ENDS Adults Who Smoke: Difference between revisions

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== Disposable Vapes ==

=== 2024: [https://www.sciencedirect.com/science/article/pii/S0033350623005036 Who would be affected by a ban on disposable vapes? A population study in Great Britain] ===

* We used a nationally representative survey of ~70,000 adults in the general population in Great Britain (the Smoking Toolkit Study) to describe trends in disposable e-cigarette use since 2021, establish the number who would currently be affected by a ban on disposables, and assess their sociodemographic and smoking profile.

* Our data show that while disposable vapes are particularly popular among young adults, they are also used by a large number of current smokers and ex-smokers and by people from disadvantaged groups – including those with a history of mental health conditions and working in lower paid jobs.

* These findings suggest banning disposable vapes isn’t a straightforward solution to stop young people from vaping. It could also have unintended consequences for smokers, including discouraging people from using e-cigarettes to try to quit smoking or triggering relapse among those who have already used disposables to quit. It may also worsen health inequalities. We suggest these trade-offs should be carefully considered when making decisions around banning disposables.

* Sarah E. Jackson, Harry Tattan-Birch, Lion Shahab, Melissa Oldham, Dimitra Kale, Leonie Brose, Jamie Brown

* Public Health https://doi.org/10.1016/j.puhe.2023.12.024 Received 26 October 2023, Revised 19 December 2023, Accepted 20 December 2023, Available online 24 January 2024.<br />

=Dual Use=

===2024: [https://www.tandfonline.com/doi/full/10.1080/10826084.2024.2374973 Associations Between Noticing E-Cigarette Advertising Features and E-Cigarette Appeal and Switching Interest Among Young Adult Dual Users]===

*Results: "Noticing fruit flavors (AOR = 1.67 and 1.28) and fruit images (AOR = 1.53 and 1.21) was positively associated with having any e-cigarette product appeal and switching interest. Noticing price promotions (AOR = 1.23) was positively associated with product appeal. In contrast, noticing nicotine warnings (AOR = 0.74 and 0.86), smoker-targeted claims (AOR = 0.78 and 0.89), and tobacco flavors (AOR = 0.92 and 0.90) was negatively associated with product appeal and switching interest."

===2023: [https://pubmed.ncbi.nlm.nih.gov/38192585/ Varenicline for smoking cessation in individuals who smoke cigarettes and use electronic cigarettes: a double-blind, randomised, placebo-controlled phase 3 trial]===

*Our findings indicate that inclusion of varenicline in a cessation programme for adults who smoke and use e-cigarettes with an intention to quit smoking could result in smoking abstinence without serious adverse events. In the absence of evidence from other smoking cessation methods, it could be useful to suggest the use of varenicline in cessation programmes specifically designed to help dual users stop smoking.

*Caponnetto P, Spicuzza L, Campagna D, Ahluwalia JS, Russell C, Maglia M, Riela PM, Longo CF, Caci G, Quattropani MC, Signorelli MS, Polosa R. Varenicline for smoking cessation in individuals who smoke cigarettes and use electronic cigarettes: a double-blind, randomised, placebo-controlled phase 3 trial. EClinicalMedicine. 2023 Nov 21;66:102316. doi: 10.1016/j.eclinm.2023.102316. PMID: 38192585; PMCID: PMC10772233.

===2021: [https://www.clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]===

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**Proposes an illiberal policy and fails to recognise a major global public health opportunity.

*Acknowledgement: We confirm that signatories report no conflicts with respect to FCTC Article 5.3 and no financial conflicts of interest with respect to tobacco or e-cigarette companies under the International Committee of Medical Journal Editors (ICJME) reporting standard.

===2020 [https://pubmed.ncbi.nlm.nih.gov/33086157/ A comparison of product dependence among cigarette only, ENDS only, and dual users: Findings from Wave 3 (2015-2016) of the PATH study]===

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=Older Adults=

===2021: Paper: [https://tobaccocontrol.bmj.com/content/early/2021/08/12/tobaccocontrol-2021-056945 Ignoring our elders: tobacco control’s forgotten health equity issue]===

*~~BMJ~~ Tobacco Control

*Those who suffer multiple forms of stigmatisation and feel devalued in society find it harder than higher status, socially valued individuals to change health behaviours, lacking resources and social encouragement to do so. The deprioritisation of older smokers is a symptom of institutionalised ageism, which must be addressed systematically to apply the tenets of health equity and inclusion in our work. Across all areas of tobacco control, we must do better by our elders.

