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