adults aged 21 years and over, there were significant increases in the use of menthol or mint flavored ENDS. There were no substantial changes in flavors of ENDS used among youth or adults aged 18-20 years. Among all age groups, the use of cartridge-based ENDS was lower in 2021 than 2018-2019, with a notable shift to disposable-style ENDS., Conclusions: Federal-level tobacco control actions taken in the U.S. in early 2020 prioritized enforcement against "any flavored, cartridge-based ENDS product (other than a tobacco- or menthol-flavored ENDS product)." Based on this analysis, there was a shift following the policy to menthol or mint-flavored ENDS and disposable-style ENDS., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Much of the population-based e-cigarette use and cigarette cessation literature is restricted to smokers who have expressed intention to quit smoking, though experimental studies suggest e-cigarette use might motivate some smokers to change their quit intentions. We used U.S. nationally representative data to evaluate whether e-cigarette use by smokers initially not planning to ever quit is associated with change in plans to quit., Methods: Longitudinal Population Assessment of Tobacco and Health (PATH) Study data collected between 2014 and 2019 were analyzed. Main analyses were conducted among adult daily cigarette smokers not currently using e-cigarettes with no plans to ever quit smoking (n = 2366 observations from n = 1532 individuals). Generalized estimating equations were used to evaluate the association between change in e-cigarette use and change in plans to quit smoking within the next six months, over three assessment pairs., Results: Daily cigarette smokers with no plans to quit had a higher rate of change to plan to quit if at follow-up they used e-cigarettes daily (41.4%, 95% CI: 27.1-57.3%) versus not at all (12.4%, 95% CI: 10.6-14.5%; aOR = 5.7, 95% CI: 2.9-11.2). Rate of change to plan to quit did not statistically differ between those who at follow-up used e-cigarettes some days versus not at all., Conclusions: Among adult daily cigarette smokers initially not planning to ever quit, subsequent daily e-cigarette use is associated with subsequent plans to quit smoking. Population-level research on e-cigarette use that is focused on smokers already motivated to quit may limit a complete evaluation of the smoker population., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar regulations to prevent cigar use among youth., Methods: We searched articles on Medline, EMBASE, and PsycINFO in April 2017 to identify articles relevant to cigars and adolescents. Two independent coders examined 48 articles to determine eligibility: (1) published between 2000-April 2017; (2) published in English; (3) conducted in the United States; (4) published in a peer-review journal; (5) examined cigars, cigarillos, or little cigars; (6) included youth (12-18 years old); and (7) included empirical data. Three independent coders reviewed the included articles (n = 48) to identify whether the studies addressed FDA's Research Priorities., Results: The studies addressed FDA's Research Priorities of "behavior" (n = 48), "communications" (n = 4), "marketing influences" (n = 1), and "impact analysis" (n = 1). Studies on "behavior" underscored the need for improvements in measurement, such as using brand names and distinguishing cigar products. The review revealed the need for restrictions on cigar flavors, development of media campaigns and interventions, increasing the cost (via taxation), and evaluating the impact of cigar policies., Conclusions: The studies mostly focused on surveillance of behaviors and use patterns, which revealed cigar specific issues to address in policies to decrease cigar use among youth. The lack of studies addressing other FDA's research priorities highlighted the critical need for future studies that inform prevention of youth cigar use., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: Hookah use is particularly prevalent among U.S. college students; however, few studies have investigated whether hookah use is a risk factor for the initiation of other tobacco products. This study examined whether hookah use predicted subsequent initiation of other combustible tobacco products (conventional cigarettes and cigar products) and Electronic Nicotine Delivery Systems (ENDS) among Texas college students during a 2.5-year study period., Methods: This study involved a longitudinal analysis of data from Waves 1-6, with 6 months between each wave, of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Two separate multilevel discrete-time survival analyses were used to model the associations between past 30-day hookah use and subsequent initiation of 1) other combustible tobacco products, and 2) ENDS during the 2.5 year study period, after controlling for demographic, other tobacco use, and risk-taking personality characteristics (i.e. sensation seeking and impulsivity)., Results: After controlling for covariates, past 30-day hookah use was associated with significantly higher odds of subsequent initiation of other combustible tobacco products. Past 30-day hookah use also predicted subsequent initiation of ENDS after controlling for covariates., Conclusions: This study is one of the first to demonstrate that hookah use is a predictor of subsequent initiation of other combustible tobacco products and ENDS among college students. These findings suggest that hookah may prime individuals to use other tobacco products, which has important implications for prevention programs and future research., (Copyright © 2018. Published by Elsevier Ltd.)

