by Carl V Phillips
As some of you know, Clive Bates puts out a weekly somewhat-annotated list of PubMed-indexed articles that are related to low-risk tobacco products and/or tobacco harm reduction (the search string for that appears at the end of what follow). It is a great resource; if you do not receive it, I am sure he would be glad to add you to the distribution list. As part of a planned projected that I have alluded to before, I am working on how to reinterpret this as an annotated weekly suggested reading (or knowing-about) list. To that end, this week I was a “guest editor” for Clive’s distribution list, and I thought I should share what I wrote here to broaden the audience. Yes, it is a little weird to publish a one-off “weekly reading” that is mostly based on an existing format that you might not be familiar with. But you should be able to get the idea. Hopefully I will be producing one every week before too long.
In the meantime, here is what I wrote that went out via Clive’s distribution lists. Sorry for the weird formatting — it is an artifact of the way the original PubMed search was formatted. Yes, I could have fixed the for aesthetics to re-optimize for this blog’s formatting, but since they do not hinder comprehension, I am not going to bother — sorry.
Greetings everyone. Carl V Phillips here, doing Clive’s list this week. I am trying out a new format for it, as follows: (1) They are not listed in the order that popped from the PubMed search string, but rather is in order of how worth reading they are. Obviously this is my own rough blend of various considerations, including importance of what is being addressed, value of what was produced, how potentially influential it is, and how much reader effort it takes to get value from it (note that I put relatively little weight on the latter). I have left the serial numbers from the search on the entries in case anyone wants to recreate the usual ordering. I add a full-text link if I think there is anyone other than specialists in the particular area would want to look at the full text. (2) I am not limiting this to PubMed-indexed papers. I am including popular press and policy statements (and would have included blogs but there were not any apparent candidates this week).
|1.||Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011-2018.|
|Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA.|
|MMWR Morb Mortal Wkly Rep. 2018 Nov 16;67(45):1276-1277. doi: 10.15585/mmwr.mm6745a5. No abstract available.|
A ton of ink has already been spilled about this one, the recent report of NYTS stats. The authors made pointless comparisons of 2018 prevalences to 2011 (i.e., when the products were only just starting to be used), and ran error statistics tests on them no less. The bigger problem is their defining “current use” as any trying within 30 days, offering no useful information about actual usage. The measured prevalence for that increased substantially from 2017, which is fueling a lot of the current “epidemic” nonsense. Naturally, the dip in 2016-2017 is not mentioned in what is being publicly touted there (the average trend over the period since 2014 or 2015 is not particularly impressive).
This is also the source of the breathless “68% of kids are using flavored ecigs!” claims (actually 100% are, but we can guess at what they are clumsily trying to say) that were parlayed into the recent proposed and actual removals of some flavored products in US stores. The careful reader might scratch his head after noticing that the vast majority of this was mint/menthol flavor, which is not targeted in these restrictions. Unsurprisingly, the authors could not stick to reporting their results, but threw in the unsubstantiated assertion that products with “flavors”, high nicotine content, and that oh-so-captivating USB-drive form factor caused the increase in “use” (which of those is it? it depends on which products they want to ban on a particular day).
Tom Miller. “Let’s not overreact about e-cigarettes”. Washington Post. 15 Nov 2018.
Miller, Bates, Glynn, Kozlowski, Niaura, Sweanor. “Re: Youth tobacco and nicotine use – proportionate and responsible reaction” (open letter to the FDA Commissioner). 14 Nov 2018.
An op-ed by the Iowa Attorney General, a longtime vaping cheerleader, and the associated policy memo. They do a nice job of summarizing the highlights of the case against restricting e-cigarettes, pitched ideally for op-ed readers and policy staffers. I have some issues with some of the factual claims (particularly in the op-ed). And personally I do not like the anti-harm-reduction pro-vape position (see my Twitter thread if you have any interest in my political philosophy opinions on that matter), nor the more general implicit endorsement of rights- and justice-free utilitarian extremism, though I suspect some of the authors were not actually trying to express such hard-line support for those positions as they ended up doing.
