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Tobacco Use: How Do We Consider Complexity?

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (15 August 2022) | Viewed by 25304

Special Issue Editor


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Guest Editor
Department of Advertising and Public Relations, College of Communication Arts and Sciences, Michigan State University, East Lansing, MI 48824, USA
Interests: health communication; tobacco control; social media; experimental design; systems science; information contagion

Special Issue Information

Dear Colleagues,

Smoking is a multifaceted behavior that puts people at risk for morbidity and mortality.  We increasingly understand that smoking, and tobacco use generally, occurs at the intersection of psychological and social factors.  This Special Issue seeks to give space for research that considers complex intersections that impact tobacco use and cessation, focusing on demographic intersectionality, the interaction between other substance use and smoking cessation, the impact of policy and physical environment on tobacco use and cessation, and other topics considering multilevel or multifaceted issues related to tobacco use or tobacco cessation. 

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Dr. Ashley Sanders-Jackson
Guest Editor

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Keywords

  • smoking cessation
  • intersectionality
  • complex systems
  • health disparities
  • tobacco use
  • polysubstance use
  • policy
  • physical environment

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Published Papers (6 papers)

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Research

12 pages, 756 KiB  
Article
Association of Polymorphism CHRNA5 and CHRNA3 Gene in People Addicted to Nicotine
by Krzysztof Chmielowiec, Jolanta Chmielowiec, Aleksandra Strońska-Pluta, Grzegorz Trybek, Małgorzata Śmiarowska, Aleksandra Suchanecka, Grzegorz Woźniak, Aleksandra Jaroń and Anna Grzywacz
Int. J. Environ. Res. Public Health 2022, 19(17), 10478; https://doi.org/10.3390/ijerph191710478 - 23 Aug 2022
Cited by 5 | Viewed by 2213
Abstract
Smoking is a chronic and relapsing addictive trait that harms public health. Among the many identified genetic variants of nicotine dependence, the variants in the CHRNA5/A3/B4 gene cluster on chromosome 15 that encode the α5, α3, and β4 subunits have recently received a [...] Read more.
Smoking is a chronic and relapsing addictive trait that harms public health. Among the many identified genetic variants of nicotine dependence, the variants in the CHRNA5/A3/B4 gene cluster on chromosome 15 that encode the α5, α3, and β4 subunits have recently received a lot of attention. Importantly, variants in this gene cluster have been associated with nicotine addiction. Among the many significant variants in this cluster, the polymorphism SNP rs16969968 seems to be the most interesting factor in nicotine addiction. This polymorphism causes an amino acid change from aspartate to asparagine at position 398 of the α5 nicotinic receptor protein sequence. Our study aimed to analyze three polymorphic variants: the rs16969968 located in the CHRNA5 gene, the rs578776 and rs1051730 located in the CHRNA3 gene in nicotine-addicted subjects, and in controls. Our study encompasses an association analysis of genotypes and haplotypes. A group of 401 volunteers was recruited for the study and divided into two groups: the study group consisted of addicted smokers and a control group of 200 unrelated non-smokers who were not dependent on any substance and healthy. A statistically significant difference was observed in the frequency of genotypes of the rs1051730 polymorphism of the CHRNA3 gene (χ2 = 6.704 p = 0.035). The T/T genotype was statistically significantly more frequent in the group of nicotine-dependent subjects. The haplotypes rs16969968, rs578776, and rs1051730 were distinguished, of which the G-T-T and G-C-T haplotypes were present only in the study group. With differences in frequencies, statistical significance was noted—for the G-T-T haplotype p = 0.01284 and the G-C-T haplotype p = 0.00775. The research stated that novel haplotypes G-T-T and G-C-T, though with very low-frequency variants in CHRNA3, were associated with nicotine addiction. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
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13 pages, 600 KiB  
Article
A Qualitative Investigation of the Experiences of Tobacco Use among U.S. Adults with Food Insecurity
by Jin E. Kim-Mozeleski, Susan J. Shaw, Irene H. Yen and Janice Y. Tsoh
Int. J. Environ. Res. Public Health 2022, 19(12), 7424; https://doi.org/10.3390/ijerph19127424 - 16 Jun 2022
Cited by 7 | Viewed by 2727
Abstract
Background: Low-income U.S. adults experiencing food insecurity have a disproportionately high prevalence of cigarette smoking, and quantitative studies suggest that food insecurity is a barrier to quitting. To guide effective tobacco control strategies, this study aimed to understand the experiences, perceptions, and context [...] Read more.
