scholarly journals Current advances in research in treatment and recovery: Nicotine addiction

2019 ◽  
Vol 5 (10) ◽  
pp. eaay9763 ◽  
Author(s):  
Judith J. Prochaska ◽  
Neal L. Benowitz

The health harms of combusted tobacco use are undeniable. With market and regulatory pressures to reduce the harms of nicotine delivery by combustion, the tobacco product landscape has diversified to include smokeless, heated, and electronic nicotine vaping products. Products of tobacco combustion are the main cause of smoking-induced disease, and nicotine addiction sustains tobacco use. An understanding of the biology and clinical features of nicotine addiction and the conditioning of behavior that occurs via stimuli paired with frequent nicotine dosing, as with a smoked cigarette, is important for informing pharmacologic and behavioral treatment targets. We review current advances in research on nicotine addiction treatment and recovery, with a focus on conventional combustible cigarette use. Our review covers evidence-based methods to treat smoking in adults and policy approaches to prevent nicotine product initiation in youth. In closing, we discuss emerging areas of evidence and consider new directions for advancing the field.

2018 ◽  
Vol 21 (10) ◽  
pp. 1401-1407 ◽  
Author(s):  
Lin Xiao ◽  
Mark Parascandola ◽  
Congxiao Wang ◽  
Yuan Jiang

Abstract Introduction This study provides nationally representative estimates of electronic cigarette (e-cigarette) use among youth in China and explores the factors associated with awareness and use of e-cigarettes and the relationship between e-cigarette and conventional tobacco use. Methods This study examined data from the Global Youth Tobacco Survey, which was completed by 155 117 middle school students (51.8% boys and 48.2% girls) in China, and employed a multistage stratified cluster sampling design. For data analysis, SAS 9.3 complex survey procedures were used, and logistic regression was used to explore factors associated with e-cigarette use and the relationship between e-cigarette and conventional tobacco use. Results About 45.0% of middle school students had heard of e-cigarettes, but only 1.2% reported using e-cigarettes in the last 30 days. Among never-smokers, e-cigarette users were more likely to intend to use a tobacco product in the next 12 months than nonusers (adjusted odds ratio [OR] = 6.970, 95% confidence interval [CI] = 4.474% to 10.857%), and more likely to say that they would enjoy smoking a cigarette (adjusted OR = 14.633, 95% CI = 11.328% to 18.902%). E-cigarette use was associated with previous experimentation with cigarette smoking (OR = 3.2), having noticed tobacco advertising in the past 30 days (OR = 2.7), having close friends who smoke (OR = 1.4), and thinking tobacco helps people feel more comfortable in social situations (OR = 3.3) and makes young people look more attractive (OR = 1.3). Conclusions E-cigarette use among youth in China remains low but awareness is high. E-cigarette use was associated with increased intentions to use tobacco. Enhanced prevention efforts are needed targeting e-cigarette use among youth. Implications This study is the first nationally representative survey of e-cigarette use among youth in China. It found that among middle school students, prevalence of e-cigarette use is 1.2% and prevalence of e-cigarette awareness is 45.0%. Chinese youths use e-cigarettes as a tobacco product rather than an aid to quitting. Among never-smokers, e-cigarette users were more likely to have intentions to use a tobacco product in the next 12 months, more likely to use a tobacco product offered by their best friends and enjoy smoking a cigarette than nonusers.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Delvon T Mattingly ◽  
Lindsay K Tompkins ◽  
Clara G Sears ◽  
Kandi L Walker ◽  
Joy L Hart