In this context, it is worth recalling the letter 11 U.S. Senators (mostly left-leaning) sent to Gottlieb in April, pushing him toward those restrictions. It would be nice if thoughtful policy analyses carried more weight than know-nothing political statements like that. On net, I suspect that both mainly have the effect of carving out the range of defensible policy space, and the agency leaders’ personal preferences then determine where within that range the policy falls. Thus the Miller et al. effort can best be seen as offering political cover for the policies those authors back in the (unlikely) event that CTP actually wants to do that.
|10.||Transitions in Tobacco Product Use by U.S. Adults between 2013⁻2014 and 2014⁻2015: Findings from the PATH Study Wave 1 and Wave 2.|
|Kasza KA, Borek N, Conway KP, Goniewicz ML, Stanton CA, Sharma E, Fong GT, Abrams DB, Coleman B, Schneller LM, Lambert EY, Pearson JL, Bansal-Travers M, Murphy I, Cheng YC, Donaldson EA, Feirman SP, Gravely S, Elton-Marshall T, Trinidad DR, Gundersen DA, Niaura RS, Cummings KM, Compton WM, Hyland AJ.|
|Int J Environ Res Public Health. 2018 Nov 9;15(11). pii: E2515. doi: 10.3390/ijerph15112515.|
Basically a reference document, reporting just what is described in the title, “transitions” meaning switching among products or to abstinence. It is fairly cleanly reported with minimal inappropriate editorializing or unsupported claims of causation.
The authors fail their readers some in not offering some kind of “normalcy normalization” for the transition rates: They observe that exclusive cigarette use is quite stable, as compared to someone who vaped in the first wave being much more likely to transition to smoking. But how much of this should be seen as regression toward the average population distribution — because cigarettes are most normal, most available, more enjoyable, or whatever? (A larger portion of Americans who ate a starfruit yesterday ate an apple today than the other way around; is it a gateway?) Putting numbers to that would require going beyond the clean reporting of survey results in the paper, of course, but the failure to mention it invites a “see! this shows vaping is causing more smoking than it is ending” interpretation. (I can’t recall seeing that spin on these results. It would be wrong both because it assumes the “gateway” transition is causal and because it fails to adjust for the much larger denominator of smokers. But it is unimaginable that no one will choose to be wrong like that.)
|9.||Are smokers who are regularly exposed to e-cigarette use by others more or less motivated to stop or to make a quit attempt? A cross-sectional and longitudinal survey.|
|Jackson SE, Beard E, Michie S, Shahab L, Raupach T, West R, Brown J.|
|BMC Med. 2018 Nov 14;16(1):206. doi: 10.1186/s12916-018-1195-3.|
Associations between self-perceptions of being around people who vape (and smoke) and smoking quit attempts and stated motivation to quit (not mentioned in title: in England 2014-2018). The results are basically null associations for everything in sight. The numbers differ a bit from the null, of course, but are close enough that they can be explained by error — random, measurement, model specification, etc. This is to say nothing of the obvious confounding.
This has been misleadingly spun (by ASH and presumably others) as suggesting that being around vapers increases quit attempts (because that result is a bit higher than the null), but there is no possible way to assess causation in these results. The analysis is not nearly deep enough to address whether — to choose just one of dozens of possible stories — having a more active social life might change both someone’s inclinations and exposures.
The erroneous causal claims trace back to the original work. The authors engage in the typical disingenuous practice (a practice so common in public health research that they probably did not even realize they were doing something wrong) of carefully hedging their result statements in the language of mere association, and thus tell themselves that they do not have to assess whether causal claims are justified. Then they go ahead and sneak in various unexamined causal claims. The stated motivation for the research is to test whether being exposed to vaping “renormalizes” smoking, a causal claim. Moreover, the authors present covariate-adjusted analyses that merely create confusion if the question is one of association, and only make sense when interpreted as a (wholly inadequate) attempt to assess causation despite the confounding. The results tend to support the claim that exposure to vaping does not cause huge changes in either direction, but that is all that can really be said.
“Statement from FDA Commissioner Scott Gottlieb, M.D., on proposed new steps to protect youth by preventing access to flavored tobacco products and banning menthol in cigarettes.” 15 Nov 2018.
On the off chance you missed it.
I made the observation that he is touting this as “carefully balanced”, by which he seems to basically mean “we did something other than the most extreme possible option, based on no analysis that suggests it is optimal, or even useful, for anything.” @patriciakova noted, “The announcement indicates that @FDATobacco will bring forward the PMTA deadline for flavored vapor products, but only selectively – if sold in a particular channel. Unprecedented.”