Background: Low-income U.S. adults experiencing food insecurity have a disproportionately high prevalence of cigarette smoking, and quantitative studies suggest that food insecurity is a barrier to quitting. To guide effective tobacco control strategies, this study aimed to understand the experiences, perceptions, and context of tobacco use and cessation among low-income populations experiencing food insecurity. Methods: We conducted in-depth, semi-structured interviews with 23 adults who were currently smoking cigarettes and were experiencing food insecurity, mostly living in rural settings. Participants were recruited through food-pantry-based needs assessment surveys and study flyers in community-based organizations. The interview guide explored participants’ histories of smoking, the role and function of tobacco in their lives, their interest in and barriers to quitting, as well as lived experiences of food insecurity. We used reflexive thematic analysis to analyze transcribed interviews. Results: Within a broader context of structural challenges related to poverty and financial strain that shaped current smoking behavior and experiences with food insecurity, we identified the following five themes: smoking to ignore hunger or eat less; staying addicted to smoking in the midst of instability; smoking being prioritized in the midst of financial strain; life stressors and the difficulty of quitting smoking and staying quit; and childhood adversity at the intersection of food insecurity and tobacco use. Conclusion: The context of tobacco use among adults with food insecurity was highly complex. To effectively address tobacco-related disparities among those who are socially and economically disadvantaged, tobacco control efforts should consider relevant lived experiences and structural constraints intersecting smoking and food insecurity. Findings are applied to a conceptualization of clustering of conditions contributing to nicotine dependence, food insecurity, and stress. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
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12 pages, 849 KiB  
Article
Diverging Trends and Expanding Educational Gaps in Smoking in China
by Lei Jin, Lin Tao and Xiangqian Lao
Int. J. Environ. Res. Public Health 2022, 19(8), 4917; https://doi.org/10.3390/ijerph19084917 - 18 Apr 2022
Cited by 4 | Viewed by 3400
Abstract
Introduction: The male smoking rate in China declined moderately through the 1990s and early 2000s, but the decline has since stagnated. It is unclear why the decline stalled and whether it stalled uniformly across all social strata. Theories that view socioeconomic status as [...] Read more.
Introduction: The male smoking rate in China declined moderately through the 1990s and early 2000s, but the decline has since stagnated. It is unclear why the decline stalled and whether it stalled uniformly across all social strata. Theories that view socioeconomic status as a fundamental cause of health predict that socioeconomic gaps in smoking may widen, but theories emphasizing the cultural context of health behavior cast doubt on the prediction. We investigated changes in the socioeconomic gaps in smoking during recent decades in China. Methods: We applied growth-curve models to examine inter- and intra-cohort changes in socioeconomic gaps in male smoking in China using data from a national longitudinal survey spanning 25 years. Results: We found diverging trends in smoking in men with different education levels among the post-1980 cohorts; for high-education men, smoking participation consistently declined, but for low-education men, the decline stopped and possibly reversed. The stagnation in the decline in overall smoking rate since 2010 was mostly due to the stalling of the decline of smoking among low-education men in the most recent cohorts. The diverging trends were a continuation of a general trend in expanding educational gaps in smoking that emerged in the cohorts born after 1960. Our analysis also identified widening educational gaps over age within each cohort. Conclusion: We identified a long-term widening in educational gaps in smoking in China. An effective way to reduce smoking, social inequality in smoking and possibly health disparities in China is to target the smoking behavior of vulnerable groups. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
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14 pages, 2187 KiB  
Article
Mixed Effect of Alcohol, Smoking, and Smokeless Tobacco Use on Hypertension among Adult Population in India: A Nationally Representative Cross-Sectional Study
by Prashant Kumar Singh, Ritam Dubey, Lucky Singh, Nishikant Singh, Chandan Kumar, Shekhar Kashyap, Sankaran Venkata Subramanian and Shalini Singh
Int. J. Environ. Res. Public Health 2022, 19(6), 3239; https://doi.org/10.3390/ijerph19063239 - 9 Mar 2022
Cited by 9 | Viewed by 4132
Abstract
Sporadic evidence is available on the association of consuming multiple substances with the risk of hypertension among adults in India where there is a substantial rise in cases. This study assesses the mutually exclusive and mixed consumption patterns of alcohol, tobacco smoking and [...] Read more.
Sporadic evidence is available on the association of consuming multiple substances with the risk of hypertension among adults in India where there is a substantial rise in cases. This study assesses the mutually exclusive and mixed consumption patterns of alcohol, tobacco smoking and smokeless tobacco use and their association with hypertension among the adult population in India. Nationally representative samples of men and women drawn from the National Family and Health Survey (2015–2016) were analyzed. A clinical blood pressure measurement above 140 mmHg (systolic blood pressure) and 90 mmHg (diastolic blood pressure) was considered in the study as hypertension. Association between mutually exclusive categories of alcohol, tobacco smoking and smokeless tobacco and hypertension were examined using multivariate binary logistic regression models. Daily consumption of alcohol among male smokeless tobacco users had the highest likelihood to be hypertensive (OR: 2.32, 95% CI: 1.99–2.71) compared to the no-substance-users. Women who smoked, and those who used any smokeless tobacco with a daily intake of alcohol had 71% (OR: 1.71, 95% CI: 1.14–2.56) and 51% (OR: 1.51, 95% CI: 1.25–1.82) higher probability of being hypertensive compared to the no-substance-users, respectively. In order to curb the burden of hypertension among the population, there is a need for an integrated and more focused intervention addressing the consumption behavior of alcohol and tobacco. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
