Kenneth Warner

• University of Michigan

Adult survival among non-Hispanic Whites (“Whites”) in the United States (US) has stagnated in recent decades, particularly among Whites with lower levels of education. We examined national mortality and population data to quantify the impact of smoking-attributable diseases, opioids, and other causes on survival between ages 30 and 79 from 1989 to...

Since the last edition of the Handbook of Food and Addiction, published in 2012, research on this topic has progressed in many ways. Evidence is growing that certain foods, particularly highly processed foods with high levels of refined carbohydrates and/or added fats, can trigger addictive processes. Ultra-processed versions of these products may...

Objective This study updates a previous paper that examined trends in the sale of cigarettes and heated tobacco products (HTPs) in Japan between 2011 and part way through 2019. The current study includes complete unit sales data through 2023. Methods Data on cigarette and HTP sales were obtained from public sources available from the websites and...

Introduction Little is known about how quitting and switching to other tobacco products affects cigarette smoking relapse. Additionally, there is no consensus on the best definition of relapse. Aims and Methods Respondents who smoked cigarettes at baseline, had quit by the first follow-up, and completed the second follow-up survey in the Populatio...

Introdution Studies have reported that the rapid rise in heated tobacco product (HTP) sales in Japan accompanied an accelerated decline in cigarette sales. However, these studies do not distinguish whether those who previously smoked cigarettes became dual users with HTPs (smoking fewer cigarettes) or instead switched completely to HTPs. If HTPs pr...

Introduction Oral nicotine pouches (ONPs) are a new class of nicotine products. This scoping review summarizes evidence on ONPs and explores their potential public health impact. Aims and Methods We conducted a structured literature search for empirical studies across three electronic databases through January 10, 2024. Outcomes included ONP produ...

Importance President Biden recently prioritized the fight against smoking as key to reducing cancer mortality. Objective To assess trends in smoking and illuminate the association between smoking and reducing deaths due to cancer. Design, Setting, and Participants This cross-sectional study used responses to National Health Interview Surveys from...

Introduction The popularity of cannabis vaping has increased rapidly, especially among adolescents and young adults. We posit some possible explanations and, to evaluate them, examine whether cannabis vapers differ from non-vaping cannabis users in other substance use. Methods Using nationally representative data from the Population Assessment of...

Background Tracking the US smoking cessation rate over time is of great interest to tobacco control researchers and policymakers since smoking cessation behaviors have a major effect on the public’s health. Recent studies have employed dynamic models to estimate the US cessation rate through observed smoking prevalence. However, none of those studi...

Philip Morris International’s recent purchase of Swedish Match may prove to be a vital tobacco industry development. We focus on PMIs potential progress in moving from primarily selling cigarettes toward primarily selling noncombustible nicotine delivery products (NCNDPs). We also consider the potential contribution of the acquisition to industry t...

Objective Tracking the US smoking cessation rate over time is of great interest to tobacco control researchers and policymakers since smoking cessation behaviors have a major effect on the public’s health. A couple of recent studies have employed dynamic models to estimate the US cessation rate through observed smoking prevalence. However, none of...

Purpose: The current study assessed the association between cannabis use among youth never e-cigarette users and subsequent e-cigarette use. Methods: The Population Assessment of Tobacco and Health Study is a nationally representative cohort study. Participants aged 12 years and older were selected using a 4-stage, stratified probability sample...

Background: Electronic nicotine delivery systems (ENDS) come in numerous flavors and may aid smoking cessation. This systematic review examines evidence on the role of ENDS flavors in smoking cessation. Methods: We searched EMBASE OVID, PsychInfo, and Medline databases for studies that: 1) examined cigarette cessation outcomes for persons using...

Importance: Many studies have reported a positive association of youth electronic cigarette (e-cigarette) use with subsequent cigarette smoking initiation, but it remains unclear whether e-cigarette use is associated with continued cigarette smoking after initiation. Objective: To assess the association of youth baseline e-cigarette use with the...

There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids.

Objective To synthesize the outcomes of policy evaluations of flavoured electronic nicotine delivery systems (ENDS) restrictions. Data sources PubMed, Scopus, Embase and Web of Science before May 3, 2022. Study selection Studies that report sales, behaviour, or compliance outcomes related to implemented or hypothetical ENDS flavour restrictions....

Growth in the market for electronic cigarettes (e-cigarettes) raises complex questions about the devices' public health implications and, hence, challenging policy issues. We propose a policy agenda addressing concerns about preventing youth uptake of e-cigarettes and the desire to realize the potential of e-cigarettes to increase adult cigarette s...

