TCORS 2.0: Center for the Assessment of Tobacco Regulations (CAsToR)

Publications, Preprints + Posters


Publications by Scientific Domain

Impact Analysis

Understanding impact of potential FDA regulatory actions

34

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Health Effects

Understanding the short and long term health effects of tobacco products

41

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Behavior

Understanding the knowledge, attitudes and behaviors related to tobacco product use and changes in tobacco product characteristics

66

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Publication: Behavior, Impact Analysis

The Role of Flavored Electronic Nicotine Delivery Systems in Smoking Cessation: A Systematic Review   AUTHORS: Alex C. Liber, Marie Knoll, Christopher J. Cadham, Mona Issabakhsh, Hayoung Oh, Steve Cook, Kenneth E. Warner, Ritesh Mistry, David T. Levy   JOURNAL: Drug and Alcohol Dependence Reports   DESCRIPTION: Background Electronic nicotine delivery systems (ENDS) come in numerous flavors and may aid smoking cessation. This systematic review examines evidence on the role of ENDS flavors in smoking cessation. Methods We searched EMBASE OVID, PsychInfo, and Medline databases for studies that: 1) examined cigarette cessation outcomes for persons using ENDS (intent, attempts, and success) and 2) reported results separated by respondent's ENDS flavor used. We extracted crude and adjusted odds ratios for associations between cessation outcomes and types of ENDS flavors used (nontobacco vs. tobacco/unflavored; ...
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Publication: Impact Analysis

Do Tobacco Companies Have an Incentive to Promote “Harm Reduction” Products?: The Role of Competition   AUTHORS: David T Levy, Frances Thirlway, David Sweanor, Alex Liber, Luz Maria Sanchez-Romero, Rafael Meza, Clifford E Douglas, K Michael Cummings   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Background: Some cigarette companies have started to talk about replacing cigarettes with less harmful alternatives, which might include nicotine vaping products (NVPs), heated tobacco products (HTPs) and oral nicotine delivery products (ONDPs). We consider market competition as a primary driver of whether cigarette companies follow through on their stated intentions. Methods: We focus on the behavior of cigarette companies in the US. We compare competition in the pre- and post-2012 time periods, analyze the impact of the growth in NVPs on smoking prevalence and cigarette company profits, and examine ...
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Publication: Health Effects

Cigarettes, ENDS Use, and Chronic Obstructive Pulmonary Disease Incidence: A Prospective Longitudinal Study   AUTHORS: Steven F. Cook PhD, Jana L. Hirschtick PhD, Nancy L. Fleischer PhD, Douglas A. Arenberg MD, Geoffrey D. Barnes MD, MSc, David T. Levy PhD, Luz Maria Sanchez-Romero PhD, Jihyoun Jeon PhD, Rafael Meza PhD   JOURNAL: American Journal of Preventive Medicine   DESCRIPTION: Introduction: Understanding the relationship between ENDS use and chronic obstructive pulmonary disease and other respiratory conditions is critical. However, most previous studies have not fully adjusted for cigarette smoking history.
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Publication: Impact Analysis

Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations   AUTHORS: Nargiz Travis, Marie Knoll, Steven Cook, Hayoung Oh, Christopher J. Cadham, Luz María Sánchez-Romero, David T. Levy   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: Background: Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrella review to summarize the evidence from existing systematic reviews (SRs). Methods: The search for SRs was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Results: Twenty-five SRs were included in our umbrella ...
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Publication: Behavior

Discrimination and Tobacco Use Outcomes Among US Adults: Effect Modification by Race/Ethnicity   AUTHORS: Delvon T Mattingly, Briana Mezuk, Michael R Elliott, Nancy L Fleischer   JOURNAL: Journal of racial and ethnic health disparities   DESCRIPTION: Abstract Introduction: Racial/ethnic discrimination (hereafter, discrimination) is associated with tobacco use. However, little is known about the relationship between discrimination and dual/polytobacco use and tobacco use disorder (TUD), including how these relationships vary by race/ethnicity. Methods: Data on adults 18 and older come from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (n = 35,881). Past-year discrimination was measured using the Experiences of Discrimination scale. Past 30-day exclusive, dual, and polytobacco use was measured as the mutually ...
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Publication: Impact Analysis

Reactions to hypothetical flavor bans among current users of flavored e-cigarettes   AUTHORS: Yong Yang, Eric N Lindblom, Kenneth D Ward, Ramzi G Salloum   JOURNAL: Translational behavioral medicine   DESCRIPTION: Banning flavors in e-cigarettes and other tobacco products may decrease their use. To examine how current users of flavored e-cigarettes might react to a ban on flavored e-cigarettes when: (i) menthol flavor is banned together with other flavors, or (ii) this ban on e-cigarettes is combined with a ban on menthol cigarettes and flavored cigars. A national cross-sectional survey of 2,347 current users of flavored e-cigarettes was conducted in May 2022. For each hypothetical ban scenario, respondents reported if they would quit all tobacco product use, continue to use e-cigarettes with no flavor or ...
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Publication: Behavior

Smoking Histories by State in the U.S   AUTHORS: Theodore R Holford, Lisa McKay, Jihyoun Jeon, Jamie Tam, Pianpian Cao, Nancy L Fleischer, David T Levy, Rafael Meza   JOURNAL: American journal of preventive medicine   DESCRIPTION: Abstract Introduction: Smoking rates across U.S. states have declined at different rates over time because some states have progressive tobacco control policies, whereas others have yet to adopt them. Therefore, each state has its own unique historical experience of smoking initiation, cessation, and prevalence. This study characterizes smoking histories for each U.S. state by birth cohort. Methods: Using 1965-2018 National Health Interview Survey and 1992-2019 Tobacco Use Supplement to the Current Population Survey data, statistical methods applied an age‒period‒cohort modeling framework ...
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Publication: Behavior

Patterns of Birth Cohort‒Specific Smoking Histories by Race and Ethnicity in the U.S   AUTHORS: Rafael Meza, Pianpian Cao, Jihyoun Jeon, Nancy L Fleischer, Theodore R Holford, David T Levy, Jamie Tam   JOURNAL: American journal of preventive medicine   DESCRIPTION: Abstract Introduction: U.S. smoking prevalence varies greatly by race/ethnicity. However, little is known about how smoking initiation, cessation, and intensity vary by birth cohort and race/ethnicity. Methods: Adult smoking data were obtained from the 1978-2018 National Health Interview Surveys. Age‒period‒cohort models with constrained natural splines were developed to estimate historical smoking patterns among non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian and Pacific Islander, and non-Hispanic American Indian and Alaskan Native individuals. Annual smoking prevalence ...
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Publication: Behavior

Birth Cohort‒Specific Smoking Patterns by Family Income in the U.S   AUTHORS: Jihyoun Jeon, Pianpian Cao, Nancy L Fleischer, David T Levy, Theodore R Holford, Rafael Meza, Jamie Tam   JOURNAL: American journal of preventive medicine   DESCRIPTION: Abstract Introduction: In the U.S., low-income individuals generally smoke more than high-income individuals. However, detailed information about how smoking patterns differ by income, especially differences by birth cohort, is lacking. Methods: Using the National Health Interview Survey 1983-2018 data, individual family income was calculated as a ratio of the federal poverty level. Missing income data from 1983 to 1996 were imputed using sequential regression multivariate imputation. Age‒period‒cohort models with constrained natural splines were used to estimate annual probabilities of ...
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Publication: Behavior

Racial/ethnic discrimination and tobacco and cannabis use outcomes among US adults   AUTHORS: Delvon T. Mattingly, Harold W. Neighbors, Briana Mezuk, Michael R. Elliott, Nancy L. Fleischer   JOURNAL: Journal of Substance Use and Addiction Treatment   DESCRIPTION: • Experiencing more discrimination was linked to dual/polytobacco and cannabis use. • Discrimination was also associated with joint tobacco and cannabis use disorders. • For each race/ethnicity, discrimination was linked to at least one use outcome. • Associations with more severe outcomes were stronger for White and Black adults.
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Publication: Impact Analysis

Should menthol e-cigarettes be banned? Reaction of adult smokers and users of e-cigarettes to hypothetical bans   AUTHORS: Yong Yang, Eric N Lindblom, Kenneth D Ward, Ramzi G Salloum   JOURNAL: Tobacco Control   DESCRIPTION: Introduction: This study examines how current smokers using menthol cigarettes or flavoured cigars, and current users of flavoured e-cigarettes may respond to three hypothetical flavour-ban scenarios: (1) banning only menthol cigarettes and flavoured cigars; (2) also banning e-cigarettes with any non-tobacco flavours except menthol; and (3) also banning e-cigarettes with any non-tobacco flavours, including menthol. Methods: Recruited from mTurk, respondents were asked if they would quit all tobacco-nicotine use or continue or start using products that were still legally available. The patterns ...
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Publication: Behavior, Health Effects

Modeling cigarette smoking disparities between people with and without serious psychological distress in the US, 1997–2100   AUTHORS: Qin Xi, Rafael Meza, Adam Leventhal, Jamie Tam   JOURNAL: Preventive Medicine   DESCRIPTION: Highlights: First tobacco simulation model of population with serious psychological distress. • 609,000 smoking-attributable deaths to occur in this population through 2100. • Up to 386,000 of these premature deaths could be averted in the population. • Trends in disparities depend on the type of metric used: absolute or relative. • Improving cessation for this group leads to large, short-term public health benefit.
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Publication: Impact Analysis

