Search

Background: With the advent of electronic nicotine delivery systems, the use of nicotine and tobacco products (NTPs) among adolescents and young adults remains high in the US. Use of e-cigarettes additionally elevates the risk of problematic use of other substances like cannabis, which is often co-used with NTPs. However, their effects on brain health, particularly the hippocampus, and cognition during this neurodevelopmental period are poorly understood. Methods: Healthy late adolescents/young adults (N = 223) ages 16-22 completed a structural MRI to examine right and left hippocampal volumes. Memory was assessed with the NIH Toolbox Picture Sequence Memory Test (PSMT) and Rey Auditory Verbal Learning Test (RAVLT). Cumulative 6-month NTP and cannabis episodes were assessed and modeled continuously on hippocampal volumes. Participants were then grouped based on 6-month NTP use to examine relationships with the hippocampus and memory: current users (CU) endorsed weekly or greater use; light/abstinent users (LU) endorsed less than weekly; and never users (NU). Results: NTP use predicted larger hippocampal volumes bilaterally while cannabis use had no impact nor interacted with NTP use. For memory, larger left hippocampal volumes were positively associated with PSMT performance, RAVLT total learning, short delay and long delay recall for the NU group. In contrast, there was a negative relationship between hippocampal volumes and performances for LU and CU groups. No differences were detected between NTP-using groups. Conclusion: These results suggest that the hippocampus is sensitive to NTP exposure during late adolescence/young adulthood and may alter typical hippocampal morphometry in addition to brain-behavior relationships underlying learning and memory processes. [ABSTRACT FROM AUTHOR]

Introduction: The FDA oversees regulatory aspects of all U.S. tobacco products. Understanding the impact of emerging health trends and incidents associated with various tobacco and nicotine products is vital for public health. This study utilizes the FDA's Tobacco Product Problem Reports (TPPRs) to characterize and track adverse health events (AHEs) associated with tobacco and nicotine products over time, considering the impact of EVALI and the COVID-19 pandemic. Methods: FDA TPPRs from 2017-2022 provided information on AHEs related to various tobacco products. After data cleaning, 839 reports were categorized by two independent coders based on affected health category, frequency of AHEs reports, and proportion of AHEs per each health category. Additionally, variations in AHEs over time were assessed, considering major health events like EVALI and the COVID-19 pandemic. Results: Among the 839 reports, electronic cigarettes (e-cigarettes) were the primary product of concern, comprising 90.6% (n = 760) of all reports, surpassing traditional cigarettes (5.1%; n = 43) and other products. Notably, 45.6% of reports (n = 383) identified the neurological system as the most frequently mentioned health category, each reporting at least one AHE. This was followed by the respiratory (39.1%; n = 328) and digestive (10.7%; n = 90) systems. Among all reported AHEs, respiratory system issues were most frequent (25.9%; n = 512), closely followed by neurological (25.2%; n = 499) and digestive (6.6%; n = 131) concerns. Most reports occurred in 2019 (65.7%; n = 551), coinciding with the EVALI outbreak, with a subsequent decline post-Q3 2019, highlighting the potential impact of specific health crises on reporting trends. Conclusion: E-cigarettes dominated adverse health reports, particularly affecting the neurological and respiratory systems, with a peak in 2019. Our findings provide insights to regulatory entities and future research, enhancing understanding of AHEs in lesser-explored bodily systems, such as the neurological and digestive systems. This study emphasizes the need for ongoing and improved surveillance of emerging tobacco products to protect public health. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the impact of the tax increase in January 2019 on changes in intention to quit and the effect of cigarette prices on quit attempts and successful quitting among male cigarette smokers in Vietnam. Methods: Data were derived from the ITC project in Vietnam, which included 1585 adult smokers at baseline (Wave 1, Aug-Oct 2018) followed up to waves 2 (Sep-Nov 2019) and 3 (Sep-Dec 2020). Generalized estimating equations regression was performed to estimate changes in the intention to quit. Multiple logistic regression analysis was used to evaluate the cigarette price of a cigarette pack in relation to quit attempts and successful quitting. Results: The increase in cigarette tax in 2019 did not significantly increase the likelihood of the intention to quit. After the tax increase, 63.6% of participants who smoked made a quit attempt, and 27.6% successfully quit smoking in the follow-up waves. However, the price of a cigarette pack was not significantly associated with quit attempts and successful quitting. The study did not observe a significant impact of cigarette prices on quit attempts and successful quitting in all subgroups of household income. Factors associated with quit attempts included the number of cigarettes smoked and the intention to quit, while those associated with successful quitting included age, dual use of cigarettes and other tobacco products, and the intention to quit. Conclusion: Current cigarette prices were not associated with cessation behaviors even within the lowest household income group. Therefore, a sharp rise in cigarette tax is required to incentivize smokers to quit smoking. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco. Methods: We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies. Results: After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use. Conclusion: Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents. [ABSTRACT FROM AUTHOR]

Purpose. This study examines smoking and alcohol use among disadvantaged Hill tribe adolescents (12–19 years old) in northern Thailand. We use Leininger's theory to better understand how cultural norms, health literacy, and perceived impacts influence these behaviors. Methods. The study utilized a cross‐sectional approach and involved 324 participants. Data were collected using standardized questionnaires (Thai‐AUDIT, FTND) to assess substance use and health literacy. Focus group discussions provided further insights into cultural norms and the impacts of such behaviors. Results. Over half (51.2%) of participants reported ever consuming alcohol, and 20.10% currently smoke cigarettes. Health literacy levels were adequate across all subgroups. Multiple regression analyses with a hierarchical approach identified the cultural and social factors including age at first drinking (β = −0.34, t = −2.68, p = 0.01) and factors related to the impact of past usage (impact on one's health: β = −0.33, t = −2.48, p = 0.01, and impact on deep feelings: β = −0.33, t = −2.33, p = 0.02), which accounted for 18.2% of the variance in current alcohol consumption frequency (adjusted R2 = 0.182, F = 3.04, p = 0.01). The analysis revealed that there was no statistically significant relationship between age at first smoking and the current amount of cigarettes (β = −0.01, p = 0.15). As expected, health literacy was shown as the only predictor that significantly predicted the current amount of cigarettes (β = −0.40, p = 0.003), accounting for 14.1% of the current amount of cigarettes (adjusted R2 = 0.141, F = 4.08, p = 0.05). Conclusion. The results provide further evidence that the standard intervention is not appropriate for utilization with this specific group. Therefore, we propose a multifaceted culturally appropriate approach that integrates the insights derived from the focus group discussion while currently targeting health literacy, alcohol attitudes, and early substance use prevention through family and community awareness initiatives. [ABSTRACT FROM AUTHOR]

Littering of cigarette butts is a major environmental challenge. In 2022, ~124 billion cigarette butts were littered in the United States. This litter may pose an environmental justice concern by disproportionately affecting human and environmental health in communities of color or communities of low socioeconomic status. However, the lack of data on the distribution and magnitude of cigarette butt littering prevents an environmental justice analysis and limits the ability to tackle this environmental challenge. We conducted an environmental justice assessment of tobacco product waste, specifically cigarette butts, through spatially-explicit, place-based estimates across the contiguous U.S. We built a bottom-up model by synthesizing census tract-level population and smoking prevalence, state-level cigarette consumption, and published littering data to assess the spatial pattern of cigarette consumption and littering, and its implications for environmental injustice in >71,600 U.S. census tracts. Further, we compared the model output to urbanicity (rural-urban commuting area) and Social-Environmental Risk (SER; CDC Environmental Justice Index). Cigarette butt density was not uniformly distributed across the U.S. and ranged from 0–45.5 butts/m2, with an area-weighted average of 0.019 ± 0.0005 butts/m2. Cigarette butt density was 96 times higher in metropolitan vs. rural areas. Cigarette butt density increased significantly with SER, with 5.6 times more littered cigarette butts, and a steeper response to population density, in census tracts with the highest SER vs. the lowest SER. These results demonstrate the relative influences of location, smoking prevalence, and population density, and show that cigarette butt littering is a potential environmental justice concern in the U.S. This study provides information that may help devise targeted strategies to reduce cigarette butt pollution and prevent disproportionate impacts. The spatial data layer with place-based cigarette consumption and butt density is a tool that can support municipal, state, and federal level policy work and future studies on associations among cigarette butt pollution and environmental health outcomes. [ABSTRACT FROM AUTHOR]

