Transitions in Smoking among Adults Newly Purchasing the JUUL System

Objectives: In this study, we prospectively assessed changes in smoking a year after US adults' first-time purchase of a JUUL Starter Kit (JSK). Methods: Descriptive analyses assessed transitions in smoking status at 12 months among adult (age ≥21) JSK purchasers providing baseline and 12-month follow-up data (N = 27,164 [49.0% of baseline]), stratified by baseline smoking status. Baseline regular use of other ENDS was also considered. Results: Purchasers included baseline past 30-day smokers (65.2%), former smokers (12.0%), and never smokers (9.7%); over 90% were ever-smokers. One year later, the majority (58%) of those smoking at baseline reported no longer smoking. Former smokers or never smokers who were smoking at 12 months represented less than 2% of respondents. Former and current smokers who were regularly using other ENDS at baseline were less likely to report smoking at 12 months. Conclusions: Past 30-day smoking prevalence in a large longitudinal study of first-time JSK purchasers fell by more than half over 12 months. Analyzing the sample composition at purchase and transitions within subgroups defined by smoking status allows for a detailed understanding to help inform assessments of the population health impact of ENDS.

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Self-reported and cotinine-verified smoking and increased risk of incident hearing loss

Scientific Reports ◽

10.1038/s41598-021-87531-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Woncheol Lee ◽

Yoosoo Chang ◽

Hocheol Shin ◽

Seungho Ryu

Keyword(s):

Smoking Status ◽

Objective Measure ◽

Self Report ◽

Urinary Cotinine ◽

Increased Risk ◽

Former Smokers ◽

Never Smokers ◽

Time Varying Covariates ◽

New Onset

AbstractWe examined the associations of smoking status and urinary cotinine levels, an objective measure of smoking, with the development of new-onset HL. This cohort study was performed in 293,991 Korean adults free of HL who underwent a comprehensive screening examination and were followed for up to 8.8 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥ 25 dB in both ears. During a median follow-up of 4.9 years, 2286 participants developed new-onset bilateral HL. Self-reported smoking status was associated with an increased risk of new-onset bilateral HL. Multivariable-adjusted HRs (95% CIs) for incident HL comparing former smokers and current smokers to never-smokers were 1.14 (1.004–1.30) and 1.40 (1.21–1.61), respectively. Number of cigarettes, pack-years, and urinary cotinine levels were consistently associated with incident HL. These associations were similarly observed when introducing changes in smoking status, urinary cotinine, and other confounders during follow-up as time-varying covariates. In this large cohort of young and middle-aged men and women, smoking status based on both self-report and urinary cotinine level were independently associated with an increased incidence of bilateral HL. Our findings indicate smoking is an independent risk factor for HL.

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Cigarette Smoking Trajectories in Adult Former Smokers Using the JUUL System

American Journal of Health Behavior ◽

10.5993/ajhb.45.3.7 ◽

2021 ◽

Vol 45 (3) ◽

pp. 505-526

Author(s):

Gem M. Le ◽

Nathan M. Holt ◽

Nicholas I. Goldenson ◽

Lauren C. Smith ◽

Cameron Hatcher ◽

...

Keyword(s):

Cigarette Smoking ◽

Smoking Prevalence ◽

Prevalence Rates ◽

Adult Age ◽

Factors Associated ◽

Former Smokers ◽

Persistent Smoking ◽

Over Time

Objective: In this study, we assessed cigarette smoking over 12 months among adult former smokers who newly purchased a JUUL Starter Kit (JSK). Methods: Prevalence of past 30-day smoking and factors associated with smoking were assessed among adult (age ≥ 21) former established smokers, stratified as recent (quitting ≤ 12 months) and long-term quitters (> 12 months), who purchased a JSK and completed ≥ 1 of 6 follow-up assessments (N = 4786). Results: Recent quitters had higher rates (16.6%-19.9%) of past 30-day smoking than long-term quitters (6.4%-9.2%) across the 12-month period; smoking prevalence did not significantly increase over time in either subgroup. Few participants (6.5% of recent quitters, 2.8% of long-term quitters) reported smoking at both 9 and 12 months, a pattern that might indicate persistent smoking. Past 30-day JUUL use remained high (≥ 87%) across the 12 months. Participants who used JUUL more frequently were less likely to smoke. Conclusions: Among former smokers who purchased JUUL, prevalence rates of smoking were low and stable across the 12-month period, suggesting there was not a growing cohort of former smokers resuming smoking. Smoking was more common in recent quitters than long-term quitters. Greater use of JUUL was associated with reduced odds of smoking resumption.

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Family History of Crohn’s Disease (CD) May Be a Risk Factor for Developing de novo CD following Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis (UC)

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.328 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S150-S150

Author(s):

H Li ◽

M Arslan ◽

Z Fu ◽

H Lee ◽

M Mikula

Keyword(s):

Family History ◽

De Novo ◽

Smoking Status ◽

Smoking History ◽

Current Smoking Status ◽

Current Smoking ◽

History Of ◽

Former Smokers ◽

Never Smokers

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.