United States public health officials need to correct e-cigarette health misinformation   AUTHORS: Michael F. Pesko, K. Michael Cummings, Clifford E. Douglas, Jonathan Foulds, Thomas Miller, Nancy A. Rigotti, Kenneth E. Warner   JOURNAL: Addiction   DESCRIPTION: Health misinformation is harmful as it can cause confusion and sow mistrust regarding the adoption of public health recommendations and policies. We provide examples of e-cigarette misinformation promoted by the United States public health officials, which have persisted despite new data challenging the validity of the original assertions. The Surgeon General of the United States (SG) recently launched an initiative to reduce health misinformation. In an advisory [1], he wrote: ‘Health misinformation is a serious threat to public health. It can cause confusion, sow mistrust, harm people’s health, ...
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Publication: Behavior

Disparities in cigarette, e-cigarette, cigar, and smokeless tobacco use at the intersection of multiple social identities in the U.S. adult population. Results from the TUS-CPS 2018-2019 survey   AUTHORS: Luis Zavala-Arciniega, Rafael Meza, Jana L Hirschtick, Nancy L Fleischer   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: Sociodemographic disparities in tobacco use are prevalent and persistent in the US. Nevertheless, few studies have examined disparities in tobacco use from an intersectionality perspective. We developed a visualization tool to identify disparities in cigarette, e-cigarette, cigar, and smokeless tobacco use at the intersection of multiple social identities.
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Publication: Impact Analysis

The actual and anticipated effects of restrictions on flavoured electronic nicotine delivery systems: a scoping review   AUTHORS: Christopher J. Cadham, Alex C. Liber, Luz María Sánchez-Romero, Mona Issabakhsh, Kenneth E. Warner, Rafael Meza, David T. Levy   JOURNAL: BMC Public Health   DESCRIPTION: Objective: To synthesize the outcomes of policy evaluations of flavoured electronic nicotine delivery systems (ENDS) restrictions. Data sources: PubMed, Scopus, Embase and Web of Science before May 3, 2022. Study selection: Studies that report sales, behaviour, or compliance outcomes related to implemented or hypothetical ENDS flavour restrictions.
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Publication: Behavior

The longitudinal association between cigarette coupon receipt and short-term smoking cessation among US adults   AUTHORS: Hayoung Oh, Steven Cook, Leeann Siegel, Alex Liber, David T Levy, Nancy L Fleischer   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: To help offset the increased price of cigarettes and promote brand loyalty, tobacco companies distribute coupons, particularly to price-sensitive consumers. Few studies, however, have examined the longitudinal association between coupon receipt and smoking cessation. Methods: Using adult data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, we examined the longitudinal association between coupon receipt and short-term smoking cessation. Multivariable discrete time survival models were fit to an unbalanced person-period dataset for adult respondents ...
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Publication: Impact Analysis

Assessing toxicant emissions from e-liquids with DIY additives used in response to a potential flavour ban in e-cigarettes   AUTHORS: Ahmad El-Hellani, Eric K Soule, Mohammad Daoud, Rola Salman, Rachel El Hage, Ola Ardati, Malak El-Kaassamani, Amira Yassine, Nareg Karaoghlanian, Soha Talih, Najat Saliba, Alan Shihadeh   JOURNAL: Tobacco Control   DESCRIPTION: Significance: Electronic cigarettes (e-cigarettes) aerosolise liquids that contain nicotine, propylene glycol, glycerol and appealing flavours. In the USA, regulations have limited the availability of flavoured e-cigarettes in pod-based systems, and further tightening is expected. In response, some e-cigarette users may attempt to make their e-liquids (do-it-yourself, DIY). This study examined toxicant emissions from several aerosolised DIY e-liquids.
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Publication: Impact Analysis

A Decision-Theoretic Public Health Framework for Heated Tobacco and Nicotine Vaping Products   AUTHORS: David T. Levy, Christopher J. Cadham, Yameng Li, Zhe Yuan, Alex C. Liber, Hayoung Oh, Nargiz Travis, Mona Issabakhsh, David T. Sweanor, Luz Maria Sánchez-Romero, Rafael Meza, K. Michael Cummings   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: Abstract: Markets for nicotine vaping products (NVPs) and heated tobacco products (HTPs) have grown as these products became positioned as harm-reduction alternatives to combusted tobacco products. Herein, we present a public health decision-theoretic framework incorporating different patterns of HTP, NVP, and cigarette use to examine their impacts on population health. Our framework demonstrates that, for individuals who would have otherwise smoked, HTP use may provide public health benefits by enabling cessation or by discouraging smoking initiation and relapse. However, the benefits are reduced ...
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Publication: Behavior

Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey   AUTHORS: Yoonseo Mok, Jihyoun Jeon, David T Levy, Rafael Meza   JOURNAL: Nicotine & Tobacco Research   DESCRIPTION: Introduction: While many studies have examined the association between e-cigarette use and smoking cessation, fewer have considered the impact of e-cigarette flavors on cessation outcomes. This study extends previous studies by examining the effects of e-cigarette use and e-cigarette flavors on quit attempts and quit success of smoking. Methods: We used data from the 2018-2019 Tobacco Use Supplement-Current Population Survey (TUS-CPS) survey. Multivariate logistic regression analyses were used to investigate the associations between flavored e-cigarette use with quit attempts and quit success of ...
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Publication: Behavior

Associations of demographics, dependence, and biomarkers with transitions in tobacco product use in a cohort of cigarette users and dual users of cigarettes and e-cigarettes   AUTHORS: Fatema Shafie-Khorassani, Megan E Piper, Douglas E Jorenby, Timothy B Baker, Neal L Benowitz, Todd Hayes-Birchler, Rafael Meza, Andrew F Brouwer   JOURNAL: Nicotine & Tobacco Research   DESCRIPTION: Introduction: It is uncertain whether e-cigarettes facilitate smoking cessation in the real world. We aimed to understand whether and how transitions among cigarette, e-cigarette, and dual use are associated with sociodemographics, dependence measures, and biomarkers.
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Publication: Impact Analysis

A Proposed Policy Agenda For Electronic Cigarettes In The US: Product, Price, Place, And Promotion   AUTHORS: Kenneth E. Warner, Karalyn A. Kiessling, Clifford E. Douglas, Alex C. Liber   JOURNAL: Health Affairs   DESCRIPTION: Growth in the market for electronic cigarettes (e-cigarettes) raises complex questions about the devices’ public health implications and, hence, challenging policy issues. We propose a policy agenda addressing concerns about preventing youth uptake of e-cigarettes and the desire to realize the potential of e-cigarettes to increase adult cigarette smoking cessation. We organize interventions according to the “four Ps” of marketing: product, price, place, and promotion. Policies include decreasing the addictiveness of combusted tobacco products while ensuring the availability of consumer-acceptable ...
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Publication: Health Effects

Longitudinal associations between exclusive and dual use of electronic nicotine delivery systems and cigarettes and self-reported incident diagnosed cardiovascular disease among adults   AUTHORS: Jana L Hirschtick, Steven Cook, Akash Patel, Geoffrey D Barnes, MD, Douglas Arenberg, MD, Irina Bondarenko, MS, David T Levy, Jihyoun Jeon, MS, Evelyn Jimenez Mendoza, MS, Rafael Meza, Nancy L Fleischer   JOURNAL: Nicotine & Tobacco Research   DESCRIPTION: Introduction: The cardiovascular health effects of electronic nicotine delivery systems (ENDS) use are not well characterized, making it difficult to assess ENDS as a potential harm reduction tool for adults who use cigarettes. Methods: Using waves 1-5 of the Population Assessment of Tobacco & Health Study (2013-2019), we analyzed the risk of self-reported incident diagnosed myocardial infarction (MI; 280 incident cases) and stroke (186 incident cases) associated with ENDS and/or cigarette use among adults aged 40+ using discrete time survival models. We employed a time-varying exposure lagged ...
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Publication: Health Effects

Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations   AUTHORS: Nargiz Travis, Marie Knoll, Christopher J. Cadham, Steven Cook, Kenneth E. Warner, Nancy L. Fleischer, Clifford E. Douglas, Luz María Sánchez-Romero, Ritesh Mistry, Rafael Meza, Jana L. Hirschtick, David T. Levy   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. The search for systematic reviews was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Seventeen systematic reviews, including five meta-analyses, were included ...
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Publication: Behavior

Perceived racial discrimination and polysubstance use among African American and Afro-Caribbean adults: Results from the National Survey of American Life   AUTHORS: Delvon T Mattingly, Nancy L Fleischer, David C Colston, Briana Mezuk   JOURNAL: Journal of ethnicity in substance abuse   DESCRIPTION: This study examined the relationship between perceived racial discrimination (PRD) and patterns of substance use. Data come from the 2001-2003 National Survey of American Life (N = 3,589). PRD was derived from the Major Experiences of Discrimination Scale. Multinomial logistic regression estimated the relationship between PRD and patterns of substance use (i.e., never/former, single-substance, dual-substance, and polysubstance [3+ substances]) based on six substances; effect modification by ethnicity and sex was assessed by stratification. Study findings indicated that PRD was associated with greater ...
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Publication: Behavior

