DOCSLIB.ORG

Comparison of Pharmaceutical, Illicit Drug, Alcohol, Nicotine and Caffeine

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Comparison of Pharmaceutical, Illicit Drug, Alcohol, Nicotine and Caffeine Baz-Lomba et al. BMC Public Health (2016) 16:1035 DOI 10.1186/s12889-016-3686-5 RESEARCH ARTICLE Open Access Comparison of pharmaceutical, illicit drug, alcohol, nicotine and caffeine levels in wastewater with sale, seizure and consumption data for 8 European cities Jose Antonio Baz-Lomba1,2*, Stefania Salvatore2, Emma Gracia-Lor3, Richard Bade4, Sara Castiglioni3, Erika Castrignanò5, Ana Causanilles6, Felix Hernandez4, Barbara Kasprzyk-Hordern5, Juliet Kinyua7, Ann-Kathrin McCall8, Alexander van Nuijs7, Christoph Ort8, Benedek G. Plósz9, Pedram Ramin9, Malcolm Reid1, Nikolaos I. Rousis3, Yeonsuk Ryu1, Pim de Voogt6, Jorgen Bramness2 and Kevin Thomas1 Abstract Background: Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys. Method: This study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison. Results: High agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4- methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data. Conclusions: This work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable. Keywords: Wastewater-based epidemiology, Drug consumption, Correlation, Europe-wide study, Seizures, Sales statistics * Correspondence: [email protected] 1Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, Oslo NO-0349, Norway 2Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, PO box 1078, Blindern, Oslo 0316, Norway Full list of author information is available at the end of the article © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Baz-Lomba et al. BMC Public Health (2016) 16:1035 Page 2 of 11 Background been used to determine nicotine use through the measure- The chemical analysis of the exogenous biomarkers of ment of its residues in wastewater at national level [6, 7, 28]. drug consumption in wastewater has been shown to be an These data were compared with local tobacco sales statistics interesting approach for studying drug use within a de- finding good agreement [29]. Caffeine is present in coffee fined population [1]. The approach, termed wastewater- and tea as well as other products such as energy drinks, based epidemiology (WBE), was first applied in 2008 to chocolate and certain medicines. Caffeine occurrence has study illicit drug use in three Italian cities [2] and it has been investigated to assess its patterns of use across different since been extended to a wider range of exogenous bio- communities [7, 30]. markers specific to the use of alcohol [3–5], tobacco [6], Very few studies to date have correlated wastewater caffeine [7] and selected pharmaceuticals [8, 9]. To date data with other sources of data. So far, pharmaceutical there has been very limited focus on evaluating the rela- concentrations in wastewater have been related to the tionship between WBE data to other drug use measures. amounts used in a population by using prescription data The use of pharmaceuticals in society is usually deter- [11, 31–33]. A Spanish study compared wastewater con- mined by prescription data or self-reports. However, centrations of 17 pharmaceuticals with annual sales data pharmaceutical prescription or sales data involve several and found a good correlation [31]. The same was true sources of uncertainties such as the inappropriate use of for studies from Australia [32], Italy [33], and Belgium a medication, household disposal through the toilet or [11]. One study compared cocaine loads in wastewater sink, sales without prescription or illegal acquisition in Oslo with cocaine measures from population survey [10–12]. Self-reports on adherence are potentially sub- data and drug tests among car drivers and found a good ject to recall and reporter bias [13]. An alternative could correlation [21]. A recent study in Belgium compared be to quantitatively measure pharmaceuticals in waste- WBE results with survey data collected simultaneously water as an indicator of use [14–16]. in a small community of around 30,000 inhabitants for Europe has a significant market for illicit drugs sus- alcohol and nicotine metabolites [34]. No significant tained by both