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Rassegna Stampa Scientifica Luglio 2021




Government ambition to make England smoke-free by 2030

Open letter to the prime minister and secretary of state on the second anniversary of England’s announcement that it would be smoke-free by 2030

BMJ 2021;374:n1839 (Published 21 July 2021)

Nicholas S Hopkinson, Helen Stokes-Lampard, Jennifer Dixon,  Maggie Rae, Linda Bauld, Bruce and John Usher Sarah Woolnough, Andrew Goddard, Jeanelle de Gruchy, Charmaine Griffiths, Ian Walker, Jon Bennett



Note: Open Access.


Related PR:


Government has failed to deliver on smoke free pledge for England



"Despite the added risk of foetal harm during pregnancy, there is no evidence that the tobacco consumption between pregnant and non-pregnant women differ in 42 LMICs [low- and middle-income countries]. A significantly higher use of smokeless tobacco among pregnant women in SEAR [South-East Asia Region] is of particular concern and warrants further investigation."


Tobacco Use Among 1 310 716 Women of Reproductive age (15–49 Years) in 42 Low- and Middle-Income Countries: Secondary Data Analysis From the 2010-2016 Demographic and Health Surveys

Nicotine & Tobacco Research, ntab131.

Published: 22 July 2021

Radha Shukla, Mona Kanaan, Kamran Siddiqi


 Note: Open Access.




Smoking Cessation and Preterm Birth in Second Pregnancy Among Women who Smoked in Their First


Trends in the Number and Type of Tobacco Product Retailers, United States, 2000-2017


Vaping disparities at the intersection of gender identity and race/ethnicity in a population-based sample of adolescents



"Parent and child data from 10,625 [UK] youth assessed in infancy and modal ages 11, 14, and 17 years… Among youth who had not smoked tobacco by age 14 (n=9,046), logistic regressions estimated that teenagers who used e-cigarettes by age 14, compared with non e-cigarette users, had over 5 times higher odds of initiating tobacco smoking by age 17 (odds ratio (OR)=5.25, 95% confidence interval (CI):[3.28-8.38]), and nearly triple the odds of being a frequent tobacco smoker at age 17 (OR=2.91, 95% CI:[1.56-5.41]), net of risk factors and demographics... Conclusions: E-cigarette use by age 14 is associated with increased odds of tobacco cigarette initiation and frequent smoking at age 17 among British youth. Similarly, tobacco smoking at age 14 is associated with increased odds of both e-cigarette initiation and frequent use at age 17."


Adolescent Electronic Cigarette Use and Tobacco Smoking in the Millennium Cohort Study

Addiction. 2021 Jul 19. Online ahead of print.

Jeremy Staff, Brian C Kelly, Jennifer L Maggs, Mike Vuolo



"On average, participants preferred non-tobacco and non-menthol flavours most, preferred open-system over closed-system e-cigarettes and preferred regular nicotine level over low nicotine level. However, the preference varied by demographics, smoking status and the primarily used e-cigarette device and flavour… Conclusions: People are unlikely to switch to another product/device because of the restriction of flavour or nicotine level. If non-tobacco and non-menthol flavours were banned from open-system e-cigarettes, users may switch to menthol flavour e-cigarettes."


Impact of flavours, device, nicotine levels and price on adult e-cigarette users' tobacco and nicotine product choices

Tob Control. 2021 Jul 22;tobaccocontrol-2021-056599. Online ahead of print.

Yong Yang, Eric N Lindblom, Ramzi G Salloum, Kenneth D Ward





Price promotion receipt and use progression of any tobacco, cigarettes, e-cigarettes and cigars among US youth between 2016 and 2018


Tobacco retail availability and cigarette and e-cigarette use among youth and adults: a scoping review


Online marketing activity following New Zealand's vaping legislation


 Note: Retail availability paper Open Access.


"The complexity of e-liquid formulations and rapid evolution of different e-cigarette devices, coupled with regulations focused on narrowly defined e-cigarette products, have resulted in exploitation of regulatory loopholes and few substantive changes in overall e-cigarette product availability, appeal and use. Future regulations governing e-cigarette devices, flavours and chemical components will need to be rigorous and thorough, with careful consideration of ways in which companies may attempt to evade regulations by making small changes to their products."



Evolving chemical landscape of e-cigarettes, 2021

Tobacco Control Published Online First: 21 July 2021.

Elise Hickman, Ilona Jaspers



Referenced Tob Control study:


Flavour chemicals, synthetic coolants and pulegone in popular mint-flavoured and menthol-flavoured e-cigarettes



"Logistic regressions found that e-cigarette use was associated with having had a myocardial infarction, but this association significantly varied on the basis of one's smoking history. With a host of demographic and clinical variables controlled, e-cigarette use was associated with lifetime myocardial infarction occurrence only among current smokers… Conclusions: There is no reliable evidence that e-cigarette use is associated with ever having had a myocardial infarction among never smokers. Contrary to concerns that the harms associated with e-cigarettes are only now emerging after more years of possible product use, the only evidence of time-dependent variation in the association between e-cigarette use and myocardial infarction ran counter to this possibility."


Re-examining the Association Between E-Cigarette Use and Myocardial Infarction: A Cautionary Tale

Am J Prev Med. 2021 Jul 22;S0749-3797(21)00290-7. Online ahead of print.

Clayton R Critcher, Michael Siegel


Note: Open Access.


"Findings support the role of nicotine in reducing cravings via vaping. They also suggest that sensorimotor similarities to smoking may be less important among experienced vapers or dual users. Indeed, in this sample, the altered sensorimotor apparatus may have reduced craving via distraction or other mechanisms."


Distinct influences of nicotine and sensorimotor stimuli on reducing cravings to smoke and vape among dual users

Addict Behav. 2021 Jul 15;122:107051. Online ahead of print.

Amanda M Palmer, Leslie E Sawyer, Thomas H Brandon



"The current data suggest that dual users are an at-risk group in terms of emotional processes. Dual users would likely benefit from targeted intervention efforts focused on reducing anxiety sensitivity and improving emotion regulation in order to reduce nicotine consumption and/or promote cessation."


Anxiety Sensitivity and Emotion Dysregulation in Dual and Exclusive E-Cigarette Users

Subst Use Misuse. 2021 Jul 26;1-6. Online ahead of print.

Alison C McLeish, Tanya Smit, Lorra Garey, Michael J Zvolensky



"A relatively high prevalence of self-reported smoking was reported among university students in the UAE [United Arab Emirates]. The findings also suggest that nicotine vaping use is relatively widespread, but still less common than traditional smoking. Vigilant and tailored university-based smoking control and preventive measures are warranted."


Patterns of Tobacco Smoking and Nicotine Vaping among University Students in the United Arab Emirates: A Cross-Sectional Study

Int J Environ Res Public Health. 2021 Jul 19;18(14):7652.

Luai A Ahmed, Marina Verlinden, Mariam Ali Alobeidli, Reem Hamad Alahbabi, Radeya AlKatheeri, Basema Saddik, Abderrahim Oulhaj, Rami H Al-Rifai


Note: Open Access.


"We present the case of a 32-year-old woman treated for COVID-19 despite multiple negative SARS CoV-2 PCR tests and nucleocapsid antibody test. On further investigation, she endorsed use of E-cigarettes and was subsequently diagnosed with EVALI [E-cigarette or vaping product use-associated lung injury]. The patient was treated with oral and intravenous steroids, resulting in significant improvement in her symptoms. This case highlights the challenge of diagnosing rarer aetiologies of respiratory distress during the COVID-19 pandemic."


E-cigarette or vaping product use-associated lung injury (EVALI) masquerading as COVID-19

BMJ Case Rep. 2021 Jul 23;14(7):e243885.

Nandita Ganne, Raj Palraj, Elizabeth Husted, Ishan Shah


Note: Open Access.


"Using Joinpoint regression, we assessed secular [US] trends of smoking and nicotine dependence as a function of co-occurring use of alcohol, prescription opioids, marijuana/hashish, cocaine/heroin/methamphetamine, or other injection drug use… Conclusions: Co-occurring substance use was associated with smaller reductions in tobacco use, over time, and with increased odds of nicotine dependence. This suggests that co-occurring substance users should be regarded as a tobacco-related disparity group and prioritized for tobacco control interventions. "


Temporal trends in smoking and nicotine dependence in relation to co-occurring substance use in the United States, 2005-2016

Drug Alcohol Depend. 2021 Jul 21;226:108903. Online ahead of print.

Yun Wang, Ying Liu, Mary Waldron, Alexandra N Houston-Ludlam, Vivia V McCutcheon, Michael T Lynskey, Pamela A F Madden, Kathleen K Bucholz, Andrew C Heath, Min Lian



"Tobacco control policies, including significant effects of comprehensive smoking bans, total vending machine restrictions, single cigarette sale restrictions, and advertising restrictions, remain robust in reducing young adult smoking, net of cannabis policy liberalization, including the legal status of possession, penalties for sale, and medical cannabis. Cannabis policies do not directly affect young adult smoking patterns in an adverse way. Conclusions: This paper provides evidence that the liberalization of cannabis laws has not adversely affected the efficacy of tobacco control efforts."


Further Consideration of the Impact of Tobacco Control Policies on Young Adult Smoking in Light of the Liberalization of Cannabis Policies

Nicotine & Tobacco Research, ntab149.

Published: 17 July 2021

Mike Vuolo, Sadé L Lindsay, Brian C Kelly



"After adjusting for potential confounders, we found elevated risks (rates) of CD [conduct disorder] symptoms in offspring born to [Western Australia] mothers smoking tobacco during the first trimester [RR 1.52 (95 % CI: 1.24-1.87)], third trimester [RR 1.36 (95 % CI: 1.09-1.69)] and during both trimesters of pregnancy [RR 1.50 (95 % CI: 1.19-1.90)]. The rates of CD symptoms in offspring increased with the level of exposure to maternal smoking during pregnancy… Conclusion: The associations we found for maternal but not paternal smoking may suggest a biological mechanism for intrauterine tobacco exposure on the risk of CD symptoms in offspring."


Prenatal tobacco exposure and the risk of conduct disorder symptoms in offspring at the age of 14 years: Findings from the Raine Study

J Psychiatr Res. 2021 Jul 20;142:1-8. Online ahead of print.

Bereket Duko, Gavin Pereira, Robert J Tait, John Newnham, Kim Betts, Rosa Alati



"We need more regulation for tobacco and nicotine products, particularly nicotine products destined for inhalation. The prevention of nicotine addiction has been more successful in the long term than smoking cessation, however, for a quick reduction in diseases and mortality from tobacco and related products, efforts to improve nicotine cessation must also be enforced, particularly forthe cessation of combustible tobacco products. Both active and passive exposures to traditional and new nicotine products and their health effects need to be reduced. This is a prerequisite for a successful public health policy and a future end‐game against the business interests of the tobacco industry and its allies."



Tobacco, Nicotine and Health

Medicina 2021, 57(8), 740.

Published: 22 July 2021

Manfred Neuberger


Note: Open Access. This Editorial introduces a Special Edition of the journal Medicina being developed devoted to 'Tobacco, Nicotine and Health'. Previously published papers from V. 57 appear at the link provided here and more may be added.


"The growing multisectoral nature of the nutrition agenda must recognise and include tobacco control as an environmental strategy to improve nutrition. However, most maternal, newborn, and child health guidelines only address tobacco cessation as a prenatal care intervention to reduce low birthweight and prematurity. The broader contributions of tobacco control to constrained fiscal environments are not addressed. In all countries, smoking diverts spending from basic needs and leads to catastrophic health expenditures for many households. To truly make progress in maternal and child undernutrition, social and fiscal environmental interventions should recognise that evidence-based tobacco control must be part of the nutrition agenda."



The nutrition agenda must include tobacco control

Lancet. 2021 Jul 24;398(10297):300-301.

Jonathan D Klein




Authors' reply:


The nutrition agenda must include tobacco control - Authors' reply


Note: Open Access.



Rassegna Stampa Scientifica Agosto 2021


Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: a systematic review and meta-analysis

BMC Public Health volume 21, Article number: 1554 (2021)

Published: 16 August 2021

Roengrudee Patanavanich & Stanton A. Glantz



Note: Open Access.


"SARS-CoV-2… gains entry into the host cell when its Spike protein is cleaved by host proteases TMPRSS2 and furin, thereby markedly increasing viral affinity for its receptor, angiotensin-converting enzyme-2(ACE2)… [Tobacco cigarette-] TCIG-smokers compared to NS [non-smokers] had a significantly increased percentage of cells that were positive for ACE2 (10-fold, p<0.001), TMPRSS2 (5-fold, p<0.001) and ADAM17 (2.5-fold, p<0.001)… Conclusions: The finding that key instigators of COVID-19 infection are lower in [e-cigarette-] ECIG-vapers compared to TCIG-smokers is intriguing and warrants additional investigation to determine if switching to ECIGs is an effective harm reduction strategy. However, the trend towards increased proteases in ECIG-vapers remains concerning."