The impact of current tobacco product use definitions on estimates of transitions between cigarette and ENDS use   AUTHORS: Andrew F Brouwer, David T Levy, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Luz María Sanchez-Romero, Ritesh Mistry, Rafael Meza   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: Definitions of current tobacco and nicotine delivery product use vary and depend on frequency of use, established use criteria, and the product type. Previous research has not considered how transition rates between current use of different products depend on the current use definition.
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Publication: Impact Analysis

An analysis of cigarette sales during Poland’s menthol cigarette sales ban: small effects with large policy implications   AUTHORS: Alex C Liber, Michal Stoklosa, David T Levy, Luz María Sánchez-Romero, Christopher J Cadham, Michael F Pesko   JOURNAL: European journal of public health   DESCRIPTION: Background: In May 2020, the European Union Tobacco Products Directive mandated that EU member states, including Poland, ban the sale of menthol cigarettes. With menthol making up 28% of cigarette sales before the ban, Poland is the country with likely the largest menthol cigarette sales share in the world to ban their sale. We analyze how this ban changed the Polish tobacco market.
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Publication: Impact Analysis

Public health impact of a US menthol cigarette ban on the non-Hispanic black population: a simulation study   AUTHORS: Mona Issabakhsh, Rafael Meza, Yameng Li, Zhe Yuan, Luz Maria Sanchez-Romero, David T Levy   JOURNAL: Tobacco control.   DESCRIPTION: Introduction: With the US Food and Drug Administration recently proposing to implement a ban on menthol cigarettes, it is critical to estimate the potential public health effects of such a ban. With high rates of menthol cigarette use and important smoking-related health disparity implications, the impact of the ban on the non-Hispanic black (NHB) population merits strong consideration.
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Publication: Behavior

Sexual Orientation Discrimination and Exclusive, Dual, and Polytobacco Use among Sexual Minority Adults in the United States.   AUTHORS: Delvon T Mattingly, Andrea R Titus, Jana L Hirschtick, Nancy L Fleischer   JOURNAL: International journal of environmental research and public health   DESCRIPTION: Research on whether sexual orientation discrimination is associated with multiple tobacco product use among sexual minority (SM) adults is limited. Thus, we explored the associations between sexual orientation discrimination and exclusive, dual, and polyuse among a subset of SM adults (18+) (n = 3453) using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. We evaluated six indicators of prior-to-past-year sexual orientation discrimination separately and as a summary scale and defined past-year exclusive, dual, and polyuse based on cigarette, electronic nicotine ...
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Publication: Behavior

Flavoring Patterns of Exclusive and Dual-Use of Cigarettes and E-Cigarettes Among US Adults: Results from the TUS-CPS 2018-2019   AUTHORS: Luis Zavala-Arciniega, Jana L Hirschtick, Rafael Meza, Nancy L Fleischer   JOURNAL: American Journal of Health Promotion   DESCRIPTION: Purpose: To describe patterns of menthol/non-menthol cigarettes with flavored e-cigarettes (tobacco, menthol, sweet/spicy, and other flavorings) use. Design: We used cross-sectional data from the 2018-2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). Setting: United States. Subjects: Adults over 18 years old. Sample: A nationally representative sample (n = 135 329).
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Publication: Behavior

Tobacco Use among Gender-Varying and Gender-Stable Adolescents and Adults Living in the U.S.   AUTHORS: Luisa Kcomt, Rebecca J Evans-Polce, Curtiss W Engstrom, Carol J Boyd, Philip T Veliz, Brady T West, Sean Esteban McCabe   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: This study examines the proportion of U.S. adolescents and adults who are variable (i.e., at least one change in gender identity) versus stable in their gender identities over time, and whether they differ significantly in their nicotine/tobacco use after adjusting for key covariates. Methods: We fit multivariable logistic regression models to data from Waves 2-4 (2014/15-2016/18) of the Population Assessment of Tobacco and Health (PATH), a nationally representative study (n=33,197 U.S. adolescents and adults aged ≥14 years). We examined associations of gender stability/variability ...
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Publication

Increased nicotine vaping due to the COVID-19 pandemic among US young adults: Associations with nicotine dependence, vaping frequency, and reasons for use   AUTHORS: Michael J Parks, Nancy L Fleischer, Megan E Patrick   JOURNAL: Preventive medicine   DESCRIPTION: Previous research has not examined increased vaping because of the pandemic using a national sample of young adults (YAs), which is a critical gap because pandemic-related increases in vaping among YAs could have important implications for nicotine dependence, prolonged regular use, and using substances to cope with stress. We examined self-reported increased vaping attributed to the COVID-19 pandemic among YAs, and its associations with outcomes that have important implications for future nicotine use. Data came from the Monitoring the Future (MTF) Vaping Supplement. Participants were selected ...
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Publication

The association between smoking behaviors and prices and taxes per cigarette pack in the United States from 2000 through 2019   AUTHORS: Thuy T T Le, Mohammed A Jaffri   JOURNAL: BMC public health   DESCRIPTION: Objective: The conclusions on how tax and price increases affect smoking behaviors are mixed. This work is devoted to re-evaluating the relationship between cigarette prices and taxes and smoking behaviors. Methods: Using 2000-2019 Behavioral Risk Factor Surveillance System data, we employed linear mixed-effect models to re-examine the impact of cigarette prices and taxes on smoking prevalence and the proportion of current smokers having tried to quit smoking in the past 12 months. All the analyses were conducted for the general population, then by age group, gender, race/ethnicity, and income ...
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Publication: Behavior, Impact Analysis

Monitoring the Increase in the U.S. Smoking Cessation Rate and its Implication for Future Smoking Prevalence   AUTHORS: David Méndez, Thuy T T Le, Kenneth E Warner   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: We calculate the U.S. adult smoking cessation rate for 2014-2019, compare it to the historical trend, and estimate the implication for future smoking prevalence. Methods: We repeated an earlier analysis, which examined the cessation rate from 1990-2014, extending the period to 2019. Employing National Health Interview Survey (NHIS) and National Survey on Drug Use and Health (NSDUH) data, we estimated the adult cessation rate in six-year intervals, using weighted non-linear least squares. We then employed a meta-regression model to test whether the cessation rate has increased beyond ...
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Publication: Impact Analysis

How Smokers of Menthol Cigarettes and Flavored Cigars Might Respond to FDA's Proposed Bans   AUTHORS: Yong Yang, Eric N Lindblom, Kenneth D Ward, Ramzi G Salloum   JOURNAL: Nicotine and tobacco research   DESCRIPTION: Introduction: We aimed to examine the response of current smokers to a hypothetical ban on menthol cigarettes and flavored cigars. Methods: Current smokers were recruited online and reported the alternative products that they may switch to under a hypothetical ban, if they would try to obtain the banned products from illicit channels, and their support to the ban. Results: 51% of current smokers would use non-flavored cigarettes and cigars as alternatives, 45% would switch to flavored heated tobacco products or e-cigarettes or quit smoking. 17% would try to obtain the banned flavored products ...
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Oral Presentation — Slides

Thumbnail for Poland’s Menthol Cigarette Ban: Small Effects with Large Policy Implications posterPoland’s Menthol Cigarette Ban: Small Effects with Large Policy Implications   AUTHORS: Luz María Sánchez-Romero, Alex C. Liber   DESCRIPTION: In May 2020 menthol cigarette sales ended across the EU. § All other flavors except menthol had been removed in May 2016. In Poland, menthol cigarette sales shares were 28%, the highest of any EU country. § Prior analyses of the effects of menthol cigarette sales bans have come from areas with low menthol cigarette sales shares or small areas with legal access to menthol cigarettes elsewhere. § OBJECTIVE: measure whether cigarette sales declined after the the May 2020 menthol ban
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Oral Presentation — Slides

Thumbnail for Electronic Nicotine Delivery Systems (ENDS) use during a six-year period is not associated with self-reported chronic obstructive pulmonary disease (COPD) after proper adjustment of cigarette smoking history: A longitudinal analysis of PATH data posterElectronic Nicotine Delivery Systems (ENDS) use during a six-year period is not associated with self-reported chronic obstructive pulmonary disease (COPD) after proper adjustment of cigarette smoking history: A longitudinal analysis of PATH data   AUTHORS: Rafael Meza, Steven Cook, Jihyoun Jeon, David T. Levy, Jana Hirschtick, Nancy L. Fleischer   DESCRIPTION: Chronic Obstructive Pulmonary Disease (COPD) is a chronic and progressive disease encompassing emphysema and chronic bronchitis. • COPD is characterized by restrictive airflow to the lungs and an abnormal inflammatory response, usually caused by exposure to noxious particles or gases. • COPD is the fourth leading cause of mortality in the US. • COPD is projected to be responsible for 9.4 million COPD-attributable deaths and more than $800 billion in direct medical costs by 2038
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Oral Presentation — Slides

Thumbnail for The EVALI Outbreak and US Tobacco Sales posterThe EVALI Outbreak and US Tobacco Sales   AUTHORS: Alex C. Liber PhD   DESCRIPTION: Vitamin E Acetate containing cannabis vaping products were responsible Media attention on e-cigarettes was the strongest ever recorded 2807 hospitalizations and 68 deaths by February 2020. FDA combined concern for EVALI with concern over rising youth e-cigarette usage rates to propose federal ban on flavored e-cig sales • 7 states proposed, 5 implemented temporary bans on sale of nontobacco flavored e-cigs • Massachusetts banned sales of all e-cigarettes for 90 days, before reverting to a nontobacco flavored e-cig sales ban
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Poster

