• Debrief from the NAQC Workshops and NCTOH!

• Webinar on July 18: Science-Based Solutions for Tobacco Cessation Masterclass.
• SelfMade Health Network (SMHN) Webinar Series.
• Webcast on July 27: Using Pharmacists to Improve Access to Tobacco Cessation Treatment for Medicaid Enrollees.
• Webinar on August 2: The Great State Update – New York and North Carolina: Effective Partnerships to Treat Tobacco Addiction in Behavioral Health Settings.
• Health Canada Welcomes Feedback on Health Warning Regulatory Proposals by August 25, 2022.
• Call for Papers Deadline of September 1: Special Journal Issue on Using Multilevel Interventions to Reduce Health Disparities.
• Deadline of October 12 - Truth Initiative Grant Opportunity for Colleges.

• Update on FDA’s Order Removing JUUL Products from US Market.
• News Article: A Bold U.K. Plan to End the Smoking Epidemic.
• New Toolkit on Vaping & E-Cigarettes for Working with Youth.
• 3 Lessons on Preventing Loopholes in Flavored Tobacco Restrictions.
• Find out How This is Quitting Aims to Combat the Youth Vaping Epidemic.
• Rising Vaping Rates among Lesbian, Gay, and Bisexual Young People Outpace Peers, Widening Tobacco Use Gap.

Ramos GG, Sussman S, Moerner L, Unger JB, Soto C.
Project SUN: Pilot Study of a Culturally Adapted Smoking Cessation Curriculum for American Indian Youth.
[published online ahead of print, 2022 Jul 5]. J Drug Educ. 2022;472379221111542. doi:10.1177/00472379221111542

American Indian Alaska Native (AIAN) youth have disproportionately higher rates of commercial tobacco product use compared to other racial and ethnic groups in the U.S. These rates underscore a need for commercial tobacco product cessation interventions that are culturally informed. This project studied the development, implementation, and some impact data of an adapted version of Project EX, an evidence-based intervention for teen smoking cessation. Implementation challenges resulted in a change from a three-arm to a single-arm trial with 37 AIAN youth who participated in an eight-week curriculum. Intent-to-treat analysis with biochemical validation results indicated that 32% (N = 12/37) of youth quit smoking at the three-month follow-up. Participants reported being satisfied with the program overall and enjoying the culturally adapted activities. This study detailed the program's adaptation and lessons learned during implementation.

Breland AB, Carroll D, Denlinger-Apte R, et al.
Centering Racial Justice for Black/African American and Indigenous American People in Commercial Tobacco Product Regulation.
[published online ahead of print, 2022 Jun 15]. Prev Med. 2022;107117. doi:10.1016/j.ypmed.2022.107117

Although overall health in the United States (US) has improved dramatically during the past century, long-standing health inequities, particularly the unequal and unjust burden of tobacco-related disease and death among racialized populations, persist. A considerable gap exists in our understanding of how commercial tobacco product regulations and policies cause and/or exacerbate race-based health inequities among Black/African American (B/AA) and Indigenous American people. The purpose of this paper is to 1) describe how existing US commercial tobacco regulatory policies may contribute to structural racism and undermine the full benefits of tobacco prevention and control efforts among B/AA and Indigenous American groups; and 2) initiate a call to action for researchers and regulators of tobacco products to examine policies using an equity lens. These actions are imperative if empirically-informed regulation of commercial tobacco products is to address health equity.