Instigators of COVID-19 in Immune Cells are Increased in Tobacco Cigarette Smokers and Electronic Cigarette Vapers Compared to Non-smokers

Nicotine & Tobacco Research, ntab168.

Published: 19 August 2021

Theodoros Kelesidis, Yuyan Zhang, Elizabeth Tran, Grace Sosa, Holly R Middlekauff


Note: Open Access.


"We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation… Noteworthy is the lack of trials by e-cigarette manufacturers in pursuit of regulatory agency approval to use e-cigarettes for smoking cessation, likely reflecting the profitability of selling e-cigarettes as consumer products, rather than medicinal devices."


Balancing Consideration of the Risks and Benefits of E-Cigarettes

American Journal of Public Health (AJPH)

Published Online: August 19, 2021

David J. K. Balfour, Neal L. Benowitz, Suzanne M. Colby, Dorothy K. Hatsukami, Harry A. Lando, Scott J. Leischow, Caryn Lerman, Robin J. Mermelstein, Raymond Niaura, Kenneth A. Perkins, Ovide F. Pomerleau, Nancy A. Rigotti, Gary E. Swan, Kenneth E. Warner, and Robert West



Note: Open Access.


Related PR:


Current focus on preventing youth vaping could hinder adults' efforts to stop smoking



"Across the four [US] studies [in California and Connecticut], e-cigarette use >5 days/month versus never use was associated with bronchitic symptoms (summary odds ratio, sOR: 1.56; 95% confidence interval, CI: 1.37, 1.77) and shortness of breath (sOR: 1.68; 95% CI: 1.35, 2.08) but not statistically significantly with asthma exacerbations (sOR: 1.36; 95% CI; 0.95, 1.95). Among past 30-day e-cigarette users, associations with respiratory symptoms did not differ by device type. In these populations, e-cigarette use was positively associated with symptoms of bronchitis and shortness of breath, but adjusted odds of symptoms did not differ meaningfully by device type. These findings suggest that risk of these respiratory outcomes is elevated among more frequent e-cigarette users regardless of device type used."


E-cigarette use and adverse respiratory symptoms among adolescents and Young adults in the United States

Prev Med. 2021 Aug 18;106766. Online ahead of print.

Benjamin W Chaffee, Jessica Barrington-Trimis, Fei Liu, Ran Wu, Rob McConnell, Suchitra Krishnan-Sarin, Adam M Leventhal, Grace Kong 


Note: Open Access.


"Data were from a nationally-representative subsample of 8th, 10th, and 12th grade students in the Monitoring the Future Study who had used JUUL or cigarettes in the past 30 days… Non-nicotine substance use and more frequent JUUL use was associated with significantly greater odds of dependence and more severe dependence symptoms in multivariable models. The severity distribution of most (craving) and least (inability to quit) dependence symptom types observed in JUUL dependence paralleled those observed in analysis of combustible cigarette dependence symptoms in past 30-day smokers."


Nicotine dependence symptoms in U.S. youth who use JUUL E-cigarettes

Drug Alcohol Depend. 2021 Aug 4;227:108941. Online ahead of print.

Afton Kechter, Junhan Cho, Richard A Miech, Jessica L Barrington-Trimis, Adam M Leventhal



"Consistent with prior findings, baseline e-cigarette use [in the Netherlands and Flanders] was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups). Conclusion: Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply."


Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders

Tobacco Control Published Online First: 05 July 2021.

Thomas Martinelli, Math J J M Candel, Hein de Vries, Reinskje Talhout, Vera Knapen, Constant P van Schayck, Gera E Nagelhout






Strategic and contested use of food laws to ban smokeless tobacco products in India: a qualitative analysis of litigation



Note: Open Access.


"While the FDA [Food & Drug Administration] continues to act at the federal level, the PSA [Public Service Announcement] framework can help guide additional multilevel coordinated efforts to inform the agency of apparent regulatory loopholes and their effects. This may best be achieved through a consortium of entities and individuals (eg, researchers, clinicians, organizations) interested in tobacco control, policy makers (eg, state attorneys general, lawmakers at all governmental levels), and other key stakeholders (eg, youth, parents, educators) convened and guided by a federal agency such as the Centers for Disease Control and Prevention."



Collaborative Public Health Strategies to Combat e-Cigarette Regulation Loopholes

JAMA Pediatr. Published online August 16, 2021.

Kar-Hai Chu, Tina Batra Hershey, Jaime E. Sidani



"The self-reported 7-day PPA [prevalence of cigarette abstinence] was statistically significantly lower among HTP [heated tobacco product] users than among non-HTP users after 6 months (19.0% vs. 34.2%; p = 0.009), with an adjusted relative risk of 0.47 (95% confidence interval: 0.24-0.91; p = 0.03)… Conclusions: Youth HTP users were less likely to abstain from tobacco use than their non-HTP-using counterparts. These results suggest that HTPs should not be promoted as smoking cessation or reduction aids among the youth population."


The association between heated tobacco product use and cigarette cessation outcomes among youth smokers: A prospective cohort study

J Subst Abuse Treat. 2021 Aug 15;108599. Online ahead of print.

Wei Xia, William Ho Cheung Li, Yuan Hui Luo, Ting Na Liang, Laurie Long Kwan Ho, Ankie Tan Cheung, Peige Song



"Pictorial warning label exposure led to increases in fear which led to increased motivation to quit smoking for the first (B = 0.12, 95% CI = 0.04, 0.26) and second (B = 0.12, 95% CI = 0.03, 0.25) model. Exposure modestly increased motivation to quit by way of fear and affective risk perceptions (B = 0.01, 95% CI = 0.00, 0.04). Exposure had a direct relationship on increased motivation to quit as well."


Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults

Ann Behav Med. 2021 Aug 20;kaab073. Online ahead of print.

Andrea C Johnson, Monique M Turner, Samuel J Simmens, W Douglas Evans, Andrew A Strasser, Darren Mays


Note: Open Access.


"All four HWL [health warning label] themes performed well [in Beijing, Shanghai and Shenzhen] for each outcome with average ratings >6.5. Harming family or children with secondhand smoke was the theme that received the highest ratings for each outcome, with credibility (8.0, 95% CI 7.86 to 8.09) and prevention of smoking (8.8, 95% CI 8.63 to 8.91) outcomes being significantly higher (p<0.05)… Conclusion: All four HWL themes tested could be effective in China; the theme of secondhand smoke harming family or children may be a particularly credible/effective theme."


Perceived effectiveness of four different cigarette health warning label themes among a sample of urban smokers and non-smokers in China

Tobacco Control Published Online First: 16 August 2021.

Qinghua Nian, Jeffrey J Hardesty, Joanna E Cohen, Xiangqiang Xie, Ryan David Kennedy



Note: Open Access.




Plant-based menthol cigarettes? Food industry trends and farm-to-pack cigarette advertising



"Significantly more African American (73.2%) compared to White (52.4%) smokers preferred menthol cigarettes (p < .001). Menthol smokers reported greater positive and negative subjective responses to smoking than non-menthol smokers. Positive and negative subjective response were both associated with greater smoking intensity and lower cigarette harm perceptions… Policies that ban menthol cigarettes may have a particularly positive impact on the cigarette smoking of African American young adult smokers."


Affirming the Abuse Liability and Addiction Potential of Menthol: Differences in Subjective Appeal to Smoking Menthol Versus Non-Menthol Cigarettes Across African American and White Young Adult Smokers

Nicotine & Tobacco Research, ntab137.

Published: 18 August 2021

Amy M Cohn, Adam C Alexander, Sarah J Ehlke



"A significant decrease in self-reported SHS [secondhand smoke] exposure [in Germany, Greece, Hungary, Poland, Romania, and Spain] was observed in workplaces, from 19.1% in 2016 to 14.0% in 2018 (-5.1%; 95% CI: -8.0%;-2.2%). Self-reported smoking did not change significantly inside bars (22.7% in W2), restaurants (13.2% in W2) and discos/nightclubs (34.0% in W2). SHS exposure in public places was significantly less likely (OR=0.35; 95% CI: 0.26-0.47) in the countries with total bans as compared to those countries with partial bans."


Secondhand smoke exposure in European countries with different smoke-free legislation. Findings from the EUREST-PLUS ITC Europe Surveys

Nicotine & Tobacco Research, ntab157.

Published: 13 August 2021

Sarah O Nogueira, Esteve Fernández, Pete Driezen, Marcela Fu, Olena Tigova, Yolanda Castellano, Ute Mons, Aleksandra Herbeć, Christina N Kyriakos, Tibor Demjén, Antigona C Trofor, Krzysztof Przewoźniak, Paraskevi A Katsaounou, Constantine I Vardavas, Geoffrey T Fong, on behalf of the EUREST-PLUS Consortium



"More varenicline users (33.3%, 95% CI: 21.7%–46.7%) quit smoking than nicotine patch users (13.3%, 95% CI: 5.9%–24.6%). The adjusted rate difference was 24.2% (95% CI: 10.2%–38.2%) and the adjusted relative risk was 2.8 (95% CI: 1.4–5.7). Conclusions: Varenicline was almost three times more effective than nicotine patches in assisting pregnant women to quit smoking."


The Comparative Effectiveness of Varenicline and Nicotine Patches for Smoking Abstinence During Pregnancy: Evidence From a Population-based Cohort Study

Nicotine & Tobacco Research, ntab063.

Published: 16 August 2021

Stephanie K Y Choi, Duong T Tran, Anna Kemp-Casey, David B Preen, Deborah Randall, Kristjana Einarsdottir, Louisa R Jorm, Alys Havard



"Expanding the serum cotinine range to 0.015-10 ng/mL more than doubles the estimated proportion of U.S. nonsmokers exposed to secondhand smoke. In contrast to a serum cotinine range of 0.05-10 ng/mL, it suggests that progress has been made in reducing population-level secondhand smoke exposure during 2011-2018, especially among nonsmokers experiencing lower exposure levels."


Trends in Secondhand Smoke Exposure, 2011-2018: Impact and Implications of Expanding Serum Cotinine Range

Am J Prev Med. 2021 Sep;61(3):e109-e117. Epub 2021 Jul 29.

James Tsai, David M Homa, Linda J Neff, Connie S Sosnoff, Lanqing Wang, Benjamin C Blount, Paul C Melstrom, Brian A King



Note: Open Access.




Chronic Obstructive Pulmonary Disease and U.S. Workers: Prevalence, Trends, and Attributable Cases Associated With Work



JAMA Netw Open: US: GWLs; Materials: Cigarette Filters & Recycling

"Tobacco giant Philip Morris has raised its bid to buy respiratory drugmaker Vectura to more than £1bn [US$1.4bn]. Vectura makes inhaled medicines and devices to treat respiratory illnesses such as asthma, and counts Novartis and GSK among its customers. The Marlboro cigarette maker increased its offer to £1.65 ($2.29) per share after US private equity firm Carlyle offered £958m ($1.3bn) on Friday. Vectura has not yet responded to requests for comment on the new bid. It previously said it was backing Carlyle's offer and withdrawing its recommendation for Philip Morris' earlier bid." [No author. Tobacco giant Philip Morris raises bid for respiratory drugmaker, BBC News. See also: Carlyle ups bid for inhaler firm Vectura, trumping tobacco giant Philip Morris, The Guardian]


"For years, FDA [Food & Drug Administration] has allowed the vast majority of e-cigarettes to stay on the market even though none of them have the premarket tobacco product application (PMTA) orders they need to be sold legally. But all that is changing. Following a court ruling, FDA must issue PMTA orders by September 9, pro or con, for every e-cigarette brand or variant that has applied to stay on the market and take any not receiving permissive orders off the market. So, the big questions are whether FDA will issue PMTA orders to allow the continued marketing of any e-cigarettes, and if so, what restrictions and requirements FDA might put on the permitted e-cigarettes, their flavors, and their marketing." [Eric N. Lindblom. All Eyes on FDA: The Upcoming Regulation of Juul E-Cigarettes, MedPage Today]


"This randomized clinical trial found that graphic warning labels decreased positive perceptions of cigarettes associated with branded cigarette packs but without clearly increasing health concerns. They also increased quitting cognitions but did not affect either cigarette cessation or consumption levels."


Effect of Graphic Warning Labels on Cigarette Packs on US Smokers’ Cognitions and Smoking Behavior After 3 Months

A Randomized Clinical Trial

JAMA Netw Open. 2021;4(8):e2121387.

August 4, 2021

David R. Strong, John P. Pierce, Kim Pulvers, Matthew D. Stone, Adriana Villaseñor, Minya Pu, Claudiu V. Dimofte, Eric C. Leas, Jesica Oratowski, Elizabeth Brighton, Samantha Hurst, Sheila Kealey, Ruifeng Chen, Karen Messer


Note: Open Access.


