MedicalResearch.com Interview with:
Avni Y Joshi, MD, MSc
Assistant Professor of Pediatrics and Medicine
Pediatric and Adult Allergy / Immunology
Cellular and Molecular Immunology Laboratory
Mayo Clinic
Medical Research: What is the background for this study? What are the main findings?
Dr. Joshi: We sought to quantify the risk of asthma outcomes in children with asthma who are exposed to second hand tobacco smoke (SHS).
This was a pooled analysis of 25 studies that were included for looking at asthma outcomes in children.
Children with asthma who were exposed to second hand tobacco smoke (SHS) were nearly twice as likely to be hospitalized as compared to children with asthma who were not exposed to second hand tobacco smoke exposure.
(more…)
MedicalResearch.com Interview with:
Brian A. Primack, MD, PhD
Associate Professor of Medicine, Pediatrics, and Clinical and Translational Science
Director, Center for Research on Media, Technology, and Health
Assistant Vice Chancellor for Research on Health and Society
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
Medical Research: What is the background for this study?
Dr. Primack: Adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes. It is unclear whether these people are at risk for progression to traditional cigarette smoking. Therefore, we followed 694 non-smokers ages 16-26 who did not intend on taking up smoking for 1 year.
Medical Research: What are the main findings?
Dr. Primack: At baseline, only 16 of the 694 participants had used e-cigarettes. However, those individuals were significantly more likely to start smoking traditional cigarettes by the 1-year follow-up. In fully adjusted models, baseline e-cigarette use was independently associated with both progression to smoking (AOR = 8.3, 95% CI = 1.2-58.6) and to susceptibility (AOR = 8.5, 95% CI = 1.3-57.2).
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MedicalResearch.com Interview with:
Dr. Morgan Elyse Levine PhD
Postdoctoral Fellow
Department of Human Genetics
University of California, Los Angeles
Medical Research: What is the background for this study? What are the main findings?
Dr. Levine: Studies using mice, worms, and flies have suggested that longevity may be linked to stress resistance. All of us are constantly encountering things that damage our cells and tissue and disrupt physiological functioning. Therefore, people who are genetically predisposed to better prevent or repair this damage may age slower. Smoking is one of the most damaging things someone can do to their health, yet some smokers are able to survive to extreme ages. This study looked at long-lived smokers to see if we could identify a "genetic signature". We generated a genetic risk score that was found to be associated with longevity both in smokers and non-smokers, and also appeared to be associated with cancer risk.
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MedicalResearch.com Interview with: Francesca M. Filbey PhD
School of Behavioral and Brain Sciences
Center for Brain Health University of Texas at Dallas
Dallas, TX
Medical Research: What is the background for this study? What are the main findings?Dr. Filbey: Most studies exclude tobacco users from participating, but 70% of marijuana users also use tobacco. We were interested in investigating the combined effects of marijuana and tobacco. Our research targeted the hippocampus because smaller hippocampal size is associated with marijuana use. We chose to study short term memory because the hippocampus is an area of the brain associated with memory and learning. The main finding was surprising. The smaller the hippocampus in the marijuana plus nicotine user, the greater the memory performance. We expected the opposite, which was true of the non-using control group. (more…)
healtMedicalResearch.com Interview with:
Sajal Chattopadhyay, Ph.D.
Economic Advisor, The Community Guide Branch
Division of Public Health Information Dissemination
Center for Surveillance, Epidemiology, and Laboratory Services
Office of Public Health Scientific Services
Centers for Disease Control and Prevention
Medical Research: What is the background for this study? What are the main findings?Dr. Chattopadhyay: Based on an updated review of all of the available scientific studies, the Community Preventive Services Task Force (CPSTF) reiterated its recommendation for tobacco price increases based on strong evidence of their effectiveness in reducing tobacco use and its harmful consequences. This study expands on the conclusions on effectiveness of price increases by systematically reviewing the evidence on the economic impact of policies that raise the unit price of tobacco products in the U.S. and other high-income countries, primarily through taxation.
