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BackgroundDual use of both e-cigarettes and cigarettes is popular among young adults and may lead to greater nicotine dependence and additive adverse health effects than single-product use. However, existing cessation programs target quitting either e-cigarettes or cigarettes, highlighting a need for interventions to help young adults quit both products (ie, dual tobacco cessation).ObjectiveThis formative study is part of a larger project to develop a smartphone intervention for dual tobacco cessation among young adults. This study aimed to (1) explore desires for and experiences with quitting both e-cigarettes and cigarettes and (2) identify needs and preferences for dual tobacco cessation intervention programming.MethodsSemistructured interviews were conducted to elicit the need for and experience with dual tobacco cessation among 14 young adults (18-29 years old) recruited through Instagram (Meta) advertisements in 2023. We conducted a thematic analysis to identify common themes related to quitting experiences and cessation needs.ResultsParticipants expressed a strong desire for dual tobacco cessation and had attempted to quit both tobacco products, mostly "cold turkey." The priority product for quitting first varied by the individual's perceived harm or level of consumption. Targets for dual tobacco cessation interventions included (1) highlighting the health effects of dual tobacco use compared with single product use, (2) providing cessation support to quit one prioritized product while cutting down the other product with the explicit goal to quit both, (3) emphasizing unique facilitators and barriers to quitting each product (eg, unpleasant smell of cigarettes facilitating smoking cessation and accessibility and flavors of e-cigarettes hindering vaping cessation), and (4) addressing co-use of tobacco with alcohol or cannabis. Participants wanted personalized interventions through smartphone apps that would tailor support to their tobacco use patterns and unique quitting goals and needs. They also suggested presenting intervention content in multimedia (eg, videos, graphic pictures, quizzes, and games) to increase engagement.ConclusionsThis study provides important insights into young adults' experiences, needs, and preferences for dual tobacco product cessation. We highlight important targets for future smartphone apps to deliver personalized and tailored support to meet the heterogeneous needs and preferences of young people who want to quit using both e-cigarettes and cigarettes.

Rates of cannabis initiation among teenagers and young adults are increasing. Further, the use of various forms of cannabis (smoked or vaped) with nicotine (dual use) is increasingly common among young people. The health effects of dual use are lesser known, particularly in the context of high-potency cannabis products and across different routes of administration, which is ominous in terms of predicting future health outcomes. There is a long history of cannabis use being associated with decreased activity and increased snacking, both of which could portend an increased risk of metabolic and cardiovascular disease, particularly when these habits begin during formative years. However, modern forms of cannabis may not have these same effects. Here, we assess whether cannabis use alone and dual use of cannabis with nicotine impact dietary and exercise habits in young people. An anonymous, social media-based survey was designed based on the UC San Diego Inhalant Questionnaire and published diet and exercise questionnaires. A total of 457 surveys were completed. Young sole cannabis users represented 29% of responders, 16% were dual users of cannabis and nicotine, and 55% were non-users of either drug. Although the sole use of cannabis was not associated with dietary or activity differences relative to non-users, dual users of cannabis and nicotine reported higher consumption of unhealthy sugars. This novel finding of dual use being associated with increased sugar intake in young people raises concerns for an increased risk of metabolic syndrome and cardiovascular disease in this population.

BackgroundE-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample.MethodsA cross-sectional survey was conducted with a sample of 4695 current and former e-cigarette users with a median age of 34 years. The survey collected data on e-cigarette use, adverse events experienced, product characteristics, related behaviors, sociodemographic factors and presence of medical comorbidities. Statistical analyses were conducted using Pearson's chi-squared tests and logistic regression.ResultsA total of 78.9% of respondents reported experiencing an adverse event within 6 h of using a vaping device, with the most common events being headache, anxiety and coughing. Product characteristics and related behaviors significantly influenced the risk of adverse events. There were also sociodemographic disparities, with Hispanic respondents and those with at least college-level education reporting higher rates of adverse events.ConclusionsOur study found a high rate of adverse events among e-cigarette users. We identified that certain e-cigarette product characteristics, behaviors and medical comorbidities significantly increased the risk of these events.

PurposeCo-use of tobacco and cannabis is a common and complex behavior. The lack of harmonized measures of co-use yields confusion and inconsistencies in synthesizing evidence about the health effects of co-use. We aimed to classify co-use patterns based on temporal proximity and describe preferred products and motives for each pattern in order to improve co-use surveillance.MethodsWe conducted semi-structured interviews in a sample of 34 young adults (Mage = 22.8 years, 32.4 % female) during 2017-2019 in California, USA. We employed a qualitative thematic analysis to identify timing, reasons, and contexts for tobacco and cannabis co-use and classify co-use patterns.ResultsFour emergent patterns of co-use with increasing temporal proximity between tobacco use and cannabis use were: Same-month different-day co-use (Pattern 1); Same-day different-occasion co-use (Pattern 2); Same-occasion sequential co-use (Pattern 3); and Same-occasion simultaneous co-use (Pattern 4). Participants used various product combinations within each pattern. Similar motives for all patterns were socialization, product availability, and coping with stress/anxiety. Unique motive for temporally distant patterns (Patterns 1 and 2) was seeking substance-specific effects (e.g., stimulant effect from nicotine, relaxation effects from cannabis), while unique motives for temporally close patterns (Patterns 3 and 4) were seeking combined effects from both substances (e.g., more intense psychoactive effects, mitigating cannabis adverse effects) and behavioral trigger (e.g., cannabis use triggers tobacco use).ConclusionsOur classification of co-use patterns can facilitate consistency for measuring co-use and assessing its health impacts. Future research should also measure product types and motives for different patterns to inform intervention efforts.

Smoking is common among adults of all ages. Decades of research have shown that smoking is linked to side effects such as lung cancer. This study aims to systematically review how smoking is linked to sleep. Database searches were done through Web of Science and Google Scholar. A total of 19 peer-reviewed journals were referenced to conduct this literature review. 15 peer-reviewed journals were used for the results. Results demonstrated that smoking was found to be correlated with sleep deprivation in both males and females of all ages. Environmental Tobacco Smoke (ETS) was a source of non-smokers' sleep complaints. Although there are multiple kinds of cigarettes, sleep quality has been shown to be poor regardless of the smoking medium. Ceasing smoking may lead to sleep benefits. Additional research will need to be conducted to further corroborate this statement.

INTRODUCTION: Mounting evidence suggests that electronic cigarettes (e-cigarettes) are extensively promoted and marketed using social media, including through user-generated content and social media influencers. This study explores how e-cigarettes are being promoted on Instagram, using a case-study approach, and the extent to which Metas Restricted Goods and Services Policy (Metas policy) is being applied and enforced. METHODS: We identified the accounts followed by an Australian Instagram influencer who primarily posts e-cigarette-related content. The main foci of these 855 accounts were coded and 369 vaping-focused accounts were identified. These vaping-focused accounts were then further coded by two trained coders. RESULTS: All (n=369; 100.0%) of the vape content posted by these accounts was positive in sentiment. One-third of the vape accounts (n=127; 34.4%) had a shared focus, indicating that vape content may permeate into other online communities through shared interests. A total of 64 accounts (17.3%) potentially violated Metas policy by attempting to purchase, sell, raffle or gift e-cigarette products. CONCLUSIONS: The findings of this study suggest that pro-vaping information is available and accessible on Instagram. Much of the content identified in this study promoted the purchase or gifting of e-cigarette products and potentially violates Metas policy. Greater regulation and/or stronger enforcement of e-cigarette content on social media platforms such as Instagram is necessary to prevent the ongoing promotion of these harmful products.