Roland KM, Anderson MD, Carroll DM, et al.
Tribal Tobacco Use Project II: Planning, Implementation, and Dissemination Using Culturally Relevant Data Collection among American Indian Communities.
Int J Environ Res Public Health. 2022;19(13):7708. Published 2022 Jun 23. doi:10.3390/ijerph19137708

American Indians have substantially higher commercial tobacco-related cancer rates when compared to the general population. To effectively combat commercial tobacco-related cancer, it is important that tribal nations obtain current and accurate community-specific data on commercial tobacco use and exposure-related attitudes and behaviors. With the goal to collect, synthesize, and disseminate data on tobacco use, including the role traditional tobacco plays among American Indian people, the American Indian Cancer Foundation (AICAF) and various stakeholders developed and implemented the Tribal Tobacco Use Project II (TTUP II) during 2018-2021. Building upon its predecessor, the Tribal Tobacco Use Project I (TTUP I), TTUP II used principles of community-based participatory research and culturally appropriate methods, such as Reality-Based Research, in partnership with tribal nations. We describe the TTUP II rationale, methods for participant recruitment and data collection, emphasizing the importance of using culturally relevant survey items to disentangle commercial tobacco use from traditional tobacco use. American Indian traditional tobacco is viewed as medicine in these communities with a unique socio-cultural context that must be addressed when engaging in commercial tobacco control efforts in American Indian communities. This approach may be useful to other tribal nations who are interested in conducting culturally relevant tobacco surveillance efforts.

Schulz JA, West JC, Hall JP, Villanti AC.
Disparities in Tobacco Use by Disability and Type: Findings from the 2019 National Health Interview Survey.
[published online ahead of print, 2022 Jun 23]. Am J Prev Med. 2022;S0749-3797(22)00296-3. doi:10.1016/j.amepre.2022.05.004

Introduction. People with disabilities report a higher prevalence of cigarette use than people without disabilities. However, evidence is limited on the relationships between disability type, degree of functional difficulty, and other tobacco product use.
Methods. Data from the 2019 U.S. National Health Interview Survey were used to estimate the prevalence and odds of tobacco product use for 6 disability types and degree of functional difficulty. Bivariate and multivariable analyses conducted in 2021 examined the associations between tobacco product use and disability type.
Results. Compared to adults who reported no difficulty, current cigarette use prevalence was higher for adults who reported a lot of difficulty/cannot do at all to vision (21.5% vs 13.1%), hearing (19.6% vs 13.6%), mobility (20.0% vs 12.9%), and cognitive (25.4% vs 12.9%) disability questions. The odds of current cigarette (AOR=1.32), pipe (AOR=1.85), and smokeless tobacco (AOR=1.57) use were significantly higher for adults who reported a lot of difficulty/cannot do at all to any disability question and significantly higher for current cigarette (AOR=1.24), e-cigarette (AOR=1.33), pipe (AOR=1.45), and smokeless tobacco (AOR=1.29) use for adults who reported some difficulty to any disability question than those who reported no difficulty. Pipe use was correlated with mobility difficulty (AOR=1.68), and smokeless tobacco use was correlated with hearing difficulty (AOR=1.95).
Conclusions. People who reported difficulty with vision, hearing, mobility, or cognition had a higher cigarette use prevalence than people without disabilities. Other tobacco use differed by disability type. Future research should tailor tobacco interventions to reduce these disparities.

Issabakhsh M, Meza R, Li Y, et al.
Public Health Impact of a US Menthol Cigarette Ban on the Non-Hispanic Black Population: a Simulation Study.
Tobacco Control Published Online First: 14 June 2022. doi: 10.1136/tobaccocontrol-2022-057298

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.
Methods. We apply the previously developed Menthol Smoking and Vaping Model to the NHB population. A status quo scenario is developed using NHB-specific population, smoking and vaping initiation, cessation and death rates. Estimates from a recent expert elicitation on behavioural impacts of a menthol cigarette ban on the NHB population are used to develop a menthol ban scenario implemented in 2021. The public health impacts of the menthol ban are estimated as the difference between smoking and vaping attributable deaths (SVADs) and life years lost (LYLs) in the status quo and the menthol ban scenarios from 2021 to 2060.
Results. Under the menthol ban scenario, overall smoking is projected to decline by 35.7% in 2026 and by 25.3% in 2060 relative to the status quo scenario. With these reductions, SVADs are estimated to fall by about 18.5% and LYLs by 22.1%, translating to 255 895 premature deaths averted, and 4.0 million life years gained over a 40-year period.
Conclusions. A menthol cigarette ban will substantially reduce the smoking-associated health impact on the NHB population, thereby reducing health disparities.

