scholarly journals Electronic cigarette communications between patients and physicians in the United States

2021 ◽  
Author(s):  
Cristine Delnevo ◽  
Michelle Jeong ◽  
Arjun Teotia ◽  
Michelle T Bover Manderski ◽  
Binu Singh ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Strong Predictor ◽  
The United States ◽  
Physician Education ◽  
Heavy Smoker ◽  
Primary Role ◽  
Cross Sectional Survey ◽  
Tobacco Products ◽  
The Past ◽  
Clinical Scenarios

Importance: Physicians play a primary role in smoking cessation, and their communication regarding e-cigarettes needs to be understood. Objective: To examine physician-patient communication regarding e-cigarettes. Design: A national, repeated cross-sectional survey in 2018 and 2019 was conducted. Setting: Participants were invited by mail; surveys were completed online. Participants: Response rates were 51.8% (2018) and 59.1% (2019), resulting in 2,058 board-certified physicians from family medicine, internal medicine, obstetrics/gynecology, cardiology, pulmonary/critical care, and hematology/oncology. Exposures: Physician demographics, tobacco use, medical specialty, and harm-reduction beliefs (i.e., not all tobacco products equally harmful); two hypothetical clinical scenarios. Main outcomes and measures: Physicians' self-reported e-cigarette communication behaviors (being asked about e-cigarettes by patients and recommending e-cigarettes to patients), and hypothetical e-cigarette communication in two clinical scenarios. Results: Among 2,058 physicians, the mean age was 51.6 years and 41.5% were female. Over 60% of physicians believed all tobacco products are equally harmful. Overall, 69.8% of physicians reported ever being asked about e-cigarettes by their patients (35.9% in the past 30 days), while 21.7% reported ever recommending e-cigarettes to a patient (9.8% in the past 30 days). Pulmonologists (adjusted odds ratio [AOR], 2.14, 95% CI, 1.10-4.16) and cardiologists (AOR, 2.04; 95% CI, 1.03-4.05), as well as physicians who implemented the US Public Health Service Clinical Practice Guidelines (AOR, 1.77; 95% CI, 1.12-2.80) had greater odds of recommending e-cigarettes to patients. Physicians who endorsed a harm-reduction perspective (AOR, 3.04, 95% CI, 2.15-4.31) and had ever smoked cigarettes (AOR, 1.98; 95% CI, 1.27-3.08) were significantly more likely to recommend e-cigarettes. Being asked about e-cigarettes by patients was a strong predictor of physicians' recommending (AOR,16.6; 95% CI, 10.3-26.7). In clinical scenarios, physicians were overall more likely to recommend e-cigarettes for cessation to an older, heavy smoker with multiple unsuccessful quit attempts than a younger, light smoker with no prior cessation treatments (49.3% vs. 15.2%, p<.001). Conclusions and relevance: Findings suggest physicians may recommend e-cigarettes for cessation under certain circumstances. Given the role of e-cigarettes in FDA's comprehensive nicotine policy, there is need for continued physician education regarding e-cigarette efficacy, particularly correcting misperceptions regarding harm reduction.

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 Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039792
Author(s):  
Anna Gottschlich ◽  
Sophia Mus ◽  
Jose Carlos Monzon ◽  
James F Thrasher ◽  
Joaquin Barnoya
Keyword(s):  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Tobacco Prevention ◽  
Guatemala City ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Middle Income ◽  
The Past

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).

E-Cigarette Advice to Patients From Physicians and Dentists in the United States

2017 ◽  
Vol 32 (5) ◽  
pp. 1228-1233 ◽  
Author(s):  
Olivier Drouin ◽  
Robert C. McMillen ◽  
Jonathan D. Klein ◽  
Jonathan P. Winickoff
Keyword(s):  
United States ◽  
The United States ◽  
Fisher Exact Test ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exact Test ◽  
The Past ◽  
Random Digit Dialing ◽  
Potential Benefits ◽  
Nationally Representative

Purpose: To report on adults’ recall of discussion by physicians and dentists about e-cigarettes. Design: A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Participants: Adults who ever used e-cigarettes. Measures: Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child’s doctor in the past 12 months. Analysis: Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Results: Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child’s doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child’s doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child’s doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Conclusions: Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.

scholarly journals Anxiety is associated with undesirable eating behaviors in university students during the COVID-19 pandemic

