Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
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Potential reduced exposure products (PREPs) purport to lower toxicant emissions, but without clinical and long-term health outcome data, claims for reduced harm status of PREPs depend heavily on standard machine yield smoke constituent data. Two prototypes of the new carbon-filtered PREP Marlboro UltraSmooth (MUS) were investigated using both standard (FTC/ISO) and intensive (Health Canada) machine methods to measure gas/vapor- and particulate-phase smoke constituents. Basic physical design characteristics that may influence smoke constituent yields, such as ventilation, pressure drop (resistance to draw), quantity of tobacco, and quantity and type of carbon, were measured. ⋯ Particulate-phase constituents were not reduced by the carbon filter under either machine-smoking regimen. The data suggest that MUS has been designed to reduce toxic yields while preserving consumer appeal. However, MUS is less effective in reducing toxic smoke constituents when smoked under intensive conditions.
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This paper assesses rates of the 5A's (ask, advise, assess, assist, and arrange) of brief provider counseling received by Medicaid-enrolled smokers and recent quitters and the differences in receipt of counseling as a function of age, gender, race, ethnicity, and health status. A random sample telephone survey was conducted among Medicaid-enrolled smokers and recent quitters in four geographic areas in the United States. Multivariate logistic regression models estimated the relationships between demographic characteristics and delivery of the 5A's. ⋯ However, they were much less likely to provide comprehensive counseling, with fewer than 25% of patients reporting receiving any assistance with quitting (i.e., a prescription for pharmacotherapy or referral to counseling) or arrangement of a follow-up visit or phone call. Receipt of the 5A's varied as a function of health status, race, and ethnicity. Medicaid needs to (a) increase provider delivery of the full spectrum of counseling interventions recommended for smoking cessation and (b) extend provider outreach to the demographic groups that receive the lowest rates of counseling.
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Most tobacco control efforts in western countries focus on the factory-made, mass-produced (FM) cigarette, whereas other tobacco products receive relatively little attention. Noncombusted tobacco products (i.e., referred to as smokeless tobacco), particularly Swedish-style snus, carry lower disease risks, compared with combusted tobacco products such as cigarettes. In this context, it is important to know what tobacco users believe about the relative harmfulness of various types of tobacco products. ⋯ Use of other tobacco products was low but may be growing among smokers in the four countries studied. Smokers are confused about the relative harms of tobacco products. Health education efforts are needed to correct smoker misperceptions.
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Review Meta Analysis
Waterpipe smoking and nicotine exposure: a review of the current evidence.
The waterpipe, also known as shisha, hookah, narghile, goza, and hubble bubble, has long been used for tobacco consumption in the Middle East, India, and parts of Asia, and more recently has been introduced into the smokeless tobacco market in western nations. We reviewed the published literature on waterpipe use to estimate daily nicotine exposure among adult waterpipe smokers. We identified six recent studies that measured the nicotine or cotinine levels associated with waterpipe smoking in four countries (Lebanon, Jordan, Kuwait, and India). ⋯ Even among subjects who were not daily waterpipe smokers, a single session of waterpipe use produced a urinary cotinine level that was equivalent to smoking two cigarettes in one day. Estimates of the nicotine produced by waterpipe use can vary because of burn temperature, type of tobacco, waterpipe design, individual smoking pattern, and duration of the waterpipe smoking habit. Our quantitative synthesis of the limited human data from four nations indicates that daily use of waterpipes produces nicotine absorption of a magnitude similar to that produced by daily cigarette use.
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Comparative Study
Higher nicotine and carbon monoxide levels in menthol cigarette smokers with and without schizophrenia.
This study examined whether smoking menthol cigarettes was associated with increased biochemical measures of smoke intake. Expired carbon monoxide (CO) and serum nicotine and cotinine were measured in 89 smokers with schizophrenia and 53 control smokers immediately after smoking an afternoon cigarette. Serum nicotine levels (27 vs. 22 ng/ml, p = .010), serum cotinine levels (294 vs. 240 ng/ml, p = .041), and expired CO (25 vs. 21 ppm, p = .029) were higher in smokers of menthol compared with nonmenthol cigarettes, with no differences in 3-hydroxycotinine/cotinine ratios between groups when controlling for race. ⋯ Although rates of mentholated cigarette smoking were not higher in smokers with schizophrenia overall, they were significantly higher in non-Hispanic White people with schizophrenia compared with controls of the same ethnic/racial subgroup (51% vs. 28%, p<.0001). The higher exhaled CO in menthol smokers suggests that the higher nicotine levels are at least partly related to increased intake of smoke from menthol cigarettes, although menthol-mediated inhibition of nicotine metabolism also may be a factor. Menthol is an important cigarette additive that may help explain why some groups have lower quit rates and more smoking-caused disease.