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Introduction Heated tobacco products (HTPs), like IQOS, are marketed as innovative, stylish, harm-reduction products distinct from cigarettes and e-cigarettes. Research is needed to better understand how adults who are newly introduced to HTPs perceive them relative to cigarettes and e-cigarettes, and the impact of these perceptions on use outcomes. Aims and Methods We analyzed 2021 cross-sectional survey data from 1914 adults who never used HTPs from the United States and Israel, two countries where IQOS has unique histories and markets. Exploratory factor analysis examined perceptions of HTPs (vs. cigarettes and e-cigarettes) across 12 perception measures (eg, innovative, trendy, harmful, addictive). Multivariable linear regression examined these factors in relation to self-reported likelihood to: (1) "try HTPs in the next year" (1 = not–7 = extremely) and (2) "suggest IQOS to a friend who smokes cigarettes" (1 = not–5 = very), controlling for demographics and past-month cigarette and e-cigarette use (10.1% dual use, 15.4% cigarette-only, 5.7% e-cigarette-only, 68.8% neither). Results Four factors were identified: HTPs' health and utility ("health-utility") and design and appeal ("design-appeal") versus cigarettes and versus e-cigarettes, separately. More favorable perceptions of HTP versus e-cigarette design-appeal (B  = 0.30, 95% CI = 0.18, 0.41) were associated with greater likelihood to try HTPs. More favorable perceptions of HTP versus cigarette design-appeal (B  = 0.38, 95% CI = 0.26, 0.51) and health-utility (B  = 0.25, 95% CI = 0.13, 0.36), and HTP versus e-cigarette design-appeal (B  = 0.32, 95% CI = 0.20, 0.45) were associated with greater likelihood to suggest HTPs to smokers. Conclusions Monitoring perceptions of HTPs versus cigarettes and e-cigarettes is critical given the role of such perceptions in HTP use and their population-level impact. Implications This study examined the relationship of perceptions of HTPs relative to cigarettes and e-cigarettes, with regard to adults' self-reported likelihood to use HTP or to suggest HTPs to those who smoke cigarettes. Favorable perceptions of HTPs' design and appeal versus e-cigarettes correlated with greater likelihood to try HTPs. Favorable perceptions of HTPs' design and appeal, as well as health and utility, versus cigarettes and e-cigarettes correlated with greater likelihood to suggest HTPs to those who smoke. Findings underscore the need for ongoing surveillance of HTP marketing and consumer perceptions to inform regulatory efforts and estimate the population-level impact of HTPs and other tobacco products. [ABSTRACT FROM AUTHOR] more...

Background and Objectives: Limited longitudinal research has examined differential interpersonal and intrapersonal correlates of young adult use and use frequency of cigarettes, e‐cigarettes, and cannabis. This study aimed to address these limitations. Methods: We analyzed five waves of longitudinal data (2018–2020) among 3006 US young adults (Mage = 24.55, 44% male, 32% sexual minority, ~30% racial/ethnic minority). Two‐part latent growth models examined likelihood of past‐month cigarette, e‐cigarette, and cannabis use (binary part) and days used (continuous part) and identified predictors (depressive symptoms, personality traits, adverse childhood experiences [ACEs], parental use) of baseline use and changes over time. Results: Regarding baseline past‐month use (27% cigarettes, 38% e‐cigarettes, 39% cannabis), depressive symptoms, ACEs, and parental substance use predicted use outcomes (i.e., likelihood, frequency) for each product; extraversion predicted cigarette and e‐cigarette use outcomes; openness predicted e‐cigarette and cannabis use outcomes; conscientiousness negatively predicted cigarette and cannabis use outcomes; and agreeableness negatively predicted cannabis use frequency. Regarding longitudinal changes, conscientiousness predicted accelerated increase of cigarette use frequency at later timepoints; depressive symptoms predicted increases in likelihood of e‐cigarette use but the association weakened over time; and parental cannabis use predicted decreased cannabis use frequency but the association weakened over time. Discussion and Conclusions: Young adult substance use interventions should target high‐risk subgroups and focus on distinct factors impacting use, including chronic, escalating, and decreasing use. Scientific Significance: This study advances the literature regarding distinct predictors of different substance use outcomes and provides unique data to inform interventions targeting young adult cigarette, e‐cigarette, and cannabis use. [ABSTRACT FROM AUTHOR] more...