2021 ◽  
Author(s):  
Kathryn E Coakley ◽  
Huyen Le ◽  
Spirit Rae Silva ◽  
Aspen Wilks
Keyword(s):  
Eating Behaviors ◽  
The United States ◽  
Eating Attitudes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Students ◽  
The Past ◽  
Severe Anxiety ◽  
Satiety Responsiveness ◽  
Food Fussiness

Abstract Background COVID-19 has impacted mental health globally, however, relationships between anxiety and eating behaviors during the pandemic have not been explored. This study evaluated anxiety, eating attitudes and behaviors, and associations between anxiety and eating behaviors in students at a large public University in the United States during the COVID-19 pandemic. Methods Current undergraduate and graduate/professional students completed a cross-sectional survey in fall 2020. Demographic information, indicators of anxiety in the past two weeks assessed by the Generalized Anxiety Disorder Screener (GAD-7), and eating behaviors assessed by the Adult Eating Behavior Questionnaire (AEBQ) were evaluated. A score ≥ 10 on the GAD-7 indicated anxiety (≥ 15 indicated severe anxiety). Eating behaviors were reported via Likert scale and combined into eight AEBQ subscales; subscale mean and standard deviation were reported. Differences in mean AEBQ subscale scores were examined between participants with and without anxiety via Mann-Whitney U tests. Multivariate linear regression was utilized to examine associations between GAD-7 score and individual AEBQ subscale scores, adjusting for age, gender, race/ethnicity, and student status. Results The final sample included 1243 students (57% undergraduates). In the full sample, 51.9% experienced anxiety in the past two weeks; 24.6% had severe anxiety. Subgroups with the highest prevalence of anxiety included non-cisgender participants (73.6%), the youngest age group [18–20 years of age (62%)], undergraduate students (60.7%), and Hispanic/Latino participants (57.5%). Participants with anxiety had significantly lower AEBQ scores for enjoyment of food and significantly higher scores for emotional over and under-eating, food fussiness, food and satiety responsiveness, and hunger than those with no anxiety (p < 0.01). In adjusted analyses, GAD-7 score was significantly and positively associated with hunger, food responsiveness, emotional over-eating, satiety responsiveness, and food fussiness and negatively associated with enjoyment of food. Conclusions The prevalence of anxiety is overwhelming in undergraduate and graduate/professional students amidst the COVID-19 pandemic. Eating behaviors differ significantly in those with anxiety; increasing anxiety severity was associated with undesirable eating behaviors including hunger and emotional over-eating. Universities and health professionals must consider strategies to address anxiety, particularly in younger students, non-cis-gender students, and across race/ethnicities keeping in mind associations between anxiety and eating behaviors.

scholarly journals Racial Discrimination and Uptake of Dental Services among American Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1558 ◽  
Author(s):  
Wael Sabbah ◽  
Aswathikutty Gireesh ◽  
Malini Chari ◽  
Elsa K. Delgado-Angulo ◽  
Eduardo Bernabé
Keyword(s):  
Racial Discrimination ◽  
Social Inequalities ◽  
Smoking Status ◽  
The United States ◽  
Emotional Impact ◽  
Behavioral Risk ◽  
Cross Sectional Survey ◽  
Dental Services ◽  
Cross Sectional ◽  
The Past

This study examined the relationship between racial discrimination and use of dental services among American adults. We used data from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of adults in the United States. Racial discrimination was indicated by two items, namely perception of discrimination while seeking healthcare within the past 12 months and emotional impact of discrimination within the past 30 days. Their association with dental visits in the past year was tested in logistic regression models adjusting for predisposing (age, gender, race/ethnicity, income, education, smoking status), enabling (health insurance), and need (missing teeth) factors. Approximately 3% of participants reported being discriminated when seeking healthcare in the past year, whereas 5% of participants reported the emotional impact of discrimination in the past month. Participants who experienced emotional impact of discrimination were less likely to have visited the dentist during the past year (Odds Ratios (OR): 0.57; 95% CI 0.44–0.73) than those who reported no emotional impact in a crude model. The association was attenuated but remained significant after adjustments for confounders (OR: 0.76, 95% CI 0.58–0.99). There was no association between healthcare discrimination and last year dental visit in the fully adjusted model. Emotional impact of racial discrimination was an important predictor of use of dental services. The provision of dental health services should be carefully assessed after taking account of racial discrimination and its emotional impacts within the larger context of social inequalities.

scholarly journals Ketamine in the Prehospital Environment: A National Survey of Paramedics in the United States

