scholarly journals “It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kim Pulvers ◽  
Myra Rice ◽  
Jasjit S. Ahluwalia ◽  
Michael J. Arnold ◽  
Crystal Marez ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Harm Reduction ◽  
Ethnic Minority ◽  
Kansas City ◽  
Electronic Cigarettes ◽  
Cigarette Use ◽  
Smoking Reduction ◽  
Facilitators And Barriers ◽  
Racial Ethnic

Abstract Background Electronic cigarettes are a harm reduction strategy for individuals who smoke cigarettes who cannot or do not want to quit using FDA-approved cessation methods. Identifying perceived facilitators and barriers to switching among people who smoke cigarettes is critical to optimizing health impact. This is particularly important for the most dominant e-cigarette device, nicotine salt pod electronic cigarettes. We investigate the experience using pod electronic cigarettes among African American and Latinx individuals who smoke, the two largest racial/ethnic minority groups who experience significant health disparities. Methods From July 2018 to May 2019, adults who smoked cigarettes, age 21 + (N = 114; M age = 44.6, 59.6% male, 52.6% African American from Kansas City, 47.4% Latinx from San Diego) received JUUL-brand electronic cigarettes (referred to hereafter as JUUL) for 6 weeks and answered interview questions at week six. We inquired what they liked and disliked about using JUUL, what helped with switching and made switching difficult, future intentions for continued JUUL use, and how JUUL compared to past smoking reduction methods. Responses were coded into themes by independent raters. Theme frequencies were analyzed separately by race/ethnicity and week 6 use trajectory (exclusive JUUL use, dual JUUL and cigarette use, exclusive cigarette use). Results Clean/smell was the aspect of using JUUL most commonly liked (23%), followed by convenience (19%). Coughing/harshness was a more common barrier to switching for African American (44%) than Latinx (9%), and for continuing cigarette use (56%) than for those who exclusively switched or dually used JUUL and combustible cigarettes (15–21%). Most (78% African American; 90% Latinx) reported that the benefits of using JUUL outweighed barriers, and this varied by JUUL use trajectory: 94% exclusive switch, 86% dual use, and 42% continued cigarette use. The majority said they would continue using JUUL to replace cigarettes (83% African American; 94% Latinx) and that JUUL worked better than other methods to reduce cigarettes (72%). Conclusion African American and Latinx individuals who smoked experience using pod electronic cigarettes was generally positive. Understanding facilitators and impediments to switching to electronic cigarettes among racial/ethnic minority people who smoke can inform harm reduction interventions and reduce tobacco-related health disparities. Trial Registration ClinicalTrials.gov Identifier: NCT03511001 posted April 27, 2018.

scholarly journals Eradicating Racism: An Endocrine Society Policy Perspective

2022 ◽  
Author(s):  
Ruban Dhaliwal ◽  
Rocio I Pereira ◽  
Alicia M Diaz-Thomas ◽  
Camille E Powe ◽  
Licy L Yanes Cardozo ◽  
...  
Keyword(s):  
Health Disparities ◽  
Ethnic Minority ◽  
Healthcare System ◽  
Health Professionals ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Minority Communities ◽  
Endocrine Society ◽  
Policy Perspective ◽  
Racial Ethnic

Abstract The Endocrine Society recognizes racism as a root cause of the health disparities that affect racial/ethnic minority communities in the United States and throughout the world. In this policy perspective, we review the sources and impact of racism on endocrine health disparities and propose interventions aimed at promoting an equitable, diverse, and just healthcare system. Racism in the healthcare system perpetuates health disparities through unequal access and quality of health services, inadequate representation of health professionals from racial/ethnic minority groups, and the propagation of the erroneous belief that socially constructed racial/ethnic groups constitute genetically and biologically distinct populations. Unequal care, particularly for common endocrine diseases such as diabetes, obesity, osteoporosis, and thyroid disease, results in high morbidity and mortality for individuals from racial/ethnic minority groups, leading to a high socioeconomic burden on minority communities and all members of our society. As health professionals, researchers, educators, and leaders, we have a responsibility to take action to eradicate racism from the healthcare system. Achieving this goal would result in high-quality health care services that are accessible to all, diverse workforces that are representative of the communities we serve, inclusive and equitable workplaces and educational settings that foster collaborative teamwork, and research systems that ensure that scientific advancements benefit all members of our society. The Endocrine Society will continue to prioritize and invest resources in a multifaceted approach to eradicate racism, focused on educating and engaging current and future health professionals, teachers, researchers, policy makers, and leaders.

Should psychiatrists support the availability of nicotine e-cigarettes in Australia?