The findings indicate that tobacco price increases generate substantial healthcare cost savings and can generate additional gains from improved workplace productivity.
(more…)
MedicalResearch.com Interview with:
W. Michael Hooten, M.D
Professor of Anesthesiology
Mayo Clinic
Medical Research: What is the background for this study? Dr. Hooten: The purpose of the study was to investigate a gap in knowledge related to the progression of short-term opioid use to longer-term use.
Medical Research: What are the main findings?
Dr. Hooten: The main findings are that a history of substance abuse or tobacco use is associated with the progression from short-term to a longer-term pattern of opioid prescribing.
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MedicalResearch.com Interview with:
Jonathan Thornburg, PhD
Director, Exposure and Aerosol Technology
RTI International
Research Triangle Park, NC
MedicalResearch: What is the background for this study? What are the main findings?Dr. Thornburg: RTI wants to improve the human condition by protecting public health from exposure to contaminants. That includes secondhand exposure to electronic cigarette vapors. RTI realized that most research has focused on the electronic cigarette user, not on secondhand exposure. Our research created a simulated lung in our laboratory to produce representative electronic cigarette aerosol that a user would exhale so we could measure the aerosol size distribution and chemical composition. Those two parameters are critical characteristics for understanding the physical and chemical properties of the aerosol as it disperses in the environment to produce the airborne concentrations that determine someone’s secondhand exposure. Our main findings were:
The aerosol particles exhaled by a user are smaller than 1000 nm, with median size between 100 and 200 nm. The aerosol size distribution varies with the type of e-liquid used.
The aerosol is made of water, glycerin/propylene glycol, nicotine, artificial flavors, and preservatives
Artificial flavors identified were ethyl maltol, 2-methyl naphthalene and 2-tert-butyl-p-cresol present.
BHA and BHT preservatives were present.
Dosimetry modeling determined that more than 50% of the electronic cigarette emissions were exhaled by the user, potentially leading to secondhand exposure.
MedicalResearch.com Interview with:
Rebecca S. Williams, MHS, PhD
University of North Carolina at Chapel Hill
Chapel Hill, NC
MedicalResearch: What is the background for this study? Dr. Williams: In recent years, the e-cigarette industry has ballooned into a multi-billion dollar market, with at least 466 brands and 7764 unique flavors of e-cigarettes sold online. With both smokers and people who never smoked turning to e-cigarettes, there are concerns about their safety, lack of regulation and accessibility to teens. The CDC reported that 17% of high school seniors use e-cigarettes, more than twice as many as use traditional cigarettes; furthermore, that hundreds of thousands of youth annually are using e-cigarettes who never smoked cigarettes.
Our previous studies of Internet cigarette sales indicated that Internet Tobacco Vendors did a poor job of preventing sales to minors, which helped inform development of state and federal regulations to regulate such sales. In 2013, North Carolina passed a law requiring age verification for online e-cigarette sales. This study was the first study to examine age verification used by Internet e-cigarette vendors and the first to assess compliance with North Carolina’s e-cigarette age verification law.
MedicalResearch: What are the main findings?Dr. Williams: It was very easy for minors to buy e-cigarettes online. It took little effort for them to bypass the age verification practices of the vendors because there was very little use of rigorous age verification. With only 5 orders rejected by vendors due to age verification, there was a youth e-cigarette purchase success rate of 94.7%. No vendors used age verification at delivery, and few used rigorous methods of age verification that could potentially block youth access. While 7 vendors claimed to use age verification techniques that could potentially comply with North Carolina’s law, only one actually did.
(more…)
MedicalResearch.com Interview with:
Virender K. Rehan, MD
LA BioMed Lead Researcher
Medical Research: What are the main findings?Dr. Rehan: A new study holds hope for reversing asthma caused by smoking during
pregnancy. The study, published online by the American Journal of Physiology
- Lung Cellular and Molecular Physiology, reported that a medication that
stimulates certain proteins in the body reversed airway damage in disease
models of asthma caused by prenatal exposure to nicotine.