Ebrahimi Kalan M, Lazard AJ, Sheldon JM, et al.
Terms Tobacco Users Employ to Describe E-cigarette Aerosol.
[published online ahead of print, 2022 Jun 21]. Tob Control. 2022;tobaccocontrol-2021-057233. doi:10.1136/tobaccocontrol-2021-057233

Background. The scientific term for the substance people inhale and exhale from a vaping device is 'aerosol', but whether the public uses this term is unclear. To inform tobacco control communication efforts, we sought to understand what tobacco users call e-cigarette aerosols.
Methods. Participants were a national convenience sample of 1628 US adults who used e-cigarettes, cigarettes or both (dual users). In an online survey, conducted in spring 2021, participants described what 'people inhale and exhale when they vape', using an open-ended and then a closed-ended response scale. Participants then evaluated warning statements, randomly assigned to contain the term 'aerosol' or 'vapor' (eg, 'E-cigarette aerosol/vapor contains nicotine, which can lead to seizures').
Results. In open-ended responses, tobacco users most commonly provided the terms 'vapor' (31%) and 'smoke' (23%) but rarely 'aerosol' (<1%). In closed-ended responses, the most commonly endorsed terms were again 'vapor' (57%) and 'smoke' (22%) but again infrequently 'aerosol' (2%). In closed-ended responses, use of the term 'vapor' was more common than other terms among people who were older; white; gay, lesbian or bisexual; college educated; or vape users only (all p<0.05). In the experiment, warnings using the terms 'aerosol' and 'vapor' were equally effective (all p>0.05).
Conclusions. The public rarely uses the term 'aerosol' to describe e-cigarette output, potentially complicating educational efforts that use the term. Future studies should explore public knowledge and understanding of the terms 'aerosol' and the more popular 'vapor' to better inform vaping risk communication.

Bold KW, Buta E, Simon P, et al.
Examining the Potential Role of E-cigarettes to Reduce Health Disparities Associated with Menthol Cigarette Use: Characterizing E-cigarette Use, Flavors, and Reasons for Use among US Adults Smoking Menthol Cigarettes.
Drug Alcohol Depend. 2022;236:109475. doi:10.1016/j.drugalcdep.2022.109475

Introduction. Menthol cigarette use contributes to disproportionate tobacco-related health disparities amongst minoritized race/ethnic groups. E-cigarettes are available in flavors such as menthol and may be a less harmful substitute among adults who smoke. Yet little is known about e-cigarette flavor preference and reasons for use by race/ethnicity among adults who smoke menthol cigarettes.
Methods. Nationally representative PATH wave 4 adult data (Dec. 2016-Jan. 2018) were used to examine how menthol cigarette status and race/ethnicity were associated with past 30-day e-cigarette use, flavors used, and reasons for use with adjusted logistic regression models.
Results. Menthol (vs. non-menthol) cigarette use was associated with higher odds of e-cigarette use (AOR=1.33, 95%CI=1.16-1.52). However, non-Hispanic (NH) Black and Hispanic individuals (vs. NH White) had lower odds of e-cigarette use (p's ≤ 0.004). In terms of flavor used, adults smoking menthol cigarettes and NH Black and Hispanic individuals had greater odds of using menthol/mint-flavored e-cigarettes (p's ≤ 0.02), and older adults (vs. 18-24-year-olds) had lower odds of using sweet-flavored e-cigarettes (p's < 0.0001). Regarding reasons for use, adults smoking menthol cigarettes had higher odds of reporting using e-cigarettes due to liking flavors (AOR=1.63, 95%CI=1.30-2.04), while NH Black adults had lower odds of liking flavors (AOR=0.64, 95%CI=0.43-0.96), and Hispanic adults had lower odds of using e-cigarettes to cut down on cigarette smoking (AOR=0.59, 95%CI=0.42-0.83).
Conclusions. Findings suggest menthol flavored e-cigarettes may be important for adults who smoke menthol cigarettes, although racial disparities in current e-cigarette use and reasons for use may exacerbate tobacco-related health disparities.

