UNASSIGNED: Incentive salience processes are important for the development and maintenance of addiction. Eye characteristics such as gaze fixation time, pupil diameter, and spontaneous eyeblink rate (EBR) are theorized to reflect incentive salience and may serve as useful biomarkers. However, conventional cue exposure paradigms have limitations that may impede accurate assessment of these markers.
UNASSIGNED: This study sought to evaluate the validity of these eye-tracking metrics as indicators of incentive salience within a virtual reality (VR) environment replicating real-world situations of nicotine and tobacco product (NTP) use.
UNASSIGNED: NTP users from the community were recruited and grouped by NTP use patterns: nondaily (n=33) and daily (n=75) use. Participants underwent the NTP cue VR paradigm and completed measures of nicotine craving, NTP use history, and VR-related assessments. Eye-gaze fixation time (attentional bias) and pupillometry in response to NTP versus control cues and EBR during the active and neutral VR scenes were recorded and analyzed using ANOVA and analysis of covariance models.
UNASSIGNED: Greater subjective craving, as measured by the Tobacco Craving Questionnaire-Short Form, following active versus neutral scenes was observed (F1,106=47.95; P<.001). Greater mean eye-gaze fixation time (F1,106=48.34; P<.001) and pupil diameter (F1,102=5.99; P=.02) in response to NTP versus control cues were also detected. Evidence of NTP use group effects was observed in fixation time and pupillometry analyses, as well as correlations between these metrics, NTP use history, and nicotine craving. No significant associations were observed with EBR.
UNASSIGNED: This study provides additional evidence for attentional bias, as measured via eye-gaze fixation time, and pupillometry as useful biomarkers of incentive salience, and partially supports theories suggesting that incentive salience diminishes as nicotine dependence severity increases.

UNASSIGNED: To identify sociodemographic and policy environment characteristics of early adopters of retail tobacco control policies in U.S. localities.
UNASSIGNED: We interviewed a sample of local tobacco control programs on policy progress for 33 specific policies, along with other program characteristics. We combine these results with secondary data in logistic regression analysis.
UNASSIGNED: Eighty (82% of 97) county tobacco control programs from 24 states were interviewed. Localities with lower smoking rates (OR: 0.7; 95%: 0.6-0.9) or higher excise taxes (OR: 6.0; 95%: 1.4-26.0) were more likely to have adopted a retail policy by late 2015. Early adopters were less likely to have voted majority Republican in the 2012 election (OR: 0.03; 95%: 0.00-0.34) or to have higher percentages of African American population (OR: 0.9; 95%: 0.8-0.99).
UNASSIGNED: While localities with more resources, eg, program capacity, political will or policy options, were more likely to adopt policies by 2015, those with higher smoking rates and proportions of priority populations were less likely to do so. As local retail policy work becomes more commonplace, only time will tell if this \"rich-get-richer\" trend continues, or if the contexts in which retail policies are adopted diversify.

There are many toxics, such as aromatic amines (AAs), in cigarette butts (CBs). As CBs are the most abundant litter worldwide, these chemicals may leach into water bodies. In the present work, for the first time, the levels of AAs leachates from CBs in distilled water (DW) and river water (RW) samples were evaluated at different exposure times ranging from 15 min to 30 days. The mean leachate levels of AAs in DW and RW samples were in the range of 0.2-566 and 0.2-596 ng L-1, respectively, with overall mean values of 569 and 556 ng L-1. There was no significant difference (p > 0.05) between the total AAs levels as well as the level of each examined AA in DW and RW samples. Aniline (ANL) had the highest leaching rate from CBs into water. The mean leachates of AAs from CBs into water were ranked as: ANL> 1-naphthylamine (1-NA)> 2-naphthylamine (2-NA) > 2,6-dimethylaniline (2, 6-DMA)> ∑toluidine (∑TOL)> o-anisidine (o-ASD)> ∑aminobiphenyl (∑ABP). Ecological risk assessment showed that ∑7AAs, ANL, p-TOL, o-TOL, 2-NA, and ∑ABP had medium risks to sensitive crustaceans and fish. As AAs are not the only hazardous chemicals which may leach from CBs into aquatic environments, restrictions on littering CBs into the environment are required due to the release of different toxics ultimately causing adverse effects on aquatic organisms.