To examine associations between depression, anxiety, and stress, as measured by the Depression, Anxiety and Stress Scale (DASS-21) scale, with current e-cigarette use. Data from the Truth Longitudinal Cohort – a nationally representative sample of youth and young adults – was collected between October 2022 to February 2023. The analytic sample was comprised of participants who provided information on e-cigarette use and the DASS-21 scale (N = 4198). Chi-square statistics were used to determine differences by current e-cigarette use across covariates and DASS-21 items. Logistic regression analyses were applied to the cross-sectional data to determine which scales predicted current e-cigarette use, adjusted for the effects of age, gender identity, race and ethnicity, parental educational attainment, perceived financial situation, and current use of alcohol, marijuana, and other tobacco use. Those who had severe/extremely severe levels of depression, anxiety, and stress had greater odds of current e-cigarette use, relative to those who had normal levels of depression, anxiety, and stress, even after adjusting for covariates. Results also demonstrated associations between age, race/ethnicity, parental education, and current use of alcohol, marijuana, and other tobacco products with current e-cigarette use. Cross-sectional analyses of self-reported data limit the ability to determine directionality of effects between depression, anxiety, stress, and current e-cigarette use. More severe levels of depression, anxiety, and stress were associated with a greater likelihood of current e-cigarette use. Future research is needed to evaluate changes in e-cigarette use, in response to depression, anxiety, and stress symptomatology. • Results demonstrate associations between depression, anxiety, and stress with current electronic nicotine delivery systems (ENDS) use. • More severe levels of depression, anxiety, and stress were associated with greater odds of current ENDS use. • Older age and current use of alcohol, marijuana, or other tobacco products were also associated with greater odds of current ENDS use. • Identifying as Non-Hispanic Black, Hispanic, and non-Hispanic Asian and having parents with higher education were associated with lower odds of current ENDS use. [ABSTRACT FROM AUTHOR]

E-cigarette use is a growing public health concern, especially because of the potential health risks it poses. This study focuses on assessing e-cigarette dependence and the factors associated with it among Palestinian young adults. A cross-sectional survey was conducted from January to May 2023 among university students in the West Bank. A self-administered questionnaire was used to collect demographic data, knowledge, and attitudes regarding e-cigarettes. E-cigarette dependence was assessed using the Penn State Electronic Cigarette Dependence Index. The study included 386 university students who used e-cigarettes. Many of them started using e-cigarettes at a young age, and 54.7% were dual users of e-cigarettes and traditional tobacco. High levels of dependence were reported in 11.4% of participants, and moderate dependence in 28.8%. Several factors were identified through multivariate linear regression as significantly associated with e-cigarette dependence: a higher monthly allowance (β = 0.116, 95% CI: 0.128- 1.124, p =.014), having a father who uses tobacco (β = 0.095, 95% CI: 0.030- 1.638, p =.042), having a close friend who smokes traditional cigarettes (β = 0.095, 95% CI: 0.019- 1.667, p =.045), using e-cigarettes in areas where traditional smoking is prohibited (β = 0.175, 95% CI: 0.689–2.330, p <.001), using e-cigarettes to quit other forms of tobacco (β = 0.134, 95% CI: 0.434–2.314, p =.004), and a more negative attitude score (β = − 0.210, 95% CI: − 0.285- − 0.112, p <.001). The study revealed high levels of e-cigarettes dependence among the participants among young adults, with associated variables such as monthly allowance, attitudes, and age of e-cigarette initiation. Policymakers, educators, and healthcare professionals should collaborate to address e-cigarette dependence among young adults, taking into consideration social, environmental, and socioeconomic factors. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Childhood traumatic experiences (CTE) have been identified as a robust risk factor for a range of substance use behaviours. However, little is known about their association with adolescent vaping. We explored prospective associations between CTEs and vaping among a sample of Australian adolescents.The sample comprised 2234 adolescents (baseline Mage = 12.7 years, SD = 0.5; 49.9% female) enrolled in the Health4Life cluster randomised controlled trial. Using mixed effects logistic regression analyses, data from the baseline and 36‐month assessment waves were used to examine whether CTEs (by ~ age 12) were associated with current or lifetime vaping and future intentions to vape (~ age 15).Adjusting for socio‐demographic variables, CTE exposure at baseline was associated with higher odds of ever having vaped (odds ratio 1.64, 95% confidence interval 1.34, 2.02), and of being a current regular vape user (odds ratio 1.63, 95% confidence interval 1.11, 2.39). Experiencing CTEs was also associated with higher odds of intending to vape in the future (odds ratio 1.44, 95% confidence interval 1.11, 1.86).This study is the first to identify CTEs as a risk factor for vaping, and intentions to vape in the future, among Australian adolescents. These findings align with global research and highlight another common risk factor across various forms of substance use. CTE exposed adolescents represent a priority group who may require earlier and more targeted vaping intervention. [ABSTRACT FROM AUTHOR]

Introduction: India is one of the few countries to have banned production, manufacture, import, export, transport, sale, distribution, storage and advertisement of electronic cigarettes (e-cigarettes). With the advent of technology, these product are being marketed extensively on internet despite the ban. Objective: To assess promotion and sales of e-cigarettes on the internet, and social networking sites (SNS); and to assess the levels of awareness regarding e-cigarettes among youth participants and the source of receiving information on e-cigarettes. Methodology: In 2022, a survey was conducted with youth (18-24 years), along with a desk review to identify influencers promoting, and e-stores selling e-cigarettes in India. Further, a content analysis was conducted on the identified influencers and online stores. Results: 370 youth with a mean age of 21.1 ± 1.7 years participated in the survey. 66.6% of participants reported being aware of e-cigarettes through social media. Instagram (46%) was identified as the most popular social networking platform for promoting e-cigarettes. 189 influencers promoting e-cigarettes on Instagram were identified and their posts positively portrayed e-cigarettes (trendy/cool, flavours, hedonic value, features cessation aid and cost-effective). Additionally, 83 e-stores (49 Indian and 34 international) were identified as selling e-cigarettes in India. Findings from content analysis of both influencers and e-stores highlighted issue of international cross-border marketing. Conclusion: To safeguard youth and achieve a path to Tobacco-free generation; there is a dire need for strengthening the monitoring and enforcement of PECA 2019, especially to address international cross-border advertisements and sales of e-cigarettes. Additionally establishing strong reporting violation mechanisms is also needed. Furthermore, educating youth, retailers, policy makers and community via sensitization programs on detrimental effects of e-cigarette use and existing policies related to e-cigarettes in India is crucial. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess tobacco and vaping habits among university students, exploring awareness of university policies, attitudes, and behaviors related to smoking and vaping. Methods: An online questionnaire was distributed among students from various universities, including institutions in Pakistan, covering demographics, smoking and vaping behaviors, awareness of policies, and beliefs. Data was analyzed using descriptive statistics, Binomial tests, Chi-square tests, and logistic regression. Results: Out of the total 683 respondents, 65.02% were female, and 34.98% were male. Most participants were undergraduate students (71.31%), with Dentistry being the most represented field (50.36%). Most students perceived smoking or vaping as socially acceptable (58.3%) and were aware of university policies (59.3%). However, 46.6% were aware of cessation programs. Most of the students expressed concern about long-term vaping health risks (74.5%). Logistic regression identified gender (Male) and field of study (Dentistry) as significant predictors of policy awareness. Conclusion: University students exhibit varied perceptions and behaviors related to smoking and vaping. The study highlights the importance of implementing effective policies and interventions to address tobacco and vaping use among them. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsTobacco brand sharing or brand stretching involves the placement of tobacco brand names, logos, or other distinctive elements of tobacco brands, on nontobacco products, e.g., merchandize, such as clothing, sunglasses, or sporting goods. The Tobacco Master Settlement Agreement (MSA) imposed major restrictions on tobacco company marketing practices in 1999, including banning the sale and distribution of merchandize with combustible cigarette or smokeless tobacco brand names or logos. However, the MSA does not include restrictions on e-cigarette marketing, as these products were not yet on the market at the time of the settlement. Exposure to or use of e-cigarette branded merchandize advertised on social media could contribute to normalization of e-cigarette use by youth.We estimated the prevalence of merchandize (e.g., t-shirts, caps, and key chains) with e-cigarette brand names or logos in 2000 TikTok videos (2021–2022) that featured U.S. and international micro-influencers (content creators with about 10,000–100,000 followers) who promoted e-cigarettes on behalf of e-cigarette brands.Of 152 (8%) promotional videos had merchandize with e-cigarette brand names or logos. Of 125 (6%) featured micro-influencers wearing branded clothing items, i.e., t-shirts, caps, beanies, hoodies, and sweatshirts; and 27 (2%) featured influencers wearing or showing branded accessories, i.e., face masks, stickers, pins, mugs, car air fresheners, lanyards, and key chains.Tobacco control authorities should consider adopting provisions banning the sale, distribution, and direct (e.g., by e-cigarette brands) or indirect (e.g., by influencers) advertising of merchandize bearing e-cigarette brand names or logos. [ABSTRACT FROM AUTHOR]