2019 ◽  
Vol 27 (4) ◽  
pp. 392-395 ◽  
Author(s):  
James G Scott ◽  
Sarah Jhetam ◽  
Renee Chen ◽  
Mark Daglish
Keyword(s):  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Position Statement ◽  
Cigarette Use ◽  
Physical And Mental Health ◽  
Limited Evidence ◽  
Tobacco Harm Reduction ◽  
People With Mental Illness ◽  
Potential Risks ◽  
Zealand College

Objective: To examine the position statement of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) regarding the availability of electronic cigarettes in Australia. Conclusion: There is limited evidence supporting the efficacy of nicotine e-cigarettes as an effective tobacco harm-reduction or cessation strategy for people with mental illness. The recommendations to increase their availability under regulation must be balanced with the physical and mental health risks of vapour inhalation and nicotine use, particularly for youth. Future recommendations by the RANZCP in relation to e-cigarettes must consider both the available evidence for harm reduction and the potential risks associated with youth e-cigarette use.

scholarly journals Perspectives on Precision Health Among Racial/Ethnic Minority Communities and the Physicians That Serve Them

2020 ◽  
Vol 30 (Suppl 1) ◽  
pp. 137-148 ◽  
Author(s):  
Lisa G. Rosas ◽  
Catherine Nasrallah ◽  
Van Ta Park ◽  
Jan J. Vasquez ◽  
Ysabel Duron ◽  
...  
Keyword(s):  
African American ◽  
Focus Groups ◽  
American Indian ◽  
Ethnic Minority ◽  
Health Research ◽  
Minority Group ◽  
Research Approach ◽  
Minority Communities ◽  
Racial Ethnic ◽  
Precision Health

 Background: In order for precision health to address health disparities, engagement of diverse racial/ethnic minority communi­ties and the physicians that serve them is critical.Methods: A community-based participatory research approach with mixed methods was employed to gain a deeper understanding of precision health research and practice among American Indian, African American, Latino, Chinese, and Vietnamese groups and physicians that serve these communi­ties. A survey assessed demographics and opinions of precision health, genetic testing, and precision health research. Focus groups (n=12) with each racial/ethnic minority group and physicians further explored at­titudes about these topics.Results: One hundred community mem­bers (American Indian [n=17], African American [n=13], Chinese [n=17], Latino [n=27], and Vietnamese [n=26]) and 14 physicians completed the survey and participated in the focus groups. Familiarity with precision health was low among com­munity members and high among physi­cians. Most groups were enthusiastic about the approach, especially if it considered influences on health in addition to genes (eg, environmental, behavioral, social fac­tors). Significant concerns were expressed by African American and American Indian participants about precision health practice and research based on past abuses in bio­medical research. In addition, physician and community members shared concerns such as security and confidentiality of genetic information, cost and affordability of genetic tests and precision medicine, discrimina­tion and disparities, distrust of medical and research and pharmaceutical institutions, language barriers, and physician’s specialty.Conclusions: Engagement of racial/ethnic minority communities and the providers who serve them is important for advancing a precision health approach to addressing health disparities.Ethn Dis. 2020;30(Suppl 1):137-148; doi:10.18865/ed.30.S1.137

scholarly journals Reducing the Smoking-Related Health Burden in the US through Diversion to Electronic Cigarettes: A System Dynamics Simulation Study

2020 ◽  
Author(s):  
Arielle Selya
Keyword(s):  
Harm Reduction ◽  
Time Delays ◽  
Electronic Cigarettes ◽  
Dynamics Simulation ◽  
Political Resistance ◽  
Cigarette Use ◽  
Ideal Case ◽  
Implementation Challenges ◽  
The Us ◽  
The Ideal

Abstract Background: Electronic cigarettes (“e-cigarettes”) have altered tobacco use trends, and their impacts are controversial. Given their lower risk relative to conventional cigarettes, e-cigarettes have potential for harm reduction. This study presents a simulation-based analysis of an e-cigarette harm reduction policy set in the US. Methods: A system dynamics simulation model was constructed, with separate aging chains representing different stages of use for both cigarette smokers and e-cigarette users. These structures interact with a policy module to close the gap between actual (simulated) and goal numbers of cigarette smokers, chosen to reduce the tobacco-attributable death rate to that due to all accidents in the general population. The policy is two-fold, removing existing flavor bans and providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on conventional smoking occurs through three mechanisms: 1) diversion from ever initiating conventional smoking; 2) reducing progression to established smoking; and 3) increasing smoking cessation. An important unintended effect was included, which increases the tobacco-related mortality accordingly with an increase in nicotine users due to e-cigarettes. Results: The base-case model replicated the historical exponential decline in smoking and the exponential increase in e-cigarette use since 2010. The ideal-case policy was able to reduce conventional smoking to the goal level approximately 40 years after implementation. Implementation obstacles (time delays, political resistance, and budgetary constraints) delayed and weakened the effect of the policy by up to 95% in the worst case, relative to the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations as negative feedback loops stabilize the system after the one-time “shock” introduced by policy changes. Conclusions: Current findings demonstrate that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current knowledge of e-cigarettes’ effects on conventional smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles is essential in policy design. Ongoing research is needed with forthcoming data on e-cigarette use prevalence and possible effects on cigarette smoking.