domestic production and import from correlations were found, but the study was impaired by a other regions [17]. Different monitoring approaches have typically low response to the surveys. Discrepancies been used to investigate the scale of drug use. Police and between wastewater and national survey data have also custom’s seizures, population surveys, hospital admissions, been found in Australia [35]. drug-overdose deaths or treatment programs have been The present study aims to compare WBE data with the most reliable data for drug use estimates [18–20]. other sources of drug use data in order to assess its correl- Under-reporting is still apparent despite the use of a num- ation. The study uses concentrations of pharmaceuticals, ber of different sources of information to improve the illicit drugs, alcohol, nicotine and caffeine in wastewater level of accuracy of self-reporting [21]. Seizure data may samples from different European cities and compares not give the correct picture and surveys suffer from these with other sources of data for drug use. The data reporting biases and low response rates [22]. WBE has used for comparison were pharmaceutical prescriptions been introduced as a promising alternative or addition to (morphine, methadone, atenolol, metoprolol, methylphen- these sources of data [23–25]. idate, carbamazepine, citalopram, paracetamol, oxazepam There is also a need to be able to accurately determine and diclofenac), police drug seizure data for illicit drugs the consumption of licit drugs, such as alcohol, nicotine (cocaine, amphetamine, and MDMA (ecstasy)), and con- and caffeine. Alcohol consumption can be estimated from sumption data for alcohol, tobacco and caffeine metabo- sales statistics but trafficking, illegal production, stock pil- lites (EtS; cotinine, nicotine and hydroxycotinine; caffeine, ing or waste can affect such data. Reid and co-workers for paraxanthine, 1-methylxanthine, 7-methylxanthine, 1- the first time applied WBE to obtain complementary methyluric acid and 1,7-dimethyluric acid). information on community alcohol consumption by ana- lysing the alcohol metabolite, ethyl sulfate (EtS) in waste- Methods water [4]. This approach has since been used in other Wastewater samples studies to report the rates of alcohol consumption in pop- Twenty-four hour composite inlet sewage samples were ulations [3, 26], but the value of these biomarkers has yet collected from 8 different European wastewater treatment to be determined. Tobacco use is commonly deduced plants (WWTP) over 7 consecutive days in March 2015. from tobacco sales statistics. Prevalence surveys and the All samples were stored in plastic containers, immediately aggregate between production and trade statistics can also frozen at −20 °C to prevent degradation of the urinary me- yield the total consumption estimates [27]. However, these tabolites and sent to Oslo and Milan within 24 h in cool data may bias the total consumption estimates (similar to boxes with dry ice or ice packs to keep the samples frozen. alcohol) indicating that additional methods are required in The average wastewater flow rate (litres per day (L/day)) order to improve tobacco use estimations. WBE has also through each of the treatment plants was recorded for Baz-Lomba et al. BMC Public Health (2016) 16:1035 Page 3 of 11 each of the daily samples. Samples were collected every methanol-ultrapure water (20:80, v/v), centrifuged and morning between 07:00 and 8:30 except for Zurich where transferred into glass vials for instrumental analysis. Fi- it was performed
Load more

Recommended publications
  • 2016 Questionnaire
