Smoking Topography in Response to Denicotinized and High-Yield Nicotine Cigarettes in Adolescent Smokers

PurposeThe objective of this study was to explore the smoking topography of adolescent smokers. It is well established that the majority of adult nicotine-dependent smokers began smoking as adolescents. Whereas recent advances have been made with respect to identification of factors that predispose to nicotine dependence, very little is known about the actual smoking behavior (e.g., topography) of adolescent smokers, or its relationship to nicotine dependence. Correspondingly, the extent to which adolescent smokers smoke to obtain nicotine is also unknown.MethodsIn the present study, we assessed several topographical indices of smoking (e.g., puff volume, puff number) in a sample of 35 light, adolescent smokers. Moreover, we examined whether smoking behavior is different in response to smoking a denicotinized relative to a high-yield, nicotine cigarette.ResultsAll participants evidenced a significant increase in expired air carbon monoxide after the smoking of a cigarette. Results of independent-sample t-tests revealed that adolescents who smoked a low-yield nicotine cigarette took significantly more puffs per cigarette than did those who smoked a high-yield cigarette.ConclusionsThese findings suggest that adolescent smokers do titrate their nicotine intake in response to smoking denicotinized cigarettes, but do so not by taking larger puffs or smoking more quickly, but by simply taking more puffs per cigarette. Implications of the findings and future directions for this type of research with adolescents are discussed.     

Smoking topography and biomarkers of exposure among Japanese smokers: associations with cigarette emissions obtained using machine smoking protocols

Objectives

Although the relative risk of lung cancer due to smoking is reported to be lower in Japan than in other countries, few studies have examined the characteristics of Japanese cigarettes or potential differences in smoking patterns among Japanese smokers.

Methods

To examine tar, nicotine and carbon monoxide (TNCO) emissions from ten leading cigarettes in Japan, machine smoking tests were conducted using the International Organization for Standardization (ISO) protocol and the Health Canada Intense (HCI) protocol. Smoking topography and tobacco-related biomarkers were collected from 101 Japanese smokers to examine measures of exposure.

Results

The findings indicate considerable variability in the smoking behavior of Japanese smokers. On average, puffing behaviors observed among smokers were more similar to the parameters of the HCI protocol, and brands with greater ventilation that yielded lower machine values using the ISO protocol were smoked more intensely than brands with lower levels of ventilation. The smokers of “ultra-low/low” nicotine-yield cigarettes smoked 2.7-fold more intensively than those of “medium/high” nicotine-yield cigarette smokers to achieve the same level of salivary cotinine (p = 0.024). CO levels in expiratory breath samples were associated with puff volume and self-reported smoking intensity, but not with nominal values of nicotine-yield reported on cigarette packages.

Conclusions

Japanese smokers engaged in “compensatory smoking” to achieve their desired nicotine intake, and levels of exposure were greater than those suggested by the nominal value of nicotine and tar yields reported on cigarette packages.     

Smoking topography and trajectory of asthmatic adolescents requesting cessation treatment

BACKGROUND: Teenage smokers cite health concerns as their primary motivators for tobacco smoking cessation. Smoke exposure aggravates the clinical course of asthma, yet few reports have examined the association between asthma and smoking topography and trajectory. METHODS: Before their enrollment in a smoking cessation trial, we assessed the smoking topography (i.e., puff volume, maximum puff velocity, puff duration, and interpuff interval) and smoking trajectory (i.e., age of first cigarette, age of daily smoking, time to treatment request, and prior quit attempts) in 30 self-reported asthmatic and 92 nonasthmatic tobacco-dependent teenagers (mean age, 15.2 +/- 1.3 years, 28.7% African-American). Approximately one-half of asthmatics used prescribed medications for their asthma. RESULTS: There was no significant difference in smoking topography or smoking trajectory variables between asthmatic and nonasthmatic adolescents, nor between medicated and nonmedicated asthma subgroups. CONCLUSIONS: Although tobacco smoking exacerbates asthmatic symptoms, these data suggest that age of smoking initiation, as well as smoking topography characteristics in asthmatic adolescents, does not differ from those of adolescents without asthma. These findings highlight the need for more effective health counseling of asthmatic youth regarding the physical and behavioral effects of smoking.     