2017 ◽  
Vol 33 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Daniel M. Buckland ◽  
Remle P. Crowe ◽  
Rebecca E. Cash ◽  
Stephen Gondek ◽  
Patrick Maluso ◽  
...  
Keyword(s):  
United States ◽  
National Survey ◽  
The United States ◽  
Prehospital Setting ◽  
Rapid Sequence Intubation ◽  
Future Research ◽  
Study Cohort ◽  
Primary Role ◽  
Cross Sectional Survey ◽  
Publication Type

AbstractBackgroundUse of ketamine in the prehospital setting may be advantageous due to its potent analgesic and sedative properties and favorable risk profile. Use in the military setting has demonstrated both efficacy and safety for pain relief. The purpose of this study was to assess ketamine training, use, and perceptions in the civilian setting among nationally certified paramedics (NRPs) in the United States.MethodsA cross-sectional survey of NRPs was performed. The electronic questionnaire assessed paramedic training, authorization, use, and perceptions of ketamine. Included in the analysis were completed surveys of paramedics who held one or more state paramedic credentials, indicated “patient care provider” as their primary role, and worked in non-military settings. Descriptive statistics were calculated.ResultsA total of 14,739 responses were obtained (response rate=23%), of which 10,737 (73%) met inclusion criteria and constituted the study cohort. Over one-half (53%) of paramedics reported learning about ketamine during their initial paramedic training. Meanwhile, 42% reported seeking ketamine-related education on their own. Of all respondents, only 33% (3,421/10,737) were authorized by protocol to use ketamine. Most commonly authorized uses included pain management (55%), rapid sequence intubation (RSI; 72%), and chemical restraint/sedation (72%). One-third of authorized providers (1,107/3,350) had never administered ketamine, with another 32% (1,070/3,350) having administered ketamine less than five times in their career. Ketamine was perceived to be safe and effective as the vast majority reported that they were comfortable with the use of ketamine (94%) and would, in similar situations (95%), use it again.ConclusionThis was the first large, national survey to assess ketamine training, use, and perceptions among paramedics in the civilian prehospital setting. While training related to ketamine use was commonly reported among paramedics, few were authorized to administer the drug by their agency’s protocols. Of those authorized to use ketamine, most paramedics had limited experience administering the drug. Future research is needed to determine why the prevalence of ketamine use is low and to assess the safety and efficacy of ketamine use in the prehospital setting.BucklandDM, CroweRP, CashRE, GondekS, MalusoP, SirajuddinS, SmithER, DangerfieldP, ShapiroG, WankaC, PanchalAR, SaraniB. Ketamine in the prehospital environment: a national survey of paramedics in the United States. Prehosp Disaster Med. 2018;33(1):23–28.

The “Temperance Mentality”: A Comparison of University Students in Seven Countries

1998 ◽  
Vol 28 (2) ◽  
pp. 265-282 ◽  
Author(s):  
Bruce K. Alexander ◽  
Gary A. Dawes ◽  
Govert F. van de Wijngaart ◽  
Hans C. Ossebaard ◽  
Michael D. Maraun
Keyword(s):  
United States ◽  
The Netherlands ◽  
University Students ◽  
Harm Reduction ◽  
Drug Policy ◽  
The United States ◽  
The Other ◽  
Drugs And Alcohol ◽  
The Past ◽  
Other Hand

In response to a ‘temperance mentality’ questionnaire, university students from Iran, Bulgaria, the United States, and Italy expressed more support for ‘temperance moralism’ than did students from Canada, Ireland, and the Netherlands. On the other hand, students from all seven countries generally supported ‘non-moralistic drug prohibitionism,’ an attitude that appears more compatible with the contemporary harm-reduction movement. In every sample, students expressed more support for temperance items that were directed towards drugs and alcohol than they did for items that were directed at alcohol alone. We argue that understanding the “temperance mentality” on a transnational level may help society to avoid repeating some of the drug policy excesses of the past.

scholarly journals E-cigarette use frequency by smoking status among youth in the United States, 2014-2019

2020 ◽  
Author(s):  
Jamie Tam
Keyword(s):  
United States ◽  
Smoking Status ◽  
The United States ◽  
Self Report ◽  
Cigarette Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past ◽  
Former Smokers ◽  
Never Smokers