Tobacco Reporter. “FDA plans welcomed.” 16 Nov 2018
Brief summary of how most of the major cigarette companies have welcomed FDA’s crackdown on e-cigarettes, though they are not all so sanguine about the proposed menthol cigarettes ban. More details can be found in the companies’ statements (e.g., BAT/Reynolds). Implications of them taking these positions, and guessing which companies came down on which sides for the particular policies, are left as exercises for the reader.
|12.||Trust of Information about Tobacco and E-Cigarettes from Health Professionals versus Tobacco or Electronic Cigarette Companies: Differences by Subgroups and Implications for Tobacco Messaging.|
|Vereen RN, Westmaas JL, Bontemps-Jones J, Jackson K, Alcaraz KI.|
|Health Commun. 2018 Nov 13:1-7. doi: 10.1080/10410236.2018.1544875. [Epub ahead of print]|
A low-quality study of a reasonably interesting question, presumably done for the purpose of designing more effective propaganda (the authors and data belong to ACS). The only real take-away, which they omitted from the abstract, is that approximately no one (<2%) trusted industry sources of health information more than the category they called “health professionals” (which includes government and NGOs in addition to actual health professionals), according to their measures. This is unfortunate because the modest claims that industry (ex random dudes selling ecigs on ebay) dare make are consistently more accurate. The 10% in their “trust industry as much or more” category, the focus of the analysis, are probably mostly people express the same deep distrust of all authorities. It is an interesting category, but results about it do really mean what the authors imply they mean. Since the reader cannot know what being in that category really means, the analysis about the demographics of those in that category, is worthless.
Tasker JP. “’Troubling signs’: Health Canada to review tobacco strategy as smoking rate spikes; Sixteen per cent of Canadians aged 25 and older smoke, a three-point increase over 2016.” CBC News. 20 Nov 2018
The most important takeaway from this news story is the reminder that surveys have errors. Most “changes” like this (certainly when at a level that is simply implausible to interpret as a real change in the population prevalence) are noise, with results bouncing around a true value. Or, if you want to be really careful about it: bouncing around the averaged biased (in some way, inevitably) measurement of the value that the particular survey method will produce. It is sad the extent to which one-off attempts to measure are treated as if they are Immutable Truth in this realm.
One interesting implication of this relates to the widespread perception that smoking control efforts are much more effective than they really are. Every time there was a downtick, the results were shouted from the rooftops as a triumph and attributed to particular policies. When the next survey result regressed back up, it received little press. As a result, a lot of people think “wait, with all these successes, how is it that smoking remains so high?” This story represents what appears to be a trend toward reacting to the upticks also. It is not clear whether such balancing of inappropriate reactions to random errors will be a net improvement.
Harris A. “How Juul, founded on a life-saving mission, became the most embattled startup of 2018.” Fast Company magazine. 19 Nov 2018.
Biz press take on things, mostly hagiographic but with a few good bits about the folly of blundering into the tobacco wars as if you were just creating an innocent new tech toy. Read this with some skepticism: The reporter makes quite a few identifiable factual errors, so the novel insider stuff she reports must be suspect too. Definitely only read it if you have a good existing knowledge base, lest you “learn” the errors.
Bloomberg “editorial board”. “The FDA Is Too Soft on E-Cigarettes; Comprehensive regulations are needed to protect kids and adults.” 16 Nov 2018.
Billionaire with a large megaphone continues to agitate for bans on personal choices. Not really worth reading (same junk, different day), but worth noting this keeps happening. At least there is Forbes as a minor counterweight, though dueling oligarchs is not exactly an ideal way to work out policies.
Hoffman J. “Q&A: The ABCs of E-Cigarettes.” New York Times. 15 Nov 2018.
Again, only worth reading for purposes of keeping track of what highly-literate non-experts — e.g., policy makers — are being told. (It is rather harder to even figure out what the average person is hearing.) One of at least two hit-job pieces in NYT in the last week. A good rule of thumb is that most any time a controversial topic is presented in “Q&A” form — or worse, “what parents need to know” — it is going to be complete misinformation, stemming from lies, author ignorance, or both.
|21.||Tobacco Heating System 2.2 has a limited impact on DNA methylation of candidate enhancers in mouse lung compared with cigarette smoke.|
|Choukrallah MA, Sierro N, Martin F, Baumer K, Thomas J, Ouadi S, Hoeng J, Peitsch MC, Ivanov NV.|
|Food Chem Toxicol. 2018 Nov 8. pii: S0278-6915(18)30822-6. doi: 10.1016/j.fct.2018.11.020. [Epub ahead of print]|
Mouse torture study from PMI. Another example of HnB having less of a presumably negatively health-affecting biomeasure than cigarettes.
