Knowledge and Beliefs Regarding Harm From Specific Tobacco Products: Findings From the H.I.N.T. Survey

2021 ◽  
pp. 089011712110261
Author(s):  
Wenxue Lin ◽  
Joshua E. Muscat

Purpose: Determine whether dual tobacco users have different levels of knowledge about nicotine addiction, perceived harm beliefs of low nicotine cigarettes (LNCs) and beliefs about electronic cigarettes (e-cigarettes) Design: Quantitative, Cross-sectional Setting: Health Information National Trends Survey 5 (Cycle 3, 2019) Participants: Nationally representative adult non-smokers (n=3113), exclusive cigarette smokers (n=302), and dual (cigarette and e-cigarette) users (n=77). Measures: The survey included single item measures on whether nicotine causes addiction and whether nicotine causes cancer. A five-point Likert scale assessed comparative harm of e-cigarettes and LNCs relative to conventional combustible cigarettes (1=much more harmful, 3=equally harmful…5 = much less harmful, or don’t know). Analysis: We used weighted multiple linear regression model to estimate means and 95% confidence intervals (CI) of e-cigarettes and LNCs beliefs by current tobacco user status. Results: Over 97% of dual users, 83% of non-smokers and 86% of exclusive cigarette smokers correctly identified that nicotine is addictive. The majority of subjects incorrectly identified nicotine as a cause of cancer, with dual users having the lowest proportion of incorrect responses (60%). Dual users rated e-cigarette harmfulness as less harmful than combustibles (mean=2.20; 95% CI=1.73, 2.66) while exclusive cigarette smokers and non-smokers rated them as similarly harmful. LNCs were considered equally harmful and addictive as conventional cigarettes. Conclusion: Dual users had a higher knowledge base of tobacco-related health effects. The effectiveness of policies or medical recommendations to encourage smokers to switch from cigarettes to LNCs or e-cigarettes will need to consider accurate and inaccurate misperceptions about the harm and addictiveness of nicotine. Improved public health messages about different tobacco products are needed.

2020 ◽  
Vol 30 (Supplement_3) ◽  
pp. iii78-iii83
Author(s):  
Lucia Maria Lotrean ◽  
Antigona Trofor ◽  
Cornel Radu-Loghin ◽  
Marius Eremia ◽  
Florin Mihaltan ◽  
...  

Abstract Background The study assessed awareness and use of heated tobacco products (HTPs) and factors that influenced these issues among cigarette smokers from six European countries in 2016 (Wave 1) and 2018 (Wave 2). Methods A survey was conducted among a nationally representative sample of cigarette smokers aged 18 years or older from Germany, Greece, Hungary, Poland, Romania and Spain in 2016 (N = 6011) and 2018 (N = 6027; 53% of smokers from the previous wave were retained, regardless of smoking status and dropouts were replaced by a replenishment sample of smokers). Data were collected through face-to-face interviews. Estimates were produced using weighted data. The study presents the cross-sectional results. Results Awareness of HTPs increased from 8% to 17% between the two waves. At Wave 1, 1.1% of the smokers declared having used HTPs at least once during their lifetime; and at Wave 2, this increased to 1.9% (around 1% or less in four countries, except for Greece and Romania where it was around 4%). Factors associated with HTPs use among those who had ever heard about these products at Wave 1 were country of residence, being a daily cigarette smoker and ever use of electronic cigarettes. At Wave 2, ever use of HTPs was significantly higher among those who had tried to quit smoking combustible cigarettes in the last 12 months, had tried electronic cigarettes during lifetime and perceived HTPs as less dangerous than combustible cigarettes; the country of residence was also associated with HTPs use. Conclusion This study offers insights into the behaviours and perceptions of European adult smokers regarding HTPs, an important emerging issue in the field of tobacco control.


Author(s):  
Paulina Majek ◽  
Mateusz Jankowski ◽  
Bartłomiej Nowak ◽  
Maksymilian Macherski ◽  
Maciej Nowak ◽  
...  