This is the first study to indicate that the damage caused by exposure to
nicotine during pregnancy could actually be reversed. Earlier studies found
this medication could prevent nicotine-induced asthma when given during
pregnancy. Researchers at Los Angeles Biomedical Research Institute (LA
BioMed) conducted the study to determine if the lung and airway damage
caused by nicotine could be reversed and found it could be.
(more…)
MedicalResearch.com Interview with:
Jon Ebbert, M.D.
Associate director for research
Mayo Clinic Nicotine Dependence Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Ebbert: Some cigarette smokers prefer to reduce the number cigarettes that they smoke before quitting smoking completely. Previous studies have evaluated the use of nicotine replacement therapy and one smaller study looked at varenicline to help smokers quit through smoking reduction. We wanted to conduct a larger study with varenicline using a longer duration of treatment.
We enrolled cigarette smokers who had no intention of quitting in the next month but who were willing to reduce the number of cigarettes they smoked while working toward a quit attempt in the next 3 months.
(more…)
MedicalResearch.com Interview with:
Mary Puckett, PhD
CDC
Division of Cancer Prevention and Control.Medical Research: What is the background for this study? What are the main findings?
Dr. Puckett: Smoking causes 480,000 deaths per year in the United States. Quitline services are offered by all 50 states. In addition to telephone quitlines, 96% of states also offer some form of web-based cessation service. Seven months after enrollment in the study, participants from four state quitlines were asked if they had smoked in the past 30 days as a measure of their smoking cessation success. Participants who used quitlines and web-based services in combination had higher rates of smoking cessation than participants who used only one of these services. (more…)
MedicalResearch.com Interview with:
Dr Hayden McRobbie MB ChB PhD
Reader in Public Health Interventions
Wolfson Institute of Preventive Medicine
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
Medical Research: What is the background for this study? What are the main findings?
Dr. McRobbi: Varenicline is an effective smoking cessation aid that acts primarily to alleviate the symptoms of tobacco withdrawal discomfort, thereby making quitting easier. It also reduces the rewarding effects of cigarettes smoked which may enhance the drugs smoking cessation effect by reducing the enjoyment of smoking prior to quitting and preventing a lapse, after quitting, progressing to relapse.
In some people the standard dose of varenicline (2mg/day) results in a decrease in the enjoyment of smoking prior to quitting and that these people appear to have higher quit rates that those that don’t experience this reaction to smoking.
The randomised placebo controlled trial was designed to investigate whether increasing the varenicline dose (up to 5mg/day) in smokers who show no reaction to the standard dose improves treatment outcomes compared to remain on the standard dose.
Medical Research: What are the main findings?
Dr. McRobbi: Whilst the increased dose, compared with the standard dose, reduced the enjoyment of smoking prior to quitting it had no additional effect on alleviating tobacco withdrawal symptoms or smoking cessation rates at 12 weeks post quit date (26% vs. 23%).
(more…)
MedicalResearch.com Interview with:
Seong Jin Jo, MD, PhD
Department of Dermatology
Seoul National University College of Medicine
Seoul Korea.
Medical Research: What is the background for this study? What are the main findings?Response: Hair graying is a natural aging process, but some people develop hair graying in their youth.
In this study of young Korean males, we found that obesity, smoking, and family history were significantly associated with premature hair graying.
(more…)
MedicalResearch.com Interview with:
Xin Xu, Ph.D.
Senior Economist Office on Smoking and Health and
Darryl Konter
Health Communications Specialist
McNeal Professional Services
Centers for Disease Control and Prevention
Office on Smoking and Health
Atlanta, GA 30341
Medical Research: What is the background for this study? What are the main findings?
