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Psychological well-being and dual-use of cigarettes and e-cigarettes among high school students in Canada

Jan 22nd, 2020
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Highlights

•6.3% of Canadian middle and high school students were dual users of cigarettes and e-cigarettes.

•Three times more Canadian youth used e-cigarettes exclusively than used cigarettes exclusively.

•High-frequency dual-users had lower psychological well-being than low-frequency dual-users.

•High-frequency cigarette dual-users had higher autonomy scores than low-frequency dual-users.

https://www.sciencedirect.com/science/article/abs/pii/S0165032719331568

Abstract

Background

Cigarette and e-cigarette use are prevalent among Canadian adolescents. Evidence shows psychiatric comorbidity with adolescent cigarette smoking, but little is known about psychological well-being among dual users of e-cigarettes and cigarettes. This study examined the association between dual-use status and psychological well-being among high school students.

Methods

We used the 2016–2017 Canadian Student Tobacco, Alcohol, and Drugs Survey. Scales of psychological well-being (relatedness, autonomy, competency, prosocial behavior, and social responsiveness) were derived from self-reported data. Dual-use status was categorized into non-users, cigarette-only smokers, e-cigarette-only users, and four types of dual-users. Multivariable linear regression models examined the association between dual-use and psychological well-being.

Results

Among the participants, 6.3% were current dual-users, 4.1% were cigarette-only smokers, 12.6% were e-cigarette-only users, and 77.0% were non-users. Compared to non-users, relatedness and social responsiveness were lower for all users. When compared to e-cigarette users, most other users had lower relatedness (high-frequency dual-users [β=-6.05], high-frequency cigarette dual-users [β=-2.27], high-frequency e-cigarette dual-users: [β=-1.32], low-frequency dual-users [β=-1.91], and cigarette-only smokers [β=-1.66]) and social responsiveness. High-frequency dual-users had lower scores for relatedness and social responsiveness, while high-frequency cigarette dual-users had higher autonomy, compared to low-frequency dual-users.

Conclusion

Dual-users had poorer psychological well-being, which differed among dual-user sub-groups. This study highlights an opportunity for specialized programs to promote psychological well-being and reduce tobacco product use among adolescents.

Limitations

The study is based on respondent self-report, and the use of cross-sectional data precludes us from determining the temporal order between dual-use and psychological well-being.

How E-Cigarettes Featured in a $42.5 Million South Florida Tobacco Verdict

Dec 9th, 2019
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Parental Tobacco Counseling in the Well-Child Visit—A Method With Enhanced Effectiveness but Nowhere to Go

Aug 12th, 2019
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https://jamanetwork.com/journals/jamapediatrics/article-abstract/2748379

Exposure to tobacco is the leading preventable cause of disease and death in the United States and as such was noted in the recent US Surgeon General’s report, “The Health Consequences of Smoking: 50 Years of Progress”: “The epidemic of smoking-caused disease in the 20th century ranks among the greatest public health catastrophes of the century, while the decline of smoking consequent to tobacco control is surely one of public health’s greatest successes.”1(p33) As the documented consequences of passive tobacco exposure make clear, these observations are as relevant for the pediatric population of this country as they are for adults.

The Science to Inform a Tobacco Product Standard for the Level of Nicotine in Combusted Cigarettes

Oct 11th, 2018
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‘Heat-Not-Burn’ Cigarettes Still Damage Lungs

Oct 11th, 2018
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Higher taxes show way to cut smoking in Hong Kong

Oct 11th, 2018
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THE TRUE COST OF TOBACCO

Oct 9th, 2018
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This week, the World Bank will release its Human Capital Index. This index rates countries on how close they are to having a healthy, educated workforce that is prepared for the more highly-skilled jobs of the future; and to compete effectively in the global economy.

The health and economic costs of tobacco are clear: it kills more than seven million people every year and millions more suffer from tobacco-related disease – often during their most economically productive years. The global economic cost of smoking amounts to nearly 2 trillion dollars annually, almost 2 per cent of the world’s GDP.