Thumbnail for Short-term ENDS use is not associated with self-reported COPD after adjusting for cigarette smoking history: A longitudinal analysis of PATH data posterShort-term ENDS use is not associated with self-reported COPD after adjusting for cigarette smoking history: A longitudinal analysis of PATH data   AUTHORS: Rafael Meza, Steven Cook, Jihyoun Jeon, David T. Levy, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: Understanding the relationship between electronic nicotine delivery systems (ENDS) and chronic obstructive pulmonary disease (COPD) and other respiratory conditions is critical • However, previous studies have not fully controlled for history of cigarette smoking
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Poster

Thumbnail for The impact of demographics, dependence, and biomarkers on transitions in tobacco product use in a cohort of smokers and dual users posterThe impact of demographics, dependence, and biomarkers on transitions in tobacco product use in a cohort of smokers and dual users   AUTHORS: Fatema Shafie-Khorassani, Megan E. Piper, Douglas E. Jorenby, Timothy B. Baker, Neal L. Benowitz, Todd Hayes-Birchler, Rafael Meza, Andrew F. Brouwer   DESCRIPTION: Electronic nicotine delivery systems (ENDS) have the potential to help people who smoke cigarettes transition to a less harmful product. It is uncertain whether and to what extent ENDS facilitate cigarette cessation in real-world settings. A better understanding of what personal and product characteristics are associated with ENDS-facilitated cigarette cessation could improve tobacco control interventions.
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Poster

Thumbnail for Changing age patterns of cigarette and ENDS transitions in the PATH study: a multistate transition model analysis of adults and youth through 2017 (Waves 1–4) vs after 2017 (Waves 4–5) posterChanging age patterns of cigarette and ENDS transitions in the PATH study: a multistate transition model analysis of adults and youth through 2017 (Waves 1–4) vs after 2017 (Waves 4–5)   AUTHORS: Andrew F. Brouwer, Jiyhoun Jeon, Evelyn Jimenez-Mendoza, Stephanie R Land, Ritesh Mistry, David T. Levy, Rafael Meza   DESCRIPTION: Sales of ENDS, particularly JUUL, rose substantially in late 2017 and 2018. Did transitions between cigarette, ENDS, and dual use change over this period? Were adult and youth transitions affected differently?
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Poster

Thumbnail for Demographic Correlates of Tobacco Poly-Use in the Population Assessment of Tobacco and Health Study: A Multistate Markov Transition Analysis posterDemographic Correlates of Tobacco Poly-Use in the Population Assessment of Tobacco and Health Study: A Multistate Markov Transition Analysis   AUTHORS: Fatema Shafie Khorassani, Andrew F. Brouwer, Jana L. Hirschtick, Rafael Meza, Nancy L. Fleischer   DESCRIPTION: Goal: Estimate transition rates between single, dual, and poly tobacco use over time to help identify areas for policy intervention. Compare between sex, race/ethnicity, and age groups. Data: Waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study, 2013-2017
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Poster

Thumbnail for Trends in Smoking (2002 to 2020) and E-cigarette use (2015 to 2020) in Mexico, a country that bans the sale and distribution of E-cigarettes posterTrends in Smoking (2002 to 2020) and E-cigarette use (2015 to 2020) in Mexico, a country that bans the sale and distribution of E-cigarettes   AUTHORS: Luis Zavala-Arciniega, Luz Myriam Reynales-Shigematsu, Nancy L. Fleischer, David T. Levy, Belén Sáenz de Miera-Juárez, Luz María Sánchez-Romero, James F. Thrasher, Rafael Meza   DESCRIPTION: This study describe changes in ecigarette use in Mexico between 2015 to 2020 and cigarette use between 2002 to 2020 by sex, age, and smoking.
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Poster

Thumbnail for Disparities in cigarettes and e-cigarettes at the Intersection of Multiple Identities in the U.S Adult Population: Results from the TUS-CPS 2018-19 posterDisparities in cigarettes and e-cigarettes at the Intersection of Multiple Identities in the U.S Adult Population: Results from the TUS-CPS 2018-19   AUTHORS: Luis Zavala-Arciniega, Rafael Meza, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: To estimate the prevalence of cigarettes and e-cigarettes at the intersection of age, sex, race/ethnicity and income, and to develop a visualization tool to aid characterization and interpretation.
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Poster

Thumbnail for Monitoring the Increase in the U.S. Smoking Cessation Rate and its Implication for Future Smoking Prevalence posterMonitoring the Increase in the U.S. Smoking Cessation Rate and its Implication for Future Smoking Prevalence   AUTHORS: David Mendez, Ph.D., Thuy T. T. Le, Ph.D., Kenneth E. Warner, Ph.D.   DESCRIPTION: In this study, we extend the analysis presented in a 2017 article by Mendez et al., extending the analysis period to 2019. The aim of this work is three-fold. First, we want to estimate the most up-to-date value for the adult cessation rate. This figure is helpful as an indicator of the country's progress in combating the smoking epidemic and as a necessary parameter to evaluate potential future scenarios of the trajectory of smoking prevalence. Second, we want to assess whether the cessation rate value obtained for the most recent period is significantly above or below the expectation ...
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Poster

Thumbnail for Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations posterHealth Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations   AUTHORS: Nargiz Travis, MSPH, Marie Knoll, MSPH, Christopher Cadham , Luz María Sánchez Romero, David T. Levy   DESCRIPTION: E cigarettes are often marketed as a safer alternative to combustible cigarettes, however their health effects, especially those associated with long term use, remain largely uncertain. We conduct an umbrella review of cardiopulmonary and carcinogenic risks of e cigarette use, distinguishing between their short term and long term health effects and considering both the absolute harm of e cigarettes and their harm/benefits relative to smoking.
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Poster

Thumbnail for Longitudinal Associations Between Multiple Tobacco Product Use and Incident Asthma Among US Youth posterLongitudinal Associations Between Multiple Tobacco Product Use and Incident Asthma Among US Youth   AUTHORS: Delvon T. Mattingly, Steven Cook, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: Use of non-cigarette tobacco products, including ENDS, have become more common over the last decade. While the health effects of cigarettes are well-documented, little is known about the effects of ENDS use and dual/poly use
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Poster

Thumbnail for Exclusive, dual, and poly tobacco use is associated with the incidence of acute bronchitis among youth posterExclusive, dual, and poly tobacco use is associated with the incidence of acute bronchitis among youth   AUTHORS: Luis Zavala-Arciniega, Yanmei Xie, Steven Cook, Jana L. Hirschtick, Richa Mukerjee, Douglas Arenberg, Geoffrey D. Barnes, Rafael Meza, Nancy L. Fleischer   DESCRIPTION: Exclusive cigarette, exclusive ENDS, dual use, and polyuse increased the risk of diagnosed acute bronchitis, pneumonia, or chronic cough among youth.
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Poster

Thumbnail for Longitudinal Association of Exclusive and Dual Use of ENDS and Cigarettes with Asthma among US Youth Population Assessment of Tobacco and Health Study Waves 1-5 (2013-2019) posterLongitudinal Association of Exclusive and Dual Use of ENDS and Cigarettes with Asthma among US Youth Population Assessment of Tobacco and Health Study Waves 1-5 (2013-2019)   AUTHORS: Akash Patel, Steven Cook, Nancy L. Fleischer, Jana Hirschtick   DESCRIPTION: Adolescents who exclusively smoked cigarettes, but not those who used ENDS, had higher risk of incident diagnosed asthma over a five year follow up period. CONCLUSIONS
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Poster

Thumbnail for Response to Restrictions on Electronic Nicotine Delivery Systems: A Systematic Review posterResponse to Restrictions on Electronic Nicotine Delivery Systems: A Systematic Review   AUTHORS: Chris Cadham   DESCRIPTION: The effects of ENDS flavour restrictions on tobacco use remain unclear. Study results are heterogenous and vary depending on jurisdiction level. Retail compliance with restrictions was high.
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Poster

Thumbnail for Nicotine/tobacco use among gender-fluid and gender-stable adolescents and adults in the U.S. posterNicotine/tobacco use among gender-fluid and gender-stable adolescents and adults in the U.S.   AUTHORS: Luisa Kcomt, Rebecca J. Evans-Polce, Curtiss W. Engstrom, MS, Carol J. Boyd, Philip T. Veliz, Brady T. West, Sean Esteban McCabe   DESCRIPTION: This longitudinal study found gender-fluid individuals areat higher risk for nicotine/tobacco use, placing them at greater risk for smoking-related health consequences.
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Publication: Behavior

Sociodemographic Patterns of Exclusive and Dual Combustible Tobacco and E-Cigarette Use among US Adolescents—A Nationally Representative Study (2017–2020)   AUTHORS: Bukola Usidame, Jana L. Hirschtick, Delvon T. Mattingly, Akash Patel, Megan E. Patrick, Nancy L. Fleischer   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: This study assessed the sociodemographic predictors of exclusive and dual use of the most frequently used nicotine/tobacco products, e-cigarettes, and combustible tobacco among adolescents. Cross-sectional data was from the 2017–2020 Monitoring the Future nationally representative study of eighth, tenth, and twelfth-grade students. We coded past 30 day nicotine/tobacco use into four mutually exclusive categories: no use, e-cigarette use only, combustible use (cigarette or cigar) only, and dual use (e-cigarette and combustible). We pooled the 2017–2020 data to examine the relationship between ...
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Publication: Behavior