|15.||Perceived health risks of electronic nicotine delivery systems (ENDS) users: The role of cigarette smoking status.|
|Ma JZ, Hart JL, Walker KL, Giachello AL, Groom A, Landry RL, Tompkins LK, Vu TT, Mattingly DT, Sears CG, Kesh A, Hall ME, Robertson RM, Payne TJ.|
|Addict Behav. 2018 Oct 30. pii: S0306-4603(18)31252-8. doi: 10.1016/j.addbeh.2018.10.044. [Epub ahead of print]|
A worthless study, from AHA’s propaganda shop (despite which, the authors lied in the journal and said they have no conflict of interest). The main problem is not the political spin, however, but that the questions the produce the core of the data are worthless, bad even by the terrible standards of this literature. Participants were asked hopelessly vague questions and answered on an arbitrary scale. Perhaps different average values for the uninterpretable answers across groups mean something, but it is difficult to be sure of even that. If you are inclined to think these answers are worth even that much, you will be unsurprised to learn that subjects, of whatever smoking status, perceived their knowledge of the health risks of smoking to be higher than their knowledge for vaping. This is the only real non-null result. The abstract claims there are differences in perceptions of risk level across smoking status and demographic variables, but these are actually rather trivial and well within the range of study uncertainty.
|8.||The effects of the European e-cigarette health warnings and comparative health messages on non-smokers’ and smokers’ risk perceptions and behavioural intentions.|
|Kimber C, Frings D, Cox S, Albery I, Dawkins L.|
|BMC Public Health. 2018 Nov 14;18(1):1259. doi: 10.1186/s12889-018-6161-7.|
This is basically a trial registration, though it fails to achieve the purpose of those. The authors tie their hands a bit on a few points they would be unlikely to game anyway (matters like sample size and outcome variable definitions), but they give themselves wiggle room for cooking an ad hoc analytic model (not actually offering their proposed main statistical model and even explicitly saying they will make ad hoc decisions after seeing the data). Pre-registering methodologies is a very useful step, whose time has long-since come, for reducing the junk science in public health that results from fitting models to the data. But this is not an example of really doing that.
|22.||E-cigarette use is associated with other tobacco use among US adolescents.|
|Auf R, Trepka MJ, Selim M, Ben Taleb Z, De La Rosa M, Bastida E, Cano MÁ.|
|Int J Public Health. 2018 Nov 9. doi: 10.1007/s00038-018-1166-7. [Epub ahead of print]|
Yet another junk “gateway” study. Teenagers who use one tobacco product are more likely than average to start using another. Who knew? The authors make the usual erroneous causal conclusions. I did not look closely enough to assess whether these authors (unknowns) are genuinely that clueless or were trying to lie.
|7||[Systematic analysis of the scientific literature on heated tobacco].|
|Dautzenberg B, Dautzenberg MD.|
|Rev Mal Respir. 2018 Nov 11. pii: S0761-8425(18)30363-2. doi: 10.1016/j.rmr.2018.10.010. [Epub ahead of print] Review. French.|
In French, but the English abstract makes clear this is really just a (even poorer-than-usual quality) nonsystematic hit job, and not worth the effort to deal with translation. The authors claim that there is no evidence of reduced risk, based on four epidemiology articles in the space, which I am pretty sure is four more than the real number, and that HnB is a gateway to smoking, which I am even more sure is not true.
|5.||Regional Rural-Urban Differences in E-Cigarette Use and Reasons for Use in the United States.|
|Mumford EA, Stillman FA, Tanenbaum E, Doogan NJ, Roberts ME, Wewers ME, Chelluri D.|
|J Rural Health. 2018 Nov 14. doi: 10.1111/jrh.12333. [Epub ahead of print]|
This won’t Sci-Hub, so I am just working from the abstract. It appears that the authors made a bunch of comparisons without any attempt to normalize for current/recent smoking prevalence, rendering the entire exercise useless. Um, yes, there is a lower prevalence of vaping in the Northeast and West Coast. That is because there is a lower density of smokers (recent or current) there. Even if they had done the analysis well, however, it could never support their assertion, “Public health campaigns and guidance for clinical care within HHS regions should be tailored to reflect regional differences in beliefs about e-cigarettes”, which really just suggests that doing the analysis was just an excuse to try to get work tailoring campaigns.
|2.||Inhibition of N-acylethanolamine acid amidase reduces nicotine-induced dopamine activation and reward.|
|Sagheddu C, Scherma M, Congiu M, Fadda P, Carta G, Banni S, Wood JT, Makriyannis A, Malamas MS, Pistis M.|
|Neuropharmacology. 2018 Nov 12. pii: S0028-3908(18)30848-7. doi: 10.1016/j.neuropharm.2018.11.013. [Epub ahead of print]|
Theoretically this is in pursuit of drugs to make people not respond to nicotine, an area of dubious ethics that is hardly ever discussed. It is not really worth discussing in this context, however, because this probably means nothing and they are basically just torturing rats because they have rats.
