scholarly journals Prevalence and characteristics of ever regular use of non-combustible nicotine for 1 year or more: a population survey in England

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sharon Cox ◽  
Jamie Brown ◽  
Loren Kock ◽  
Lion Shahab

Abstract Introduction Up-to-date monitoring of non-combustible nicotine products (e.g. e-cigarettes, nicotine replacement therapies (NRT), heated tobacco products (HTP); NNP) is important to assess their impact. To date, there is little evidence on the association between ever regular use (defined here as 1 year or more) of NNP and current smoking status. Aims/methods The purpose of this study was to examine the prevalence, and sociodemographic, alcohol and smoking status correlates, of ever regular use of NNP in England in 2020. A cross-sectional survey of adults in England was conducted between February and June 2020. Results A total of 8486 adults were surveyed; 94.9% (8055) were complete cases. The weighted prevalence of ever regular NNP use was 5.4% (n = 436; 95% CI 5.0–6.0), of which 82% (n = 360; 95% CI 78.7–85.8) was single and 18% (n = 79; 95% CI 14.8–22) multiple product use. Amongst ever regular NNP users, the prevalence of ever regular NRT, e-cigarette and HTP use was 64.7% (95% CI 60.1–69), 43.4% (95% CI 38.8–48) and 2.5% (95% CI 1.4–4.5), respectively. In adjusted analysis, ever regular NNP use was associated with smoking status, being significantly higher among current (22.3%; adjusted OR (aOR) 34.9, 95% CI 24.0–50.8) and ex-smokers (12.7%, aOR 19.8, 95% CI 11.1–14.4) than among never-smokers (0.6%). More advantaged occupational grade (aOR, 1.27 95% CI 1.02–1.57) and at least hazardous alcohol use (aOR, 1.38 95% CI 1.06–1.78) were associated with greater prevalence of ever regular NNP use. Conclusions Ever regularly using NNP was highest among smokers and ex-smokers and rare among never-smokers. Among people who have ever regularly used NNP, NRT is the most popular.

2021 ◽  
Author(s):  
Sharon Cox ◽  
Jamie Brown ◽  
Loren Kock ◽  
Lion Shahab

Abstract Introduction: Up-to-date monitoring of non-combustible nicotine products (NNP) is important to assess their impact. To date, there is little evidence on the association between long-term regular use (defined here as one-year or more) of NNP and current smoking status. Aims/methods: The purpose of this study was to examine the prevalence, and sociodemographic, alcohol and smoking status correlates, of ever regular use of NNP in England in 2020.A cross sectional survey of adults in England between February and June 2020. Results: 8,486 adults were surveyed, 94.9% (8,055) were complete cases. The weighted prevalence of ever regular NNP use was 5.4% (n=436; 95%CI 5.0-6.0), of which 82% (n=360; 95%CI 78.7-85.8) was single, and 18% (n=79; 95%CI 14.8-22) multiple product use. Amongst ever regular NNP users, the prevalence of ever regular nicotine replacement therapies (NRT), e-cigarette and heated tobacco product use was 64.7% (95% CI 60.1-69), 43.4% (95%CI 38.8-48) and 2.5% (95% CI 1.4-4.5), respectively. In regression analysis, ever regular NNP use was independently associated with smoking status, being significantly higher among current (22.3%; Adjusted OR (aOR) 34.9, 95%CI 24.0-50.8) and ex-smokers (12.7%, aOR 19.8, 95%CI 11.1-14.4) than among never smokers (0.6%). More advantaged occupational grade (aOR, 1.27 95% CI 1.02-1.57) and at least hazardous alcohol use (aOR, 1.38 95%CI 1.06-1.78) were independently associated with greater prevalence of ever regular NNP use.Conclusions: Ever regularly using NNP was highest among smokers and ex-smokers and rare among never smokers. Among people who have ever regularly used NNP, NRT is the most popular.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sidsel Graff-Iversen ◽  
Stephen Hewitt ◽  
Lisa Forsén ◽  
Liv Grøtvedt ◽  
Inger Ariansen

Abstract Background Studies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently. The present study aimed to assess the associations of smoking status and volume smoked with HC and WC and their ratio in a population with low prevalence of obesity together with high prevalence of smoking. Methods We used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997–99 including 65,875 men and women aged 39–44 years. Analysis of associations were adjusted for confounding by socioeconomic position, health indicators, and additionally for BMI. Results Compared with never-smokers, when adjusting for confounders and in addition for BMI, mean HC remained lower while mean WC and waist-hip-ratio (WHR) were higher in current smokers. The finding of a lower HC and higher WHR level among smokers was consistent by sex and in strata by levels of education and physical activity, while the finding of higher WC by smoking was less consistent. Among current smokers, BMI-adjusted mean HC decreased whereas WC and WHR increased by volume smoked. Compared with current smokers, former smokers had higher BMI-adjusted HC, lower WHR and among women WC was lower. Conclusions The main finding in this study was the consistent negative associations of smoking with HC. In line with the hypothesis that lower percentage gluteofemoral fat is linked with higher cardiovascular risk, our results suggest that smoking impacts cardiovascular risk through mechanisms that reduce the capacity of fat storage in the lower body region.


