Alternative tobacco products use and its impact on urologic health – Will the lesser evil still be evil? A commentary and review of literature

Background. Exposure to advertisements for tobacco products and tobacco warning labels evokes emotions. This study evaluated the association of discrete positive and negative emotions with interest in alternative tobacco products. Method. In 2013, 1,226 U.S. adult nonsmokers and current smokers viewed advertisements for moist snuff, snus, and electronic cigarettes (e-cigarettes) with various warning labels and then indicated their emotional responses in terms of anger, anxiety, sadness, guilt, disgust, discouragement, hope, and contentment. Outcomes were openness to using moist snuff, snus, and e-cigarettes in the future and interest in a free sample of each product. Data were analyzed in 2016. Results. Hope was positively associated with openness and interest across all alternative tobacco products as was contentment for moist snuff and snus. Anger was negatively associated with openness to moist snuff and e-cigarettes, disgust negatively to moist snuff and snus, and anxiety negatively to e-cigarettes. Being a current smoker, ever trying a corresponding product, being male, and younger age were associated with greater openness to and interest in moist snuff and snus. For e-cigarettes, being a current smoker, ever trying e-cigarettes, and being female were associated with greater openness, and being a current smoker was associated with greater odds of selecting a free sample. Conclusions. Positive emotions, particularly hope, were consistently positively associated with interest in alternative tobacco products. Hope is widely used by tobacco and e-cigarette companies to advertise their products. Antitobacco messages should aim to lower hope associated with tobacco products but increase hope for cessation or life without tobacco.

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Country Participation in the WHO Framework Convention on Tobacco Control Health Warnings Database

Tobacco Use Insights ◽

10.1177/1179173x211064214 ◽

2021 ◽

Vol 14 ◽

pp. 1179173X2110642

Author(s):

Christopher M. Seitz ◽

Kenneth D. Ward ◽

Zubair Kabir

Keyword(s):

Tobacco Control ◽

World Health ◽

Warning Labels ◽

Health Warnings ◽

Tobacco Products ◽

Health Warning ◽

Pictorial Warnings ◽

The World ◽

Alternative Tobacco Products ◽

Tobacco Packaging

Background The World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) Health Warnings Database is an online, publicly available resource created for countries to upload and share pictorial health warnings for tobacco packaging. The purpose of this study was to evaluate the extent to which the database is used by countries for the sharing of pictorial warnings. Methods The study’s sample included parties to the FCTC who required graphic health warning labels on cigarette packaging from. Those countries were categorized as having a low, middle, and high Socio-Demographic Index (SDI). The Health Warnings Database was then analyzed for those countries’ unique pictorial images, as well as the number of pictorials that were shared between countries. Results Of the 110 countries that required pictorial warnings on cigarette packaging, only 53 (48%) voluntarily contributed pictorials to the database, with most of those (53%) being high SDI-level countries. There were 342 unique pictorials on the database, with 62 images posted by seven countries that were used by 13 other countries. Conclusion While sharing was evident from the database, there remains a need for more countries to upload the pictorials to the database. There is also a need to expand the database to include alternative tobacco products, such as waterpipe tobacco and e-cigarettes.

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Cigarette, E-Cigarette and Waterpipe Use among Young Adults: Differential Cognitions about These Three Forms of Smoking

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113787 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3787 ◽

Cited By ~ 2

Author(s):

Mark J.M. Sullman ◽

Maria-Eugenia Gras ◽

Antonios Kagialis ◽

Ioulia Papageorgi ◽

Sílvia Font-Mayolas

Keyword(s):