AbstractBackground: Electronic nicotine delivery system (ENDS) use is prevalent in the United States, especially among youth and young adults. It is important to monitor current ENDS use and identify at-risk groups, particularly among tobacco naïve individuals. Methods: Using data from the 2021 National Survey on Drug Use and Health, we examined the prevalence of past 30-day nicotine/tobacco ENDS use and correlates, stratified by age. Results: The prevalence of past 30-day ENDS use was as follows: ages 12-17 (5.0%), ages 18-20 (13.5%), ages 21-25 (14.6%), ages 26-34 (7.2%), and ages ≥35 (2.5%). Among youth ages 12-17, female respondents were more likely to report past 30-day ENDS use compared to male respondents (aOR = 1.41, 95% CI = 1.01-1.97). Among all adult age groups, current cigarette smoking status was associated with an increased likelihood of current ENDS use, versus never smoking. Among all age groups, those reporting non-Hispanic Black, non-Hispanic Other, and Hispanic race/ethnicity had a decreased likelihood of past 30-day ENDS use versus non-Hispanic White respondents, while past-year drug/alcohol use disorder, versus no use disorder, was associated with an increased likelihood of past 30-day ENDS use. Conclusions: ENDS use was most prevalent among young adults and least prevalent among persons ages ≥35. Most youth who reported ENDS use also reported never smoking cigarettes—compared to adults who reported ENDS use, who primarily reported current or former cigarette smoking. Our findings—which have identified characteristics of those most likely to use ENDS products—have the potential to inform screening and targeted intervention efforts aimed at reducing ENDS use. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionElectronic cigarettes (e-cigarettes) are often marketed as safer alternatives to traditional smoking, yet evidence suggests potential health risks, especially among vulnerable populations. This study examines the immediate adverse events following e-cigarette use in individuals with preexisting health conditions to better understand these risks.We conducted a STROBE-compliant observational study to identify specific preexisting medical conditions that may increase the risk of adverse events following e-cigarette use. A cross-sectional survey was deployed from January 3rd to March 3rd, 2023. A total of 4695 current and former e-cigarette users completed the survey. Logistic regression models were utilized to examine associations between 23 distinct preexisting conditions and 48 adverse events, adjusting for age, sex, race/ethnicity, education level, and income.The analysis encompassed 4,421 respondents, demonstrating that individuals with solid organ transplants faced notably pronounced risks, with odds ratios indicating a seven-fold increase in mouth/tongue blisters (OR = 7.05), nearly five-fold for heart palpitations (OR = 4.92), and heartburn (OR = 4.79). Stem cell transplantation recipients also showed significantly heightened risks for similar adverse events, including mouth/tongue blisters (OR = 5.53) and heart palpitations (OR = 4.65). Metabolic diseases were linked to substantially increased odds of mouth/tongue blisters (OR = 5.63), hair loss (OR = 4.09), and migraine (OR = 3.50), highlighting a specific vulnerability to e-cigarette aerosol exposure among these groups.The findings highlight the acute health risks associated with e-cigarette use in individuals with certain preexisting conditions. These results challenge the notion that e-cigarette use poses limited harm to human health and highlight the need for tailored public health strategies to protect vulnerable populations. [ABSTRACT FROM AUTHOR]

Aims Design Setting Participants Measurements Findings Conclusions To provide data on prevalence and trends in the use of different types of e‐cigarettes (disposable, pod, tank) in Germany (a country with high smoking prevalence of approximately 30%) from 2016 to 2023, and to analyse the characteristics and smoking behaviours of users of these types.A series of nationally representative cross‐sectional face‐to‐face household surveys.General population of Germany, 2016–2023.A total of 92 327 people (aged ≥14 years) of which 1398 reported current use of e‐cigarettes.Type of e‐cigarette usually used (single choice: disposable, pod, or tank), person characteristics, and smoking/vaping behaviour.E‐cigarette use in the population of Germany has increased from 1.6% (95% confidence interval [CI] = 1.1,2.2) in 2016 to 2.2% (95% CI = 1.6,3.0) at the end of 2023. Disposable e‐cigarette use has increased in this period from 0.1% (95% CI = 0.0,0.3) to 0.8% (95% CI = 0.4,1.8). Pod type use exhibited the most stable trend, with a steady rise to 0.6% (95% CI = 0.4,0.9) in 2023. Tank e‐cigarette use peaked at 1.6% (95% CI = 1.3,1.9) in November 2017, declined to 0.7% (95% CI = 0.6,0.9) in December 2020, and has since remained constant at 0.8% (95% CI = 0.6,1.0). Disposable e‐cigarette users were on average 3.5 and 4.1 years younger than tank and pod users, respectively. They were more likely than tank users to be female, non‐daily users, and dual users of tobacco. In the subgroup of dual users, there were no significant differences with regard to urges to smoke, cigarettes smoked per day, motivation to stop, and attempts to stop smoking between users of disposables and other types.The use of e‐cigarettes has increased in Germany from 2016 to 2023, especially that of disposable e‐cigarettes, which are now the most commonly used type with a prevalence rate of 0.8%. However, the use of e‐cigarettes is still much lower compared with tobacco smoking. [ABSTRACT FROM AUTHOR]

The use of e‐cigarette or vape devices is a growing concern on an international scale, given the devices' addictive nature and questions regarding their short‐ and long‐term health impacts. Their use is especially an issue in young people, many of whom have little or no previous nicotine use experience. This study tested an integrated dual process model in 363 young Australian undergraduates where prospectively measured e‐cigarette use was predicted by the psychological constructs of the theory of planned behavior, supplemented with risk perception, e‐cigarette dependence, habit, and implicit attitude. Intention to use an e‐cigarette was predicted by affective attitude, subjective norm, and e‐cigarette dependance, but not instrumental attitude, perceived behavioral control, or risk perception. E‐cigarette use was predicted by e‐cigarette dependance, intention, habit, implicit attitude, and previous nicotine use, although perceived behavioral control did not directly predict behavior nor moderate the intention–behavior relationship. Current findings provide evidence for important psychological predictors of e‐cigarette use, signposting potential intervention targets. Specifically, interventions may benefit from using strategies that tap affective or normative beliefs alongside automatic constructs and dependence, while focusing less on beliefs about the health impacts of e‐cigarettes or control over using. [ABSTRACT FROM AUTHOR]

Objectives: Evidence has emerged on the health dangers of electronic cigarette (e-cigarette) use among pregnant women and neonates. We examined whether rural residence is a risk factor for smoking and e-cigarette use among women during the peripartum period in the United States. Methods: This study was based on pooled cross-sectional 2015-2020 data from the Pregnancy Risk Assessment Monitoring System. The outcome was exclusive smoking, exclusive e-cigarette use, and use of both products (ie, dual use) versus use of neither tobacco product by women with live infants aged 2 to 6 months. We examined rural–urban differences in outcome by using univariate and multivariable multinomial logistic regressions with post hoc contrasts and marginal analyses, adjusting for complex survey design and nonresponse. Results: During the peripartum period, 5.0% of women were smoking combustible cigarettes, 5.0% were using e-cigarettes, and 1.9% were using both tobacco products. The crude prevalence of e-cigarette use was 1.1 percentage point higher, and the adjusted prevalence was 0.8 percentage points lower for rural versus urban women (P <.001 for both). Among rural women, 6.7% (95% CI, 6.3%-7.1%) smoked combustible cigarettes exclusively and 2.6% (95% CI, 2.3%-2.8%) used both products, as compared with 4.5% (95% CI, 4.4%-4.8%) and 1.7% (95% CI, 1.6%-1.8%) of urban women, respectively, adjusting for sociodemographic and health-related characteristics. Conclusions: Maternal sociodemographic and health-related characteristics differed by combustible smoking versus e-cigarette use during the peripartum period. The effect of residence on e-cigarette use was significantly confounded by sociodemographic and health-related characteristics, resulting in clinically comparable prevalence of e-cigarette use in rural and urban mothers with live infants aged 2 to 6 months. [ABSTRACT FROM AUTHOR]