Ontologies are ways of representing information that improve clarity and the ability to connect different data sources. This paper proposes an initial version of an ontology of tobacco, nicotine and vaping products with the aim of reducing ambiguity and confusion in the field.
Terms related to tobacco, nicotine and vaping products were identified in the research literature and their usage characterised. Basic Formal Ontology was used as a unifying upper-level ontology to describe the domain, and classes with definitions and labels were developed linking them to this ontology. Labels, definitions and properties were reviewed and revised in an iterative manner until a coherent set of classes was agreed by the authors.
Overlapping, but distinct classes were developed: \'tobacco-containing product\', \'nicotine-containing product\' and \'vaping device\'. Subclasses of tobacco-containing products are \'combustible tobacco-containing product\', \'heated tobacco product\' and \'smokeless tobacco-containing product\'. Subclasses of combustible tobacco-containing product include \'cigar\', \'cigarillo\', \'bidi\' and \'cigarette\' with further subclasses including \'manufactured cigarette\'. Manufactured cigarettes have properties that include \'machine-smoked nicotine yield\' and \'machine-smoked tar yield\'. Subclasses of smokeless tobacco product include \'nasal snuff\', \'chewing tobacco product\', and \'oral snuff\' with its subclass \'snus\'. Subclasses of nicotine-containing product include \'nicotine lozenge\' and \'nicotine transdermal patch\'. Subclasses of vaping device included \'electronic vaping device\' with a further subclass, \'e-cigarette\'. E-cigarettes have evolved with a complex range of properties including atomiser resistance, battery power, properties of consumables including e-liquid nicotine concentration and flavourings, and the ontology characterises classes of product accordingly.
Use of an ontology of tobacco, nicotine and vaping products should help reduce ambiguity and confusion in tobacco control research and practice.

Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunctive treatment strategy for peri-implant diseases. This systematic review aimed to determine whether aPDT as an adjunct to mechanical debridement has an additional benefit for smokers with peri-implant diseases. Randomized controlled trials (RCTs), which evaluated the clinical outcomes of mechanical debridement alone versus mechanical debridement + aPDT among smokers, were considered eligible to be included. The primary outcome was bleeding on probing (BOP) and secondary outcomes included probing depth (PD), plaque index (PI), and crestal bone loss (CBL). Meta-analyses using a random-effects model were conducted to calculate the mean difference (MD) with a 95% confidence interval (CI). The quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of four RCTs (188 participants) were included. The aPDT group showed significantly improved PD (MD =  - 1.26, 95% CI =  - 2.19 to - 0.32, p = 0.008) and PI (MD =  - 10.6%, 95% CI =  - 14.46 to - 6.74%, p = 0.0001) compared with mechanical debridement group at 3-month follow-up. No significant difference in bleeding on probing (BOP) was observed at 3-month follow-up (MD =  - 0.60%, 95% CI =  - 2.36 to 1.16%, p = 0.50). The subgroup analyses on photosensitizers demonstrated significant differences between the two groups on PD (MD =  - 1.23, 95% CI =  - 2.41 to - 0.05, p = 0.04) and PI (MD =  - 12.33, 95% CI =  - 14.74 to - 9.92, p < 0.00001) by the use of methylene blue (MB). Within the limitation of this study, compared with mechanical debridement alone, combined use of aPDT was more effective in reducing PD and PI in smokers at 3-month follow-up. MB was a predictable photosensitizer for aPDT. However, the findings should be interpreted with caution due to the limited number of included studies, methodological deficiencies, and heterogeneity between studies.

OBJECTIVE: This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers.
METHODS: This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Community Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥19 years of age) were included. Multi-level logistic regression analysis was conducted to investigate regional differences associated with smokers\' attempts to quit and to evaluate the effects of individual and regional characteristics on quit attempts.
RESULTS: Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030).
CONCLUSIONS: This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.

This multicentre cohort study investigates the effect of smoking on the outcome of rotator cuff repair (RCR), with attention to age at presentation for surgery, pre-operative and post-operative pain and function and intra-operative findings.
Patient information was collected pre-operatively, including Flex Shoulder Function (Flex SF) and visual analogue scale pain, then at 6 months, 1, 2 and 5 years post-operatively. Intra-operative technical data were collected by the operating surgeon. Current smokers were classified by daily cigarette consumption.
A total of 1383 RCRs in as many patients were included with an 84% 5-year follow-up. Smokers were on average 6.7 years younger than non-smokers (51.8 vs. 58.5, P < 0.001). There was no difference in intra-operatively assessed tear size both in anteroposterior dimension (P = 0.5) and retraction (P = 0.9). Pre-operative Flex SF score in smokers was below that of non-smokers (23.0 vs. 24.5, P = 0.002) and at 6 months (P = 0.02) but no different at 5 years (P = 0.7). Pain scores were higher in smokers than non-smokers both pre-operatively (5.34 vs. 4.67, P < 0.001) and up to 2 years (P < 0.001) but not at 5 years (P = 0.073).
Smokers undergoing RCR were younger than non-smokers, and had worse pre-operative pain scores and shoulder function. Poorer post-operative function persisted to 6 months, and with higher reported pain to 2 years in smokers. However, at 5-year follow-up, patient-reported outcomes were not affected by smoking status.