2019 ◽  
Vol 47 (10) ◽  
pp. 1514-1521 ◽  
Author(s):  
Monica Hui Yan Chua ◽  
Irene Ai Ting Ng ◽  
Mike W.L.-Cheung ◽  
Anselm Mak

ObjectiveThe association between cigarette smoking and the risk of systemic lupus erythematosus (SLE) remains a matter for debate. Additionally, the effect of the change of smokers’ demographics on the risk of development of SLE over time has not been formally addressed. We aimed to examine the association between cigarette smoking and the risk of SLE by performing an updated metaanalysis.MethodsA literature search using keywords including “lupus,” “smoking,” “cigarette,” “environmental,” “autoimmune,” and “connective tissue disease” was performed in computerized databases to identify studies addressing the relationship between cigarette smoking and SLE occurrence. A Bayesian metaanalysis was conducted by computing the log-OR between current and never smokers, and between former and never smokers. The average log-OR (subsequently converted to OR) and their corresponding 95% credible intervals (CrI) were calculated. The effect of publication time, sex, and age of patients with SLE on the effect sizes was examined by multivariate metaregression.ResultsData aggregation of 12 eligible studies comprising 3234 individuals who developed SLE and 288,336 control subjects revealed a significant association between SLE occurrence and current smoking status (OR 1.54, 95% CrI 1.06–2.25), while only a non-significant trend was demonstrated between SLE occurrence and former smoking status (OR 1.39, 95% CrI 0.95–2.08). Publication time, sex, and the mean age of patients with SLE did not explain the heterogeneity of the effect sizes.ConclusionCurrent smoking status is associated with risk of SLE. Sex and age of patients with SLE had no significant effect on the risk of SLE over time.


2010 ◽  
Vol 70 (4) ◽  
pp. 446-457 ◽  
Author(s):  
Randy M Page ◽  
Bettina F Piko ◽  
Mate A Balazs ◽  
Tamara Struk

Objective: To assess smoking media literacy in a sample of Hungarian youth and to determine its association with current smoking and susceptibility to future smoking. Design: Quantitative cross-sectional survey. Setting: Four elementary and four high schools in Mako, Hungary. Method: A survey form was administered in regularly-scheduled classes to 546 eighth- and twelfth-grade students that included the smoking media literacy (SML) scale and items assessing cigarette use. Logistic regression was used to examine the relationship of smoking media literacy with current smoking, and also separately for susceptibility to smoking in the future, as dependent dichotomous variables. Results: Smoking media literacy was lower among the Hungarian adolescents than what has been previously reported in American adolescents. Multivariate logistic regression analysis results showed smoking media literacy to be associated with reduced risk of current smoking status at a similar level to that found in American adolescents. However, unlike previous research in American adolescents, smoking media literacy and susceptibility to future smoking was not associated. Reduced smoking may be most associated with the representation-reality domain of media literacy, which relates recognition of what is portrayed in the media with reality. Conclusion: Based on this study’s findings, prevention and health promotion planners in Hungary should consider media literacy training as a possible addition to smoking prevention efforts in community- and school-based efforts.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
H Li ◽  
M Arslan ◽  
Z Fu ◽  
H Lee ◽  
M Mikula

