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The document published in the Annals of the American Thoracic Society explores the association between rural residence, tobacco use, and chronic obstructive pulmonary disease (COPD) prevalence in the United States. The study, based on the National Health Interview Survey (NHIS), reveals that individuals in rural and low-income communities face a higher risk of COPD due to unique environmental exposures and greater tobacco use. Despite adjustments for tobacco-related factors, rural residence remains associated with higher COPD prevalence, especially among never-smokers. The findings underscore the need for continued research to address urban-rural disparities in COPD and investigate additional risk factors beyond tobacco exposure in rural communities. [Extracted from the article]

INTRODUCTION Cigarette smoking and smoking-related lung disease are more common in rural (vs urban) areas of the United States (US). This study examined relationships between geographical location, cigarette risk perceptions, and current smoking among older adults who are at greatest risk of developing smoking-related lung disease. METHODS The study was a secondary data analysis of 12126 respondents aged ≥40 years from Wave 5 of the Population Assessment of Tobacco and Health Study. Weighted descriptive statistics and Poisson regressions assessed current smoking (vs never or former) as a function of geographical location in a stepwise fashion, first unadjusted, then adjusting for sociodemographic characteristics, and finally for both sociodemographic characteristics and cigarette risk perceptions (4-item scale), in three separate models. Sensitivity analyses examined whether individual risk perceptions items had a greater impact on the association between geographical location and current smoking. RESULTS Current smoking was more common among rural (20.6%) than urban (17.6%) residents. The risk ratio (RR) for rural (vs urban) residence on current smoking decreased from 1.17 (95% CI: 1.03-1.32) to 1.14 (95% CI: 1.01-1.29) to 1.08 (95% CI: 0.96-1.21) across the stepwise models. Lower cigarette risk perceptions confounded the rural-current smoking association and was an independent risk factor for smoking (adjusted RR, ARR=2.15; 95% CI: 1.94-2.18). In sensitivity analyses, believing that cigarettes are very or extremely (vs somewhat, slightly, or not at all) harmful to health and agreeing (vs not agreeing) that secondhand smoke causes lung disease in people who do not smoke, confounded the rural-current smoking association whereas beliefs about smoking causing lung cancer or lung disease in people who smoke did not. CONCLUSIONS Lower cigarette risk perceptions among rural residents confounded the positive association between rural residence and current smoking. Results from sensitivity analyses highlight potential targets for communication campaigns aimed at promoting more accurate perceptions of the harmful health consequences of cigarette smoking. [ABSTRACT FROM AUTHOR]

Objective: This study measured anatalline and nicotelline, two minor tobacco alkaloids, to discriminate between exclusive smokeless tobacco (SLT) use, exclusive electronic nicotine delivery systems (ENDS) use, exclusive cigarette use, dual SLT and cigarette use, and dual ENDS and cigarette use. Methods: N = 664 urine samples from participants in the Population Assessment of Tobacco and Health Study were analyzed for anatalline and nicotelline. Geometric means and 95% confidence intervals were calculated for biomarker levels and their ratios. Non-parametric Receiver Operating Characteristic analyses were used to determine optimal cut-points of natural log-transformed biomarker ratios for distinguishing between tobacco use groups. Results: The anatalline/nicotelline ratio distinguished exclusive cigarette from exclusive SLT use (threshold = 18.1, sensitivity = 89.3%, specificity = 86.4%, AUC = 0.90), and exclusive SLT from exclusive ENDS use (threshold = 12.8, sensitivity = 96.4%, specificity = 76.3%, AUC = 0.90) very well, but had reduced sensitivity and specificity when distinguishing exclusive cigarette from exclusive ENDS or any dual use with cigarettes. Conclusions: This research fills a gap in understanding the public health consequences of SLT and ENDS use by providing objective measures that can signal use of these products alone or in combination with cigarettes. [ABSTRACT FROM AUTHOR]

This document emphasizes the importance of accurately measuring the use of oral nicotine products (ONPs), such as nicotine pouches. The authors highlight the potential for misclassification of ONPs as nicotine replacement therapy or other smokeless tobacco products, which can affect prevalence estimates and hinder understanding of factors related to ONP use. They recommend developing standardized questions to measure ONP use and exploring areas such as flavors and nicotine strengths. The document also suggests including ONPs in clinical trials and patient-reported outcomes. The authors acknowledge the need for urgent research to inform tobacco control and regulation efforts. [Extracted from the article]

Participation in college classrooms remains low, despite evidence that increased participation contributes to better grades. Incorporating active student educational strategies may help combat poor participation. The Good Behavior Game is a tool for improving various behaviors of children and adolescents in schools. However, strategies similar to the Good Behavior Game have not yet been assessed with young adults in college classrooms. We used an alternating treatments design to evaluate effects of a modified version of the Good Behavior Game on participation across three introductory psychology courses at a public university. We collected baseline data on class participation and then compared two variations of the Good Behavior Game--one included delivering a preferred reward to individuals on the winning team and one did not include a reward. Incorporating components of the Good Behavior Game increased class participation with and without a preferred reward, relative to baseline. Students reported preferring the game with a reward relative to the game with no reward and not playing the game. Because class participation has been correlated with better course grades, incorporating features of the Good Behavior Game may be a feasible approach for improving college students' education.