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The Adult JUUL Switching and Smoking Trajectories (ADJUSST) Study: Methods and Analysis of Loss-to-Follow-up

American Journal of Health Behavior ◽

10.5993/ajhb.45.3.3 ◽

2021 ◽

Vol 45 (3) ◽

pp. 419-442

Author(s):

Saul Shiffman ◽

Mark A. Sembower ◽

Erik M. Augustson ◽

Nicholas I. Goldenson ◽

Farhana Haseen ◽

...

Keyword(s):

Smoking Status ◽

Potential Bias ◽

Study Methods ◽

Loss To Follow Up ◽

Longitudinal Observational Study ◽

System User ◽

History Of ◽

Former Smokers ◽

First Time

Objectives: The Adult JUUL System User Switching and Smoking Trajectories (ADJUSST) study assessed the smoking and JUUL use trajectories of adults who purchased JUUL. In this paper, we describe study methods, characterize the sample, and assesses potential for bias due to loss to follow-up. Methods: We entered 55,414 US adults (≥ age 21) who purchased a JUUL Starter Kit for the first time (online or at retail) in 2018 into a naturalistic, longitudinal observational study, irrespective of baseline smoking status. Participants were invited for follow-ups 1, 2, 3, 6, 9, and 12 months later, focused on assessing past-30-day smoking and JUUL use. Analyses assessed potential bias due to non-response. Results: Over 90% of participants had a history of smoking; 62.8% were past-30-day smokers; 23.3% were former smokers. Participants' average age was 30; 75% were white. Most participants (77.6%) completed some follow-ups; 25% completed all follow-ups. Baseline differences among complete responders (N = 13,729), partial responders (N = 29,252), and complete non-responders (N = 12,433) were small. When recontacted, few 12-month non-responders said their non-response was due to smoking; many reported no past-30-day smoking. Conclusions: The study may elucidate smoking trajectories of adult JUUL users. The potential for bias due to loss to follow-up in ADJUSST was limited.

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Combined hormonal contraception and risk of venous thromboembolism within the first year following pregnancy

Thrombosis and Haemostasis ◽

10.1160/th13-09-0797 ◽

2014 ◽

Vol 112 (07) ◽

pp. 73-78 ◽

Cited By ~ 1

Author(s):

Thomas Bergholt ◽

Anne Nielsen ◽

Michael J. Paidas ◽

Ellen Christine L. Løkkegaard ◽

Jesper Petersen

Keyword(s):

Venous Thromboembolism ◽

Hormonal Contraception ◽

Hormonal Contraceptives ◽

First Year ◽

The Difference ◽

Combined Hormonal Contraception ◽

One Year ◽

First Time ◽

Combined Hormonal Contraceptives

SummaryEstimating the risk of venous thromboembolism (VTE) associated with combined hormonal contraceptives following early terminated pregnancies or birth, a Danish nationwide retrospective cohort observing a one-year follow-up was defined using three unique registries. All Danish women with confirmed pregnancies aged 15–49 during the period of 1995–2009 were included. The main outcomes were relative and absolute risks of first time venous thromboembolism in users as well as non-users of combined hormonal contraceptives. In 985,569 person-years, 598 venous thromboembolisms were recorded. After early terminated pregnancies and births, respectively, 113 and 485 events occurred in 212,552 and 773,017 person-years. After early terminated pregnancies, the crude VTE incidence ratios were similar, and the numbers needed to harm were equal between groups that did or did not use combined hormonal contraceptives throughout the follow-up year. After childbirth, individuals that used combined hormonal contraceptives were more likely than non-users to experience VTE depicted by crude incidence ratios; however, the difference was only significant after 14 weeks. This implied that the numbers needed to harm were lower for those that used compared to those that did not use combined oral contraceptives in the initial 14 weeks postpartum. In conclusion, the use of combined hormonal contraceptives after early terminated pregnancies was not detrimental, but during the puerperal period, they should be used with caution.

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Abstract P204: Tobacco Use And The AHA 2030 Impact Goals: A Simulation

Circulation ◽

10.1161/circ.143.suppl_1.p204 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Douglas Levy ◽

Sydney L Goldberg ◽

Emily P Hyle ◽

Krishna P Reddy

Keyword(s):

Cigarette Smoking ◽

Smoking Prevalence ◽

Smoking Initiation ◽

Potential Contribution ◽

Cvd Risk ◽

The Us ◽

Former Smokers ◽

Never Smokers ◽

Projected Changes ◽

The Impact

Background: The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US. Methods: We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%. Results: Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W). Conclusion: Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.