Introduction: In Appalachia, youth tobacco use rates exceed the national average, and youth in these rural areas are increasingly aware of new and emerging tobacco products, such as e-cigarettes. Given that e-cigarettes are a commonly used tobacco product by youth, additional inquiry is needed to better understand both youth product perceptions and use patterns, especially in communities with entrenched acceptance of tobacco. Study Aim and Hypothesis: Our aim is to examine the prevalence of conventional tobacco and e-cigarette use among Appalachian youth and to examine associations between use and tobacco harm perceptions. We hypothesized that conventional tobacco users would be less likely than non-users to perceive e-cigarette use as harmful and that e-cigarette users would be less likely than non-users to perceive e-cigarette use as harmful. Methods: A survey of middle and high school students (n=1,008) was conducted in rural Appalachia. The primary outcome in this analysis, tobacco use, was categorized as never user, conventional tobacco only user (cigarettes or smokeless), or e-cigarette only user. Descriptive characteristics were compared among the three use groups. Relationships between harm perceptions and tobacco product use were assessed using multinomial logistic regression models adjusted for age, race, gender, and grade level. Results: Nearly one-fourth (23%) of the participants had tried e-cigarettes. Compared to never users, conventional users were more likely to indicate that e-cigarettes did not cause: (1) health problems (OR: 1.65; CI: 1.075-2.521) or (2) addiction (OR: 1.63; CI: 1.064-2.496). Youth who indicated e-cigarettes do not cause health problems were more likely to be e-cigarette users than non-e-cigarette users (OR: 2.04, CI: 1.460-2.838), and youth who indicated smoking does not cause addiction were more likely to be conventional users than never or e-cigarette only users (OR: 1.96; CI: 1.181-3.262). Conclusions: In summary, youth who use conventional tobacco products or e-cigarettes are less likely to perceive e-cigarettes as harmful. These findings reinforce the need for vigilance in restricting youth access to tobacco products, increased emphasis on health campaigns that clarify scientific uncertainty surrounding tobacco safety, and regulation of e-cigarette marketing that targets youth.


2020 ◽  
pp. tobaccocontrol-2020-055764 ◽  
Author(s):  
Erika Trapl ◽  
Andrew Anesetti-Rothermel ◽  
Stephanie Pike Moore ◽  
Haley Gittleman

BackgroundAssociations between retail tobacco availability and tobacco use have been mixed. This study examined associations between school-based retail environment exposures and current use of cigarettes, cigar products and e-cigarettes among middle school youth in Cleveland, OH.MethodsRetailers selling tobacco products were identified using the 2015 Cleveland Food Retail Database (n=639 stores). Youth survey data were drawn from the 2016 Cleveland Youth Risk Behavior Survey, administered to all 7th/8th graders across the Cleveland Metropolitan School District (n=3778, response rate=83.0%). Past 30-day cigarette, cigar product and e-cigarette use were assessed. Student demographics, number of days walking to/from school each week and number of times youth stopped at a retailer to/from school each week were included. For each school (n=63), tobacco retail density (TRD) and proximity (TRP) to nearest retailer were calculated for each product. Multiple regression analysis assessed associations between retail exposures and youth tobacco use.ResultsAcross all schools, 3.9%, 10.2% and 8.6% of students currently use cigarettes, cigar products and e-cigarettes, respectively, and 15.2% currently use at least one tobacco product. TRD and TRP were not associated with current use; frequency of walking to school and stopping at retailers were strongly associated with current use.ConclusionsAlthough TRD and TRP were not significantly associated with tobacco product use, youth who reported regularly walking to/from school or who reported stopping at a retail store before/after school were significantly more likely to be a current tobacco product user. This may be due to increased exposure to exterior and point-of-sale marketing.


2021 ◽  
pp. tobaccocontrol-2020-056159
Author(s):  
Summer Sherburne Hawkins ◽  
Claudia Kruzik ◽  
Michael O'Brien ◽  
Rebekah Levine Coley

BackgroundIn the USA, many states do not pre-empt municipalities from enacting stricter tobacco-control policies than state or federal laws. Several municipalities in Massachusetts have passed progressive local laws aimed at reducing adolescent tobacco use. We exploited this variability to examine the associations between county-level flavoured tobacco product restrictions, tobacco 21 policies and smoke-free laws prohibiting e-cigarettes with adolescent cigarette and e-cigarette use in Massachusetts, and to assess whether policy effects varied by age.MethodsWe conducted difference-in-differences models to link changes in county-level tobacco-control policies to changes in adolescents’ use of cigarettes and e-cigarettes using 2011–2017 biennial Massachusetts Youth Health Surveys.ResultsCounties with greater implementation of flavoured tobacco product restrictions were associated with a decrease in the level of cigarette use among users (incidence rate ratio −1.56; 95% CI −2.54 to −0.58). A significant interaction (p=0.03) revealed the largest reductions among 14 and 18 year olds. Increasing flavoured tobacco product restrictions were also associated with reductions in the likelihood of e-cigarette use (OR −0.87; 95% CI −1.68 to −0.06). Increasing tobacco 21 restrictions were associated with decreases in cigarette use only among 18 year olds, while there was no evidence of associations between smoke-free laws with use of either tobacco product.ConclusionsAdolescents in Massachusetts decreased their use of cigarettes and e-cigarettes in response to local restrictions that limited the sale of flavoured tobacco products to adult-only retail tobacco stores. Local legislation can reduce adolescent tobacco use and municipalities should enact stricter tobacco-control policies when not pre-empted by state law.