Response: Tips From Former Smokers (Tips), the first federally funded national mass media antismoking campaign, launched by the CDC, provides a unique opportunity to assess the cost effectiveness of a nationwide public health intervention that meets the ad exposure recommendation in CDC’s 2014 Best Practices for Comprehensive Tobacco Control Programs. The 2012 campaign spent $393 per year of life saved—far less than the $50,000 per year of life saved figure used as a common threshold for cost-effectiveness. The campaign added about 179,000 healthy life years, at $268 per healthy year gained. The campaign spent about $480 per smoker who quit. The campaign averted more than 17,000 premature deaths, at a cost of about $2,200 per premature death averted.(more…)
MedicalResearch.com Interview with:
Darryl Konter
Health Communications Specialist
McNeal Professional Services
Centers for Disease Control and Prevention
Office on Smoking and Health Atlanta, GA 30341Medical Research: What is the background for this study? What are the main findings?
Darryl Konter:
Fifty years after the first Surgeon General’s report, tobacco use remains the nation’s leading preventable cause of death and disease, despite declines in adult cigarette smoking prevalence. Smoking-attributable healthcare spending is an important part of overall smoking attributable costs in the U.S.
Data came from the 2006–2010 Medical Expenditure Panel Survey (MEPS) linked to the 2004–2009 National Health Interview Survey (NHIS). The MEPS is a nationally representative survey of civilian non-institutionalized families and individuals, their medical providers, and employers that collects information on individual healthcare utilization and medical expenditures.
By 2010, 8.7% of annual healthcare spending in the U.S. could be attributed to cigarette smoking, amounting to as much as $170 billion per year. More than 60% of the attributable spending was paid by public programs, including Medicare, other federally-sponsored programs, or Medicaid.
(more…)
MedicalResearch.com Interview with:
Marcus Munafò PhD
Professor of Biological Psychology
MRC Integrative Epidemiology Unit
UK Centre for Tobacco and Alcohol Studies
School of Experimental Psychology
University of Bristol United Kingdom
Medical Research: What is the background for this study? What are the main findings?Dr. Munafo: We were conducting an analysis of data on smoking behaviour and body mass index (BMI), in order to better understand the potential causal effects of smoking on different measures of adiposity. Mendelian randomisation uses genetic variants associated with the exposure of interest (in this case smoking) as proxies for the exposure, in order to reduce the risk of spurious associations arising from confounding or reverse causality. As expected, we found that, among current smokers, a genetic variant associated with heavier smoking was associated with lower BMI, providing good evidence that smoking reduces BMI. However, we also unexpectedly found that the same variant was associated with higher BMI in never smokers. This suggests that this variant might be influencing BMI via pathways other than smoking.
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MedicalResearch.com Interview with:
Darryl Konter
Health Communications Specialist, Office on Smoking and Health at Centers for Disease Control and PreventionMedical Research: What is the background for this study? What are the main findings?Response: Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. Cigarette smoking among U.S. adults declined from 20.9% in 2005 to 17.8% in 2013. Among cigarette smokers who smoke daily, the average number of cigarettes smoked per day declined from 16.7 in 2005 to 14.2 in 2013, and the proportions of daily smokers who smoked 20–29 or ≥30 cigarettes per day also declined. However, an estimated 42.1 million adults still smoked cigarettes in 2013. Moreover, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are lesbian, gay, or bisexual. (more…)
MedicalResearch.com Interview with:
Brian King, Ph.D.
Senior Scientific Advisor with the CDC Office on Smoking and Health.
MedicalResearch: What is the background for this study? What are the main findings?Dr. King: This study presents data from the 2013 National Youth Tobacco Survey, an annual school-based survey of U.S. middle and high school students in grades 6 through 12. The data show that more than 1 in 5 high school students and more than 1 in 20 middle school students have used a tobacco product in the past 30 days; and nearly half of high school students and almost 1 in 5 middle school students have used a tobacco product at least once in their life. Nine of ten high school tobacco users used a combustible tobacco product such as a cigarette, cigar, hookah, pipe, bidi, or kretek; there was lower use of only noncombustible tobacco products or only electronic cigarettes among both current and ever tobacco users.
(more…)
MedicalResearch.com Interview with:Dr. John Cherrie PhD
Honorary Professor in Occupational Hygiene
Institute of Applied Health Sciences
Aberdeen, UK
Medical Research: What are the main findings of the study?Dr. Cherrie:We set out to bring together measurements of fine particle levels in homes where smoking takes place, to compare these with smoke-free homes and then to estimate how much of these fine particles are inhaled by people at different stages in their life. We also wanted to look at the exposure to particles of non-smokers living with smokers and compare this with the exposure of people living in heavily polluted major cities around the world.
