Awareness, Susceptibility, and Use of Oral Nicotine Pouches and Comparative Risk Perceptions with Smokeless Tobacco Among Young Adults in the United States

Journal: PLoS One, 2023, doi: 10.1371/journal.pone.0281235

Authors: Meghan E. Morean, Krysten W. Bold, Danielle R. Davis, Grace Kong, Suchitra Krishnan-Sarin & Deepa R. Camenga


Background: Oral nicotine pouches (NPs) that contain nicotine but no tobacco leaves are rapidly gaining popularity. However, there is limited research on NPs, including within priority populations. In the current study, we examined awareness of, susceptibility to, and use of NPs in young adults as well as comparative risk perceptions with smokeless tobacco.

Methods: In 2021, 609 young adults (18-25 years) completed an online survey. Participants reported on NP awareness, susceptibility, and use as well as on comparative product perceptions for NPs versus smokeless tobacco. We ran unadjusted between-groups comparisons and an adjusted multinomial logistic regression to identify relationships between product perceptions and NP susceptibility and use.

Results: 41.5% of participants had heard of NPs before. Participants were non-susceptible (66.2%), susceptible (23.5%), or had used NPs (10.3%). Comparative product perceptions between NPs and smokeless tobacco suggested that young adults, as a whole, expressed uncertainty about the relative risk/benefit of using NPs versus smokeless tobacco. However, as expected, unadjusted and adjusted findings indicated that favorable perceptions of NPs versus smokeless tobacco were disproportionately observed among susceptible participants and NP users compared to non-susceptible individuals. Demographic differences were also observed (e.g., NP users were more likely than non-susceptible and susceptible individuals to have used smokeless tobacco).

Conclusions: Young adults reported awareness of, susceptibility to, and use of NPs, with findings indicating that favorable perceptions of NPs versus smokeless tobacco may contribute to NP susceptibility and use beyond known correlates like smokeless tobacco use. However, further research is needed to understand the full range of factors that are associated with NP susceptibility and use. It will be important to disentangle factors that are associated with potential positive public health impacts (e.g., switching from smokeless tobacco to exclusive NP use) from those associated with negative public health impacts (e.g., initiation among nicotine naïve individuals).

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Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey

Journal: International Journal of Environmental Research & Public Health, 2023, doi: 10.3390/ijerph20021399

Authors: Elizabeth K. Do, Kathleen Aarvig, Emily M. Donovan, Barbara A. Schillo, Donna M. Vallone & Elizabeth C. Hair


Background: This study aims to describe the primary sources of e-cigarettes among young people and to explore how these sources may differ by individual-level characteristics.

Methods: Data were obtained from a cross-sectional, continuous tracking survey of participants. The analytic sample includes current e-cigarette users (aged 15-20 years) surveyed from January to August 2022 (N = 1296). Respondents provided information on e-cigarette source of acquisition, device type, and flavors used, as well as sociodemographic and residential characteristics. Chi-square tests were used to determine differences in source of acquisition by age, gender, race/ethnicity, United States (US) census region, urban-rural classification, flavors used, and device type.

Results: Although most current e-cigarette users obtained their devices through a social source (56.9%), a considerable proportion obtained e-cigarettes from a retail source (43.1%). The primary retail sources of e-cigarette acquisition were vape shops (22.0%) and gas station/convenience stores (15.9%). Source of e-cigarette acquisition differed by age, gender, US census region, flavors used, and device type, such that a lower proportion of those who were younger, female, residing in the West, and used vape pens had reported obtaining e-cigarettes via retail sources.

Conclusions: Results indicate that a significant proportion of youth report obtaining e-cigarettes from retail sources, despite the federal, state, and local policies that prohibit the sale of any tobacco products to those under the age of 21. Comprehensive retail regulations to help restrict tobacco product access are needed to reduce e-cigarette use among young people.

