Latino Cigarette Smoking Patterns by Gender in a US-National Sample.
ABSTRACT: BACKGROUND:Latino smokers are a rising public health concern who experience elevated tobacco-related health disparities. PURPOSE:Additional information on Latino smoking is needed to inform screening and treatment. ANALYSIS:Latent class analysis using smoking frequency, cigarette preferences, onset, smoking duration, cigarettes per day, and minutes to first cigarette was used to create multivariate latent smoking profiles for Latino men and women. RESULTS:Final models found seven classes for Latinas and nine classes for Latinos. Despite a common finding in the literature that Latino smokers are more likely to be low-risk intermittent smokers, the majority of classes for both males and females described patterns of high-risk daily smoking. Gender variations in smoking classes were noted. CONCLUSIONS:Several markers of smoking risk were identified among both male and female Latino smokers, including long durations of smoking, daily smoking, and preference for specialty cigarettes, all factors associated with long-term health consequences.
Project description:A statewide survey examined prevalence, reasons for using, discontinuing use, and not wanting to try e-cigarettes. Methods:Participants (n?=?6052) were adult Minnesota residents. E-cigarette initiation and current use prevalence rates were calculated for demographic characteristics and smoking status. The percent of respondents endorsing a reason for trying e-cigarettes are reported overall and by smoking status. The percent of respondents endorsing each reason for discontinuing or not using e-cigarettes are reported for daily and occasional smokers. All descriptive analyses were weighted. To develop profiles of e-cigarette users, a latent class analysis (LCA) was undertaken. Results:Overall, 20.7% of adults reported ever use and 4.6% were current users. Use varied notably by age and smoking status. Only 2.8% of never smokers were current e-cigarette users. Among young adults, 14.6% reported current use but most (70.0%) were never smokers. The reasons given for using e-cigarettes varied by smoking status. Curiosity was the top reason for all groups except recent former smokers, for whom cutting down or quitting other tobacco products was primary. Most smokers discontinuing e-cigarettes preferred cigarettes, and four-fifths of smokers who never tried e-cigarettes lacked interest. From the LCA four profiles were evident: young adult experimenters, curious adults, smokers trying to quit cigarettes, and dual users. Conclusions:Innovative higher nicotine content devices have sustained interest in e-cigarettes especially among young adults and smokers with a goal of cutting down or quitting smoking. Future regulations and communication should focus on reducing e-cigarette use among young adult nonsmokers.
Project description:Although recent research indicates that many Latino smokers are nondaily smokers or daily smokers who smoke at a low level (<or =5 cigarettes/day), almost no research has investigated the characteristics of low-level smokers because such individuals are typically excluded from clinical trial research.The present study examined the associations of daily smoking level and demographics, tobacco dependence, withdrawal, and abstinence during a specific quit attempt among 280 Spanish-speaking Latino smokers (54% male) who participated in a clinical trial of a telephone counseling intervention. Daily smokers were classified as low-level (1-5 cigarettes/day; n = 81), light (6-10 cigarettes/day; n = 99), or moderate/heavy smokers (> or =11 cigarettes/day; n = 100). Data were collected prior to the quit attempt and at 5 and 12 weeks postquit.Results yielded three key findings. First, smoking level was positively associated with the total score and 12 of 13 subscale scores on a comprehensive, multidimensional measure of tobacco dependence. Low-level smokers consistently reported the least dependence, and moderate/heavy smokers reported the most dependence on tobacco. Second, low-level smokers reported the least craving in pre- to postcessation longitudinal analyses. Third, despite significant differences on dependence and craving, low-level smoking was not associated with abstinence. Smoking level was not associated with demographic variables.This is a preliminary step in understanding factors influencing tobacco dependence and smoking cessation among low-level Spanish-speaking Latino smokers, a subgroup with high prevalence in the Latino population.
Project description:INTRODUCTION:Psychometrically sound measures of e-cigarette dependence are lacking. METHODS:We modified the PROMIS Item Bank v1.0-Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. RESULTS:All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. CONCLUSIONS:Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. IMPLICATIONS:The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.
