BACKGROUND: Online health information can influence consumers to make informed decisions. There are conflicting messages online about health concerns on the use of e-cigarettes. We aimed to investigate differences in those messages through Naver and Google's English versions, which are the most representative portal sites in Korea and in the world. METHODS: We reviewed the top 100 web pages related to health effects of e-cigarettes on Naver and Google in May 2018. Two medical doctors sorted the web pages into three groups as positive, negative, and mixed messages for e-cigarettes, as well as two groups based on the relative safety of conventional smoking versus e-cigarettes. RESULTS: There were 10 and 27 positive, 65 and 45 negative, and 25 and 28 mixed messages on Naver and Google, respectively. There were 15 messages on Naver and 53 on Google that considered e-cigarettes safer than conventional cigarettes. The most frequent topics were toxicity (71%) and diseases (22%) on Naver. Google provides topics of health concerns for young people, including gateway effect (47%), diseases (35%), and toxicity (25%). Particularly, harm reduction which was not present on Naver, came up on Google as 24%. CONCLUSIONS: We found that Naver provides more negative messages on e-cigarettes than does Google, which means that Koreans are exposed more to negative information on e-cigarettes than are foreign people who use Google. In future, more open discussions about harm reduction should be conducted to resolve the imbalance in information regarding health effects of e-cigarettes in Korea.
Electronic Cigarettes ; Harm Reduction ; Internet ; Korea ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products

There have been numerous studies on the association between 5-HTTLPR (polymorphisms in the promoter region of the serotonin transporter gene) and anxietyrelated personality traits, with conflicting results. In this study, we administered Korean version of the Temperament and Character Inventory (K-TCI) to a sample of 158 Korean college students and genotyped for the 5-HTTLPR in order to compare the TCI dimensional scores including harm avoidance according to the 5-HTTLPR genotype and sex. We could not find the association between 5-HTTLPR and harm avoidance and other TCI measures. Considering known allele frequencies differences of 5-HTTLPR among different ethnic groups, further cross-cultural studies with a larger sample would be needed.
Temperament ; Serotonin Plasma Membrane Transport Proteins/*genetics ; Personality ; Male ; Humans ; *Harm Reduction ; Genotype ; Female ; Exploratory Behavior ; Adult

One person dies every six seconds from a smoking-related disease and this problem is likely to worsen. While many people try to quit smoking on their own or with using medicinal products, many of them fail. There is an ongoing debate within the public health community about e-cigarettes on whether they have a potential role in smoking cessation, whether their use can reduce harm for individual users, whether the widespread use of these devices has the potential to reduce or increase population-level harm, and how best to regulate e-cigarette use to minimize both individual and population-level harm. Although the long-term effects of e-cigarette use among smokers and non-smokers are not known, nicotine aerosol produced from a solution, rather than from burning tobacco, releases fewer harmful substances than cigarette smoke does. Some experts advocate wider availability and softer regulations regarding e-cigarette use and perceive them as having the potential to help smokers quit or switch to a harm-reducing means of consuming nicotine. Based on scientific evidence on e-cigarettes, this article explores its pros and cons to public health in order to guide practice, policy, and regulation through reviews of debate articles. ‘Quit or die’ is no longer the only option for those who cannot quit. Safer nicotine products offer another way. There is substantial international and independent evidence that these products are safer than cigarettes.
Burns ; Electronic Cigarettes ; Harm Reduction ; Humans ; Nicotine ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Control, Formal ; Tobacco ; Tobacco Products

E-cigarettes, or electronic nicotine delivery systems, are popular among smokers who are looking for a less harmful alternative to conventional tobacco, and the use of e-cigarettes is affected by existing tobacco control policies. E-cigarettes, which are electronic devices designed to allow the user to inhale nicotine as a vapor, are controversial in terms of their harm reduction claims as it can undermine existing tobacco control policies and has the potential to re-normalize smoking behavior. Currently, many of the chemicals used in e-cigarettes have not been comprehensively disclosed, and there is no adequate data on their emissions. Furthermore, the benefits of e-cigarettes have not been adequately shown. To date, a small number of studies have evaluated e-cigarettes as a harm reduction and cessation aid and have found conflicting findings. Meanwhile, e-cigarette or vaping product use associated lung injury has been identified, and an increased use of e-cigarettes in the youth has also been reported recently in the United States. These raise a great social concern around how to regulate e-cigarettes for the protection of public health. A range of current and proposed legislative and regulatory options exists. Some countries have banned e-cigarettes entirely, while others are ready to regulate e-cigarettes as a type of medicine. A lack of consensus on whether e-cigarettes facilitate or threaten existing tobacco control strategies is driving a discussion on how to regulate e-cigarettes in terms of the protection of public health.
Adolescent ; Consensus ; Electronic Cigarettes ; Harm Reduction ; Humans ; Lung Injury ; Nicotine ; Public Health ; Smoke ; Smoking ; Tobacco ; United States

