The Schroeder Institute for Tobacco Research and Policy Studies

Schroeder, United States

The Schroeder Institute for Tobacco Research and Policy Studies

Schroeder, United States
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Villanti A.C.,The Schroeder Institute for Tobacco Research and Policy Studies | Pearson J.L.,The Schroeder Institute for Tobacco Research and Policy Studies
Addictive Behaviors | Year: 2015

In the evolving landscape of tobacco use, it remains unclear how tobacco control efforts should be designed and promoted for maximum impact. The current study links the identification of latent classes of young adult combustible tobacco users with anticipated responses to graphic health warning labels (HWLs). Data were collected in January 2012 using an online address-based panel as part of the Legacy Young Adult Cohort Study, and analyses were conducted in 2013. Latent class analyses identified five groups of tobacco users in a national sample of 4,236 young adults aged 18-34. years: (1) little cigar/cigarillo/bidi (LCC) and hookah users (4%); (2) nonusers, open to smoking (3%); (3) daily smokers who self-identify as "smokers" (11%); (4) nondaily, light smokers who self-identify as "social or occasional smokers" (9%); and (5) nonusers closed to smoking (73%). Of the nonusers closed to smoking, 23% may be better characterized as at risk for tobacco initiation. Results indicate differences in the potential effectiveness of HWLs across classes. Compared to the daily "smokers," LCC and hookah users (RRR. =. 2.35) and nonusers closed to smoking (RRR. =. 2.33) were more than twice as likely to report that new graphic HWLs would make them think about not smoking. This study supports the potential of graphic HWLs to prevent young nonusers from using tobacco products. It suggests that the extension of prominent HWLs to other tobacco products, including LCCs and hookah tobacco, may also serve a prevention function. © 2014 Elsevier Ltd.


Cantrell J.,Legacy | Anesetti-Rothermel A.,The Schroeder Institute for Tobacco Research and Policy Studies | Anesetti-Rothermel A.,West Virginia University | Pearson J.L.,The Schroeder Institute for Tobacco Research and Policy Studies | And 3 more authors.
Addiction | Year: 2015

Aims: This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Design: Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Setting: Eight large Designated Media Areas across the United States. Participants: A total of 2377 baseline smokers followed over three waves from 2008 to 2010. Measurements: Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Findings: Smokers in high poverty census tracts living between 500m and 1.9km from an outlet were over two times more likely to be abstinent than those living fewer than 500m from an outlet (P<0.05). Density within 500m of home was associated with reduced abstinence [odds ratio (OR)=0.94; confidence interval (CI)=0.90, 0.98) and lower pro-cessation attitudes (Coeff=-0.07, CI=-0.10, -0.03) only in high poverty areas. In low poverty areas, density within 500m was associated with greater pro-cessation attitudes (OR=0.06; CI=0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. Conclusions: In the United States, density of tobacco outlets within 500m of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas. © 2014 Society for the Study of Addiction.


Villanti A.C.,The Schroeder Institute for Tobacco Research and Policy Studies | Jiang Y.,Milliman Incorporated | Abrams D.B.,The Schroeder Institute for Tobacco Research and Policy Studies | Abrams D.B.,Georgetown University | Pyenson B.S.,Milliman Incorporated
PLoS ONE | Year: 2013

Background:A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.Methods and Findings:The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.Conclusions:The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations. © 2013 Villanti et al.


PubMed | United States Rutgers Cancer Institute of New Jersey, The Schroeder Institute for Tobacco Research and Policy Studies and Center for Tobacco Studies
Type: Journal Article | Journal: Tobacco control | Year: 2016