|11.||The Impact of the Opioid Antagonist Naloxone on Experimentally Induced Craving in Nicotine-Dependent Individuals.|
|Krause D, Warnecke M, Schuetz CG, Soyka M, Manz KM, Proebstl L, Kamp F, Chrobok AI, Pogarell O, Koller G.|
|Eur Addict Res. 2018 Nov 13;24(5):255-265. doi: 10.1159/000494346. [Epub ahead of print]|
Similar concept as the previous, though actual potentially-useful human research. Not sure if we should be sorry or glad they did not find much effect — it might save a few lives if people quitting smoking were all carrying Naloxone with them, but then again we can imagine people using overdose rescue kits on their kids when they catch them vaping.
|3.||Nicotine promotes lymph node metastasis and cetuximab resistance in head and neck squamous cell carcinoma.|
|Shimizu R, Ibaragi S, Eguchi T, Kuwajima D, Kodama S, Nishioka T, Okui T, Obata K, Takabatake K, Kawai H, Ono K, Okamoto K, Nagatsuka H, Sasaki A.|
|Int J Oncol. 2018 Nov 12. doi: 10.3892/ijo.2018.4631. [Epub ahead of print]|
The usual “here is how nicotine promotes cancer growth” stuff. Never mind that there is no measurable elevated cancer risk among (non-combustion) nicotine users.
|6.||Chronic Nicotine Exposure Induces Murine Aortic Remodeling and Stiffness Segmentation-Implications for Abdominal Aortic Aneurysm Susceptibility.|
|Wagenhäuser MU, Schellinger IN, Yoshino T, Toyama K, Kayama Y, Deng A, Guenther SP, Petzold A, Mulorz J, Mulorz P, Hasenfuß G, Ibing W, Elvers M, Schuster A, Ramasubramanian AK, Adam M, Schelzig H, Spin JM, Raaz U, Tsao PS.|
|Front Physiol. 2018 Oct 31;9:1459. doi: 10.3389/fphys.2018.01459. eCollection 2018.|
Megadosing mice with nicotine (equivalent of like 50 packs a day for weeks — yes, really, it is surprising the poor critters even survived long enough to be cut into pieces) creates measurable effects. Does this matter for anything other than finding very expensive ways to kill mice? We will never learn that from this type of work.
|4||How Do Waterpipe Smoking Establishments Attract Smokers? Implications for Policy.|
|Asfar T, Ben Taleb Z, Osibogun O, Ruano-Herreria EC, Sierra D, Ward KD, Salloum RG, Maziak W.|
|Subst Use Misuse. 2018 Nov 15:1-12. doi: 10.1080/10826084.2018.1524489. [Epub ahead of print]|
Did you know that merchants promote the particular products they sell, and sometimes offer specials on them? Whoa! Wait until Target hears about this. Of course, having “discovered” that, without in any way analyzing its implications, let alone how intervening would affect anything, the authors conclude, “Waterpipe online advertisements and promotions should be monitored and restricted.”
|20.||Vape shop location and marketing in the context of the Food and Drug Administration regulation.|
|Public Health. 2018 Nov 8;165:142-145. doi: 10.1016/j.puhe.2018.09.002. [Epub ahead of print]|
A lazy paper that non-systematically reviews a half dozen publications about vape shops. It discovers that the most attractive place to open a vape shop is in an urban area or town center area with foot traffic or in a depressed strip mall. Oh, except the author presumably does not know enough about the business to understand that is what he found, so he spins it as “disproportionately located near vulnerable populations”. Can you imagine how much louder the outcry would be if vape shops were instead concentrated in white suburbs?