Introduction: Armenia's and Georgia's high rates of smoking and secondhand smoke and recent implementation of smoke-free laws provide a timely opportunity to examine factors that increase compliance, like social enforcement and support for governmental enforcement. Methods: Using 2022 data from 1,468 Armenian and Georgian adults (Mage=42.92, 48.6% male, 31.6% past-month smoking), multilevel linear regression examined tobacco-related media exposures, social exposures, and perceptions/attitudes in relation to: 1) likelihood of asking someone to extinguish cigarettes where a) prohibited and b) allowed; and 2) support of fines for smoke-free violations (1=not at all to 4=very). Results: There was low average likelihood of asking someone to extinguish cigarettes where allowed (M=1.01, SD=1.12) or prohibited (M=1.57, SD=1.21) and "little" agreement with fines for smoke-free violations (M=2.13, SD=1.06). Having fewer friends who smoked, greater support for indoor smoke-free laws, and no past-month cigarette use were positively associated with all 3 outcomes. Greater exposure to media and community-based action supporting smoke-free policies, and witnessing more requests to stop smoking where prohibited were associated with higher likelihood of asking someone to extinguish cigarettes where allowed or prohibited. Less exposure to news stories opposing smoke-free policies and cigarette ads and higher perceived harm of cigarettes were also related to higher likelihood of asking someone to stop smoking where prohibited. Higher perceived harm of cigarettes was also associated with greater agreement with fines for smoke-free violations. Conclusions: Comprehensive strategies targeting social norms, media exposure, and risk perceptions are needed to effectively facilitate strategies to enhance smoke-free law enforcement. [ABSTRACT FROM AUTHOR] more...

The article discusses the availability of kratom, a supplement that is often marketed as having pain-relieving and mood-enhancing properties, and for being a safer substitute for opioids, throughout the U.S. Topics include kratom availability in tobacco specialty stores, the growing national attention being paid to kratom, and the need for policymakers, regulatory bodies and public health professionals to collaborate for the marketing of kratom products. more...

Aims Sweeping policy changes during the COVID-19 pandemic increased alcohol availability through permitted to-go sales, potentially posing unique risks to college students. While to-go sales may make binge drinking more convenient, little remains known about these practices. Therefore, this study aimed to assess whether drinking establishments' to-go sales practices are associated with their other operational practices and state policy. Method This cross-sectional analysis included 221 randomly selected bars, nightclubs, and restaurants within two miles of a large public university. Telephone interviews assessed establishment practices, and the Alcohol Policy Information System provided state alcohol to-go laws. Regression models tested whether establishment to-go sales practices were associated with their business practices (logistic regression) and state policy (generalized estimating equations). Results Nearly one-half (44.8%) of drinking establishments sold alcohol to-go. Establishments with higher vodka prices had nearly 30% higher odds of selling spirits to-go (aOR  = 1.29) and establishments offering happy hours specials had more than twice the odds of selling beer (aOR  = 2.22), wine (aOR  = 2.53), and spirits to-go (aOR  = 2.60). Additionally, establishments that implemented physical distance requirements had higher odds of selling wine to-go (aOR  = 3.00). State to-go laws were associated with higher odds of selling wine (aOR  = 3.99) and spirits to-go (aOR  = 5.43) in the full sample and beer to-go (aOR  = 4.92) in urban counties. Conclusions Establishments that sell alcohol to-go tend to engage in other practices designed to drive sales. Evaluations of alcohol to-go sales laws on risky consumption among priority populations, including college students, are urgently needed to inform decisions about how to appropriately regulate sales. [ABSTRACT FROM AUTHOR] more...