Young Adults ◽

Health Risks ◽

Self Efficacy ◽

Peer Pressure ◽

Tobacco Product ◽

Tobacco Products ◽

Best Friend ◽

Alternative Tobacco Products ◽

Waterpipe Use ◽

Clear Information

Background: Polytobacco use is common among young adults. The purpose of the present study was to investigate a number of cognitions related to the use of three tobacco products (cigarettes, e-cigarettes and waterpipes) among young adults. Methods: Participants (n = 799, 59.4% women) aged 18–25 years old (M = 21.8, SD = 1.7) completed an online tobacco cognitions questionnaire. Results: For all three tobacco products, there was significantly more agreement with the cognition “I would smoke if my best friend offered” among tobacco users (used one or more tobacco products) than among non-users. For e-cigarettes and waterpipes, there was significantly more agreement with the cognition “It would be easy to quit these products” than was reported by non-users. Polytobacco users (three tobacco products) endorsed the cognitions scale (the six cognition items were combined to form a single cognitions scale for each tobacco product) significantly more than non-users for cigarettes and e-cigarettes. Furthermore, waterpipe users, polytobacco users, dual users and single users all endorsed the combined cognitions scales more strongly than non-users. Conclusions: Efforts to prevent polytobacco use should ensure that young adults have the necessary self-efficacy to resist peer pressure and provide them with clear information about the health risks associated with using alternative tobacco products.

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Cigarette Smokers Versus Cousers of Cannabis and Cigarettes: Exposure to Toxicants

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz199 ◽

2019 ◽

Vol 22 (8) ◽

pp. 1383-1389 ◽

Cited By ~ 4

Author(s):

Ellen Meier ◽

Ryan Vandrey ◽

Nathan Rubin ◽

Lauren R Pacek ◽

Joni A Jensen ◽

...

Keyword(s):

Cannabis Use ◽

Group Differences ◽

Nicotine Exposure ◽

Cigarette Smokers ◽

Tobacco Products ◽

Toxicant Exposure ◽

Biomarkers Of Exposure ◽

Volatile Organic ◽

Polycyclic Aromatic ◽

Alternative Tobacco Products

Abstract Introduction Cannabis and tobacco couse is common and could expose users to higher levels of toxicants. No studies have examined biomarkers of toxicant exposure in cousers of cannabis and cigarettes, compared with cigarette smokers (CS). Aims and Methods Adult daily CS were recruited from 10 US sites for a study of reduced nicotine cigarettes. In this analysis of baseline data, participants were categorized as either cousers of cannabis and tobacco (cousers; N = 167; urine positive for 11-nor-9-carboxy-Δ 9-tetrahydrocannnabinol and self-reported cannabis use ≥1×/week), or CS (N = 911; negative urine and no self-reported cannabis use). Participants who did not meet either definition (N = 172) were excluded. Self-reported tobacco and cannabis use and tobacco and/or combustion-related biomarkers of exposure were compared between groups. Results Compared to CS, cousers were younger (couser Mage = 38.96, SD = 13.01; CS Mage = 47.22, SD = 12.72; p < .001) and more likely to be male (cousers = 67.7%, CS = 51.9%, p < .001). There were no group differences in self-reported cigarettes/day, total nicotine equivalents, or breath carbon monoxide, but cousers had greater use of non-cigarette tobacco products. Compared to CS, cousers had higher concentrations of 3-hydroxypropylmercapturic acid, 2-cyanoethylmercapturic acid, S-phenylmercapturic acid, 3-hydroxy-1-methylpropylmercapturic acid (ps < .05), and phenanthrene tetraol (p < .001). No biomarkers were affected by number of cannabis use days/week or days since last cannabis use during baseline (ps > .05). Conclusions Cousers had higher concentrations of biomarkers of exposure than CS, but similar number of cigarettes per day and nicotine exposure. Additional studies are needed to determine whether cannabis and/or alternative tobacco products are driving the increased toxicant exposure. Implications Cousers of cannabis and tobacco appear to be exposed to greater levels of harmful chemicals (ie, volatile organic compounds and polycyclic aromatic hydrocarbons), but similar levels of nicotine as CS. It is unclear if the higher levels of toxicant exposure in cousers are due to cannabis use or the increased use of alternative tobacco products compared with CS. It is important for studies examining biomarkers of exposure among CS to account for cannabis use as it may have a significant impact on outcomes. Additionally, further research is needed examining exposure to harmful chemicals among cannabis users.