Heated tobacco products (HTPs) are devices for generating a nicotine aerosol by heating the tobacco sticks. This study aimed to assess (1) the prevalence of HTP and tobacco cigarette usage among medical students, (2) to characterize smoking habits and (3) to assess students’ awareness and opinions about HTPs. A cross-sectional survey on the frequency and attitudes toward cigarettes, e-cigarettes and HTP use was performed between 2019–2020 at the Medical University of Silesia in Katowice (Poland). The data were obtained from 1344 students aged 21.8 ± 1.9 years (response rate: 66.9%). Current traditional tobacco use was 13.2%, e-cigarettes use 3.5%, and HTP use 2.8% of students. Duration of use was shorter among HTPs users comparing to cigarette smokers (p < 0.001) although the number of tobacco sticks used daily was similar (p = 0.1). Almost 30% of respondents have ever tried HTPs. HTPs were considered safe by 5.3% of respondents (43.2% of HTP users vs. 3.9% of non-HTP users, p < 0.001). HTP users were more likely to report that heating tobacco is not addictive (odds ratio (OR) = 8.9, 95% confidence interval (CI): 1.8–45.8) and disagreed with a public ban on HTP use (OR = 4.9, 95%CI: 2.5–9.8). Among students, HTP use was less popular than cigarette smoking, but awareness of their presence is widespread.


2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.


Author(s):  
Cheol Min Lee ◽  
Choon-Young Kim ◽  
Kiheon Lee ◽  
Sungroul Kim

Since the advent of heated tobacco products in June 2017 in South Korea, the sale of heated tobacco products accounted for 10.5% of total tobacco sales in 2019. However, the decreasing trend in total tobacco sales is gradually weakening and the number of visitors using stop smoking services has also dropped. This study examines the association between the use of new tobacco products and related products and cessation behaviors. A cross-sectional study using a self-administered questionnaire was conducted from March 2019 to July 2019 for 2831 adult tobacco users. The difference in rates of quit attempts using the type of tobacco products and related products in the past year were noted (55.6% (any cigarette smoker), 46.7% (any e-cigarette user), and 39.6% (any heated tobacco product user)). About a 30% increase in quit attempts was observed for the triple users of either conventional cigarette or heated tobacco product than exclusive users. Exclusive heated tobacco product and e-cigarette users were approximately 40% and 20% less likely to quit the product they used than exclusive cigarette smokers, respectively. These findings can explain recent occurrences in South Korea, such as the reduction of visitors at smoking cessation clinics and the attenuation of the decline in tobacco sales.


2020 ◽  
pp. tobaccocontrol-2019-055465
Author(s):  
Yanakawee Siripongvutikorn ◽  
Takahiro Tabuchi ◽  
Sumiyo Okawa

ObjectivesHeated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) are rapidly gaining popularity, especially in Japan. However, at the time of the survey (2018), there was no national legislation banning HTPs or e-cigarette use in the workplace. The objective is to examine the current situation for workplace smoke-free policies which ban the use of HTPs/e-cigarettes and the associations of such rules with the use of HTP and e-cigarette as well as conventional cigarette smoking.MethodsAn internet-based self-reported questionnaire survey was conducted in 2018 as a part of the Japan Society and New Tobacco Internet Survey study. 5646 eligible employees aged 15–72 years were analysed. Proportions and adjusted rate ratios for HTP and e-cigarette use were calculated according to covariates, using Poisson regression models. Those who reported HTP or e-cigarette use within 30 days were defined as current user of the products.ResultsIn workplaces which prohibited smoking indoors but permitted the use of HTPs/e-cigarettes, the rate ratios of HTP use was 2.19 (95% CI 1.57 to 3.06), e-cigarette use was 3.86 (95% CI 1.97 to 7.57) and combustible cigarette use was 1.67 (95% CI 1.19 to 2.34) when using workplaces which also prohibited HTPs/e-cigarettes as a reference category.ConclusionsWorkplaces that allow HTP/e-cigarette use indoors were associated with higher rate for HTP and e-cigarette users, and for combustible cigarette smokers. National legislation banning tobacco should be enforced and also cover HTPs and e-cigarettes in order to avoid renormalisation of smoking and nicotine addiction.