E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. T...

Importance: Electronic cigarette (e-cigarette) use has been reported to increase the likelihood of future cigarette smoking among adolescents. The prospective association between e-cigarette use and cannabis use has been less clear, especially in recent years. Objective: To examine the association between e-cigarette use among cannabis-naive ado...

Introduction We calculate the U.S. adult smoking cessation rate for 2014-2019, compare it to the historical trend, and estimate the implication for future smoking prevalence. Methods We repeated an earlier analysis, which examined the cessation rate from 1990-2014, extending the period to 2019. Employing National Health Interview Survey (NHIS) and...

Background Tobacco couponing continues to be part of contemporary tobacco marketing in the US. We performed a systematic review of the evidence of tobacco product coupon receipt and redemption to inform regulation. Methods We searched EMBASE OVID and Medline databases for observational (cross-sectional and longitudinal) studies that examined the p...

This cross-sectional study examines the prevalence and frequency of cannabis vaping, which is distinct from nicotine vaping, among young people aged 12 to 24 years.

Aims: To investigate whether e-cigarette and cigarette susceptibility predict e-cigarette and cigarette use among American youth 1 year later. Design and Setting Longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study - a four-stage, stratified probability cohort study of youth (12-17 years old) sampled from the U.S. ci...

Introduction Prospective studies have consistently reported a strong association between e-cigarette use and subsequent cigarette smoking, but many failed to adjust for important risk factors. Methods Using longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, we employed multivariable logistic regressions to assess...

The US Centers for Disease Control and Prevention (CDC) closely monitors tobacco use trends among US adolescents.¹,2 Through the annual National Youth Tobacco Survey (NYTS), the agency examines middle school and high school students’ current (past 30 days) use of multiple tobacco products, including cigarettes, cigars, smokeless tobacco, hookahs, p...

Introduction The US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its im...

Importance With increasing e-cigarette use among US adolescents and decreasing use of other tobacco products, it is unclear how total use of nicotine products, and its long-term health risks, have changed. The Centers for Disease Control and Prevention’s standard measure—any tobacco product use in the past 30 days—considers neither frequency of use...

The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes’ risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public...

Introduction Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios. Metho...

Introduction The US FDA announced its intention to ban menthol in cigarettes. However, information is needed on how a federal ban would affect population health. We conducted an expert elicitation to gauge the impact of a menthol cigarette and cigar ban in the US. Methods We developed and pilot tested a questionnaire that focused on tobacco use tr...

Reliance on 30-day prevalence as the principal means of assessing trends in youth cigarette smoking may understate the magnitude of the decrease in youth smoking, because prevalence does not account for smoking frequency or intensity. We analyzed Youth Risk Behavior Survey (YRBS) data from 1997 through 2017 and estimated cigarette smoking prevalenc...

Introduction: We examine the proportion of U.S. smoking-produced mortality that e-cigarettes might eliminate under assumptions regarding vaping's ability to increase smoking cessation, vaping's health risks, and the possibility that vaping will increase smoking among young people. Methods: We employ a dynamic population simulation model that tra...

Tobacco-related health disparities disproportionately affect smokers with major depression (MD). Although tobacco simulation models have been applied to general populations, to date they have not considered populations with a comorbid mental health condition. We developed and calibrated a simulation model of smoking and MD comorbidity for the US ad...

Objective To determine how much future smoking-related mortality in the USA can be prevented, recognising that some of that future mortality results from past smoking. Methods Employing a dynamic population simulation model, we estimate smoking’s expected mortality burden in the USA, measured as life-years lost (LYL), in a status-quo scenario run...

Background According to the 2014 Surgeon General’s Report (SGR), ‘5.6 million (American) youth currently aged 0–17 years of age will die prematurely of a smoking-related illness.’ Advocates cite this number as evidence that smoking will exact an enormous toll for decades to come. This paper examines whether the projected toll accurately portrays sm...

In countries around the world, tobacco use, excessive alcohol consumption, and consumption of sugar-sweetened beverages (SSBs) are significant contributors to the global epidemic of noncommunicable diseases. As a consequence, they contribute, as well, to excess health care costs and productivity losses. A large and growing body of research document...

Through a combination of governmental and private sector interventions, with an emphasis on policies, tobacco control has dramatically reduced smoking and its burden of preventable premature disease and death. Since publication of the first Surgeon General’s report in 1964, the prevalence of cigarette smoking in the USA has dropped by nearly two-th...