Author(s):  
Olivia A. Wackowski ◽  
Michelle Jeong

Measures of tobacco product harm perceptions are important in research, given their association with tobacco use. Despite recommendations to use more specific harm and risk perception measures, limited research exists comparing different wordings. We present exploratory survey data comparing young adults’ (ages 18–29) responses to a general e-cigarette harm perception measure (“How harmful, if at all, do you think vaping/using an e-cigarette is to a user’s health?”) with a more specific conditional measure, which personalized the behavior/harm (“imagine you vaped,” “your health”) and presented a specific use condition (exclusive daily vaping) and timeframe (10 years). Data were collected in January 2019 (n = 1006). Measures were highly correlated (r = 0.76, Cronbach’s α = 0.86), and most (65%) provided consistent responses, although more participants rated e-cigarettes as very or extremely harmful using the conditional (51.6%) versus the general (43.9%) harm measure. However, significant differences in harm ratings were not observed among young adults who currently vaped. Correlations between each harm perception measure and measures of e-cigarette use intentions were similar. More specifically worded harm perception measures may result in somewhat higher e-cigarette harm ratings than general measures for some young adults. Additional research on best practices for measuring e-cigarette and other tobacco harm perceptions is warranted.


2021 ◽  
Vol 45 (5) ◽  
pp. 849-855
Author(s):  
Dale S. Mantey ◽  
Stephanie L. Clendennen ◽  
Aslesha Sumbe ◽  
Anna V. Wilkinson ◽  
Melissa B. Harrell

Objectives: Multiple-tobacco product (MTP) use is common among adolescent tobacco users. Low positive affect is a risk factor for e-cigarette use and combustible tobacco smoking. In this study, we examine the longitudinal relationship between positive affect and MTP use in a diverse cohort of adolescents in Texas. Methods: We analyzed 6 waves of biennial data (fall 2014-spring 2017) from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were 3868 sixth-, eighth-, and tenth-grade students in urban Texas, at enrollment. Multinomial logistic regression models examined the longitudinal relationship between positive affect and categories of MTP use, controlling for sex, race/ethnicity, past 30-day alcohol use, cohort, survey wave, and peer tobacco use. Results: The sample was comprised of 4.6% single-product users, 1.7% dual-users, and 0.7% poly-users. Each unit decrease in positive affect was associated with increased risk for single- (RRR: 1.29; 95% CI: 1.16-1.44), dual- (RRR: 1.35; 95% CI: 1.11-1.64), and poly- (RRR: 1.98; 95% CI: 1.54-2.54) use, relative to non-use. Similarly, each unit decrease in positive affect was also associated with increased risk for poly-tobacco use relative to single- (RRR: 1.53; 95% CI: 1.19-1.97) and dual- (RRR: 1.47; 95% CI: 1.11-1.95) use. Positive affect did not differentiate between single- and dual-use. Conclusion: We observed a gradient relationship between low positive affect and greater number of tobacco products used. Findings reinforce the association between poor mental health and tobacco use during adolescence. Prevention efforts may need to incorporate methods of addressing low positive affect.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Cristian Zamora ◽  
Lindsay M Reynolds ◽  
Un Jung Lee ◽  
Andrew Stokes ◽  
Benjamin Emelia J ◽  
...  

Introduction: Although tobacco product transitions have been characterized in the general population, few studies have examined use in individuals with established cardiovascular disease (CVD). Methods: We examined tobacco use prevalence, and longitudinal patterns of tobacco product transitions in adult respondents (≥18 years) of the 2013-2014 (Wave 1) through 2016-2018 (Wave 4) Population Assessment of Tobacco and Health Study. Analysis was restricted to adults with prevalent CVD. Prevalent CVD was defined based on self-report at Wave 1 to the question from a health professional if she/he had: 1) a heart attack, 2) heart failure, 3) a stroke, or 4) some other heart condition. Factors associated with tobacco use (cigarette, e-cigarette, cigar, pipe tobacco, hookah, smokeless, dissolvable, or snus) and tobacco product transitions were investigated using logistic regression. Results: At Wave 1, 28.8% reported tobacco use among adults with CVD, the most commonly product was cigarettes (82.8%), followed by use of any type of cigar (49%) and e-cigarette use (23.2%), including 5.4% reporting dual use of cigarettes and e-cigarettes. E-cigarette use without concurrent cigarette use was uncommon (1.1%). Young male with lower level of education and lack of knowledge about the association between smoking and heart disease, were associated with tobacco use. Transition rates reported between Waves 1 and 4 demonstrate decreased cigarette use over time, with increased use of e-cigarette but less dual use. Male with prevalent CVD were less likely to use e-cigarettes compared to female (OR = 0.5, 95% CI: 0.4 - 0.8). Conclusions: Despite known harmful cardiovascular effects, almost a quarter of adults with prevalent CVD smoke cigarettes and few are quitting smoking.


