Objectives. We sought to promote cervical cancer screening among Vietnamese American women in Santa Clara County, Calif. Methods. In 2001–2004, we recruited and randomized 1005 Vietnamese American women into 2 groups: lay health worker outreach plus media-based education (combined intervention) or media-based education only. Lay health workers met with the combined intervention group twice over 3 to 4 months to promote Papanicolaou (Pap) testing. We used questionnaires to measure changes in awareness, knowledge, and Pap testing. Results. Testing increased among women in both the combined intervention (65.8% to 81.8%; P<.001) and media-only (70.1% to 75.5%; P<.001) groups, but significantly more in the combined intervention group (P=.001). Among women never previously screened, significantly more women in the combined intervention group (46.0%) than in the media-only group (27.1%) obtained tests (P<.001). Significantly more women in the combined intervention group obtained their first Pap test or obtained one after an interval of more than 1 year (became up-to-date; 45.7% to 67.3%, respectively; P<.001) than did those in the media-only group (50.9% to 55.7%, respectively; P=.035). Conclusions. Combined intervention motivated more Vietnamese American women to obtain their first Pap tests and to become up-to-date than did media education alone.

While the impacts of cigarette smoking on human health are widely known, a less recognized impact of tobacco product use and disposal is environmental pollution. This review discusses the current literature related to cigarette and e-cigarette contamination in the context of environmental sources and impacts, with a focus on the documented influences on biota, ranging from bacteria to mammals. Cigarette butts and electronic cigarette components can leach contaminants into soil, water, and air. Cellulose acetate cigarette filters comprising the butts are minimally degradable and are a source of bulk plastic and microplastic pollution, especially in aquatic ecosystems where they tend to accumulate. Cigarette combustion and aerosol production during e-cigarette use result in air contamination from sidestream, exhaled, and thirdhand pathways. The chemical byproducts of tobacco product use contaminate wastewater effluents, landfill leachates, and urban storm drains. The widespread detection of nicotine and cotinine in the environment illustrates the potential for large-scale environmental impacts of tobacco product waste. Studies show that cigarette butt leachate and nicotine are toxic to microbes, plants, benthic organisms, bivalves, zooplankton, fish, and mammals; however, there remain critical knowledge gaps related to the environmental impacts of tobacco product waste on environmental health and ecosystem functioning.

Despite global efforts to monitor, mitigate against, and prevent trash (mismanaged solid waste) pollution, no harmonized trash typology system has been widely adopted worldwide. This impedes the merging of datasets and comparative analyses. We addressed this problem by 1) assessing the state of trash typology and comparability, 2) developing a standardized and harmonized framework of relational tables and tools, and 3) informing practitioners about challenges and potential solutions. We analyzed 68 trash survey lists to assess similarities and differences in classification. We created comprehensive harmonized hierarchical tables and alias tables for item and material classes. On average, the 68 survey lists had 20.8% of item classes in common and 29.9% of material classes in common. Multiple correspondence analysis showed that the 68 surveys were not significantly different regarding organization type, ecosystem focus, or substrate focus. We built the Trash Taxonomy Tool (TTT) web-based application with query features and open access at openanalysis.org/trashtaxonomy. The TTT can be applied to improve, create, and compare trash surveys, and provides practitioners with tools to integrate datasets and maximize comparability. The use of TTT will ultimately facilitate improvements in assessing trends across space and time, identifying targets for mitigation, evaluating the effectiveness of prevention measures, informing policymaking, and holding producers responsible.

Waste from e-cigarette products can contain plastics, nicotine, heavy metals, other chemical toxins, and hazardous lithium-ion batteries.

The heated tobacco product (HTP) IQOS was authorized for sale in the US in 2019. We investigated how young adults with experience using multiple tobacco products reacted to, perceived, and developed interest in IQOS, informing policies that might prevent HTPs from becoming ubiquitous. We used a novel qualitative method in which 33 young adult tobacco users in California (fall 2019) “unboxed” an IQOS device, tobacco sticks, and marketing materials and narrated their impressions and opinions. We conducted content and thematic analyses of participants’ reactions, sensory experiences, and interest. Multiple attributes influenced appeal for participants, including sleek electronic design, novel technology, perceived harmfulness, complexity, and high cost. The “no smoke” claim and heating technology suggested that smoking IQOS was safer than smoking cigarettes. Public health programs should closely monitor HTP marketing and uptake, particularly as “reduced exposure” claims were authorized in July 2020. Evidence-based regulations (e.g., requiring plain packaging for tobacco sticks), actions addressing IQOS’ unique attributes (e.g., regulating device packaging to reduce high-tech appeal), and public education might help to counter the appeal generated by potentially misleading IQOS marketing tactics.

How Thailand’s greater convergence created sustainable funding for emerging health priorities caused by globalization