Impulsive choice underlies several psychological disorders and can be assessed in laboratory rats using delay- discounting tasks, in which choice is for either one food pellet immediately or three food pellets after a delay. Choice for the smaller, immediate reinforcer is considered the impulsive choice. Lewis (LEW) and Fischer 344 (F344) rats differ in the number of impulsive choices made during this task when singly housed, with LEW choosing the impulsive option more often. Due to increasing recommendations to provide environmental enrichment as a component of animal-husbandry practices, a systematic replication of two previous studies was conducted using pair-housed LEW and F344. Delay discounting was assessed with pair-housed LEW and F344 and compared to previous data from singly housed LEW and F344 collected from the same laboratory. Results showed that differences in impulsive choice between the two strains were attenuated with pair housing. The main result driving this change appears to be an increase in impulsive choice in pair-housed F344 relative to singly housed F344. Keywords Delay discounting * Housing * Lewis rat * Fischer 344 rat * Impulsive choice, Several psychological disorders list impulsivity or impaired self-control as a component of their description or diagnostic criteria (American Psychiatric Association, 2013). Operationally, impulsive choice is defined as choice for a [...]

Introduction E-cigarette advertising exposure is linked to e-cigarette initiation and use. Thus, monitoring trends in e-cigarette advertising practices is important to understand e-cigarette use patterns observed over recent years. Aims and Methods E-cigarette advertising expenditures (January 2016–July 2021; Numerator Ad Intel) for 154 U.S. market areas were harmonized with U.S. Census sociodemographic data through Nielsen zip code designations by market area. Descriptive statistics and multivariable linear regressions were used to examine trends in e-cigarette advertising expenditures across media outlets and associations between sociodemographic characteristics and e-cigarette advertising over time. Results E-cigarette advertising expenditures peaked in 2018/2019, followed by a sharp decline in 2020. Expenditures were concentrated primarily on print (58.9%), TV (20.6%), and radio (14.4%). Major print outlets were Sports Illustrated, Rolling Stone, and Star magazines. Top TV channels were AMC, Investigation Discovery, and TBS. TV advertisements were purchased commonly during popular movies and TV series (eg King of Queens, Everybody Loves Raymond, The Walking Dead). Higher expenditures were associated with U.S. market areas that had (1) a larger percentage of non-rural zip codes (radio), (2) smaller male populations (radio), and (3) larger White or Caucasian, Black or African American, American Indian or Alaska Native, Asian, and Other or Multiracial populations (radio, print, online display, and online video). Conclusions E-cigarette companies advertised in print magazines geared toward males and youth and young adults, radio commercials focused in urban areas with smaller male populations, and nationwide TV commercials. Declines in e-cigarette advertising expenditures in 2020 demonstrate the potential impact that federal policies may have on protecting populations who are at higher risk for tobacco use from predatory advertising practices. Implications E-cigarette advertising exposure is associated with the initiation and use of e-cigarettes. This study shows how e-cigarette marketing expenditures in the United States may have targeted specific consumers (eg youth and young adults) between 2016 and 2021. The precipitous drop in advertising expenditures across all outlets during early 2020 corresponds with the implementation of the Tobacco 21 federal policy, the federal enforcement policy to remove most unauthorized flavored e-cigarette cartridges from the U.S. market, preparations for FDA's premarket review of e-cigarette products, and the decision by several TV broadcast companies to stop showing e-cigarette ads. The potential impact of federal policies may have far-reaching implications for protecting populations who are at high risk for tobacco use and its health consequences. [ABSTRACT FROM AUTHOR]

