Clear The Air News Tobacco Blog Rotating Header Image


Knowledge about electronic cigarettes and its perception: a community survey, Egypt

GDE Error: Error retrieving file - if necessary turn off error checking (404:Not Found)

Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group

GDE Error: Error retrieving file - if necessary turn off error checking (404:Not Found)

Smoking status and subjective well-being



A debate is currently underway about the Food and Drug Administration’s (FDA’s) methods for evaluating antitobacco regulation. In particular, the US government requires a cost-benefit analysis for significant new regulations, which has led the FDA to consider potential lost subjective well-being (SWB) of ex-smokers as a cost of any proposed antitobacco policy. This practice, which significantly limits regulatory capacity, is premised on the assumption that there is in fact a loss in SWB among ex-smokers.


We analyse the relationship between SWB and smoking status using a longitudinal internet survey of over 5000 Dutch adults across 5 years. We control for socioeconomic, demographic and health characteristics, and in a contribution to the literature, we additionally control for two potential confounding personality characteristics, habitual use of external substances and sensitivity to stress. In another contribution, we estimate panel fixed effects models that additionally control for unobservable time-invariant characteristics.


We find strong suggestive evidence that ex-smokers do not suffer a net loss in SWB. We also find no evidence that the change in SWB of those who quit smoking under stricter tobacco control policies is different from those who quit under a more relaxed regulatory environment. Furthermore, our cross-sectional estimates suggest that the increase in SWB from quitting smoking is statistically significant and also of a meaningful magnitude.


In sum, we find no empirical support for the proposition that ex-smokers suffer lower net SWB compared to when they were smoking.

Reasons for Electronic Nicotine Delivery System use and smoking abstinence at 6 months

A descriptive study of callers to employer and health plan-sponsored quitlines



Describe cigarette smoking abstinence among employer and health plan-sponsored quitline registrants who were not using Electronic Nicotine Delivery Systems (ENDS), were using ENDS to quit smoking or were using ENDS for other reasons at the time of quitline registration.


We examined 6029 quitline callers aged ≥18 years who smoked cigarettes at registration, and completed ≥1 counselling calls, baseline ENDS use questions and a 6-month follow-up survey (response rate: 52.4%). 30-day point prevalence smoking quit rates (PPQRs) were assessed at 6-month follow-up (ENDS-only users were considered quit). Data were weighted for non-response bias. Logistic regression analyses controlled for participant characteristics and programme engagement.


At registration, 13.8% of respondents used ENDS (7.9% to quit smoking, 5.9% for other reasons). 30-day PPQRs were: 55.1% for callers using ENDS to quit, 43.1% for callers using ENDS for other reasons, and 50.8% for callers not using ENDS at registration. Callers using ENDS for other reasons were less likely to quit than other groups (adjusted ORs=0.65–0.77); quit rates did not significantly differ between non-ENDS users and those using ENDS to quit. Among callers using ENDS to quit at baseline, 40% used ENDS regularly at follow-up.


ENDS users not using ENDS to quit smoking were less successful at quitting at 6-month follow-up compared with callers using ENDS to quit smoking and callers who did not use ENDS at programme registration. Incorporating reasons for ENDS use may be important for future studies examining the role of ENDS in tobacco cessation.

Tobacco point-of-sale advertising in downtown Buenos Aires, Argentina and compliance with the new tobacco advertising restrictions


Despite increased awareness of the health threat posed by tobacco use, Latin America continues to experience high smoking rates. Argentina is no exception, where an estimated 22.1% of adults were smokers in 2012.1 Prior to 2011, few limitations were placed on the advertisement of tobacco products in Argentina, and any restrictions were largely self-imposed by the tobacco companies.2

On 14 June 2011, Argentina enacted the ‘National Law of Tobacco Control: Law 26.687’. This law provides 42 articles that address tobacco advertising, packaging, product composition, sale/distribution, secondhand smoke, and preventive education. Notably, it largely prohibits all forms of tobacco advertisements except for those indoors at the point of sale (PoS) (table 1).3 Unfortunately it is unclear how many convenience stores are compliant with its provisions.


To investigate the compliance with the new restrictions, we surveyed all convenience stores (n=137) found in an 8 by 7 block area of Buenos Aires from July to August of 2014. This area was selected due …

Impact of Graphic Pack Warnings on Adult Smokers’ Quitting Activities

Impact of Graphic Pack Warnings on Adult Smokers’ Quitting Activities: Findings from the ITC Southeast Asia Survey (2005–2014)


Malaysia introduced graphic health warning labels (GHWLs) on all tobacco packages in 2009.

We aimed to examine if implementing GHWLs led to stronger warning reactions (e.g., thinking about the health risks of smoking) and an increase in subsequent quitting activities; and to examine how reactions changed over time since the implementation of the GHWLs in Malaysia and Thailand where GHWL size increased from 50–55% in 2010.

Data came from six waves (2005–2014) of the International Tobacco Control Southeast Asia Survey.

Between 3,706 and 4,422 smokers were interviewed across these two countries at each survey wave.

Measures included salience of warnings, cognitive responses (i.e., thinking about the health risks and being more likely to quit smoking), forgoing cigarettes, and avoiding warnings.

The main outcome was subsequent quit attempts.

Following the implementation of GHWLs in Malaysia, reactions increased, in some cases to levels similar to the larger Thai warnings, but declined over time.

In Thailand, reactions increased following implementation, with no decline for several years, and no clear effect of the small increase in warning size. Reactions, mainly cognitive responses, were consistently predictive of quit attempts in Thailand, but this was only consistently so in Malaysia after the change to GHWLs.

In conclusion, GHWLs are responded to more frequently, and generate more quit attempts, but warning wear-out is not consistent in these two countries, perhaps due to differences in other tobacco control efforts.

Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use



Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence.


Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children’s Health Study during the spring of 2014.


Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends’ use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use.


Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.


Download (PDF, 268KB)

Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents



To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents and determine whether established risk factors for smoking discriminate user categories.


School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking).

Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product).


Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers.


This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.

Cigarette pack design and adolescent smoking susceptibility

Download (PDF, 1.19MB)