**Citation: McAfee T, Malone RE, Cataldo J, Ignoring our elders: tobacco control’s forgotten health equity issue. Tobacco Control 2021;30:479-480.

===2019: Article: [https://filtermag.org/older-smokers-vaping/amp/ Older Smokers Are the Forgotten Victims of Our Vaping Wars]===

*Filter Magazine

*I’ve since discovered that older smokers, like all of us, have a lot to learn about smoking. Older people are more likely than younger smokers to think that the evidence about the harms of smoking has been exaggerated, and that smoking is something they can do little to change. They are also more likely to inaccurately believe that nicotine is the primary disease-causing ingredient in cigarettes, and that cigarettes without nicotine are safer than those with nicotine.

**Source: Annie Kleykamp, ''Filter Magazine''

===2018: Power Point: [https://archive.gfn.events/downloads/2018/AnnieKleykamp.pdf Rethinking nicotine across the lifespan: What about the older smoker?]===

*GFN: Annie Kleykamp, PhD

===2017: Article: [https://www.nytimes.com/2017/12/08/health/smokers-vaping-ecigarettes-elderly.html Some Older Smokers Turn to Vaping. That May Not Be a Bad Idea.]===

*~~NY Times~~

*A retired secretary in her 70s, she’s often the oldest customer in the shop. Not that she cares. What matters is that after ignoring decades of doctors’ warnings and smoking two packs a day, she hasn’t lit up a conventional cigarette in four years and four months...But while the proportion of Americans who smoke continues to decrease — down to 15.1 percent in 2015 — the decline has stalled among older adults.

*[https://archive.is/EInlT Archived Link]

**Source: Paula Span, ''The New York Times''

~~===2017: Article:~~ [https://~~www~~.~~aarp.org/health/conditions-treatments/info-2017~~/~~vaping-popularity-fd.html Vaping Becoming Popular Among Older Smokers~~]~~===~~

*~~AARP~~

===2017: Article: [https://web.archive.org/web/20171221001520/https://www.aarp.org/health/conditions-treatments/info-2017/vaping-popularity-fd.html Vaping Becoming Popular Among Older Smokers]===

*Public health officials, however, are divided over vaping’s benefits for older smokers. Some say it reduces the harm of smoking and it's better than doing nothing...“Old policies need to be supplemented with policies that encourage substituting e-cigarettes for the far more deadly cigarettes,” said David Levy, a professor of oncology at Georgetown University's School of Medicine and the leader of the study.

**Source: Beth Brophy, ''AARP''

===2011: Paper: [https://jamanetwork.com/journals/jama/article-abstract/1104250 The Older Smoker]===

*JAMA

*Understanding how these age-related differences impact smoking-related outcomes (eg, tobacco withdrawal, acute effects of smoking, treatment efficacy) is limited because research examining older smokers is lacking. In a systematic review of tobacco withdrawal symptoms, the mean (SD) age of participants across 15 studies, chosen for their scientific rigor, was 37.8 (8.1) years.

*[https://sci-hub.st/10.1001/jama.2011.1221 PDF Full Paper]

**Citation: Kleykamp, B. A., & Heishman, S. J. (2011). The Older Smoker. JAMA, 306(8). doi:10.1001/jama.2011.1221

=Personal Testimonies from people who used to smoke=

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=Regulations (not including taxes)=

2023: [https://pubmed.ncbi.nlm.nih.gov/37452656/ Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation.]

===2023: [https://pubmed.ncbi.nlm.nih.gov/37452656/ Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation.]===

* Moore G, Hallingberg B, Brown R, McKell J, Van Godwin J, Bauld L, Gray L, Maynard O, Mackintosh AM, Munafò M, Blackwell A, Lowthian E, Page N. Public Health Res (Southampt). 2023 Jun;11(5):1-102. doi: 10.3310/WTMH3198. PMID: 37452656

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*Citation: Hall, W., Gartner, C., & Forlini, C. (2015). Ethical issues raised by a ban on the sale of electronic nicotine devices. Addiction, 110(7), 1061–1067. doi:10.1111/add.12898

*Acknowledgement: C.G. is supported by an NHMRC Career Development Award. C.F. is supported by funding from the Australia Research Council for research on the use of stimulant drugs as cognitive enhancers. We would like to thank Sarah Yeates for her assistance in preparing this paper for publication.