Tattan-Birch H, Kock L, Brown J, et al.
E-cigarettes to Augment Stop Smoking In-person Support and Treatment with Varenicline (E-ASSIST): a Pragmatic Randomised Controlled Trial.
[published online ahead of print, 2022 Jun 23]. Nicotine Tob Res. 2022;ntac149. doi:10.1093/ntr/ntac149

Background. We examined whether, in adults receiving behavioural support, offering e-cigarettes together with varenicline helps more people stop smoking cigarettes than varenicline alone.
Methods. A two-group, parallel-arm, pragmatic randomised controlled trial was conducted in six English stop smoking services from 2019-2020. Adults enrolled onto a 12-week programme of in-person one-to-one behavioural smoking cessation support (N=92) were randomised to receive either (i) a nicotine e-cigarette starter-kit alongside varenicline or (ii) varenicline alone. The primary outcome was biochemically-verified abstinence from cigarette smoking between weeks nine-to-12 post quit-date, with those lost to follow-up considered not abstinent. The trial was stopped early due to COVID-19 restrictions and a varenicline recall (92/1266 participants recruited).
Results. Nine-to-12-week smoking abstinence rates were 47.9% (23/48) in the e-cigarette-varenicline group compared with 31.8% (14/44) in the varenicline-only group, a 51% increase in abstinence among those offered e-cigarettes; however, the confidence interval (CI) was wide, including the possibility of no difference (risk ratio [RR]=1.51, 95%CI=0.91-2.64). The e-cigarette-varenicline group had 43% lower hazards of relapse from continuous abstinence than the varenicline-only group (hazards ratio [HR]=0.57, 95%CI=0.34-0.96). Attendance for 12 weeks was higher in the e-cigarette-varenicline than varenicline-only group (54.2% versus 36.4%; RR=1.49, 95%CI=0.95-2.47), but similar proportions of participants in both groups used varenicline daily for ≥8 weeks after quitting (22.9% versus 22.7%; RR=1.01, 95%CI=0.47-2.20). Estimates were too imprecise to determine how adverse events differed by group.
Conclusion. Tentative evidence suggests offering e-cigarettes alongside varenicline to people receiving behavioural support may be more effective for smoking cessation than varenicline alone.
Implications. Offering e-cigarettes to people quitting smoking with varenicline may help them remain abstinent from cigarettes, but the evidence is tentative because our sample size was smaller than planned - caused by COVID-19 restrictions and a manufacturing recall. This meant our effect estimates were imprecise, and additional evidence is needed to confirm that providing e-cigarettes and varenicline together helps more people remain abstinent than varenicline alone.

Martinez-Loredo V, González-Roz A, Dawkins L, Singh D, Murphy JG, MacKillop J.
Is E-cigarette Use Associated with Persistence or Discontinuation of Combustible Cigarettes? A 24-month Longitudinal Investigation in Young Adult Binge Drinkers.
Nicotine Tob Res. 2022;24(7):962-969. doi:10.1093/ntr/ntac049

