Smoking, Tobacco Research / 15.07.2024
The Realities of Smoking: Fact vs Fiction
We've all grown up knowing that smoking is bad for us. But beyond the basic warnings on cigarette packs, there are many myths and misconceptions about smoking that cloud the real picture. It's time to separate fact from fiction and understand the true impact of smoking on our health.
Image Source[/caption]
When we think about smoking, we often focus on how it affects our lungs. Sure, it's common knowledge that smoking can lead to lung cancer and breathing problems. But the truth is, smoking doesn't stop there. It affects every part of your body, from your heart to your skin. Nicotine and the chemicals in cigarettes get into your bloodstream, causing damage throughout.
Myth: Smoking only harms your lungs
[caption id="attachment_62305" align="alignleft" width="200"]
Image Source[/caption]
When we think about smoking, we often focus on how it affects our lungs. Sure, it's common knowledge that smoking can lead to lung cancer and breathing problems. But the truth is, smoking doesn't stop there. It affects every part of your body, from your heart to your skin. Nicotine and the chemicals in cigarettes get into your bloodstream, causing damage throughout.
Dr. Pierce[/caption]
John Pierce, PhD
Professor Emeritus
Department of Family Medicine and Public Health
Moores Cancer Center Director for Population Sciences
Co-leader of the Cancer Prevention program
UC San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Graphic Warning Labels are to be implemented in the US in July 2022, depending on litigation. This will be about 10 years after they were first proposed. Meanwhile, 120 other countries have implemented them already.
The FDA states that their purpose for the warnings is to provide a constant reminder to smokers about the health consequences of smoking, not to force them to quit.
In our study, 3 months of having cigarettes repackaged into graphic warning packs was associated with smokers thinking more about quitting and not getting as much pleasure out of their cigarettes. However, thinking about quitting is only the first step to conquering a nicotine addiction.
Dr. Silverstein[/caption]
Dr. Michael Silverstein M.D., M.P.H
Professor of Pediatrics
Director of the Division of General Academic Pediatrics
Vice Chair of Research, Department of Pediatrics
Boston University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Tobacco use is the leading preventable cause of disease, disability, and death in the United States and quitting is one of the best things people can do for their health. Additionally, smoking during pregnancy can cause serious harms to both the pregnant person and the baby.
The Task Force continues to recommend that clinicians ask all adults and pregnant people about their tobacco use, advise those who use tobacco to quit, and connect them to proven, safe methods to help them quit.
Dongmei Li, Ph.D.[/caption]
Dongmei Li, Ph.D., Associate Professor
Clinical and Translational Science Institute
University of Rochester Medical Center
MedicalResearch.com: What is the background for this study?
Response: Previous animal and human studies have found that nicotine exposure could harm adolescents’ brain development and impact their cognitive functions. Electronic cigarettes, which have become very popular among youth in the US in recent years, usually contain nicotine at equivalent or possibly higher levels than traditional tobacco cigarettes. Thus, it is reasonable to assume that vaping might be associated with self-reported cognitive complaints.
MedicalResearch.com: What are the main findings?
Response: Main findings from our study are:
Dr. Halpern-Felsher[/caption]
Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her)
Professor of Pediatrics
Taube Endowed Research Faculty Scholar
Professor (by courtesy), Epidemiology and Population Health
Professor (by courtesy), Psychiatry and Behavioral Sciences
Director of Fellows’ Scholarship, Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Co-leader, Scholarly Concentrations, Pediatrics Residency Program
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic.
There were 4 main findings:
Dr. Al Rifai[/caption]
Mahmoud Al Rifai, MD, MPH
Cardiovascular Disease Fellow
Baylor College of Medicine Houston, TX
[caption id="attachment_55680" align="alignleft" width="150"]
Dr. Virani[/caption]
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: E-cigarettes have gained popularity since their introduction in the U.S. market nearly 20 years ago and their use has increased especially among younger adults. On the other hand, public health efforts aimed at curbing tobacco use over the past few decades have resulted in a decrease in cigarette use. However, state-specific laws and regional cultural differences with regards to perception of these products may result in variability in tobacco use patterns. We therefore evaluate temporal changes in e-cigarette and cigarette use in each U.S. state between the years 2016 to 2018.
Dr. Villanti[/caption]
Andrea Villanti, PhD, MPH
Associate Professor
Department of Psychiatry
Vermont Center on Behavior and Health
University of Vermont
MedicalResearch.com: What is the background for this study?