    N R P F S S Administrative Use Only Nebraska Risk & School Name: Protective Factor Student Survey School ID: School District: Year 2016 The purpose of this survey is to learn how students in our schools feel about their community, family, peers, and school. The survey also asks about health behaviors. - The survey is completely voluntary and anonymous. Do NOT put your name on the questionnaire. - This is not a test, so there are no right or wrong answers. We would like you to work quickly so you can finish. - All of the questions should be answered by completely filling in one of the answer spaces. If you do not find an answer that fits exactly, use the one that comes closest. If any question does not apply to you, or you are not sure what it means, just leave it blank. You can skip any question that you do not wish to answer. - Mark only one answer to each question unless instructed otherwise. About You Your Experiences at School 1 Are you: 6 Putting them together, what were your grades Male like last year ? (Mark the one best answer.) Female Mostly F's Mostly D's Mostly C's 2 How old are you? Mostly B's 12 or younger 16 Mostly A's 13 17 14 18 15 19 or older 7 How interesting are most of your courses to you? Very interesting and stimulating Quite interesting 3 What grade are you in? Fairly interesting 7th 10th Slightly dull 8th 11th Very dull 9th 12th 8 How important do you think the things you are learning in school are going to be for your later life? 4 Are you Hispanic or Latino? Yes (Hispanic or Latino) Very important Quite important
    [Show full text]
  • Cincinnati Region
    Ohio Substance Abuse Monitoring Network Drug Abuse Trends in the Cincinnati Region June 2010-January 2011 John R. Kasich, Governor Orman Hall, Director FAYETTE BUTLER WARREN CLINTON ROSS HAMILTON HIGHLAND PIKE CLERMONT BROWN ADAMS SCIOTO LAWRENCE Regional Epidemiologist: Jan Scaglione, BS, MT, PharmD, DABAT OSAM Staff: R. Thomas Sherba, PhD, MPH, LPCC Principal Investigator Rick Massatti, MSW Research Administrator • Ohio Department of Alcohol and Drug Addiction Services • Division of Planning, Outcomes & Research • 280 N. High St., 12th floor, Columbus, OH 43215• 1-800-788-7254 • www.odadas.ohio.gov • Cincinnati Region Surveillance of Drug Abuse Trends in the State of Ohio Cincinnati Region Regional Profile Indicator1 Ohio Cincinnati Region OSAM Drug Consumers Total Population, 2009 estimate 11,514,603 2,053,493 38 Gender (Female), 2009 51.2% 51.1% 50.0% Whites, 2009 82.2% 83.2% 47.4% African Americans, 2009 11.9% 12.6% 47.4% Hispanic or Latino Origin, 2009 2.8% 2.0% 2.6% High school graduates, 2008 84.6% 89.9% 76.3% Median household income, 2009 $45,467 $41,672 Less than $12,000 Persons below poverty, 2009 15.1% 16.2% 48.6%2 Ohio and Cincinnati statistics are derived from the U.S. Census Bureau1. Respondents reported income by selecting a category that best represented their household’s approximate income for 20092. Poverty status was unable to be determined for three respondents due to missing or insufficient income data3. Drug Consumer Characteristics (N=38) Male 19 Female 19 20's 17 30's 9 40's 6 50's + 6 Less than high school graduate
    [Show full text]
  • (MAI) Substance Abuse/HIV Prevention Initiative Adult Questionnaire
    Form Approved OMB No.: 0930–0357 Expiration Date: March 31, 2022 National Minority AIDS Initiative (MAI) Substance Abuse/HIV Prevention Initiative Adult Questionnaire TO BE FILLED OUT BY THE LOCAL GRANT SITE DATA COLLECTOR Participant ID #: National Minority AIDS Initiative (MAI) Substance Abuse/HIV Prevention Initiative Adult Questionnaire Funding for data collection supported by the Center for Substance Abuse Prevention (CSAP), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) These questions are part of a data collection effort about how to prevent substance abuse and HIV infection. The questions are being asked of hundreds of other individuals throughout the United States. The data findings will be used to help prevention initiatives learn more about how to keep people from using drugs and getting infected with HIV. Completing this questionnaire is voluntary. If you do not want to answer any of the questions, you do not have to. If you decide not to participate in this survey, it will have no effect on your participation in direct service programs. However, your answers are very important to us. Please answer the questions honestly—based on what you really do, think, and feel. Your answers will not be told to anyone in your family or community. Do not write your name anywhere on this questionnaire. We would like you to work fairly quickly so that you can finish. Please work quietly by yourself. If you have any questions or do not understand something, let the data collector know. We think you will find the questionnaire to be interesting and that you will like filling it out.