Smoking-Related Cue-Induced Brain Activation in Adolescent Light Smokers

PurposeTo examine using functional magnetic resonance imaging whether adolescents with low levels of nicotine exposure (light smokers) display neural activation in areas shown to be involved with addiction in response to smoking-related stimuli.Design/Setting/ParticipantsA total of 12 adolescent light smokers (aged 13–17, who smoked 1–5 cigarettes per day) and 12 nonsmokers (ages 13–17, never smoked a cigarette) from the San Francisco Bay Area underwent functional magnetic resonance imaging scanning. During scanning, the adolescents were shown photographic blocks of smoking and control cues. Smoking cues comprised pictures of individuals smoking cigarettes and smoking-related objects such as lighters and ashtrays. Neutral cues comprised images of everyday objects and individuals engaged in daily activities.FindingsFor smokers, smoking cues elicited greater activation than neutral cues in the mesolimbic reward circuit (left anterior cingulate: t = 7.04, p < .001; right hippocampus: t = 6.37, p < .001). We found activation from smoking cues versus neutral cues within both the left and right frontal medial orbital regions (t = 5.09, p < .001 and t = 3.94, p = .001, respectively). Nonsmokers showed no significant difference in activation between smoking-related cues and neutral cues.ConclusionOur finding that smoking cues produced activation in adolescent light smokers in brain regions, similar to that seen in adult and teenage heavy smokers, suggests that adolescents exhibit heightened reactivity to smoking cues even at low levels of smoking. This article adds to the existing published data by suggesting that nicotine dependence may begin with exposure to low levels of nicotine, thus underscoring the need for early intervention among adolescent smokers.     

Menthol vs nonmenthol cigarettes: effects on smoking behavior.

OBJECTIVES. The purpose of this study was to examine intraindividual differences in smoking behavior between smoking regular and mentholated cigarettes. METHODS. Healthy male smokers (n = 29) smoked either a regular or a mentholated cigarette in two separate sessions 1 week apart. Commercial brands with comparable tar, nicotine, and CO content were used. Smoking behavior was constrained by fixed 15-second interpuff intervals, but puff volume and number of puffs were unconstrained. RESULTS. When smoking the non-mentholated brand of cigarettes, participants smoked 22% more puffs and had 13% higher mean volumes per puff than they did when smoking the mentholated brand of cigarettes. The aggregate 39% excess exposure to cigarette smoke in the regular-cigarette condition was not accompanied by commensurate excesses in expired carbon monoxide or in physiological measures normally correlated with nicotine exposure. CONCLUSIONS. These findings parallel differences in physiological correlates of exposure to nicotine found in cross-sectional comparisons of African-American and White smokers and are consistent with the results of emerging laboratory investigations.     

Smoking behaviours and contextual influences on adolescent nicotine dependence

Objective: The objectives of the study were to analyse nicotine‐dependence patterns among secondary school students in New Zealand (NZ), and identify factors associated with levels of nicotine dependence. Method: This study uses data from the 2004 Youth Lifestyle Study, a survey of Year 10 and 12 students from randomly selected schools in NZ. The analysis included 625 current adolescent smokers. Nicotine dependence was measured with the Hooked on Nicotine Checklist (HONC). Potential dependence‐associated factors studied include: socio‐demographic factors; smoking behaviours; and smoking contexts. Results: A large percentage (87.9%) of the current adolescent smokers reported at least one HONC symptom, with a mean HONC score of 4.9 out of a possible 10. Multivariate analyses identified: school decile; age at which started smoking monthly; lifetime cigarette consumption; and peers smoking as statistically significant predictors of nicotine dependence. Conclusions: Adolescent smokers are very likely to become dependent on nicotine. Students from the highest school decile had markedly lower HONC scores. Earlier onset of monthly smoking, heavier overall consumption and peers smoking were associated with higher HONC scores. These findings provide important insights into factors that may need to be modified to help reduce nicotine dependence among adolescents.     