=Taxes=

@@ Line 8: / Line 8: @@
+== Disposable Vapes ==
+=== 2024: [https://www.sciencedirect.com/science/article/pii/S0033350623005036 Who would be affected by a ban on disposable vapes? A population study in Great Britain] ===
+* We used a nationally representative survey of ~70,000 adults in the general population in Great Britain (the Smoking Toolkit Study) to describe trends in disposable e-cigarette use since 2021, establish the number who would currently be affected by a ban on disposables, and assess their sociodemographic and smoking profile.
+* Our data show that while disposable vapes are particularly popular among young adults, they are also used by a large number of current smokers and ex-smokers and by people from disadvantaged groups – including those with a history of mental health conditions and working in lower paid jobs.
+* These findings suggest banning disposable vapes isn’t a straightforward solution to stop young people from vaping. It could also have unintended consequences for smokers, including discouraging people from using e-cigarettes to try to quit smoking or triggering relapse among those who have already used disposables to quit. It may also worsen health inequalities. We suggest these trade-offs should be carefully considered when making decisions around banning disposables.
+* Sarah E. Jackson, Harry Tattan-Birch, Lion Shahab, Melissa Oldham, Dimitra Kale, Leonie Brose, Jamie Brown
+* Public Health https://doi.org/10.1016/j.puhe.2023.12.024 Received 26 October 2023, Revised 19 December 2023, Accepted 20 December 2023, Available online 24 January 2024.<br />
 =Dual Use=
+===2024: [https://www.tandfonline.com/doi/full/10.1080/10826084.2024.2374973 Associations Between Noticing E-Cigarette Advertising Features and E-Cigarette Appeal and Switching Interest Among Young Adult Dual Users]===
+*Results: "Noticing fruit flavors (AOR = 1.67 and 1.28) and fruit images (AOR = 1.53 and 1.21) was positively associated with having any e-cigarette product appeal and switching interest. Noticing price promotions (AOR = 1.23) was positively associated with product appeal. In contrast, noticing nicotine warnings (AOR = 0.74 and 0.86), smoker-targeted claims (AOR = 0.78 and 0.89), and tobacco flavors (AOR = 0.92 and 0.90) was negatively associated with product appeal and switching interest."
+===2023: [https://pubmed.ncbi.nlm.nih.gov/38192585/ Varenicline for smoking cessation in individuals who smoke cigarettes and use electronic cigarettes: a double-blind, randomised, placebo-controlled phase 3 trial]===
+*Our findings indicate that inclusion of varenicline in a cessation programme for adults who smoke and use e-cigarettes with an intention to quit smoking could result in smoking abstinence without serious adverse events. In the absence of evidence from other smoking cessation methods, it could be useful to suggest the use of varenicline in cessation programmes specifically designed to help dual users stop smoking.
+*Caponnetto P, Spicuzza L, Campagna D, Ahluwalia JS, Russell C, Maglia M, Riela PM, Longo CF, Caci G, Quattropani MC, Signorelli MS, Polosa R. Varenicline for smoking cessation in individuals who smoke cigarettes and use electronic cigarettes: a double-blind, randomised, placebo-controlled phase 3 trial. EClinicalMedicine. 2023 Nov 21;66:102316. doi: 10.1016/j.eclinm.2023.102316. PMID: 38192585; PMCID: PMC10772233.
 ===2021: [https://www.clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]===
@@ Line 29: / Line 43: @@
 **Proposes an illiberal policy and fails to recognise a major global public health opportunity.
 *Acknowledgement: We confirm that signatories report no conflicts with respect to FCTC Article 5.3 and no financial conflicts of interest with respect to tobacco or e-cigarette companies under the International Committee of Medical Journal Editors (ICJME) reporting standard.
 ===2020 [https://pubmed.ncbi.nlm.nih.gov/33086157/ A comparison of product dependence among cigarette only, ENDS only, and dual users: Findings from Wave 3 (2015-2016) of the PATH study]===
@@ Line 304: / Line 317: @@
 =Older Adults=
 ===2021: Paper: [https://tobaccocontrol.bmj.com/content/early/2021/08/12/tobaccocontrol-2021-056945 Ignoring our elders: tobacco control’s forgotten health equity issue]===
-*BMJ Tobacco Control