2019 ◽  
Vol 21 (7) ◽  
pp. 970-973 ◽  
Author(s):  
Jennifer L Pearson ◽  
Meghan Moran ◽  
Cristine D Delnevo ◽  
Andrea C Villanti ◽  
M Jane Lewis

Abstract Significance US smokers of Natural American Spirit, a brand marketed as “organic” and “additive-free,” are more likely than other cigarette smokers to believe that their brand might be less harmful than other brands. This article (1) describes the prevalence of belief that “organic” and “additive-free” tobacco is less harmful than regular tobacco products in the US population and (2) describes the sociodemographic characteristics of adults who believe tobacco products with these descriptors are less harmful. Methods Data were drawn from the 2017 Health Information National Trends Survey (HINTS), a nationally representative survey of US adults. Logistic regression models were used to examine correlates of the belief that “organic” or “additive-free” tobacco products are less harmful than regular tobacco products. Results Overall, 26.7% of US adults and 45.3% of adult smokers believe that “organic” tobacco products are less harmful than regular tobacco products. Similarly, 35.2% of US adults and 47.1% of smokers believe that “additive-free” tobacco products are less harmful. When examining gender, age, education, race/ethnicity, sexual orientation, and smoking status, only age (adjusted odds ratio [aOR] ~0.98, 95% confidence interval [CI]: 0.97, 0.99 for both outcomes) and smoking status (current vs. never smokers, aOR ~1.78, 95% CI 1.03, 3.07 for both outcomes) were correlates of believing that “organic” or “additive-free” tobacco is less harmful than regular tobacco products. Conclusions Belief that “organic” and “additive-free” tobacco products are less harmful than other products is widespread. Younger adults and current smokers are most likely to be misinformed by “organic” or “additive-free” tobacco product descriptors. Implications Belief that “organic” and “additive-free” tobacco products are less harmful than other products is widespread among US adults and most prevalent among smokers. Removal of terms that incorrectly imply reduced harm may correct current and future consumers’ misperceptions about the brand.


1970 ◽  
Vol 20 (2) ◽  
pp. 3-16 ◽  
Author(s):  
Hong Huang ◽  
Yiu Ming Chan ◽  
Dong Feng

Health numeracy skills help people interpret health risks, and make effective medical decisions. Lower health numeracy confidence was observed for blacks and Hispanic groups than whites. Little is known about the important factors that explain racial differences in health numeracy confidence. For this study, we used a nationally representative, cross-sectional data sample of 4,610 U.S. adults from the National Cancer Institute’s 2007 Health Information National Trends Survey. Bivariate (Chi-squares) and multiple logistic regression analyses were conducted to identify the contribution factors that predict health numeracy confidence.Non-linear Fairlie decompositions were used to quantify the factor contributions to racial differences in health numeracy confidence. The priority rankings of the important factors to explain the health numeracy confidence racial and ethnic disparities are different depending on the particular racial and ethnic group. Diverse, culturally appropriate approaches are needed to improve numeracy confidence for specific racial and ethnic groups.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048462
Author(s):  
Israel Terungwa Agaku ◽  
Catherine O Egbe ◽  
Olalekan A Ayo-Yusuf

ObjectivesIn South Africa, the Control of Tobacco and Electronic Delivery Systems Bill seeks to regulate e-cigarettes as tobacco products, including their advertising, promotion and sponsorship. Population data on e-cigarette advertising in South Africa are needed to inform public health programs, practice and policy. We examined self-reported e-cigarette advertising exposure during 2017.DesignCross-sectional.SettingHousehold-based survey.Participants3063 individuals who participated in the 2017 South African Social Attitudes survey, a nationally representative, in-person survey of the non-institutionalised civilian adult population aged ≥16 yearsExposure‘In the past 12 months, have you seen advertisements or promotions for e-cigarettes (including e-shisha, e-pipe) on any of the following media: newspapers/magazines, billboards, in the malls or any other source?’Main outcomesBeliefs and attitudes regarding e-cigarettes.FindingsParticipants’ mean age was 37.7 years. Overall, 20.1% reported exposure to e-cigarette advertisements. By age, exposure was most prevalent among those aged 16–19 years (24.6%). Top sources of exposure among those exposed were stores, 40.7%; malls, 30.9%; and television, 32.5%. Of those aware of e-cigarettes, 61.2% believed ‘e-cigarette advertisements and promotion may make adolescents think of smoking traditional cigarettes’; 62.7% believed that ‘e-cigarette advertisements and promotions may make ex-smokers think of starting smoking cigarettes again’; and 59.5% supported the statement that ‘e-cigarette smoking should be banned indoors just as traditional cigarette smoking’. Notably, teens aged 16–19 reported the lowest prevalence (49.0%) of those believing that ‘e-cigarette advertisements and promotion may make adolescents think of smoking traditional cigarettes’, whereas this percentage was highest among those aged 55–64 years (73.2%).ConclusionComprehensive regulatory efforts are needed to address e-cigarette advertising, marketing and sponsorship in order to protect public health. The urgent enactment of the new tobacco control legislation, The Control of Tobacco Products and Electronic Delivery Systems Bill, can help reduce youth exposure to e-cigarette advertising in South Africa.


