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1. Subtypes of Dual Users of Combustible and Electronic Cigarettes: Longitudinal Changes in Product Use and Dependence Symptomatology

   https://doi.org/10.1093/ntr/ntac151  

   Buu, Anne ; Tong, Zhaoxue ; Cai, Zhanrui ; Li, Runze ; Yang, James J. ; Jorenby, Douglas E. ; Piper, Megan E. ( June 2022 , Nicotine & Tobacco Research)

   Cross-sectional surveys found behavioral heterogeneity among dual users of combustible and electronic cigarettes. Yet, prior classification did not reflect dynamic interactions between cigarette and e-cigarette consumption, which may reveal changes in product-specific dependence. The contexts of dual use that could inform intervention were also understudied.

   This study conducted secondary analysis on 13 waves of data from 227 dual users who participated in a 2-year observational study. The k-means method for joint trajectories of cigarette and e-cigarette consumption was adopted to identify the subtypes of dual users. The time-varying effect model was used to characterize the subtype-specific trajectories of cigarette and e-cigarette dependence. The subtypes were also compared in terms of use contexts.

   The four clusters were identified: light dual users, predominant vapers, heavy dual users, and predominant smokers. Although heavy dual users and predominant smokers both smoked heavily at baseline, by maintaining vaping at the weekly to daily level the heavy dual users were able to considerably reduce cigarette use. Yet, the heavy dual users’ drop in cigarette dependence was not as dramatic as their drop in cigarette consumption. Predominant vapers appeared to engage in substitution, as they decreased their smoking and increased their e-cigarette dependence. They were also more likely to live in environments with smoking restrictions and report that their use of e-cigarettes reduced cigarette craving and smoking frequency.

   Environmental constraints can drive substitution behavior and the substitution behavior is able to be sustained if people find the substitute to be effective.

   This study characterizes subtypes of dual users based on the dynamic interactions between cigarette use and e-cigarette use as well as product-specific trajectories of dependence. The subtypes differ in not only sociodemographic characteristics but also contexts of cigarette and e-cigarette use. Higher motivation to use e-cigarettes to quit smoking and less permissive environment for smoking may promote substitution of cigarettes by e-cigarettes.

    

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2. Bacterial communities of hookah tobacco products are diverse and differ across brands and flavors

   https://doi.org/10.1007/s00253-022-12079-7  

   Malayil, Leena ; Chattopadhyay, Suhana ; Mongodin, Emmanuel F. ; Sapkota, Amy R. ( September 2022 , Applied Microbiology and Biotechnology)

   Abstract Young adults are increasingly using non-cigarette products, such as hookahs, since they are perceived as healthier alternatives to cigarette smoking. However, hookah users are exposed to not only carcinogenic compounds but also microorganisms that may play an active role in the development of both infectious and chronic diseases among users. Nevertheless, existing hookah research in this area has focused only on microorganisms that may be transferred to users through the smoking apparatus and not on bacterial communities associated with hookah tobacco. To address this knowledge gap, we conducted time-series experiments on commercially available hookah brands (Al Fakher (flavors: two apple, mint, and watermelon) and Fumari (flavors: white gummy bear, ambrosia, and mint chocolate chill)) stored under three different temperature and relative humidity conditions over 14 days. To characterize bacterial communities, the total DNA was extracted on days 0, 5, 9, and 14, PCR-amplified for the V3V4 region of the bacterial 16S rRNA gene, sequenced on the Illumina HiSeq platform, and analyzed using R. Diversity (alpha and beta) analyses revealed that the microbiotas of Fumari and Al Fakher products differed significantly and that flavor had a significant effect on the hookah microbiota. Overall, Pseudomonas , Bacillus , Sphingomonas , and Methylobacterium were the predominant bacterial taxa across all products . Additionally, we observed compositional differences between hookah brands across the 14-day incubation . These data suggest that the bacterial communities of hookah tobacco are diverse and differ across brands and flavors, which may have critical implications regarding exposures to specific bacteria among hookah users. Key points • Commercial hookah products harbor diverse bacterial communities . • Brands and flavors impact the diversity of these communities . • Research on their viability and transmission to users’ respiratory tracts is needed . Graphical abstract 

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3. Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans

   https://doi.org/10.1111/add.15238  

   Bello, Mariel S. ; Liautaud, Madalyn M. ; De La Cerda, Julianne T. ; Pang, Raina D. ; Ray, Lara A. ; Ahluwalia, Jasjit A. ; Leventhal, Adam M. ( October 2020 , Addiction)

   Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco‐related health disparities. This laboratory study (2013–17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers.