Accessibility of nicotine dependence therapy

Bulgaria and Poland are two leading countries in Eastern Europe in terms of smoking prevalence. One of the main reasons that makes the process of quitting smoking so difficult is nicotine dependence (ND). Its pharmacological treatment has shown very good results. This provides a basis for limiting cigarette consumption among nicotine-dependent smokers. The aim of the study was to determine whether nicotine dependence therapy (NDT) is within the means of all social levels in both countries examined and how the prices of nicotine dependence treatment reflect on sales of anti-smoking drugs. For this purpose the drugs used in NDT, registered during 2005, have been examined and the prices of one course in Bulgaria and Poland have been compared. The price of one course of NDT against the average salary for the duration of the course period has been recalculated. The results show higher accessibility of NDT in Poland in comparison with the rather high therapy expenses in Bulgaria. Nevertheless, there is a cytisine product that shows higher accessibility authorized for use in both countries.     

Early-Emerging Nicotine Dependence Has Lasting and Time-Varying Effects on Adolescent Smoking Behavior

Novice and light adolescent smokers can develop symptoms of nicotine dependence, which predicts smoking behavior several years into the future. However, little is known about how the association between these early - emerging symptoms and later smoker behaviors may change across time from early adolescence into young adulthood. Data were drawn from a 7-year longitudinal study of experimental (<100 cigarettes/lifetime; N?=?594) and light (100+ cigarettes/lifetime, but ≤5 cigarettes/day; N?=?152) adolescent smokers. Time-varying effect models were used to examine the relationship between baseline nicotine dependence (assessed at age 15?±?2 years) and future smoking frequency through age 24, after controlling for concurrent smoking heaviness. Baseline smoking status, race, and sex were examined as potential moderators of this relationship. Nicotine dependence symptoms assessed at approximately age 15 significantly predicted smoking frequency through age 24, over and above concurrent smoking heaviness, though it showed declining trends at older ages. Predictive validity was weaker among experimenters at young ages (<16), but stronger at older ages (20–23), relative to light smokers. Additionally, nicotine dependence was a stronger predictor of smoking frequency for white smokers around baseline (ages 14.5–16), relative to nonwhite smokers. Nicotine dependence assessed in mid-adolescence predicts smoking frequency well into early adulthood, over and above concurrent smoking heaviness, especially among novice smokers and nonwhite smokers. Early-emerging nicotine dependence is a promising marker for screening and interventions aimed at preventing smoking progression.     

E-cigarette use among women of reproductive age: Impulsivity,cigarette smoking status,and other risk factors

IntroductionThe study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant.MethodSurvey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24–44 years from the US. Half (n = 400) reported current, daily smoking and half (n = 400) reported smoking < 100 cigarettes lifetime. Participants completed questionnaires regarding sociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression.ResultsDaily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products.ConclusionsE-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs.     

Ethnic Discrimination and Smoking-Related Outcomes among Former and Current Arab Male Smokers in Israel: The Buffering Effects of Social Support

We examined the relationship between two forms of ethnic discrimination—interpersonal and institutional—and smoking outcomes among Arab men in Israel, and whether social support buffered these associations. We used cross-sectional data of adult Arab men, current or former smokers (n?=?954). Mixed-effects regression models estimated the association between discrimination and smoking status, and nicotine dependence among current smokers. Interpersonal discrimination was associated with higher likelihood of being a current smoker compared to a former smoker, whereas institutional group discrimination was not. Social support moderated the ethnic discrimination-nicotine dependence link. Among men with low social support, greater interpersonal discrimination was associated with greater nicotine dependence. Similarly, among smokers with high institutional group discrimination, those with high social support reported lower nicotine dependence compared to those with low social support. Ethnic discrimination should be considered in efforts to improve smoking outcomes among Arab male smokers in Israel.     