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MedicalResearch.com Interview with:Dr. Brian Rostron PhD, MPH
Center for Tobacco Products
US Food and Drug Administration
Silver Spring, Maryland
Medical Research: What are the main findings of the study?Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking. COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking.
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MedicalResearch.com: Interview with: Girija Syamlal MBBS, MPH , Epidemiologist
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
CDC, Morgantown, West Virginia
CDC/NIOSH/DRDS
Morgantown,WV 26505
Medical Research: What are the main findings of the study?
Dr. Syamlal: During 2004–2011, of the 141 million U.S. adults, 20.7% were current cigarette smokers. Smoking prevalences were higher among men (22.8%) than women (18.3%). In both men and women, cigarette smoking prevalence varied widely by occupational group. In certain occupations, the prevalence of smoking was three times greater than the Healthy People 2020 goal that aims to reduce cigarette smoking prevalence to 12%.
(more…)
MedicalResearch.com Interview with: Michelle Scollo
Senior policy adviser, Tobacco
Centre for Behavioural Research in Cancer
Medical Research: What are the main findings of the study?Answer: Each November the Cancer Council Victoria conducts a survey asking smokers about their tobacco purchasing habits and smoking attitudes, intentions and behaviours. This study compared what smokers said about where and what they purchased in:
November 2011, a year before the introduction of world-first legislation mandating standardized packaging of tobacco products throughout Australia
In November 2012, while the new plain packs were being rolled out onto the market and
In November 2013 one year later.
The tobacco industry had strenuously opposed the legislation, but—contrary to the industry predictions and continuing claims in other countries contemplating similar legislation—we found:
1. No evidence of smokers shifting from purchasing in small independent outlets to purchasing in larger supermarkets
2. No evidence of an increase in use of very cheap brands of cigarettes manufactured by companies based in Asia and
3. No evidence of an increase in use of illicit unbranded tobacco.
(more…)
MedicalResearch.com Interview with:
Helene Nordahl, MS, PhD
Department of Public Health, University of Copenhagen
Copenhagen, Denmark.
Medical Research: What are the main findings of...
MedicalResearch.com: Interview Invitation Dr. Bente Glintborg:
Copenhagen Centre for Arthritis ResearchCentre for Rheumatology and Spine Diseases
Copenhagen University Hospital Glostrup
Copenhagen, Denmark
Medical Research: What are the main findings of the study?Dr. Glintborg: Current smoking had a negative impact among patients with psoriatic arthritis treated with TNFi. This was especially observed among male patients and among patients treated with infliximab and etanercept. Current smokers had a shorter treatment duration (=poorer treatment adherence rate) compared to non-smokers. And current smokers had poorer treatment response (measured as ACR20, ACR50 and ACR70 responses and EULAR good response) compared to non smokers. Especially among male smokers the EULAR good response and ACR20 response rates were nearly half of the rates among male non-smokers. The response rates among women did not seem to be affcted by smoking status. Current smokers had poorer self reported outcome measures (HAQ and VAS global and VAS fatigue) when they started treatment with TNFi.
(more…)
MedicalResearch.com: Interview with:Gabriel Arefalk
Department of Medical Sciences
Uppsala University Hospital
Uppsala, Sweden
Medical Research: What are the main findings of the study?Answer: In this prospective cohort study, we investigated mortality risk in 2474 smokeless tobacco users who had been hospitalized for a myocardial infarction between the years of 2005-2009 in Sweden. We used a nationwide quality register and database called SWEDEHEART and found that those who stopped using snus (the Swedish type of snuff) after their MI had half the risk of dying during follow up relative to those who continued to use snus. This association, which was of the same magnitude as for smoking cessation, seemed to be independent of age, gender and smoking habits, as well as of many other relevant covariates.