Related PR:


Graphic warning labels on cigarette packaging changes perceptions



"Among tobacco naïve adolescents (N = 9455), tobacco ads exposure was positively associated with tobacco use susceptibility, compared with the non-exposure group. Seeing cigarettes/other non-ENDS [electronic nicotine delivery systems] tobacco products only was associated with a 1.64 increase in odds being susceptible to tobacco use; tobacco ads exposure via website and/or social media sites only (cigarette/other non-ENDS tobacco, AOR: 1.87, 95%CI: 1.25-2.81; ENDS, AOR: 2.25, 95%CI: 1.43-3.55) was associated with higher odds of tobacco use susceptibility, compared to the non-exposure group. With rapidly increasing rates of ENDS use in adolescents, it is crucial that advertisements promoting the initiation and continued use of ENDS are strictly regulated, especially among advertisements that are online and on social media sites."


Exploring how tobacco advertisements are associated with tobacco use susceptibility in tobacco naive adolescents from the PATH study

Prev Med. 2021 Aug 3;106758. Online ahead of print.

Xiao Li, Jacob Borodovsky, Erin Kasson, Nina Kaiser, Raven Riordan, Andrea Fentem, Patricia A Cavazos-Rehg



"With health care systems putting new efforts into identifying patients eligible for lung cancer screening, we have an opportunity to connect these patients with effective tobacco treatment. Continuing to rely on hurried conversations as the gateway to tobacco treatment is unacceptable. We must consider proactive tobacco treatment as a core component of lung cancer screening and make the incredibly modest investment to make it happen."



Smoking Cessation Resources Can and Should Be Integrated in Lung Cancer Screening

Chest. 2021 Aug;160(2):413-414.

Steven B Zeliadt



Related Chest study:


Provision of Smoking Cessation Resources in the Context of In-Person Shared Decision-Making for Lung Cancer Screening


Note: Open Access.


Modern Perioperative Practices May Mitigate Effects of Continued Smoking Among Lung Cancer Patients

Ann Thorac Surg. 2021 Aug 3;S0003-4975(21)01317-5. Online ahead of print.

Erin M Corsini, Nicolas Zhou, Kyle G Mitchell, Mara B Antonoff, Reza J Mehran, David C Rice, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, Paul M Cinciripini, Maher Karam-Hage, Jack A Roth, Wayne L Hofstetter



"Nearly all physicians reported asking patients whether they smoke (95.6%) and advising them to stop (94.8%), slightly fewer assessed the readiness to quit (86.5%), and only a minority assisted with a quit plan (27.4%) or arranged a follow-up (18.6%). Only 18% reported using the U.S. Public Health Service Guidelines in clinical practice. Time-related factors were the most common barriers (53.4%), with patient factors (36.9%) and financial/resource factors (35.1%) cited less frequently… Conclusions: This national survey highlights the need for increased implementation of all aspects of the latest guidelines for evidence-based tobacco treatments, including community-based resources."


Tobacco Treatment Guideline Use and Predictors Among U.S. Physicians by Specialty

Am J Prev Med. 2021 Aug 4;S0749-3797(21)00329-9. Online ahead of print.

Daniel A Schaer, Binu Singh, Michael B Steinberg, Cristine D Delnevo



"In two national samples of US youth, smoking prevalence declined by a sizeable relative percentage. Intent to smoke in the future and harm perceptions of smoking declined or remained unchanged while EC [e-cigarette] use increased. Results provide little evidence that EC use has increased conventional cigarette smoking among youth."


Has increased youth e-cigarette use in the USA, between 2014 and 2020, changed conventional smoking behaviors, future intentions to smoke and perceived smoking harms?

Addict Behav. 2021 Jul 30;123:107073. Online ahead of print.

Tianze Sun, Carmen C W Lim, Daniel Stjepanović, Janni Leung, Jason P Connor, Coral Gartner, Wayne D Hall, Gary C K Chan





Maternal smoking during pregnancy and poor academic performance in adolescent offspring: A registry data-based cohort study



"There was no association between past-year ENP [electronic nicotine product] use and exercise-induced wheezing or asthma diagnosis. Among those with asthma, there was no evidence of an association between ENP use and long-acting inhaler or quick-relief inhaler use. ENP use among adolescents is associated with increased frequency of wheezing and dry cough. Early recognition of pulmonary clinical manifestations among young ENP users should be critical considerations in regulatory and prevention efforts to protect public health, and clinical efforts to prevent progression to serious pulmonary complications."


Association of Vaping and Respiratory Health among Youth in the Population Assessment of Tobacco and Health (PATH) Study Wave 3

Int J Environ Res Public Health. 2021 Aug 3;18(15):8208.

Christie Cherian, Eugenia Buta, Patricia Simon, Ralitza Gueorguieva, Suchitra Krishnan-Sarin





Analysis of a Vaping-Associated Lung Injury Outbreak through Participatory Surveillance and Archival Internet Data


Note: Open Access.


"Overall, both exclusive menthol and non-menthol cigarette use declined from 2013-2017. Exclusive ENDS [electronic nicotine delivery systems] use increased, particularly among youth who were non-Hispanic White or had a higher socioeconomic status (measured by parental education, household income, and homeownership). Dual use of ENDS with either menthol or non-menthol cigarettes did not change significantly."


Sociodemographic Patterns of Exclusive and Dual Use of ENDS and Menthol/Non-Menthol Cigarettes among US Youth (Ages 15-17) Using Two Nationally Representative Surveys (2013-2017)

Int J Environ Res Public Health. 2021 Jul 22;18(15):7781.

Akash Patel, Jana L Hirschtick, Steven Cook, Bukola Usidame, Ritesh Mistry, David T Levy, Rafael Meza, Nancy L Fleischer





Exploring How Exposure to Truth and State-Sponsored Anti-Tobacco Media Campaigns Affect Smoking Disparities among Young Adults Using a National Longitudinal Dataset, 2002-2017


A Cluster Analysis of Risk Factors for Cancer across EU Countries: Health Policy Recommendations for Prevention



Note: Open Access.


"Results indicate that e-cigarette use was not helpful for quitting or reducing combustible cigarette use in the 30 s [in the Seattle Social Development Project (SSDP)]. Rather, across extensive tests of moderation, e-cig initiation consistently predicted less quitting during this important age period for successful cessation."


The role of electronic cigarette use for quitting or reducing combustible cigarette use in the 30s: Longitudinal changes and moderated relationships

Drug Alcohol Depend. 2021 Jul 28;227:108940. Online ahead of print.

Rick Kosterman, Marina Epstein, Jennifer A Bailey, Madeline Furlong, J David Hawkins



"Previous research has demonstrated a negative relationship between health literacy [HL] and conventional cigarette (CIG) use. However, the relationship between health literacy and e-cigarette (ECIG) use remains unclear… After adjusting for covariates, higher levels of oral health literacy was associated with lower odds of current dual use. However, there was no significant association between written HL and either conventional cigarette use or electronic cigarette use or after adjusting for covariates. Oral messaging around the dangers of CIG use may be effective at lowering odds of CIG or dual use, especially for those with higher levels of HL."


The Association Between Health Literacy and Tobacco Use: Results from a Nationally Representative Survey

J Community Health. 2021 Aug 6. Online ahead of print.

James S Clifford, Juan Lu, Courtney T Blondino, Elizabeth K Do, Elizabeth C Prom-Wormley



"Tobacco/nicotine prevention in early adolescence has implications for preventing tobacco/nicotine-related harms during pregnancy among young adults. Intervention programs and clinicians informed about various types of tobacco/nicotine are needed to address tobacco/nicotine cessation among adolescents to prevent consequences of tobacco/nicotine use during pregnancy."


An examination of how e-cigarette/cigarette use during adolescence is associated with future use during the third trimester of pregnancy

Subst Abus. 2021 Aug 6;1-5. Online ahead of print.

Dana C Beck, Carol J Boyd, Rebecca Evans-Polce, Sean Esteban McCabe, Phil T Veliz 



"Otolaryngology residents have not received formal education in e-cigarettes and are not confident discussing e-cigarettes with their patients. This highlights the need for e-cigarette education during otolaryngology residency to improve patient e-cigarette counseling."


Otolaryngology Resident Education and Perceptions of e-cigarettes

Ann Otol Rhinol Laryngol. 2021 Aug 7;34894211037415. Online ahead of print.

Elliot Y Koo, Vivian Jin, Heather M Weinreich, Barry L Wenig



"For one of the suggested key regions for addiction, the amygdala, we observed significantly stronger brain responses to the valence aspect of the presented images than to the craving aspect. Our results emphasize the need for carefully selecting stimulus material for cue-reactivity paradigms, in particular with respect to emotional valence. Further, they can help designing future research on teasing apart the diverse psychological dimensions that comprise nicotine dependence and, therefore, can lead to a more precise mapping of craving-associated brain areas, an important step towards more tailored smoking cessation treatments."


Disentangling craving- and valence-related brain responses to smoking cues in individuals with nicotine use disorder

Addict Biol. 2021 Aug 7;e13083. Online ahead of print.

Amelie Haugg, Andrei Manoliu, Ronald Sladky, Lea M Hulka, Matthias Kirschner, Annette B Brühl, Erich Seifritz, Boris B Quednow, Marcus Herdener, Frank Scharnowski


Note: Open Access.


"The world is witnessing a global epidemic of lung cancer in women. Cigarette smoking remains the dominant risk factor in both sexes, but multiple observations suggest that important sex-related distinctions in lung cancer exist. These include differences in histologic distribution, prevalence in never-smokers, frequency of activating EGFR mutations, likelihood of DNA adduct accumulation, and survival outcomes... A deeper understanding of sex-related differences in lung cancer may lead to improved outcomes for both women and men."


Women and Lung Cancer

Clin Chest Med. 2021 Sep;42(3):467-482.

Lynn T Tanoue



"With the proposed previous conditioning of used cigarette butts (cleaning and drying them), the new prepared samples keep high absorption coefficient values for medium and high frequencies, showing their potential application as acoustic absorbers. In any case, further studies related to the different influences on absorption—for instance, of density or thickness—and the possibility of the establishment of a standard method for preparing large samples would be desirable."


Initial Conditioning of Used Cigarette Filters for Their Recycling as Acoustical Absorber Materials

Materials (Basel). 2021 Jul 27;14(15):4161.

Valentín Gómez Escobar, Celia Moreno González, María José Arévalo Caballero, Ana Mᵃ Gata Jaramillo


Note: Open Access.


"Exposure to tobacco smoke toxicants either through smoking or environmental tobacco smoke is a major health issue. The present investigation revealed toxic interactions of nicotine and cadmium in A549 lung cancer cells that remained minimal after a single exposure. However, individual toxicity levels remained unaltered and suggest that different constituents of tobacco smoke may interact minimally but contribute significantly to overall toxic effects, for example targeting different organs, cells, or cell organelles. This is the reason why the health effects of tobacco smoke are very complex and it remains a major preventable cause of mortality and morbidity in millions worldwide."


Toxicological interaction between tobacco smoke toxicants cadmium and nicotine: An in-vitro investigation

Saudi J Biol Sci. 2021 Aug;28(8):4201-4209. Epub 2021 May 11.

Wajhul Qamar, Mohammad A Altamimi, Muneeb U Rehman, Nemat Ali, Faisal Imam, Fawaz Essa Alanazi


Note: Open Access.


"Political will differs according to ministerial mandates and priorities, fostering a fragmented policy approach and undermining the development of a coherent response. Without political will from the president or national parliament to create an overarching framework for tobacco control, either via ratification of the Framework Convention on Tobacco Control or another mechanism, there remains no formal impetus for intragovernmental cooperation."


Policy incoherence and tobacco control in Indonesia: an analysis of the national tobacco-related policy mix

Tob Control. 2021 Aug 6;tobaccocontrol-2021-056633. Online ahead of print.

Elisabeth Kramer, Abdillah Ahsan, Vaughan W Rees



"The study population ranged from 618 957 individuals in 2010 to 498 812 in 2018. An estimated average increase in ED [emergency department] visits for asthma in infants aged 0-1 years of 0.42 per 100 individuals (95% CI: 0.09 to 0.75) and a 57% relative increase corresponding to the 2015 SFOA was observed. A significant decrease in ED visits for asthma-related conditions of 0.19 per 100 individuals (95% CI: -0.37 to -0.01) and a 22% relative decrease corresponding to the 2015 SFOA [Smoke-Free Ontario Act] was observed. Conclusion: Based on the observed positive effect of restricting smoking on patios, playgrounds and sports fields on respiratory morbidity in children with asthma, other jurisdictions globally should consider implementing similar smoke-free policies."


Effect of smoke-free legislation on respiratory health services use in children with asthma: a population-based open cohort study in Ontario, Canada

BMJ Open. 2021 Aug 5;11(8):e048137.

Teresa To, Ivy Fong, Jingqin Zhu, Rachel McGihon, Kimball Zhang, Emilie Terebessy



Note: Open Access.