+*Those who suffer multiple forms of stigmatisation and feel devalued in society find it harder than higher status, socially valued individuals to change health behaviours, lacking resources and social encouragement to do so. The deprioritisation of older smokers is a symptom of institutionalised ageism, which must be addressed systematically to apply the tenets of health equity and inclusion in our work. Across all areas of tobacco control, we must do better by our elders.
+**Citation: McAfee T, Malone RE, Cataldo J, Ignoring our elders: tobacco control’s forgotten health equity issue. Tobacco Control 2021;30:479-480.
 ===2019: Article: [https://filtermag.org/older-smokers-vaping/amp/ Older Smokers Are the Forgotten Victims of Our Vaping Wars]===
-*Filter Magazine
+*I’ve since discovered that older smokers, like all of us, have a lot to learn about smoking. Older people are more likely than younger smokers to think that the evidence about the harms of smoking has been exaggerated, and that smoking is something they can do little to change. They are also more likely to inaccurately believe that nicotine is the primary disease-causing ingredient in cigarettes, and that cigarettes without nicotine are safer than those with nicotine.
+**Source: Annie Kleykamp, ''Filter Magazine''
 ===2018: Power Point: [https://archive.gfn.events/downloads/2018/AnnieKleykamp.pdf Rethinking nicotine across the lifespan:  What about the older smoker?]===
 *GFN: Annie Kleykamp, PhD
 ===2017: Article: [https://www.nytimes.com/2017/12/08/health/smokers-vaping-ecigarettes-elderly.html Some Older Smokers Turn to Vaping. That May Not Be a Bad Idea.]===
-*NY Times
+*A retired secretary in her 70s, she’s often the oldest customer in the shop. Not that she cares. What matters is that after ignoring decades of   doctors’ warnings and smoking two packs a day, she hasn’t lit up a conventional cigarette in four years and four months...But while the proportion of Americans who smoke continues to decrease — down to 15.1 percent in 2015 — the decline has stalled among older adults.
+*[https://archive.is/EInlT Archived Link]
+**Source: Paula Span, ''The New York Times''
-===2017: Article: [https://www.aarp.org/health/conditions-treatments/info-2017/vaping-popularity-fd.html Vaping Becoming Popular Among Older Smokers]===
-*AARP
+===2017: Article: [https://web.archive.org/web/20171221001520/https://www.aarp.org/health/conditions-treatments/info-2017/vaping-popularity-fd.html Vaping Becoming Popular Among Older Smokers]===
+*Public health officials, however, are divided over vaping’s benefits for older smokers. Some say it reduces the harm of smoking and it's better than doing nothing...“Old policies need to be supplemented with policies that encourage substituting e-cigarettes for the far more deadly cigarettes,” said David Levy, a professor of oncology at Georgetown University's School of Medicine and the leader of the study.
+**Source: Beth Brophy, ''AARP''
 ===2011: Paper: [https://jamanetwork.com/journals/jama/article-abstract/1104250 The Older Smoker]===
-*JAMA
+*Understanding how these age-related differences impact smoking-related outcomes (eg, tobacco withdrawal, acute effects of smoking, treatment efficacy) is limited because research examining older smokers is lacking. In a systematic review of tobacco withdrawal symptoms, the mean (SD) age of participants across 15 studies, chosen for their scientific rigor, was 37.8 (8.1) years.
+*[https://sci-hub.st/10.1001/jama.2011.1221 PDF Full Paper]
+**Citation: Kleykamp, B. A., & Heishman, S. J. (2011). The Older Smoker. JAMA, 306(8). doi:10.1001/jama.2011.1221
 =Personal Testimonies from people who used to smoke=
@@ Line 415: / Line 427: @@
 =Regulations (not including taxes)=
-: [https://pubmed.ncbi.nlm.nih.gov/37452656/ Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation.]
+===2023: [https://pubmed.ncbi.nlm.nih.gov/37452656/ Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation.]===
 * Moore G, Hallingberg B, Brown R, McKell J, Van Godwin J, Bauld L, Gray L, Maynard O, Mackintosh AM, Munafò M, Blackwell A, Lowthian E, Page N. Public Health Res (Southampt). 2023 Jun;11(5):1-102. doi: 10.3310/WTMH3198. PMID: 37452656
@@ Line 522: / Line 535: @@
 *Citation: Hall, W., Gartner, C., & Forlini, C. (2015). Ethical issues raised by a ban on the sale of electronic nicotine devices. Addiction, 110(7), 1061–1067. doi:10.1111/add.12898
 *Acknowledgement: C.G. is supported by an NHMRC Career Development Award. C.F. is supported by funding from the Australia Research Council for research on the use of stimulant drugs as cognitive enhancers. We would like to thank Sarah Yeates for her assistance in preparing this paper for publication.
 =Taxes=