    [Show full text]
  • Myth and Facts About Tobacco
    Congratulations SWAT N:Formerz Teachers! Thank you for your commitment to keeping our youth healthy and tobacco- free, by incorporating these interactive classroom prevention lesson plans into your existing curricula. The Tobacco Use Prevention Service is proud of dedicated teachers like you who work hard every day to educate our youths. These grade specific lesson plans will teach children about the physical and social consequences of tobacco use, decision-making, problem solving and refusal skills, which will help youth resist pressure to use tobacco. The materials are designed for student participation and each lesson’s objectives meet the Priority Academic Student Skills Competencies in several areas. Therefore, you can use these lesson plans while teaching reading, writing, and social studies, and at the same time strengthen your students’ resistance to using tobacco. You are a critical factor in the fight against tobacco use, as you are with the youth every day, and have a great influence on their lives. Sincerely, Dave Wattenbarger, MS School Programs Coordinator Oklahoma State Department of Health Jennifer Wilson Statewide SWAT Program Coordinator Oklahoma State Department of Health 1 Students Working Against Tobacco Priority Academic Student Skills Lesson Plan # 1 • Health and Safety Literacy Standard 1,2,3,4,5 & 6 Lesson Plan # 2 • Health and Safety Literacy Standard 1 & 5 Lesson Plan # 3 • Health and Safety Literacy Standard 1,4 & 5 • Language Arts/Visual Literacy Standard 2 & 3 Lesson Plan # 4 • Health and Safety Literacy Standard 2 & 3 • Language Arts/Visual Literacy Standard 2 Lesson Plan # 5 • Health and Safety Literacy Standard 5 • Contact your SWAT Regional Coordinator to borrow the video Behind the Smoke Screen: Facts about Tobacco.
    [Show full text]
  • Cancer Council Victoria
    Tobacco in Australia Facts & Issues A comprehensive online resource tobaccoinaustralia.org.au Book excerpt List of chapters available at tobaccoinaustralia.org.au Introduction Chapter 1 Trends in the prevalence of smoking Chapter 2 Trends in tobacco consumption Chapter 3 The health effects of active smoking Chapter 4 The health effects of secondhand smoke Chapter 5 Factors influencing the uptake and prevention of smoking Chapter 6 Addiction Chapter 7 Smoking cessation Chapter 8 Tobacco use among Aboriginal peoples and Torres Strait Islanders Chapter 9 Smoking and social disadvantage Chapter 10 The obaccot industry in Australian society Chapter 11 Tobacco advertising and promotion Chapter 12 The construction and labelling of Australian cigarettes Chapter 13 The ricingp and taxation of tobacco products in Australia Chapter 14 Social marketing and public education campaigns Chapter 15 Smokefree environments Chapter 16 Tobacco litigation in Australia Chapter 17 The economics of tobacco control Chapter 18 The WHO Framework Convention on Tobacco Control Appendix 1 Useful weblinks to tobacco resources Tobacco in Australia: Facts and Issues. A comprehensive review of the major issues in smoking and health in Australia, compiled by Cancer Council Victoria. First edition published by ASH (Australia) Limited, Surry Hills, NSW, 1989 Second edition published by the Victorian Smoking and Health Program, Carlton South, Victoria (Quit Victoria), 1995 Third (2008) and fourth (2012) editions, and ongoing updating, published by Cancer Council Victoria in electronic format only. ISBN number: 978-0-947283-76-6 Suggested citation: Scollo, MM and Winstanley, MH. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2016. Available from www.TobaccoInAustralia.org.au OR <Author(s) of relevant chapter section>, <Name of chapter section> in Scollo, MM and Winstanley, MH [editors].