Influence of puffing conditions on the carbonyl composition of e-cigarette aerosols

Owing to their harmful effects on human health, the presence of carbonyl compounds in e-cigarette aerosols raises concerns. To date, the reported concentration levels in e-vapors vary greatly between studies and several factors that markedly influence carbonyl emission during vaping have been highlighted including the heating temperature, the power supply, the device architecture, the filling level of the tank and the main e-liquid constituents. This study investigated the impact of puffing regimen parameters on the carbonyl composition of e-cigarette aerosols with the aim of: (1) better estimating the variability of carbonyl emissions depending on puffing conditions; (2) highlighting puffing profiles that increase the exposure to carbonyls; and (3) estimating to what extent puffing topography could be implied in the variability of carbonyl concentrations reported in the current literature.E-vapors from a single e-liquid were generated from two e-cigarette models with a smoking machine. A total of 7 different puffing regimens were used to individually study the influence of the puff volume, duration and frequency. Carbonyls were collected by DNPH cartridges and analysed by HPLC-UV. E-liquid consumption and e-vapor temperature were also monitored.E-vapor concentrations of formaldehyde, acetaldehyde, acetone, acrolein, propionaldehyde and methylglyoxal were affected, sometimes differently, by the modification of the puffing regimen, as well as by the e-cigarette model. For example, formaldehyde concentration ranged from 20 to 255 ng/puff depending on the puffing conditions. The results of principal component analyses, applied to the concentration data sets for the 6 carbonyls, suggest that the studied parameters interact and highlight some “carbonyl-emitting” combinations of concern (e-cigarette model/puffing regimen). However, the highest concentrations measured in the present study remain far lower than those observed in conventional cigarette mainstream smoke.This study confirms that the chosen puffing regimen contributes a part of the observed variability in the carbonyl levels reported in the scientific literature, hampering comparisons between studies and making interpretation difficult. Thus, harmonized and realistic protocols for the assessment of e-cigarette toxicity by physicochemical or experimental approaches are clearly needed.     

Stages of change, smoking characteristics, and cotinine concentrations in smokers: setting priorities for smoking cessation

ObjectiveWe assessed whether the salivary cotinine content of daily smokers varied with the readiness to quit and smoking characteristics.MethodsThis cross-sectional study was conducted in Barcelona, Spain (n = 1245) in 2004–2005. We administered a questionnaire to assess smoking behaviour and collected saliva to determine the cotinine content. We determined the distribution of 278 adult daily smokers across different stages of change and categorised them by individual and smoking characteristics. We used medians and interquartile ranges (IQR) to relate cotinine concentrations to different stages of change, tobacco consumption, and nicotine dependence based on the Fagerström Test for Nicotine Dependence (FTND).ResultsAround 68%, 22%, and 11% of smokers were in precontemplation, contemplation, and preparation stages, respectively. A mean of 17.0 cigarettes was smoked daily, with no differences among stages of change. The median cotinine concentration was 151.3 ng/ml (IQR: 83.2–227.8 ng/ml), with no differences among stages of change. The cigarette consumption scores, FTND, and time to first cigarette of the day were positively associated with cotinine concentration.ConclusionsThe cotinine concentration was similar among the stages of change, but varied within each stage according to the number of cigarettes smoked, time to first cigarette of the day, and nicotine dependence.     

吸烟大学生尝试戒烟及其影响因素研究

目的 了解吸烟大学生的尝试戒烟情况及其影响因素，为有效防控大学生吸烟提供参考依据。方法以自填式结构问卷调查广州某大学271名吸烟大学生的尝试戒烟行为、戒烟信心、吸烟情况、吸烟相关的知识与信念水平、环境因素以及相关的社会学特征。结果吸烟大学生中，40．6％曾尝试过戒烟。尝试过戒烟的学生中，50．0％曾戒烟2次，戒烟持续时间最长的1a以上，平均1个月左右。多因素Logistic分析发现，“尼古丁成瘾”、“认为戒烟困难”是大学生尝试戒烟的显著性影响因素。结论在大学校园开设戒烟干预是必要和紧迫的。戒烟干预应注重尼古丁成瘾性和戒断症状的宣传和治疗，从而提高戒烟成功率，降低大学生吸烟率。     

