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Research & Evidence

The findings of this study underscore the importance of proven interventions to prevent all forms of tobacco use, including e-cigarette use, among youths.
Electronic Cigarettes as an Introductory Tobacco Product Among Eighth and 11th Grade Tobacco Users — Oregon, 2015
Hines, Jonas Z. MD ; Steven C. Fiala, MPH ; Katrina Hedberg, MD
CDC Morbidity and Mortality Weekly Report (MMWR)

2018

Halpern, Scott D., M.D., Ph.D., Michael O. Harhay, Ph.D., Kathryn Saulsgiver, Ph.D., Christine Brophy, Andrea B. Troxel, Sc.D., and Kevin G. Volpp, M.D., Ph.D.. "A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation." New England Journal of Medicine, June 14, 2018.

BACKGROUND: Whether financial incentives, pharmacologic therapies, and electronic cigarettes (e-cigarettes) promote smoking cessation among unselected smokers is unknown.

CONCLUSIONS: In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. (Funded by the Vitality Institute; ClinicalTrials.gov number, NCT02328794.)

Marian Freedman and Michael G Burke, MD. "High-nicotine e-cigarettes lead to more smoking and vaping." Contemporary Pediatrics, February 1, 2018.

Compared with adolescents who use e-cigarettes with relatively low or no nicotine concentrations, those who use e-cigarettes with higher nicotine concentrations are more likely to progress to more frequent and intense combustible cigarette smoking and vaping.

National Academies of Sciences, Engineering, and Medicine. "Incorporating weight management and physical activity throughout the cancer care continuum: Proceedings of a workshop." Washington, DC: The National Academies Press., 2018.

The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop.

Hackshaw, Allan; Joan K. Morris; Sadie Boniface; Jin-Ling Tang, Dušan Milenković,. "Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports." The BMJ, January 24, 2018.

Around one billion adults worldwide smoke,1 with high prevalence in developing countries, where 49% of men and 11% of women use tobacco.2 Although the prevalence of current smokers has decreased over time in several countries, the global absolute number of smokers has increased owing to population growth.3 Policies have successfully encouraged people to quit, using aids such as nicotine replacement therapy and electronic cigarettes (e-cigarettes).4

National Academies of Sciences, Engineering, and Medicine. "Public Health Consequences of E-Cigarettes." Washington, DC: The National Academies Press, 2018.

Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes.

Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.

Ahmed Jamal, MBBS; Elyse Phillips, MPH; Andrea S. Gentzke, PhD; David M. Homa, PhD; Stephen D. Babb, MPH; Brian A. King, PhD; Linda J. Neff, PhD. "Current Cigarette Smoking Among Adults — United States, 2016." CDC Morbidity and Mortality Weekly Report, January 19, 2018.

The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products. Proven population-based interventions, including tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns, and barrier-free access to tobacco cessation counseling and medications, are critical to reduce cigarette smoking and smoking-related disease and death among U.S. adults, particularly among subpopulations with the highest prevalences.

"Cancer Facts & Figures 2018." American Cancer Society, January 2018.

Estimated numbers of new cancer cases for 2018, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder. Estimates are not available for Puerto Rico.

Note: State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding.

Siegel, Rebecca L., MPH; Kimbertly D. Miller, MPH; Ahmedin Jemal, DVM, PhD. "Cancer Statistics, 2018." Wiley Online Library, January 4, 2018.

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. 

Cancer is a major public health problem worldwide and is the second leading cause of death in the United States. In this article, we provide the estimated numbers of new cancer cases and deaths in 2018 in the United States nationally and for each state, as well as a comprehensive overview of cancer occurrence based on the most current population‐based data for cancer incidence through 2014 and for mortality through 2015. We also estimate the total number of deaths averted as a result of the continual decline in cancer death rates since the early 1990s and quantify the black‐white disparity in cancer mortality by state and age based on the actual number of reported cancer deaths in 2015.

Aiuppa, Laura; Maria Hewitt; Sharyl J. Nass. "Long-Term Survivorship Care After Cancer Treatment." The National Academies of Sciences, 2018.

The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment (IOM and NRC, 2006). Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care.

2017

Farhad Islami, MD, PhD; Ann Goding Sauer, MSPH; Kimberly D. Miller, MPH; Rebecca L. Siegel, MPH; Stacey A. Fedewa, PhD, MPH; Eric J. Jacobs, PhD; Marjorie L. McCullough, ScD, RD; Alpa V. Patel, PhD; Jiemin Ma, PhD, MHS; Isabelle Soerjomataram, MD, PhD, MS. "Proportion and Number of Cancer Cases and Deaths Attributable to Potentially Modifiable Risk Factors in the United States." CA: A Cancer Journal for Clinicians, November 21, 2017.

Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer-associated infections).

Elyse Phillips, MPH; Teresa W. Wang, PhD; Corinne G. Husten, MD; Catherine G. Corey, MSPH; Benjamin J. Apelberg, PhD; Ahmed Jamal, MBBS; David M. Homa, PhD; Brian A. King, PhD . "Tobacco Product Use Among Adults — United States, 2015." Centers for Disease Control and Prevention, November 10, 2017.

In 2015, approximately one in five U.S. adults (48.7 million) currently used any tobacco product, with most using combustible tobacco products. Any tobacco product use was significantly higher among males; adults aged <65 years; non-Hispanic AI/AN, whites, blacks, and persons of multiple races; persons living in the Midwest; persons with a GED; persons with annual household income <$35,000; persons who were single/never married/not living with a partner or divorced/separated/widowed; persons who were uninsured or insured through Medicaid; persons with a disability; and persons who identified as LGB. Adults with serious psychological distress had the highest prevalence of any tobacco product use of any subpopulation.

Girija Syamlal, MBBS; Brian A. King, PhD; Jacek M. Mazurek, MD. "Tobacco Use Among Working Adults — United States, 2014–2016." Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, October 27, 2017.

Cigarette smoking has declined considerably among U.S. adults over several decades; however, increases have occurred in the use of noncigarette tobacco products in recent years, and the use of multiple tobacco products has become common among current users of noncigarette tobacco products.

Babb, Stephen MPH, Benmei Liu PhD, Brandon Kenemer MPH, Carissa Baker Holmes MPH, Anne M. Hartman MS, MA, James T. Gibson BS, Brian A. King PhD, MPH. "Changes in Self-Reported Smokefree Workplace Policy Coverage Among Employed Adults— United States, 2003 and 2010–2011." Oxford University Press on behalf of Society for Research on Nicotine & Tobacco Research, October 12, 2017.

The workplace is a major source of exposure to secondhand smoke from combustible tobacco products. Smokefree workplace policies protect nonsmoking workers from secondhand smoke and help workers who smoke quit. This study examined changes in self-reported smokefree workplace policy coverage among U.S. workers from 2003 to 2010–2011.

Greta M. Massetti, PhD; William H. Dietz, MD, PhD; Lisa C. Richardson, MD, MPH. "Excessive Weight Gain, Obesity, and Cancer." JAMA, October 3, 2017.

Even though the effects of overweight and obesity on diabetes, cardiovascular disease, all-cause mortality, and other health outcomes are widely known, there is less awareness that overweight, obesity, and weight gain are associated with an increased risk of certain cancers. A recent review of more than 1000 studies concluded that sufficient evidence existed to link weight gain, overweight, and obesity with 13 cancers, including adenocarcinoma of the esophagus; cancers of the gastric cardia, colon and rectum, liver, gallbladder, pancreas, corpus uteri, ovary, kidney, and thyroid; postmenopausal female breast cancer; meningioma; and multiple myeloma.

Drope, J., Cahn, Z., Kennedy, R., Liber, A. C., Stoklosa, M., Henson, R., Douglas, C. E. and Drope, J. "Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine." CA: A Cancer Journal for Clinicians, September 29, 2017.

Over the last decade, the use of electronic nicotine delivery systems (ENDS), including the electronic cigarette or e-cigarette, has grown rapidly. More youth now use ENDS than any tobacco product. This extensive research review shows that there are scientifically sound, sometimes competing arguments about ENDS that are not immediately and/or completely resolvable. However, the preponderance of the scientific evidence to date suggests that current-generation ENDS products are demonstrably less harmful than combustible tobacco products such as conventional cigarettes in several key ways, including by generating far lower levels of carcinogens and other toxic compounds than combustible products or those that contain tobacco. To place ENDS in context, the authors begin by reviewing the trends in use of major nicotine-containing products. Because nicotine is the common core—and highly addictive—constituent across all tobacco products, its toxicology is examined. With its long history as the only nicotine product widely accepted as being relatively safe, nicotine-replacement therapy (NRT) is also examined. A section is also included that examines snus, the most debated potential harm-reduction product before ENDS. Between discussions of NRT and snus, ENDS are extensively examined: what they are, knowledge about their level of “harm,” their relationship to smoking cessation, the so-called gateway effect, and dual use/poly-use. 

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