Tobacco industry capitalises on the COVID-19 pandemic

Lancet Respir Med. 2021 Jul 29;S2213-2600(21)00361-1. Online ahead of print.

Talha Khan Burki


Note: Open Access.


"Our study reveals that the amount of smoking causally and positively influences the risk of COVID-19 severity, presumably due to reduced lung function caused by smoking of the tobacco, which is proportional to cigarette pack-years. However, the binary defined smoking status does not show any effect on susceptibility to COVID-19 or its severity. This inconsistency may reflect a balanced effect of possible protective effects of cigarette smoking as such, including intermittent ones, on susceptibility to COVID-19 and the extent of smoking-related lung damage which is evident in heavy smokers. Our study suggests that heavy smokers have an increased risk for the development of severe outcomes after the SARS-CoV-2 infection."


Letter to the Editor

Smoking quantitatively increases risk for COVID-19

Eur Respir J. 2021 Jul 29;2101273. Online ahead of print.

Fuquan Zhang, Ancha Baranova


Note: Open Access.


"The protocol outlines principles governing research funding, including requirements that universities develop criteria for accepting research funding and “normally reveal the source of funds for research.” Yet even for tobacco, university policies are typically underspecified. Minimalist assertions that a university “does not accept research funding from the tobacco industry” leave many unanswered questions. Do existing policies preclude funding from initiatives like the Foundation for a Smoke-Free World, which supplies grants of $80m (£58m; €68m) a year based on revenue from cigarette giant Philip Morris? Do they apply to manufacturers of e-cigarettes and other nicotine devices, or only when these are owned by tobacco companies? Does rejection of funding extend to philanthropic donations or teaching support through scholarships or placements?"



Conflicted and confused? Health harming industries and research funding in leading UK universities

BMJ 2021;374:n1657 (Published 27 July 2021)

Jeff Collin, Alex Wright, Sarah Hill, Kat Smith



"This analysis contributes to advancing the nascent literature on predictors of electronic nicotine product (ENP) cessation, which can guide the development of ENP cessation interventions by indicating which populations, psychosocial and environmental constructs and co-occurring behaviors interventions should target. This research also highlights the importance of considering cigarette smoking status when designing ENP cessation interventions and defining intervention outcomes."


Electronic nicotine product cessation and cigarette smoking: analysis of waves 3 and 4 from the PATH study

Nicotine & Tobacco Research, ntab155.

Published: 27 July 2021

Nandita Krishnan, Lorien C Abroms, Carla J Berg





Multiethnic Prediction of Nicotine Biomarkers and Association With Nicotine Dependence


Note: Biomarkers paper Open Access.


"24.2% of e-cigarette users (and 57.6% of non-users) supported (strongly/somewhat) sales restrictions on flavored vape products; 15.1% of e-cigarette users (45.1% of non-users) supported complete vape product sales restrictions. If restricted to tobacco flavors, 39.1% of e-cigarette users reported being likely (very/somewhat) to continue using e-cigarettes (30.5% not at all likely); 33.2% were likely to switch to cigarettes (45.5% not at all)… Conclusions: While lower-risk users may be more positively impacted by such policies, other young adult user subgroups may not experience benefit."


Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US

Nicotine Tob Res. 2021 Jul 31;ntab154. Online ahead of print.

Heather Posner, Katelyn Romm, Lisa Henriksen, Debra Bernat, Carla J Berg



"Results showed that exposure to IQOS produced smoking urge and behavior in young adult smokers, implicating IQOS use as a smoking and vaping cue. As HTPs [heated tobacco products] gain popularity, product impact on passive observers should be included in their risk-benefit profile."


Effects of Visual Exposure to IQOS Use on Smoking Urge and Behavior

Tob Regul Sci. 2021 Jan;7(1):31-45.

Emma I Brett, Krista Miloslavich, Ashley Vena, Nathan Didier, Andrea C King 


Note: Open Access.


"There was an increase in current ENDS [electronic nicotine delivery systems] use prevalence from 2014–2015 (3.4%) to 2018–2019 (5.4%). The presence of a tax on ENDS products was significantly associated with reduced current ENDS use (adjusted OR (AOR)=0.64, 95% CI=0.43 to 0.95). Importantly, respondents living in states with the policy showed significantly lower increase in ENDS use prevalence during the study period (interaction between within-state changes and between-state differences: AOR=0.57, 95% CI=0.35 to 0.91), controlling for other state-level policies and sociodemographic characteristics."


Statewide vaping product excise tax policy and use of electronic nicotine delivery systems among US young adults, 2014–2019

Tobacco Control Published Online First: 29 July 2021.

Dae-Hee Han, Dong-Chul Seo, Hsien-Chang Lin





Evolving chemical landscape of e-cigarettes, 2021         


Responses to pictorial versus text-only cigarillo warnings among a nationally representative sample of US young adults


Association of cigarette production and tobacco retailer density on secondhand smoke exposure in urban China


Note: Retailer density in China paper Open Access.


"A final sample of 808 e-cigarette/vaping-related videos that met study criteria were included. Collectively, these videos were viewed over 1.5 billion times, with a median view count of 1 000 000 (range 112 900–78 600 000) and a median ‘likes’ count of 143 000 (range 10 000–1 000 000). A majority of the videos portrayed e-cigarette use positively (63%; collectively viewed over 1.1 billion times). Neutral depictions of e-cigarette use were viewed a total of 290 million times (24%) and negative depictions of e-cigarettes were viewed a total of 193 million times (13%)."


Vaping on TikTok: a systematic thematic analysis

Tobacco Control Published Online First: 26 July 2021.

Tianze Sun, Carmen C.W. Lim, Jack Chung, Brandon Cheng, Lily Davidson, Calvert Tisdale, Janni Leung, Coral E Gartner, Jason Connor, Wayne D Hall, Gary C.K. Chan



"The implementation of standardised packaging was associated with a significant step reduction in the odds of being a smoker after May 2017 (OR: 0.93; 95% CI 0.87 to 0.99). The magnitude of the association was similar when modelling the step change in May 2016 at the start of the 1-year policy implementation period (OR: 0.90; 95% CI: 0.83 to 0.97)."


Was the implementation of standardised tobacco packaging legislation in England associated with changes in smoking prevalence? A segmented regression analysis between 2006 and 2019

Tobacco Control Published Online First: 29 July 2021.

Magdalena Opazo Breton, John Britton, Jamie Brown, Emma Beard, Ilze Bogdanovica



"The menthol ban [in Ontario, Canada] aided some menthol smokers to quit, while others reported the ban did not play a role in smoking cessation. These data suggest the menthol ban had direct and indirect effects on smoking reduction behavior. Campaigns supporting similar bans that target both types of effects will likely be most effective for smoking reduction."


Smoking cessation strategies used by former menthol cigarette smokers after a menthol ban

Addictive Behaviors

Volume 123, December 2021, 107046

Available online 13 July 2021.

Eric K. Soule, Jolene Dubray, Joanna E. Cohen, Robert Schwartz, Michael Chaiton



"Over three quarters (77.3%) of students reported a quit attempt and half of them (50.1%) reported quit success. Prevalence rates of quit success and quit attempts, showed relatively small variations between schools within countries. Associations of smoke-free school policy, tobacco educational programmes and cessation programmes with quit attempts and quit success could not be demonstrated with statistical significance. Quit attempts and quit success were inversely associated with alcohol use, parental smoking, and friend smoking."


Smoking cessation among adolescents in Europe: The role of school policy and programmes

Drug Alcohol Depend. 2021 Jul 28;227:108945. Online ahead of print.

Aukje E J Mertens, Anton E Kunst, Vincent Lorant, Joana Alves, Arja Rimpelä, Luke Clancy, Mirte A G Kuipers



"The adjusted median overall survival time was 21.6 months higher among patients who had quit smoking than those who continued smoking (6.6 vs. 4.8 years, respectively; P = 0.001). Higher 5-year overall survival (60.6% vs. 48.6%; P = 0.001) and progression-free survival (54.4% vs. 43.8%; P = 0.004) were observed among patients who quit than those who continued smoking. After adjustments, smoking cessation remained associated with decreased risk for all-cause mortality (HR, 0.67 [95% CI, 0.53 to 0.85]), cancer-specific mortality (HR, 0.75 [CI, 0.58 to 0.98]), and disease progression (HR, 0.70 [CI, 0.56 to 0.89])… Conclusion: Smoking cessation after diagnosis materially improved overall and progression-free survival among current smokers with early-stage lung cancer."


Postdiagnosis Smoking Cessation and Reduced Risk for Lung Cancer Progression and Mortality

A Prospective Cohort Study

Annals of Internal Medicine

July 27, 2021

Mahdi Sheikh, Anush Mukeriya, Oxana Shangina, Paul Brennan, David Zaridze



Related Ann Int Med Editorial:


Treating Tobacco Smoking After the Diagnosis of Lung Cancer: It's Not Too Late and a Call to Action



Related PR:


Quitting smoking after lung cancer diagnosis may extend life without cancer recurrence



"Using data from the China Health and Nutrition Survey (CHNS), we examine the association between smoking cessation and body weight in China… We find that smoking cessation is associated with a modest increase in weight (0.329 kg, 0.51 % off the mean) and no significant changes in the prevalence of overweight or obesity."


Smoking cessation and weight gain: Evidence from China

Econ Hum Biol. 2021 Jul 16;43:101045. Online ahead of print.

Kevin Callison, Cuiping Schiman, Jeffrey C Schiman



"We followed 45 923 never-smoking women, aged 34-70 years, who completed a baseline questionnaire between 1991 and 2007 through linkages to national registries through December 2018… Our results suggest that 1 in 14 breast-cancer cases [in Norway] could have been avoided in the absence of SHS [secondhand smoke] exposure from parents during childhood in a population of never-smoking women. The cancer burden attributable to SHS may be underestimated."


Never-smokers and the fraction of breast cancer attributable to second-hand smoke from parents during childhood: the Norwegian Women and Cancer Study 1991-2018

Int J Epidemiol. 2021 Aug 1;dyab153. Online ahead of print.

Inger T Gram, Arne Bastian Wiik, Eiliv Lund, Idlir Licaj, Tonje Braaten


Note: Open Access.


"Our study identified 9,096,788 births between 2004 and 2014. Of which, 443,590 (4.8%) had a documented diagnosis of smoking. A significantly higher risk was found for PTB [preterm birth] (odds ratio 1.39, CI 1.35-1.43), preterm premature rupture of membranes (odds ratio 1.52, CI 1.43-1.62) and small for gestational age (SGA) neonates (odds ratio 2.27, CI 2.19-2.35)… Conclusions: This large database confirms the findings of previous smaller studies, according to which smoking decreases the risk of preeclampsia while increasing the risk of PTB and SGA neonates. The current study also revealed a decreased risk for PPH [post partum hemorrhage] as well as for chorioamnionitis among pregnant smokers."


The relation between cigarette smoking with delivery outcomes. An evaluation of a database of more than nine million deliveries

J Perinat Med. 2021 Jul 30. Online ahead of print.

Ido Feferkorn, Ahmad Badeghiesh, Haitham Baghlaf, Michael H Dahan



"SHSE [secondhand smoke exposure] was associated with higher odds of dyslipidemia with higher odds among women and old adults. Primary intervention(s) targeted at reducing SHSE may show benefits in reducing the odds of dyslipidemia, and longitudinal studies would be necessary to clarify the association between SHSE and dyslipidemia."


Secondhand smoke exposure and dyslipidemia among non-smoking adults in the United States

Indoor Air. 2021 Jul 30. Online ahead of print.