Introduction: The potential of e-cigarettes to elicit symptoms of nicotine dependence has not been adequately studied, particularly in adolescent populations. The present study examined the prevalence of e-cigarette-specific symptoms of nicotine dependence ("symptoms of e-cigarette dependence") and the associations between these symptoms, e-cigarette usage group, and e-cigarette cessation-related items among Texas adolescents., Methods: This study involved a cross-sectional analysis of adolescents from Wave 4 of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) (n = 2891/N = 461,069). Chi-Square analyses examined differences in the prevalence of symptoms of dependence by e-cigarette usage group (exclusive versus dual users of e-cigarettes and combustible tobacco products) and demographic characteristics. Weighted multivariable logistic regression analyses examined the associations between symptoms of e-cigarette dependence, e-cigarette usage group, and e-cigarette cessation items., Results: Exclusive e-cigarette users experienced symptoms of e-cigarette dependence, although the prevalence of most of the symptoms was higher for dual users. Adolescents who reported more symptoms of dependence were less likely to report both wanting to quit e-cigarettes and a past-year quit attempt for e-cigarettes (adjusted odds ratio "AOR" = 0.61 (95% CI = 0.41, 0.92) and AOR = 0.52 (95% CI = 0.30, 0.92), respectively)., Conclusions: This study is the first to demonstrate that adolescent e-cigarette users are experiencing symptoms of dependence specific to e-cigarettes. In addition, symptoms of dependence may be barriers to e-cigarette cessation. Future research is needed to determine if characteristics of e-cigarette use (e.g. frequency and intensity) are associated with dependence., (Copyright © 2018. Published by Elsevier Ltd.)

Measuring perceptions associated with e-cigarette use can provide valuable information to help explain why youth and adults initiate and continue to use e-cigarettes. However, given the complexity of e-cigarette devices and their continuing evolution, measures of perceptions of this product have varied greatly. Our goal, as members of the working group on e-cigarette measurement within the Tobacco Centers of Regulatory Science (TCORS) network, is to provide guidance to researchers developing surveys concerning e-cigarette perceptions. We surveyed the 14 TCORS sites and received and reviewed 371 e-cigarette perception items from seven sites. We categorized the items based on types of perceptions asked, and identified measurement approaches that could enhance data validity and approaches that researchers may consider avoiding. The committee provides suggestions in four areas: (1) perceptions of benefits, (2) harm perceptions, (3) addiction perceptions, and (4) perceptions of social norms. Across these 4 areas, the most appropriate way to assess e-cigarette perceptions depends largely on study aims. The type and number of items used to examine e-cigarette perceptions will also vary depending on respondents' e-cigarette experience (i.e., user vs. non-user), level of experience (e.g., experimental vs. established), type of e-cigarette device (e.g., cig-a-like, mod), and age. Continuous formative work is critical to adequately capture perceptions in response to the rapidly changing e-cigarette landscape. Most important, it is imperative to consider the unique perceptual aspects of e-cigarettes, building on the conventional cigarette literature as appropriate, but not relying on existing conventional cigarette perception items without adjustment., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Introduction: Research shows that adolescents who are overweight or obese may be at greater risk of cigarette smoking, and that this relationship may vary by gender. However, this relationship is understudied for electronic cigarettes (e-cigarettes). Given the high rate of adolescent obesity and the rise in e-cigarette use in adolescents, this relationship should be investigated., Methods: Data are from the third wave (collected October 2015-January 2016) of the Texas Adolescent Tobacco and Marketing Surveillance system. Students were in the seventh, ninth, and 11th grades (n=2,733) from five counties surrounding four major Texas metropolitan areas (Houston, Austin, San Antonio, Dallas). Weighted logistic regression was used to determine if weight status (healthy weight, overweight, or obese) was correlated with ever and past 30-day cigarette or e-cigarette use, controlling for sociodemographics. Models were stratified by gender. Data analyses were conducted in March 2017., Results: Compared with healthy-weight boys, obese boys had higher odds of past 30-day e-cigarette use (AOR=3.45, 95% CI=1.34, 8.33) and cigarette smoking (AOR=4.52, 95% CI=1.32, 15.51). There was no significant relationship between weight status and cigarette or e-cigarette use in girls., Conclusions: This study supports that there is a positive relationship between weight status and past 30-day cigarette and e-cigarette use for boys, but that there is no association for girls., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Sensation seeking is strongly associated with cigarette use in adolescents. However, few studies have investigated its relationship with adolescent e-cigarette use. This study examined cross-sectional and longitudinal associations between sensation seeking and a variety of e-cigarette use behaviors among Texas adolescents., Methods: This study utilized two waves of data collected 6months apart through the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) in 2014-2015 (n=2,488/N=461,069). TATAMS employs a complex probability-sampling design and is representative of students in 6th, 8th and 10th grades from five counties surrounding the four largest cities in Texas (Houston, Dallas/Ft. Worth, San Antonio, Austin). Weighted multivariable logistic regression was used to examine the cross-sectional and longitudinal associations between sensation seeking and susceptibility to e-cigarette use, ever e-cigarette use, and current (past 30day) e-cigarette use., Results: In the cross-sectional analyses, higher mean sensation seeking scores were associated with higher odds of both susceptibility to e-cigarette use and ever e-cigarette use (AOR=1.25, 95% CI=1.07, 1.47; AOR=1.24, 95% CI=1.08, 1.43, respectively). For the longitudinal analyses, only the association between higher mean sensation seeking scores and transition to ever e-cigarette use remained statistically significant (AOR=1.45, 95% CI=1.01, 2.08). There were no significant associations between sensation seeking and current e-cigarette use in either the cross-sectional or longitudinal analyses., Conclusions: Higher sensation seeking scores were consistently and significantly related to experimentation with e-cigarette use among Texas adolescents. Future interventions (e.g., communication campaigns) should target high sensation seeking adolescents to reduce initiation of e-cigarette use among this population., (Copyright © 2017. Published by Elsevier Ltd.)