Abstract Introduction/Objective A subset of patients with an established diagnosis of UC develops signs of CD (de novo CD) following IPAA. While the etiology and risk factors of de novo CD remain largely unknown, preliminary studies have shown controversial results regarding family history of inflammatory bowel disease (IBD) and smoking history. Methods Patients that underwent IPAA for UC, with at least 1 year of follow-up, were identified (n=161; 1996 to 2018). We retrospectively reviewed the electronic medical records. Patients that were diagnosed with de novo CD during the follow-up period were further identified. Smoking history and family history of IBD were evaluated. Chi square test was performed to compare the frequencies. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated by logistic regression model. P<0.05 was considered statistically significant. Results 29 de novo CD were identified. At the time of proctocolectomy, the family history of IBD and smoking history was documented in 152 UC patients including 27 that subsequently developed de novo CD. 23 of 152 had a family history of IBD (12 UC, 9 CD and 2 IBD, NOS). 19/129 (14.7%) UC patients without a family history of any type of IBD, 4/9 (44.4%) with a family history of CD, and 4/12 (33.3%) with a family history of UC developed de novo CD. Patients with a family history of CD were more likely to develop de novo CD post IPAA than those without a family history of any type of IBD (OR 4.63, 95% CI 1.14-18.82, p=0.03). Family history of UC did not correlate with development of de novo CD (OR 2.90; 95% CI 0.79-10.57, p=0.108). At the time of proctocoletomy, 11 were current smokers, 25 were former smokers, and 116 never smoked. In de novo CD group, there were 4/27 (14.8 %) former smokers and 23/27 (85.2 %) never smokers. No de novo CD patient was current smoker. In the UC group that remained as UC following IPAA, 11/125 (8.8%) were current smokers, 21/125 (16.8 %) former smokers, and 93/125 (74.4 %) were never smokers. Current smoking status was not associated with development of de novo CD (p = 0.214). Conclusion Family history of CD may be a risk factor for developing de novo CD following IPAA for UC. Current smoking status was not associated with development of de novo CD following IPAA for UC.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027175 ◽  
Author(s):  
Trisha M Parekh ◽  
Chengyi Wu ◽  
Leslie A McClure ◽  
Virginia J Howard ◽  
Mary Cushman ◽  
...  

ObjectivesWhile awareness of cigarette smoking’s harmful effects has increased, determinants associated with smoking status remain understudied, including potential racial differences. We aim to examine factors associated with former versus current smoking status and assess whether these associations differed by race.SettingWe performed a cross-sectional analysis using the population-based Reasons for Geographic and Racial Differences in Stroke(REGARDS)study.Outcome measuresLogistic regression was used to calculate the OR of former smoking status compared with current smoking status with risk factors of interest. Race interactions were tested using multiplicative interaction terms.Results16 463 participants reported smoking at least 100 cigarettes in their lifetime. Seventy-three per cent (n=12 067) self-reported former-smoker status. Physical activity (reference (REF) <3×/week; >3×/week: OR=1.26, 95% CI 1.11 to 1.43), adherence to Mediterranean diet (REF: low; medium: OR=1.46, 95% CI 1.27 to 1.67; high: OR=2.20, 95% CI 1.84 to 2.64), daily television viewing time (REF: >4 hours; <1 hour: OR=1.32, 95% CI 1.10 to 1.60) and abstinence from alcohol use (REF: heavy; none: OR=1.50, 95% CI 1.18 to 1.91) were associated with former-smoker status. Male sex, higher education and income $35 000–$74 000 (REF: <$20 000) were also associated with former-smoker status. Factors associated with lower odds of reporting former-smoker status were younger age (REF: ≥65 years; 45–64 years: OR=0.34, 95% CI 0.29 to 0.39), black race (OR=0.62, 95% CI 0.53 to 0.72) and single marital status (REF: married status; OR=0.66, 95% CI 0.51 to 0.87), being divorced (OR=0.60, 95% CI 0.50 to 0.72) or widowed (OR=0.70, 95% CI 0.57 to 0.85). Significant interactions were observed between race and alcohol use and dyslipidaemia, such that black participants had higher odds of reporting former-smoker status if they were abstinent from alcohol (OR=2.32, 95% CI 1.47 to 3.68) or had a history of dyslipidaemia (OR=1.31, 95% CI 1.06 to 1.62), whereas these relationships were not statistically significant in white participants.ConclusionEfforts to promote tobacco cessation should consist of targeted behavioural interventions that incorporate racial differences.


2020 ◽  
pp. tobaccocontrol-2020-055842
Author(s):  
Danielle Mitchell ◽  
Nathan Critchlow ◽  
Crawford Moodie ◽  
Linda Bauld

ObjectivesThere has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a health warning. We therefore explored reactions to, and trial intentions for, three ‘dissuasive’ cigarette designs among adolescents in Scotland.MethodsA cross-sectional survey with 12–17 year olds in Scotland (n=594) was conducted between November 2017 and November 2018. Participants were shown one ‘standard’ cigarette (imitation cork filter with white paper casing) and three dissuasive cigarettes: (1) a cigarette with the warning ‘smoking kills’; (2) a cigarette with the warning ‘toxic’ and a skull and cross-bones image and (3) a dark green cigarette. Participants rated each cigarette on nine five-point reaction measures (eg, appealing/unappealing or attractive/unattractive). A composite reaction score was computed for each cigarette, which was binary coded (overall negative reactions vs neutral/positive reactions). Participants also indicated whether they would try each cigarette (coded: Yes/No). Demographics, smoking status and smoking susceptibility were also measured.ResultsMore participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared with the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs older adolescents), never-smokers (vs ever smokers) and non-susceptible never-smokers (vs susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84%–91%).ConclusionDissuasive cigarettes present an opportunity to further reduce the appeal of smoking among adolescents.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S693-S693
Author(s):  
Carole K Holahan ◽  
Charles J Holahan ◽  
Sangdon Lim ◽  
Yen T Chen ◽  
Daniel A Powers