Project description:To evaluate the safety and effectiveness of e-cigarettes, by comparing users of only e-cigarettes, smokers of only tobacco cigarettes and dual users.Prospective cohort study. We update previous 12-month findings and report the results of the 24-month follow-up.Direct contact and questionnaires by phone or via internet.Adults (30-75?years) were classified as: (1) tobacco smokers, if they smoked ?1 tobacco cigarette/day, (2) e-cigarette users, if they inhaled ?50 puffs/week of any type of e-cigarette and (3) dual users, if they smoked tobacco cigarettes and also used e-cigarettes. Carbon monoxide levels were tested in 50% of those declaring tobacco smoking abstinence. Hospital discharge data were used to validate possibly related serious adverse events in 46.0% of the sample.Sustained abstinence from tobacco cigarettes and/or e-cigarettes after 24?months, the difference in the number of tobacco cigarettes smoked daily between baseline and 24?months, possibly related serious adverse events.Data at 24?months were available for 229 e-cigarette users, 480 tobacco smokers and 223 dual users (overall response rate 68.8%). Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence). The rate (18.8%) of stopping use of either product (tobacco and/or e-cigarettes) was not higher for e-cigarette users compared with tobacco smokers or dual users. Self-rated health and adverse events were similar between all groups. Among those continuing to smoke, there were no differences in the proportion of participants reducing tobacco cigarette consumption by 50% or more, the average daily number of cigarettes and the average self-rated health by baseline group. Most dual users at baseline abandoned e-cigarettes and continued to smoke tobacco. Those who continued dual using or converted from tobacco smoking to dual use during follow-up experienced significant improvements in the 3 outcomes compared with those who continued or switched to only smoking tobacco (p<0.001).E-cigarette use alone might support tobacco quitters remaining abstinent from smoking. However, dual use did not improve the likelihood of quitting tobacco or e-cigarette use, but may be helpful to reduce tobacco consumption. Adverse event data were scarce and must be considered preliminary.NCT01785537.
Project description:BACKGROUND:The dose-response relationships between number of cigarettes smoked per day (CPD) and health outcomes, such as cancer and heart disease, are well established, but much less is known about the relationships between CPD and biomarkers of exposure. METHODS:We analyzed biomarker data by CPD from more than 2,700 adult daily cigarette smokers in Wave 1 of the Population Assessment of Tobacco and Health Study. Tobacco use categories consisted of exclusive cigarette smokers, dual cigarette and e-cigarette users, and dual cigarette and smokeless tobacco users. RESULTS:Biomarker concentrations consistently increased with CPD for each tobacco user group, although concentrations tended to level off at high smoking levels, such as those at and above 20 CPD. Dual cigarette and e-cigarette users had higher levels of some biomarkers such as Total Nicotine Equivalents-2 (P = 0.0036) than exclusive cigarette smokers, and dual cigarette and smokeless tobacco users had higher levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (P < 0.0001) and N'-nitrosonornicotine (P = 0.0236) than exclusive cigarette smokers. CONCLUSIONS:Among daily smokers, exposure to tobacco toxicants and constituents exhibits a dose-response relationship by number of cigarettes smoked, but the relationship is not necessarily linear in form. Dual users of cigarettes with either e-cigarettes or smokeless tobacco are exposed to higher levels of certain toxicants and carcinogens than exclusive cigarette smokers. IMPACT:Availability of biomarker data by CPD may aid in comparisons between cigarette smoking and use of new and potentially reduced exposure tobacco products, which may result in different levels of constituent and toxicant exposure.
Project description:BACKGROUND:Electronic cigarettes (e-cigarettes) may help cigarette smokers quit smoking, yet they may also facilitate cigarette smoking for never-smokers. We quantify the balance of health benefits and harms associated with e-cigarette use at the population level. METHODS AND FINDINGS:Monte Carlo stochastic simulation model. Model parameters were drawn from census counts, national health and tobacco use surveys, and published literature. We calculate the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort. RESULTS:The model estimated that 2,070 additional current cigarette smoking adults aged 25-69 (95% CI: -42,900 to 46,200) would quit smoking in 2015 and remain continually abstinent from smoking for ?7 years through the use of e-cigarettes in 2014. The model also estimated 168,000 additional never-cigarette smoking adolescents aged 12-17 and young adults aged 18-29 (95% CI: 114,000 to 229,000), would initiate cigarette smoking in 2015 and eventually become daily cigarette smokers at age 35-39 through the use of e-cigarettes in 2014. Overall, the model estimated that e-cigarette use in 2014 would lead to 1,510,000 years of life lost (95% CI: 920,000 to 2,160,000), assuming an optimistic 95% relative harm reduction of e-cigarette use compared to cigarette smoking. As the relative harm reduction decreased, the model estimated a greater number of years of life lost. For example, the model estimated-1,550,000 years of life lost (95% CI: -2,200,000 to -980,000) assuming an approximately 75% relative harm reduction and -1,600,000 years of life lost (95% CI: -2,290,000 to -1,030,000) assuming an approximately 50% relative harm reduction. CONCLUSIONS:Based on the existing scientific evidence related to e-cigarettes and optimistic assumptions about the relative harm of e-cigarette use compared to cigarette smoking, e-cigarette use currently represents more population-level harm than benefit. Effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future.