Smoking trajectories of adolescent novice smokers in a longitudinal study of tobacco use

PURPOSE: To describe longitudinal trajectories of smoking intensity in adolescent novice smokers and to identify predictors of trajectory class membership. METHODS: Cigarette consumption among 369 novice smokers (mean age 13 years) was measured over a mean 24 months of follow-up after smoking onset. Classes of smoking intensity trajectories were identified using latent class growth modeling. Predictors of trajectory class membership were identified in polytomous logistic regression. RESULTS: There was considerable between-subject heterogeneity in individual trajectories over time. Four classes of smoking intensity trajectories were identified: low-intensity, non-progressing smokers (72.4% of subjects), and slow, moderate, and rapid escalators (11.1%, 10.8%, and 5.7% of subjects, respectively). Gender, poor academic performance, and having more than half of friends who smoke at smoking onset independently predicted development of trajectory pattern. Escalating trajectory patterns were associated with earlier development of nicotine dependence and tolerance. CONCLUSIONS: Cigarette consumption will not escalate rapidly among three-quarters of adolescent novice smokers. Novice smokers who do escalate rapidly should be targeted for early tobacco control intervention to prevent development of nicotine dependence and sustained smoking.     

Nicotine Dependence and Withdrawal Symptoms among Occasional Smokers

PurposeThis study describes the levels of nicotine dependence, withdrawal symptoms, depressive mood, and risk behavior reported by male and female weekly and monthly adolescent smokers in South Africa.MethodsA cross-sectional survey was conducted among 554 grade 9–11 weekly and monthly smokers in the Southern Cape-Karoo Region. Differences between the gender groups and smoking status were analyzed while controlling for demographic characteristics.ResultsWeekly and monthly smokers were classified as light smokers having smoked 6–10 cigarettes and 0–1 cigarettes a week, respectively. However, they displayed substantial levels of dependence, with 11.6% of weekly smokers classified as highly dependent. Furthermore, 55.9% of weekly smokers and 47.1% of the overall sample experienced more than two withdrawal symptoms. Although dependency levels and withdrawal symptoms were higher among weekly smokers, the levels were not negligible among monthly smokers. Weekly smokers reported higher levels of depressive mood and risk behavior than monthly smokers. Females reported higher levels of dependence, withdrawal symptoms, depressive mood, and lower levels of risk behavior than males. Gender differences were not found on the number of cigarettes smoked in a week.ConclusionsThis study demonstrates multiple symptoms of dependence among a large sample of adolescent occasional smokers in a multi-ethnic cultural setting. Smoking cessation programs may, therefore, be required to help adolescents quit smoking and possibly consider pharmacotherapy for highly dependent smokers. Prevention programs should also consider providing occasional smokers skills to identify and cope with withdrawal symptoms.     

The Role of Carbon Monoxide in Cigarette Smoking

? The carbon monoxide deliveries of 20 major Canadian brands of cigarettes, determined by gas chromatography and using standard smoking conditions, were estimated and found to vary by a factor of about two. The CO yields were found to increase with puff volume and tobacco moisture, decrease with increased paper porosity, but remain essentially constant with puff duration.

The data suggest that reduced CO deliveries can be achieved by increasing the cigarette paper porosity. Combustion temperature presumably also influences CO deliveries, but the relative role ascribed to dilution and combustion is not clear. It may be concluded that smokers can lower their CO exposure by reducing their puff volume, smoking cigarettes manufactured from high porosity paper, by taking fewer puffs, and decreasing their tendency to inhale.

Since CO and tar deliveries are correlated, these measures would also tend to decrease a smoker’s exposure to tar.     