In 2017, the U.S. Food and Drug Administration (FDA) announced a regulatory plan to reduce the nicotine content of cigarettes. This study examines the association of exposure to industry-sponsored corrective statements on perceptions of the addictiveness of low-nicotine cigarettes relative to typical cigarettes within the general US population. The study comprised 4975 US adult respondents of the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3). Multinomial logistic regression models were used to examine associations between exposure to tobacco industry corrective messages and perceptions of the addictiveness of low-nicotine cigarettes relative to typical cigarettes. In the overall population, 4.1% reported that low-nicotine cigarettes were much more addictive than typical cigarettes, 67.5% said they were equally addictive, while 28.4% reported they were slightly/much less addictive. Adults exposed to industry-sponsored corrective messages had higher odds of perceiving low-nicotine cigarettes as equally addictive as typical cigarettes (aOR 1.57; 95% CI, 1.13–2.19) than those who saw no corrective messages. Those exposed to the corrective messages specifically about the addictiveness of smoking and nicotine had higher odds of perceiving low-nicotine cigarettes as equally addictive as typical cigarettes (aOR, 1.73; 95% CI, 1.07–2.81) compared to those who saw no corrective message. Our findings suggest that exposure to court-ordered tobacco industry corrective statements may have reinforced perceptions on the addictive potential of nicotine. However, study findings indicate a need for campaigns specifically tailored to address misperceptions observed in this study. 67.5% of US adults perceived low-nicotine cigarettes and typical cigarettes as being equally addictive Exposure to court-ordered corrective statements increased the odds of equal addictiveness perception Exposure to corrective statements specifically tailored to addiction increased the odds of equal addictiveness perception [ABSTRACT FROM AUTHOR]

Background: Although social determinants of health (SDoH) have increasingly been understood as clinically important factors in the onset, maintenance, and relapse of substance use behavior, little research has evaluated neighborhood vigilance in terms of smoking. Objectives: The present investigation sought to evaluate the role of neighborhood vigilance in terms of smoking abstinence expectancies (i.e., perceived consequences of refraining from smoking, including negative mood, somatic symptoms, harmful consequences, and positive consequences) and severity of problems when trying to quit among adults who smoke. Results: Participants included 93 treatment-seeking people who smoke (45.2 years of age and 29% identified as female). Results: indicated that greater levels of neighborhood vigilance were associated with negative mood and harmful consequences abstinence expectancies. No effect was evident for somatic symptom abstinence expectancies after Bonferroni correction. Conclusions: As expected, neighborhood vigilance was not predictive of positive abstinence expectancies, offering explanatory specificity. Neighborhood vigilance was also associated with more severe problems when trying to quit smoking. The current findings suggest neighborhood vigilance represents an important contextual factor involved in certain negative beliefs about abstinence and challenges in quitting. [ABSTRACT FROM AUTHOR]

Objective: Tobacco use and obesity are leading causes of preventable death in the U.S. E-cigarette use is on the rise; however, obesity prevalence among e-cigarette users is unknown. The present study characterized obesity prevalence among e-cigarette and tobacco users in a national sample of U.S. adults. Method: Data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Approximately 249,726 participants provided data on e-cigarette and tobacco use, height, weight, and demographics, and were categorized as follows: Ever vaped, ever smoked; Ever vaped, never smoked; Never vaped, ever smoked; Never vaped, never smoked. Results: Obesity prevalence (BMI ≥30 kg/m2) differed significantly across groups: 33.0% (ever vaped, ever smoked); 27.7% (ever vaped, never smoked); 33.1% (never vaped, ever smoked); 32.1% (never vaped, never smoked), p <.001. Groups also differed demographically. Logistic regressions adjusted for demographics revealed subjects in the never vaped, ever smoked group were significantly more likely to have obesity relative to those in the never vaped, never smoked group (p < 0.001) with vaping status having no main effect. Secondary analyses using never smokers as the reference found current smokers were less likely to have obesity and former smokers were more likely to have obesity, p <.001. Discussion: The present study is the first to characterize U.S. obesity prevalence among e-cigarette and tobacco users. Obesity prevalence was lower in the ever vaped, never smoked group; however, this finding appears to be attributable to demographic variables. As e-cigarette use becomes more common, future research should examine the development and maintenance of obesity among users. [ABSTRACT FROM AUTHOR]

Despite the popularity of electronic cigarettes (e-cigs) among adolescent never-smokers and adult smokers seeking a less pernicious substitute for tobacco cigarettes, the long-term health impact of vaping is largely unknown. Like cigarette smoke, e-cig vapor contains harmful and potentially harmful compounds, although in fewer numbers and at substantially lower concentrations. Many of the same constituents of e-cig vapor and cigarette smoke induce epigenetic changes that can lead to the dysregulation of disease-related genes. MicroRNAs (MiRNAs) are key regulators of gene expression in health and disease states. Extensive research has shown that miRNAs play a prominent role in the regulation of genes involved in the pathogenesis of smoking-related diseases. However, the use of miRNAs for investigating the disease-causing potential of vaping has not been fully explored. This review article provides an overview of e-cigs as a highly consequential electronic nicotine delivery system, describes trends in e-cig use among adolescents and adults, and discusses the ongoing debate on the public health impact of vaping. Highlighting the significance of miRNAs in cell biology and disease, it summarizes the published and ongoing research on miRNAs in relation to gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. It identifies gaps in knowledge and priorities for future research while underscoring the need for empirical evidence that can inform the regulation of tobacco products to protect youth and promote public health. [ABSTRACT FROM AUTHOR]

Background: Undergraduate dental curricula and courses containing ergonomic principles are introduced to students from the very beginning of dental education. Still, dentists present a high prevalence of musculoskeletal disorders, which are a direct burden on quality of life, leading to early retirement from the profession. This study aimed to assess the state of students' knowledge and awareness regarding the role of ergonomics in dentistry and its practical implementation. Methods: a cross-sectional study using a predesigned self-administered questionnaire was conducted among fourth- and fifth-year dental students of the Medical University of Silesia in Katowice, Poland (response rate of 69.2%). Results: A total of 94.6% of students declared a good, fair, or moderate level of knowledge of the subject, with a significant difference in favor of the fifth-year students (p = 0.008). Moreover, 76.1% of respondents showed a good or very good attitude toward ergonomics as a university curriculum subject. A total of 72.3% of respondents declared that the practical application of ergonomic rules in clinical dentistry is very important (five in a five-point scale). Women found dental ergonomics more important than men (p < 0.001). However, 79.3% of participants admitted not following basic ergonomic principles during clinical procedures. Conclusion: The research revealed a discrepancy between theoretical knowledge and awareness and the practical application of ergonomics in a clinical environment. Only by inculcating correct occupational standards and abiding by them from the commencement of dental education can consistency between theory and practice be achieved. This will hopefully ensure the health and well-being of dental team members throughout their professional lives. [ABSTRACT FROM AUTHOR]

Background: Philip Morris International's IQOS, with its heatsticks (HEETS), is the heated tobacco product with the largest global market share. IQOS and/or electronic cigarettes use rate is higher among Arabs vs. Jews in Israel. This paper aims to compare IQOS point-of-sale marketing strategies, and regulatory compliance in Arab vs. Jewish neighborhoods in Israel. Methods: We integrated data from two separate studies including a cross-sectional survey with IQOS retailers (December 2020–April 2021) and audits of points-of-sale that sold IQOS/HEETS (April 2021–July 2021) in 5 large cities in Israel, after marketing restrictions including a points-of-sale display ban and plain packaging became effective in Israel (January 2020). The survey included 69 points-of-sale (21 Arab, 48 Jewish neighborhoods) and the audits included 129 points-of-sale (48 Arab, 81 Jewish neighborhoods). Comparisons of IQOS marketing strategies between points-of-sale in Arab and Jewish neighborhoods were conducted using Chi-Square test, Fisher's exact test or Mann–Whitney test, as appropriate. Thematic analysis was used to analyze open-ended questions. Results: The survey showed that most marketing strategies, such as promotions to customers, were uniform across points-of-sale in Arab and Jewish neighborhoods. The most noteworthy differences were that a higher proportion of retailers from Arab neighborhoods were invited to IQOS parties (47.6% vs. 21.7%, p < 0.05) and reported personal communication with a Philip Morris International's representative (80.0% vs. 51.2%, p < 0.05). Additionally, Philip Morris International's representatives assisted points-of-sale in both Arab and Jewish neighborhoods in implementing the display ban by providing free compliant cabinets and product placement instructions, and directly interacted with customers. The audits showed that points-of-sale in Arab neighborhoods were more compliant with the display ban (25.5% vs. 8.8%, p < 0.05), but less compliant with plain packaging (62.5% vs. 79.3%, p < 0.05). Conclusions: There were not many notable differences in IQOS marketing across points-of-sale in Arab vs. Jewish neighborhoods, but Philip Morris International utilized marketing elements of cultural significance, especially for points-of-sale in Arab neighborhoods, such as more personal communication and invitation to social events. Continuous surveillance of tobacco points-of-sale marketing and legislation compliance is needed, with a special focus on demographic/location-based differences. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodsResultsConclusionThis study, aimed to determine and compare DNA damage in e-cigarette and HTP (IQOS) users by assessing DNA-adducts, which are biomarkers of various DNA alkylation and oxidation.For the evaluation of DNA alkylation, N3-Ethyladenine (N3-EtA) and N3-Methyladenine (N3-MeA) adducts were used. DNA oxidation was assessed using, 8-hydroxy-2’-deoxyguanosine(8-OHdG). The urinary cotinine, N3-MeA, N3-EtA, and 8-OHdG concentrations of the cigarette smokers (n:39), e-cigarette users (n:28), IQOS users (n:20), passive smokers (n:32), and nonsmokers(n:41) who lived Ankara, Turkiye were determined using, liquid chromatography–tandem mass spectrometry (LC–MS/MS).In light of the detected 8-OHdG levels, e-cigarette (3.19 ng/g creatinine) and IQOS (4.38 ng/g creatinine) users had higher oxidative DNA damage than healthy nonsmokers (2.51 ng/g creatinine). Alkylated DNA-adducts were identified in the urine of e-cigarette (N3-MeA: 3.92 ng/g creatinine; N3-EtA: 0.23 ng/g creatinine) and IQOS (N3-MeA: 7.54 ng/g creatinine; N3-EtA: 0.29 ng/g creatinine) users. In the generation of N3-MeA adducts, a significant difference was found between IQOS users and e-cigarette users (p < 0.05). Also, DNA alkylation in flavored e-cigarette users (N3-MeA: 4.51 ng/g creatinine; N3-EtA: 0.27 ng/g creatinine) was higher than in non-flavored e-cigarette users (N3-MeA: 2.27 ng/g creatinine; N3-EtA: 0.06 ng/g creatinine). The highest cotinine levels were found in cigarette smokers (16.1316 ng/g creatinine). No significant difference was found when e-cigarette (1163.02 ng/g creatinine) and IQOS smokers were compared (1088.3 ng/g creatinine).People who use e-cigarettes and IQOS may be at higher risk of genotoxicity than those who do not use and are not exposed to any tobacco products. Furthermore, the usage of flavoring additives in e-cigarettes contributed to additional genotoxic damage risks. [ABSTRACT FROM AUTHOR]