E-cigarette characteristics and cigarette smoking cessation behaviors among U.S. Adult dual users of cigarettes and e-cigarettes   AUTHORS: Luis Zavala-Arciniega, Jana L. Hirschtick, Rafael Meza, Nancy L. Fleischer   JOURNAL: Preventive Medicine Reports   DESCRIPTION: It is critical to understand determinants of cigarette smoking cessation in the current tobacco product landscape. This study assesses the roles of e-cigarette flavoring, device type, and use frequency on cigarette smoking cessation behaviors among US adult dual users of cigarettes and e-cigarettes. We analyzed a sample of 1,038 adult dual users of cigarettes and e-cigarettes from the 2018–2019 Tobacco Use Supplement-Current Population Survey. We defined three smoking cessation behavior stages in current smokers: pre-contemplation, contemplation, and preparation to quit smoking. Multinomial ...
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Publication: Behavior, Health Effects

Sociodemographic differences in patterns of nicotine and cannabis vaping among US adults   AUTHORS: Mattingly DT, Patel A, Hirschtick JL, Fleischer NL   JOURNAL: Preventive Medicine Reports   DESCRIPTION: Nicotine and cannabis vaping has increased over the past several years. While patterns of cigarette and cannabis co-use are well-documented, less is known about the intersection between nicotine and cannabis vaping, especially among adults. Thus, we categorized nicotine and cannabis vaping among adults (18+) who currently (past 30-day) used electronic vapor products (EVPs) from Wave 4 of the Population Assessment of Tobacco and Health Study (n = 3795) as: 1) nicotine only, 2) cannabis only, 3) nicotine and cannabis, and 4) non-nicotine/non-cannabis e-liquid. We calculated vaping pattern proportions ...
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Publication: Behavior

A Machine Learning Approach to Identify Predictors of Frequent Vaping and Vulnerable Californian Youth Subgroups.   AUTHORS: Fu R, Shi J, Chaiton M, Leventhal AM, Unger JB, Barrington-Trimis JL   JOURNAL: Nicotine and tobacco research   DESCRIPTION: Introduction: Machine learning presents a unique opportunity to improve electronic cigarette (vaping) monitoring in youth. Here we built a random forest model to predict frequent vaping status among Californian youth and to identify contributing factors and vulnerable populations. Methods: In this prospective cohort study, 1,281 ever-vaping twelfth-grade students from metropolitan Los Angeles were surveyed in Fall and in 6-month in Spring. Frequent vaping was measured at the 6-month follow-up as nicotine-containing vaping on 20 or more days in past 30 days. Predictors (n=131) encompassed sociodemographic ...
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Publication: Behavior

Relationships Between E-cigarette Use and Subsequent Cigarette Initiation Among Adolescents in the PATH Study: an Entropy Balancing Propensity Score Analysis.   AUTHORS: Xu S, Coffman DL, Liu B, Xu Y, He J, Niaura RS   JOURNAL: Prevention Science   DESCRIPTION: This study aimed to examine the relationship between electronic cigarette use and subsequent combustible cigarette use, controlling for confounding by using a propensity score method approach. Data from the first three annual waves of the Population Assessment of Tobacco and Health study were analyzed (n = 6309). Participants were tobacco-naïve at Wave 1; used e-cigarettes exclusively (n = 414), used combustible cigarettes exclusively (n = 46), or not used any tobacco products (n = 5849) at Wave 2. We conducted entropy balancing propensity score analysis to examine the association between exclusive ...
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Publication: Behavior, Impact Analysis

Tobacco Couponing: A Systematic Review of Exposures and Effects on Tobacco Initiation and Cessation   AUTHORS: Alex C Liber PhD, Luz María Sánchez-Romero PhD, Christopher J Cadham MPH, Zhe Yuan MS, Yameng Li MS, Hayoung Oh BA, Steven Cook PhD, Kenneth E Warner PhD, Lisa Henriksen PhD, Ritesh Mistry PhD, Rafael Meza PhD, Nancy L Fleischer PhD, David T Levy PhD   JOURNAL: Nicotine & Tobacco Research   DESCRIPTION: Background: Tobacco couponing continues to be part of contemporary tobacco marketing in the US. We performed a systematic review of the evidence of tobacco product coupon receipt and redemption to inform regulation. Methods: We searched EMBASE OVID and Medline databases for observational (cross-sectional and longitudinal) studies that examined the prevalence of tobacco coupon receipt and coupon redemption across different subpopulations, as well as studies of the association between coupon receipt and redemption with tobacco initiation and cessation at follow-up. We extracted unadjusted and ...
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Publication: Behavior

Short communication: Racial/ethnic disparities in cigar and cigarette exclusive, dual, and polyuse among adults   AUTHORS: Jana L. Hirschtick, Richa Mukerjee, Ritesh Mistry, Delvon Mattingly, Nancy L. Fleischer   JOURNAL: Addictive behaviors   DESCRIPTION: Background: Despite documented racial/ethnic differences in cigar use, disparities in the context of dual and polyuse with cigarettes are unclear. Methods: Using the Population Assessment of Tobacco and Health Study (2016–18), we examined prevalence and intensity of use patterns among adults (18+) who were Non-Hispanic (NH) Black, NH White, Hispanic, or another race/ethnicity: exclusive cigarillo, filtered cigar, traditional cigar, or cigarette use; dual use of each cigar product with cigarettes; dual or polyuse of cigars without cigarettes; and cigar and cigarette polyuse. We used multinomial ...
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Publication: Behavior, Impact Analysis

Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States.   AUTHORS: Gravely S, Smith DM, Liber AC, Cummings KM, East KA, Hammond D, Hyland A, O’Connor RJ, Kasza KA, Quah ACK, Loewen R, Martin N, Meng G, Ouimet J, Thompson ME, Boudreau C, McNeill A, Sweanor DT, Fong GT   JOURNAL: Addictive behaviors   DESCRIPTION: Introduction: Some jurisdictions have implemented nicotine vaping product (NVP) flavor restrictions because of concerns about rising adolescent use. However, little is known how these restrictions may impact adult vapers. This study describes the level of support and predictive behavioral responses to a hypothetical NVP ban on non-tobacco flavors among regular adult vapers who only use flavors that would be banned.
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Publication: Impact Analysis

Follow the money: a closer look at US tobacco industry marketing expenditures   AUTHORS: David T Levy, Alex C Liber, Christopher Cadham, Luz Maria Sanchez-Romero, Andrew Hyland, Michael Cummings, Cliff Douglas, Rafael Meza, Lisa Henriksen   JOURNAL: Tobacco Control   DESCRIPTION: In the 1980s, famed American investor Warren Buffet said, ‘I’ll tell you why I like the cigarette business… It costs a penny to make. Sell it for a dollar. It’s addictive. And there’s fantastic brand loyalty.’ While the retail price of cigarettes has gone up, the relative magnitude between manufacturer’s cost of production and marketing, tax burden and retail price has not markedly changed. The large profits achieved by cigarette companies are the result of decades of strategic marketing activities, designed to increase and maintain consumer demand for their products. Much of tobacco ...
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Publication: Behavior

Trends in Exclusive, Dual and Polytobacco Use among U.S. Adults, 2014–2019: Results from Two Nationally Representative Surveys   AUTHORS: Delvon T. Mattingly, Luis Zavala-Arciniega, Jana L. Hirschtick, Rafael Meza, David T. Levy, Nancy L. Fleischer   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: Although increases in the variety of tobacco products available to consumers have led to investigations of dual/polytobacco use patterns, few studies have documented trends in these patterns over time. We used data from the 2014/2015 and 2018/2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) and the 2015–2019 National Health Interview Survey (NHIS) to estimate trends in the following use patterns: exclusive use of cigarettes, electronic nicotine delivery systems (ENDS), other combustibles (cigars/cigarillos/little filtered cigars and traditional pipes/hookah), and smokeless ...
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Publication: Health Effects

Self-Reported Quit Aids and Assistance Used By Smokers At Their Most Recent Quit Attempt: Findings from the 2020 International Tobacco Control Four Country Smoking and Vaping Survey   AUTHORS: Shannon Gravely, K Michael Cummings, David Hammond, Ron Borland, Ann McNeill, Katherine A East, Ruth Loewen, Nadia Martin, Hua-Hie Yong, Lin Li, Alex Liber, David T Levy, Anne C K Quah, Janine Ouimet, Sara C Hitchman, Mary E Thompson, Christian Boudreau, Geoffrey T Fong   JOURNAL: Nicotine & tobacco research   DESCRIPTION: Introduction: This study retrospectively describes smoking cessation aids, cessation services, and other types of assistance used by current and ex-smokers at their last quit attempt in four high-income countries. Aims and methods: Data are from the Wave 3 (2020) International Tobacco Control Four Country Smoking and Vaping Survey in Australia, Canada, England, and the United States (US). Eligible respondents were daily smokers or past-daily recent ex-smokers who made a quit attempt/quit smoking in the last 24-months, resulting in 3614 respondents. Self-reported quit aids/assistance included: ...
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Publication: Health Effects

