Longitudinal impact of perceived harm and addiction on e-cigarette initiation among tobacco-naïve youth: Population Assessment of Tobacco and Health study (Waves 1-5).

OBJECTIVES: This study investigates the effect of e-cigarette-related harm and addiction perceptions on e-cigarette initiation among US tobacco-naïve adolescents. STUDY DESIGN: This is a longitudinal study. METHODS: Using data from five waves (2013-2019) of the Population Assessment of Tobacco and Health Study, we created a longitudinal data set for 2775 youth aged 12-17 years who had no prior use of tobacco products at Wave 1. E-cigarette initiation was defined as transitioning from non-use at Wave 1 to ever use in subsequent waves. Kaplan-Meier survival and Cox proportional hazard regression models were used to assess the impact of harm and addiction perceptions on e-cigarette initiation. RESULTS: Our analytic sample comprised 63.1% of youth who had never used tobacco products at Wave 1 and consequently initiated e-cigarette use in subsequent waves. Over time, fewer individuals perceived e-cigarettes as harmless (14.1%-2.1%), whereas more perceived them as likely to cause addiction (53.7%-76.6%). Compared with perceiving e-cigarettes as a lot of harm, those perceiving some harm (adjusted hazard ratio [aHR] = 1.30, 95% confidence interval [CI]: 1.12-1.52), little harm (aHR = 1.42, 95% CI: 1.20-1.68), or no harm (aHR = 2.09, 95% CI: 1.64-2.65) were more likely to initiate e-cigarette use. Demographic factors for initiation included being Black or Hispanic ethnicity (vs White), younger age (12-14 vs15-17 years), and receiving over $20 per week (vs $0) in pocket money, with P-values <0.05. However, in adjusted results, addiction perceptions did not significantly impact e-cigarette initiation (P-values >0.05). CONCLUSIONS: Among youth without prior tobacco/nicotine use, perceiving e-cigarettes as having low harm significantly predicted initiation over time. Effective prevention strategies, including targeted risk communication interventions, are essential for discouraging e-cigarette use among youth.

E-cigarette, cigarette, dual e-cigarette with cigarette use, and disability status among reproductive-aged women.

OBJECTIVE: E-cigarettes have increased steadily among reproductive-aged women, despite our limited understanding of their effect on reproductive health. This study examined the associations of e-cigarette, cigarette, and dual use with disability in reproductive-aged women. STUDY DESIGN: This was a cross-sectional study. METHODS: Data for this study were obtained from reproductive-aged women (18-44 years; n = 24,904) from the 2020 Behavioral Risk Factor Surveillance System. Descriptive statistics and logistic regression analyses were conducted to assess the associations of tobacco use patterns (dependent variable, i.e. non-use, current e-cigarette use, current cigarette use, and current dual use of e-cigarettes and cigarettes) with overall disability and the type of disability (independent variables). RESULTS: Among women who reported any disability, 70.6%, 8.7%, 11.4% and 9.3% reported non-use, e-cigarette, cigarette, and dual use, respectively. In adjusted analysis, relative to non-use, women who reported any disability had higher odds of e-cigarette (adjusted odds ratio [aOR]: 1.88; 95% confidence interval [CI]: 1.15-3.07), cigarette (aOR: 1.58; 95% CI: 1.12-2.25), and dual use (aOR: 2.37; 95% CI: 1.55-3.62) compared with women without disabilities. CONCLUSIONS: This cross-sectional study found higher odds of current e-cigarette use, cigarette use, and dual use of e-cigarettes and cigarettes among women of reproductive age with ≥1 disability. Improved screening for the use of nicotine products among women of reproductive age with disabilities may be necessary to lessen the use of nicotine products in this vulnerable population.

Exposure to Anti-Tobacco Messaging and Quit Attempts among Adolescent and Young Adult in Lagos, Nigeria: A Population-based Study.

BACKGROUND: Health behavior theories suggest that knowledge about the health risks of the behavior precedes behavior change. Tobacco control messages aim to promote knowledge of health risks associated with tobacco use and encourage smoking cessation behaviors such as quit attempts and intention to quit. This study assessed the relationship between exposure to Anti-Tobacco Messaging (ATM) and quit attempts among adolescents and young adults in Lagos, Nigeria. METHODS: This was an online cross-sectional survey of 947 participants aged between 15-35 years. The survey obtained sociodemographic information, smoking status, exposure to ATM, intention to quit and quit attempts in the past 12-months. Logistic regression analysis was used to identify the relationship between exposure to ATM and quit attempts; pvalues <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS: The mean age of respondents was 23.4 years (SD:4.0). Less than one-third of the respondents were smokers (23.4%). The most common source of ATM were digital sources (online and social media - 29.6%). Based on the multivariable logistic regression model, younger age (p:0.03) and an intention to quit (p: <0.001) were significantly associated with a quit attempt. Exposure to ATM in the past 12 months was also significantly associated with higher odds of a quit attempt (OR:5.33; 95% CI: 1.26,22.60; p: 0.02). CONCLUSION: Our findings suggest an association between exposure to ATM and quit attempts among adolescent and young adult smokers in Lagos State, Nigeria. Policymakers should consider measures aimed at promoting tobacco control education and improving access to smoking cessation services.