Background: Tobacco is one of the major causes of preventable deaths worldwide. Around the world, tobacco is one of the leading causes of tobacco-related cancer. Objectives: To estimate the proportion of tobacco use among tribal adolescents in Terai-Doars region, and to determine the related risk factors. Methodology: A school based cross-sectional study was conducted among 680 tribal adolescent students of government schools in Teria-Dooars region of West Bengal, from April 2022 to October 2022. After obtaining consent, data on socio-demographics and tobacco consumption were collected. Significance was tested using multivariable logistic regression. Results: The proportion of tobacco consumption among tribal adolescent students was found to be 45.7%. Male (58.1%) and female (28.2%) adolescents were found to be regular consumers. Male adolescents primarily prefer smokeless tobacco, with 58% starting their habit between 12-15 years age. Male adolescents preferred smokeless tobacco, with a significant proportion starting their habit between 12-15 years (58%). High consumption of Khaini (52.6%), Guthka (46.6%), and Cigarette (42.4%) is observed. Age (<0.001), sex (<0.001), religion (0.029), socio-economic level (0.004), and family history (0.003) significantly associated with tobacco consumption. Conclusions: Overall proportion of tobacco use was high among the tribal adolescents, with most starting smoking at an early age. The major risk factor that contributed was the family members' tobacco use. [ABSTRACT FROM AUTHOR]

Introduction: Singapore phased in standardized tobacco packaging on 1 July 2020 following a three-month grace period. This pre-post study evaluated its impacts on smoking-related behaviors and perceptions among adults who currently smoke. Methods: Baseline and follow-up data were collected in a pre- and post-questionnaire from a cohort of 1873 Singaporean adults who were currently smoking at baseline. Baseline data were collected from December 2019 to May 2020, and followup data from July 2021 to September 2021. We used descriptive statistics and bivariate analyses to assess pre-post changes (Bhapkar's test, Wilcoxon signed rank test) and to identify characteristics of participants who had quit or cut down smoking at follow-up (Pearson's chi-squared, Fisher's exact test). Results: At follow-up, 11.7% (n=220) had quit smoking. There was a higher proportion of those smoking non-daily (pre: 13.1%, post: 16.9%; p<0.001), and those intending to quit within the next year (pre: 14.8%, post: 17.5%; p<0.05) or six months (pre: 10.4%, post: 13.2%; p<0.01). Tobacco products were scored more negatively in relation to packaging, quality, satisfaction, value for money and overall appeal (scores pre: 15.9, post: 14.3; p<0.001), harmfulness (scores pre: 0.61, post: 0.54; p<0.05), noticing others smoking the same brand (scores pre: 1.92, post: 1.65; p<0.001), and considering quitting due to health warnings (scores pre: 0.81, post: 0.86, p<0.05). Fewer reported that some cigarette brands have higher prestige (pre: 58.0, post: 54.3%; p<0.01), and more reported using flavored cigarettes (pre: 42.2%, post: 60.1%; p<0.001) and e-cigarettes (pre: 4.2%, post: 6.1%; p<0.01). Conclusions: In Singapore, the changes observed before and after the implementation of standardized packaging suggest that it might be associated with quit-related outcomes, reduced tobacco product appeal, and increased effectiveness of graphic health warnings. [ABSTRACT FROM AUTHOR]

Introduction: The research regarding the effect of hookah smoking on health is still deficient, even though it has been proven to jeopardize human health by raising the hazard of different types of cancers, infections, and cardiovascular disease. We aimed to study the effect of dual tobacco smoking (hookah and cigarettes) on semen parameters of infertile men. Methods: In this cross-sectional study, we studied the effect of different types of smoking patterns on human semen parameters among men who visited IVF laboratories to do a seminal fluid analysis (SFA). A total number of 761 participants were included, divided into the following: 108 dual smokers, 219 hookah smokers, 222 cigarette smokers, and 212 non-smokers. To analyze the effect of dual smoking on normal morphology, an interaction term between the cigarette index and hookah index was used. Results: Multivariable regression analysis after adjustment for age, BMI, education level, children, chronic diseases, varicocele, testicular surgery history, infertility duration, and cause revealed no significant difference in the sperm concentration and the percentage of progressive motility between non-smokers, cigarette smokers, or hookah smokers. However, there was a significant difference in the log of normal morphology percentage between the three groups. Cigarette and hookah smoking were significantly associated with having lower percentages of normal morphology. There was a significant difference in the log-normal morphology %, where light and heavy dual smokers had the least exponential beta of log-normal morphology %, 0.43 (95% CI: 0.33–0.55) and 0.36 (95% CI: 0.24–0.53), respectively. Conclusions: Dual tobacco smoking can adversely affect sperm morphology. [ABSTRACT FROM AUTHOR]

Introduction: Smoking elevates catecholamines that increase the risk for cardiovascular disease. Sparse evidence exists about the effects of e-cigarettes and catecholamines. Higher levels of catecholamines could trigger the increased heart rate, blood pressure, and decreased vascular function reported with the use of e-cigarettes. We investigated the difference in urinary catecholamines and their metabolites before and after the use of an e-cigarette containing nicotine or cigarettes compared to no tobacco use. Methods: In our observational cohort exposure study, healthy adults aged 21– 45 years who were currently using e-cigarettes, cigarettes, or had never used tobacco, participated in an acute exposure visit using their most common tobacco product. Urine was collected before, 1, and 2 hours after a 3-second puff every 30 seconds for 10 minutes on an e-cigarette or straw or use of 1 cigarette. Urinary catecholamines and their metabolites were measured by ultra-high-performance liquid chromatography. Participants (n=323) were grouped by the product used at the visit. We compared levels of creatinine normalized log-transformed urinary catecholamines and their metabolites across groups using Dunn's test following a Kruskal-Wallis test in unadjusted and demographically adjusted models. Results: Prior to use, individuals who used cigarettes (n=70) had lower urinary metabolites from epinephrine, serotonin, and norepinephrine. No differences were seen in those who used e-cigarettes (n=171) and those who did not use tobacco (n=82). In fully adjusted models, 1 h after the use of a combustible or e-cigarette, log-transformed urinary metabolites from norepinephrine (β=1.22; 95% CI: 0.39– 2.05, p=0.004 and β=1.06; 95% CI: 0.39–1.74, p=0.002), dopamine (β=0.37; 95% CI: 0.24–0.5, p<0.001 and β=0.15; 95% CI: 0.05–0.26, p<0.001), and epinephrine (β=1.89; 95% CI: 0.51–3.27, p=0.008 and β=1.49; 95% CI: 0.38–2.61, p=0.009) were elevated. In fully adjusted models, combustible cigarette use was associated with elevated urinary norepinephrine (β=0.46; 95% CI: 0.13–0.81, p=0.007) and dopamine (β=0.19; 95% CI: 0.06–0.31, p=0.003) 1 h after use. Conclusions: We found that the use of both e-cigarettes and cigarettes was associated with elevated urinary catecholamines or their metabolites. Catecholamines could be useful as a biomarker of harm for tobacco use and considered by tobacco regulatory scientists in future research. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of smoking, including heated tobacco products (HTPs), among Japanese dentists was reported to be 16.5%, significantly higher than that among Japanese physicians and United States dentists. However, large-scale studies on smoking cessation implementation based on dentists' smoking status and perceptions since the introduction of HTPs are lacking. Therefore, we aimed to investigate and assess dentists' attitudes toward smoking, including HTP use and smoking cessation, according to smoking status. Methods: A self-administered questionnaire comprising six major items was mailed to 3883 dentists who were members of the Aichi Dental Association in August 2019. The primary outcome was smoking cessation status. The secondary outcome was the impact of smoking on intervention for smoking cessation. This study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results: Among the 1317 (42%) dentists analyzed, men were more positive toward smoking than women. Current and former smokers were more positive about smoking than never smokers/users, regardless of the tobacco product type. Additionally, the current smoker group using conventional cigarettes was less likely to ask for their patients' smoking status than the never smoker group. Furthermore, the current smoker (OR=2.0; 95% CI: 1.3–3.1 vs never smoker) and HTP user (OR=1.9; 95% CI: 1.2–3.1 vs never user) groups were less likely to engage in smoking cessation than the never smoker/user groups, regardless of the tobacco product type. Conclusions: Since the smoking status of dentists affects the implementation of smoking cessation interventions, it is crucial to encourage them to quit using all tobacco products to promote smoking cessation interventions in dental practice. Additionally, providing proper smoking prevention education to dentists is an important task. [ABSTRACT FROM AUTHOR]