Background The 2018 National Academies of Sciences, Engineering, and Medicine Report found substantial evidence that electronic cigarette use (vaping) by youth is strongly associated with an increased risk of ever using cigarettes (smoking) and moderately associated with progressing to more established smoking. However, the Report also noted that r...

American students' 30-day smoking prevalence has decreased dramatically over the past two decades. The frequency of smoking within the 30-day measure has shifted from heavy smoking (>1/2 pack/day) toward light smoking (<1 to 5 cigarettes/day). 30-day prevalence thus understates the extent of the decline in youth smoking. To capture this shift towar...

Introduction: There is concern that youth e-cigarette use may serve as a gateway to cigarette smoking, and that nicotine exposure may harm brain development. It is therefore important to know how much nonsmoking youth perceive being exposed to nicotine through e-cigarettes. Methods: Data on smoking and vaping from the 2016 Monitoring the Future...

Introduction: The debate over tobacco harm reduction (THR) has divided the tobacco control community into two camps, one expressing serious reservations about THR while the other believes that reduced-risk products like e-cigarettes will disrupt the cigarette market. The often emotional debate would benefit from dispassionate data-based evaluation...

Introduction: The public health community is divided regarding electronic cigarettes. Skeptics emphasize potential vaping-induced increases in smoking among children and possible health hazards for adults. Enthusiasts consider e-cigarettes much less dangerous than smoking and believe they increase adult smoking cessation. We compare potential heal...

On July 28, 2017, US Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, announced a comprehensive regulatory plan to expedite reducing the toll of more than 480 000 annual tobacco-related deaths in the United States.¹ The plan is predicated on recognition that “nicotine—while highly addictive—is delivered through products that repr...

Survey data find Americans' self-reported cigarette smoking prevalence dropping steadily. However, the accuracy of national surveys has been questioned, given declining response rates and increasing stigmatization of smoking. Using data from two repeated cross-sectional nationally-representative health surveys (National Survey on Drug Use and Healt...

New report is a must read for those charged with protecting the public health A new publication, The Economics of Tobacco and Tobacco Control ,1 reminds us that “tobacco use remains the single largest preventable cause of death in the world.” It is a reminder we need to contemplate seriously. Too many people in affluent countries think of tobacco...

Introduction We examine the trajectory of adult smoking prevalence in the US over the period 1990 – 2014 to investigate whether the smoking cessation rate has changed during this period. Methods We employ a dynamic model of smoking prevalence, and data from the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health...

Introduction: People with serious mental illness experience substantially reduced life expectancy, likely due in part to their higher smoking rates relative to the general population. However, the extent to which smoking affects their life expectancy, independent of mental illness, is unknown. This study quantifies the potential contribution of sm...

Introduction: High school students' electronic cigarette (e-cigarette) use rose rapidly in 2014, to levels higher than cigarette smoking, which declined significantly. This study assesses how frequency of e-cigarette use is associated with students' smoking status. Methods: Using Monitoring the Future data in 2015, this study evaluated the assoc...

Objective: To examine decreases over time in cigarette smoking prevalence and intensity among American students in 8th, 10th, and 12th grades. Methods: Data from Monitoring the Future on students' smoking, across four measures of differing intensity of smoking, are compared over time and across grade levels. Data are available since 1975 for 12t...

Cigarette smoking is the leading behavioral cause of preventable, premature death, killing 6 million people annually. This article describes the burden of smoking, explains how epidemiological science unearthed the principal tobacco-related disease connections, and summarizes the causes of tobacco consumption. The article then describes the efforts...

Background and objective: Maternal smoking increases the risk for preterm birth, low birth weight, and sudden infant death syndrome, which are all causes of infant mortality. Our objective was to evaluate if changes in cigarette taxes and prices over time in the United States were associated with a decrease in infant mortality. Methods: We compi...

In the face of a rapidly evolving nicotine-product marketplace, policymakers could consider differentially taxing these products to maximize incentives for tobacco users to switch from the most harmful products to the least harmful ones.

Despite their lethality, cigarettes are subject to little regulation that directly restricts their contents or their legality. This may change in the near future with the Framework Convention on Tobacco Control (FCTC), the world's first global health treaty, now in force, as well as developments in a few individual countries. Cigarettes are subject...

The Family Smoking Prevention and Tobacco Control Act of 2009 gave the Food and Drug Administration (FDA) regulatory authority over cigarettes and smokeless tobacco products and authorised it to assert jurisdiction over other tobacco products. As with other Federal agencies, FDA is required to assess the costs and benefits of its significant regula...