The role of carbon monoxide in cigarette smoking. I. Carbon monoxide yield from cigarettes.

The carbon monoxide deliveries of 20 major Canadian brands of cigarettes, determined by gas chromatography and using standard smoking conditions, were estimated and found to vary by a factor of about two. The CO yields were found to increase with puff volume and tobacco moisture, decrease with increased paper porosity, but remain essentially constant with puff duration. The data suggest that reduced CO deliveries can be achieved by increasing the cigarette paper porosity. Combustion temperature presumably also influences CO deliveries, but the relative role ascribed to dilution and combustion is not clear. It may be concluded that smokers can lower their CO exposure by reducing their puff volume, smoking cigarettes manufactured from high porosity paper, by taking fewer puffs, and decreasing their tendency to inhale. Since CO and tar deliveries are correlated, these measures would also tend to decrease a smoker's exposure to tar.     

Effect of individually diversified smoking habits on carbon monoxide retention in the respiratory tract of active smokers and validation of results based of environmental categories

Cigarette smoke, treated as smoke inhaled by active smokers, was generated using self-made smoking-machine and with application of formerly established parameters of individual smoking process. Carbon monoxide was analysed in generated smoke. It was concluded, that diversified smoking process is very individual (different volume and duration time of puff and intervals between puffs) and therefore influences levels of carbon monoxide in MS (from 3.5 to 17.5 mg/cigarette). Simultaneously, carbon monoxide was analysed in exhaled air by active smokers just after each puff. Difference between inhaled and exhaled dose of carbon monoxide was treated to calculated individual retention of carbon monoxide in active smoker's respiratory tract. Mean relative retention was 57.6% and differences between single values were lower than in the cases of CO levels in MS and absolute retention. Estimation of carbon monoxide inhaled doses was proceeded according to environmental standards. Forecasted blood concentration of HbCO after smoking of twenty cigarettes equals 2.3 to 10.4%. These results are similar to the situation that people would inhale air containing CO with concentration 1.2 to 5.5-times higher than limiting value.     

Smoking characteristics among lesbian,gay, and bisexual adults

ObjectiveCigarette smoking is the leading preventable cause of death and disease in the United States. Sexual minorities (lesbians, gay men, and bisexuals), smoke at higher rates than the general population. However, little else is known about sexual minority smokers. Furthermore, the sexual minority population is diverse and little research exists to determine whether subgroups, such as lesbians, gay men, and female and male bisexuals, differ on smoker characteristics. We examine differences in smoking characteristics (advertising receptivity, age of first cigarette, non-daily smoking, cigarettes per day, nicotine dependence, desire to quit and past quit attempts) among lesbians, gay men, and female and male bisexual adults in the United States.MethodsSecondary analysis of the CDC's (Centers for Disease Control and Prevention) 2009–2010 National Adult Tobacco Survey (N = 118,590).ResultsControlling for age, race, socioeconomic status and geographic region, identifying as a female bisexual was associated with fewer past quit attempts, lower age at first cigarette, and higher nicotine dependence when compared to heterosexual women. There were no differences in desire to quit between male or female sexual minorities and their heterosexual counterparts.ConclusionSexual minority individuals smoke at higher rates than heterosexuals and yet similarly desire to quit. Tailored efforts may be needed to address smoking among bisexual women.     

Analyse des Rauchverhaltens bei Zigarettenrauchern

Summary Cigarette puffing behavior and depth of inhalation (expired CO) were measured in 110 non successful abstainers when smoking their habitual brand. CO-uptake was similar for smokers of all types of cigarettes (0.1–1.7 mg nicotine yield).

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Analyse quantitative de bouffées de cigarette et d'inhalation

Résumé Une analyse quantitative de bouffées de cigarette et d'inhalation (CO exhalé) a été effectuée chez 110 fumeurs récidivistes fumant leurs marques habituelles de cigarette. L'absorption de CO était semblable pour les fumeurs de toutes marques de cigarette (contenant entre 0.1 et 1.7 mg de nicotine).