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Participants who received e-cigarette-related information from FF (OR=2.42; 95% CI 1.42-4.13) and PUB (OR=2.13; 95% CI 1.25-3.65) had greater odds of being e-cigarette-only users compared to never users. Participants who shared e-cigarette-related information with FF had greater odds of being e-cigarette-only users (OR=3.16; 95% CI 1.80-5.58) and polytobacco users (OR=4.48; 95% CI 3.16-6.35) compared to never users. Conclusions Receiving and sharing tobacco-related and e-cigarette-related information via multiple communication channels is associated with e-cigarette and polytobacco use among Appalachian youth. Several channels may need to be utilized in health campaigns to influence youth.Introduction Electronic nicotine delivery systems (ENDS) are a relatively new type of nicotine-containing product that has risen greatly in use within the past decade, displacing conventional tobacco products as the dominant source of nicotine exposure by many groups. Among those impacted are large sections of US youth. Though health outcomes associated with ENDS use are still being assessed, several potential harms have been noted in the extant literature. The purpose of this study is to examine which US youth subpopulations are at greatest risk for ENDS ever use and how perceptions pertaining to nicotine-containing products relate to this risk. Methods A nationwide online survey was administered to US youth ENDS users and non-users aged 13-18 years. A total weighted sample of 2501 participants was obtained. Statistical analyses included binomial logistic regression and a likelihood ratio test. Results Of these youth, 1346 (53.8%) reported having ever used an ENDS product. Those most likely to have used ENDS were White males in their late teens. Those who reported ever using a conventional tobacco product were much more likely to have reported ever using ENDS (AOR= 19.96; 95% CI 15.30-26.05). A number of perceptions related to nicotine-containing products, including product safety and health effects, were significantly associated with an increased likelihood of ENDS use. Conclusions Certain sections of the US youth population have elevated odds of being ENDS ever users. As increasing evidence supports the need to combat ENDS use by youth, effectively targeted education and prevention campaigns will be necessary.Introduction This study aimed to assess the association between toombak (smokeless tobacco) advertisement at point-of-sale (PoS) and its use among adolescents in Sudan. Methods A cross-sectional school-based and self-administered questionnaire study was conducted. Schools were randomly selected using a one-stage stratified sampling procedure, during 2013-2014, as part of a larger research project focusing on the use of toombak among secondary school students in Khartoum State, Sudan. The sample size was 1526 students. Data were collected on exposure to toombak advertisement, social acceptability, perceived accessibility to toombak, susceptibility, and toombak use. Results A total of 41.8% of the adolescents were exposed to an advertisement at PoS, while 12.5% perceived direct access to toombak, 5.3% reported that they were susceptible to use toombak, and 10.9% were ever toombak users. Exposure to the advertisement of toombak at PoS was found to be associated with the older age group (44.3%) (p≤0.05). Males were more than females (45.2% vs 38.8%; p≤0.05). Those exposed to toombak advertisements at PoS reported more social acceptability towards toombak (48.9% vs 37.6%; p≤0.001) and direct accessibility to toombak (68.8% vs 47.2%; p≤0.05). Ever toombak users reported higher exposure to advertisements than non-users (54.5% vs 40.3%; p≤0.001). Conclusions Exposure to toombak advertisements at PoS was found to be high and associated with increased toombak use in Khartoum State, Sudan, in addition to increasing social acceptability to its use and perceived easy accessibility. The current law, which bans toombak advertisement and promotion at PoS, needs to be enforced.Introduction Tobacco smoking is a major preventable risk factor for non-communicable diseases. The aim of this study was to investigate predictors of tobacco smoking among acute medically ill patients admitted to a Moscow hospital, and the association between smoking and alcohol use. Methods Patients admitted to the V. P. Demikhov hospital in Moscow from November 2016 through December 2017 were asked to participate in this study (inclusion criteria were acute medically ill patients aged ≥18 years). Sociodemographic data were collected, in addition to questionnaires on mental distress (Hopkins Symptom Checklist 5), alcohol use (Alcohol Use Disorder Identification Test 4, AUDIT-4) and smoking (Fagerström Test for Nicotine Dependence). selleck chemical Results A total of 3009 patients were recruited to the study. Using a binary logistic regression model adjusted for all variables, it was found that living without a partner resulted in a higher risk of smoking tobacco compared to being married or living with a partner (odds ratio, OR=1.60 for divorced, p=0.001; and OR=1.62 for single, p=0.002), and being economically non-active resulted in a higher risk compared to being economically active (OR=1.47; p=0.003). Harmful alcohol use (AUDIT-4 score ≥5 [for females] / 7 [for males]) resulted in a higher risk of smoking compared to those without harmful alcohol use (OR=4.04; p less then 0.001). Conclusions Smoking was highly prevalent and associated with other adverse sociodemographic and lifestyle factors such as harmful alcohol use.Introduction Given existing regulations that ban the tobacco industry from engaging in traditional forms of advertising and require warning labels on cigarette packaging, we suggest that one response on the part of tobacco manufacturers has been to make alterations to design elements of cigarette packages themselves. The current research seeks to examine how cigarette manufacturers have altered elements of cigarette packaging in response to regulatory changes by the Government of Canada in 2011, which increased health warning sizes on cigarette packages from 50% of the principal display surface to 75%. Methods Cigarette packages (n=1689) that had been on the market in Canada in the period 2001-2017 were examined and coded for package design elements including package innovation (size and package style), color (hue and saturation), and branding elements (use of iconography and variant names). Characteristics of pre-regulation packaging were then systematically compared to characteristics of post-regulation packaging.