A longitudinal study of menthol cigarette use and smoking cessation among adult smokers in the US: Assessing the roles of racial disparities and E-cigarette use   AUTHORS: Steven Cook, Jana L. Hirschtick, Akash Patel, Andrew Brouwer, Jihyoun Jeon, David T. Levy, Rafael Meza, Nancy L. Fleischer   JOURNAL: Preventive Medicine   DESCRIPTION: Highlights: • We found disparities in smoking cessation among adults who smoke menthol cigarettes. • Non-Hispanic Black menthol smokers had low odds of smoking cessation. • Smoking cessation was higher for menthol smokers who used e-cigarettes.
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Oral Presentation — Slides

Thumbnail for An Estimation of the Harm of Menthol Cigarettes in the United States from 1980-2018 posterAn Estimation of the Harm of Menthol Cigarettes in the United States from 1980-2018   AUTHORS: Thuy Le, David Mendez   DESCRIPTION: Objective: To quantify the harm caused by menthol cigarettes, we estimate the excess smoking prevalence, smoking initiation, and mortality in the US, from 1980 through 2018, that can be attributed to menthol cigarettes. Methods: Figure 1. The dynamics of the menthol cigarettes model (see the TPSAC menthol report). § Used data from various published sources, for example menthol and nonmenthol smoking prevalence data from the 1980-2018 National Health Interview Surveys (NHIS) § Developed a simulation scenario using retrospective NHIS data to reproduce the US smoking trends from 1980 through ...
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Oral Presentation — Slides

Thumbnail for Modeling public health impacts of vaping posterModeling public health impacts of vaping   AUTHORS: Ken Warner (Avedis Donabedian Distinguished University Professor Emeritus of Public Health; Professor Emeritus of Health Management & Policy; Dean Emeritus of Public Health)   DESCRIPTION: Presented to the Scientific Advisory Board on Vaping Products November 1, 2021
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Publication: Behavior

The Impact of Menthol Cigarette Flavor in the U.S.: Cigarette and ENDS Transitions by Sociodemographic Group   AUTHORS: Andrew F.Brouwer PhD, Jihyoun Jeon PhD, Steven F.Cook PhD, Bukola Usidame PhD, Jana L. Hirschtick PhD, Evelyn Jimenez-Mendoza MSc, Ritesh Mistry PhD, Nancy L. Fleischer PhD, Theodore R. Holford PhD, David Mendez PhD, David T. Levy PhD, Rafael Meza PhD   JOURNAL: American Journal of Preventive Medicine   DESCRIPTION: Introduction: A better understanding of how menthol cigarette flavoring and ENDS impact smoking initiation, cessation, and transitions between tobacco products could help elucidate the potential impact of a U.S. menthol ban on combustible tobacco products. Conclusions: Sociodemographic differences in product transitions should be accounted for when estimating the potential impact of a menthol ban.
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Oral Presentation — Slides

Thumbnail for Demographic Correlates of Polytobacco Transitions posterDemographic Correlates of Polytobacco Transitions   AUTHORS: Fatema Shafie-Khorassani, Andrew F. Brouwer, Jana L. Hirschtick, Rafael Meza, Nancy L. Fleischer   DESCRIPTION: Markov Transition Analysis: Goal: transition analysis using multiple products (cigs, e-cigs, combustible, smokeless) and compare hazards of transition between: • Male and female sex • Age groups • Race/ethnicity groups Current use definition: now uses product everyday or some days Data: Population Assessment of Tobacco and Health (PATH) study • Weighted to represent the US population • Waves 1-4: 2013-2018
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Oral Presentation — Slides

Thumbnail for A machine learning approach to identify product characteristics that contribute to increased risk of frequent vaping and vulnerable youth populations posterA machine learning approach to identify product characteristics that contribute to increased risk of frequent vaping and vulnerable youth populations   AUTHORS: Rui Fu (Ray), Post‐doctoral Fellow   DESCRIPTION: Implications for FDA’s tobacco regulatory authorities • Nicotine use / dependence as the primary predictor of becoming frequent vapers in 6 months • Scoring >= 1 on the Hooked on Vaping Checklist predicts a higher risk • Vulnerable youth subpopulations • Younger students with high levels of perceived discrimination and/or belong to certain racial/ethnical minority groups • Potentials of using machine learning to predict vaping behaviour progression in youth
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Oral Presentation — Slides

Thumbnail for Tobacco Transitions Tool: Development of a Web Aid to Facilitate Exploration of Tobacco Use Patterns and Transitions in PATH posterTobacco Transitions Tool: Development of a Web Aid to Facilitate Exploration of Tobacco Use Patterns and Transitions in PATH   AUTHORS: Jihyoun Jeon, Andrew Brouwer, Evelyn Jimenez-Mendoza, Ritesh Mistry, Rafael Meza   DESCRIPTION: To understand how tobacco use patterns are changing in the US - New and emerging tobacco products such as electronic nicotine delivery systems (ENDS) - Provide insights into tobacco regulatory research • To monitor the dynamics of tobacco use and estimate transition ratesacross product use categories - May vary depending on use definitions, type of products, sociodemographic factors - Interactive web aid tools to facilitate exploration of tobacco use patterns • Population Assessment of Tobacco and Health Study (PATH) - Nationally representative longitudinal data for US ...
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Oral Presentation — Slides

Thumbnail for Latent Transition Analysis of Tobacco Use Frequencies for Multiple Products in US Adults posterLatent Transition Analysis of Tobacco Use Frequencies for Multiple Products in US Adults   AUTHORS: Ritesh Mistry, Irina Bondarenko, Rafael Meza, Andrew F. Brouwer, Jihyoun Jeon, David T. Levy, Michael R. Elliott, Jeremy M. G. Taylor, Jana Hirschtick, Nancy L. Fleischer   DESCRIPTION: In the context of multi-tobacco products, there are practical and computational challenges in characterizing the complexity and dynamism in tobacco use behaviors over time. • There is particular interest in transitions between tobacco use products and behaviors. • transitions between single, dual and poly tobacco use • transitions in frequency and intensity of use, product switching, cessation and relapse.
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Poster

Thumbnail for The impact of demographics, dependence, and biomarkers on transitions in tobacco product use in a cohort of smokers and dual users posterThe impact of demographics, dependence, and biomarkers on transitions in tobacco product use in a cohort of smokers and dual users   AUTHORS: Fatema Shafie-Khorassani, Megan E. Piper, Douglas E. Jorenby, Timothy B. Baker, Neal L. Benowitz, Todd Hayes-Birchler, Rafael Meza, Andrew F. Brouwer   DESCRIPTION: Electronic nicotine delivery systems (ENDS) have the potential to help people who smoke cigarettes transition to a less harmful product. • It is uncertain how much ENDS facilitate cigarette cessation in real-world settings. • A better understanding of what personal and product characteristics are associated with ENDS-facilitated cigarette cessation could improve tobacco control interventions.
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Poster

Thumbnail for Sociodemographic Differences in Patterns of Nicotine and Marijuana Vaping Among US Adults posterSociodemographic Differences in Patterns of Nicotine and Marijuana Vaping Among US Adults   AUTHORS: Delvon T. Mattingly, Akash Patel, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: Vaping is a public health concern and electronic nicotine delivery systems (ENDS) can be used to consume not only nicotine but also marijuana. However, patterns of nicotine and marijuana vaping among US adults are not well understood.
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Publication: Impact Analysis

The Use of Expert Elicitation among Computational Modeling Studies in Health Research: A Systematic Review   AUTHORS: Christopher J. Cadham, Marie Knoll, Luz María Sánchez-Romero, Clifford E. Douglas, Alex Liber, David Mendez, Rafael Meza, Ritesh Mistry, Aylin Sertkaya, Nargiz Travis, David T. Levy   JOURNAL: Medical Decision Making   DESCRIPTION: Expert elicitation (EE) has been used across disciplines to estimate input parameters for computational modeling research when information is sparse or conflictual. We conducted a systematic review to compare EE methods used to generate model input parameters in health research. We find extensive use of expert elicitation for the development of model input parameters, but most studies do not provide adequate details of their elicitation methods. Lack of reporting hinders greater discussion of the merits and challenges of using expert elicitation for model input parameter development. There is ...
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Publication: Behavior

The importance of peer imitation on smoking initiation over time: a dynamical systems approach   AUTHORS: Carl Simon, David Mendez   JOURNAL: Health Care Management Science   DESCRIPTION: A recent Institute of Medicine Report calls for explicit modeling of smoking initiation, cessation and addiction processes. We introduce a model of smoking initiation that explicitly teases out the percentage of initiation due to social pressures, which we call “peer-imitation,” and the percentage due to other factors, such as media ads, family smoking, and psychological factors, which we call “self-initiation.” We propose a dynamic non-linear behavioral contagion model of smoking initiation and employ data from the National Survey on Drug Use and Health to estimate the relative contributions ...
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Publication: Health Effects, Impact Analysis

Estimated Prevalence of Smoking and Smoking-Attributable Mortality Associated With Graphic Health Warnings on Cigarette Packages in the US From 2022 to 2100   AUTHORS: Jamie Tam, Jihyoun Jeon, James F. Thrasher, David Hammond, Theodore R. Holford, David T. Levy, Rafael Meza   JOURNAL: JAMA Health Forum   DESCRIPTION: What are the estimated population health outcomes associated with implementation of graphic health warnings on cigarette packages in 2022 and with delayed implementation of the warnings since 2012, as originally planned, in the US? In this decision analytical model using simulation modeling of smoking prevalence and smoking-attributable mortality in the US from 2012 to 2100, graphic health warnings, if implemented from 2022 to 2100, would be associated with 539,000 smoking-attributable deaths averted and 7.9 million life-years gained, and if implemented in 2012, with 718 000 deaths averted and ...
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Publication: Behavior

