scholarly journals Not Quite the Rule, But No Longer the Exception: Multiple Tobacco Product Use and Implications for Treatment, Research, and Regulation

2019 ◽  
Vol 22 (11) ◽  
pp. 2114-2117
Author(s):  
Lauren R Pacek ◽  
Andrea C Villanti ◽  
F Joseph Mcclernon
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Tobacco Dependence ◽  
The United States ◽  
Tobacco Product ◽  
Regulatory Science ◽  
Tobacco Products ◽  
The Past ◽  
Product Use ◽  
Treatment Research

Abstract The patterns of tobacco product use in the United States have changed during the past several decades. Currently, a large proportion of tobacco users report using multiple tobacco products (MTPs). The prevalence of MTP use varies significantly by cigarette smoking frequency, as well: nearly half (46.9%) of all non-daily smokers report using other tobacco products within the past 30 days. Despite this, much of extant tobacco dependence treatment efforts, tobacco regulatory science research, and tobacco product research, in general, has focused largely on single product use (ie, cigarette smoking). To effectively design interventions and model the potential impact of regulations on tobacco products aimed at reducing tobacco use, as well as effectively study tobacco users, it is essential to consider actual use patterns in the population of tobacco users. Implications: MTP use is increasingly common in the United States. This commentary highlights the impact that MTP use has for efforts to treat tobacco dependence, tobacco regulatory science efforts, as well as on tobacco research, in general.

scholarly journals Mortality Risks Associated With Dual– and Poly–Tobacco-Product Use in the United States

2019 ◽  
Author(s):  
Kelvin Choi ◽  
Maki Inoue-Choi ◽  
Timothy S McNeel ◽  
Neal D Freedman
Keyword(s):  
United States ◽  
The United States ◽  
Tobacco Product ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Mortality Risks ◽  
Use Patterns ◽  
Product Use ◽  
Nationally Representative ◽  
The Impact

Abstract Increasing numbers of adults in the United States use more than 1 tobacco product. Most use cigarettes in combination with other tobacco products. However, little is known about the all-cause and cancer-specific mortality risks of dual– and poly–tobacco-product use. We examined these associations by pooling nationally representative data from the 1991, 1992, 1998, 2000, 2005, and 2010 National Health Interview Surveys (n = 118,144). Mortality information was obtained through linkage to the National Death Index. Cigarette smokers who additionally used other tobacco products smoked as many if not more cigarettes per day than exclusive cigarette smokers. Furthermore, cigarette smokers who additionally used other tobacco products had mortality risks that were as high as and sometimes higher than those of exclusive cigarette smokers. As tobacco use patterns continue to change and diversify, investigators in future studies need to carefully assess the impact of noncigarette tobacco products on cigarette use and determine associated disease risks.

scholarly journals Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014

2017 ◽  
Vol 376 (4) ◽  
pp. 342-353 ◽  
Author(s):  
Karin A. Kasza ◽  
Bridget K. Ambrose ◽  
Kevin P. Conway ◽  
Nicolette Borek ◽  
Kristie Taylor ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Tobacco Product ◽  
Product Use

scholarly journals Review of Cases of E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Brief Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Amr Essa ◽  
Jeffrey Macaraeg ◽  
Nikhil Jagan ◽  
Daniel Kwon ◽  
Saboor Randhawa ◽  
...  
Keyword(s):  
United States ◽  
Lung Injury ◽  
The United States ◽  
Cigarette Use ◽  
Review Of The Literature ◽  
The Past ◽  
Product Use ◽  
Vitamin E Acetate ◽  
Pathologic Features ◽  
Growing Body

Since the appearance of the E-Cigarette in the early 2000s, its industry, popularity, and prevalence have risen dramatically. In the past, E-Cigarette use with the vaping of nicotine or cannabis products had been associated with a few reported cases of lung injury. However, in 2019, thousands of cases of E-Cigarette or vaping product use-associated lung injury (EVALI) were reported in the United States. Evidence linked this outbreak with vaping of tetrahydrocannabinol (THC). We report two confirmed cases of EVALI and their associated clinical, radiologic, and pathologic features. This report supports the growing body of information regarding EVALI. It also discusses various substances, particularly vitamin E acetate, which has been suggested as a causative agent.

Human Abuse Liability Assessment of Tobacco and Nicotine Products: Approaches for Meeting Current Regulatory Recommendations

2021 ◽  
Author(s):  
Andrea Vansickel ◽  
Sarah Baxter ◽  
Neil Sherwood ◽  
Michael Kong ◽  
Leanne Campbell
Keyword(s):  
United States ◽  
The United States ◽  
Tobacco Product ◽  
Abuse Liability ◽  
Background Information ◽  
Regulatory Review ◽  
Tobacco Products ◽  
Public Health Officials ◽  
Regulatory Bodies ◽  
Study Designs