2021 ◽  
Vol 2 (2) ◽  
pp. 100-107
Author(s):  
Mira Yustika ◽  
Agung Ikhssani

Nicotine dependence is a chronic relapse defined as a compulsive desire to use it, regardless of social consequences, loss of control over intake, and appearance of withdrawal symptoms. Nicotine dependence develops over time as a person continues to use nicotine. The most commonly used tobacco product is cigarettes, but any form of tobacco use and use of e-cigarettes can lead to dependence. Nicotine dependence is a serious public health problem because it causes continued tobacco use, which is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year. The result of the journal review is that preventing the use of tobacco products among adolescents is critical to ending nicotine addiction worldwide. The impact caused by nicotine tends to be bad, so stopping is the way out. Different levels of influence should be considered in interventions aimed at adolescent smokers, including psychological influences, addictions, peers and parents. This review article contains about the effect of nicotine on adolescents and what strategies can be done to stop the problem.


Author(s):  
Matthew Taing ◽  
Vijay Nitturi ◽  
Tzuan A. Chen ◽  
Bryce Kyburz ◽  
Isabel Martinez Leal ◽  
...  

Tobacco use is exceedingly high among individuals receiving care for opioid addiction, but not commonly addressed by clinicians in treatment settings. Taking Texas Tobacco Free (TTTF) is a comprehensive tobacco-free workplace (TFW) program that builds treatment centers’ capacity to address tobacco use with evidence-based tobacco cessation policies and practices. Here, we examine the process and outcomes of TTTF’s implementation within 7 opioid addiction centers. Program goals were structured according to the RE-AIM framework. Pre- and post-implementation data were collected from client facing and non-client facing employees to assess changes in education, training receipt, knowledge, and intervention behaviors, relative to program goals. Centers reported tobacco screenings conducted and nicotine replacement therapy (NRT) delivered through 6 months post-implementation. Overall, 64.56% of employees participated in TTTF-delivered tobacco education, with a 54.9% gain in tobacco control and treatment knowledge (p < 0.0001), and significant increases in exposure to education about tobacco use and harms among individuals with opioid use disorder (p = 0.0401). There were significant gains in clinicians’ receipt of training in 9/9 tobacco education areas (ps ≤ 0.0118). From pre- to post-implementation, there were mean increases in the use of the 5A’s (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with statistically significant gains seen in NRT provision/referral (p < 0.0001). Several program goals were achieved or exceeded; however, 100% center participation in specialized clinical trainings was among notable exceptions. One program withdrew due to competing pandemic concerns; all others implemented comprehensive TFW policies. Overall, TTTF may have improved participating opioid treatment centers’ capacity to address tobacco use, although study limitations, including lower post-implementation evaluation response rates, suggest that results require replication in other opioid addiction treatment settings.


2019 ◽  
Vol 6 (5) ◽  
pp. 427-437
Author(s):  
Daisy Le ◽  
Meghan B. Moran ◽  
Rebkha Atnafou ◽  
Pamela A. Matson ◽  
Miranda R. Jones ◽  
...  

Objective: We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting. Methods: Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessation interest, and beliefs and risk perceptions about tobacco use were explored. Results: All participants had a history of polyuse, and 85% were current polyusers. Stress was the primary reason reported for tobacco use. Compared to single-product users, current polyusers also were more likely to mention environment and cheap cost as reasons for use. Most participants perceived cigarettes to be as addictive as cocaine or heroin, although this perception was less common among e-cigarette users than non-users. Among study participants, 59% reported wanting to stop using tobacco completely. Among current polyusers, those that used e-cigarettes were more likely to report cessation attempts during the past year and express interest in enrolling in a quit smoking text messaging program. Conclusion: In our sample there was a high prevalence of polytobacco product use and complex tobacco use patterns among young adults, both in and out of college, from an urban community.


Sign in / Sign up

Export Citation Format

Share Document