Exclusive and dual menthol/non-menthol cigarette use with ENDS among adults, 2013–2019   AUTHORS: Bukola Usidame, Jana Hirschtick, Luis Zavala-Arciniega, Delvon T. Mattingly, Akash Patel, Rafael Meza, David T. Levy, Nancy L. Fleischer   JOURNAL: Preventive Medicine Reports   DESCRIPTION: This study examines patterns of use for menthol/non-menthol cigarettes and Electronic Nicotine Delivery Systems (ENDS) from 2013 to 2019 among U.S. adults. We calculated the weighted population prevalence of current exclusive and dual use for each product (i.e., menthol/non-menthol cigarettes and ENDS) stratified by age, sex, race/ethnicity, household income, and education in all surveys using data from three nationally representative surveys: the Population Assessment of Tobacco and Health (PATH) Study Waves 1–4 (W1-W4), 2013–2018; the National Health Interview Survey (NHIS) 2015; and the ...
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Publication: Health Effects, Impact Analysis

Consequences of a match made in hell: the harm caused by menthol smoking to the African American population over 1980–2018   AUTHORS: David Mendez, Thuy Tt Le   JOURNAL: Tobacco control   DESCRIPTION: Background For many years, national surveys have shown a consistently disproportionately high prevalence of menthol smokers among African Americans compared with the general population. However, to our knowledge, no prior study has quantified the harm that menthol smoking has caused on that population. In this work, we estimate the public health harm that menthol cigarettes have caused to the African American community over the last four decades. Methods Using National Health Interview Survey data, we employed a well-established simulation model to reproduce the observed smoking trajectory over ...
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Publication: Health Effects, Impact Analysis

Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study   AUTHORS: David T Levy, Rafael Meza, Zhe Yuan, Yameng Li, Christopher Cadham, Luz Maria Sanchez-Romero, Nargiz Travis, Marie Knoll, Alex C Liber, Ritesh Mistry, Jana L Hirschtick, Nancy L Fleischer, Sarah Skolnick, Andrew F Brouwer, Cliff Douglas, Jihyoun Jeon, Steven Cook, Kenneth E Warner   JOURNAL: Tobacco control   DESCRIPTION: Introduction: The US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs). Methods: After calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate ...
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Publication: Behavior, Health Effects

Trends in Nicotine Product Use Among US Adolescents, 1999-2020   AUTHORS: Ruoyan Sun, David Mendez, Kenneth E Warner   JOURNAL: JAMA network open   DESCRIPTION: Importance: With increasing e-cigarette use among US adolescents and decreasing use of other tobacco products, it is unclear how total use of nicotine products, and its long-term health risks, have changed. The Centers for Disease Control and Prevention's standard measure-any tobacco product use in the past 30 days-considers neither frequency of use nor product risk implications.
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Preprint: Behavior

Longitudinal Transitions in Initiation, Cessation, and Relapse of Smoking and E-Cigarette Use Among US Youth and Adults   AUTHORS: Eli Schwamm, Farzad Noubary, Nancy A. Rigotti, Krishna P. Reddy   JOURNAL: medRxiv   DESCRIPTION: Introduction: Longitudinal surveys provide data to estimate transition probabilities between cigarette smoking, e-cigarette use, and dual use of both, facilitating projections of future use and the impact of policies. Methods: We fit a continuous time Markov multi-state model for youth (ages 12-17y) and adults (≥18y) in Waves 1-4.5 of the Population Assessment of Tobacco and Health (PATH) longitudinal survey and estimated smoking and e-cigarette transition frequencies, including initiation, cessation, and relapse. We validated transition frequency results in a microsimulation model by projecting ...
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Publication: Behavior

Latent class analysis of use frequencies for multiple tobacco products in US adults   AUTHORS: Ritesh Mistry, Irina Bondarenko, Jihyoun Jeon, Andrew F Brouwer, Delvon T Mattingly, Jana L Hirschtick, Evelyn Jimenez-Mendoza, David T Levy, Stephanie R Land, Michael R Elliott, Jeremy M G Taylor, Rafael Meza, Nancy L Fleischer   JOURNAL: Preventive medicine   DESCRIPTION: A persistent challenge is characterizing patterns of tobacco use in terms of product combinations and frequency. Using Wave 4 (2016-17) Population Assessment of Tobacco and Health Study adult data, we conducted latent class analyses (LCA) of past 30-day frequency of use for 9 tobacco products. One-step LCA with joint multinomial logistic regression models compared sociodemographic factors between users (n = 13,716) and non-users (n = 17,457), and between latent classes of users. We accounted for survey design and weights. Our analyses identified 6 classes: in addition to non-users class (C0: 75.7%), ...
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Publication: Behavior

Sociodemographic Patterns of Exclusive and Dual Use of ENDS and Menthol/Non-Menthol Cigarettes among US Youth (Ages 15–17) Using Two Nationally Representative Surveys (2013–2017)   AUTHORS: Akash Patel, Jana L. Hirschtick, Steven Cook, Bukola Usidame, Ritesh Mistry, David T. Levy, Rafael Meza, Nancy L. Fleischer   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: The use of electronic nicotine delivery systems (ENDS) among youth in the United States has increased rapidly in the past decade. Simultaneously, while youth cigarette smoking has declined considerably, youth are still more likely to use menthol cigarettes than any other age group. We used nationally representative data on 15–17-year-olds from the Population Assessment of Tobacco and Health (PATH) Study and the National Youth Tobacco Survey (NYTS) (2013–2017) to better understand current cigarette (by menthol flavoring) and ENDS use in the US. We calculated weighted population prevalence estimates ...
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Publication: Behavior, Health Effects, Impact Analysis

The Potential Impact of Widespread Cessation Treatment for Smokers With Depression   AUTHORS: Jamie Tam, Kenneth E.Warner, Kara Zivin, Gemma M.J.Taylor, Rafael Meza   JOURNAL: American Journal of Preventive Medicine   DESCRIPTION: Introduction: Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios. Methods: Cessation interventions were simulated for U.S. adult smokers seeing a health professional for depression from 2020 to 2100. Interventions included (1) Any Treatment (behavioral counseling, pharmacological, combination) and (2) Pharmacological Treatment ...
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Publication: Behavior, Health Effects, Impact Analysis

Modeling smoking-attributable mortality among adults with major depression in the United States   AUTHORS: Jamie Tam, Gemma M J Taylor, Kara Zivin, Kenneth E Warner, Rafael Meza   JOURNAL: Preventive medicine.   DESCRIPTION: Tobacco-related health disparities disproportionately affect smokers with major depression (MD). Although tobacco simulation models have been applied to general populations, to date they have not considered populations with a comorbid mental health condition. We developed and calibrated a simulation model of smoking and MD comorbidity for the US adult population using the 2005-2018 National Surveys on Drug Use and Health. We use this model to evaluate trends in smoking prevalence, smoking-attributable mortality and life-years lost among adults with MD, and changes in smoking prevalence by mental ...
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Publication: Behavior

A comparison of tobacco product prevalence by different frequency of use thresholds across three US surveys   AUTHORS: Luz María Sánchez-Romero, Christopher J Cadham, Jana L Hirschtick, Delvon T Mattingly, Beomyoung Cho, Nancy L Fleischer, Andrew Brouwer, Ritesh Mistry, Stephanie R Land, Jihyoun Jeon, Rafael Meza, David T Levy   JOURNAL: BMC Public Health   DESCRIPTION: Background: With the increasing changes in tobacco use patterns, “current use” definition and the survey used may have important implications for monitoring population use trends. Methods: Using three US surveys (2014/15 TUS-CPS, NHIS and PATH), we compared the adult (age 18+) prevalence of four product groups (cigarettes, other combustibles, smokeless tobacco, and e-cigarettes) based on three past 30-day frequency of use thresholds: 1+, 10+, and 25+ days. We also examined mutually exclusive single, dual, and polytobacco users as a percentage of total users for each product group.
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Publication: Impact Analysis

An Expert Elicitation on the Effects of a Ban on Menthol Cigarettes and Cigars in the United States   AUTHORS: David T Levy, Christopher J Cadham, Luz Maria Sanchez-Romero, Marie Knoll, Nargiz Travis, Zhe Yuan, Yameng Li, Ritesh Mistry, Clifford E Douglas, Jamie Tam, Aylin Sertkaya, Kenneth E Warner, Rafael Meza   JOURNAL: Nicotine and tobacco research   DESCRIPTION: Introduction: The US FDA announced its intention to ban menthol in cigarettes. However, information is needed on how a federal ban would affect population health. We conducted an expert elicitation to gauge the impact of a menthol cigarette and cigar ban in the US. Methods: We developed and pilot tested a questionnaire that focused on tobacco use transitions of current smokers (age 18-24 menthol, age 35-54 menthol, and age 35-54 non-menthol) and potential menthol smokers (age 12-24). Using a structured expert elicitation, we estimated mean net transitions under a ban from cigarette use to combustible ...
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Publication: Health Effects