The 1964 Surgeon General's report on smoking and health concluded that "Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action." The adoption of remedial actions over the next half century produced what is arguably the most important public health triumph of that period in the Unite...

January 2014 marks the 50th anniversary of the first surgeon general's report on smoking and health. This seminal document inspired efforts by governments, nongovernmental organizations, and the private sector to reduce the toll of cigarette smoking through reduced initiation and increased cessation. To model reductions in smoking-related mortality...

U.S. smoking prevalence has been declining over the last several decades. During this time, the population has also experienced changes in its demographic composition, as Americans are living longer and becoming increasingly racially and ethnically diverse. Since smoking rates vary across age and race/ethnicity groups, demographics alone could cont...

Objectives: We assessed the impact of tobacco control on adult per capita cigarette consumption in the United States from 1964 to 2011. Methods: We used logit regression to model the diffusion of smoking from 1900 to 2011. We also projected hypothetical cigarette consumption after 1963 in the absence of tobacco control. Model predictors included...

January 11, 2014, marks the 50th anniversary of what is arguably one of the most important documents in the history of public health in America: Smoking and Health. Report of the Advisory Committee to the Surgeon General of the Public Health Service, more commonly known as the first Surgeon General's report on smoking and health.(1) The New York Pu...

Few studies have examined the effects of smoking on nursing home utilization, generally using poor data on smoking status. No previous study has distinguished utilization for recent from long-term quitters. Using the Health and Retirement Study, we assessed nursing home utilization by never-smokers, long-term quitters (quit >3 years), recent quitte...

Since its origins in the 1960s, tobacco control has achieved remarkable success against the scourge of tobacco-produced disease and death. Yet tobacco use, especially cigarette smoking, remains the world's leading cause of preventable premature death and is likely to do so for decades to come. Evidence-based policies seem incapable of substantially...

Background: Research has contributed significantly to tobacco control in high-income nations, but has not yet played a comparable role in low- and middle-income countries (LMIC). In recent years, efforts have been devoted to building research capacity in LMICs. Using publication in Tobacco Control as a proxy for all tobacco control research, we ex...

We compared projections from a dynamic model of US adult smoking prevalence with official estimates of prevalence from the National Health Interview Survey. Ten years after they were made, the model projections closely fit the National Health Interview Survey estimates for 2005 and 2010. We conclude that a verified model of adult smoking prevalence...

Food and Addiction: A Comprehensive Handbook brings scientific order to the issue of food and addiction, spanning multiple disciplines to create the foundation for what is a rapidly advancing field and to highlight needed advances in science and public policy. It assembles leading scientists and policy makers from fields such as nutrition, addictio...

Background The authors develop projections for global smoking prevalence for the years 2020 and 2030 with and without the implementation, starting in 2010, of the WHO's recommended multipronged approach to tobacco control known as the MPOWER policy package. Methods Using data from the WHO's Global InfoBase Database and the WHO's Global Adult Tobacc...

To assess progress in tobacco control policy research and the relevance of research to policy making. Over 100 experts were surveyed about their opinions on the body of research existing in 1992 and 2011 concerning 11 areas of tobacco control policy, the state of policy implementation in both years, the extent to which research has affected policy...

As a fundamental matter of social justice, Americans worry about health disparities experienced by racial/ethnic minorities, the poor, and other minority groups. Typically concerns focus on inequalities in access to high-quality health care and on often large differences in health outcomes. Ironically, with the exception of the tobacco control comm...

We examined the effect of current patterns of smoking rates on future radon-related lung cancer. We combined the model developed by the National Academy of Science's Committee on Health Risks of Exposure to Radon (the BEIR VI committee) for radon risk assessment with a forecasting model of US adult smoking prevalence to estimate proportional declin...

Introduction: Tobacco control policies have contributed to dramatic declines in smoking in the developed nations. However, the circumstances under which these policies altered the smoking landscape have changed and are likely to change further. As well, decreases in smoking prevalence may have "stalled" at current levels. Because today's smokers d...

Because important strides have been made in tobacco control, it is tempting to believe that the battle is largely won and that we should move on to other pressing public health issues. Dr. Steven Schroeder and Kenneth Warner argue that continued attention to tobacco control is warranted.

Over the past half century, tobacco control arguably has been America's greatest public health success story. Antismoking campaign–induced decisions to quit smoking or not to start in the first place have translated into the avoidance of more than 5 million premature smoking-related deaths. On