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High-Intensity Sweeteners in Alternative Tobacco Products

Nicotine & Tobacco Research ◽

10.1093/ntr/ntw141 ◽

2016 ◽

Vol 18 (11) ◽

pp. 2169-2173 ◽

Cited By ~ 20

Author(s):

Shida Miao ◽

Evan S. Beach ◽

Toby J. Sommer ◽

Julie B. Zimmerman ◽

Sven-Eric Jordt

Keyword(s):

High Intensity ◽

Tobacco Products ◽

Alternative Tobacco Products

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New Alternative Tobacco Products - A Threat to Adolescent Health

Pediatrics in Review ◽

10.1542/pir.2015-0146 ◽

2016 ◽

Vol 37 (7) ◽

pp. 310-312 ◽

Cited By ~ 1

Author(s):

L. Lee ◽

J. A. Shearston ◽

M. Weitzman

Keyword(s):

Adolescent Health ◽

Tobacco Products ◽

Alternative Tobacco Products

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Exclusive and concurrent use of cigarettes and alternative tobacco products among Hong Kong adolescents

Tobacco Prevention & Cessation ◽

10.18332/tpc/90659 ◽

2018 ◽

Vol 4 (May) ◽

Author(s):

Nan Jiang ◽

SY Ho ◽

Man Ping Wang ◽

Lok Tung Leung ◽

Tai Hing Lam

Keyword(s):

Hong Kong ◽

Tobacco Products ◽

Concurrent Use ◽

Hong Kong Adolescents ◽

Alternative Tobacco Products

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Evaluating the predictive value of measures of susceptibility to tobacco and alternative tobacco products

Addictive Behaviors ◽

10.1016/j.addbeh.2019.03.017 ◽

2019 ◽

Vol 96 ◽

pp. 50-55 ◽

Cited By ~ 4

Author(s):

Jessica L. Barrington-Trimis ◽

Fei Liu ◽

Jennifer B. Unger ◽

Todd Alonzo ◽

Tess Boley Cruz ◽

...

Keyword(s):

Predictive Value ◽

Tobacco Products ◽

Alternative Tobacco Products

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Popular Flavors Used in Alternative Tobacco Products Among Young Adults

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2019.05.004 ◽

2019 ◽

Vol 65 (2) ◽

pp. 306-308 ◽

Cited By ~ 6

Author(s):

Nhung Nguyen ◽

Karma McKelvey ◽

Bonnie Halpern-Felsher

Keyword(s):

Young Adults ◽

Tobacco Products ◽

Alternative Tobacco Products

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Who Is Using Alternative Tobacco Products and Why?

10.1093/oso/9780190676001.003.0013 ◽

2018 ◽

Author(s):

Alexandra Loukas ◽

Deepti Agarwal

Keyword(s):

Developmental Trajectories ◽

The United States ◽

Future Research ◽

Cigarette Use ◽

Longitudinal Models ◽

Tobacco Products ◽

Factors Associated ◽

Product Use ◽

Patterns Of Use ◽

Alternative Tobacco Products

There is a growing array of alternative tobacco and nicotine products, such as hookah, cigarillos, snus, and electronic nicotine delivery systems (e-cigarettes). Both e-cigarette and hookah use are now more prevalent than cigarette use among adolescents in the United States. Alternative products are appealing to adolescents and young adults because they are available in a variety of flavors, often cheaper than cigarettes, and perceived to be less harmful than cigarettes. Existing studies are beginning to provide important information on the prevalence, correlates, and patterns of alternative tobacco and nicotine product use. Longitudinal models that map developmental trajectories and transitions of tobacco and nicotine use are needed to examine factors associated with persistence, progression, or desistence of use and also with changes in patterns of use. Future research can draw on developmental traditions in other areas of substance use to describe the heterogeneity in product use across time.

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