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Waterpipe Tobacco Smoking: A Global Epidemic

March 20, 2015 Comments off

Waterpipe Tobacco Smoking: A Global Epidemic
Source: Tobacco Control

The story has been told many times: waterpipe, a centuries-old tobacco use method in which smoke is passed through water before being inhaled, probably originated on the Indian subcontinent and southeast Asia. Over the years, it spread and became popular in the Middle East. During most of the 20th century, it seemed that waterpipe’s heyday had passed, in favour of easy-to-use types of tobacco such as cigarettes. Its use was not even registered in the expanding body of global tobacco surveillance systems. The medical and public health literatures made little note of it: Rakower and Fatal’s examination of lung cancer mortality rates by ethnic groups in Jerusalem that differed in their use of waterpipe, appearing in the British Journal of Cancer, was the first notice of waterpipe in Medline in 1962, and almost 20 years were to pass before any additional studies were to appear. But things suddenly changed in the 1990s: upticks in use were observed in the Middle East, especially among teenagers and young adults. This was mostly fuelled by the invention of flavoured and easier-to-use tobacco, a growing café culture in the Middle East, and expanding internet availability and globalisation. As a result, waterpipe use has snowballed globally at the start of the 21st century.

Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products (2015)

March 19, 2015 Comments off

Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products (2015)
Source: Institute of Medicine

Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine.

At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.

Youth Tobacco Product Use in the United States

February 12, 2015 Comments off

Youth Tobacco Product Use in the United States
Source: Pediatrics

BACKGROUND: Noncigarette tobacco products are increasingly popular among youth, especially cigarette smokers. Understanding multiple tobacco product use is necessary to assess the effects of tobacco products on population health. This study examines multiple tobacco product use and associated risk factors among US youth.

METHODS: Estimates of current use were calculated for cigarettes, cigars, smokeless tobacco, hookah, e-cigarettes, pipes, bidis, kreteks, snus, and dissolvable tobacco by using data from the 2012 National Youth Tobacco Survey (n = 24 658), a nationally representative sample of US middle and high school students. Associations between use patterns and demographic characteristics were examined by using multinomial logistic regression.

RESULTS: Among youth, 14.7% currently use 1 or more tobacco products. Of these, 2.8% use cigarettes exclusively, and 4% use 1 noncigarette product exclusively; 2.7% use cigarettes with another product (dual use), and 4.3% use 3 or more products (polytobacco use). Twice as many youth use e-cigarettes alone than dual use with cigarettes. Among smokers, polytobacco use was significantly associated with male gender (adjusted relative risk ratio [aRRR] = 3.71), by using flavored products (aRRR = 6.09), nicotine dependence (aRRR = 1.91), tobacco marketing receptivity (aRRR = 2.52), and perceived prevalence of peer use of tobacco products (aRRR = 3.61, 5.73).

CONCLUSIONS: More than twice as many youth in the United States currently use 2 or more tobacco products than cigarettes alone. Continued monitoring of tobacco use patterns is warranted, especially for e-cigarettes. Youth rates of multiple product use involving combustible products underscore needs for research assessing potential harms associated with these patterns.

Government of Canada Reveals New Research on Tobacco, Alcohol and Drug Use

February 6, 2015 Comments off

Government of Canada Reveals New Research on Tobacco, Alcohol and Drug Use
Source: Health Canada

The Government of Canada published today the results of the 2013 Canadian Tobacco, Alcohol, and Drugs Survey (CTADS), which demonstrate progress made in sustaining all-time lows in smoking rates, while also highlighting the need for continued attention to issues such as marijuana use among youth and prescription drug abuse.

The CTADS is a national general population survey of tobacco, alcohol and drug use among Canadians aged 15 years and older, with a focus on 15-24 year olds. More than 14,500 Canadians were interviewed for the survey, conducted by Statistics Canada on behalf of Health Canada.

The survey includes the first national data on e-cigarette use, which will add to the growing body of knowledge Health Canada is gathering to determine next steps in regulating this product. Last fall, Minister Ambrose asked the Standing Committee on Health to study the potential risks and benefits of e-cigarettes and to seek the advice of a variety of health stakeholders. The Standing Committee report is expected to be released in early 2015.

Understanding trends in tobacco, alcohol and drug use is vital to the effective development and implementation of strategies, policies and programs. The CTADS data will contribute to sources of evidence as the Government of Canada continues to create policies and programs that respond to the needs of Canadians and protect health and safety.

This is the first release of the CTADS, which merged two previous survey tools – the Canadian Tobacco Use Monitoring Survey (CTUMS) and the Canadian Drug and Alcohol Use Monitoring Survey (CADUMS), streamlining federal efforts and representing the first time that tobacco, drug and alcohol data has been reported together.

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012

February 6, 2015 Comments off

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists.

Methods:
National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing.

Results:
Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans.

Conclusion:
Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing.

Implications for Public Health Practice:
Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.

Guide to Cigarette Litter Prevention

January 19, 2015 Comments off

Guide to Cigarette Litter Prevention
Source: Keep America Beautiful

A cigarette butt or cigar tip dropped to the ground seems insignificant. But follow that butt as it’s carried off by rain into storm drains and eventually to streams and rivers. It now adds up to a big impact on the places we live: In fact, 32% of litter at storm drains is tobacco products.

Cigarette butt litter creates blight. It accumulates in gutters, and outside doorways and bus shelters. It’s the number one most littered item anywhere. Increasing amounts of litter in a business district, along riverfronts, or recreation areas create a sense that no one cares, leading to more community disorder and crime.

Cigarette butts and cigar tips don’t disappear. About 95% of cigarette filters are composed of cellulose acetate, a form of plastic which does not quickly degrade and can persist in the environment. Cigar tips, too, are predominantly plastic.

Filters are harmful to waterways and wildlife. Litter traveling through storm drains and water systems, ends up in local streams, rivers, and waterways. Nearly 80% of marine debris comes from land-based sources. Cigarette butt litter can also pose a hazard to animals and marine life when they mistake filters for food.

Tobacco Use Among Middle and High School Students — United States, 2013

January 5, 2015 Comments off

Tobacco Use Among Middle and High School Students — United States, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

Tobacco use is the leading preventable cause of disease and death in the United States, and nearly all tobacco use begins during youth and young adulthood (1,2). Among U.S. youths, cigarette smoking has declined in recent years; however, the use of some other tobacco products has increased (3), and nearly half of tobacco users use two or more tobacco products (4). CDC analyzed data from the 2013 National Youth Tobacco Survey* to determine the prevalence of ever (at least once) and current (at least 1 day in the past 30 days) use of one or more of 10 tobacco products (cigarettes, cigars, hookahs, smokeless tobacco, electronic cigarettes [e-cigarettes], pipes, snus, bidis, kreteks, and dissolvable tobacco) among U.S. middle school (grades 6–8) and high school (grades 9–12) students. In 2013, 22.9% of high school students reported current use of any tobacco product, and 12.6% reported current use of two or more tobacco products; current use of combustible products (i.e., cigarettes, cigars, pipes, bidis, kreteks, and/or hookahs) was substantially greater (20.7%) than use of other types of tobacco. Also, 46.0% of high school students reported having ever tried a tobacco product, and 31.4% reported ever trying two or more tobacco products. Among middle school students, 3.1% reported current use of cigars, and 2.9% reported current use of cigarettes, with non-Hispanic black students more than twice as likely to report current use of cigars than cigarettes. Monitoring the prevalence of the use of all available tobacco products, including new and emerging products, is critical to support effective population-based interventions to prevent and reduce tobacco use among youths as part of comprehensive tobacco prevention and control programs.

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