   Mixed design with the between‐subjects continuous variable of perceived discrimination crossed with the within‐subject variable of tobacco deprivation status (deprived versus non‐deprived).

   Academic medical center in Los Angeles, CA, USA.

   African American non‐treatment seeking daily cigarette smokers (n = 607, ≥ 10 cig/day).

   At a baseline visit, self‐reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16‐hour tobacco deprivation versusad‐libitumsmoking), self‐report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith–Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured.

   Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation‐induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning—effect sizes were small in magnitude (βs = 0.09–0.13;Ps < 0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation‐induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior.

   Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation‐induced tobacco withdrawal symptoms in African American smokers.

    

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4. Association of Cardiovascular Disease Risk Factors with Exclusive Smokeless Tobacco Use among US Males: Cross-Sectional Analysis of NHANES Data 2003-2018

   https://doi.org/10.1177/08901171221141980  

   Mushtaq, Nasir ; Sarwar, Zoona ; Kouplen, Kate ; Ahmed, Rizwan ; Beebe, Laura A ( June 2023 , American Journal of Health Promotion)

   To evaluate cardiovascular disease (CVD) risk factors among smokeless tobacco (ST) users. Exclusive ST users were compared to exclusive cigarette smokers and non-tobacco users.

   Cross-sectional study

   Data were used from 16,336 adult males who participated in one of the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018.

   Biochemically verified tobacco use, CVD risk factors (hypertension, cholesterol levels, BMI categories), physical activity, cotinine concentration, and sociodemographic variables.

   Weighted analysis of the aggregate data was performed. ST users were compared with cigarette smokers and nontobacco users for their association with CVD risk factors. Associations were examined using univariate and multiple logistic regression with odds ratios (OR) and 95% confidence intervals (CI) reported.

   Prevalence of exclusive ST use was 4.4% whereas, exclusive smoking was 22.2%. Among ST users, 36.2% were hypertensive, 24.5% had high cholesterol levels, and most of them were overweight (31.1%) or obese (52.6%). ST users were more likely to have hypertension compared to smokers (aOR = 1.48, 95%CI: 1.12, 1.95) and nontobacco users (aOR = 1.41, 95%CI: 1.09, 1.83) adjusted for other covariates. ST users were twice more likely to be obese than nontobacco users (aOR = 2.18, 95%CI: 1.52, 3.11). ST users had significantly higher cotinine concentration than smokers.

   Study findings indicate substantial association of ST use among males with hypertension and obesity which are independent risk factors of CVD.

    

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5. Electronic Cigarettes and Fecundability: Results From a Prospective Preconception Cohort Study

   https://doi.org/10.1093/aje/kwaa067  

   Harlow, Alyssa F ; Hatch, Elizabeth E ; Wesselink, Amelia K ; Rothman, Kenneth J ; Wise, Lauren A ( May 2020 , American Journal of Epidemiology)

   Abstract Although electronic cigarette (e-cigarette) aerosol contains similar toxicants to combustible cigarettes, few studies have examined their influence on fecundability. We assessed the association between e-cigarette use and fecundability, overall and according to combustible cigarette smoking history, in a cohort of 4,586 North American women (aged 21–45 years) enrolled during 2017–2020 in Pregnancy Study Online, a Web-based prospective preconception study. Women reported current and former e-cigarette use on baseline and follow-up questionnaires, and they completed bimonthly follow-up questionnaires until self-reported pregnancy or censoring. Fecundability ratios and 95% confidence intervals were calculated using proportional probabilities models, controlling for potential confounders. Overall, 17% of women had ever used e-cigarettes and 4% were current users. Compared with never use of e-cigarettes, current e-cigarette use was associated with slightly lower fecundability (fecundability ratio = 0.84, 95% confidence interval (CI): 0.67, 1.06). Compared with current nonusers of e-cigarettes and combustible cigarettes, fecundability ratios were 0.83 (95% CI: 0.54, 1.29) for current dual users of e-cigarettes and combustible cigarettes, 0.91 (95% CI: 0.70, 1.18) for current e-cigarette users who were nonsmokers of combustible cigarettes, and 1.01 (95% CI: 0.85, 1.20) for nonusers of e-cigarettes who were current smokers of combustible cigarettes. Current e-cigarette use was associated with slightly reduced fecundability, but estimates of its independent and joint associations with combustible cigarette smoking were inconsistent and imprecise. 

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