AbstractAimsTo report annual 2014-2019 youth estimates of past 30-day e-cigarette use frequency by smoking status in the United States (US).DesignWeighted prevalence estimates of student’s e-cigarette use using the 2014-2019 National Youth Tobacco Surveys (NYTS). For each year, t-tests for significance were used to compare estimates with those from the preceding year; t-tests were not performed on data for 2019 due to the change in survey format from paper to electronic.SettingThe NYTS is an annual school-based cross-sectional survey of US middle school (MS) and high school (HS) students.Participants117,472 students.MeasurementsSelf-report of past 30 day e-cigarette use based on students’ smoking status. Smoking status is assessed by asking if students have ever tried smoking, “even one or two puffs”, with never smokers responding “no”. Former smokers respond “yes” but have not smoked at all in the past 30 days. Current smokers used cigarettes at least once in the past 30 days. Frequent e-cigarette use is defined as use on ≥20 days in the past month.FindingsPast 30-day and frequent e-cigarette use increased among never, former, and current smoker youth from 2014-2019. In 2019, a greater proportion of current smokers used e-cigarettes frequently (HS = 46.1%, 95% CI: 39.1, 53.2; MS = 27.4%, 95% CI: 21.1, 33.6) compared to former smokers (HS = 23.2%, 95% CI: 18.1, 28.2; MS = 10.9%, 95% CI: 6.1, 15.7) and never smokers (HS = 3.7%, 95% CI: 3.0, 4.3; MS = 0.7%, 95% CI: 0.4, 0.9). From 2018 to 2019, the total number of youth using e-cigarettes frequently who were never smokers (2018: 180,000; 2019: 490,000) or former smokers (2018: 260,000; 2019: 640,000) surpassed that of current smokers (2018: 420,000; 2019: 460,000).ConclusionsThe proportion and number of never smoker youth using e-cigarettes frequently increased greatly since 2014.

scholarly journals Smokers who have not tried alternative nicotine products: a 2019 survey of adults in Great Britain

2020 ◽  
Author(s):  
Erikas Simonavicius ◽  
Ann McNeill ◽  
Hazel Cheeseman ◽  
Deborah Arnott ◽  
Leonie S. Brose
Keyword(s):  
Great Britain ◽  
Harm Reduction ◽  
Ethnic Groups ◽  
Online Survey ◽  
Electronic Cigarettes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Stop Smoking ◽  
Minority Ethnic Groups

Abstract Aims: Switching from smoking to using nicotine replacement therapy (NRT), electronic cigarettes (e‑cigarettes) or heated tobacco products can reduce tobacco-related health risks. However, not all smokers in Great Britain have tried these products, which is a missed opportunity for harm reduction. This study aims to identify and describe smokers who have never tried alternative nicotine products. Methods: Study analysed cross-sectional survey data of smokers ( n =1777) from a representative adult sample from Great Britain. The online survey was run in March 2019. The proportion of smokers who had never used alternative nicotine products was measured. A multivariate logistic regression assessed the association between never using alternative nicotine products and smokers’ sociodemographic and smoking characteristics and motivation to stop smoking. Results: One in four smokers (27.8%, 95% CI: 25.8%–29.9%) had never tried NRT, e-cigarettes or heated tobacco products. These smokers were more commonly from Black and Minority than White ethnic groups (AOR=1.55; 95% CI: 1.02–2.31), were more likely to smoke up to 10 versus more cigarettes per day (AOR=1.52; 95% CI: 1.14–2.03) and reported low versus moderate or high motivation to stop smoking (AOR=1.79; 95% CI: 1.20–2.74). Conclusion: Light smokers, those unmotivated to stop and smokers from Black and Minority ethnic groups are less likely to have ever tried alternative nicotine products. Different approaches are needed to facilitate harm reduction and smoking cessation among these groups of smokers.

International Research and Variation in Views of Ethnicity

2012 ◽  
Vol 2 (2) ◽  
pp. 66-72
Author(s):  
Ella Inglebret ◽  
Amy Skinder-Meredith ◽  
Shana Bailey ◽  
Carla Jones ◽  
Ashley France
Keyword(s):  
United States ◽  
Classification System ◽  
International Research ◽  
The United States ◽  
Research Articles ◽  
Journal Articles ◽  
Research Participants ◽  
The Past ◽  
International Scale ◽  
Publication Patterns

The authors in this article first identify the extent to which research articles published in three American Speech-Language-Hearing Association (ASHA) journals included participants, age birth to 18 years, from international backgrounds (i.e., residence outside of the United States), and go on to describe associated publication patterns over the past 12 years. These patterns then provide a context for examining variation in the conceptualization of ethnicity on an international scale. Further, the authors examine terminology and categories used by 11 countries where research participants resided. Each country uses a unique classification system. Thus, it can be expected that descriptions of the ethnic characteristics of international participants involved in research published in ASHA journal articles will widely vary.

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