Abstract Many regulatory bodies now recommend that tobacco product manufacturers provide information regarding new tobacco products’ abuse liability to inform regulatory authorization of currently marketed tobacco products or new product applications (including premarket tobacco product applications in the United States). In addition, the US Food and Drug Administration (FDA) recommends including this information as part of modified risk tobacco product applications. Regulators, including FDA, and many public health officials and researchers consider abuse liability assessment a model which predicts the likelihood that the use of the tobacco product would result in addiction and be used repeatedly or even sporadically resulting in undesirable effects. Abuse liability of a new, potentially reduced harm product can also inform its ability to substitute completely for more harmful tobacco products. While many methods exist, no standard tobacco product abuse liability assessment has been established. The purpose of this review is to provide background information and practical recommendations for human abuse liability testing methods to meet tobacco regulatory needs. A combination of nicotine test product pharmacokinetic, subjective effect and/or behavioral response, and physiological response data relative to comparator products with known abuse liability satisfies some regulatory requirements. Implications: This review provides a practical inspection of the current, international regulatory recommendations for abuse liability assessment of tobacco and regulatory review of such information within the United States and also recommends study designs and methods for abuse liability testing of tobacco products based on scientific and regulatory knowledge. Given that tobacco product abuse liability testing is of increasing interest to regulatory bodies globally, especially with the emergence of novel tobacco products, this timely work provides background and functional recommendations for tobacco product abuse liability testing.

scholarly journals Exposure to a Tobacco-Specific Carcinogen Among Adolescent Smokeless Tobacco Users in Rural California, United States

2019 ◽  
Vol 22 (10) ◽  
pp. 1764-1771
Author(s):  
Benjamin W Chaffee ◽  
Peyton Jacob ◽  
Elizabeth T Couch ◽  
Neal L Benowitz
Keyword(s):  
United States ◽  
High School ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
The United States ◽  
Tobacco Product ◽  
Geometric Means ◽  
Tobacco Products ◽  
Smokeless Tobacco Products ◽  
Smokeless Tobacco Use

Abstract Introduction Approximately the same percentage of male high school students in the United States currently uses conventional smokeless tobacco as smokes cigarettes, resulting in toxin exposure. Methods This study assessed tobacco product use (smokeless, combustible, and electronic cigarettes) and nicotine and carcinogen exposures in a sample of 594 male rural high school baseball players—a population traditionally at risk for smokeless tobacco use. Salivary specimens were assayed for cotinine (a biomarker of nicotine exposure) and urine specimens for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a biomarker of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) using liquid chromatography–tandem mass spectrometry. Results The prevalence of past 30-day use of any tobacco product was 29%. Past 7-day smokeless tobacco use (prevalence: 13%) was associated with the highest levels of cotinine and NNAL observed in the sample, whether smokeless tobacco was used exclusively (geometric means: cotinine 11.1 ng/mL; NNAL 31.9 pg/mg-creatinine) or in combination with combustible products (geometric means: cotinine 31.6 ng/mL; NNAL 50.0 pg/mg creatinine). Cotinine and NNAL levels were incrementally higher in each increasing category of smokeless tobacco use frequency. However, observed levels were lower than previously reported for adults, likely reflecting less smokeless use per day among adolescents. Conclusions Based on these biomarker observations, adolescents who use conventional smokeless tobacco products are exposed to substantial levels of nicotine and NNK. Although exposed to lower levels than adult smokeless users, the findings are concerning given the young age of the sample and tendency for smokeless tobacco users to increase use intensity over time. Implications This study demonstrates that adolescents using smokeless tobacco are exposed to levels of nicotine and NNK that increase with use frequency and that exceed exposures among peers using other tobacco products. Youth smokeless tobacco use in the United States has not declined along with youth smoking prevalence, giving greater importance to this health concern. To reduce youth (and adult) exposures, needed actions include effective smokeless tobacco use prevention, potentially in combination with reducing the levels of harmful and potentially harmful chemicals in smokeless tobacco products currently popular among adolescents.

Drinking Water Microbiology Research in the United States: An Overview of the Past Decade

1988 ◽  
Vol 20 (11-12) ◽  
pp. 101-107 ◽  
Author(s):  
Donald J. Reasoner
Keyword(s):  
United States ◽  
Water Quality ◽  
Drinking Water ◽  
Pathogenic Bacteria ◽  
Heterotrophic Bacteria ◽  
The United States ◽  
Drinking Water Quality ◽  
Giardia Cyst ◽  
The Past ◽  
Treatment Research

The passage of the Safe Drinking Water Act (SDWA) in 1974 (Public Law 93-523) significantly influenced microbiological, chemical and engineering research on drinking water quality in the United States. Microbiological quality research during the past 10 years encompassed the two basic areas of treatment and distribution. Much of the treatment research focused on generation of data to support the evaluation of turbidity and coliform maximum contaminant levels (MCLs) for the Interim Primary Drinking Water Standards. Major effort was also directed toward disinfection research on enteric viruses, pathogenic bacteria and the protozoan pathogen, Giardialamblia. Basic distribution system studies examined the occurrence of heterotrophic bacterial numbers and types in treated and untreated distribution waters, and coliform occurrence and colonization problems. Methodology developments bridged both treatment and distribution, and included enteric virus detection methods, injured ooliform recovery, heterotrophic bacteria enumeration, and Giardia cyst detection. Knowledge gained from the research efforts of the past deoade has resulted in new challenges and opportunities to improve drinking water quality.

Youth Tobacco Product Use in the United States

PEDIATRICS ◽  
2015 ◽  
Vol 135 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Y. O. Lee ◽  
C. J. Hebert ◽  
J. M. Nonnemaker ◽  
A. E. Kim
Keyword(s):  
United States ◽  
The United States ◽  
Tobacco Product ◽  
Product Use
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