Akinkunmi Paul Okekunle, Jeffery Osahon Asowata, Babatunde Adedokun, Onoja Matthew Akpa






Rassegna Stampa Scientifica Gennaio 2023





“[Hockey star Mike] Bossy’s cancer was already at Stage 4 (the worst) when he was diagnosed and he died six months later [at 65]… Bossy was a heavy smoker during his playing days with the [New York] Islanders, something that was common with pro athletes during the 1970s and ’80s. The Islanders actually had a “smoking section” in the corner of their locker room. [Montreal] Canadiens Hall of Famer Guy Lafleur was also a heavy smoker and he also died from lung cancer last April — seven days after Bossy — at age 70… “It’s not a patient’s fault,” said [medical oncologist Stephanie] Snow... “It’s the tobacco companies’ fault for creating such an addictive thing as the cigarette. We should never judge patients. All cancer patients deserve to be treated with compassion and with good care. Our lung cancer patients really do face a lot of this stigma and they internalize it … they feel a lot of guilt. We should treat them no differently than a patient with a different kind of cancer. We’re trying to remove that stigma.”” [Stu Cowan. Mike Bossy's family takes up battle against lung cancer, Montreal Gazette]


“R.J. Reynolds has wasted no time since California’s ban on flavored tobacco went into effect in late December. “California, We’ve Got You Covered,” the company declared in bold letters on a flier mailed to its cigarette customers. The law prohibits flavors, odors or “tastes” in tobacco products, including menthol cigarettes. But antismoking experts argue that R.J. Reynolds, the maker of Camel and Newport brands, is trying to circumvent the ban by luring smokers with a suite of what it says are new non-menthol versions offering “a taste that satisfies the senses” and “a new fresh twist.”… To public health authorities, the potential reduction in smoking rates from a menthol ban could extend the length and quality of millions of lives. To R.J. Reynolds and other tobacco companies, the loss of sales from menthol cigarettes could be financially damaging…


“Dr. Robert Jackler, a professor at Stanford Medicine who provided the ads to The New York Times, called the new marketing “outrageous.” “The thing that surprises me is there’s no camouflage,” said Dr. Jackler, who received the mailers along with staff members of Stanford’s program on tobacco advertising. “They’re saying, ‘This is our menthol replacement. And by the way — wink, wink — it is not really menthol.’” [Christina Jewett, Emily Baumgaertner. R.J. Reynolds Pivots to New Cigarette Pitches as Flavor Ban Takes Effect, NY Times. Note: Full text available upon request if paywalled. See also: HERE ARE THE DECEPTIVE WAYS CIGARETTE COMPANIES ARE GETTING AROUND CALIFORNIA’S FLAVORED TOBACCO BAN, L.A. Taco]


"E-cigarette use in children and young people is a new and serious public health challenge. A bold review of the regulation of e-cigarettes, making it similar to successful smoking legislation, may prevent a further rise in use among young people, many of whom would otherwise never have smoked. Measures that regard vaping in the same way as smoking should be supported, along with bans on flavourings and designs targeted at children and young people. Advertising for vaping products should be controlled in public places and across social media platforms... The current UK policy promotes vaping for smokers at the expense of the health of children and young people, who are now more likely to be exposed to a lifetime of inhaled nicotine and vape fluid. Without legislation similar to the tobacco control that led to reduced smoking rates over the past 50 years, harm among children and young people will only increase."



Protecting children from harms of vaping

BMJ 2022;379:e073824 (Published 16 December 2022)

Kenneth Macleod, Andy Bush, Jonathan Coutts, Ross Langley







Rassegna Stampa Scientifica Settembre 2021




Association between electronic nicotine delivery systems and electronic non-nicotine delivery systems with initiation of tobacco use in individuals aged < 20 years. A systematic review and meta-analysis


Published: September 8, 2021

Sze Lin Yoong ,Alix Hall,Heidi Turon,Emily Stockings,Alecia Leonard,Alice Grady,Flora Tzelepis,John Wiggers,Hebe Gouda,Ranti Fayokun,Alison Commar,Vinayak M. Prasad,Luke Wolfenden


Note: Open Access.


Related coverage:


"Serene Yoong, an associate professor at Swinburne University of Technology in Melbourne and the study’s lead author, said the findings pointed to the need for youth prevention programs and better regulation of e-cigarette products. “Every single study showed an association between [e-cigarette] use among non-smokers and increased use of cigarettes at follow-up,” she said… “Experimenting is not as benign as people might think in terms leading to later cigarette use,” Yoong said."


International research shows ‘strong evidence’ linking vaping to cigarette smoking



"Collagen-induced aggregation was higher in vapers compared to non-smokers (non-smokers 52.55 ± 23.97 vs. vapers 66.63 ± 18.96 AUC [area under the curve], p = 0.002) and to smokers (vapers vs. smokers 49.50 ± 26.05 AUC, p < 0.0001)… This study provides first evidence that vaping leads to enhanced platelet reactivity compared to standard smoking and non-smoking. This suggests health effects of vaping might be more severe than previously assumed."


Platelet reactivity is higher in e-cigarette vaping as compared to traditional smoking

Int J Cardiol. 2021 Sep 7;S0167-5273(21)01325-5. Online ahead of print.

Daniel Metzen, René M'Pembele, Saif Zako, Philipp Mourikis, Carolin Helten, Dorothee Zikeli, Samantha Ahlbrecht, Denis Ignatov, Aysel Ayhan, Ragnar Huhn, Tobias Zeus, Bodo Levkau, Tobias Petzold, Malte Kelm, Lisa Dannenberg, Amin Polzin 



"268 experts were contacted, 92 (34%) completed the first, 55/92 (60%) the second round. Consensus for ENDS [electronic nicotine delivery systems]: components of e-liquids, an upper limit of nicotine concentration should be defined; a warning on the lack of evidence in long-term safety and addiction potential should be stated; ENDS should not be regulated as consumer products but either as a new category of nicotine delivery or tobacco products; ENDS should not be sold in general stores but in specialised shops, shops selling tobacco or in pharmacies with restriction on sale to minors; administration of illegal drugs is likely with ENDS."


International expert consensus on electronic nicotine delivery systems and heated tobacco products: a Delphi survey

BMJ Open 2021;11:e045724.

Online issue publication September 07, 2021

Ivan Berlin, Isabelle Jacot-Sadowski, Jean-Paul Humair, Jacques Cornuz


Note: Open Access.


"As cannabis becomes increasingly integrated as part of a ‘wellness’ platform by multinational tobacco companies, questions continue about the suitability of having Big Tobacco—the producers of addictive and harmful products with a documented history of deceit and intentional marketing to vulnerable populations—oversee a supposed mission of ‘harm reduction’. The expansion of drugs that become fast-moving consumer products, sold by major and powerful global companies, needs careful evaluation. While tobacco industry denormalisation is regarded as an effective tobacco control intervention,29 tobacco companies are counteracting such measures and seeking to improve their corporate reputation by becoming associated with more legitimised and socially acceptable products."


‘Beyond nicotine’ marketing strategies: Big Tobacco diversification into the vaping and cannabis product sectors

Tobacco Control Published Online First: 12 September 2021

Timothy Dewhirst





Interplay of food and tobacco product descriptors and health claims


Note: Interplay Editorial Open Access.


"When considering their US pack, approximately two-thirds of smokers had a low (31.5%) to medium (34.6%) positive response (reactivity=1.29; polarity=0.14) with expressed feelings of joy and trust. Blank packaging prompted a largely (65.4%) neutral response (reactivity=0.03; polarity=0.00). The gangrenous foot GWL [graphic warning label] provoked mostly medium (46.9%) to high (48.1%) negative responses (reactivity=−2.44; polarity=−0.20), followed by neonatal baby (reactivity=−1.85; polarity=−0.10) and throat cancer (reactivity=−1.76; polarity=−0.08) warnings. GWLs varied in their elicitation of disgust, anger, fear and sadness."


Role of affective reactivity induced by cigarette packaging including graphic warning labels: the CASA Study

Tobacco Control Published Online First: 12 September 2021.

Matthew Stone, David Strong, Claudiu Dimofte, Elizabeth Brighton, Jesica Oratowski, Tingyi Yang, Manar Alkuzweny, Atean Asslani, Katherine Velasco, Michael Skipworth, Noe C Crespo, Samantha Hurst, Eric C Leas, Kim Pulvers, John P Pierce



"The results showed that both emotion dysregulation and negative affect had indirect effects on urge to smoke via positive metacognitions about smoking as well as on nicotine dependence via negative metacognitions about smoking. The findings suggest that metacognitions about smoking have different roles in different patterns of nicotine use so that positive and negative metacognitions have important roles respectively in urge to smoke and nicotine dependence in smokers with high emotion dysregulation and negative affect."


The effects of emotion dysregulation and negative affect on urge to smoke and nicotine dependence: The different roles of metacognitions about smoking

Addict Behav. 2021 Sep 3;124:107108. Online ahead of print.

Hossein Poormahdy, Mahmoud Najafi, Vahid Khosravani



"This review provides a practical inspection of the current, international regulatory recommendations for abuse liability assessment of tobacco, regulatory review of such information within the U.S., and recommends study designs and methods for abuse liability testing of tobacco products based on scientific and regulatory knowledge."


Human Abuse Liability Assessment of Tobacco and Nicotine Products: Approaches for Meeting Current Regulatory Recommendations

Nicotine & Tobacco Research, ntab183.

Published: 09 September 2021

Andrea Vansickel, Sarah Baxter, Neil Sherwood, Michael Kong, Leanne Campbell





New Zealand Smokers’ Perceptions of Tobacco Endgame Measures: A Qualitative Analysis



"Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU [Intensive Care Unit] admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients."


Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity

Int J Environ Res Public Health. 2021 Aug 25;18(17):8939.

E Melinda Mahabee-Gittens, Angelico Mendy, Ashley L Merianos





Tobacco Craving, Nicotine Dependence, and Quit Intentions among LGB and Non-LGB High School Students: A Quasi-Experimental Analysis


Theory-Based Social and Non-Social Engagement Features in Smoking Cessation Mobile Apps: A Content Analysis


Feasibility of a Smoking Cessation Smartphone App (Quit with US) for Young Adult Smokers: A Single Arm, Pre-Post Study


Smoking Cessation Messages for Pregnant Aboriginal and Torres Strait Islander Women: A Rapid Review of Peer-Reviewed Literature and Assessment of Research Translation of Media Content


Note: Open Access.


"This study uses regional-level panel data from the Monitoring the Future survey and a fixed effects model to estimate the effect of perceived risk on three regional measurements of smoking behavior: consumption, lifetime prevalence, and daily smoking prevalence. Elasticity measurements at regional levels show that an increase in perceived risk decreases these regional measurements of smoking behavior. Moreover, the results show that, at regional levels, these measurements of smoking behavior are more responsive to changes in the perceived risk associated with smoking than to changes in the price of cigarettes."


Regional Effects of Perceived Risks of Harm on Cigarette Smoking among U.S. High School Seniors: Evidence from Monitoring the Future

Int J Environ Res Public Health. 2021 Aug 29;18(17):9120.

Jorge Medina





Parenting Styles as a Moderator of the Association between Pubertal Timing and Chinese Adolescents' Smoking Behavior


Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009-2018


Association between Self-Reported Survey Measures and Biomarkers of Second-Hand Tobacco Smoke Exposure in Non-Smoking Pregnant Women


Implementation of the Department of Housing and Urban Development's Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions


Note: Open Access.


Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

Tobacco Control Published Online First: 02 September 2021.

David T Levy, Rafael Meza, Zhe Yuan, Yameng Li, Christopher Cadham, Maria Sanchez-Romero, Nargiz Travis1, Marie Knoll, Alex C Liber, Ritesh Mistry, Jana L Hirschtick, Nancy L Fleischer, Sarah Skolnick, Andrew F Brouwer, Cliff Douglas, Jihyoun Jeon, Steven Cook, Kenneth E Warner



Related PR:


Menthol ban would save 650,000 lives in the next 40 years



"Roughly 14 % of students in the [Healthy Minds Survey] sample reported psychotic experiences over the past year, and around 14–15 % of students reported vaping over the past month. In multiple logistic regression models, vaping was significantly associated with psychotic experiences (aOR 1.88; 95 % CI: 1.63–2.18). This association attenuated but remained statistically significant even after adjusting for any cigarette use and marijuana use, and after adjusting for depression and anxiety."


Vaping and psychotic experiences among college students in the United States

Drug and Alcohol Dependence

Volume 227, 1 October 2021, 108987

Available online 1 September 2021.

Hans Oh, Rachel Banawa, Jungeun Olivia Lee, Sasha Zhou, Jimi Huh



Related coverage:


Vaping ‘significantly’ associated with psychotic experiences in U.S. college students: study



"Applying a continuous treatment difference-in-differences approach to data from two large national datasets (Monitoring the Future and the Youth Risk Behavior Surveillance System), this study explores the impact of ENDS [electronic nicotine delivery systems] taxes on youth tobacco use. We find that ENDS taxes reduce youth e-cigarette consumption, with estimated e-cigarette tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax elasticities, suggesting economic substitution between cigarettes and e-cigarettes for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may more than fully offset any public health gains."


Intended and Unintended Effects of E-cigarette Taxes on Youth Tobacco Use


ISSUE DATE September 2021

Rahi Abouk, Charles J. Courtemanche, Dhaval M. Dave, Bo Feng, Abigail S. Friedman, Johanna Catherine Maclean, Michael F. Pesko, Joseph J. Sabia & Samuel Safford



"The most common first-flavor [in a young adult cohort from Los Angeles, California] was sweet (71%); the most common first-device was a vape pen (37%), then Juul (22%). First-flavor of mint/menthol (vs. other; adjusted odds ratio [AOR]: 2.22[95%CI=1.16-4.25]), and first-device mod (AOR=2.40[95%CI=1.34-4.31]) and non-Juul pod (2.64[95% CI=1.41-4.92]) (vs. pen) were associated with past-30-day vaping, and twice as many vaping days (ARRs [Adjusted rate ratios] range: 1.96-2.12;ps<0.05). First flavor of mint/menthol (vs. other; AOR: 1.95[95% CI=1.003-3.79) and first device mod, box, non-juul pod and other (AORs range: 2.36-4.01;ps<0.05) were associated with nicotine dependence."