CONTEXTE: Les théories du comportement en matière de santé suggèrent que la connaissance des risques sanitaires du comportement précède le changement de comportement. Les messages de lutte contre le tabagisme visent à promouvoir la connaissance des risques pour la santé associés au tabagisme et à encourager les comportements de renoncement au tabac tels que les tentatives d'abandon et l'intention d'abandonner. Cette étude a évalué la relation entre l'exposition aux messages antitabac (MTA) et les tentatives d'arrêt du tabac chez les adolescents et les jeunes adultes de Lagos, au Nigeria. MÉTHODES: Il s'agissait d'une enquête transversale en ligne auprès de 947 participants âgés de 15 à 35 ans. L'enquête a permis d'obtenir des informations sociodémographiques, le statut tabagique, l'exposition au MTA, l'intention d'arrêter et les tentatives d'arrêt au cours des 12 derniers mois. Une analyse de régression logistique a été utilisée pour identifier la relation entre l'exposition à la GTA et les tentatives d'abandon ; les valeurs p <0,05 ont été considérées comme significatives. L'analyse statistique a été réalisée à l'aide du logiciel STATA-15.0. RÉSULTATS: L'âge moyen des répondants était de 23,4 ans (écarttype:4,0). Moins d'un tiers des répondants étaient fumeurs (23,4%). La source de DAB la plus courante était les sources numériques (médias en ligne et sociaux-29, 6%). D'après le modèle de régression logistique multivariable, un âge plus jeune (p: 0,03) et une intention d'arrêter de fumer (p:<0,001) étaient significativement associés à une tentative d'arrêt. L'exposition à la GTA au cours des 12 derniers mois était également associée de manière significative à une probabilité plus élevée de tentative d'abandon (OR:5,33;IC à 95%: 1,26,22,60; p:0,02). CONCLUSION: Nos résultats suggèrent une association entre l'exposition à la GTA et les tentatives d'arrêt chez les fumeurs adolescents et jeunes adultes de l'État de Lagos, au Nigeria. Les décideurs politiques devraient envisager des mesures visant à promouvoir l'éducation à la lutte antitabac et à améliorer l'accès aux services d'aide au sevrage tabagique. Mots clés: Adolescent, Intention d'arrêter de fumer, Tentative d'arrêt du tabac, Jeunes, Tabac.

HIV/HCV coinfection and the risk of cardiovascular disease: A meta-analysis.

The emergence of improved antiretroviral therapy has increased the life expectancy of human immunodeficiency virus (HIV)-infected individuals, although there is an increased susceptibility to developing cardiovascular diseases (CVD). The risk for CVD is purported to be even higher among people with HIV and hepatitis C virus (HCV) coinfection because of the increased inflammatory response, which may synergistically impact CVD risk. However, studies comparing CVD outcomes between HIV alone and HIV/HCV individuals have been discordant. Accordingly, we conducted a meta-analysis to clarify and quantify the association between HIV/HCV coinfection and the risk for CVD. We searched EMBASE, CINAHL, Google Scholar, PubMed, and Web of Science from inception to December 2016 to identify studies that provided information on HIV/HCV coinfection and CVD, defined as coronary artery disease, congestive heart failure and stroke. We used a random-effects model to abstract and pool data on the hazard ratios (HRs) for CVD. HRs were adjusted for traditional CVD risk factors including age, sex, smoking, hypertension, diabetes and LDL cholesterol. Among the 283 articles reviewed, four cohort studies met inclusion criteria with a total of 33 723 participants. The pooled adjusted HRs for the association between HIV/HCV coinfection and CVD were 1.24 (95% CI: 1.07-1.40) compared to HIV monoinfection. The test for heterogeneity was not statistically significant (I2 =0.0%, P=.397). In conclusion, individuals with HIV/HCV coinfection had an increased CVD risk compared to those with HIV monoinfection. More research is needed to further examine the nature of this association, and response to traditional risk-reduction therapies.