Progression to regular smoking often occurs during young adulthood. This study examines self-reported changes in past year smoking among young adults and the potential influence of tobacco products on these trajectories.Respondents to the 2011 National Young Adult Health Survey who smoked 100 cigarettes in their lifetime (n=909) described smoking behaviour at the time of the survey and 1year prior. Cigarette smoking trajectories were categorised as: no change, quit, decreased smoking or increased smoking. Participants were also asked about current use of menthol cigarettes and other tobacco products (ie, cigars, smokeless tobacco, hookah) and ever use of e-cigarettes.Most young adults (73.1%) reported stable cigarette smoking behaviours, while 8.2% reported having quit, 5.8% reported that they smoke on fewer days, 5% progressed from someday to daily smoking and 8% increased from not at all to current smoking. The youngest smokers (18-20) had significantly higher odds (adjusted OR (AOR) =2.6) of increasing cigarette use over the past year compared to those aged 30-34, as did blacks versus whites (AOR=2.35). Menthol cigarette use nearly doubled (AOR=1.87) the odds of increased smoking behaviour. E-cigarette and other tobacco product (OTP) use were not associated with increasing smoking but OTP use was negatively associated with remaining quit from cigarettes.Young adulthood is a critical period for smoking interventions, particularly among those most vulnerable to increasing smoking behaviours (ie, black and younger young adults). Policy efforts to restrict menthol cigarettes may reduce young adult smoking progression.


PubMed | The Schroeder Institute for Tobacco Research and Policy Studies and Institute for Global Tobacco Control
Type: Journal Article | Journal: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco | Year: 2016

We systematically reviewed research examining use of and attitudes toward nonmenthol-flavored tobacco products to provide information relevant to a decision to regulate these products in the future.To identify eligible studies, we searched PubMed, CINHAL, Embase, LILACS, and PsycINFO on September 19, 2013, without date restrictions. We obtained additional studies via gray literature searches, expert contacts, and hand-searching citations of included articles. We included participants of all ages. We conducted a qualitative synthesis for included studies.The 32 studies included in this review exhibited substantial heterogeneity and were of varied methodological quality. Findings from observational, experimental, and quasiexperimental studies suggest that flavored tobacco use is associated with young age and that consumers may perceive flavored products more favorably than nonflavored products. Evidence from qualitative studies indicates that flavoring in tobacco is viewed favorably by users and nonusers of these products.The Food and Drug Administration has expressed interest in regulating flavored tobacco products. This systematic review strengthens the evidence base relating to this issue by synthesizing the literature from the United States on the use of and attitudes toward flavored tobacco. To address gaps in the literature, more research is needed to understand how flavoring impacts tobacco use over time. The evidence base would further be strengthened with the collection of brand-, flavor-, and product-specific data.


Hitsman B.,Northwestern University | Buka S.L.,Brown University | Veluz-Wilkins A.K.,Northwestern University | Mohr D.C.,Northwestern University | And 2 more authors.
Psychology of Addictive Behaviors | Year: 2011

History of major depression is increasingly being measured in smoking cessation trials using brief screening scales, typically only 1-2 items, despite that their validity has not been fully established. The aim of this study was to evaluate the positive predictive value (PPV) of a 4-item screening scale of lifetime major depressive episode (MDE). Current (n = 475), former (n = 401), and never (n = 646) smokers were asked about a history of depressed mood and anhedonia lasting several days or longer. Endorsers of either depressed mood or anhedonia were then asked about whether the symptom(s) lasted most of the day nearly every day for two weeks or longer. Symptom endorsers, regardless of symptom duration, were administered the depression module of the Composite International Diagnostic Interview. Eight hundred and thirty-five (54.9%) participants had no history of either screening symptom, 296 (20.9%) had a history of depressed mood and/or anhedonia < 2 weeks, and 369 (24.2%) had a history of depressed mood and/or anhedonia ≥ 2 weeks. PPV of depressed mood and/or anhedonia ≥ 2 weeks was high (84.8%) for detecting lifetime MDE, as compared to only 23.9% for symptom(s) <2 weeks. PPV did not vary by either smoking status or gender. This 4-item screening scale has high predictive value in detecting lifetime MDE. Smoking cessation trials that do not require a history of depressed mood and/or anhedonia for two weeks or longer may overestimate rates of lifetime MDE and confound tests of the association between depression and treatment outcome. © 2011 American Psychological Association.