    [Show full text]
  • Communities That Care Youth Survey
    Communities That Care Youth Survey The questions contained in this booklet are designed to obtain your opinion about a number of things concerning you, your friends, your family, your neighborhood and your community. In a sense, many of your answers will count as "votes" on a wide range of important issues. In order for this survey to be helpful, it is important that you answer each question as thoughtfully and honestly as possible. All of your answers will be kept strictly confidential and will never be seen by anyone at your school. This survey is completely voluntary so you may skip any question that you do not wish to answer. Be sure to read the instructions below before you begin to answer. Thank you for your participation. I nstructions 1. This is not a test, so there are no right or wrong answers; we would like you to work quickly, so that you can finish. 2. All of the questions should be answered by marking one of the answer spaces. If you don't find an answer that fits exactly, use one that comes closest. If any question does not apply to you, or you are not sure of what it means, just leave it blank. 3. Your answers will be read automatically by a computer. Please follow these instructions carefully. • Use only a blue or black pen or pencil. • Make heavy marks inside the circles. This kind of mark will work: Correct Mark • Erase cleanly or mark a big "X" over any answer you wish to change. • Make no other markings or comments on the answer These kinds of marks will NOT work: pages, since they interfere with the automatic reading.
    [Show full text]
  • NRPFSS School Name: Nebraska Risk & Protective Factor Student Survey School ID: School District: Year 2018
    Administrative Use Only NRPFSS School Name: Nebraska Risk & Protective Factor Student Survey School ID: School District: Year 2018 The purpose of this survey is to learn how students in our schools feel about their community, family, peers, and school. The survey also asks about health behaviors. • The survey is completely voluntary and anonymous. Do NOT put your name on the questionnaire. • This is not a test, so there are no right or wrong answers. We would like you to work quickly so you can finish. • Mark only one answer to each question unless instructed otherwise. • If you do not find an answer that fits exactly, use the one that comes closest. If any question does not apply to you or you are not sure what it means, just leave it blank. You can skip any question that you do not wish to answer. 1. Are you: 6. Putting them together, what were your grades Male like LAST YEAR? (Mark the one best answer.) Female Mostly F’s Mostly D’s 2. How old are you? Mostly C’s 12 or younger 16 Mostly B’s 13 17 Mostly A’s 14 18 15 19 or older Please indicate how much you agree or disagree 3. What grade are you in? with the following statements. 7th 10th 8th 11th 7. I feel safe at my school. 9th 12th Strongly disagree Disagree 4. Are you Hispanic or Latino? Agree Yes (Hispanic or Latino) Strongly agree No (Not Hispanic or Latino) 5. What is your race? (Select one or more.) 8. In my school, there is an adult (such as a Black or African American counselor, teacher, or coach) who listens to me Asian when I have something to say.
    [Show full text]
  • Policy 314 Tobacco Use Reduction and Prevention Policy
    Manual of Policy and Procedures Title Number Page TOBACCO USE REDUCTION 314 1 of 2 Date AND PREVENTION POLICY November 30, 2016 PURPOSE The Vermont State Colleges (“VSC”) are committed to maintaining a healthy and safe working and learning environment for all of its students, faculty, and staff. Cigarette smoking causes more than 480,000 deaths in the United States each year, which includes 42,000 deaths from exposure to secondhand smoke.1 Secondhand smoke is a serious health hazard and a human carcinogen with no known safe level of exposure. Even brief exposure to secondhand smoke can have adverse health effects, especially for those with asthma or other lung-related conditions. No one should have to risk his or her health in order to enter, exit, or stand outside any VSC building. In addition, the evidence shows that many people start to smoke in college and that tobacco-free policies are effective in decreasing smoking rates in society.2 Accordingly, the purpose of this policy is to reduce harm from tobacco use and secondhand smoke, to provide an environment that encourages persons to become and/or remain tobacco-free, and to promote a culture of wellness. DEFINITIONS “Tobacco” is defined as any manufactured product containing tobacco or nicotine, including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, dipping tobacco, shisha, pipes, water pipes (hookah), dissolvable tobacco products, electronic cigarettes, other electronic or battery-powered vaping devices, and all forms of smokeless tobacco. However, “tobacco” does not include any product that has been approved by the U.S.