Introduction. It remains unclear whether electronic cigarette (e-cigarette) use promotes persistent combustible tobacco use or smoking discontinuation over time. Alcohol use is associated with a greater risk of adverse health effects of tobacco, and higher likelihood of e-cigarette use, making drinkers a high-priority subpopulation.
Aims and methods. This study examined longitudinal patterns of combustible tobacco and e-cigarette use over 24 months in young adult binge drinkers. A pooled dataset of 1002 (58.5% female; M age = 22.14) binge drinkers from the United States (60%) and Canada (40%) was used. The primary outcomes were past month combustible tobacco and e-cigarette use. Nicotine dependence was measured using the Fagerström Test of Cigarette Dependence. Alcohol severity was measured using the Young Adult Alcohol Consequences Questionnaire. Latent transition analysis (LTA) was used to identify patterns of cigarette smoking and e-cigarette use over 24 months.
Results. The LTA yielded a four-class solution: (1) e-cigarettes-only users (prevalence over time: 7.75%-10.10%), (2) dual-product users (2.61%-9.89%), (3) combustible-only smokers (8.12%-20.70%), and (4) nonusers (61.66%-80.06%). Dual-product users predominantly transitioned to complete abstinence or exclusively e-cigarette use. In combustible-only smokers, the most common transition was to abstinence, followed by persistence of combustible-only status. At 24 months, 63% of e-cigarettes-only users transitioned to abstinence, with 37% continuing e-cigarettes-only use and 0% transitioning to dual or combustible cigarette use.
Conclusions. Dual-product use in young adult binge drinkers was associated with discontinuation of combustible tobacco over time, and e-cigarette-only use was not associated with subsequent combustible tobacco use.
Implications. These findings suggest that concurrent or exclusive e-cigarette use is not a risk factor for the persistence or development of combustible tobacco use in this subpopulation, with dual-product use reflecting a transitional pattern away from combustible use, toward discontinuation.

Technology

Kwon DM, Santiago-Torres M, Mull KE, Sullivan BM, Bricker JB.
Older Adults who Smoke: Do they Engage with and Benefit from Web-based Smoking Cessation Interventions?
[published online ahead of print, 2022 Jun 17]. Prev Med. 2022;161:107118. doi:10.1016/j.ypmed.2022.107118

Quitting smoking at any age increases life expectancy, but older adults face barriers to receiving cessation services. Despite the promise of web-based smoking cessation interventions to help address access barriers, whether older adults who participate in smoking cessation programs engage with and benefit from these tools at the same rate as younger adults remains unknown. In this secondary analysis, we compared engagement and satisfaction with two web-based smoking cessation interventions and quit rates between older, middle-aged, and young adults in the United States enrolled in the WebQuit trial between March 2014 and August 2015. Participants were divided into age groups: older (60 years and older, n = 439/2637), middle-aged (40-59 years, n = 1308/2637), and young adults (18-39 years, n = 890/2637). Treatment engagement and satisfaction, and 12-month quit rates (self-reported complete-case 30-day PPA and missing-as-smoking) were compared between groups. Older adults engaged more with the websites than young adults through multiple indicators of intervention engagement (i.e., number of sessions, unique days of use, and time spent on the site), and older adults spent more time on the site per session than their counterparts. Satisfaction with websites was high (81%) and non-differential between groups. Older and middle-aged adults quit smoking at a similar rate as younger adults (24%, 24%, 27%, respectively, p = 0.905). Older and middle-aged adults who participated in a web-delivered smoking cessation intervention engaged more with the intervention than their younger counterparts and they quit smoking at a similar rate, thereby demonstrating high acceptability and potential of digital interventions to help older adults quit smoking. Trial registration:ClinicalTrials.gov Identifier: NCT1166334.