Project description:Alveolar macrophage (AM) gene expression studies in cigarette smokers have identified dysregulated molecular pathways relevant to clinical outcomes. However, parallel studies in cannabis smokers are limited, despite marijuana’s increasing public health relevance. We performed the first genome-wide gene expression analysis from the lungs of marijuana smokers to test the hypothesis that marijuana is associated with changes in AM gene expression that may contribute to altered immune function. AMs from bronchoalveolar lavage from 15 marijuana smokers, 16 cigarette smokers, and 10 non-smokers were isolated for RNA sequencing. We performed differential expression analysis to identify genes that differed on average between smoking groups, with emphasis on genes associated with M1/M2 macrophage polarization and immunity. Overall design: N = 15 marijuana smokers, N = 16 cigarette smokers, N = 10 non-smoker controls with no major comorbidities (see publication supplement). Marijuana smokers reported daily or near-daily use and smoking equivalent to at least 20 joint-years, <1 pack-year cigarette history, and no active tobacco use. Tobacco smoking participants reported daily or near-daily cigarette smoking, no active marijuana consumption, and <1 joint-year of marijuana use. Tobacco smoking participants reported daily or near-daily cigarette smoking, no active marijuana consumption, and <1 joint-year of marijuana use. Non-smoking control participants reported no active use of either substance, <1 joint-year marijuana use, and <1 pack-year tobacco use.
Project description:Most smokers who use electronic cigarettes (e-cigarettes) to stop smoking simultaneously use conventional cigarettes (dual users). We aimed to compare the prevalence of cardiovascular risk factors among dual users, cigarette-only smokers, and never smokers in Korean men. We used data acquired from Korean National Health and Nutrition Examination Survey (2013-2017) pertaining to 7,505 male participants aged 19 years or older. About 85% of e-cigarette users were dual users. Dual users had greater nicotine dependence and higher urinary cotinine levels than cigarette-only smokers. Dual users had more psychosocial and behavioural risk factors, including perceived high stress, depressive mood, high daily intake of energy, and obesity, than never smokers and cigarette-only smokers. The prevalence of metabolic syndrome (MetS) was higher among dual users, and their multivariate-adjusted prevalence odds ratio for MetS was 2.79 (P?<?0.001) compared with never smokers and 1.57 (P?=?0.038) compared with cigarette-only smokers. Given that most e-cigarette users are dual users and dual users are more vulnerable to cardiovascular risk factors than cigarette-only smokers and never smokers, more active treatment for smoking cessation and intensive lifestyle interventions for dual users should be considered with priority.
Project description:Many smokers reported using Electronic Nicotine Delivery System (ENDS, e.g., electronic cigarettes or e-cigarettes) to quit cigarette smoking. Previous studies suggested that daily ENDS use may promote cigarette smoking cessation. We assessed variations in the prevalence of daily ENDS use among adult smokers by demographics and implications for cigarette smoking disparities. Data were from a nationally representative sample of US adults who participated in the 2014-2015 Tobacco Use Supplement to the Current Population Survey (n = 163,920). Participants reported socio-demographics, current cigarette smoking, current ENDS use, and past-year cigarette smoking cessation attempts. We estimated the prevalence of current cigarette smoking in the full sample by socio-demographics. We also estimated the prevalence of daily ENDS use among current smokers (n = 23,232) and those who attempted to quit smoking in the past year (n = 9,341) by socio-demographics. Multivariable logistic regression models were used to assess associations between daily ENDS use and socio-demographics. Prevalence of daily ENDS use was low: 1-6% among current smokers and 2-9% among those who made a past-year quit attempt, across socio-demographics. Hispanic (Adjusted odds ratio [AOR] = 0.45, 95% confidence interval [CI] = 0.29-0.69) and non-Hispanic black smokers (AOR = 0.38, 95% CI = 0.23-0.61) were less likely than non-Hispanic white smokers to use ENDS daily. Similar associations were observed among current smokers who made a past-year quit attempt (p < 0.05). Low prevalence of daily ENDS use suggests that ENDS may only promote smoking cessation in a small fraction of smokers. Lower prevalence of daily ENDS use among non-Hispanic black smokers may worsen race-related cigarette smoking disparities.
Project description:To determine characteristics of smokers discussing e-cigarette use with their physician and receiving recommendations from their physician to use e-cigarettes for smoking cessation.US adult smokers who had visited a physician in the previous 12 months (n = 2671) were surveyed. Logistic generalized estimating equation models were used to assess the characteristics of smokers who (1) talked to a physician about e-cigarettes, and (2) received physician advice to use e-cigarettes for smoking cessation.15% (n = 406) of smokers who visited a physician talked with their physician about e-cigarettes. Among those asked whether their physician recommend e-cigarettes for smoking cessation (n = 257), 61% responded affirmatively. Current e-cigarette users were more likely to talk to their physicians about e-cigarettes (nondaily users vs never users: OR, 2.70; 95% CI, 1.79-4.05; daily users vs never users: OR, 4.29; 95% CI, 2.34-7.84) and have their physician recommend e-cigarettes for smoking cessation (daily users vs never users: OR, 9.40; 95% CI, 2.54-34.71).The majority of smokers who talk to their physician about e-cigarettes report that they received advice to use e-cigarettes to quit smoking, despite limited evidence for their efficacy. More studies are needed to better understand e-cigarette recommendations in clinical settings.