    [Show full text]
  • The Effect of Recreational Drugs on Seminal Parameters in Males of Pashtoon Tribe of Khyber Pakhtunkhwa, Pakistan
    Central JSM Sexual Medicine Research Article *Corresponding author Mohammad Shoaib Khan, Department of Biochemistry, Bannu Medical College, Bannu, Khyber Pakhtunkhwa, The Effect of Recreational Pakistan, Email: [email protected] Submitted: 05 May 2020 Accepted: 08 June 2020 Drugs on Seminal Parameters Published: 10 June 2020 ISSN: 2578-3718 Copyright in Males of Pashtoon Tribe of © 2020 Zada N, et al. OPEN ACCESS Khyber Pakhtunkhwa, Pakistan Keywords • Recreational drugs (Naswar, marijuana, & cigarette) Nawab Zada1 and Mohammad Shoaib Khan2 seminal parameters; Pashtoon tribes 1Department of Physiology, Bannu Medical College, Pakistan 2Department of Biochemistry, Bannu Medical College, Pakistan Abstract Objective: The present study aimed to determine the effects of the different recreational drugs (cigarette, dipping tobacco and marijuana) on the semen parameters of infertile males. Study Design: Case Control study: 1.1.2. Study Population: The study population consisted of 160 apparently healthy infertile adult males of Pashtoon ancestry which were divided in to four groups, consisting of (n = 40) subjects each. Study Settings: The study was conducted in Institute of Basic Medical Science, Khyber medical university (IBMS-KMU), Peshawar, Bannu Medical College (BMC), Samad Clinical laboratories and Shah Noor Medical laboratories Bannu. Methodology: The semen samples were obtained through masturbation and were analyzed by conventional method as described by WHO. Results: The results showed no significant changes in the baseline characteristics (Age, BMI, Blood pressure) of the study populations when compared with control group. The semen parameters showed that active motile sperms were 50.18 ± 19.8%, 45.83 ± 20.4%, 43.78 ± 21% and 42.28 ± 16.8% in control, smokers, dippers and marijuana users respectively.
    [Show full text]
  • Clearfield County
    Clearfield County 1 2 3 Funding provided by About the cover photographs: 1. Railroad bridge over Susquehanna River, Harrisburg, PA Credit: Commonwealth Media Services 2. A bronze statue of Maj. Gen. G. K. Warren surveys the battlefield at Little Round Top, Gettysburg National Military Park Credit: Commonwealth Media Services 3. Susquehanna River, Asylum Township, Bradford County, PA as seen from Marie Antoinette Overlook along Route 6. Credit: Nicholas A. Tonelli ACKNOWLEDGMENTS The Pennsylvania Commission on Crime and Delinquency (PCCD), the Pennsylvania Department of Education (PDE), and the Pennsylvania Department of Drug and Alcohol Programs (DDAP) would like to thank Bach Harrison, L.L.C. and Dr. Rose Baker of the Center for Evaluation and Education Policy Analysis at The Pennsylvania State University for their contributions and guidance during the administration of the 2013 Pennsylvania Youth Survey. Additionally, a great deal of thanks for the leadership of this survey needs to go to the PCCD Resource Center Steering Committee, who provided guidance and oversight to this effort. The administration of the survey would not have been a success without the contributions of the PAYS Advisory Group (PAYSAG), whose tireless efforts and ideas helped make this year’s PAYS the most widely administered survey since Pennsylvania has been administering the tool. The 2013 PAYSAG members included: Kelly Brown, Family Services of Montgomery County Geoff Kolchin, PCCD – OJJDP Alicia Chico, Allegheny County IU Phyllis Law, EPISCenter Michelle Denk, PACDAA Joe Loccisano, PDE Office of Safe Schools Shaye Erhard, DPW – OMHSAS Ken Martz, DDAP Mark Feinberg, PSU Prevention Research Center Sharron Michels, Adams County CTC Staci Fehr, PCCD – ORESPD Andrea Niedererr, Communities In Schools Beth Gardner, PLCB Michelle Nutter, Center for Safe Schools Donna Gority, Fmr.