The tobacco industry pushes a narrative about its own economic contribution as an obstacle to the implementation of tobacco control policies. The true cost of tobacco is to be found in the stories of suffering told by the victims like Ike, a non-smoking mother of two from Indonesia, who developed throat cancer from second-hand smoke exposure, or Sunita, a 27-year old smokeless tobacco user from India, who never smoked but developed fatal oral cancer.

The FCTC and the ITP are solutions to reducing tobacco’s harm. If they are properly implemented, cost savings from improved health and productivity, and increased taxes, can fund investments in a country’s human capital and save lives.

Vital Strategies

The male fertility crisis continues: Quality of sperm plummets

Oct 8th, 2018
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The devastating effects of smoking

Oct 8th, 2018
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‘Heat-not-burn’ cigarettes still damage lungs

Sep 22nd, 2018
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https://www.reuters.com/article/us-health-iqos/heat-not-burn-cigarettes-still-damage-lungs-idUSKCN1M12CB

(Reuters Health) – A new type of “heat-not-burn” cigarette may lead to just as much lung damage as traditional cigarettes, a recent study suggests.

So-called “heat-not-burn” devices are designed to heat disposable tobacco sticks and give users the taste of tobacco without the smoke or ash.

For the study, researchers analyzed data submitted by Philip Morris International to the U.S. Food and Drug Administration when the company was trying to win regulatory approval to market its I-Quit-Ordinary Smoking (IQOS) product as a safer alternative to traditional cigarettes.

The FDA has yet to weigh in on whether Philip Morris can sell its IQOS device as a lower-risk cigarette alternative. But an expert scientific panel convened by the FDA recommended against such a move earlier this year, and the new study offers fresh evidence of health risks associated with IQOS.

When smokers switched from traditional cigarettes to “heat-not-burn” devices, researchers didn’t find any evidence of improvements in lung function or reductions in inflammation that can signal tobacco-related blood vessel damage.

“Even if a patient could switch completely from regular cigarettes to heat-not-burn products, Philip Morris International’s own data shows that there will continue to be significant health risks associated with these products,” said lead study author Dr. Farzad Moazed of the University of California, San Francisco.

“Although quitting smoking is challenging, there are many other options for smoking cessation that are more effective and safer than the use of these products,” Moazed said by email.

There is evidence that IQOS may reduce exposure to certain harmful chemicals, Moazed said, a point Philip Morris emphasized in a statement released after the FDA advisory panel decision. (bit.ly/2O0S42z)

Philip Morris also disputed the study authors’ conclusions.

“The totality of evidence available on IQOS supports that it is likely to present less risk of harm compared to continued smoking,” Philip Morris said in an emailed statement to Reuters Health. “This includes a significant reduction in inflammatory response and favorable changes in lung function.” (bit.ly/2QPuiVF)

“Heated tobacco products, also known as heat-not-burn products, generate a nicotine aerosol by heating sticks made up of tobacco and other chemicals without lighting them on fire,” Moazed said. “While this reduces the amount of some of the harmful chemicals associated with smoking, it increases the levels of other chemicals, and the evidence to date shows that these products continue to result in harm.”

While there’s limited data on the safety of IQOS relative to traditional cigarettes, and no long-term studies, the available evidence suggests that the devices are just as harmful to the lungs and immune system as traditional cigarettes, Moazed’s team concludes in Tobacco Control.

It’s also unclear from research to date whether IQOS might help smokers quit, a factor that might influence how scientists think about the safety of these devices and other tobacco products sold as alternatives to traditional cigarettes.

The human studies Philip Morris submitted to the FDA excluded people who were “dual users” of both traditional cigarettes and IQOS devices, the study authors note.

Any safety advantage relative to traditional cigarettes might be diminished if people continue to smoke traditional cigarettes once they start using IQOS devices, said Bonnie Halpern-Felsher, a tobacco prevention researcher at Stanford University School of Medicine in Palo Alto, California, who wasn’t involved in the study.

“We have no studies outside of Philip Morris on whether these IQOS will actually help people quit or on their relative safety,” Halpern-Felsher added. “People are unlikely to understand what “switching completely” means and that therefore they are likely to be misled,” by any safety claims that are contingent on smoking cessation.

SOURCE: bit.ly/2NVTxXY Tobacco Control, online August 27, 2018.

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