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7 pages, 290 KiB  
Communication
Traditional Cigarette and Poly-Tobacco Use Are Associated with Medical Opioid Use in Rural Areas of the US
by Mariaelena Gonzalez and Ashley Sanders-Jackson
Int. J. Environ. Res. Public Health 2021, 18(22), 11864; https://doi.org/10.3390/ijerph182211864 - 12 Nov 2021
Cited by 1 | Viewed by 2899
Abstract
Introduction: Medical prescriptions for opioids are higher in rural areas of the US as compared to urban areas. Tobacco use may also play a role in this process. This analysis examines the association between differing types of tobacco use and medical opioid use. [...] Read more.
Introduction: Medical prescriptions for opioids are higher in rural areas of the US as compared to urban areas. Tobacco use may also play a role in this process. This analysis examines the association between differing types of tobacco use and medical opioid use. Methods: We analyze the relationship between tobacco product use and medical opioid use among the US general population living in rural (non-metropolitan) areas using the publicly available sample adult file 2019 National Health Interview Survey (NHIS) (n = 5028). Tobacco use was classified into the following categories: only using cigarettes, only using e-cigarettes/vapes, only using cigars, only using smokeless tobacco, or using two or more of the following products. We used a binary logistic regression, controlling for individual differences. Results: Individuals who reported using only traditional cigarettes (and no other tobacco product, OR = 1.62, 95% CI: 1.31, 2.01), or who reported being a poly-tobacco users (OR = 2.13, 95% CI: 1.40, 3.22) had higher odds of medical opioid use in the last twelve months. Conclusion: Results suggest a link between tobacco use, particularly cigarette use and poly-tobacco use, and medical opioid use in rural communities. Clinical and structural level interventions need to be implemented in rural communities to reduce comorbid tobacco and opioid use. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
25 pages, 784 KiB  
Article
Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions
by Isabel Martinez Leal, Matthew Taing, Virmarie Correa-Fernández, Ezemenari M. Obasi, Bryce Kyburz, Kathy Le, Litty Koshy, Tzuan A. Chen, Teresa Williams, Kathleen Casey, Daniel P. O’Connor and Lorraine R. Reitzel
Int. J. Environ. Res. Public Health 2021, 18(11), 5764; https://doi.org/10.3390/ijerph18115764 - 27 May 2021
Cited by 20 | Viewed by 8558
Abstract
Intersecting socially marginalized identities and unique biopsychosocial factors place women with substance use disorders (SUDs) experiencing myriad disadvantages at higher risk for smoking and stigmatization. Here, based on our work with women receiving care for SUDs in four participating treatment/women-serving centers (N = [...] Read more.
Intersecting socially marginalized identities and unique biopsychosocial factors place women with substance use disorders (SUDs) experiencing myriad disadvantages at higher risk for smoking and stigmatization. Here, based on our work with women receiving care for SUDs in four participating treatment/women-serving centers (N = 6 individual clinics), we: (1) describe the functions of smoking for women with SUDs; and (2) explore participants’ experiences of a comprehensive tobacco-free workplace (TFW) program, Taking Texas Tobacco-Free (TTTF), that was implemented during their SUD treatment. Ultimately, information gleaned was intended to inform the development of women-tailored tobacco interventions. Data collection occurred pre- and post-TTTF implementation and entailed conducting client (7) and clinician (5) focus groups. Using thematic analysis, we identified four main themes: “the social context of smoking,” “challenges to finding support and better coping methods,” “addressing underlying conditions: building inner and outer supportive environments,” and “sustaining support: TFW program experiences.” Women reported that: smoking served as a “coping mechanism” for stress and facilitated socialization; stigmatization hindered quitting; non-stigmatizing counseling cessation support provided alternative coping strategies; and, with clinicians, the cessation opportunities TTTF presented are valuable. Clinicians reported organizational support, or lack thereof, and tobacco-related misconceptions as the main facilitator/barriers to treating tobacco addiction. Effective tobacco cessation interventions for women with SUDs should be informed by, and tailored to, their gendered experiences, needs, and recommendations. Participants recommended replacing smoking with healthy stress alleviating strategies; the importance of adopting non-judgmental, supportive, cessation interventions; and the support of TFW programs and nicotine replacement therapy to aid in quitting. Full article
(This article belongs to the Special Issue Tobacco Use: How Do We Consider Complexity?)
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