    [Show full text]
  • Use of Conventional and Novel Smokeless Tobacco Products Among US Adolescents
    Use of Conventional and Novel Smokeless Tobacco Products Among US Adolescents WHAT’S KNOWN ON THIS SUBJECT: Despite declines in cigarette smoking, smokeless tobacco use among youth has remained AUTHORS: Israel T. Agaku, DMD, MPH,a Olalekan A. Ayo- a,b unchanged in the United States. Modified or novel smokeless Yusuf, BDS, MPH, PhD, Constantine I. Vardavas, MD, MPH, PhD,a Hillel R. Alpert, ScM, ScD,a and Gregory N. Connolly, tobacco products are being increasingly promoted to youth in the DMD, MPHa United States as an alternative to smoking. aCenter for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, WHAT THIS STUDY ADDS: Among US students in grades 6 through Massachusetts; and bDepartment of Community Dentistry, 12, 5.0% used snuff or chewing or dipping tobacco, whereas 2.2% University of Pretoria, Pretoria, South Africa used snus or dissolvable tobacco products. Approximately two- KEY WORDS thirds of smokeless tobacco users concurrently smoked smokeless, adolescents, smoking, tobacco, cigarette, harm combustible tobacco; risk perception of all tobacco products was reduction, addiction protective of smokeless tobacco use. ABBREVIATIONS aOR—adjusted odds ratio CI—confidence interval Dr Agaku conceptualized and designed the study, carried out the initial analyses, and drafted the initial manuscript; Dr Ayo-Yusuf participated in analysis and critically reviewed and revised the abstract manuscript; Drs Vardavas, Alpert, and Connolly critically OBJECTIVES: To assess the prevalence and correlates of use of con- reviewed and revised the manuscript; and all authors approved the final manuscript as submitted. ventional and novel smokeless tobacco products among a national Dr Agaku initiated the reported research while affiliated with sample of US middle and high school students.
    [Show full text]
  • Blunt Wrap Presentation
    Blunt Wrap Presentation Dallas City Council Public Safety Committee Meeting August 2, 2010 Cigar Association of America Craig Williamson Robert Peeler What are "blunt wraps" used for? "Blunt wraps are primarily intended for use with marijuana or cannabis." "Blunt wraps constitute drug paraphernalia." SOURCE: US Customs and Border Protection Agency ruling, November 26, 2008 "Blunt wraps are heavily marketed to the youth and often used as drug paraphernalia." Source: City of Boston Public Health Commission Ordinance, adopted December 11, 2008 "According to focus groups with teens, blunts remain the most popular form for smoking cannabis." Source: National Institute on Drug Abuse, Community Epidemiology Work Group Report, "Epidemiological Trends in Drug Abuse " "While blunts generally contain more marijuana than a regular joint, they look like a regular cigar." Tobacco Technical Assistance Consortium ‐ Tobacco 101/Tobacco Products, See www.ttac.org "Blunts may be laced with other substances including PCP and crack cocaine." Source: National Institute on Drug Abuse, Community Epidemiology Work Group Report, "Epidemiological Trends in Drug Abuse" 2 “It is quite evident from the vast number references on the Internet that blunt wraps are sold and bought for use with marijuana or cannabis.” SOURCE: US Customs and Border Protection Agency ruling, November 26, 2008 A cursory search of the internet will return thousands of results relating blunt wraps to illegal drug use. For example, the website grasscity.com shows the following guide on how to roll your own marijuana blunt using blunt wraps: 3 Blunt Wraps Are Marketed With Obvious Drug References 4 Blunt Wraps Are Now Being Marketed as “Cigar Wraps” In An Attempt to Legitimize the Product ‐A Distinction Without a Difference‐ Changing the label on package from “blunt wrap” to “cigar wrap” does not change the fact that the product inside the package is the same product that U.S.
    [Show full text]