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Estimating the Public Health Impact from Introducing Tobacco-Free Nicotine Pouches Into the US

10.21203/rs.3.rs-1124367/v1 ◽

2021 ◽

Author(s):

Peter N Lee ◽

John S Fry ◽

Tryggve Ljung

Keyword(s):

Smoking Status ◽

Health Impact ◽

Sensitivity Analyses ◽

Base Case ◽

Initiation Rate ◽

Individual Parameter ◽

Product Use ◽

The Us ◽

Current Product

Abstract BackgroundFor smokers not intending to quit, switching to a reduced-risk nicotine product should be healthier than continuing smoking. We estimate the health impact, over the period 2000-2050, of introducing into the US the nicotine pouch ZYN. ZYN’s toxicant profile and method of use is like that for Swedish snus, a product with known health effects much less than smoking. MethodsOur modelling approach is similar to others developed for estimating potential effects of new tobacco products. It starts with a simulated cohort of 100,000 individuals in the year 2000 subdivided by age, sex, and smoking status (including years since quitting). They are followed annually accounting for births, net immigrations, deaths and product use changes, with follow-up carried out in the Base Case (ZYN not introduced) and Modified Case (ZYN introduced). Using informed assumptions about initiation, quitting and switching rates, distributions of the population over time are then constructed for each Case, which are used to estimate product-related mortality based on assumptions about the relative risk according to product use. ResultsWhereas in both Base and Modified Cases, the prevalence of any current product use is predicted to decline from about 22% to 10% during follow-up, in the Modified Case about 25% of current users use ZYN by 2050, about a quarter being dual users and the rest ZYN-only users. Over the 50 years, deaths at ages 35-84 from product use among the 100,000 are estimated as 249 less in the Modified than the Base Case, equivalent to about 700,000 less deaths in the whole US. Sensitivity analyses varying individual parameter values confirm the benefits of switching to ZYN, which increase as either the switching rate to ZYN increases or the initiation rate of ZYN relative to smoking increases. Even assuming the reduction in excess mortality risk using ZYN use is 20% of that from smoking rather than the 3.5% assumed in the main analyses, the reduction in product-related deaths would still be 213, or about 600,000 in the US. ConclusionsAlthough such model-based estimates are subject to uncertainties, the results suggest that introducing ZYN could substantially reduce smoking-attributable deaths.

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One-year outcomes in a multicentre cohort study of incident rare diffuse parenchymal lung disease in children (ChILD)

Thorax ◽

10.1136/thoraxjnl-2019-213217 ◽

2019 ◽

Vol 75 (2) ◽

pp. 172-175 ◽

Cited By ~ 3

Author(s):

Steve Cunningham ◽

Catriona Graham ◽

Morag MacLean ◽

Paul Aurora ◽

Michael Ashworth ◽

...

Keyword(s):

Cohort Study ◽

Lung Disease ◽

Low Oxygen ◽

Child Survivors ◽

Diffuse Parenchymal Lung Disease ◽

Multicentre Cohort Study ◽

Observational Cohort ◽

One Year ◽

First Time

We performed a prospective, observational, cohort study of children newly diagnosed with children’s interstitial lung disease (ChILD), with structured follow-up at 4, 8, 12 weeks and 6 and 12 months. 127 children, median age 0.9 (IQR 0.3–7.9) years had dyspnoea (68%, 69/102), tachypnoea (75%, 77/103) and low oxygen saturation (SpO2) median 92% (IQR 88–96). Death (n=20, 16%) was the most common in those <6 months of age with SpO2<94% and developmental/surfactant disorders. We report for the first time that ChILD survivors improved multiple clinical parameters within 8–12 weeks of diagnosis. These data can inform family discussions and support clinical trial measurements.

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Secondary Prevention of Non-fatal Deliberate Self-harm

The British Journal of Psychiatry ◽

10.1192/bjp.163.1.111 ◽

1993 ◽

Vol 163 (1) ◽

pp. 111-112 ◽

Cited By ~ 116

Author(s):

H. G. Morgan ◽

E. M. Jones ◽

J. H. Owen

Keyword(s):

British Journal ◽

Early Stage ◽

Psychiatric Services ◽

Easy Access ◽

Deliberate Self Harm ◽

Self Harm ◽

One Year ◽

First Time ◽

Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

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The change of teeth color, whiteness variations and its psychosocial and self-perception effects when using low vs. high concentration bleaching gels: a one-year follow-up.

10.21203/rs.2.18384/v4 ◽

2020 ◽

Author(s):

Juan Estay ◽

Pablo Angel ◽

Cristian Bersezio ◽

Mateus Tonetto R ◽

Gilbert Jorquera ◽

...

Keyword(s):

Hydrogen Peroxide ◽

Health Impact ◽

Psychosocial Impact ◽

Tooth Bleaching ◽

Self Perception ◽

High Concentration ◽

Low Concentration ◽

Positive Effects ◽

One Year

Abstract Background: Dental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after one year.Methods: Patients (n=25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa=0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols.Results: The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after one year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained.Conclusions: Low concentration (6%) achieved effective bleaching with good stability after one year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up.Trial registration: NCT03217994 (before enrollment of the first participant). Data register: July 14, 2017

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