Graham AL, Cha S, Papandonatos GD, et al.
E-cigarette and Combusted Tobacco Abstinence among Young Adults: Secondary Analyses from a U.S.-based Randomized Controlled Trial of Vaping Cessation.
[published online ahead of print, 2022 Jun 28]. Prev Med. 2022;107119. doi:10.1016/j.ypmed.2022.107119

Objective. To examine patterns of abstinence from e-cigarettes, combusted tobacco products (CTPs), both, or neither among young adults enrolled in a U.S.-based randomized trial of a text message vaping cessation intervention.
Methods. At baseline, 1829 young adult e-cigarette users were categorized as Exclusive E-cigarette Users (no past 30-day CTP use; n = 1036, 56.6%) or Dual Users (past 30-day CTP use; n = 793, 43.4%). Four groups were defined at 7-months: 1) Dual Abstinent, 2) Exclusive Vaping, 3) Exclusive CTP Use, and 4) Dual Users. The proportion of participants who were Dual Abstinent was the outcome of interest.
Results. At follow-up, 22.1% (95% CI: 20.3, 24.1) of participants were Dual Abstinent, 44.8% (95% CI: 42.5, 47.1) reported Exclusive Vaping, 6.3% (95% CI: 5.2, 7.5) reported Exclusive CTP Use, and 26.8% (95% CI: 24.8, 28.9) were Dual Users. A higher proportion of participants randomized to Intervention were Dual Abstinent (25.9%, 95% CI 23.1, 28.9) compared to Control (18.5%, 95% CI 16.0, 21.1; p = .0002). Analyses of treatment effects on dual abstinence by baseline tobacco product use favored Intervention over Control among both Exclusive E-cigarette Users (p = .019) and Dual Users (p = .0014).
Conclusion. A text message vaping cessation intervention was effective in promoting dual abstinence from e-cigarettes and CTPs among young adults. The advantage of treatment over control was equivalent for Exclusive E-cigarette Users and Dual Users. Rates of dual abstinence were higher among exclusive vapers than dual users, signaling the need for more research to optimize cessation programs for poly-tobacco users.

Alphonse A, Stewart K, Brown J, Perski O.
Exploring Users' Experiences with a Quick-response Chatbot Within a Popular Smoking Cessation Smartphone App: Semistructured Interview Study.
JMIR Form Res. 2022;6(7):e36869. Published 2022 Jul 7. doi:10.2196/36869

Background. Engagement with smartphone apps for smoking cessation tends to be low. Chatbots (ie, software that enables conversations with users) offer a promising means of increasing engagement.
Objective. We aimed to explore smokers' experiences with a quick-response chatbot (Quit Coach) implemented within a popular smoking cessation app and identify factors that influence users' engagement with Quit Coach.
Methods. In-depth, one-to-one, semistructured qualitative interviews were conducted with adult, past-year smokers who had voluntarily used Quit Coach in a recent smoking cessation attempt (5/14, 36%) and current smokers who agreed to download and use Quit Coach for a minimum of 2 weeks to support a new cessation attempt (9/14, 64%). Verbal reports were audio recorded, transcribed verbatim, and analyzed within a constructivist theoretical framework using inductive thematic analysis.
Results. A total of 3 high-order themes were generated to capture users' experiences and engagement with Quit Coach: anthropomorphism of and accountability to Quit Coach (ie, users ascribing human-like characteristics and thoughts to the chatbot, which helped foster a sense of accountability to it), Quit Coach's interaction style and format (eg, positive and motivational tone of voice and quick and easy-to-complete check-ins), and users' perceived need for support (ie, chatbot engagement was motivated by seeking distraction from cravings or support to maintain motivation to stay quit).
Conclusions. Anthropomorphism of a quick-response chatbot implemented within a popular smoking cessation app appeared to be enabled by its interaction style and format and users' perceived need for support, which may have given rise to feelings of accountability and increased engagement.