Background: England, Australia and the United States have approached the regulation of e‐cigarettes in very different ways, yet all three countries have appealed to the concept of evidence as underpinning policy responses. We compared these policy responses using a combination of the methodologies of historians and policy scientists in order to elucidate the factors that had influenced policy in each country. Argument/Analysis: Each country's evidence and values intersected in different ways, producing very different responses within specific national contexts and histories. Our analysis accordingly emphasized the historical precursors of the policy issues raised by e‐cigarettes and placed the policy debate within the context of regulatory bodies and the networks of researchers and advocates who influenced policy. Issues also of importance were the nature of the state; political context; the pre‐history of nicotine for smoking cessation; the role of activism and its links with government; the influence of harm reduction ideas from drugs and HIV; and finally, whom policy was perceived to benefit. In the United Kingdom, based on this pre‐history of the smoking issue, it was the existing smoker, while in the United States and Australia, protecting children and adolescents has played a central role. Conclusions: Structural and historical factors appear to underpin differences in e‐cigarette policy development in England, Australia and the United States. [ABSTRACT FROM AUTHOR]

Aim: We want to verify the correlation between the increasing use of novel nicotine‐containing products (NNCPs) and non‐nicotine delivery products (NNDPs) among young individuals and the escalating negative health consequences, necessitating their prohibition. Methods: We performed a comprehensive analysis of the most relevant literature about the utilisation of NNCPs and NNDPs among young individuals and their health effects. Results: Despite being initially seen as less harmful alternatives, for smokers aiming to quit, these products have become more popular due to misleading marketing claims. Teenagers using NNCPs and NNDPs, despite having no smoking history, are more likely to transition to tobacco smoking. Consistent use can lead to health issues like pulmonary damage, asthma, and cardiovascular and ocular problems. Conclusion: The EAP and the ECPCP endorse the WHO's appeal to outlaw these hazardous products. They urge European governments to forbid the sale of NNCPs and NNDPs to children and adolescents in order to safeguard their well‐being. They also propose specific recommendations (box 4) to support this cause. [ABSTRACT FROM AUTHOR]

Little is known about vaping and its associated factors among Asian adolescents worldwide. We did a scoping review of the international literature on vaping among Asian adolescents. The prevalence of Asian adolescent vaping varied by the country's e-cigarette policies: the highest prevalence in Indonesia 32.2% (ever vapers) and 11.8% (current vapers) in 2019 and the lowest in Japan with 2.1% to 3.5% (ever vapers) and 0.7% to 1.0% (current vapers) in 2017. In New Zealand, a Western country with strong tobacco control but liberal policies on vaping, the prevalence of ever vaping was 20.4%, regular vaping 4.2%, and weekly vaping 2.8% in 2019. The most common reasons for vaping in both contexts were curiosity and peer influence. The internet as a popular source of information on vaping was identified mostly in Asian studies. In Asian contexts, the most common reasons for more frequent vaping were the desire to quit smoking and the ability to vape indoors, whereas in Western countries, the top three reasons were nicotine concentration, nicotine dependence, and more daily vaping sessions. Regular monitoring and more targeted research to understand adolescents' vaping behaviors will need to be undertaken on this heterogeneous population to inform appropriate policies and regulations. [ABSTRACT FROM AUTHOR]

The rising prevalence of e-cigarette use among children and adolescents poses a significant challenge to public health prevention efforts. As these electronic nicotine delivery systems gain popularity among youth, concerns about the health impacts and long-term consequences have escalated. In this article, we delve into the concerning trends of e-cigarette use among the younger population, exploring the factors driving this phenomenon and evaluating the failures in current public health prevention strategies. By examining the regulatory gaps in e-cigarette marketing to the youth and proposing interventions to combat this growing issue, we aim to shed light on the urgent need for stronger policies and enforcement mechanisms to protect the health and well-being of our youth. [ABSTRACT FROM AUTHOR]

Although marketed as a safer alternative to traditional cigarettes, e-cigarettes still contain nicotine and other harmful chemicals that can negatively impact adolescent health. E-cigarette use by adolescents is associated with an increased risk of transitioning to smoking traditional cigarettes, as well as negative impacts on their overall wellbeing. Numerous factors contribute to the rise in e-cigarette use among adolescents. By acquiring a more profound comprehension of the concerns about e-cigarettes in young populations, researchers can formulate more efficacious preventative and intervention techniques to diminish e-cigarette consumption among adolescents and alleviate any health risks linked to their use. [ABSTRACT FROM AUTHOR]

E-cigarettes, once touted as a safer alternative to traditional cigarettes for adult smokers, have rapidly gained popularity among a younger demographic - children and adolescents. The allure of sleek designs, enticing flavors, and perceived social acceptance has made these electronic devices like a snake in the grass, silently creeping into the hands of youth across the globe. However, this burgeoning trend comes with a host of concerning implications, from the potential health risks associated with vaping at a young age to the insidious marketing tactics employed to target this vulnerable population. [ABSTRACT FROM AUTHOR]

The prevalence of e-cigarette use among young people has become a growing concern, prompting the question of who is responsible for the promotion and marketing of these products to the vulnerable demographic: children and adolescents. The man behind the scenes in this scenario often is complicated. As we continue to navigate through the complexities surrounding e-cigarettes and youth consumption, it is essential that policymakers, public health officials, and parents work together to address this issue and prevent further harm to our future generations. [ABSTRACT FROM AUTHOR]

E-cigarettes have gained notable popularity among youth in recent years, posing a serious societal issue that has elicited much concern from public health professionals and legislators. The increase in e-cigarette consumption among adolescents can be ascribed to assertive marketing strategies employed by corporations that focus on appealing to young consumers through flavored offerings and aesthetically pleasing designs. This rise is concerning because of the possible long-term health ramifications linked to vaping, such as nicotine addiction and exposure to hazardous chemicals found in numerous e-cigarette formulations. The normalization of e-cigarette usage in social contexts may result in heightened peer pressure and the endorsement of detrimental conduct. To properly address this issue, government agencies must enforce stronger rules on e-cigarette sales and marketing directed at minors, while schools and community organizations should educate youth about the risks of vaping. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsNeighborhood disadvantage is associated with a higher concentration of tobacco, cannabis and alcohol retailers and greater risk of certain substance use behaviors among youth. Less is known about the impact of subjective neighborhood disorder, which captures distinct exposures that may be relevant to substance use outcomes, including neighborhood social processes, safety, physical characteristics, and neighborhood drug use.Data are from two waves (Feb-Dec 2022) of a prospective cohort of Southern California high school students (n = 2,139; mean[SD] age = 15.7.[0.6]). We examined associations of perceived neighborhood disorder at baseline with (a) perceived ease of purchase (continuous scale 0-100) for alcohol, cannabis, e-cigarettes, cigarettes, hookah, cigars/cigarillos, and oral nicotine at baseline and follow-up, and (b) repeated measures of past 6-month and past-30-day alcohol, vaped cannabis, smoked cannabis, cannabis edibles, e-cigarette, cigarette, cigarillo, hookah, and oral nicotine use.E-cigarettes were perceived to be the easiest product to purchase. Participants in the highest (vs. lowest) quartile of neighborhood disorder reported greater mean ease of purchasing scores for all products (mean difference range = 5.43 [95%CI: 1.64-9.21] for mint/menthol oral nicotine products to 9.40 [95%CI: 6.16-12.64] for hookah) and greater odds of e-cigarette, smoked cannabis, edibles, vaped THC, and alcohol use (odds ratio range = 1.52 [95%CI: 1.05 to 2.18] for past 6-month alcohol to 5.40 [95% CI: 3.46 to 8.42] for 30-day smoked cannabis).Interventions that shape youth perceptions of their neighborhood and reduce youth retail access in disadvantaged neighborhoods are needed and may help to prevent youth substance use. [ABSTRACT FROM AUTHOR]