Multi-level, place-based interventions have proven effective at promoting a range of health behaviors, including tobacco control and discouraging the uptake of tobacco products. This paper describes the implementation and impact of a 3-year, multi-level tobacco prevention and control program at a community-college minority-serving institution (MSI) on the Texas Gulf Coast within the context of a broader multi-sector, cross-functional health coalition. The intervention studied included a tobacco-free policy, a large-scale communication campaign highlighting parts of the intervention and prevention and cessation resources. The intervention was bolstered by the support of a community-led Steering Committee and tobacco control experts. Results from the first 3 years of implementation show that tobacco-free policies were largely supported by community members, awareness of the policy increased over time, and tobacco prevention and cessation resources were successfully embedded into campus norms. This multi-component approach shows how a community college was able to effectively reach students and staff on their campus to increase awareness of both the campus tobacco-free policy and the availability of tobacco prevention and cessation resources. Additionally, it also offers lessons for future tobacco prevention and control work in higher education. [ABSTRACT FROM AUTHOR]

Since long-term effects of heated tobacco products (HTP) on the progression of chronic obstructive pulmonary disease (COPD) are unknown, we used COPD mice model to compare immune cell-dependent pathological changes in the lungs of animals which were exposed to HTP or combustible cigarettes (CCs). We also performed intracellular staining and flow cytometry analysis of immune cells which were present in the blood of CCs and HTP users who suffered from immune cell-driven chronic obstructive respiratory diseases. CCs enhanced NLRP3 inflammasome-dependent production of inflammatory cytokines in lung-infiltrated neutrophils and macrophages and increased influx of cytotoxic Th1, Th2, and Th17 lymphocytes in the lungs of COPD mice. Similarly, CCs promoted generation of inflammatory phenotype in circulating leukocytes of COPD patients. Opposite to CCs, HTP favored expansion of immunosuppressive, IL-10-producing, FoxP3-expressing T, NK, and NKT cells in inflamed lungs of COPD mice. Compared with CCs, HTP had weaker capacity to promote synthesis of inflammatory cytokines in lung-infiltrated immune cells. Significantly lower number of inflammatory neutrophils, monocytes, Th1, Th2, and Th17 lymphocytes were observed in the blood of patients who consumed HTP than in the blood of CCs users, indicating different effects of CCs and HTP on immune cells' phenotype and function. [ABSTRACT FROM AUTHOR]

People's reaction to the FDA's ban on flavored cigarettes and cigars may be modified by a concurrent ban on flavored e-cigarettes. We aim to estimate the prevalence of smoking and e-cigarette use among U.S. adults under various ban scenarios. We collected the reactions of people who used cigarettes, cigars, and e-cigarettes reactions to three hypothetical ban scenarios, (1) restricting menthol cigarettes and flavored cigars only, or (2) further restricting e-cigarettes with any flavors except menthol or tobacco, or (3) further restricting e-cigarettes with all flavors. The above data were analyzed to identify determinants of reactions and to estimate and calibrate the probabilities of quitting and switching to non-flavored cigarettes and cigars. Afterward, the probabilities were applied to 2018–2019 TUS-CPS respondents to estimate the prevalence of smoking and e-cigarette use. Compared with the baseline, the prevalence of smoking decreased from 12.6% to 10.5%, and e-cigarette use increased from 2.6% to 3.8% in Scenario No.1. In Scenario No.2 and No.3, the prevalence of smoking was 10.5% and 10.7%, and the prevalence of e-cigarette use were 3.1% and 2.4%, respectively. For black people, the prevalence of smoking decreased from 14.2% in baseline to 8.1%-8.8% in three scenarios. The result indicated that for a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes with an exemption of menthol flavor could be more effective in encouraging people to quit smoking. Black people may see a disproportionate benefit from all ban scenarios compared with other race/ethics groups. What is already known on this topic: ban menthol in cigarettes and flavored cigars increases quitting among people who currently smoke. What this study adds: For a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes could be complementary if menthol flavor was exempted. How this study might affect research, practice or policy: For flavor bans, inventions to mitigate the increasing use of e-cigarettes and alternative tobacco products are needed, also the interventions should be tailored to various population segments. In a study that examined how flavor bans may affect smoking and the use of e-cigarettes, we found for a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes with an exemption of menthol flavor could be more effective in encouraging people to quit smoking. We wanted to see how people would react if the government banned certain types of flavored cigarettes and cigars, and also e-cigarettes with flavors. We surveyed people who used cigarettes, cigars, and e-cigarettes and found that if they banned menthol cigarettes and flavored cigars, more people might quit smoking, but some might switch to non-flavored products. This effect was even more noticeable when menthol e-cigarettes were also banned. Our study suggested that if menthol flavor is exempted, banning flavored e-cigarettes alongside menthol cigarettes and flavored cigars could work together. Interestingly, the benefits of these bans might be more significant for Black people compared to other racial groups. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18–69 years in Bolivia in 2019. Cross-sectional study. The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified. [ABSTRACT FROM AUTHOR]

Because of the increasing popularity of e-cigarettes, monitoring the e-cigarette market has become important for national health authorities to guarantee safety and quality. In the EU, the Tobacco Products Directive requires emission studies for e-cigarette products. The absence of industry guidelines for studying these emissions and the lack of proper validation in the literature led us to develop and validate a method using the total error approach for the determination of nicotine in e-cigarette aerosols. A commercial vaping device was used to generate aerosols, which were then collected on Cambridge filter pads and measured for nicotine concentration by UHPLC-DAD after extraction. The method was successfully validated by generating accuracy profiles, which show that the β-expectation tolerance intervals remained below the acceptance limits of ±20%. Within-run repeatability and intermediate precision were considered acceptable since the highest RSD value obtained was below 5%. The method was applied to 15 commercial e-liquids. A complete validation of a method for the analysis of e-cigarette emissions is presented, including several parameters that impact the accuracy and reproducibility. Similar systematic approaches for method development and validation could be used for other e-cigarette emission analysis methods to ensure the reliability of the measurements. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate oral alterations among university students and explore possible associations with tobacco consumption in its various forms. A cross-sectional study was conducted in 2 phases: the first phase involved administering an electronic questionnaire to participants determine the prevalence of tobacco use and the second phase involved a physical examination of the participants. The participants were grouped on the basis of their reported habits and compared using statistical analysis (P <.05). Of the 620 participants, 57.1% reported using tobacco in some form, with 47.4% reporting electronic cigarette (e-cigarette) use. In the clinical phase, comparing the presence of oral changes in tobacco users vs nonusers, e-cigarette users had a higher proportion of white-spot caries lesions (P =.041) and gingivitis (P =.012). When e-cigarette use was combined with other forms of tobacco use, additional oral changes were more prevalent, including coated tongue and nicotinic stomatitis (P <.05). The use of alternative forms of tobacco consumption is common among university students, with e-cigarette use being the most prevalent form, and may lead to detrimental effects on the oral cavity, such as caries and gingivitis, particularly when used in conjunction with other tobacco products. The use of tobacco in alternative forms, such as e-cigarettes, can affect oral health directly or indirectly. Dentists should be familiar with the characteristics of this population and the potential oral repercussions associated with tobacco use to address the impact on health and raise awareness of the associated risks. [ABSTRACT FROM AUTHOR]

Electronic cigarette (e-cig) use, otherwise known as "vaping", is widespread among adolescent never-smokers and adult smokers seeking a less-harmful alternative to combustible tobacco products. To date, however, the long-term health consequences of vaping are largely unknown. Many toxicants and carcinogens present in e-cig vapor and tobacco smoke exert their biological effects through epigenetic changes that can cause dysregulation of disease-related genes. Long non-coding RNAs (lncRNAs) have emerged as prime regulators of gene expression in health and disease states. A large body of research has shown that lncRNAs regulate genes involved in the pathogenesis of smoking-associated diseases; however, the utility of lncRNAs for assessing the disease-causing potential of vaping remains to be fully determined. A limited but growing number of studies has shown that lncRNAs mediate dysregulation of disease-related genes in cells and tissues of vapers as well as cells treated in vitro with e-cig aerosol extract. This review article provides an overview of the evolution of e-cig technology, trends in use, and controversies on the safety, efficacy, and health risks or potential benefits of vaping relative to smoking. While highlighting the importance of lncRNAs in cell biology and disease, it summarizes the current and ongoing research on the modulatory effects of lncRNAs on gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. The gaps in knowledge are identified, priorities for future research are highlighted, and the importance of empirical data for tobacco products regulation and public health is underscored. [ABSTRACT FROM AUTHOR]