Tobacco Use

Duan Z, Henriksen L, Vallone D, et al.
Nicotine Pouch Marketing Strategies in the USA: an Analysis of Zyn, On! and Velo.
Tobacco Control Published Online First: 11 July 2022. doi: 10.1136/tc-2022-057360

Introduction. Nicotine pouches are gaining popularity, yet their marketing is understudied.
Methods. Using Numerator advertising data from January 2019 to September 2021 regarding three popular brands of nicotine pouch in the USA—Zyn (by Swedish Match, introduced in the USA in July 2016), On! (Altria, August 2016) and Velo (RJ Reynolds, July 2019)—we examined (1) general advertising characteristics (eg, media type, year); (2) ad content (ie, headlines and imagery themes); (3) prominent media channels (ie, specific websites, magazines, etc); and (4) ad expenditures.
Results. There were 286 unique ads (Zyn: 44.4%; On!: 2.8%; Velo: 52.8%), 119 143 occurrences (Zyn: 3.5%; On!: 0.5%; Velo: 96.0%) and $24 774 650 total expenditures (Zyn: 4.7%; On!: 0.6%; Velo: 94.7%). The greatest proportion of ad occurrences and expenditures were accounted for by radio (75.9% and 28.2%, respectively) and television (16.2% and 56.5%), followed by mobile (0.5% and 7.2%) and online display (6.7% and 3.6%). Across ad occurrences and expenditures, prominent headline themes included ‘freedom’ (26.0% and 17.1%, respectively), ‘brand’ (9.6% and 18.6%) and ‘flavour’ (16.4% and 7.6%); images mainly featured the product alone (61.4% and 56.1%), text (16.2% and 24.6%) or men (8.7% and 8.6%); and prominent channel themes were entertainment (34.7% and 37.3%), news/weather (14.3% and 21.7%), business/finance (12.9% and 9.0%) and sports (9.5% and 1.0%). Zyn and On! prioritised online display and print; Velo prioritised radio and television. Zyn’s and Velo’s headlines focused on ‘freedom’, with Zyn also emphasising ‘brand’ and Velo ‘innovation’; On!’s headlines emphasised ‘flavour’.
Conclusions. Regulatory efforts must be informed by surveillance of nicotine pouch marketing and impacts on consumer subgroups (eg, young people).

COVID-19

Chun HR, Cheon E, Hwang JE.
Systematic Review of Changed Smoking Behaviour, Smoking Cessation and Psychological States of Smokers According to Cigarette Type During the COVID-19 Pandemic.
BMJ Open. 2022;12(6):e055179. Published 2022 Jun 14. doi:10.1136/bmjopen-2021-055179

Objectives. Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions and associated psychological states among smokers are still scarce. This study aimed to systematically review the literature related to this subject.
Design. A systematic review of published articles on cigarettes and COVID-19-related topics DATA SOURCES: Our search was conducted in January 2021. We used the keywords COVID-19, cigarettes, electronic cigarettes (e-cigarettes) and psychological factors in PubMed and ScienceDirect and found papers published between January and December 2020.
Data selection. We included articles in full text, written in English, and that surveyed adults. The topics included smoking behaviour, smoking cessation, psychological state of smokers and COVID-19-related topics.
Data extraction and synthesis. Papers of low quality, based on quality assessment, were excluded. Thirteen papers were related to smoking behaviour, nine papers were related to smoking cessation and four papers were related to psychological states of smokers.
Results. Owing to the COVID-19 lockdown, cigarette users were habituated to purchasing large quantities of cigarettes in advance. Additionally, cigarette-only users increased their attempts and willingness to quit smoking, compared with e-cigarette-only users.
Conclusions. Owing to the COVID-19 outbreak, the intention to quit smoking was different among smokers, according to cigarette type (cigarette-only users, e-cigarette-only users and dual users). With the ongoing COVID-19 pandemic, policies and campaigns to increase smoking cessation intentions and attempts to quit smoking among smokers at high risk of COVID-19 should be implemented. Additionally, e-cigarette-only users with poor health-seeking behaviour require interventions to increase the intention to quit smoking.

• Location: Marriott Marquis | Washington, DC 
• Dates: September 27th- 29th, 2022
• Cost: Truth Initiative will cover the cost of transportation, lodging and meals for all accepted student participants. 

• Must be at least 18 years of age
• Must be currently enrolled in a higher education institution 
• Must provide proof of vaccination and booster