AbstractPurpose: The use of e-cigarettes can worsen mental health symptoms in young adults. However, little is known about how young adults’ mental health may relate to their reasons for using e-cigarettes (vaping). We examined the association of mental health and vaping reasons among young adults who currently vape. Methods: Data were analyzed from a sample of young adults who vape (N = 436, Mage=25.19) who participated in an online survey assessing mental health (stress, anxiety, and depression) and vaping reasons (vape for tension reduction or relaxation, user experience, product or substance, or utility). We conducted multiple regressions and ANCOVAs, controlling for age, gender, past 30-day e-cigarette use, and past 30-day cigarette smoking. Results: Experiencing higher levels of stress, anxiety, and depression were associated with vaping for tension reduction or relaxation among young adults who vape (ps < 0.001) and for those who dual use e-cigarettes and cigarettes (ps < 0.01). Experiencing severe anxiety level was associated with vaping for tension reduction or relaxation than among those experiencing minimal, mild or moderate anxiety (ps < 0.05). Conclusions: Findings show that higher stress, anxiety, and depression are associated with greater likelihood of vaping for tension reduction or relaxation. More research should examine the association of stress, anxiety, and depression on vaping in young adults to identify and determine appropriate interventions to help with vaping cessation. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Results Conclusion Despite a brief decline during the COVID‐19 pandemic, vaping behaviors among adolescents continue to be an international public health concern because of associated health risks and harms. A thorough investigation of existing interventions preventing adolescent vaping is needed to help address this public health crisis and reduce serious and avoidable vaping‐related health risks. We reviewed the literature to identify public health interventions aimed at preventing adolescent vaping and summarized their key components and outcome measures.We conducted a scoping review of the literature using the Joanna Briggs Institute methodology searching in MEDLINE, CINAHL, Embase, PubMed, PsycINFO, ProQuest, and Web of Science. Two reviewers screened 589 records for relevance. Studies from any location, reported in English, and described vaping prevention interventions targeting adolescents were included. Records were excluded if they were reported in other languages, published outside the review timeframe, lacked an evaluation, focused on cessation‐based interventions, or were review articles. Data extracted included intervention type, key components, and outcome measures.Thirty‐eight included articles were identified and categorized into three intervention categories: school‐based, public education/risk communication campaigns, and public policies/government regulations. Key components of the interventions included format, duration, and topics. Formats varied from single to multi‐sessions. Prominent topics covered included risks and harms associated with vaping, and the most frequently reported outcome measures used were knowledge, attitudes, and beliefs.Our findings summarize existing public health interventions found in the literature and insights into approaches used to address the global adolescent vaping crisis. [ABSTRACT FROM AUTHOR]

AbstractRespiratory co-exposure to ambient PM2.5 and electronic cigarettes (e-cigarettes) frequently occurs in public. However, the combined effects on human respiratory health have not been well documented. To discuss potential co-effects and possible biological mechanisms, A549/THP-1 co-cultures and BEAS-2B cells were exposed to unvapedtobacco or mint-flavored e-liquids (0–7.2% v/v), e-cigarette aerosol extract (ECE, 0–50% v/v), PM2.5 (60 μg/mL), or PM2.5 + ECE for 24 h. Cell viability assessments on e-liquids, ECE, PM2.5 + ECE showed that the mint flavor exhibited higher cytotoxicity compared to the tobacco flavor in both A549/THP-1 and BEAS-2B. However, the influence of flavors on ROS levels and mRNA expression of inflammatory markers (IL-6, TNF-α, IL-8, IL-1β) after ECE exposure demonstrated inconsistency in the two cell models. PM2.5 + ECE treatment notably elevated ROS production and inflammation responses compared to ECE alone exposure. Only co-exposure induced a significant increase in nuclear transcription factor-κB p65 (NF-κB p65) and NOD-like receptor 3 (NLRP3) protein expression regardless of flavors. Our results indicate that PM2.5-treated cells exacerbate the adverse effects induced by ECE in both A549/THP-1 and BEAS-2B cells. Flavors in unvaped e-liquids affect cytotoxicity, oxidative stress and inflammation response, but these effects vary depending on the vaping process and the specific cell line. [ABSTRACT FROM AUTHOR]

Vaping use has skyrocketed especially among young adults, however there is no consensus on how vaping impacts the lungs. We aimed to determine whether there were changes in lung function acutely after a standard vaping session or if there were differences in lung function metrics between a healthy never‐vaping cohort (N = 6; 27.3 ± 3.0 years) and a young asymptomatic vaping cohort (N = 14; 26.4 ± 8.0 years) indicating chronic changes. Pulmonary function measurements and impulse oscillometry were obtained on all participants. Oxygen‐enhanced and Arterial Spin Labelling MRI were used to measure specific ventilation and perfusion, respectively, before and after vaping, and in the control cohort at baseline. MRI metrics did not show any significant differences in specific ventilation or perfusion after vaping. Heart rate increased post‐vaping (68.1 ± 10.5 to 71.3 ± 8.7, p = 0.020); however, this and other metrics did not show a nicotine dose‐dependent effect. There was a significant negative correlation between BMI and change in mean perfusion post‐vaping (p = 0.003); those with normal/low BMI showing an increase in perfusion and vice versa for high BMI. This may be due to subjects lying supine during vaping inhalation. Pulmonary function metrics indicative of airways resistance showed significant differences between the vaping and control cohorts indicating early airway changes. [ABSTRACT FROM AUTHOR]

AbstractInternational research documents the popularity of youth e-cigarette use and factors associated with consumption. However, less research has examined the behaviour in jurisdictions where such products are illegal. This study therefore investigated social and demographic factors associated with the use of e-cigarettes among youth in Thailand, where such products are prohibited. An online cross-sectional survey was conducted among middle and high school students (n = 6,111) to capture individual, interpersonal, organizational, and social factors potentially related to the behaviour. Multinomial logistic regression was used to assess associations with e-cigarette susceptibility and use. The prevalence of e-cigarette susceptibility was 15.9%, with 9.7% reporting current use. Risk factors, including lower GPA, current smoking, current substance use, and peer vaping, were associated with susceptibility (vs. non-susceptibility) and use (vs. susceptibility). Parental vaping was linked solely to current use, while middle school attendance, current alcohol use, exposure to e-cigarette use in school and exposure to online marketing, were linked to susceptibility. Negative attitude towards e-cigarettes and regular exposure to anti-e-cigarette activities in school were protective factors against both. High-risk perceptions and regular parental supervision were protective factors for susceptibility. Despite bans, a significant proportion of Thai youth engage in e-cigarette use or are susceptible to it. Unique factors influence susceptibility and use, highlighting the need for strengthening laws and adjusting prevention efforts. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsImplicationsE-cigarette use has risen rapidly, especially among young people. TikTok is one of the most commonly used social media platforms among young people. The representation of vaping cessation messages in TikTok content remains unexplored. We aimed to address this gap by analyzing the vaping cessation content prevalent on TikTok.This cross-sectional mixed methods study analyzed the top 100 TikTok videos—determined based on view-counts—related to vaping cessation. Our quantitative analysis examined video characteristics, while our qualitative analysis identified key thematic representations.The final sample included 87 videos, with a combined total of over 100 billion views. Most videos were created by regular users (general TikTok content creators) rather than those identifying as health experts or professionals such as doctors, acupuncturists or dental hygienists. Very few posts mentioned evidence-based cessation aids or support. Videos scored high on understandability but low on actionability based on standardized criteria. Qualitative analysis identified nine key themes: motivations for quitting, barriers to quitting, use of aids and strategies, relapse experiences, identity and self-image, celebrating cessation success, emotional journey of quitting vaping, seeking social support, and limited mentions of healthcare providers.TikTok appears to be a useful influential forum for studying quitting behavior through the sharing of personal experiences and perspectives on vaping cessation. Opportunities exist to integrate evidence-based messaging and support into this platform. Findings can inform social media interventions designed to counter pro-vaping content and promote quitting e-cigarette use.Partnerships among health professionals, public health experts, and social media influencers may be leveraged to disseminate proven vaping cessation techniques on leading social media platforms such as TikTok. [ABSTRACT FROM AUTHOR]

Introduction: Electronic cigarettes (e-cigarettes) have been gaining worldwide popularity for several years now, making vaping a major alternative to regular tobacco smoking. Aim: There is still a lack of data on the occurrence of dermatological diseases due to e-cigarettes, so the research was performed. Methods: A systematic review of the literature was performed in Embase and Medline databases. The search included EMTREE and MESH approaches and was conducted according to the PRISMA guidelines. Results: Electronic cigarettes were identified both as an initiating and aggravating factor in several dermatological diseases. Vaping resulted in impaired wound healing and thermal injuries in the healthy skin. Conclusions: Electronic cigarettes have been reported to contribute to the development of various skin diseases and be a source of thermal injury. Lack of data and poor compliance concerning reporting the side effects of vaping make this topic an important issue to monitor. [ABSTRACT FROM AUTHOR]