Introduction The use of electronic vaping products (EVPs) containing nicotine, marijuana, and/or other substances remains prominent among youth; with EVPs containing nicotine being the most commonly used tobacco product among youth since 2014. However, a detailed understanding of the chemical composition of these products is limited. Aims and Methods From February 25th to March 15th, 2019, a total of 576 EVPs, including 233 e-cigarette devices (with 43 disposable vape pens) and 343 e-liquid cartridges/pods/bottled e-liquids, were found or confiscated from a convenience sample of 16 public high schools in California. Liquids inside 251 vape pens and cartridges/pods/bottled e-liquids were analyzed using a gas chromatography/mass spectrometry (GC/MS). For comparison, new JUUL pods, the most commonly used e-cigarette among youth during 2018–2019, with different flavorings and nicotine content were purchased and analyzed. Results For e-cigarette cartridges/pods/bottled e-liquids, nicotine was detected in 204 of 208 (98.1%) samples. Propylene glycol and vegetable glycerin were dominant solvents in nicotine-containing EVPs. Among 43 disposable vape pen devices, cannabinoids such as tetrahydrocannabinol (THC) or cannabidiol (CBD) were identified in 39 of 43 (90.1%) samples, of which three contained both nicotine and THC. Differences in chemical compositions were observed between confiscated or collected JUULs and purchased JUULs. Measured nicotine was inconsistent with labels on some confiscated or collected bottled e-liquids. Conclusions EVPs from 16 participating schools were found to widely contain substances with known adverse health effects among youth, including nicotine and cannabinoids. There was inconsistency between labeled and measured nicotine on the products from schools. Implications This study measured the main chemical compositions of EVPs found at 16 California public high schools. Continued efforts are warranted, including at the school-level, to educate, prevent, and reduce youth use of EVPs. [ABSTRACT FROM AUTHOR]

Introduction In recent years, hundreds of jurisdictions around the world have enacted policies that prohibit sales of flavored e-cigarettes. In most cases, these jurisdictions permit the sale of tobacco flavored e-cigarettes. We sought to understand how tobacco flavor in e-cigarette advertisements were presented. Aims and Methods Our sample included 2966 U.S. English-language e-cigarette ads compiled by a market research firm, Numerator, that ran from January 2018 to December 2020. We describe the prevalence of different tobacco flavor names in our sample and classified each name into one of the following thematic categories: Traditional Tobacco, Pipe/Cigar Tobacco , Sensory Expectancies , Color , Physical Attribute , Place , and non-characterizing Concept flavor. Results In our sample, 28% (n  = 832/2966) of ads promoted at least one tobacco flavored e-cigarette product (e-cigarette device or liquid). Across the 832 ads, we counted 1019 tobacco flavored products and identified 51 unique tobacco flavor names. The most common tobacco flavor names were Traditional Tobacco names like "Tobacco" (n  = 393), "Classic tobacco" (n  = 107) and 'Original' (n  = 59). Some names were associated with Color (eg, 'Golden tobacco'; n  = 153), Sensory Expectancy (eg, 'Rich tobacco'; n  = 148), Place where tobacco cultivation takes place (eg, 'Carolina tobacco'; n  = 83), Physical Attributes of tobacco (eg, 'Cut tobacco'; n  = 17) and non-characterizing Concept flavor (eg, 'Freedom juice'; n  = 14). Few tobacco flavors suggested a type of Pipe/Cigar Tobacco (eg, "Cavendish"; n  = 4). Conclusions We identified 51 different tobacco flavor names, highlighting the practice describing the flavor beyond "tobacco." Future research can investigate whether these flavor names and descriptors influence consumers' perceptions, including perceived risks, of e-cigarette products. Implications Flavors are used to market e-cigarettes. Globally, many jurisdictions restrict flavored e-cigarette sales, but few restrict tobacco flavor. This study identified 51 unique ways tobacco flavored e-cigarettes have been named in a sample of U.S. English-language ads, suggesting diversified ways to market "tobacco." We identified several sub-categories of tobacco flavor names that rely on Color , Sensory Expectancies , and non-characterizing Concept flavor attributes. As e-cigarette flavor restrictions that exempt tobacco flavor are still prevalent, this study highlights the need for continued monitoring of naming conventions of tobacco flavored products and examination of how nuanced flavor names influence perceptions and expectations. [ABSTRACT FROM AUTHOR]

Introduction Electronic cigarettes (e-cigarettes) are the most widely used tobacco product by youth and young adults in the United States. Effective prevention campaigns require the identification of appropriate content focus for message construction. Aims and Methods A sample of 2622 youth and young adults ages 15–24 were recruited through social media advertisements and completed an online survey. Respondents reported current e-cigarette use or intention to use if not currently using. They also indicated agreement or disagreement with 75 e-cigarette-related beliefs representing 16 themes. The relative promise of each theme/belief for campaign messaging was investigated by examining its association with the behavior/intention outcomes and the opportunity for positive change in its distribution (room to move). Results All themes showed significant associations with the behavior (ORs = 2.49–19.04) and intention (ORs = 2.21–6.11) outcomes. Room to move for themes ranged from 32.9% to 96.3% in behavior analysis and 15.6–93.9% in intention analysis. A normed relative promise index (M = 50, SD = 17) showed flavors (72), comparison to cigarettes (69), and relaxation and mental health (68) as the top ranked themes. Subgroup analyses by demographics revealed few differences. Results on the belief level were largely consistent with those on the theme level. Conclusions Data from this study provide timely evidence for the relative value of various themes/beliefs as potential targets for message development in e-cigarette prevention campaigns. The final selection of target themes/beliefs requires consideration of openness to persuasion, which may be informed by additional testing. Implications Electronic cigarettes (e-cigarettes) are the most widely used tobacco products among youth and young adults in the United States. This study adds new evidence on the relative promise of a wide range of e-cigarette beliefs and belief clusters (themes) as potential targets for message development in educational campaigns. This evidence is important to consider in future campaign efforts directed at the youth and young adult populations in the United States. [ABSTRACT FROM AUTHOR]

Introduction Sales data analyses are increasingly used to guide tobacco regulatory science. However, such data do not cover specialist retailers like vape shops or tobacconists. Understanding the extent of the cigarette and electronic nicotine delivery system (ENDS) markets covered by sales data is critical to establishing such analyses' generalizability and potential biases. Methods Using retail sales data from Information Resources Incorporated (IRI) and Nielsen, we conduct tax gap analyses comparing states' cigarette and ENDS tax revenue to tax collection estimates based on retail sales data. For the 23 US states in both retail sales datasets, cigarette tax gap analyses were conducted for each year from 2018 to 2020. Four (Louisiana, North Carolina, Ohio, and Washington) of those 23 states levied per-unit ENDS taxes and provided monthly tax revenue data covering January 2018 to October 2021, where we conducted monthly tax gap analyses for both cigarettes and ENDS. Results Across states covered by both sales datasets, annual mean cigarette sales in IRI and Nielsen account for 92.3% (95% CI = 88.3% to 96.2%) and 84.0% (95% CI = 79.3% to 88.7%) of state cigarette tax revenue, respectively. Monthly average coverage rates for ENDS sales were lower, ranging from 42.3% to 86.1% for IRI and 43.6% to 88.5% for Nielsen, but remained stable over time. Conclusions IRI and Nielsen sales data capture almost the entire US cigarette market and a substantial but lower portion of the US ENDS market. With proper care to address shortcomings, sales data analyses can capture changes in the US market for these tobacco products. Implications Policy evaluations and analyses using e-cigarette and cigarette sales data are often criticized because these data do not cover online sales or sales by specialty retailers like tobacconists. Cigarette sales data consistently cover nearly 90% of taxed sales, while e-cigarette sales data cover around 50% of taxed volumes. Retail sales data capture nearly all cigarette sales and a substantial portion of ENDS sales with relatively stable rates of coverage over time, supporting their continued use in tobacco surveillance and policy evaluation work. [ABSTRACT FROM AUTHOR]