scholarly journals E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

2019 ◽  
Vol 134 (5) ◽  
pp. 528-536 ◽  
Author(s):  
Robert McMillen ◽  
Jonathan D. Klein ◽  
Karen Wilson ◽  
Jonathan P. Winickoff ◽  
Susanne Tanski
Keyword(s):  
Cigarette Smoking ◽  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Computer Assisted ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Increased Risk ◽  
Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

scholarly journals Reducing the smoking-related health burden in the USA through diversion to electronic cigarettes: a system dynamics simulation study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Arielle S. Selya
Keyword(s):  
Harm Reduction ◽  
Tobacco Smoking ◽  
Lower Risk ◽  
Time Delays ◽  
Electronic Cigarettes ◽  
Dynamics Simulation ◽  
Political Resistance ◽  
Cigarette Use ◽  
Implementation Challenges ◽  
The Usa

Abstract Background Electronic cigarettes (“e-cigarettes”) have altered tobacco smoking trends, and their impacts are controversial. Given their lower risk relative to combustible tobacco, e-cigarettes have potential for harm reduction. This study presents a simulation-based analysis of an e-cigarette harm reduction policy set in the USA. Methods A system dynamics simulation model was constructed, with separate aging chains representing people in different stages of use (both of combustible cigarettes and e-cigarettes). These structures interact with a policy module to close the gap between actual (simulated) and goal numbers of individuals who smoke, chosen to reduce the tobacco-attributable death rate (i.e., mostly combustible cigarette-attributable, but conservatively allowing e-cigarette-attributable deaths) to that due to all accidents in the general population. The policy is two-fold, removing existing e-liquid flavor bans and providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on tobacco smoking occur through three mechanisms: (1) diversion from ever initiating smoking; (2) reducing progression to established smoking; and (3) increasing smoking cessation. An important unintended effect of possible death from e-cigarettes was conservatively included. Results The base-case model replicated the historical exponential decline in smoking and the exponential increase in e-cigarette use since 2010. Simulations suggest tobacco smoking could be reduced to the goal level approximately 40 years after implementation. Implementation obstacles (time delays, political resistance, and budgetary constraints) could delay and weaken the effect of the policy by up to 62% in the worst case, relative to the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations as negative feedback loops stabilize the system after the one-time “shock” introduced by policy changes. Conclusions The simulation suggests that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current evidence that e-cigarettes offset or divert from smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles can usefully inform policy design. Ongoing research is needed, given continuing changes in e-cigarette use prevalence, new policies being enacted for e-cigarettes, and emerging evidence for substitution effects between combustible cigarettes and e-cigarettes.

scholarly journals Community Recruitment of Asian, Latino and African American Older Adults With Depression Symptoms During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 474-474
Author(s):  
Ravali Mukthineni ◽  
Sahnah Lim ◽  
Aida Jimenez ◽  
Caroline Ferreira ◽  
Sheri Lapatin Markle ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Ethnic Minority ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Retention Data ◽  
Care Providers ◽  
Community Agencies ◽  
Racial Ethnic ◽  
African American Older Adults

Abstract Recruitment and engagement of racial/ethnic minority older adults in clinical trials is crucial to expand implementation of evidence-based interventions for disability prevention. Public Health measures to counteract COVID-19 pandemic have increased the challenges on reaching this population. This study seeks to comprehensively evaluate a set of recruitment strategies to enroll Latino, Asian and African American older adults with symptoms of depression and anxiety during the first year of a randomized clinical trial. A partnership of three academic sites across the U.S. (NYC, MA and PR) involving several collaborations with community agencies recruited racial/ethnic minority older adults using different strategies involving bilingual interviewers calling from hospital research dataset and community agencies’ list of clients, referrals from primary care providers or psychotherapy waitlist. In this presentation we will report various recruitment and retention data including individual and organizational predictors of successful recruitment as well as challenges across all three sites.

scholarly journals Developing a Policy Brief on Child Mental Health Disparities to Promote Strategies for Advancing Equity among Racial/Ethnic Minority Youth

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 421-426 ◽  
Author(s):  
Ashley M. Butler ◽  
Caryn R. R. Rodgers
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Disparities ◽  
Ethnic Minority ◽  
Child Mental Health ◽  
Children’S Mental Health ◽  
Minority Youth ◽  
Children's Mental Health ◽  
Ethnic Minority Youth ◽  
Racial Ethnic

Research has identified a broad range of risk factors during early childhood that have neurobiological consequences and negatively affect children’s mental health. Such risk factors disproportionately affect racial/ethnic minority youth. Disparities in children’s mental health service use have also been documented for minority youth. Yet, compared with the focus on strategies to address health disparities (including men­tal health disparities) during adulthood, very little work has concentrated on addressing the roots of health disparities that occur in childhood. The purpose of this commentary is to describe the development and dissemi­nation of a policy brief for policy advocates. The goal of this work is to help achieve the implementation of evidence-based programs, practices, and policies that target and modify risk factors to reduce disparities in child mental health burden. Ethn Dis. 2019;29(Suppl 2): 421-426; doi:10.18865/ed.29.S2.421.

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