This research aims to study the cigarette smoking behavior of individuals living in semi-urban communities in Ubon Ratchathani Province, Thailand. The study employed a quantitative research design, with a sample consisting of 276 participants. The primary data collection tool was a smoking behavior questionnaire, which demonstrated a Cronbach's alpha coefficient of 0.75. Statistical methods were used in data analysis to determine frequency counts, percentage distributions, mean scores, and standard deviations. The majority of the sample were male (80.43%), with an average age of 45.45 years (S.D. = 13.36). Among the participants, 48.92% were employed, and 53.98% identified as smokers. Most smokers reported initiating their smoking habit between the ages of 19 and 21 (24.64%), while the youngest age at which participants began smoking was 12 years or younger (0.36%). The majority of smokers consumed 3 to 5 cigarettes per day (16.30%), and a significant proportion (96.38%) had observed smoking in public places. The study found significant relationships between gender, education level, and occupation with smoking behavior and e-cigarette use (p-value ≤ 0.05). The results indicate that smoking is more prevalent in semi-urban areas. Therefore, government entities, local authorities, and community organizations must play crucial roles in implementing tobacco control measures and preventing the emergence of new smokers in these semi-urban communities. [ABSTRACT FROM AUTHOR]

E-cigarette use (or vaping) is widespread in young people and is a rapidly growing public health problem. While the tobacco and vaping industry has promoted vaping as a smoking cessation aid for adults, the industry has strategically targeted young people through marketing and appealing designs to orientate a new generation of consumers to use their products. These strategies are not new and replicate what we have previously seen employed by the tobacco industry in past decades to maintain and grow their tobacco profits. We review the evidence on tobacco and vaping industry interference, highlighting the calculated and strategic use of interference tactics as a discourse to curb tobacco control efforts. We demonstrate how these tried and tested strategies are now being purposefully re-used in the context of vaping. As Australia is currently undergoing significant policy reforms for the access and retail of vaping products, we also provide a case study of the industry response played out in this contemporary landscape. Government and public health advocates are in a key position to be one step ahead in proactively tackling the vaping crisis. We recommend that continued monitoring of industry activities and strategies, achieving political transparency and tightening loopholes in current regulations are all needed to identify and eliminate the tobacco and vaping industry's influence on policymaking. Given their previous track record, we emphasize the need to counter industry interference tactics with urgency to prevent a new generation of nicotine dependence and to support and protect future action in tobacco control. [ABSTRACT FROM AUTHOR]

Causal inference represents a rapidly expanding interdisciplinary subfield that involves various assumptions, study designs, and estimation strategies, allowing researchers to establish causal relationships from both clinical trials and observational data. In tobacco research, numerous studies address causal questions, including the contentious issue of whether vaping in nonsmoking youth leads to smoking initiation, known as the "gateway effect." Determining the effectiveness and safety of many health interventions will continue to rely on observational [mainly longitudinal] data because randomized trials are not always feasible, ethical, or timely. Therefore, review articles that are synthesizing evidence on the gateway effects of electronic nicotine delivery systems [ENDS] on subsequent cigarette smoking must also consider observational studies as first-rate evidence that can help bring together the polarized tobacco research community and help better understand the "gateway effect." In addition, this will help ongoing efforts to rigorously prevent ENDS use by youth while expanding the cessation potential of ENDS among adult established smokers who are unwilling to quit otherwise. In this commentary, we discuss causal inference tobacco research as one of the public health challenges and provide some recommendations/implications. [ABSTRACT FROM AUTHOR]

This study aimed to examine the efficacy of school-based e-cigarette preventive interventions via a systematic review and meta-analysis. We searched Medline, Embase, PsycINFO, Scopus, CINAHL, Cochrane, and clinical trial registries for studies published between January 2000 and June 2023 using keywords for e-cigarettes, adolescents, and school. Of 1566 double-screened records, 11 met the criteria of targeting adolescents, evaluating an e-cigarette preventive intervention, being conducted in a secondary school, using a randomized controlled trial (RCT), cluster RCT, or quasi-experimental design, and comparing an intervention to a control. Pre-specified data pertaining to the study design, outcomes, and quality were extracted by one reviewer and confirmed by a second, and where necessary, a third reviewer. Meta-analyses found no evidence that school-based interventions prevented e-cigarette use at the longest follow-up, which ranged between 6 and 36 months post-intervention (OR = 0.43, 95% CI = 0.16, 1.12; p = 0.09). However, subgroup analyses identified significant effects at post-test and when studies with < 12-month follow-up were omitted. No effect was found for tobacco use at the longest follow-up (OR = 1.01, 95% CI = 0.65, 1.59, p = 0.95); however, reductions in past 30-day tobacco use (OR = 0.59, 95% CI = 0.39, 0.89, p = 0.01) which encompassed e-cigarettes in some studies were identified. Narrative synthesis supported these mixed results and found some school-based interventions prevented or reduced e-cigarette and/or tobacco use; however, some increased use. School-based interventions were also associated with improved knowledge (SMD = − 0.38, 95% CI = − 0.68, − 0.08, p = 0.01), intentions (SMD = − 0.15, 95% CI = − 0.22, − 0.07, p = 0.0001), and attitudes (SMD = − 0.14, 95% CI = − 0.22, − 0.06; p = 0.0007) in the short term. Overall, the quality of evidence was low-to-moderate. School-based interventions hold the potential for addressing e-cigarette use, however, can have null or iatrogenic effects. More high-quality research is needed to develop efficacious interventions, and schools must be supported to adopt evidence-based programs. This is the first systematic review and meta-analysis to examine the efficacy of school-based preventive interventions for e-cigarette use. It provides crucial new knowledge about the efficacy of such interventions in preventing e-cigarette use and improving other outcomes (e.g., tobacco use, knowledge, intentions, attitudes, and mental health) among adolescents and the key characteristics associated with efficacious interventions. Our findings have important practical implications, highlighting future research directions for the development and evaluation of e-cigarette preventive interventions, along with the need to provide support to schools to help them identify and adopt evidence-based programs. [ABSTRACT FROM AUTHOR]

Introduction: Electronic cigarettes, or e‐cigarettes, are rapidly gaining popularity throughout the globe as safer alternatives to traditional cigarette smoking. There are significant public health concerns due to the uncertainty of long‐term health consequences. This study aims to examine the experiences, attitudes and social dynamics of e‐cigarette users to provide guidance for public health policies and interventions. Methods: In this qualitative descriptive study, semi‐structured interviews were conducted. Fifteen e‐cigarette users were recruited using a snowball sampling strategy, where initial participants referred other suitable users. All participants had at least 6 months of regular e‐cigarette use. Data were collected through face‐to‐face interviews with open‐ended questions. The interviews were transcribed verbatim and reviewed by the researchers. This review identified four main themes and eight sub‐themes. Results: The four main themes identified as a result of the analysis are as follows: (1) initiation and usage experiences; (2) perceptions of health effects; (3) social and environmental factors and (4) addiction and future plans. Participants primarily began using e‐cigarettes out of curiosity, due to the appealing fragrance and the belief that they were less harmful than traditional cigarettes. Usage patterns varied among participants, with some reporting minimal cravings in the early morning hours. Opinions on the long‐term health effects of e‐cigarettes were diverse, with many participants acknowledging uncertainty. Peers and family members perceived e‐cigarettes as more socially acceptable than traditional smoking, resulting in fewer negative reactions. Finally, participants' levels of addiction and intentions to quit varied, with some expressing a desire to reduce or cease usage due to health concerns. Conclusion: The findings of this study indicate that the adoption of e‐cigarettes is influenced by a confluence of factors, including curiosity, the perception of reduced damage in comparison to conventional cigarettes and social acceptance. Notwithstanding these claimed advantages, users have a diverse array of beliefs and understandings concerning the enduring health consequences of e‐cigarettes. The presence of varying levels of addiction and the corresponding aspirations to cease the behaviour highlight the necessity for focused public health interventions. Patient or Public Contribution: E‐cigarette users were actively involved in this study, providing essential insights and feedback throughout. Their first‐hand experiences shaped the interview guide and contributed to the identification of key themes. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data. [ABSTRACT FROM AUTHOR]