UNASSIGNED: Characterize physical design features of cigarette brands sold in the US according to the delivery method of menthol that may affect sensory perception among users.
UNASSIGNED: Twelve cigarette brands, mentholated and non-mentholated, were purchased for analyses of the physical design characteristics, quantification of nicotine and menthol, and identification of flavor additives.
UNASSIGNED: Physical design characteristics did not differ significantly between the various cigarette brands. However, significant differences were seen in levels of menthol. Menthol levels were greatest in products that had dual delivery methods of menthol (6.7mg/cigarette; SE=0.27) followed by products mentholated in a filter capsule only (5.7mg/cigarette; SE=0.25), and those mentholated in the tobacco only (3.8mg/cigarette; SE=0.12); products that were not mentholated had the least (0.38mg/cigarette; SE=0.31). Finally, flavor additives with a mint flavor profile other than menthol were identified, such as pulegone and limonene, and differed between cigarette brands, which are likely contributing to the menthol flavor experience associated with use of these products.
UNASSIGNED: The regulation of menthol delivery method, flavorings added to the capsule, and/or menthol concentration may be beneficial for the public health as these factors are likely creating unique sensory experiences.

Electronic cigarette (ECIG) use has increased dramatically in recent years. Negative ECIG-related acute health effects have included explosion/burn injuries from battery failure and child ingestion/poisoning of liquid nicotine. However, there is an urgent need for continued surveillance of ECIG health effects to determine whether these outcomes change as ECIG devices and liquids rapidly evolve. This study updates national estimates of ECIG-related emergency department (ED) visits and describes the context of these injuries.
A keyword search of case narrative text was used to identify ECIG-related ED visits in the National Electronic Injury Surveillance System (NEISS) data. These cross-sectional data are designed to be weighted to provide national estimates of consumer product-related injuries treated in EDs. ECIG-related injuries were described and categorized, and sampling weights applied to model national estimates.
From 2015 to 2019 there were an estimated 3369 ED visits from ECIG explosion/burn injuries (95% CI = 2020, 4718), and an estimated 676 visits from 2019 alone (95% CI = 315, 1036). In 2018-2019, there were an estimated 1550 cases of children <5 years old ingesting ECIG liquids (95% CI = 778, 2322).
Despite a notable shift in the US market towards ECIG devices that use lower electrical power and disposable \"pods\" (e.g., JUUL), liquid chemical ingestion among young children and ECIG explosion/burn injuries persist. Improved product regulations are urgently needed to prevent negative health effects caused by ECIGs, as well as prevent their ingestion and use by children.

Menthol, which is a natural cyclic monoterpene alcohol with a minty smell, is one of the main constituents of essential oils that naturally occur in some aromatic plants, such as Mentha × piperita L. This natural compound shows many biological properties, such as anesthetic, analgesic, antibacterial and antifungal, immunomodulating, and skin penetration-enhancing. It is added to a variety of goods, such as food, oral-care products, OTC products, cosmetics, and tobacco products. Menthol is not just a simple flavoring agent, especially when it comes to tobacco products. Its ability to \'mask\' the negative effects of nicotine and its additional positive sensory effects makes it the most common additive in such products. For the customers, mentholated tobacco products may be mistakenly perceived as less harmful for health, which may increase their consumption. However, as the evidence shows, menthol cigarettes are no safer than conventional cigarettes and may lead to more frequent disease exacerbation during prolonged exposure to smoke from such products. In addition, because of its complex interactions with nicotine, menthol may affect smoking behavior and may increase addiction to nicotine. For those reasons, the European Union banned flavored cigarettes (whose sale size reached more than 3% of the total tobacco product market) by implementing the Tobacco Products Directive (2014/40/EU) on 20th May 2020. While the menthol ban was based on health concerns, the ultimate effect on consumers, regarding potential quitting, is yet to be determined.