First e-cigarette flavor and device type used: Associations with vaping persistence, frequency, and dependence in young adults

Nicotine & Tobacco Research, ntab172.

Published: 30 August 2021

James D Sargent, Mike Stoolmiller, Hongying Dai, Jessica L Barrington-Trimis, PhD, Rob McConnell, Janet Audrain-McGovern, Adam M Leventhal





Stability of varenicline concentration in saliva over twenty-one days at three storage temperatures


What do people want in a smoking cessation app? An analysis of user reviews and app quality


Newspaper coverage of snus in an emerging Norwegian snus market 2002-2011: A content analysis



"Given the significant prevalence of e-cigarettes use and their pulmonary complications, EVALI [e-cigarette/Vaping-associated lung injury] should be considered a potential etiology in the broad differential diagnosis of patients with pulmonary disease and a history of vaping. Herein, we present a case of cryptogenic organizing pneumonia with a chest C.T. [computerized tomography] showing a crazy-paving pattern in a patient with a history of vaping."



Crazy vaping and crazy-paving, a case of E-Cigarette/Vaping-Associated Lung Injury (EVALI) with chest CT showing crazy-paving pattern

Radiol Case Rep. 2021 Aug 26;16(11):3208-3212. eCollection 2021 Nov.

Sherif Roman, Christopher Millet, Shady Geris, Rajapriya Manickam, Ashesha Mechineni


Note: Open Access.


"In this sample of MTurk [Mechanical Turk] workers, young adults with experience in vaping were more demographically and psychologically vulnerable than young adults with no experience in vaping. Young adults interested in vaping, but without prior experience, were less conscientious than their non-interested peers. Interventions to target vaping use should focus on economically disadvantaged young adults and those lower in conscientiousness."


Psychological and Demographic Predictors of Vaping and Vaping Susceptibility in Young Adults

Front Psychol. 2021 Aug 17;12:659206. eCollection 2021.

Grace E Teah, Tamlin S Conner





Pictures Library of Smoking Cravings: Development and Verification of Smokers and Non-smokers


Note: Open Access.


"The majority of vapers succeeded in maintaining their vaping behavior as usual, highly likely due to (illegally) buying consumables online. Nevertheless, for a minority the lockdown period resulted in unintended consequences and these vapers relapsed (completely) to smoking. Even during periods of lockdown, smokers and vapers should be able to purchase low(er)-risk alternatives to smoking, for example e-cigarettes."


Vaping during the COVID-19 lockdown period in Belgium

BMC Public Health. 2021 Sep 3;21(1):1613.

Karolien Adriaens, Dinska Van Gucht, Sven Van Lommel, Frank Baeyens


Note: Open Access.


"The results suggest that COVID-19-related warnings elicit a similar level of negative emotional arousal, relative to traditional warnings. However, COVID-19 warnings, specifically, elicit especially strong emotional responses in less impulsive smokers, who report low delay discounting. Therefore, there is preliminary evidence supporting COVID-19 related warnings for tobacco products to aid smoking cessation."


Smokers’ Affective Responses to COVID-19-Related Health Warnings on Cigarette Packets: The Influence of Delay Discounting

Nicotine & Tobacco Research, ntab176,

Published: 01 September 2021

Chris R H Brown, Paul Faulkner





Claims of reduced odor on tobacco packs in low- and middle-income countries


Absolute and Relative Smokeless Tobacco Product Risk Perceptions: Developing and Validating New Measures that are Up-to-Snuff


Note: Open Access.


"Twenty-six cohort and one case-control study were included in the final meta-analysis. We found elevated pooled risks of tobacco smoking initiation [RR = 2.08, (95 % CI: 1.18–3.68)], ever tobacco smoking [RR = 1.21, (95 % CI: 1.05–1.38)], current tobacco smoking [RR = 1.70, (95 % CI: 1.48–1.95)] and tobacco dependence [RR = 1.50, (95 % CI: 1.31–1.73)] in offspring exposed to maternal prenatal tobacco use compared to non-exposed."





Rassegna Stampa Scientifica Dicembre 2021




Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study

American Journal of Preventive Medicine

Published: November 30, 2021

Omar El-Shahawy, Tanmik Shah, Olufunmilayo H. Obisesan, Meghan Durr, Andrew C. Stokes, Iftekhar Uddin, Ria Pinjani, Emelia J. Benjamin, Mohammadhassan Mirbolouk, Albert D. Osei, Tom Loney, Scott E. Sherman, Michael J. Blaha




Note: Open Access.


Related coverage:


E-cigarettes may be independently linked to erectile dysfunction, new research finds


Men who vape are twice as likely to have erectile dysfunction: study


Men who use e-cigarettes are more than twice as likely to suffer erectile dysfunction than non-smokers, study finds



"Soon after FDA’s [Food & Drug Administration's] January 2020 announcement of prioritized enforcement against flavored pod/cartridge-based e-cigarettes and during the pandemic lockdown, adolescents’ and young adults’ past 30-day use included mostly flavored disposables rather than pod/cartridge-based e-cigarettes, mint/menthol flavors, and some used add-on flavor enhancers. To reduce youth use, comprehensive regulation of e-cigarette devices and flavors should be enacted and enforced at federal, state, and local levels."


E-cigarette devices, brands, and flavors attract youth: Informing FDA's policies and priorities to close critical gaps

Addictive Behaviors

Volume 126, March 2022, 107179

Available online 14 November 2021.

Shivani Mathur Gaiha, Lauren Kass Lempert, Karma McKelvey, Bonnie Halpern-Felsher



Related PR:


Whack-a-mole vaping policies do not protect youth, Stanford Medicine study shows



"This investigation highlighted that, unhealthy behaviors, particularly e-cigarette use, cigarette smoking, and excessive use of screens, tend to co-occur among Canadian adolescents. Therefore, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously particularly in school and community settings. As an exception, new and stable e-cigarette use appears to co-occur with achieving sufficient levels of physical activity. Increasing awareness about the risk of e-cigarette use may target population groups that are physically and socially active (e.g., athletes, sport teams)."


Longitudinal associations between e-cigarette use, cigarette smoking, physical activity and recreational screen time in Canadian adolescents

Nicotine & Tobacco Research, ntab248.

Published: 28 November 2021

Dylan S Irvine, Ellen McGarity-Shipley, Eun-Young Lee, Ian Janssen, Scott T Leatherdale





Trajectories of Nicotine Use Leading to Dual and Cyclical Tobacco Product Use in Young Adults



"Over half (53.6%) of students were exclusive e-cigarette users, 20.4% were dual e-cigarette and combustible cigarette users, 4.6% were dual e-cigarette and cigar users, and 21.4% were poly users of e-cigarettes, combustible cigarettes, and cigars. Compared to exclusive e-cigarette users, dual users of e-cigarettes and combustible cigarettes (AOR=2.12, 95%CI=1.05–4.27) and poly users of e-cigarettes, combustible cigarettes, and cigars (AOR=3.70, 95%CI=1.78–7.70) had increased odds of COVID-19 symptomatology, even when accounting for covariates."


Assessment of Exclusive, Dual, and Polytobacco E-Cigarette Use and COVID-19 Outcomes Among College Students

Am J Health Promot. 2021 Dec 6;8901171211055904. Online ahead of print.

Ashley L Merianos, Alex M Russell, E Melinda Mahabee-Gittens, Adam E Barry, Meng Yang, Hsien-Chang Lin



"In our opinion, the current evidence suggests it is critical that physicians be aware of the effects of nicotine concentration and flavourants when prescribing e-liquids to Australian vapers. Prescribing physicians should combine e-cigarettes with structured behavioural support to promote tobacco cessation and, ideally, complete nicotine abstinence, rather than seeking to reduce patients’ nicotine intake through dual use of e-cigarettes and tobacco cigarettes. A starting level of nicotine should be chosen that is no higher than that in tobacco cigarettes, but which is sufficient to suppress nicotine cravings. The (perceived) benefits of inclusion of flavourants on smoking cessation must be balanced with their potential for toxicity and promotion of nicotine addiction."



What doctors should consider before prescribing e-liquids for e-cigarettes

Medical Journal of Australia

First published: 28 November 2021

Miranda P Ween, David G Chapman, Alexander N Larcombe



Related MJA Editorial:


E-liquids and vaping devices: public policy regarding their effects on young people and health



"This is a secondary data analysis of 2016-2018 data of the U.S. Pregnancy Risk Assessment Monitoring System… Rates of cessation during pregnancy were highest among exclusive e-cigarette users (weighted percentage 80.7% [49,378/61,173]), followed by exclusive cigarette users (54.4% [421,094/773,586]) and then dual users (46.4% [69,136/149,152). Among exclusive e-cigarette users, continued users of e-cigarettes during pregnancy had a higher risk of small-for-gestational-age than non-users (16.5% [1,849/11,206]) vs. 8.8% [384,338/4,371,664]; confounder-adjusted RR, 1.52 [95% confidence interval, 1.45-1.60]), whereas quitters of e-cigarettes had a similar risk of small-for-gestational-age to non-users (7.7% [3,730/48,587] vs. 8.8% [384,338/4,371,664]; RR, 0.84 [0.82-0.87])."


Changes in e-cigarette and cigarette use during pregnancy and their association with small-for-gestational-age birth

Am J Obstet Gynecol. 2021 Dec 2;S0002-9378(21)02583-7. Online ahead of print.

Abdal Aziz T Shittu, Brinda P Kumar, Ugonna Okafor, Sara Berkelhamer, Maciej L Goniewicz, Xiaozhong Wen



"A 59-year-old female ex-smoker with 40 pack year smoking history and a 5-year current e-cigarette (EC) use history, presented with progressive dyspnea on exertion and daily cough for 2 months… Despite the recommendation of vaping cessation, the patient continued to use EC [e-cigarettes]. A new CT [Computed tomography] exam, carried out after 18 months, showed reversed halo sign (RHS), patchy ground-glass opacity (GGO), pleuro-parenchymal bands, and indeed perilobular pattern, suggestive of organizing pneumonia (OP). The final diagnosis was E-cigarette, or vaping, product use Associated Lung Injury (EVALI)- related OP."


E-cigarette, or vaping, product use Associated Lung Injury (EVALI): new scenarios for physicians and radiologists

Monaldi Arch Chest Dis. 2021 Dec 3. Online ahead of print.

Carmine Guarino, Ilaria Pedicelli, Francesco Perna, Valentina Di Spirito, Giuseppe Fiorentino, Fabio Procaccini, Gaetano Rea




Note: Open Access.


"Continuing declines in adolescent menthol prevalence indicate that both menthol prevalence and also black/non-black disparities in its use are steadily decreasing. However, these decreases in adolescence will take decades to reach later ages through generational replacement. Efforts to accelerate menthol decreases will require new initiatives to increase cessation among adult menthol users."


Recent, national trends in US adolescent use of menthol and non-menthol cigarettes

Tobacco Control Published Online First: 01 December 2021.

Richard A Miech, Adam M Leventhal, Lloyd D Johnson





Risk perceptions and continued smoking as a function of cigarette filter ventilation level among US youth and young adults who smoke



"Of 53 studies included, six were global, 32 from Asia, Middle East and Africa (AMEA), nine from USA and six from Europe. 'Poor'-rated studies predominated (23;43%), in particular, for global (4;66%) and AMEA (16;50%). Health outcomes differed between SLT-products and regions; those in AMEA were associated with higher mortality (overall, cancer, Coronary heart disease (CHD), respiratory but not cardiovascular disease (CVD)), and morbidity (CVD, oral and head and neck cancers), with odds ratios up to 38.7."


The health impact of smokeless tobacco products: a systematic review

Harm Reduct J. 2021 Dec 4;18(1):123.

C Hajat, E Stein, L Ramstrom, S Shantikumar R Polosa


This investigator initiated study was sponsored by ECLAT srl, a spin-off of the University of Catania, with the help of a grant from the Foundation for a Smoke-Free World Inc., a US nonprofit 501(c)(3) private foundation with a mission to end smoking in this generation.



Note: Open Access. Funding statement does not note that FSFW is entirely funded by Philip Morris International (PMI). See also lengthy Competing Interests statement.


"Our results suggest blood nicotine and nicotine content both predict behavioral economic demand abuse liability. In addition, our results suggest a nicotine content of 1.3mg/g or lower may be effective at reducing cigarette uptake among first-time (naïve) smokers. Our results largely conform to previous findings suggesting a very low nicotine content cigarette maintains lower abuse liability than full-strength cigarettes."


Blood Nicotine Predicts the Behavioral Economic Abuse Liability of Reduced-Nicotine Cigarettes

Nicotine Tob Res. 2021 Dec 3;ntab227. Online ahead of print.

Brent A Kaplan, Elisa M Crill, Christopher T Franck, Warren K Bickel, Mikhail N Koffarnus





Preliminary evaluation of short-term abstinence effects among never-smoking experienced users of modern electronic cigarettes



Note: Short-term abstinence paper Open Access.