We study the impact of an information shock created by an outbreak of lung injuries apparently related to e‐cigarettes. We use data from multiple sources: surveys of risk perceptions conducted before, during, and after the outbreak; an in‐depth survey on risk perceptions and vaping and smoking behavior; and national aggregate time‐series sales data. We find that after the outbreak, consumer perceptions of the riskiness of e‐cigarettes sharply increased. From our estimated e‐cigarette demand models, we conclude that the information shock reduced e‐cigarette demand and the use of e‐cigarettes for smoking cessation by about 30 percent. [ABSTRACT FROM AUTHOR]

Objective: Research has indicated potentially neutral or even positive cognitive effects of e-cigarette usage in adults, but whether these findings extend to adolescents remains uncertain. This study aimed to examine the interplay between e-cigarette use, mind wandering and self-efficacy, and mood. Method: The responses of 432 adolescents aged 11-18 years from an online survey were analyzed. Among them, 88 adolescents had used e-cigarettes. Results: Adolescents who have used e-cigarettes reported poorer academic self-efficacy, t (430) = 3.26, 95% CI [1.12, 4.51], p < 0.001; greater mind-wandering tendencies t(430) = −3.38, 95% CI [-4.14, −1.10], p < 0.001; and greater severity of depression, t(430) = −3.38, p < 0.001, anxiety t(430) = −2.67, p = 0.01, and stress t(430) = −3.32, p <.001. Increased frequency of e-cigarette use was also associated with attitudes toward e-cigarette use, r (86) = 0.31, p = 0.003 and lower academic self-efficacy, r (86) = −0.27, p =.010. However, there was no significant correlation between frequency of use and mind-wandering. Further network analysis suggested negative relationships between frequency of e-cigarette use, academic self-efficacy and mind-wandering. Conclusion: Our findings suggest a potential adverse impact of e-cigarette use on mind-wandering and academic confidence among adolescents. However, the direct or indirect relationship between e-cigarette use and these effects could not be definitively determined due to the cross-sectional survey design employed in our study. Nonetheless, our findings underscore the importance of considering developmental differences and the unique vulnerabilities of adolescents when assessing the impact of e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: E-cigarette advertising, which often includes various features, may prompt e-cigarette use and product switching. This study examined the associations between noticing e-cigarette ad features and perceived product appeal and interest in completely switching from cigarettes to advertised e-cigarettes among young adult dual users of both products. Methods: We analyzed data from an online heatmap experiment among young adult dual users defined as established cigarette smokers who currently used e-cigarettes (ages 18-34 years; n = 1,821). Participants viewed 12 e-cigarette ads, clicked on ad features (e.g., fruit flavors, nicotine warnings, price promotions, smoker-targeted claims) that attracted their attention (defined as "noticing"), and answered questions about e-cigarette product appeal and interest in completely switching from cigarettes to the e-cigarettes shown. We examined within-person associations between noticing specific ad features and outcomes, controlling for demographic and tobacco use-related characteristics. Results: Noticing fruit flavors (AOR = 1.67 and 1.28) and fruit images (AOR = 1.53 and 1.21) was positively associated with having any e-cigarette product appeal and switching interest. Noticing price promotions (AOR = 1.23) was positively associated with product appeal. In contrast, noticing nicotine warnings (AOR = 0.74 and 0.86), smoker-targeted claims (AOR = 0.78 and 0.89), and tobacco flavors (AOR = 0.92 and 0.90) was negatively associated with product appeal and switching interest. Conclusions: Noticing certain e-cigarette ad features (e.g., fruit flavors and nicotine warnings) may be associated with product appeal and/or switching interest among young adult dual users. More research is needed to assess the influence of e-cigarette ad features that promote product switching interests among cigarette smokers while discourage interests among tobacco-naïve individuals. [ABSTRACT FROM AUTHOR]

Objective: The current study examined group differences in college students' views on e-cigarettes in terms of safety, popularity, health risks, social acceptability, efficacy as a cessation aid, and promoting combustible cigarette use. Participants: 337 undergraduates (Mage = 20.84, SD = 3.79; 72.1% female; 68.5% White) divided into three groups: Never Users (n = 178), Ever Users (n = 108), and Current Users (n = 51). Methods: Participants completed questionnaires for course credit. Results: Compared to Ever and Never Users, Current Users believed e-cigarettes were safer, healthier, a useful tool to quit smoking, did not lead to combustible cigarette smoking, and that nicotine was less dangerous. Current Users also were less likely to endorse boosting social image as a motive for use. Conclusions: Public health campaigns could benefit from targeting current users' positive beliefs about e-cigarettes to reduce the prevalence of e-cigarette use among college students. [ABSTRACT FROM AUTHOR]

INTRODUCTION E-cigarette and heated tobacco product (HTP) marketing often leverages digital media and points-of-sale (POS) and advertises risk reduction, including in Armenia and Georgia where male cigarette use rates are high. METHODS Using 2022 survey data from Armenian and Georgian adults (n=1468, mean age=42.92 years, 51.4% female; and past-month use of e-cigarettes 3.2%, HTPs 2.7%, and cigarettes 31.6%), multivariable linear regression examined 4 outcomes – e-cigarette and HTP use intentions and perceived risk (1=not at all, to 7=extremely) – in relation to past-month e-cigarette or HTP advertisement exposure via digital media, traditional media, and POS, controlling for covariates (country, age, gender, education level, relationship status, children, past-month cigarette and e-cigarette/HTP use). RESULTS E-cigarette and HTP use intentions were low (mean score=1.47, SD=1.39 each), while perceived risk was high (mean score=5.83, SD=1.6, and mean score=5.87, SD=1.56, respectively). Past-month exposure to e-cigarette and HTP advertisements, respectively, were 12.9% and 11.2% via digital media, 6.1% and 4.8% traditional media, and 22.5% and 21.1% POS. For e-cigarettes, ad exposure via digital media was associated with greater use intentions (β=0.24; 95% CI: 0.03– 0.44), ad exposure via traditional media (β= -0.32; 95% CI: -0.55 – -0.09) and POS (β= -0.30; 95% CI: -0.60 – -0.004) was associated with lower risk perceptions. For HTPs, ad exposure via digital media (β=0.35; 95% CI: 0.14–0.56) and POS (β=0.21; 95% CI: 0.04–3.63) was associated with greater use intentions, and ad exposure at POS was associated with lower risk perceptions (β= -0.23; 95% CI: -0.42 – -0.03). CONCLUSIONS Tobacco control efforts should monitor and regulate e-cigarette and HTP marketing, particularly via digital media which may effectively promote use, and via POS which may target and influence risk perceptions. [ABSTRACT FROM AUTHOR]

The association of cigarette smoking with several severe and very severe diseases (oncological, cardiovascular, respiratory) which have dramatic epidemiological, medical, and financial impact, is a well-known public threat. Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent diseases in Italy, posing significant public health challenges. Tobacco smoking, a primary risk factor for COPD and a common asthma trigger, remains a critical preventable public health issue. While universally acknowledged that quitting smoking drastically reduces the risk of smoking-related health issues, a significant portion of smokers and patients find quitting challenging or undesirable, hence a need for new ways to deal with it. A worth considering alternative might be the switch to electronic cigarettes (e-cig), and heat-not-burn/heated tobacco products (HnB/HTP). Emerging evidence suggests potential benefits in asthma and COPD management when transitioning from traditional smoking to e-cigs or HnB devices. However, the effectiveness of these products in facilitating smoking cessation is still debated, alongside concerns about their role in promoting smoking initiation among non-smokers. Internists are among the physicians who most frequently assist patients with smoking-related diseases, and in this perspective they cannot avoid paying attention to the progressive diffusion of smoking products alternative to the traditional cigarette, and to the controversies with respect to their use. In this context, the Italian Society of Internal Medicine, also recognizing a growing need for clarity for healthcare providers, has undertaken a comprehensive analysis of existing literature to offer an informed perspective on the health impact of e-cigs and HnB/HTP on asthma and COPD. [ABSTRACT FROM AUTHOR]