Abstract Although sociodemographic disadvantage is a recognized risk factor for obesity, the potential role of living with a smoker in this relationship has been unexamined. This study investigated: (a) the association between sociodemographic disadvantage and living with a smoker, and (b) the role of living with a smoker in partially explaining the link between sociodemographic disadvantage and obesity. The study used limited access data from the Women’s Health Initiative Observational Study obtained from NHLBI. Participants were 91,888 women ranging in age from 50 to 79; 6,527 participants reported living with a smoker. Analyses were cross-sectional. Logistic regression analyses examined paths in the proposed model; bias-corrected bootstrapped confidence intervals tested indirect effects. All analyses controlled for age, marital status, and participants’ current smoking status. Results demonstrated a significant association (p &lt; .001) between sociodemographic disadvantage and living with a smoker across three measures of disadvantage (for low education, low income, and Black ethnicity, ORs were 1.95, 2.10, and 2.63, respectively), as well as between living with and smoker and obesity (OR = 1.71). Moreover, the unstandardized indirect effect (CIs are in brackets) from sociodemographic disadvantage to obesity through living with a smoker was statistically significant for all three measures of disadvantage (for low education, low income, and Black ethnicity, indirect effects = .05 [.04, .06], .06 [.05, .06], and .07 [.06, .08], respectively). These findings underscore the need for innovative household-level interventions for disadvantaged families living with a smoker integrating smoking- and obesity-prevention efforts. This project was supported by the NIH/NCI (R03CA215947).


Author(s):  
Sarah E. Jackson ◽  
Jamie Brown ◽  
Lion Shahab ◽  
Andrew Steptoe ◽  
Daisy Fancourt

AbstractObjectivesTo examine associations between smoking and COVID-19 relevant outcomes, taking into account the influence of inequalities and adjusting for potential confounding variables.DesignOnline cross-sectional survey.SettingUK.Participants53,002 men and women aged ≥18y.Main outcome measuresConfirmed and suspected COVID-19, worry about catching and becoming seriously ill from COVID-19, and adherence to protective behaviours. Socioeconomic position was defined according to highest level of education (post-16 qualifications: yes/no).ResultsCompared with never smokers (0.3% [95%CI 0.2-0.3%]), prevalence of confirmed COVID-19 was higher among current (0.6% [0.4-0.8%]) but not ex-smokers (0.2% [0.2-0.3%]). The associations were similar before (current: OR 2.14 [1.49-3.08]; ex-smokers: OR 0.73 [0.47-1.14]) and after (current: OR 1.79 [1.22-2.62]; ex-smokers: OR 0.85 [0.54-1.33]) adjustment for potential confounders. For current smokers, this was moderated by socioeconomic position, with higher rates relative to never smokers only seen in those without post-16 qualifications (OR 3.53 [2.04-6.10]). After including suspected cases, prevalence was higher among current smokers (11.2% [10.6-11.9%], OR 1.11 [1.03-1.20]) and ex-smokers (10.9% [10.4-11.5%], OR 1.07 [1.01-1.15]) than never smokers (10.2% [9.9-10.6%]), but remained higher only among ex-smokers after adjustment (OR 1.21 [1.13-1.29]). Current and ex-smokers had higher odds than never smokers of reporting significant stress about catching (current: OR 1.43 [1.35-1.52]; ex-smokers: OR 1.15 [1.09-1.22]) or becoming seriously ill from COVID-19 (current: OR 1.34 [1.27-1.43]; ex-smokers: OR 1.22 [1.16-1.28]). Adherence to recommendations to prevent the spread of COVID-19 was generally high (96.3% [96.1-96.4%]), but lower among current than never smokers (OR 0.70 [0.62-0.78]).ConclusionsWhen assessed by self-report in a population sample, current smoking was independently associated with confirmed COVID-19 infection. There were socioeconomic disparities, with the association only apparent among those without post-16 qualifications. Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.RegistrationThe analysis plan was pre-registered on Open Science Framework (https://osf.io/pcs49/).What is already known on this topicFormer or current smoking can increase the risk of respiratory viral and bacterial infections and is associated with worse outcomes for those infected.However, data from several countries indicate that rates of current smoking are substantially lower among hospitalised COVID-19 patients than would be expected based on population-level smoking prevalence.What this study addsData from a large population-based sample of adults in the UK conflict with the hypothesis that smoking is protective against COVID-19 infection; rather, we found that current smoking was independently associated with increased odds of confirmed COVID-19 infection after adjusting for relevant confounders.Socioeconomic disparities were evident, with the association between smoking and confirmed COVID-19 only apparent among those without post-16 qualifications.Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.


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