Author(s):  
Mateusz Jankowski ◽  
Iwona Wrześniewska-Wal ◽  
Aurelia Ostrowska ◽  
Aleksandra Lusawa ◽  
Waldemar Wierzba ◽  
...  

Perceptions of the harmfulness of tobacco products may be a determinant of smoking behaviors. This study aimed to: (1) assess the perception of harmfulness of various tobacco products and e-cigarettes in Poland as well as (2) to assess the awareness of the health effects of using tobacco and e-cigarettes. A cross-sectional survey was conducted in 2019 with a nationally representative sample of 1011 individuals aged 15 and over. In the studied group, 22.3% were smokers. Smokeless tobacco was most likely to be perceived as less harmful than cigarettes (25%), followed by water pipe (24.5%), heated tobacco products (22%), e-cigarettes (21.6%), slim cigarettes (17.1%), flavored cigarettes (except menthol ones) (16.1%), menthol cigarettes (15.6%) and cigarillos (12.6%). In this study, 10% of respondents denied that smoking causes serious diseases. Most of the respondents (88.9%) were aware that smoking causes lung cancer (88.9%), but only 70.4% were aware that smoking causes stroke. Smokers compared to non-smokers were less likely to declare that smoking causes a stroke (OR: 0.43, 95%CI: 0.31–0.59; p < 0.001) or myocardial infarction (OR: 0.41, 95%CI: 0.29–0.60; p < 0.001). There were no significant differences (p > 0.05) in the perception of harmfulness of various tobacco products and e-cigarettes by gender, age, or occupational status.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Silvano Gallus ◽  
Chiara Stival ◽  
Giulia Carreras ◽  
Giuseppe Gorini ◽  
Andrea Amerio ◽  
...  

AbstractOnly a few studies investigated changes in electronic cigarette (e-cigarette) and heated tobacco product (HTP) use during pandemic restrictions. We conducted a web-based cross-sectional study of a representative sample of 6,003 Italian adults during the strictest phase of the Covid-19 lockdown (April–May 2020). Participants were asked to report changes in e-cigarette and HTP use compared to before the pandemic. E-cigarette users increased from 8.1% to 9.1% and HTP users from 4.0% to 4.5%. Among e-cigarette non-users before lockdown, 1.8% started using e-cigarettes during lockdown. New users were more frequently younger (p for trend 0.001), men (odds ratio, OR 1.56; 95% confidence interval, CI: 1.03–2.34), cannabis users (OR 2.35; 95% CI: 1.33–4.13), gamblers (OR 3.34; 95% CI: 2.18–5.11) and individuals with anxiety symptoms (OR 1.58; 95% CI: 1.00–2.52). 1.0% of HTP non-users started using it during lockdown. New users were less frequently current than never cigarette smokers (OR 0.19; 95% CI: 0.06–0.61) and more frequently gamblers (OR 2.23; 95% CI: 1.22–4.07). E-cigarettes and HTPs played little role as smoking cessation tools for hardcore smokers but rather provided opportunities for young never smokers to engage in socially acceptable activities, perhaps reflecting the obstacles they faced in obtaining other addictive substances during confinement.


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