Driving under the influence (DUI) of alcohol or cannabis poses public health risks. Little is known about DUI of Delta-8 THC, a newer cannabis product. Using 2022 survey data among 189 U.S. adults ages 18–25 (58.73% male, 59.26% non-Hispanic White), multivariable logistic regression examined substance-specific (alcohol, cannabis, Delta-8) DUI perceived likelihood and risk in relation to past-year DUI among those with past-year use of each. Overall, 72.49% reported past-year alcohol use, 50.53% cannabis, and 22.46% Delta-8. Among those reporting past-year use of each respective substance, 33.58% reported DUI of alcohol, 32.63% cannabis, and 57.14% Delta-8. On average, participants had the same DUI perceived likelihood (“somewhat unlikely”) across substances and perceived alcohol DUI as riskiest. Higher alcohol DUI perceived likelihood and lower perceived risk were associated with alcohol-related DUI. Greater cannabis-related perceived likelihood (but not risk) was associated with cannabis-related DUI. Neither Delta-8 DUI perceived likelihood nor risk were associated with Delta-8 DUI. In sum, perceived DUI likelihood for alcohol, cannabis, or Delta-8 tended to be similar. Among those with past-year use of each, the proportion of DUI was highest for Delta-8. Interventions should target DUI-related perceived likelihood and promote protective behavioral strategies that reduce substance-specific DUI risk. [ABSTRACT FROM AUTHOR] more...

INTRODUCTION: As e-cigarette marketing strategies diversify, it is important to examine exposure to and impact of e-cigarette advertisements and non-advertising content (e.g. on social media) via multiple media channels among adults in different regulatory contexts. METHODS: Using 2021 cross-sectional data among 2222 adults in the US (n=1128) and Israel (n=1094), multivariable regression examined past-month e-cigarette advertisement and non-advertising content exposure in relation to past-month e-cigarette use (logistic regression), as well as use intentions and risk perceptions (linear regressions), controlling for sociodemographics and tobacco use. RESULTS: Overall, 20.3% reported past-month e-cigarette use (15.5% US, 25.2% Israel), 46.1% any advertisement exposure (28.7% digital media, 25.2% traditional media, 16.8% retail settings), and 34.1% any non-advertising exposure (19.4% social media, 13.6% websites, 12.3% movie/television/theater, 5.8% radio/podcasts). Exposure to digital media advertisements (AOR=1.95; 95% CI: 1.42-2.66), traditional media advertisements (AOR=2.00; 95% CI=1.49-2.68), and social media non-advertising (AOR=1.72; 95% CI: 1.25-2.36) correlated with e-cigarette use. Exposure to traditional media advertisements (β = 0.23; 95% CI: 0.08-0.38) and social media non-advertising (β = 0.26; 95% CI: 0.09-0.43) correlated with use intentions. Exposure to digital media advertisements (β = -0.32; 95% CI: -0.57 - -0.08), retail setting advertisements (β = -0.30; 95% CI: -0.58 - -0.03), and radio/podcast non-advertising (β = -0.44; 95% CI: -0.84 - -0.03) correlated with lower perceived addictiveness. Radio/podcast non-advertising exposure (β = -0.50; 95% CI: -0.84 - -0.16) correlated with lower perceived harm. However, retail setting advertisement exposure was associated with e-cigarette non-use (AOR=0.61; 95% CI: 0.42-0.87), and traditional media advertisement (β = 0.38; 95% CI: 0.15-0.61) and social media non-advertising exposure (β = 0.40; 95% CI: 0.14-0.66) correlated with greater perceived addictiveness. CONCLUSIONS: E-cigarette-related promotional content exposure across media platforms impacts perceptions and use, thus warranting regulation. [ABSTRACT FROM AUTHOR] more...

The author discusses health concerns on the possible high levels of tetrahydrocannabinol (THC) in beverages infused with them that are being publicly sold in the U.S. as of January 2025. Topics covered include cannabis beverages' possession of various compounds that may have negative effects in combination, and their availability in licensed dispensaries that need to be monitored. Also noted are concerns on the alcohol industry's possible marketing of these beverages to the youth. more...