Hitsman B.,Northwestern University | Papandonatos G.D.,Brown University | McChargue D.E.,University of Nebraska - Lincoln | Demott A.,Northwestern University | And 4 more authors.
Addiction | Year: 2013

Aims: To update our prior meta-analysis that showed past major depression (MD+) to be unrelated to smoking cessation outcome. Methods: Eligible trials included 14 from our original review and 28 identified through an updated systematic review (2000-2009). We coded for assessment of past MD, exclusion for recent MD episode (MDE; ≤6 months versus no exclusion), duration/modality of cognitive behavioral treatment (CBT; face-to-face versus self-help) and other factors. To minimize influence of experimental treatments that may selectively benefit MD+ smokers we analyzed placebo/lowest intensity control arms only. Study-specific ORs for the effect of past MD on short-term (≤3 months) and long-term (≥6 months) abstinence were estimated and combined using random effects. Two-way interaction models of past MD with study methodology and treatment factors were used to evaluate hypothesized moderators of the past MD-abstinence association. Results: MD+ smokers had 17% lower odds of short-term abstinence (n=35, OR=0.83, 95% CI=0.72-0.95, P=0.009) and 19% lower odds of long-term abstinence (n=38, OR=0.81, 95% CI=0.67-0.97, P=0.023) than MD- smokers after excluding the sole study of varenicline because of its antidepressant properties. The association between past MD and abstinence was affected by methodological (recent MDE exclusion, type of MD assessment) and treatment (CBT modality) factors. Conclusions: Past major depression has a modest adverse effect on abstinence during and after smoking cessation treatment. An increased focus on the identification of effective treatments or treatment adaptations that eliminate this disparity in smoking cessation for MD+ smokers is needed. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.


PubMed | The Schroeder Institute for Tobacco Research and Policy Studies, Survos, Evaluation Science and Research and New York University
Type: Journal Article | Journal: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco | Year: 2016

In 2015, the Food and Drug Administration issued warnings to three tobacco manufacturers who label their cigarettes as additive-free and/or natural on the grounds that they make unauthorized reduced risk claims. The goal of this study was to examine US adults perceptions of three American Spirit (AS) pack descriptors (Made with Organic Tobacco, 100% Additive-Free, and 100% US Grown Tobacco) to assess if they communicate reduced risk.In September 2012, three cross-sectional surveys were posted on Amazon Mechanical Turk. Adult participants evaluated the relative harm of a Marlboro Red pack versus three different AS packs with the descriptors Made with Organic Tobacco, 100% Additive-Free, or 100% US Grown Tobacco (Survey 1; n = 461); a Marlboro Red pack versus these AS packs modified to exclude descriptors (Survey 2; n = 857); and unmodified versus modified AS pack images (Survey 3; n = 1001).The majority of Survey 1 participants rated the unmodified AS packs as less harmful than the Marlboro Red pack; 35.4%-58.8% of Survey 2 participants also rated the modified (no claims) packs as less harmful than Marlboro Red. In these surveys, prior use of AS cigarettes was associated with reduced perceptions of risk (adjusted odds ratio [AOR] 1.59-2.40). Made with Organic Tobacco and 100% Additive-Free were associated with reduced perceptions of risk when comparing the modified versus the unmodified AS packs (Survey 3).Data suggest that these AS pack descriptors communicate reduced harm messages to consumers. Findings have implications for regulatory actions related to product labeling and packaging.These findings provide additional evidence that the Made with Organic Tobacco, 100% Additive-Free, and 100% US Grown descriptors, as well as other aspects of the AS pack design, communicate reduced harm to non-, current, and former smokers. Additionally, they provide support for the importance of FDAs 2015 warning to Santa Fe Natural Tobacco Company on 100% Additive Free as an unauthorized modified risk claim.


Ehlke S.J.,The Schroeder Institute for Tobacco Research and Policy Studies | Cohn A.M.,The Schroeder Institute for Tobacco Research and Policy Studies | Cohn A.M.,Georgetown University
Addictive Behaviors | Year: 2016

Introduction: Dual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women. Methods: Data utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected. Results: Dual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit. Discussion: Alcohol use may be a risk factor for men's dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed. © 2016.


PubMed | The Schroeder Institute for Tobacco Research and Policy Studies
Type: | Journal: Addictive behaviors | Year: 2016

Dual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women.Data utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected.Dual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit.Alcohol use may be a risk factor for mens dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed.

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