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Using SBIRT (Screen, Brief Intervention, and Referral Treatment) Training to Reduce the Stigmatization of Substance Use Disorders Among Students and Practitioners

Journal: Substance Abuse, 2023, doi: 10.1177/11782218221146391

Authors: Efren Gomez, Matthew Gyger, Stephanie Borene, Amanda Klein-Cox, Ramona Denby, Sara Hunt & Oscar Sida


Negative attitudes and stigmatization of substance-using patients lead to treatment avoidance and poor physical and health outcomes. Research suggests that training in substance use disorders is a vital tool to abate negative attitudes among health workers. The present longitudinal study trained students and experienced practitioners from various disciplines on the evidence-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) model. The study found significant improvements in the attitudes of students-but not practitioners-who were trained during the program. The paper discusses policy and implementation implications to support and complement sustained impact of training on models such as SBIRT.

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Evaluation of All-Cause and Cause-Specific Mortality by Race and Ethnicity among Pregnant and Recently Pregnant Women in the US, 2019 to 2020

Journal: JAMA Network Open, 2023, doi:10.1001/jamanetworkopen.2022.53280

Authors: Jeffrey T. Howard, Jessica K. Perrotte, Caleb Leong, Timothy J. Grigsby & Krista J. Howard


Study on all-cause and cause-specific mortality rates among pregnant and recently pregnant women 2019-2020. The all-cause mortality rate for recently pregnant women increased by 29%. Mortality rates increased by 22% for pregnancy-associated causes and 36% for nonpregnancy causes. Mortality rates increased significantly for drug poisoning, motor vehicle collision, and homicide. Compared with non-Hispanic White women, mortality rates were 3- to 5-fold higher among American Indian/Alaska Native women for every cause. Non-Hispanic Black women experienced significantly higher mortality rates for all causes except drug poisoning and suicide. Hispanic women had lower mortality rates for causes including all, all nonpregnancy, drug poisoning, motor vehicle collision, and suicide. Asian/Pacific Islander women had lower rates across all causes.

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Genetic Predisposition to Major Depressive Disorder Differentially Impacts Alcohol Consumption and High-Risk Drinking Situations in Men and Women with Alcohol Use Disorder

Journal: Drug and Alcohol Dependence, 2023, doi: 10.1016/j.drugalcdep.2022.109753

Authors: Victor M. Karpyak, Brandon J. Coombes, Jennifer R. Geske, Vanessa M. Pazdernik, Terry Schneekloth, Bhanu Prakash Kolla, Tyler Oesterl, … Joanna M Biernack


Lifetime history of major depressive disorder (MDD) has a sex-specific association with pretreatment alcohol consumption in patients with alcohol dependence. Here, we investigated the association of genetic load for MDD estimated using a polygenic risk score (PRS) with pretreatment alcohol consumption assessed with Timeline Follow Back in a sample of 287 men and 156 women meeting DSM-IV-TR criteria for alcohol dependence. Preferred drinking situations were assessed using the Inventory of Drug Taking Situations (IDTS). Linear models were used to test for association of normalized alcohol consumption measures with the MDD-PRS, adjusting for ancestry, age, sex, and number of days sober at baseline. We fit models both with and without adjustment for MDD history and alcohol-use-related PRSs as covariates. Higher MDD-PRS was associated with lower 90-day total alcohol consumption in men (β = -0.16, p = 0.0012) but not in women (β = 0.11, p = 0.18). The association of MDD-PRS with IDTS measures was also sex-specific: higher MDD-PRS was associated with higher propensity to drink in temptation-related situations in women, while the opposite (negative association) was found in men. MDD-PRS was not associated with lifetime MDD history in our sample, and adjustment for lifetime MDD and alcohol-related PRSs did not impact the results. Our results suggest that genetic load for MDD impacts pretreatment alcohol consumption in a sex-specific manner, which is similar to, but independent from, the effect of history of MDD. The clinical implications of these findings and contributing biological and psychological factors should be investigated in future studies.

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