"In England, small retailers’ support for the four point-of-sale tobacco control policies varied between 54-66%. Support seems unrelated to perceived importance of tobacco sales, and contact with the tobacco industry, but seems strongly related to the perceived impact of tobacco control policies on their business."


Tobacco retailers’ support for point-of-sale tobacco control policies in England: Association study of retailers’ perceived importance of tobacco sales, contact with the tobacco industry, and the perceived impact of the policy

Nicotine & Tobacco Research, ntab244.

Published: 30 November 2021

Tessa R D van Deelen, Deborah Arnott, Sara Hitchman, Bas van den Putte, Anton E Kunst, Mirte A G Kuipers



"This study provides longitudinal evidence that among adult smokers, misperceiving nicotine as a primary cause of smoking-related diseases may be associated with reduced cessation success and lower likelihood of using less harmful nicotine products. These misperceptions may therefore impede efforts to encourage smokers ready to quit to use evidence-based cessation support such as nicotine replacement during quit attempts and limit the success of policies designed to shift smokers to less harmful sources of nicotine."


Associations Between Nicotine Knowledge and Smoking Cessation Behaviors among U.S. Adults Who Smoke

Nicotine & Tobacco Research, ntab246.

Published: 25 November 2021

L M Snell, S M Colby, T DeAtley, R Cassidy, J W Tidey





Effect of Electronic Nicotine Delivery Systems on Cigarette Abstinence in Smokers with no Plans to Quit: Exploratory Analysis of a Randomized Placebo-Controlled Trial


Smoking patterns among urban Alaska Native and American Indian adults: The Alaska EARTH 10-year follow-up study



"We included 279 RCTs [randomized controlled trials] from 13 Cochrane reviews. Of all studies, 51 (18.3%) explicitly excluded participants with any MHDs [mental health disorders], 152 (54.5%) conditionally excluded based on certain MHD criteria and 76 (27.2%) provided insufficient information to ascertain either inclusion or exclusion. Studies of antidepressant medications used for smoking cessation were found to be 3.33 times more likely (95% CI 1.38 to 8.01, p=0.007) to conditionally exclude smokers with MHDs than explicitly exclude compared with studies of nicotine replacement therapy."


Inequity in smoking cessation clinical trials testing pharmacotherapies: exclusion of smokers with mental health disorders

Tob Control. 2021 Dec 3;tobaccocontrol-2021-056843. Online ahead of print.

Saki Rubaiya Talukder, Julia M Lappin, Veronica Boland, Hayden McRobbie, Ryan James Courtney





Variations in cigarette brand characteristics: can consumers tell the difference?



Note: Open Access.


"The continuous abstinence rate was significantly higher in the financial incentives group (16%, 38/231) than control group (7%, 17/229): odds ratio 2.45 (95% confidence interval 1.34 to 4.49), P=0.004). The point prevalence abstinence rate was higher (4.61, 1.41 to 15.01, P=0.011), the median time to relapse was longer (visit 5 (interquartile range 3-6) and visit 4 (3-6), P<0.001)), and craving for tobacco was lower (β=−1.81, 95% confidence interval −3.55 to −0.08, P=0.04) in the financial incentives group than control group… Conclusions: Financial incentives to reward smoking abstinence compared with no financial incentives were associated with an increased abstinence rate in pregnant smokers. Financial incentives dependent on smoking abstinence could be implemented as a safe and effective intervention to help pregnant smokers quit smoking."


Financial incentives for smoking cessation in pregnancy: multicentre randomised controlled trial

BMJ 2021; 375 (Published 01 December 2021)

Ivan Berlin, Noémi Berlin, Marie Malecot, Martine Breton, Florence Jusot, Léontine Goldzahl




Related BMJ Editorial:


Incentives for smoking cessation in pregnancy




Note: Open Access.


"882 849 patients registered with participating practices recorded as current smokers during 2007-2014…The majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI [severe mental illness] than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups."


Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care

BMJ Open. 2021 Dec 3;11(12):e048341.

Milena Falcaro, David Osborn, Joseph Hayes, Gary Coyle, Lisa Couperthwaite, Scott Weich, Kate R Walters



Note: Open Access.


"Findings indicated that as grades increased from “Best” to “Still Desirable” to “Definitely Declining” and “Hazardous,” retailer density increased monotonically. These results highlight the persisting impacts of redlining and how disparities, once intentionally created, can be perpetuated over time."


The legacy of redlining: Associations between historical neighborhood mapping and contemporary tobacco retailer density in Ohio

Health & Place

Volume 68, March 2021, 102529

Available online 22 February 2021.

Elli Schwartz, Nathaniel Onnen, Peter F. Craigmile, Megan E. Roberts



Trends in Prevalence of Tobacco Use by Sex and Socioeconomic Status in 22 Sub-Saharan African Countries, 2003-2019

JAMA Netw Open. 2021;4(12):e2137820.

December 8, 2021

Chandrashekhar T. Sreeramareddy, Kiran Acharya



Note: Open Access.


"People working in the field have long talked about tobacco as a social justice issue, but considerations of just what to do about addressing that have often been secondary to identifying and documenting the numerous disparities that persist between groups with social advantages and those without. In a sense, this is understandable: for some disadvantaged populations, it has been a real fight to simply become recognised and visible enough to have data systematically collected for research. For others, it has been a struggle to articulate within their own communities why tobacco has something to do with the overarching systemic injustices that permeate daily life. This issue [Tobacco and social justice, V30:e2] features a set of papers that speak broadly to the theme of tobacco and social justice, demonstrating how researchers are thinking about these issues in work that moves the field forward."



Justice, disparities and the tobacco endgame

Tobacco Control 2021;30:e76-e77.

Online issue publication December 08, 2021

Ruth E Malone




Note: Open Access.


"Among 7541 screening-eligible adults, current cigarette use was reported by 3604 (47.8%) participants. Ever and current e-cigarette use were reported by 3003 (39.8%) and 670 (8.9%) participants, respectively. Conclusions: Cigarette and e-cigarette exposure are common among U.S. adults who are eligible for lung cancer screening. Expanded USPSTF [United States Preventative Services Taskforce] criteria will capture a patient population with greater exposure to both of these products."


Prevalence of cigarette and e-cigarette use among U.S. adults eligible for lung cancer screening based on updated USPSTF guidelines

Cancer Epidemiol. 2021 Dec 8;76:102079. Online ahead of print.

Brendan T Heiden, Kathryn E Engelhardt, Chao Cao, Bryan F Meyers, Varun Puri, Yin Cao, Benjamin D Kozower



"Never-smoking ECIG users experience some aversive nicotine withdrawal symptoms within two to three hours of abstinence. Relative to ad lib ECIG use, abstinence decreased heart rate and inhibitory control, as well as increased subjective ratings of withdrawal such as craving and intention to vape. Those same symptoms might be suppressed by self-administration of ECIGs. Experiencing withdrawal upon abstinence may indicate that ECIGs can cause dependence without a history of other tobacco use."


Preliminary evaluation of short-term abstinence effects among never-smoking experienced users of modern electronic cigarettes

Nicotine & Tobacco Research, ntab252.

Published: 05 December 2021

Nicholas Felicione, Ashley Douglas, F Joseph McClernon, Melissa D Blank





Blood Nicotine Predicts the Behavioral Economic Abuse Liability of Reduced-Nicotine Cigarettes



"Secondary analysis of data from a longitudinal web-based survey of smokers, ex-smokers and vapers (n=3883) in the UK in 2019… Overall, 53.4% used TI [tobacco industry] products… TI products used were less likely to be refillable (‘open’) than independent brands (60.9% vs. 18.3%, chi-square=228.98, p<0.001), more likely to use nicotine salts (16.7% vs. 8.6%, chi-square=25.04, p<0.001) and tobacco flavours (23.8% vs. 17.9%, chi-square=12.65, p<0001)… Implications: Consequences of regulations need to be carefully considered to ensure that independent producers are not more negatively impacted than tobacco industry producers, and to avoid reducing utility of products for smoking cessation."


The use of tobacco industry vaping products in the UK and product characteristics: A cross-sectional survey

Nicotine & Tobacco Research, ntab253.

Published: 09 December 2021

Elliot J Cornish, Leonie S Brose, Ann McNeill





Building a foundation for evidence-based decision-making on e-cigarettes



Note: Open Access.


"Noticing warnings was higher among NVP [nicotine vaping product]  users (18.8%) than non-users (2.1%). Noticing warnings was associated with perceiving nicotine to pose little or no harm to health among NVP users, but there was no association among non-users. There was little evidence of an association between noticing warnings and perceptions of NVP harms relative to smoking among NVP users and non-users. Noticing warnings was associated with perceiving NVPs as less addictive than cigarettes among non-users but not NVP users. "


Associations Between Noticing Nicotine Vaping Product Health Warning Labels, Harm Perceptions, and Use among adult vapers, current and former smokers. Findings From the 2018 ITC Four Country Smoking and Vaping Survey

Nicotine Tob Res. 2021 Dec 10;ntab256. Online ahead of print.

Eve Taylor, Sarah Aleyan, Katherine East, K Michael Cummings, James F Thrasher, Geoffrey T Fong, Anne C K Quah, Grace Li, Ron Borland, David Hammond, Sara C Hitchman





Parsing intra- and inter-individual covariation between the sensory attributes and appeal of e-cigarettes: Associations and Gender Differences



"Careful real-time monitoring of nicotine exposure is critical in alleviating the potential health impacts of not just smokers but also those exposed to second-hand and third-hand smoke… Here, we experimentally demonstrate a vanadium dioxide (VO2)-based nicotine sensor and explain its conductometric mechanisms with compositional analysis and density functional theory (DFT) calculations… Collectively, the technique of sensor development and integration expands the use of wearable electronics for real-time monitoring of hazardous elements in the environment and biosignals wirelessly."


Nicotine Sensors for Wearable Battery-Free Monitoring of Vaping

ACS Sens. 2021, XXXX, XXX, XXX-XXX

Publication Date: December 8, 2021

Md. Ataur Rahman, Le Cai, Sherif Abdulkader Tawfik, Stuart Tucker, Alex Burton, Ganganath Perera, Michelle J. S. Spencer, Sumeet Walia, Sharath Sriram, Philipp Gutruf, and Madhu Bhaskaran



Related PR:


Wearable sensor measures airborne nicotine exposure from e-cigarettes



"Among men, former smoking significantly increased the risk of grade 3/4/5 and grade 5, using grade 0 as a reference group, with age- and admission-date-adjusted ORs (95% CI) of 1.51 (1.18-1.93) and 1.65 (1.22-2.24), respectively… Similar results were seen for women… The severity of COVID-19 was not associated with current or former smoking per se but with the comorbidities caused by smoking. Thus, smoking cessation is likely to be a key factor for preventing smoking-related disease and hence for reducing the risk of severe COVID-19."


Smoking and severe illness in hospitalized COVID-19 patients in Japan

Int J Epidemiol. 2021 Dec 11;dyab254. Online ahead of print.

Yumi Matsushita, Tetsuji Yokoyama, Kayoko Hayakawa, Nobuaki Matsunaga, Hiroshi Ohtsu, Sho Saito , Mari Terada, Setsuko Suzuki, Shinichiro Morioka, Satoshi Kutsuna, Tetsuya Mizoue, Hisao Hara, Akio Kimura, Norio Ohmagari



Note: Open Access.


"Secondhand smoke exposure was positively associated with the risk of mortality from pancreatic cancer in adulthood; the multivariable HR [Hazard Ratio] of 3+ smoking family members was 2.32 (95% CI: 1.14, 4.72), compared with 0 members. The associations were not evident for the risks of total or other types of smoking-related cancers. In conclusion, secondhand smoke exposure during childhood was associated with an increased risk of mortality from pancreatic cancer in adulthood."


Secondhand Smoke Exposure during Childhood and Cancer Mortality in Adulthood among Never Smokers: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk

Am J Epidemiol. 2021 Dec 8;kwab284. Online ahead of print.

Masayuki Teramoto, Hiroyasu Iso, Kenji Wakai, Akiko Tamakoshi 



"We reviewed industry documents in the Truth Tobacco Industry Documents (TTID) Library. In 1976, Philip Morris and BAT [British American Tobacco] introduced ‘low tar’ or ‘light’ cigarettes in Brazil to maintain and attract new young smokers. At the time it was a novel tobacco product that implied lower health risks… In the mid-1990s, BAT used the success in Brazil to expand the lights segment throughout Latin America. BAT drove the lights segment through brand marketing and claims of a healthier alternative."