Aims Design Setting Participants Interventions Measurements Findings Conclusions To determine whether nicotine mouth spray provides rapid and prolonged relief of urges to vape and measure the steady‐state plasma nicotine levels during vaping and ad libitum mouth spray usage in e‐cigarette users.Randomized, parallel group, double‐blind trial.Single site at Hammersmith Medicines Research Ltd (HMR), London, UK.216 (25.9% females, average age 27.6 ± 7.63 [standard deviation, SD]) exclusive vapers who used their e‐cigarette within 30 minutes of waking up and had vaped about 2 years on average.Two sprays of 1 mg nicotine mouth spray (Nicorette QuickMist Freshmint, n = 109), or placebo (identical in appearance and presentation, n = 107).Urge to vape was rated on a 100 mm visual analogue scale before and repeatedly for 2 hours after administration. The primary outcome measured average change from baseline in urges to vape ratings during the first hour.Nicotine mouth spray achieved statistically significantly greater reductions in urges to vape than placebo from the first assessment point at 30 seconds to 1 hour, when the estimated mean treatment difference was 11.90 mm (95% confidence interval [CI] = 6.86–16.95, P < 0.001). The integrated urge to vape over 11 hours ad libitum usage showed a statistically significant benefit compared with placebo (2.00 [0.88 SD] vs 2.51 [0.84 SD], P < 0.001). Mean steady‐state plasma nicotine concentrations were lower after nicotine mouth spray usage compared with vaping (6.22 [4.70 SD] ng/ml vs 9.91 [7.59 SD] ng/ml, respectively). Adverse events were more commonly reported in the nicotine mouth spray group and were mostly mild.Among regular e‐cigarette users, nicotine mouth spray provided statistically significant and fast relief of urges to vape one hour after dosing. Nicotine mouth spray showed statistically significant reductions in urges to vape as soon as 30 seconds and up to 2 hours after dosing compared with placebo, and nicotine mouth spray was well‐tolerated and safe. [ABSTRACT FROM AUTHOR]

Background: Vaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types. Methods: Data were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245). Logistic regression tested cross-sectional associations between living in social (vs. other) housing and current vaping among adults; vaping frequency, device type, nicotine concentration, and source of purchase among current vapers; use of vaping products as a smoking cessation aid among past-year smokers who tried to quit; and harm perceptions of vaping products relative to cigarettes among current smokers. Results: Current vaping prevalence was twice as high among adults living in social housing (19.4%) compared with those in other housing types (10.4%; OR = 2.07, 95%CI = 1.84–2.33). This was partly explained by differences in sociodemographic characteristics and smoking status; after adjustment, the odds of being a current vaper were 33% higher (ORadj=1.33, 95%CI = 1.14–1.54). Among vapers, there were no notable differences by housing tenure in vaping frequency, main device type used, usual nicotine concentration, usual source of purchase, or use as a smoking cessation aid. However, current smokers living in social housing were more likely to think vaping is more harmful than cigarettes (31.6% vs. 21.8%; ORadj=1.61, 95%CI = 1.30–1.99). Conclusions: In Great Britain, adults who live in social housing are more likely to vape than those who live in other housing types, even after accounting for their younger age and higher smoking rates. However, misperceptions about the relative harms of vaping products and tobacco are common among smokers living in social housing. Interventions addressing these misperceptions could help encourage more people living in social housing to switch from smoking to vaping and reduce smoking-related health inequalities. Pre-registration: The study protocol and analysis plan were pre-registered on Open Science Framework (https://osf.io/n3mvs/). [ABSTRACT FROM AUTHOR]

Background: Ireland's Smoking Ban reduced health inequalities known to be associated with smoking but some groups may not have benefitted. Mental ill-health and smoking are known to be associated with health inequalities. Whether similar patterns exist for e-cigarette use is less clear, as few data exist. Objectives: To examine: (1) self-reported doctor-diagnosed mental ill-health in Irish 20-year-olds; (2) smoking, e-cigarette, and dual use in those with and without mental ill-health; and (3) protective and risk factors for smoking and e-cigarette use in these groups. Methods: We use cross-sectional data from 20 year-olds in Wave 4 of Growing Up in Ireland Child Cohort. They were asked to self-report mental ill-health which had been diagnosed by a clinician, and their smoking and e-cigarette use. All analyses were performed using SPSS v27. Results: 19.4% (n = 1008) of the total sample (n = 4729) reported a mental ill-health diagnosis. Comparing those with and without, those with mental ill-health had significantly higher prevalence of current smoking (47%, n = 419 vs 36%, n = 1361; OR 1.57, CI: 1.36, 1.82), e-cigarette use (17%, n = 152 vs 13%, n = 485; OR 1.40, CI:1.15, 1.70), and dual use (12%, n = 109 vs 9%, n = 328; OR 1.46, CI:1.16, 1.84). Risk factors for smoking and e-cigarette use were, earlier smoking initiation, peers or primary caregivers who smoked, being in paid employment, one-parent family background, and social media use. Being female was protective. Most risk factors were significantly higher in young adults with mental ill-health but, after adjusting for these variables, respondents with mental ill-health still have significantly higher adjusted higher odds of smoking (aOR 1.28, CI:1.05, 1.56). Conclusions: Inequalities in smoking and e-cigarette use in young adults with mental ill-health are evident 20 years after Ireland's National Smoking Ban. Despite extensive Tobacco Control interventions in the past 20 years, there is still need in Ireland for new targeted interventions to reduce health inequalities for left-behind young smokers with mental ill-health. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMaterials and MethodsResultsConclusionsNetflix pledged to avoid depictions of e-cigarette use in scripted series and movies rated TV-14 or below. However, this policy did not extend to young adults, many of whom are below the legal tobacco purchasing age. This study examined the association between recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and susceptibility to use e-cigarettes among never users.A non-probability representative sample of young adults (ages 18-24; N = 1500) living in California were recruited to complete an online survey assessing their recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and e-cigarette-related behaviors. Adjusted and weighted logistic regression analyses were used among participants who had never used e-cigarettes (n = 967).Among participants who had never used e-cigarettes, 68.1% (n = 659/967) recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, including 66.4% (n = 192/289) of participants under the legal tobacco purchasing age. Participants who recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, compared with those who did not, had greater odds of reporting susceptibility to use e-cigarettes among never users (AOR = 1.65, 95% CI = 1.20-2.25).Young adults living in California recalled Netflix scripted series or movies previously identified to contain e-cigarette imagery. Such recall was associated with susceptibility to use e-cigarettes among never users. These findings should motivate prevention programmers to design tobacco-related digital media literacy interventions for young adults. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors. Methods: Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups. Results: Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students. Conclusions: The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION There needs to be more up-to-date evidence on the prevalence of e-cigarette use among Chinese adults. This study aims to investigate the prevalence and associated factors of e-cigarette use among adults aged 18-44 years in China. METHODS Cross-sectional design and convenience sampling were used. The data for this study were obtained from an online survey conducted in mainland China from April to May 2023. The target population was adults aged 18-44 years. Descriptive analysis was employed to report the prevalence of e-cigarette use, while adjusted multivariable logistic regression was performed to examine the association between e-cigarette use and related factors. RESULTS A total of 4256 participants were included in this study; 12.9% were current e-cigarette users, 5.9% were frequent users, and 7.0% were occasional users. The descriptive analysis results indicated that males and cigarette users had a higher prevalence of e-cigarette use. Multivariable analysis showed that e-cigarette use was significantly associated with female gender (AOR=0.76, 95% CI: 0.60-0.96), those aged 25-34 years with monthly income 6000-8999 CNY (AOR=2.01; 95% CI: 1.18-3.41), those aged 25-34 years with monthly income ≥9000 CNY (AOR=2.20; 95% CI: 1.26-3.82), college or undergraduate degree (AOR=1.91; 95% CI: 1.22-3.00), urban residence (AOR=1.72; 95% CI: 1.34-2.20), being a current smoker (AOR=3.32; 95% CI: 2.64-4.16), perception of harm (AOR=0.66; 95% CI: 0.60-0.73), and perception of benefit (AOR=2.31; 95% CI: 2.04-2.61). CONCLUSIONS The prevalence of current e-cigarette use among adults in China was 12.9% within our sample. In addition to sociodemographic factors, individuals with a higher perception of the harm associated with e-cigarettes were less likely to engage in e-cigarette consumption. Conversely, individuals who perceive the 'benefits' of e-cigarettes more favorably use them. Targeted interventions, such as health education, are recommended to help adults develop a correct understanding of e-cigarettes and lower the prevalence of e-cigarette use. [ABSTRACT FROM AUTHOR]