Time-varying survival effects for squamous cell carcinomas at oropharyngeal and nonoropharyngeal head and neck sites in the United States, 1973-2015   AUTHORS: Andrew F. Brouwer, Kevin He, Steven B Chinn, Alison M Mondul, Christina H Chapman, Marc D Ryser, Mousumi Banerjee, Marisa C Eisenberg, Rafael Meza, Jeremy M G Taylor   JOURNAL: Cancer   DESCRIPTION: Background: Anatomical site is strongly associated with head and neck cancer etiology, and etiology and patient sociodemographic characteristics are prognostic factors for survival. It is not known whether the effects of these predictors persist over the postdiagnosis period or are strongest proximal to the time of diagnosis.
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Publication: Health Effects, Impact Analysis

US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths   AUTHORS: David T. Levy, Luz María Sánchez-Romero, Nargiz Travis, Zhe Yuan, Yameng Li, Sarah Skolnick, Jihyoun Jeon, Jamie Tam, Rafael Meza   JOURNAL: International Journal of Environmental Research and Public Health   DESCRIPTION: The public health impact of nicotine vaping products (NVPs) is subject to a complex set of uncertain transitions between NVP and cigarette use. Instead, we apply an indirect method to gauge the impact of NVP use on smoking prevalence and smoking-attributable deaths (SADs) using the well-established SimSmoke tobacco control policy simulation model.
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Publication: Health Effects

Respiratory Symptom Incidence Among People Using Electronic Cigarettes, Combustible Tobacco, or Both   AUTHORS: Krishna P Reddy, Eli Schwamm, Sara Kalkhoran, Farzad Noubary, Rochelle P Walensky, Nancy A Rigotti   JOURNAL: American journal of respiratory and critical care medicine   DESCRIPTION: Keywords: electronic cigarettes; tobacco; smoking; respiratory symptoms
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Publication: Health Effects, Impact Analysis

Public health implications of vaping in the USA: the smoking and vaping simulation model   AUTHORS: David T Levy, Jamie Tam, Luz María Sanchez-Romero, Yameng Li, Zhe Yuan, Jihyoun Jeon, Rafael Meza   JOURNAL: Population health metrics.   DESCRIPTION: Background: Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), a user-friendly model which estimates the public health implications of NVPs in the USA.
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Poster

Thumbnail for Sociodemographic Patterns of Exclusive and Dual Use of Menthol/Non Menthol Cigarettes and ENDS among US Youth (Ages 15 17) Population Assessment of Tobacco and Health Study (2013 2017) posterSociodemographic Patterns of Exclusive and Dual Use of Menthol/Non Menthol Cigarettes and ENDS among US Youth (Ages 15 17) Population Assessment of Tobacco and Health Study (2013 2017)   AUTHORS: Akash Patel, Jana Hirschtick, Bukola Usidame, Nancy L. Fleischer   DESCRIPTION: Sociodemographic patterns of exclusive and dual use of menthol/non menthol cigarettes and ENDS can reveal disproportionately affected populations and inform future research, policies, and strategies.
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Poster

Thumbnail for Patterns of Tobacco Poly-Use in the Population Assessment of Tobacco and Health Study: A Multistate Markov Transition Analysis posterPatterns of Tobacco Poly-Use in the Population Assessment of Tobacco and Health Study: A Multistate Markov Transition Analysis   AUTHORS: Fatema Shafie Khorassani, Andrew F. Brouwer, Jana L. Hirschtick, Rafael Meza, Nancy L. Fleischer   DESCRIPTION: Goal: Estimate transition rates between single, dual, and poly tobacco use categories over time to help identify areas for policy intervention. Data: Waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study, 2013-2017
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Poster

Thumbnail for Trends in single-, dual-, and poly-tobacco use among US adults, 2014-2019: Results from two nationally representative surveys posterTrends in single-, dual-, and poly-tobacco use among US adults, 2014-2019: Results from two nationally representative surveys   AUTHORS: Delvon T. Mattingly, Luis Zavala-Arciniega, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: While numerous investigations of patterns of dual- and poly-tobacco use exist, trends in patterns of tobacco product use over time are not well documented.
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Poster

Thumbnail for Correlates of smoking cessation behaviors among dual users of cigarettes and e-cigarettes. Results from the TUS-CPS 2018-2019 posterCorrelates of smoking cessation behaviors among dual users of cigarettes and e-cigarettes. Results from the TUS-CPS 2018-2019   AUTHORS: Luis Zavala-Arciniega, Nancy L. Fleischer, Jana L. Hirschtick, Rafael Meza   DESCRIPTION: Few studies have examined the roles of e-cigarette frequency of use and device type in cigarette smoking cessation.. • Our study examines how e-cigarette frequency of use, device type, and flavorings affect the stages of cigarette smoking cessation among a national sample of dual users.
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Poster

Thumbnail for Flavoring patterns of exclusive and dual-use of cigarettes and e-cigarettes among US adults. Results from the TUS-CPS 2018-2019 posterFlavoring patterns of exclusive and dual-use of cigarettes and e-cigarettes among US adults. Results from the TUS-CPS 2018-2019   AUTHORS: Luis Zavala-Arciniega, Rafael Meza, Jana L. Hirschtick, Nancy L. Fleischer   DESCRIPTION: Describe the patterns of use of menthol/non-menthol cigarettes with flavored e-cigarettes (tobacco, menthol, sweet/spice/fruit, and other flavorings) among US adults.
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Poster

Thumbnail for Racial/ethnic disparities in cigarette and cigar prevalence and intensity of use among exclusive, dual, and polyusers posterRacial/ethnic disparities in cigarette and cigar prevalence and intensity of use among exclusive, dual, and polyusers   AUTHORS: Jana L. Hirschtick, Akash Patel, Jihyoun Jeon, Nancy L. Fleischer   DESCRIPTION: Racial/ethnic disparities in cigar prevalence and intensity of use are unclear in the context of exclusive use or concurrent use with cigarettes.
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Oral Presentation — Slides

Thumbnail for Expert Elicitation on the Effects of a Federal Menthol Ban posterExpert Elicitation on the Effects of a Federal Menthol Ban   AUTHORS: Christopher Cadham   DESCRIPTION: • FDA announced its intention to ban menthol in cigarettes, effects remain unknown • Expert Elicitation can be used to quantify uncertainty • Has been used by FDA, EPA, NASA, and IPCC among others
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Oral Presentation — Slides

Thumbnail for The impact of current tobacco product use definitions on estimates of transitions between cigarette and e-cigarette use posterThe impact of current tobacco product use definitions on estimates of transitions between cigarette and e-cigarette use   AUTHORS: Andrew F. Brouwer, David T. Levy, Jihyoun Jeon, Evelyn Jimenez-Mendoza, Luz María Sánchez-Romero, Ritesh Mistry, Rafael Meza  
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Oral Presentation — Slides

Thumbnail for Retail availability of tobacco and cigarette and e-cigarette use among youth and adults: a scoping review. posterRetail availability of tobacco and cigarette and e-cigarette use among youth and adults: a scoping review.   AUTHORS: Nargiz Travis, MSPH   DESCRIPTION: Current state of research • Limiting tobacco retailer availability may be an effective tobacco control strategy to reduce smoking and improve public health in the population • Understanding the relationship between retailer exposure and tobacco use patterns in both youth and adult populations is essential for evidence-based policy making • Evidence on the associations between tobacco retailer density/proximity and smoking outcomes is mixed • There are inconsistencies in measures of retailer exposure and tobacco use outcomes across studies
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Publication: Health Effects

Prediction of COPD risk accounting for time-varying smoking exposures   AUTHORS: Joanne T Chang, Rafael Meza, David T Levy, Douglas Arenberg, Jihyoun Jeon   JOURNAL: Public Library of Science (PLoS One)   DESCRIPTION: Rationale: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the United States. Studies have primarily assessed the relationship between smoking on COPD risk focusing on summary measures, like smoking status. Objective: Develop a COPD risk prediction model incorporating individual time-varying smoking exposures. Methods: The Nurses' Health Study (N = 86,711) and the Health Professionals Follow-up Study (N = 39,817) data was used to develop a COPD risk prediction model. Data was randomly split in 50-50 samples for model building and validation. Cox regression ...
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Publication: Health Effects, Impact Analysis

Evaluation of the Benefits and Harms of Lung Cancer Screening With Low-Dose Computed Tomography: Modeling Study for the US Preventive Services Task Force   AUTHORS: Rafael Meza, Jihyoun Jeon, Iakovos Toumazis, Kevin Ten Haaf, Pianpian Cao, Mehrad Bastani, Summer S Han, Erik F Blom, Daniel E Jonas, Eric J Feuer, Sylvia K Plevritis, Harry J de Koning, Chung Yin Kong   JOURNAL: Journal of the American Medical Association (JAMA)   DESCRIPTION: Importance: The US Preventive Services Task Force (USPSTF) is updating its 2013 lung cancer screening guidelines, which recommend annual screening for adults aged 55 through 80 years who have a smoking history of at least 30 pack-years and currently smoke or have quit within the past 15 years. Objective: To inform the USPSTF guidelines by estimating the benefits and harms associated with various low-dose computed tomography (LDCT) screening strategies. Design, setting, and participants: Comparative simulation modeling with 4 lung cancer natural history models for individuals from the 1950 ...
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