Introduction E-cigarette flavor bans could reduce or exacerbate population health harms. To determine how US e-cigarette flavor restrictions might influence tobacco use behavior, this study assesses responses to real-world and hypothetical flavor bans among young adults who use flavored e-cigarettes. Aims and Methods An online, national survey of young adults ages 18–34 who use flavored e-cigarettes was conducted in 2021 (n  = 1253), oversampling states affected by e-cigarette flavor restrictions. Participants were asked about their responses to real-world changes in the availability of flavored e-cigarettes. Unaffected participants were asked to predict their responses under a hypothetical federal e-cigarette flavor ban. Results The most common response to real-world changes in flavored e-cigarettes availability was to continue vaping (~80%). Among those who exclusively vaped, 12.5% switched to combustible tobacco. Quitting all forms of tobacco was selected by 5.3% of those exclusively vape versus 4.2% who dual use. Under a hypothetical federal ban, more than half of respondents stated they would continue vaping; 20.9% and 42.5% of those who exclusively vape versus dual use would use combustible tobacco. Quitting all tobacco products was endorsed by 34.5% and 17.2% of those who exclusively vape versus dual use. Conclusions Young adults who vape flavored e-cigarettes have mixed responses to e-cigarette flavor bans. Under both real-world and hypothetical e-cigarette flavor bans, most who use flavored e-cigarettes continue vaping. Under a real-world ban, the second most common response among those who exclusively vape is to switch to smoking; under a hypothetical federal ban, it is to quit all tobacco. Implications This is the first national survey to directly ask young adults who use flavored e-cigarettes about their responses to real-world changes in flavored e-cigarette availability due to state and local flavor restrictions. The survey also asked individuals to predict their responses under a hypothetical federal e-cigarette flavor ban. Most who use flavored e-cigarettes would continue vaping following e-cigarette flavor restrictions, but many would switch to or continue using combustible tobacco, highlighting potential negative public health consequences of these policies. Policymakers must consider the impact of e-cigarette flavor bans on both e-cigarette and cigarette use. [ABSTRACT FROM AUTHOR]

Introduction The global market for capsule cigarettes has grown rapidly, especially in Latin America. This research examined the sales trends and patterns as well as packaging characteristics of capsule cigarette in Mexico in recent years. Methods National data on cigarette sales in Mexico between October 2018 and September 2021 licensed from NielsenIQ were supplemented with cigarette pack pictures and Internet searches to determine whether characterizing flavor, concept flavor, and action descriptors were used. Market share in sales value and volume was calculated by capsule and flavor status, descriptors, price tier, manufacturer, pack size, and cigarette length for the whole time period and for each month. Number of unique brand variants was also examined. Results Capsule cigarette sales totaled US$4.29 billion or 30.99 billion sticks during the assessed period, comprising 37.7% of the cigarette market share in sales value or 35.5% in sales volume. Over half of capsule cigarettes sold during this time period had concept flavor descriptors, 17.8% contained characterizing flavor descriptors, and 15.1% contained action descriptors that were suggestive of the interactive aspects of capsules. The monthly market share of capsule cigarette sales volume among all cigarette sales in Mexico increased steadily from 33.3% in October 2018 to 37.3% in September 2021. Conclusions The expanding capsule cigarette market in Mexico is concerning, given the product's associated misconceptions of reduced harm and greater appeal among youth. Findings underline the need for enhanced regulations to address the public health threat posed by capsule cigarettes. Implications Capsule cigarettes have a substantial market share in Mexico, with increasing popularity. Descriptors and other product characteristics such as cigarette length might be used to increase the appeal and target particular populations. Policy makers should consider banning capsules and flavors in cigarettes including descriptors or other indication in product presentation that could be perceived as denoting a taste, aroma, or sensation, and making the appearance and design of tobacco products more commensurate with the harm they cause by adopting plain and standardized packaging. [ABSTRACT FROM AUTHOR]

In volume 3, number 3 of NEJM Evidence, we published an article entitled "Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes" (DOI: 10.1056/EVIDoa2300229) by Glantz et al. In that report, the authors conducted a meta-analysis to estimate the pooled odd ratios for a number of health effects associated with the use of e-cigarettes, dual use of e-cigarettes and cigarettes, and use of cigarettes alone. Based on an analysis of 107 primarily cross-sectional studies, they concluded that e-cigarette use and dual use may be associated with higher health risks than commonly assumed. [ABSTRACT FROM AUTHOR]

Aim: Some previous studies suggest that the consumption of tobacco and nicotine products overall declined during the COVID-19 pandemic, but the results are mixed. We investigated tobacco and nicotine product sales in Finland, including the sales of nicotine replacement therapy (NRT). Our particular focus was on nicotine pouches used as NRT. We aimed to evaluate the effect of the COVID-19 pandemic on the sales of tobacco and NRT products in 2020 by comparing the sales to the previous year. Methods: The data were derived from a large sales group (S group) in Finland, representing 46% of the market share in grocery trade in 2020. The gross weekly sales of tobacco (cigarettes, loose tobacco) and NRT (patches, inhalers, tablets, gum and "other", consisting mainly of nicotine pouches) were retrieved from February to December 2020 from 1062 points of sale throughout the country and compared to the same period in 2019. Results: During this period, there was a significant increase in cigarette sales. Moreover, the sales of NRT were significantly higher throughout 2020 compared with 2019. Specifically, the sales of nicotine pouches sold as NRT increased, especially after the travel restrictions in Finland were initiated and the national boundaries closed in the spring of 2020. Conclusions: During the COVID-19 pandemic in Finland, the sales of cigarettes and NRT products increased, especially those of nicotine pouches sold as NRT. Our findings call for further research to reveal the factors leading to this increase and to determine whether the situation is long-standing. [ABSTRACT FROM AUTHOR]

The marketing of heated tobacco products (HTPs), like IQOS, influences consumers' perceptions. This mixed-methods study analyzed (i) survey data (2021) of 2222 US and Israeli adults comparing perceptions of 7 IQOS attributes (design, technology, colors, customization, flavors, cost and maintenance) and 10 marketing messages (e.g. 'Go smoke-free...') across tobacco use subgroups and (ii) qualitative interviews (n  = 84) regarding IQOS perceptions. In initial bivariate analyses, those never using HTPs (86.2%) reported the least overall appeal; those currently using HTPs (7.7%) reported the greatest appeal. Notably, almost all (94.8%) currently using HTPs also currently used cigarettes (82.0%) and/or e-cigarettes (64.0%). Thus, multivariable linear regression accounted for current cigarette/e-cigarette use subgroup and HTP use separately; compared to neither cigarette/e-cigarette use (62.8%), cigarette/no e-cigarette use (17.1%) and e-cigarette/no cigarette use (6.5%), those with dual use (13.5%) indicated greater overall IQOS appeal (per composite index score); current HTP use was not associated. Qualitative data indicated varied perceptions regarding advantages (e.g. harm, addiction and complexity) of IQOS versus cigarettes and e-cigarettes, and perceived target markets included young people, those looking for cigarette alternatives and females. Given the perceived target markets and particular appeal to dual cigarette/e-cigarette use groups, IQOS marketing and population impact warrant ongoing monitoring to inform regulation. [ABSTRACT FROM AUTHOR]

