Association between Herpes Simplex Virus Type 1 and Type 2 with Prevalent Diabetes Mellitus Among the US Adults: Findings from the National Health and Nutrition Examination Survey, 2007-2016

Background:Infectious diseases are associated with an increase in the risk of developing insulin resistance and subsequent diabetes mellitus due to a possible role of chronic inflammation. While this relationship is well established for viral infections like hepatitis C or hepatitis B, little is known about the association of herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) with diabetes mellitus. Methods: We conducted a cross-sectional study using the data from the 2007-2016 cycle of the National Health and Nutrition Examination Survey. Participants from the age group of 18-49 years with valid diabetes mellitus and HSV-1 and HSV-2 results and who completed the interview and examination were eligible for the analysis. HSV-1 and HSV-2 were defined by type specific enzymatic immunodot assay as positive or negative. Diabetes status was defined by glycohemoglobin level (HbA1c) as euglycemic (≤5.6%), prediabetes (5.7-6.4%), and diabetes (≥6.5%); participants who self-reported being diabetic were considered as having diabetes regardless of their HBA1c levels. We conducted logistic regression analysis to estimate the crude and adjusted odds ratio and 95% confidence interval of diabetes mellitus comparing participants with positive HSV-1 and HSV-2 to those with negative HSV-1 and HSV-2. Results: The prevalence of HSV-1 among participants with diabetes was 67.2% (95% CI 62.3,72.0), and the prevalence of HSV-2 among participants with diabetes was 26.9% (95% CI 23.2,30.7). The prevalence of diabetes among participants with HSV-1 infection was 5.7% (95% CI 5.1,6.3), and the prevalence of diabetes among HSV-2 infection was 7.9% (95% CI 6.8,8.9). After adjusting for confounding factors, the odds of diabetes versus euglycemia among participants with HSV-1 was 1.05 (95% CI 0.9,1.2), and odds of diabetes versus euglycemia among participants with HSV 2 was 1.1 (95% CI 0.9,1.2). Conclusion: After controlling for potential confounders, HSV-1 and HSV-2 infections are not associated with diabetes mellitus in the US population aged 18-49 years, 2007-201

Exploration Of Tobacco Use Behaviors Amid Societal Or Policy Changes And Rise Of E-cigarettes In US

This three-paper dissertation contributes to the broader understanding of the complex tobacco use behaviors such as exclusive and dual use of cigarettes and e-cigarettes, the transitions between them and the factors associated, in consideration of the COVID-19 pandemic, cannabis legalization policies as well as concurrent use of cigarettes and e-cigarettes in the initial weeks following initiation of e-cigarettes by adults who smoke cigarettes. The first paper examines the quantitative survey data from a national probability online sample of 1460 US adults, and qualitative data from an online focus group study of 61 adults from Atlanta, GA, US. The study found significant differences in tobacco purchasing behaviors between exclusive and dual users of cigarettes and e-cigarettes as well as identified risk perceptions, prices of tobacco products and access to tobacco product as factors driving the changes in tobacco purchasing behaviors during COVID-19 pandemic. With the rapidly changing cannabis policies in the US, the second paper reports the findings from a systematic review to understand the impact of such policies on the tobacco use of adolescents and young adults. The findings suggest a lower likelihood of cigarette use in states with cannabis legalization as compared to states with no cannabis legalization. The review also highlights the limitations in the existing literature potentially responsible for continued uncertainty in the association. Overall, this paper may inform state, local, and federal policymakers, the relationship between state cannabis legalization and tobacco use among adolescents and young adults in the US and guides future research to develop robust findings. The third paper examines the transitions between cigarette and e-cigarette use behaviors over three months, among adult smokers following their past-month initiation or re-initiation of e-cigarettes. The study found a higher likelihood of continuing the same behavior for exclusive users as compared to dual users. Dual users were more likely to transition towards the exclusive use of the tobacco product they predominantly used than to remain stable. The findings from this paper informs policymakers, researchers ad physicians the importance of early interventions for smoking cessation specifically during the experimentation period of e-cigarette use for adult smokers

Examining longitudinal associations between initial perceptions and experiences with electronic nicotine delivery system (ENDS) use and use patterns among adults who smoke and recently initiated ENDS

IntroductionLimited data exist on factors associated with concurrent use patterns of electronic nicotine delivery systems (ENDS) and cigarettes. We examined longitudinally perceptions and experiences with ENDS in relationship to concurrent use patterns among established, recent smokers who recently initiated ENDS.MethodsParticipant recruitment took place using paid digital advertisements on social media. Between December 2020 and October 2021, 303 adults aged ≥21 years from across the US who currently or recently smoked and had initiated ENDS use within the past 30 days or reinitiated ENDS use after more than one year of non-use were surveyed. Multinomial logistic regressions were conducted to analyze association between the outcome of current use pattern at follow-up at 1 month [rejectors (discontinued ENDS, continued smoking), primary smokers (concurrent users, mostly smoke), dual user (similar smoking and ENDS use), primary vapers (concurrent users, mostly vape), and switchers (discontinued smoking, continued using ENDS) or quitters (discontinued both smoking and ENDS] and perceptions of and experiences with ENDS predictors at baseline.ResultsAt follow-up at 1 to 2 months after initiating ENDS, 20% were rejectors, 31% were primary smokers, 13% were dual users, 19% were primary vapers, and 17% were switchers/quitters. Perceiving ENDS as less harmful than smoking or being uncertain and as equally or more enjoyable smoking, experiencing a lot or complete reduction in cravings to smoking and in irritability with ENDS use, liking the taste of ENDS, and being satisfied with vaping were associated with higher odds of quitting smoking compared to rejecting ENDS or mostly smoking at follow-up at 1 month.ConclusionsFindings highlight the importance of initial ENDS perceptions and experiences when examining tobacco outcomes and potentially for developing policies and interventions targeting smoking cessation. ENDS initiators are differentiating into distinct use patterns based on these factors within a short period of time

IQOS Direct Marketing

IQOS direct marketing items (email and mail) were collected between September 2019 and July 2021 in Atlanta, Georgia and coded for content-related themes.https://scholarworks.gsu.edu/sph_datasets/1003/thumbnail.jp