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The perceived reduced formation of harmful chemicals (RF) or perceived reduced risk of harm (RH) of a smoke-free tobacco product relative to combustible tobacco products may influence its acceptance and use patterns among adult smokers and therefore impact public health. We analyzed whether and how the RF and/or RH of the heated tobacco product (HTP) IQOS™ impacted "exclusive" (100%) IQOS™ use in Japan, Italy, Germany, and Russia. Between 2016 and 2020, adult participants from longitudinal IQOS™ user cohorts in Japan (N = 6257), Italy (N = 8137), Germany (N = 8474), and Russia (N = 7231) repeatedly indicated the reasons for using IQOS™, including reasons referring to RF and RH, during their first 48 weeks in the cohort. Logistic and Cox regression were used to analyze the relationships between RF and/or RH indications for using IQOS™ and exclusive or stable exclusive IQOS™ use. At week 48, exclusive IQOS™ use in Japan (odds ratio [OR] = 1.89), Italy (OR = 3.35), Germany (OR = 3.48), and Russia (OR = 3.05) was more likely among participants who more frequently (highest vs. lowest category of number of RF and/or RH indications) indicated RF and/or RH as a reason for using IQOS™. In Japan, where other HTPs were also marketed, this was also true for the overall HTP category. Also, in Japan where RF and RH could be indicated separately as reasons for using IQOS™, indicating RH (OR = 2.92) compared to RF (OR = 1.81) resulted in a greater likelihood of exclusive IQOS™ use within the highest category of RF or RH indications. In Japan (hazard ratio [HR] = 0.74), Italy (HR = 0.80), Germany (HR = 0.72), and Russia (HR = 0.85), IQOS™ users who indicated RF and/or RH as a reason for using IQOS™ had a lower risk of becoming a stable nonexclusive than stable exclusive IQOS™ user as well as a 10–25% lower number of weeks until reaching stable exclusive IQOS™ use. Perceived reduced formation of harmful chemicals (RF) or perceived reduced risk of harm (RH) of IQOS™ have a significant impact on IQOS™ users' switching to exclusive IQOS™ use and the acceleration of stable exclusive IQOS™ use. This may also be true for the overall HTP category. Moreover, perceived RH of IQOS™ seems to be a stronger driver for exclusive IQOS™ use than perceived RF. [Contrib. Tob. Nicotine Res. 32 (2023) 50–64] [ABSTRACT FROM AUTHOR]

Objectives: Examine the prevalence of cognitive impairment within Wave 1 of the Irish Longitudinal Study on Aging (TILDA) cohort and its relationship with comorbidities and lifestyle factors. The effect of cognitive impairment on quality-of-life scores was also investigated. Methods: A secondary cross-sectional analysis of data from Wave 1 of the TILDA cohort was undertaken. Results: Prevalence of cognitive impairment ranged between 5.8% and 51.2%, depending on the instrument used (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA], respectively). Having hypertension (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.36–2.08), being a past or current smoker (OR 1.25; 95% CI 1.01–1.55) and having low physical activity (OR 2.04; 95% CI 1.64–2.53) increased the odds of being classified as cognitively impaired (MMSE <25). Similarly, being obese (OR 1.31; 95% CI 1.17–1.47), having hypertension (OR 1.42; 95% CI 1.27–1.57), and having diabetes (OR 1.71; 95% CI 1.40–2.09) increased the odds of cognitive impairment (MoCA <26). High cholesterol was associated with a protective effect (OR 0.79; 95% CI 0.63–0.98) under MMSE <25 classification while, problematic alcohol behavior reduced the odds of being classified as cognitively impaired using MoCA <26 by 35% (OR 0.65; 95% CI 0.55–0.76). Depression was not associated with increased odds of cognitive decline. Lastly, mean quality of life (QoL) scores decreases as severity of cognitive impairment increases from normal to moderate cognitive impairment (P < 0.001). Conclusions: Several modifiable risk factors for cognitive decline were identified, including smoking, low physical activity, hypertension, diabetes, and obesity. Policies aimed at reducing the prevalence of these risk factors in the population might reduce the impact of cognitive decline on public health. [ABSTRACT FROM AUTHOR]

The Loeber Risk Score (LRS) was developed to predict early-onset cannabis use in adolescence from late childhood, facilitating early identification. However, the LRS was developed in non-representative historical samples, leaving uncertain its generalizability to children/adolescents across the U.S. today. We externally validated the LRS in a diverse, nationwide cohort (N = 4,898) weighted to the composition of the U.S. Census. Participants in 20 cities completed assessments when youth were approximately 5, 9, and 15 years old. Parents completed the LRS at the age ∼5 and ∼9 interviews. At the age ∼15 interview, youth reported on the onset of alcohol/drug use before age 15, monthly drinking/binge drinking at ages 14-16, and use of cannabis multiple times per month at ages 14-16. First, we validated the LRS measured at age ∼9. Area under the receiver operating curve was 0.62 for onset of cannabis use before age 15, 0.68 for onset of cigarette use before age 15, and 0.62 for use of cannabis multiple times per month at ages 14-16. For drinking outcomes, LRS performance could not be distinguished from chance prediction. The recommended screening cutoff of LRS ≥ 2 identified 24% of children, among whom early-onset cannabis/cigarette use outcomes occurred 1.4-2.2 times more frequently than the general population. The LRS' performance did not vary significantly by sex, race, or ethnicity. When the LRS was measured at age ∼5, AUROC was significantly lower for some outcomes. Together, findings support the LRS measure as a potential tool for identifying children in early or late childhood at risk of early-onset drug use in adolescence. [ABSTRACT FROM AUTHOR]