The use of smokeless tobacco products (STP) as a substitute for tobacco smoking is driving increasing consumption of these products especially in developing countries. The study sought to make comparison of cardiovascular risk profile between chronic STP users and suitably matched tobacco-naïve controls. This is a preliminary report from the cross sectional part of a two-arm prospective study of Smokeless Tobacco Products Composition and Exposure Outcome in Enugu metropolis, Nigeria. Consecutively recruited current Smokeless tobacco users, who had no history of cigarette smoking, aged 18 years and above, residing in selected communities in Enugu metropolis, Nigeria were recruited for the study from October 2022 to July 2023. Age and sex matched non-tobacco users from same localities as the study subjects served as controls. Written informed consent to participate in the study was obtained from all study participants. All participants were screened by the investigators, using the study case report forms, to obtain data on medical history, demographic, clinical, laboratory, and electrocardiographic evaluation. Data from 54 STP-users and 54 non-STP-users (mean age 56.58 ± 8.15 years) were analyzed. Anthropometric parameters were similar in both groups. Smokeless tobacco users had higher erect and supine blood pressure indices as well as greater postural drop in systolic blood pressure. The occurrence of diabetes mellitus (20.37% versus 5.56%) and hypertension (25.93%; 11.11%) was significantly higher in the STP-users than in the non-user population, (p = 0.02192 and 0.04751 respectively). Electrocardiographic evaluation showed significantly increased QTc and dispersions of P-wave, QRS and QT intervals as well as reduced PR interval in STP users. Electrocardiographic abnormalities observed in STP users include left ventricular hypertrophy, left atrial enlargement, ST-segment elevation, short PR interval and long QTc. Use of smokeless tobacco products is associated with increased risk burden of diabetes mellitus and hypertensive heart disease. Electrocardiographic findings linked to STP-use in this study are features consistent with arrhythmia, ventricular repolarization abnormality, myocardial hypertrophy and ischaemia, suggesting that smokeless tobacco products are not safe substitutes for tobacco smoking. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Henan Agricultural Sciences is the property of Editorial Board of Journal of Henan Agricultural Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: This study aimed to evaluate and compare the impact of cigarette smoking (CS) and heated tobacco (HT) on the alteration of color and ultrastructural characteristics of human enamel and cementum. Background: According to tobacco companies, a less harmful substitute for CS is HT products. Nevertheless, comprehensive research on the effects of HT on tooth structures has been lacking. This study aimed to evaluate and compare the impact of CS and HT on the alteration of color and ultrastructural characteristics of human enamel and cementum. Materials and Methods: Thirty intact and noncarious human maxillary premolars extracted for orthodontic treatment purposes, previously disinfected, were used in the study. The specimens were randomly separated into six groups (n = 10), as follows: Group 1: enamel without smoking exposure; Group 2: enamel exposed to CS; Group 3: enamel exposed to HT; Group 4: cementum without smoking exposure; Group 5: cementum exposed to CS; and Group 6: cementum exposed to HT. The measurement of color change was conducted using a spectrophotometer. The surface alterations and mineral composition of enamel and cementum were evaluated using scanning electron microscopy and energy‐dispersive X‐ray spectroscopy. ANOVA test followed by Tukey's post hoc test was used to determine significant differences between groups. Results: Results showed that CS had a more pronounced effect on enamel and cementum color changes than HT. The impact of CS and HT on color changes was more evident in cementum than in enamel. Surface morphology of enamel and cementum showed alterations in histology following exposure to both smoking types. Moreover, the mineral content experienced a significant reduction after using CS and HT. The reduction in calcium content after CS and HT exposure was similar. However, HT led to a significant decrease in the phosphorus content of enamel when compared with CS. At the same time, CS exposure in cementum resulted in a more significant reduction in Ca/P ratio than HT. Conclusions: Although HT may appear to present a lower danger to hard dental tissues than CS, it is not entirely harmless. CS results in more color changes on the enamel and cementum of teeth. Both smoking methods affected the mineral content of teeth, with CS having a significant effect on the roots, while HT significantly affected the crowns' mineral composition. Clinical Relevance: The study addresses a knowledge gap on how smoking and HT products affect hard tooth tissues. Few studies compared the histological and colorimetric effects of these two smoking strategies before this study. Our research shows that cigarette smoke and HT products affect dental enamel and cementum differently, revealing their potential tooth harm. The use of HT products may cause tooth cavities and periodontal disease. This research can help clinicians advise patients on the oral health effects of these smoking alternatives. This will help improve preventive and corrective dental procedures as HT products become more prevalent. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Professional Business Review (JPBReview) is the property of Open Access Publications LLC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In vitro toxicology research has accelerated with the use of in silico, computational approaches and human in vitro tissue systems, facilitating major improvements evaluating the safety and health risks of novel consumer products. Innovation in molecular and cellular biology has shifted testing paradigms, with less reliance on low-throughput animal data and greater use of medium- and high-throughput in vitro cellular screening approaches. These new approach methodologies (NAMs) are being implemented in other industry sectors for chemical testing, screening candidate drugs and prototype consumer products, driven by the need for reliable, human-relevant approaches. Routine toxicological methods are largely unchanged since development over 50 years ago, using high-doses and often employing in vivo testing. Several disadvantages are encountered conducting or extrapolating data from animal studies due to differences in metabolism or exposure. The last decade saw considerable advancement in the development of in vitro tools and capabilities, and the challenges of the next decade will be integrating these platforms into applied product testing and acceptance by regulatory bodies. Governmental and validation agencies have launched and applied frameworks and "roadmaps" to support agile validation and acceptance of NAMs. Next-generation tobacco and nicotine products (NGPs) have the potential to offer reduced risks to smokers compared to cigarettes. These include heated tobacco products (HTPs) that heat but do not burn tobacco; vapor products also termed electronic nicotine delivery systems (ENDS), that heat an e-liquid to produce an inhalable aerosol; oral smokeless tobacco products (e.g., Swedish-style snus) and tobacco-free oral nicotine pouches. With the increased availability of NGPs and the requirement of scientific studies to support regulatory approval, NAMs approaches can supplement the assessment of NGPs. This review explores how NAMs can be applied to assess NGPs, highlighting key considerations, including the use of appropriate in vitro model systems, deploying screening approaches for hazard identification, and the importance of test article characterization. The importance and opportunity for fit-for-purpose testing and method standardization are discussed, highlighting the value of industry and cross-industry collaborations. Supporting the development of methods that are accepted by regulatory bodies could lead to the implementation of NAMs for tobacco and nicotine NGP testing. [ABSTRACT FROM AUTHOR]

Smoking increases the risk of severe illness and mortality from COVID-19. However, the impact of risk perception on smoking over time is unknown. Participants (n = 487) who reported having smoked daily or nondaily in February 2020 were recruited through Reddit and completed a cross-sectional survey. Linear regression models examined the impact of perception that smoking increases the risk of COVID-19 on changes in cigarettes per day (CPD). The greater perceived risk of smoking on COVID-19 predicted greater decreases in CPD from before the pandemic (December 2019 – February 2020) to March – May 2020, but no change was observed from March – May 2020 to June – August 2020. However, greater perceived risk predicted increases in CPD from June – August 2020 to November 2020 – January 2021. Participants with high levels of perceived risk (>75th percentile) were more likely to reduce their CPD in the beginning of the pandemic compared to those with low perceived risk (≤25th percentile), but more likely to increase their CPD between June – August 2020 to November 2020 – January 2021, even though perceived risk remained stable over time. Perceived risk is associated with a reduction in CPD, but participants returned to their pre-COVID smoking behavior within less than a year. [ABSTRACT FROM AUTHOR]

In this study the aim was to examine the factors associated with the tobacco use status of individuals aged 60 and older. In this study, the microdata set obtained from the Turkey Health Survey conducted by TURKSTAT in 2016 and 2019 was used. The binary logistic regression analysis was used to identify variables associated with tobacco use status at old age. According to the findings, 15.62% of older adults use tobacco. According to the results of the analysis, gender, age, educational status, marital status, employment status, body mass index, visiting a psychotherapist and psychiatrist, exposure to tobacco smoke and alcohol use influence tobacco use among older adults. At the end of this study, it was concluded that older males are in the high-risk group for tobacco use. For this reason, it is suggested that male specific tobacco prevention policies be implemented. The results indicated that being an older single was a risk factor for tobacco use. Therefore, efforts to increase social support for older adults living alone and social activities for older adults should be supported, and this issue should be highlighted in government action plans. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectiveMethodsResultsConclusionTobacco use is one of the leading causes of preventable mortality and morbidity. Although Cyprus is considered a developed country, the tobacco prevalence and related issues have not been explored sufficiently in the general population of North Cyprus.The objective of this study is to determine the rate of tobacco product consumption and related factors among the visitors of a community health center and a university hospital in Northern Cyprus.The study was designed as a cross-sectional study The data were collected using a questionnaire developed in compliance with WHO guidelines. The data were analyzed using IBM-SPSS18.0 with p < 0.05 evaluated as significant.Out of a total of 635 individuals approached, 615 provided responses. The participation rate was 96%. The frequency of male smokers was 47.2%, while the frequency of female smokers was 34.0%, with a total smoking rate of 40.7%, much higher than world averages. The survey identified friendship influence as the primary reason for starting tobacco use, accounting for 42%, followed by being stressed at 34.6%. Male gender, being single, having no children, Turkish nationality were predictors of smoking, while financial status was not. The participants indicated a high frequency regarding exposure to passive smoke (51.1%). More than half of the respondents thought tobacco control in Northern Cyprus is not satisfactory.More research needs to be done to determine the exact overall prevalence of tobacco consumption in the population, which was found high in this study. Moreover, implementation of comprehensive tobacco control strategies is essential to control the prevalent tobacco dependence. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the effect of whitening toothpastes on the color stability and surface roughness of resin composites stained with coffee and cigarette smoke. Methods: Seventy-two disk-shaped specimens (6 × 2 mm) of suprananohybrid resin composite were randomly divided into two groups and exposed to coffee and cigarette smoke (n = 36). After staining, the samples randomly divided into four groups according to whitening toothpastes and were brushed for 4 min: Opalescence Whitening (OW); Colgate Optic White (COW); Curaprox Black is White (CPX) and, distilled water (control) (n = 9). Color was measured with spectrophotometer at the initial, after staining, and after brushing, and surface roughness was measured with profilometer at the initial and after brushing. A surface morphology analysis was examined using scanning electron microscopy and atomic force microscopy. The obtained data were statistically analyzed. (p < 0.05). Results: Cigarette smoke caused a significantly higher color change than coffee in the resin composite (p < 0.05). Brushing with hydrogen peroxide and silica-containing whitening toothpaste showed significant differences in color change (p < 0.05). The lowest whitening effect was found in activated charcoal-containing toothpaste. While all toothpastes increased the degree of surface roughness of resin composites, the highest roughness was caused by whitening toothpastes containing activated charcoal. (p < 0.05). Conclusions: The color stability and surface properties of resin composites can be affected by brushing them with whitening toothpaste. The utilization of whitening toothpaste containing hydrogen peroxide can be considered a safe method for increasing the whiteness of discolored resin composites. [ABSTRACT FROM AUTHOR]

Accurate detection and rejection of debris in tobacco products play an essential part in ensuring the quality of tobacco products. In recent years, the detection of detritus in the production process has been widely investigated, but there is still room for further improvement in the research of visible light-based tobacco debris detection methods. In this study, we collected visible light images from the tobacco industry production line and constructed a dataset for tobacco debris detection. In addition, a we propose a tobacco debris detection model named the FARLut. The FARLut model preprocesses images obtained from the tobacco production process based on the color and then inputs the processed images into a two-stage target detection algorithm with an attention mechanism for debris detection. The proposed model is verified experimentally. The experimental results show that the FARLut model achieves an average accuracy of 94.91% and a recall rate of 97.20% on the test dataset. Thus, the proposed detection model can effectively identify familiar clutter in tobacco production. The results of this study provide a useful reference for further research on clutter detection in the tobacco production field. [ABSTRACT FROM AUTHOR]