Skin and soft tissue infections (SSTIs) are the most common medical complication of injection drug use in the United States, though little work has been done assessing SSTI treatment among people who inject drugs (PWID). We examined past‐3‐month abscess characteristics, treatment utilization, and barriers to medical treatment among N = 494 community‐recruited PWID. We used descriptive statistics to determine the frequencies of self‐treatment and medical treatment for their most recent past‐3‐month abscess as well as barriers to seeking medical treatment. We then used bivariate and multivariate logistic regression to identify factors associated with having an abscess in the past 3 months. Overall, 67% of participating PWID ever had an abscess and 23% had one in the past 3 months. Only 29% got medical treatment for their most recent abscess whereas 79% self‐treated. Methods for self‐treatment included pressing the pus out (81%), applying a hot compress (79%), and applying hydrogen peroxide (67%). Most (91%) self‐treated abscesses healed without further intervention. Barriers to medical treatment included long wait times (56%), being afraid to go (49%), and not wanting to be identified as a PWID (46%). Factors associated independently with having an abscess in the past 3 months were injecting purposely into muscle tissue (adjusted odds ratio [AOR] = 2.64), having difficulty finding a vein (AOR = 2.08), and sharing injection preparation equipment (AOR = 1.74). Our findings emphasize the importance of expanding community‐based access to SSTI education and treatment services, particularly at syringe service programs where PWID may be more comfortable seeking resources. [ABSTRACT FROM AUTHOR]

Implications: The electronic cigarette (ECIG) research community faces several challenges when it comes to regulatory science; not only is the ECIG market changing at a rapid pace, but the terms used by researchers, health organizations, ECIG users, and ECIG manufacturers/distributors to describe devices are inconsistent. These discrepancies make it difficult to advance science and develop regulations. Although researchers have used "generations" to categorize ECIG device types based on various characteristics, with the constantly evolving ECIG market, it is unclear where one "generation" of devices ends and the next begins. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the current study was to evaluate associations between geographic rurality and tobacco use patterns among adolescents. Methods: High school students (N = 566) from north‐central Appalachia reported on their lifetime and/or current use of cigarettes, electronic cigarettes (ECIGs), cigars, and smokeless tobacco. Geographic rurality was measured via the Isolation scale, whereby residential ZIP Codes determined the degree to which respondents have access to health‐related resources. Latent class analysis (LCA) was used to identify discrete classes of adolescent tobacco users based on their use of tobacco products. Then, associations between participants' geographic rurality and class membership were evaluated using a series of multinomial logistic regressions. Findings: LCA classified participants as Nonusers, Current ECIG Users, Cigarette/ECIG Experimenters, and Polytobacco Users. Individuals with higher Isolation scores were more likely to be Polytobacco Users and Cigarette/ECIG Experimenters than Nonusers, and were more likely to be Polytobacco Users than Current ECIG Users. Conclusions: The continuous Isolation scale used in the present study predicted polytobacco use patterns among adolescents in a manner that is consistent with, while simultaneously expanding upon, prior work. Tobacco control practices and policies should be viewed through a lens that considers the unique needs of geographically isolated areas. [ABSTRACT FROM AUTHOR]

Impulsivity (choosing a smaller, more immediate reward over a larger, more delayed reward) and substance abuse are positively correlated. It is important to understand how factors like delay to reward and drug effects determine impulsive choice, which can be studied using animal models. This study evaluated impulsive choice in rats, where delays to the larger reward (three food pellets) were presented in decreasing order versus one food pellet delivered immediately. Then, effects of d-amphetamine were assessed. It was found that in three of four rats, d-amphetamine increased impulsive choice when the larger option was presented with decreasing delays. This effect is contrary to what has generally been found with increasing delays. Thus, environmental context can influence drug effects on impulsive choice. [ABSTRACT FROM AUTHOR]

Background: Snus tobacco characteristics may attract non-tobacco users, including relatively low, but pharmacologically active, doses of nicotine. Lower nicotine doses may limit adverse drug effects while also producing a physiologically active response.Objectives: This pilot study is the first to profile the acute effects of snus on physiological and subjective assessments in a sample of never-tobacco users.Methods: Eleven never-tobacco users (five women; <100 uses/lifetime) were recruited from the community via university-approved advertisements. Using a within-subject design, participants consumed six pouches in ascending dose order (0, 1.6, 3.2, 4.8, 6.4, and 8.0 mg nicotine) within one session. The start of each snus bout was separated by 45 minutes, and pre- and post-pouch assessments included ratings of drug effects and physiological response.Results: The average heart rate and systolic blood pressure increased significantly from pre- to post-pouch use as a function of dose, though these increases were reliable for 8.0 mg nicotine only (p < .05). Collapsed across time, diastolic blood pressure was significantly higher for 8.0 mg nicotine than for all other doses (p < .05). Subjective ratings for "excessive salivation" and "satisfying" increased significantly from pre- to post-pouch use (p < .05), independent of dose.Conclusion: Significant increases in physiological response at some doses suggest that users were exposed to pharmacologically active doses of nicotine. The lack of reliable subjective effects may be the product of the dosing regimen or the relatively small sample size. Findings highlight the need for identification of doses of snus that may promote abuse among naïve users. [ABSTRACT FROM AUTHOR]