BACKGROUND: As one of harm reduction strategies, tobacco manufacturers have begun to introduce lower-yield cigarettes. Lower-yield cigarettes, so called light cigarettes, have been perceived as less hazardous by some smokers. However, there have been very few studies concerning smoking lower yield products the lead to lower nicotine absorption. We evaluated the association between brand nicotine yield of cigarettes and actual nicotine intake by measuring urinary cotinine. METHODS: Four hundred sixty four male smokers aged 18 or over who participated in health check-ups in a hospital from May to October 2007 filled out a self-administered smoking questionnaire. Urinary cotinine concentration was measured at the time of participation. The subjects were divided into three groups (ultralight [nicotine: 0.05 mg], light [0.1 mg], and regular [> 0.1 mg] group) according to the level of brand nicotine yield of cigarettes which they smoked. RESULTS: The median urinary cotinine concentrations of ultralight (N = 62), light (N = 216), and regular (N = 186) groups were 735.5 ng/mL (interquartile range, 320 to 1,300 ng/mL), 956.0 ng/mL (429 to 1,491 ng/mL), and 1,067.5 ng/mL (615 to 1,613 ng/mL), respectively. There was a signifi cant difference in urinary cotinine between the regular and the other groups (P = 0.015). However, multiple logistic regression analysis to evaluate the risk of being in the highest quartile of urinary cotinine concentration (> or = 1,532 ng/mL) after adjusting for possible confounding variables showed that the odds ratios were 0.84 (95% CI, 0.52 to 1.37) in the light nicotine group and 0.82 (95% CI, 0.38 to1.72) in the ultralight nicotine group compared to the regular nicotine group. CONCLUSION: There was no significant difference in the risk of elevated urinary cotinine concentrations in male adult smokers according to brand nicotine yield of cigarettes groups.
Absorption ; Adult ; Aged ; Androsterone ; Confounding Factors (Epidemiology) ; Cotinine ; Harm Reduction ; Humans ; Light ; Logistic Models ; Male ; Nicotine ; Odds Ratio ; Smoke ; Smoking ; Tobacco ; Tobacco Products

OBJECTIVES: To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.METHODS: Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.RESULTS: Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.CONCLUSIONS: Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Cross-Sectional Studies ; Drug Users ; Harm Reduction ; HIV ; Humans ; Iran ; Methods ; Needles ; Prevalence ; Principal Component Analysis ; Risk-Taking ; Sexual Behavior ; Socioeconomic Factors ; Syringes ; Unsafe Sex

E-cigarettes, heat-not-burn (HNB) tobacco, and other new types of tobacco products are emerging in Korea. These products are particularly popular among smokers who are looking for less harmful means of tobacco consumption, and are highly relevant for existing tobacco control policies. E-cigarettes, which are electronic devices designed to allow the user to inhale nicotine as a vapor, are controversial in terms of their safety and effects on smoking cessation, as a variety of harmful substances have been detected in e-cigarette vapor. Due to policy differences in tobacco harm reduction, the regulations on e-cigarettes differ from country to country, and domestic regulations regulate e-cigarettes in a manner similar to conventional cigarettes. In contrast, HNB tobacco was introduced in Korea in June 2017, and is rapidly expanding in the market, as active marketing campaigns seek to communicate to consumers that HNB tobacco use involves no tar and is less harmful to health. However, the World Health Organization and several professional groups have argued that based on independent studies not supported by tobacco companies, HNB tobacco should be regulated in the same way as conventional cigarettes because there is no evidence that HNB tobacco is less harmful. Clinicians need to expand their understanding of new tobacco products so that they can provide appropriate counseling.
Counseling ; Electronic Cigarettes ; Harm Reduction ; Korea ; Marketing ; Nicotine ; Smoking Cessation ; Social Control, Formal ; Tobacco Products ; Tobacco Use ; Tobacco ; World Health Organization

OBJECTIVES: To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants. METHODS: Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex. RESULTS: Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%. CONCLUSIONS: Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Cross-Sectional Studies ; Drug Users ; Harm Reduction ; HIV ; Humans ; Iran ; Methods ; Needles ; Prevalence ; Principal Component Analysis ; Risk-Taking ; Sexual Behavior* ; Socioeconomic Factors ; Syringes ; Unsafe Sex

Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.
Adolescent ; Body Weight ; Cholesterol ; Coronary Artery Disease ; Financial Management ; Harm Reduction* ; Hope ; Humans ; Hypertension ; Indonesia* ; Informed Consent ; Motivation ; Practice Guidelines as Topic ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Tobacco Use ; Tobacco*