|17.||Reduced Nicotine Content Cigarettes and Cannabis Use in Vulnerable Populations.|
|Parker MA, Streck JM, Bergeria CL, Bunn JY, Gaalema DE, Davis DR, Barrows AJ, Sigmon SC, Tidey JW, Heil SH, Higgins ST.|
|Tob Regul Sci. 2018 Sep;4(5):84-91. doi: 10.18001/TRS.4.5.8.|
|18.||Response to reduced nicotine content cigarettes among smokers with chronic health conditions.|
|Streck JM, Bergeria CL, Parker MA, Davis DR, DeSarno M, Sigmon SC, Hughes JR, Gaalema DE, Heil SH, Tidey JW, Stitzer ML, Rothman M, Higgins ST.|
|Prev Med Rep. 2018 Oct 15;12:321-329. doi: 10.1016/j.pmedr.2018.10.001. eCollection 2018 Dec.|
Random methodological aside: These two, secondary analyses of a larger study (published last year) out of FDA’s shop at University of Vermont, offer a good illustration of problems that are endemic in public health papers. We see here the “least publishable unit” game, which is normally just characterized as nothing more than a way to boost one’s academic scorekeeping and is only harmful because it makes it difficult to read all the study results. But it also serves to allow authors to use conflicting ad hoc models for different parts of their study, counting on readers not cross-indexing to see they were model shopping. (The Karolinska analyses of snus use and disease from their Workers cohort is perhaps that grossest example of this, for those familiar with it.) Moreover, in this case, it gets used to create the illusion of greater support for a conclusion. These two little studies found no apparent difference in responses to low-nic cigarettes among smokers who used cannabis or had particular health conditions, as compared to others. Fine. That is mildly interesting and worth reporting (albeit better as a couple of lines in the main study report). But if you look, you will notice that they spun this as evidence that low-nic does what they want to to do for these subpopulations. But that is not true — it merely has the same effects across these subpopulations. Everything from the original study’s analysis and conclusions that is, um, debatable applies equally. But these will be cited as if they are confirmation of the conclusion: “Studies show that low-nic works for all smokers  as well as for cannabis users [2018a] and those with chronic conditions [2018b].” Of course, that is exactly what FDA is paying them to do. But it should be recognized as the propaganda technique that it is.
|13.||US Food and Drug Administration considers comments on proposed nicotine product regulations: Some criticize the agency for not moving fast enough to stop youth e-cigarette use.|
|Cancer. 2018 Oct 15;124(20):3959-3960. doi: 10.1002/cncr.31792. No abstract available.
Does anyone actually read ivory tower journals in search of mediocre feature news stories? And why does PubMed index them as if they were research?
|14.||Nicotine Enhances <i>Staphylococcus epidermidis</i> Biofilm Formation by Altering the Bacterial Autolysis, Extracellular DNA Releasing, and Polysaccharide Intercellular Adhesin Production.|
|Wu Y, Ma Y, Xu T, Zhang QZ, Bai J, Wang J, Zhu T, Lou Q, Götz F, Qu D, Zheng CQ, Zhao KQ.|
|Front Microbiol. 2018 Oct 29;9:2575. doi: 10.3389/fmicb.2018.02575. eCollection 2018.|
|16.||Persistent attenuation of nicotine self-administration in rats by co-administration of chronic nicotine infusion with the dopamine D<sub>1</sub> receptor antagonist SCH-23390 or the serotonin 5-HT<sub>2C</sub> agonist lorcaserin.|
|DiPalma D, Rezvani AH, Willette B, Wells C, Slade S, Hall BJ, Levin ED.|
|Pharmacol Biochem Behav. 2018 Nov 9. pii: S0091-3057(18)30398-8. doi: 10.1016/j.pbb.2018.11.002. [Epub ahead of print]|
Search: (Nicotine[Title]) OR (Electronic cigarette[Title/Abstract]) OR (E-cigarette[Title/Abstract]) OR (Electronic cigarettes[Title/Abstract]) OR (E-cigarettes[Title/Abstract]) OR (Electronic Nicotine Delivery System[Title/Abstract]) OR (Electronic Nicotine Delivery Systems[Title/Abstract]) OR (Alternative Nicotine Delivery System[Title/Abstract]) OR (Alternative Nicotine Delivery Systems[Title/Abstract]) OR (personal vaporizer[Title/Abstract]) OR (Vaping[Title/Abstract]) OR (vapers[Title/Abstract]) OR (heated tobacco[Title/Abstract]) OR (heat-not-burn tobacco[Title/Abstract]) OR (reduced risk tobacco product[Title/Abstract]) OR (modified risk tobacco product[Title/Abstract]) OR (reduced risk tobacco products[Title/Abstract]) OR (modified risk tobacco products[Title/Abstract]) OR (snus[Title]) OR (smokeless tobacco[Title]) OR (toombak[Title]) OR (spit tobacco[Title]) OR (waterpipe[Title]) OR (hookah[Title]) OR (shisha[Title]) OR (narguile[Title]) OR (e-hookah[Title/Abstract]) OR (e-shisha[Title/Abstract])