Response: Our earlier work documented a significant association between first use of a flavored tobacco product and current tobacco use (
Dr. Hongying (Daisy) Dai[/caption]
Hongying (Daisy) Dai, PhD
Associate Professor
Department of Biostatistics | College of Public Health
University of Nebraska Medical Center
Omaha
MedicalResearch.com: What is the background for this study?
Response: Previous studies have reported a surge in e-cigarette use among youth during the 2017 - 2018. For instance, the prevalence of current (past 30-day) e-cigarette use increased by 77.8% (from 11.7% to 20.8%) among high school students and by 48.5% (from 3.3% to 4.9%) among middle school students.
As a result, the Food and Drug Administration (FDA) warns that youth e-cigarette use is reaching an epidemic proportion in September 2018. Whether e-cigarette use prevalence also increased among young adults (aged 18-24 years), a population with high e-cigarette use rates and vulnerability to nicotine dependence, is unknown.


Hoda S. Abdel Magid, MHS, PhD
Postdoctoral Scholar
Department of Health Research & Policy
Stanford University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Dr. Hoda Magid, my former graduate student, and I wanted to examine whether owning promotional items for e-cigarettes and other non-cigarette products predicted youth use of those products. Other studies have examined whether ownership of coupons, samples, and other promotional materials influenced cigarette use, but no longitudinal study examined other tobacco products.
Our findings show that non-tobacco using youth who own items to promote e-cigarettes and other alternative tobacco products are twice as likely to use alternative tobacco products a year later.

Dr. Leas[/caption]
Eric Leas PhD, MPH
Stanford Prevention Research Center
University of California, San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recent research has demonstrated the importance that neighborhood context has on life opportunity, health and well-being that can perpetuate across generations. A strongly defining factor that leads to differences in health outcomes across neighborhoods, such as differences in chronic disease, is the concurrent-uneven distribution of modifiable risk factors for chronic disease.
The main goal of our study was to characterize inequities in smoking, the leading risk factor for chronic disease, between neighborhoods in America's 500 largest cities. To accomplish this aim we used first-of-its-kind data generated from the 500 Cities Project—a collaboration between Robert Wood Johnson Foundation and the US Centers for Disease Control and Prevention—representing the largest effort to provide small-area estimates of modifiable risk factors for chronic disease.
We found that inequities in smoking prevalence are greater within cities than between cities, are highest in the nation’s capital, and are linked to inequities in chronic disease outcomes. We also found that inequities in smoking were associated to inequities in neighborhood characteristics, including race, median household income and the number of tobacco retailers.
Dr. Dai[/caption]
Dr. Hongying Dai, PhD
Associate Professor at the College of Public Health
University of Nebraska Medical Center.
MedicalResearch.com: What is the background for this study?
Response: The 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) banned cigarettes with characterizing flavors (e.g., candy, fruit, clove) except menthol. However, there are no restrictions on the marketing and sales of flavored non-cigarette tobacco products. This has led to a proliferation of flavored tobacco products in the marketplace. Flavoring has become one of the leading reasons for current tobacco use among youth. It is reported that 81% of e-cigarette users, 79% of hookah users, 74% of cigar users, 69% of smokeless tobacco users, and 67% of snus users attributed the availability of appealing flavors for their tobacco use in 2013–2014 among teenagers aged 12 to 17 years. In November 2018, the FDA proposed new restrictions on flavored tobacco products.
Dr. Miech[/caption]
Richard Miech Ph.D
Professor
Principal Investigator, Monitoring the Future
Institute for Social Research
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use. We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools. Our survey is representative of U.S. 8th, 10th, and 12th grade students. In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points.
An increase in vaping is the big news for 2018. In 10th and 12th grade the increase in nicotine vaping was the largest we've ever seen for any substance in the past 43 years. As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use. We also saw a significant increase in marijuana vaping.
Dr. Dermody[/caption]
Dr. Sarah Dermody, PhD
Assistant Professor
School of Psychological Science
Oregon State University
Corvallis Oregon
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Drinking alcohol is a risk factor for sustained smoking. In a sample of daily cigarette smokers receiving treatment for alcohol use disorder, we examined if reductions in drinking corresponded with reductions in nicotine metabolism as indexed by the nicotine metabolite ratio. The nicotine metabolite ratio is important because it is associated with smoking level and lapses. We found that for men, alcohol use and the nicotine metabolite ratio reduced significantly; however, for women, neither drinking nor nicotine metabolite ratio changed.

