E-cigarette use common, especially among younger adults and those in the LBGTQ community

1. E-cigarette use common, especially among younger adults and those in the LBGTQ community

American heart Association survey looks at self-reported e-cigarette use among U.S. adults

Abstract: http://annals.org/aim/article/doi/10.7326/M17-3440

Editorial: http://annals.org/aim/article/doi/10.7326/M18-2176

URLs go live when the embargo lifts

E-cigarette use is prevalent among U.S. adults, especially among men; lesbian, gay, bisexual, and transgender persons (LGBT); those who are unemployed; and those with chronic disease. E-cigarette use was also more common among those living in the South and West. Findings from a large U.S. survey are published in Annals of Internal Medicine.

As e-cigarette use has risen, the medical community has become concerned about potential adverse health effects. In 2015, the American College of Physicians (ACP) recommended that the U.S. Food and Drug Administration (FDA) provide regulatory oversight of e-cigarettes. Understanding their use patterns could help to inform research efforts, public education campaigns, and tobacco regulatory policy.

Researchers supported by the American Heart Association Tobacco Regulation and Addiction Center used the largest and most extensive dynamic health survey – the 2016 Behavioral Risk Factor Surveillance System (BRFSS) national survey – to determine the most up-to-date national and state-level prevalence of current e-cigarette use among U.S. adults. The researchers also examined the prevalence of e-cigarette use among key demographic subgroups, which included stratification by cigarette smoking status. They found that about 4.5 percent of the U.S. adult population were current e-cigarette users and adults younger than 35 years accounted for more than half of this figure. Their use was especially high among those in the LGBT community and use varied widely by state, with estimates ranging from 3.1 percent in South Dakota to 7 percent in Oklahoma.

Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected] To interview the lead author, Michael j. Blaha, MD, MPH, please contact Helen Jones at [email protected] To speak with someone at the American Heart Association, please contact Cathy Lewis at [email protected]

2. Clinical guidelines may lead to better prescribing practices

Release of CDC guidelines associated with a rapid reduction in risky opioid prescribing practices

Abstract: http://annals.org/aim/article/doi/10.7326/M18-1243

URLs go live when the embargo lifts

The Centers for Disease Control and Prevention's (CDC) Guideline for Prescribing Opioids for Chronic Pain was associated with a decline in opioid prescribing corresponding to the time of the guideline's release. These findings suggest that guidelines may lead to better prescribing practices. The research is published in Annals of Internal Medicine.

Data from patients prescribed opioids indicates a connection between prescribing practices and opioid-related harms. Seeing a need to change clinician behavior, the CDC released its broad-reaching recommendations for opioid prescribing in March 2016. The guideline provided evidence-based recommendations for opioid use in treating chronic pain–excluding cancer treatment, palliative care, and end-of-life care–in patients aged 18 years and older in primary care settings.

Researchers from the CDC and the University of Michigan sought to determine if release of guideline corresponded with a decline in specific opioid prescribing practices. While opioid prescribing in the United States has steadily declined in terms of the overall number of prescriptions written and the frequency of specific risky prescribing practices, the time of the CDC's guideline release was associated with a statistically significantly faster rate of decline in several key opioid prescribing practices. Decreases were observed in the overall rate of opioid prescribing, the rate of high-dosage opioid prescriptions, and the percentage of patients with overlapping benzodiazepine and opioid prescriptions.

Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected] To interview the lead author, Gery P. Guy Jr., PhD, MPH, please contact LaKia Bryant at [email protected] or Courtney Lenard at [email protected]

3. One in seven U.S. adults used marijuana in 2017

Use of multiple forms of marijuana, including edibles and vaping, was more common in states where recreational use is legal

Abstract: http://annals.org/aim/article/doi/10.7326/M18-1681

URLs go live when the embargo lifts

One in seven U.S. adults used marijuana in 2017, with smoking being the most common form of use nationwide. Use of different forms of marijuana, such as edibles and vaping, was more common in states where recreational use is legal. A brief research report is published in Annals of Internal Medicine.

Marijuana is commercially available in increasingly novel forms, such as edibles and concentrates, and with tetrahydrocannabinol (THC) content at levels that have unknown health effects. Despite legalization of recreational marijuana in some states and the development of a multibillion dollar cannabis industry, national data on the prevalence of use of other forms of marijuana are not available. According to the authors, annual epidemiologic data on use of different forms of marijuana will be necessary to inform public policy.

Researchers from the Northern California Institute for Research and Education and the San Francisco VA Medical Center surveyed a nationally representative sample of more than 16,000 U.S. adults aged 18 years or older to assess use of different forms of marijuana (smoked, vaporized, edibles, concentrates, and topicals) in the past year. Overall, 6.7 percent of respondents reported using multiple forms of marijuana in the past year, with persons aged 18 to 34 years using marijuana in any form more frequently than those in other age groups. The prevalence of smoking marijuana was 16 percent in states where recreational use legal, compared with 11.4 percent in states were no use of marijuana is legal.

Media contact: For an embargoed PDF, please contact Lauren Evans at [email protected] To interview the lead author, Stacy Steigerwald, MSSA, please contact her directly at [email protected]

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Also new in this issue:

Medical Education and the Public Service Loan Forgiveness Program: Unnecessary Uncertainties
Justin A. Grischkan, MD; Benjamin P. George, MD, MPH; E. Ray Dorsey, MD, MBA; David A. Asch, MD, MBA

Ideas and Opinions

Abstract: http://annals.org/aim/article/doi/10.7326/M18-1511

The MCAT's Restrictive Effect on the Minority Physician Pipeline: A Legal Perspective
Inginia Genao, MD; Jacob Gelman, JD

Ideas and Opinions

Abstract: http://annals.org/aim/article/doi/10.7326/M18-0545

Disappearance of the National Guideline Clearinghouse: A Huge Loss for Evidence-Based Health Care
Zachary Munn, PhD; Joanna Briggs; Amir Qaseem, MD, PhD, MHA
Ideas and Opinions
Abstract: http://annals.org/aim/article/doi/10.7326/M18-2216

Media Contact

Lauren Evans
[email protected]
215-351-2513
@ACPinternists

http://www.acponline.org

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