Background and Aims: Delta‐8 tetrahydrocannabinol (THC) is a psychoactive substance from the Cannabis plant that has been rising in popularity in the United States since the 2018 US Farm Bill implicitly legalized it. This study reviewed research from peer‐reviewed and non‐peer‐reviewed (e.g. anecdotal and news) reports related to delta‐8 THC to summarize current knowledge and implications for public health and safety. Methods: A scoping review was conducted using PubMed, Scopus, Google Scholar and Google as search engines, leading to the identification of 103 documents that were summarized. The themes that emerged were (1) legality, (2) use (popularity, motives, psychoactivity/potency, benefits/consequences), (3) synthesis (byproducts, laboratory testing) and (4) retail (availability, price, packaging, youth‐oriented marketing). A second author independently coded 20% of the documents, which verified the categorization of articles by these emergent themes. Results: Most research used animal/cell models or focused upon ways to identify the chemical structure of delta‐8 THC in various products. Findings suggest that people often use delta‐8 THC as a substitute for other substances. Anecdotally, delta‐8 THC is a less potent psychoactive than delta‐9 THC; however, several negative consequences have been reported. There is no federal age restriction for purchase/possession of delta‐8 THC products. Delta‐8 THC is readily accessible on‐line, is typically less expensive than delta‐9 THC and is often marketed in ways that would seemingly appeal to children. There are no regulations on synthesis, resulting in products being contaminated and/or yielding inconsistent effects. There have been thousands of calls to US poison control centers due to accidental delta‐8 THC exposure among minors. Conclusions: Most research on delta‐8 THC is largely anecdotal, not peer‐reviewed and does not involve human subjects. Future research should examine delta‐8 THC use using nationally representative samples to more clearly understand the prevalence and consequences of use. Laws are needed to mitigate the risks of using delta‐8 THC, particularly quality control of synthesis and minimum purchase age. [ABSTRACT FROM AUTHOR] more...

Objective: Delta-8 tetrahydrocannabinol (THC) is a largely unregulated psychoactive substance rising in popularity in the United States. This study aimed to understand how retailers explained Delta-8 THC to potential customers and if these descriptions were associated with socioeconomic deprivation surrounding the retail location. Method: In Fort Worth, Texas, stores with retail alcohol, cannabidiol (CBD), or tobacco licenses were called. Among the 133 stores that sold Delta-8 THC, 125 retailers (94%) answered the question "What is Delta-8?" Qualitative methods were used to identify related themes; logistic regression models tested associations between themes and area deprivation index (ADI) scores, a measure of socioeconomic deprivation (1-10; 10 = most deprived areas). Results: Retailers often compared Delta-8 THC to other substances (49%). Although most often described as a type of cannabis (34%), several retailers likened Delta-8 to CBD (19%) or hemp (7%), which are nonpsychoactive. Retailers also described potential effects from use (35%). Some retailers reported that they were unsure of what Delta-8 was (21%), told surveyors to look it up themselves (6%), or withheld information (9%). Higher ADI scores were associated with higher odds of retailers communicating limited information (odds ratio = 1.21, 95% CI [1.04, 1.40], p = .011). Conclusions: Study findings may inform the development of marketing regulations, as well as informational campaigns for both retailers and consumers. [ABSTRACT FROM AUTHOR] more...

Given the diverse sources of cannabis messaging and potential differential effects, this study examined pro- and anti-cannabis messaging exposure overall and via specific channels in relation to cannabis-related perceptions (social acceptability and harm) and behaviors (use status, intentions and frequency; past-year quit attempts). Multivariable regression analyses of 2023 survey data from 4031 US young adults (Mage = 26.29, 59.4% female, 19.0% Hispanic, 13.5% Black and 13.6% Asian) used independent variables representing overall exposure and via specific sources (stores, online, billboards/posters/flyers, TV/movies/radio, print and direct communication), respectively. Greater pro-cannabis messaging exposure correlated with greater perceived social acceptability, lower perceived harm, past-month use, greater use intentions among those reporting past-month nonuse and more days used and fewer quit attempts among those reporting use. Less anti-cannabis messaging exposure correlated with these outcomes, except intentions. Particularly, influential sources of pro-cannabis messaging were online (associated with perceptions, use status, intentions and frequency) and direct communication (perceptions, use, use frequency and quit attempts), and those of anti-cannabis messaging were online (harm and use intentions), direct communication (acceptability, quit attempts) and stores (perceptions, use and quit attempts). Exposure differed by sociodemographics (e.g. sex, race/ethnicity and education). The impact of digital media and targeted communications overall and stores in communicating cannabis-related risks suggest the need for regulation and monitoring., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.) more...