Simple Summary: Quality of life significantly affects health outcomes in cancer patients. However, evidence of an association between diet quality and quality of life in cancer survivors is sparse in Mediterranean countries. The aim of this study was to evaluate the associations between an a priori diet quality index, the Healthy Eating Index-2015 (HEI-2015), and quality of life, assessed through a validated questionnaire targeted at women with a breast cancer diagnosis. A higher HEI-2015 score was positively associated with summary quality of life score and inversely associated with symptom scores. Health-related quality of life (HRQoL) represents one of the most concerning aspects for cancer patients. The Healthy Eating Index (HEI) is an a priori diet quality index directly associated with health outcomes and HRQoL in cancer survivors in North American populations. We evaluated, in a Mediterranean population, the baseline associations between HEI-2015 and HRQoL in 492 women with breast cancer recruited in a DEDiCa lifestyle trial. Dietary data were obtained from 7-day food records; HRQoL was assessed through the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30) and the C30 Summary Score (SumSc). Analysis of variance and multivariable linear and log-gamma regression models were performed. Mean and standard deviation for HEI-2015 score was 68.8 ± 11.2; SumSc was 81.5 ± 12.9. Women with lower HEI-2015 score had higher BMI, were more frequently exposed to tobacco smoke and had fewer years of education. Patients with a HEI-2015 score greater than 68.7 (median value) showed a significant increase in SumSc of 4% (p = 0.02). HEI-2015 components also associated with SumSc were beans and greens (β = 1.04; p = 0.02). Weak associations were found for total vegetables and saturated fats. Higher diet quality in breast cancer survivors was associated with higher overall HRQoL in this cross-sectional analysis. [ABSTRACT FROM AUTHOR]

This study investigated the effects of different exercise interventions on cardiopulmonary function in male tobacco-dependent college students. Forty-five male tobacco-dependent college students were recruited as the tobacco-dependent (TB) group, and 45 non-tobacco-dependent college students were recruited as the control group. The TB group was randomly assigned to three subgroups: non-exercise (NE), high-intensity interval training (HIIT), and moderate-intensity continuous training (MICT). The HIIT and MICT groups underwent a 10-week exercise training, while the NE group received no intervention. Cardiac parameters, including maximal oxygen uptake (VO2max), heart rate max (HRmax), and heart rate reserve (HRR), and pulmonary indicators, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), vital capacity (VC), maximum ventilation volume (MVV), and peak expiratory flow (PEF) were investigated. The results showed that the TB group had significantly lower cardiopulmonary function than the control group. The degree of tobacco dependence was negatively correlated with VO2max, FVC, FEV1, FEV1/FVC, and MVV. Furthermore, both HIIT and MICT training improved cardiopulmonary function. HIIT training exhibited superior efficacy compared to MICT in improving HRmax, HRR, FVC, FEV1, FEV1/FVC, and PEF. In conclusion, tobacco dependence adversely affects cardiopulmonary function in male college students. Both HIIT and MICT effectively improved cardiopulmonary function, with HIIT showing superior efficacy. [ABSTRACT FROM AUTHOR]

Pharmacokinetic (PK) studies can provide essential information on abuse liability of nicotine and tobacco products but are intrusive and must be conducted in a clinical environment. The objective of the study was to explore whether changes in plasma nicotine levels following use of an e-cigarette can be predicted from real time monitoring of physiological parameters and mouth level exposure (MLE) to nicotine before, during, and after e-cigarette vaping, using wearable devices. Such an approach would allow an -effective pre-screening process, reducing the number of clinical studies, reducing the number of products to be tested and the number of blood draws required in a clinical PK study Establishing such a prediction model might facilitate the longitudinal collection of data on product use and nicotine expression among consumers using nicotine products in their normal environments, thereby reducing the need for intrusive clinical studies while generating PK data related to product use in the real world. An exploratory machine learning model was developed to predict changes in plasma nicotine levels following the use of an e-cigarette; from real time monitoring of physiological parameters and MLE to nicotine before, during, and after e-cigarette vaping. This preliminary study identified key parameters, such as heart rate (HR), heart rate variability (HRV), and physiological stress (PS) that may act as predictors for an individual's plasma nicotine response (PK curve). Relative to baseline measurements (per participant), HR showed a significant increase for nicotine containing e-liquids and was consistent across sessions (intra-participant). Imputing missing values and training the model on all data resulted in 57% improvement from the original'learning' data and achieved a median validation R2 of 0.70. The study is in its exploratory phase, with limitations including a small and non-diverse sample size and reliance on data from a single e-cigarette product. These findings necessitate further research for validation and to enhance the model's generalisability and applicability in real-world settings. This study serves as a foundational step towards developing non-intrusive PK models for nicotine product use. [ABSTRACT FROM AUTHOR]

Background: This study described the marketing strategies tobacco companies use to advertise tobacco products to the Queer community. Methods: In this secondary qualitative analysis, 15 Queer participants were interviewed to explore their life experiences with tobacco product advertisements during the early days of the COVID-19 pandemic. Results: Participants self-reported as male (n = 5), followed by female (n = 4), gender non-binary (n = 4) and, transgender (n = 2). In addition, most participants identified as Black/African American (n = 7) or White (n = 7). Many participants identified as Bisexual (n = 5) or Queer (n = 4). Using narrative analysis, the themes for this study were: (1) tobacco and vaping companies target minoritized and Queer people; (2) tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons; and (3) the use of social media influencers represents a new social marketing technique. As a result, Queer participants were more likely to encounter many different types of advertisements from tobacco companies and, most recently, social media influencers. Conclusion: Social media influencers are a new factor that needs further study to understand the new tobacco advertising landscape. [ABSTRACT FROM AUTHOR]

Background: This study aimed to: (1) assess healthcare providers' opinions on e-cigarette safety and compare them across professions; (2) evaluate providers' recommendations for e-cigarettes as a tobacco product cessation tool and identify any associations with their safety perceptions. Methods: A self-administered questionnaire was completed by 760 healthcare professionals (January–March 2020). The survey included eight opinions on e-cigarette safety with five Likert-scale answers and a question on recommending them for tobacco product cessation. Results: Among 760 healthcare providers (173 physicians/dentists, 69 pharmacists, and 518 nurses), only 20% reported prior experience with tobacco product cessation counseling. Providers expressed uncertainty regarding e-cigarette safety (mean ± SD: 2.5 ± 0.7 on a 5-point Likert scale), with no significant differences between professions (p = 0.836). Similarly, e-cigarette recommendations for tobacco product cessation remained low across professions (13%, 85/637), with no significant differences found (p = 0.072). The recommendation of e-cigarettes for tobacco cessation is associated with perceived safety, lower respiratory irritation, lower coughing, a lower risk of cancer, and a lower risk for secondhand smokers when compared to traditional cigarettes (p < 0.05). Conclusions: Most healthcare providers were unsure about the safety of e-cigarettes; about 13% of providers suggested using them for tobacco product cessation, with safety perceptions influencing recommendations. [ABSTRACT FROM AUTHOR]

Background Tobacco consumption is a significant public health challenge, particularly among young adults. Despite the presence of anti-tobacco laws and control measures, awareness and compliance remain suboptimal. This study aims to assess the awareness, knowledge, and perceptions regarding anti-tobacco laws among young adults, along with their attitudes towards potential interventions for effective tobacco control. Materials andMethods A cross-sectional study was conducted among 500 young adults aged 18-25 years across colleges and public spaces in a metropolitan city. A structured questionnaire was used to collect data on participants' awareness of anti-tobacco laws, knowledge of the harmful effects of tobacco, and their perceptions of intervention strategies. The questionnaire included multiple-choice and Likert-scale questions. Data were analyzed using descriptive statistics and chi-square tests to assess the association between awareness levels and demographic factors. Results Out of the 500 participants, 65% (n=325) were aware of the existence of anti-tobacco laws, but only 40% (n=200) could recall specific provisions like the ban on smoking in public places. Approximately 58% (n=290) recognized the significance of warning labels on tobacco products. However, only 30% (n=150) were aware of penalties for violations of these laws. Participants indicated a strong preference (75%, n=375) for educational campaigns over punitive measures for effective tobacco control. Awareness levels were significantly higher among urban participants compared to those from semi-urban areas (p < 0.05). Conclusion The findings suggest that while awareness of anti-tobacco laws is moderate among young adults, there are gaps in specific knowledge about legal provisions. Educational interventions, including awareness campaigns and peergroup initiatives, are likely to be more effective than punitive measures in promoting tobacco control. There is a need for collaborative efforts involving policymakers, educational institutions, and healthcare professionals to enhance the reach and impact of anti-tobacco programs. [ABSTRACT FROM AUTHOR]