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MedicalResearch.com Interview with: Ms Qi Wu:
Mental Health and Addiction Research Group, Department of Health Sciences
University of York, Heslington
York UK
Medical Research: What are the main findings of the study?Ms Qi Wu: At any time in the UK about one in six adults has a mental health problem, the prevalence of smoking in this group is over 33%, which is around 50% higher than in the general population. It is estimated that 3 million adults with mental disorders were smokers in 2009-10. Meanwhile, people with mental health disorders are also more likely to smoke heavily, this group accounts for as much as 42% of the total national tobacco consumption. In this study, we calculated the avoidable economic burden of smoking in people with mental disorders.
The main finding was that people with mental disorders who smoke cost the UK economy £2.34 billion a year. The total costs are more or less equally divided among losses sustained from premature death, lost productivity, and healthcare costs to treat smoking related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease (COPD) in this group. An estimated £719 million (31% of the total cost) was spent on treating diseases caused by smoking. Productivity losses due to smoking-related diseases were about £823 million (35%) for work- related absenteeism and £797 million (34%) was associated with premature mortality.
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MedicalResearch.com Interview with:Coenie Koegelenberg, MBChB, MMed (Int), FCP (SA), MRCP (UK), Cert Pulm (SA), PhD
Associate Professor: Pulmonology
Stellenbosch University & Tygerberg Academic Hospital
Medical Research: What are the main findings of the study?Dr. Koegelenberg: The aim of this study was to evaluate the efficacy of combining varenicline and a nicotine patch versus varenicline alone as an aid to smoking cessation in a double-blind study design in a larger group and with a longer assessment period than has been studied to date. It was found that the combination treatment was associated with a statistically significant and clinically important higher continuous abstinence rate at 12 weeks (55.4% vs. 40.9%; P=.007) and 24 weeks (49.0% vs. 32.6%; P=.004), and point prevalence abstinence rate at 6 months (65.1% vs. 46.7%; P=.002). The present study was not adequately powered to fully assess safety and tolerability endpoints, but the results suggest that adverse events were balanced across treatment arms, except for mild skin reactions that were more frequently observed in the nicotine patch group (14.4% vs. 7.8%, P=.03).
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MedicalResearch.com Interview with Dr. Wojciech Feleszko
Department of Pediatric Respiratory Diseases and Allergy
The Medical University of Warsaw
Działdowska Warsaw, Poland
MedicalResearch: What are the main findings of the study?Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects. We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke. (more…)
MedicalResearch.com Interview with:
Nathalie E. Holz, MA
Department of Child and Adolescent Psychiatry and Psychotherapy
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany MedicalResearch: What are the main findings of the study?Dr. Holz: Using data from a prospective community sample followed since birth, we investigated the impact of prenatal maternal smoking on lifetime Attention-Deficit/ Hyperactivity Disorder (ADHD) symptoms and on brain structure and inhibitory control assessed with Magnetic Resonance Imaging in the adult offspring. Those who were prenatally exposed to tobacco not only exhibited more ADHD symptoms, but also showed decreased activity in the inhibitory control network encompassing the inferior frontal gyrus as well as the anterior cingulate cortex. Activity in these regions was inversely related to lifetime ADHD symptoms and novelty seeking, respectively. In addition volume in the inferior frontal gyrus was decreased in these participants.
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MedicalResearch.com Interview with: Pamela Ling, MD MPH
Associate Professor, Department of Medicine
Director, Tobacco Control Policy Fellowship
Center for Tobacco Research and Education
University of California San Francisco
San Francisco, CA 94143-1390
MedicalResearch.com: What are the main findings of the study?Dr. Ling: We followed a sample of smokers from a nationally representative panel for one year. We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not. Put another way, smokers who had used e-cigarettes at the beginning of the study were equally likely to have quit smoking one year later as those who did not use e-cigarettes. There was no relationship between e-cigarette use and quitting even after taking into account measures of tobacco dependence (number of cigarettes smoked per day, how early in the day a smoker has his first cigarette) and intention to quit smoking.
(more…)
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