Promoting healthier options? Inside the branding of light cigarettes and targeting youth in Brazil

Global Public Health

Published online: 01 Dec 2021

Eric Crosbie, Johnny Hartman, Brian Tran & Stella Bialous



"CBs [Cigarette butt] samples were obtained through artificial smoking from 10 high-consumption brands in the Iranian market, and their samples in urban areas were taken and analyzed in terms of heavy metals pollution. The results showed that the average concentrations of Lead, Cadmium, Chromium, Zinc, Copper, Nickel in the studied CBs were 1.71, 0.36, 1.59, 24.61, 12.83, and 2.66 µg/g, respectively. The long persistency of CBs in the environment leads to increased release of all heavy metals to 9.7%. In addition, the rainfall can accelerate the leaching of heavy metals to 17.7% compared to the control scenario."


Estimation of the heavy metals released from cigarette butts to beaches and urban environments

J Hazard Mater. 2021 Dec 1;425:127969. Online ahead of print.

Mahdi Farzadkia, Mina Salehi Sedeh, Afsaneh Ghasemi, Navid Alinejad, Malihe Samadi Kazemi, Naghmeh Jafarzadeh, Javad Torkashvand



"Compared with high nicotine dependence, low and moderate nicotine dependence (4.628, 2.596) had a positive impact on willingness to quit smoking.Smoking patients in neurology department are more willing to quit smoking (67.9%). Factors such as occupation, smoking attitude, and nicotine dependence should be considered when establishing smoking cessation interventions for stroke smokers."


Exploring the degree of nicotine dependence and willingness to quit smoking in Chinese smoking patients with stroke: A cross-sectional survey

Medicine (Baltimore). 2021 Dec 10;100(49):e27715.

Ling Li, Haifeng Li, Ying Zhang, Chengyuan Zheng, Houyun Xu, Zizhen Cheng



Note: Open Access.


‘Growth of a movement’: 30 years on

Online issue publication December 19, 2021

Ruth E Malone




Note: Open Access. A new issue of the journal Tobacco Control (V.31:1) has just appeared online. Most studies have been highlighted previously in this bulletin and remain available upon request. Please include a full reference, with abstract link, and send requests to Questo indirizzo email è protetto dagli spambots. È necessario abilitare JavaScript per vederlo..


"Controversies regarding the association between COVID-19 hospitalizations and smoking suggest that nAChRs [nicotinic acetylcholine receptors] may contribute to SARS-CoV-2 respiratory syndrome... Since virus association with nAChRs has been shown in the past, we hypothesize that nAChR subunits act as SARS-CoV-2 Spike co-receptors. Based on sequence alignment analysis, we report domains of high molecular similarities in nAChRs with the binding domain of hACE2 for SARS-CoV-2 Spike protein."


Nicotinic receptors as SARS-CoV-2 spike co-receptors?

Med Hypotheses. 2022 Jan;158:110741. Epub 2021 Dec 14.

Valérian Dormoy, Jeanne-Marie Perotin, Philippe Gosset, Uwe Maskos, Myriam Polette, Gaëtan Deslée



Note: Open Access.


"Few countries have banned HTP [heated tobacco product] commercialisation (n=3) or regulated commercialisation and use (n=7), while the majority of countries have existing legislation that applies to HTPs (n=19). A few countries (n=4) have no tobacco control legislation and therefore do not regulate HTPs. Conclusion: NTNPs [New tobacco and nicotine products] are emerging products in the LAC [Latin America and the Caribbean] region. Governments should follow WHO guidance and the decisions of the Conference of Parties to the WHO Framework Convention on Tobacco Control and ban or regulate NTNPs as tobacco products; otherwise NTNPs could create a new generation of tobacco and nicotine users."


New tobacco and nicotine products in Latin America and the Caribbean: assessing the market and regulatory environment

Tobacco Control Published Online First: 16 December 2021.

Eric Crosbie, Gianella Severini, Alexandra Beem, Brian Tran, Ernesto Marcelo Sebrie





Nicotine replacement therapy ‘gift cards’ for hospital inpatients who smoke: a prospective before-and-after controlled pilot evaluation



Classifying the comprehensiveness of flavoured tobacco sales restrictions: development and application of a tool to examine US state and local tobacco policies



Note: NRT 'gift cards' paper Open Access.


"In multiple logistic regression, interest in using e-cigarettes for future smoking cessation was independently associated with having ever used e-cigarettes for smoking cessation, current e-cigarette use, and perceiving e-cigarettes to be less harmful than cigarettes (p’s<0.05). In qualitative data, many current vapers/former smokers reported that e-cigarettes had been helpful for quitting cigarettes. For current smokers who currently or formerly vaped, frequently reported challenges in switching to e-cigarettes were concerns about replacing one addiction with another and e-cigarettes not adequately substituting for cigarettes. Conclusions: E-cigarettes had a moderate level of acceptability for smoking cessation among cigarette smokers in OUD [opioid use disorder] treatment."


Interest in electronic cigarettes for smoking cessation among adults with OUD in buprenorphine treatment: A mixed-methods investigation

Nicotine & Tobacco Research, ntab259.

Published: 16 December 2021

Joanna M Streck, Susan Regan, Jordan Neil, Sara Kalkhoran, Priya S Gupta, Benjamin Bearnot, Faith K Coker, Kelly M Kalagher, Elyse Park, Sarah Wakeman, Nancy A Rigotti





The Impact of Coping with Stressful Events on Negative Affect and Cravings among Smokers with Mood Disorders



"The proportion of erectile dysfunction varied from 20.7% (full sample) to 10.2% (restricted sample). The prevalence of current ENDS [electronic nicotine delivery systems] use within the full and restricted samples was 4.8% and 5.6%, respectively, with 2.1% and 2.5%, respectively, reporting daily use. Current daily ENDS users were more likely to report erectile dysfunction than never users in both the full (AOR=2.24, 95% CI=1.50, 3.34) and restricted (AOR=2.41, 95% CI=1.55, 3.74) samples… Conclusions: The use of ENDS seems to be associated with erectile dysfunction independent of age, cardiovascular disease, and other risk factors. While ENDS remain under evaluation for harm reduction and smoking-cessation potential, ENDS users should be informed about the possible association between ENDS use and erectile dysfunction."


Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study

Am J Prev Med. 2022 Jan;62(1):26-38. Epub 2021 Nov 30.

Omar El-Shahawy, Tanmik Shah, Olufunmilayo H Obisesan, Meghan Durr, Andrew C Stokes, Iftekhar Uddin, Ria Pinjani, Emelia J Benjamin, Mohammadhassan Mirbolouk, Albert D Osei, Tom Loney, Scott E Sherman, Michael J Blaha




Note: Open Access.


"The results show that a message portraying physical health consequences of smoking in a loss frame (i.e., overfamiliar frame) induced greater message fatigue than that in a gain frame. Message fatigue, in turn, was associated with higher levels of active (i.e., reactance) and passive resistance (i.e., disengagement) toward antitobacco messages… Conclusions: Overfamiliar antitobacco message frames may activate greater message fatigue and resistance to persuasion, which may dampen campaign effects. The findings caution against the habitual use of conventional antitobacco messages."


Counterproductive effects of overfamiliar antitobacco messages on smoking cessation intentions via message fatigue and resistance to persuasion

Psychology of Addictive Behaviors

Advance online publication, December 17, 2021

So, Jiyeon



"Our findings revealed that the influence of selection outweighed that of socialization for predicting early adolescent cigarette use, with both processes reciprocally influencing each other… Specifically, we found that early adolescent cigarette use predicted perceived friend cigarette use at subsequent waves, with significant indirect effects on future adolescent cigarette use and perceived friend use. No indirect effects were observed in the opposite direction, that is, from perceived friend cigarette use to either later adolescent cigarette use or later perceived friend use."


Selection versus socialization effects of peer norms on adolescent cigarette use

Tob Use Insights. 2021 Dec 14;14:1179173X211066005. eCollection 2021.

Christopher M Loan, Atika Khurana, Joanna Wright, Daniel Romer






Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017)




Note: Open Access.


"Dollar sales of e-cigarettes declined 29% from their pre-EVALI [E-cigarette, or Vaping Product-Use Associated Lung Injury] peak by January 2020. Total sales of e-cigarettes declined in response to EVALI deaths and the total e-cigarette sales ban put in place in Massachusetts adopted in its wake. Cigarette sales were largely unchanged by either the direct or indirect policy effects of the EVALI outbreak, except for in Massachusetts, where cigarette sales—particularly those smoked by young people—rose temporarily after a total ban on e-cigarette sales."


The EVALI outbreak and tobacco sales in the USA, 2014–2020

Tobacco Control Published Online First: 15 December 2021

Alex C Liber, Zachary Cahn, Megan C Diaz, Emily Donovan, Donna Vallone, Barbara Schillo





Standardising the measurement of e-cigarette taxes in the USA, 2010–2020


Cheaper tobacco product prices at US Air Force Bases compared with surrounding community areas, 2019



"Data came from the nationally representative Monitoring the Future study, consisting of 12th graders (n=6,982) from the 48 contiguous U.S. states (2017-2019)… Students with higher assets were less likely to vape nicotine and marijuana, even after adjusting for covariates. The odds of nicotine vaping were lower for students with medium assets (AOR=0.65, 95% CI=0.54, 0.78) and high assets (AOR=0.22, 95% CI=0.16, 0.29) than for students with low assets… Promoting cumulative assets may help to prevent vaping among U.S. adolescents, and increasing the specific assets of social competence and positive peer norms could be particularly fruitful."


Protective Factors for Nicotine and Marijuana Vaping Among U.S. Adolescents

Am J Prev Med. 2021 Dec 16;S0749-3797(21)00508-0. Online ahead of print.

Michael J Parks, Megan E Patrick



"This study provides important insight into nicotine pharmacokinetics and subjective effects during NP [nicotine pouch] use, and demonstrates that NPs can provide nicotine in amounts sufficient to replicate cigarette smokers' nicotine uptake following a switch from conventional cigarettes to these potentially less harmful NP products."


A Randomised Study to Investigate the Nicotine Pharmacokinetics of Oral Nicotine Pouches and a Combustible Cigarette

Eur J Drug Metab Pharmacokinet. 2021 Dec 18. Online ahead of print.

Michael McEwan, David Azzopardi, Nathan Gale, Oscar M Camacho, George Hardie, Ian M Fearon, James Murphy

Ethics declarations


The study was supported by British American Tobacco (Investments) Limited, the manufacturer of Lyft and Velo smokeless oral nicotine pouches.

Competing interests

All authors are current employees of British American Tobacco (Investments) Limited except JM who is an employee of RAI Services Company and IMF who is a consultant contracted by British American Tobacco (Investments) Limited.



Note: Open Access tobacco industry research.


"Before their pregnancy, women smoked 19 cigarettes per day on average, while during their pregnancy they dropped to eight cigarettes per day; 65.8% of respondents stated that their husband smoked, while 58.8% answered that they had been exposed to secondhand smoke; 13.2% of pregnant smokers stated that they had had depression at some point in their lives and 14.9% reported having undergone domestic violence; 55.3% of respondents acknowledged that smoking was responsible for a variety of adverse effects to the fetus; and 97.4% of pregnant women did not follow a smoking cessation counseling program, compared to just 2.6% who did."



Barriers to Smoking Cessation and Characteristics of Pregnant Smokers in Greece

Maedica (Bucur). 2021 Sep;16(3):405-414.

Athina Diamanti, Aikaterini Galiatsatou, Antigoni Sarantaki, Paraskevi Katsaounou, Dimitra Varnakioti, Aikaterini Lykeridou



Note: Open Access.


"Tobacco use was seen as a core part of Air Force culture and a low risk behavior, in contrast to other potential activities. Three themes of Air Force culture that facilitate tobacco use emerged: 1) opportunity for work breaks; 2) finding common ground; and 3) stress management or stress relief during deployment. Smoke pits were seen as serving several functions that were not perceived to occur anywhere else: an opportunity for informal communication with leadership, a source of valuable information, and a space for problem solving."


"Nobody Views It As a Negative Thing to Smoke": A Qualitative Study of the Relationship Between United States Air Force Culture and Tobacco Use

Mil Psychol. 2021;33(6):409-416. Epub 2021 Oct 8.

Rebecca A Krukowski, Kathleen Porter, Tina Boothe, G Wayne Talcott, Melissa A Little



"Smoking modulates both humoral and cell-mediated responses by restricting the proliferation of lymphocytes and inducing their apoptosis and ultimately decreasing the surveillance of cancer cells. Moreover, it has been determined that heavy smoking impacts the response of hepatitis C patients to interferon (IFN) therapy through different mechanisms, which can be improved by phlebotomy."


Tobacco Smoking and Liver Cancer Risk: Potential Avenues for Carcinogenesis

J Oncol. 2021 Dec 10;2021:5905357. eCollection 2021.

Divya Jain, Priya Chaudhary, Nidhi Varshney, Khandaker Sabit Bin Razzak, Devret Verma, Tasnim Reza Khan Zahra, Pracheta Janmeda, Javad Sharifi-Rad, Sevgi Durna Daştan, Shafi Mahmud, Anca Oana Docea, Daniela Calina




Note: Open Access.