Vaughan W Rees

Harvard University | Harvard · Harvard School of Public Health

Introduction: Nicotine pouches are a new type of nicotine-containing product that have been marketed in many countries worldwide, generating growing acceptance among consumers. The aim of this study was to assess factors associated with public awareness and use of nicotine pouches among adults in Poland. Methods: A cross-sectional survey was condu...

Meta-analyses have concluded that positive emotions do not reduce appetitive risk behaviors (risky behaviors that fulfill appetitive or craving states, such as smoking and excessive alcohol use). We propose that this conclusion is premature. Drawing on the Appraisal Tendency Framework and related theories of emotion and decision-making, we hypothes...

Objectives: People living in subsidised low-income housing are more likely to smoke and experience secondhand smoke exposure compared to the general population. While tobacco control interventions have yielded substantial population health benefits, people living in subsidised housing experience a greater burden of tobacco-related harms. We synthes...

The objective of the current study was to evaluate the impact of a reduced risk claim about lung cancer, presented in various formats, on smokers’ and non-smokers’ interest in trying Camel Snus and intention to purchase Camel Snus. We varied claim formats by varying advertising messages for Camel Snus in 4 ways (1) text only; (2) bar chart; (3) tex...

Background: Tobacco smoke incursion (TSI) into private residences is a widespread problem in many countries. We sought to assess the prevalence of self-reported TSI and public attitudes about TSI in Israel, a country with a relatively high smoking prevalence and high population density. Methods: We conducted a random digit dial survey among resi...

Background: Compared to single substance use, adolescents' use of multiple substances is associated with more severe dependence, cessation outcomes, and health risks. This study examined correlates of use and co-use of e-cigarettes, combusted tobacco, and cannabis among high school-aged (9th-12th grade, approximately aged 14-18) adolescents. Meth...

Introduction: We compared the design features of popular filtered and non-filtered cigarettes sold in the United States between 1960 and 1990, to assess the relationship between cigarette filter and tobacco weight. Methods: We analyzed data on the design features of six popular filtered and three non-filtered cigarette brands sold in the US incl...

Reddit is a popular hub for discussing vaping. A deeper understanding of the factors that influence this online discourse could inform public health messaging efforts targeting this platform. Using a network analysis framework, we sought to investigate the role of opinion leaders and online communities in facilitating vaping discussions on Reddit....

We assessed vaping behaviors, environments, COVID-19 influences, and barriers and facilitators of existing approaches that address adolescent vaping in Massachusetts middle and high schools. Findings from this study will provide considerations for individual schools or districts as they advance adolescent vaping prevention and treatment efforts. We...

Introduction: Cigarette filter ventilation and light descriptors are associated with lowered perceptions of risk and smoking more cigarettes per day (CPD). This study examined the relationship between usual cigarette ventilation, perception, and CPD. Methods: A crowdsourced sample (N = 995) of individuals who smoke higher-ventilated (=>20% venti...

Introduction: To better understand the inequitable impact of the pandemic by examining associations between stay-at-home orders and indoor smoking in public housing, measured by ambient particulate matter (PM2.5), a marker for secondhand smoke (SHS). Methods: PM2.5 was measured in six public housing buildings in Norfolk, VA from 2018 - 2022. Mul...

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures...

Background Regulation of filter ventilation (FV) has been proposed to reduce misperceptions that ventilation reduces the health risks of smoking. We describe smoking behaviour and exposure after switching to a cigarette brand variant (CBV) with a different FV level. Methods Wave 1 (2013–2014) of the Population Assessment of Tobacco Use and Health...

Introduction Excise taxes have proved to be a powerful mechanism to lower demand for tobacco products. The purpose of this study was to summarize current combusted and e-cigarette excise taxes by state, and assess whether harmonization of combusted cigarette and e-cigarette excise taxes is more likely to occur in states comprehensive tobacco contro...

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in t...

Secondhand smoke (SHS) exposure causes chronic illness and occurs at a higher prevalence in low-income communities than the general public. In 2018, the U.S. Department of Housing and Urban Development (HUD) instituted a smoke-free housing rule for Public Housing Authorities (PHAs) to address persistent health inequities. However, the success of sm...

Introduction Tobacco manufacturers design and marketed products with appealing sensory characteristics to drive product uptake and continued use. We assessed smokers’ and non-smokers’ cognitive, affective, and sensory responses to Camel Snus (CS) and Nicotine gum (NG) to gauge future intentions to use. Method In a single laboratory session, 348 pa...

Background While evidence demonstrates that the industry’s marketing of cigarettes with higher filter ventilation (FV) misleads adults about their health risks, there is no research on the relationships between FV, risk perceptions and smoking trajectories among youth (ages 12–17) and young adults (ages 18–24). Methods Data on FV levels of major U...

Objectives: Whereas smoke-free housing (SFH) has the potential to protect residents from tobacco smoke, evidence suggests that SFH could lead to increased indoor smoking. In this study, we examine how perceptions of a residential smoking ban could be related to non-compliance. Methods: We conducted 8 focus group interviews of low-income housing res...

Introduction: Indonesia has a high smoking prevalence that has not diminished significantly since 1990. Considering this, we aim to summarise the existing national tobacco-related policy mix and explore markers of policy incoherence in tobacco control between 2014 and 2020. Methods: We conducted (1) a review and synthesis of Indonesian tobacco-r...

Background: Police assisted referral (PAR) programs provide people with substance use disorders (SUD) with a non-arrest treatment pathway, yet systemic barriers, including stigma and access to treatment services, may limit engagement. We sought to understand how the dual contextual challenges of COVID-19 and the Black Lives Matter movement have imp...

Background The prevalence of cigarette smoking continues to be a major public health problem In the United Arab Emirates (UAE); the government has recently implemented policies to reduce smoking prevalence. Innovative strategies to support cessation are needed. Community pharmacies are vital venues to extend the reach and effectiveness of smoking c...

Smoking cessation medications (SCMs) are an evidence-based cornerstone of comprehensive tobacco control programs globally. However, the impact of SCMs on population smoking prevalence is controversial, with inconsistencies between randomized controlled trials (RCTs) and population-based observational studies. We estimated SCM impact on permanent ce...

Introduction: Cigarette brand descriptors such as ‘light’ are banned in several countries and often replaced by alternative descriptors that continue to mislead smokers about the relative risk from those brands. The objective of this study was to evaluate perceptions from current brand descriptors when presented independently of cigarette packaging...

Background: Relationships between cigarette filter ventilation levels, biomarkers of exposure (BOE) and potential harm (BOPH), and harm perceptions were examined. Methods: Filter ventilation levels in cigarette brands were merged with Wave 1 (2013-2014) Population Assessment of Tobacco Use and Health study. Data were restricted to smokers who re...

Smoke-free policies have been shown to significantly reduce secondhand smoke (SHS) exposure in private and public places. The objectives of this study were to: (1) to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland; and (2) assess the association of smoke-free rules with self-reported SHS exposure in private h...

Objective: We assessed changes in secondhand smoke (SHS) exposure in workplaces and public venues in Poland over a 9-year period following the adoption of a smoke-free policy in Poland in 2010. Design: Six waves of cross-sectional surveys were carried out between 2009 and 2019. Participants: A nationally representative sample of adult Polish r...

Background Tobacco taxes, as with other ‘sin taxes’, are generally regarded as a highly cost-effective mechanism to reduce consumption but are often considered by policymakers to be regressive, undermining efforts to fully implement them at levels recommended by the WHO due to concerns of fairness. We aim to demonstrate whether there are circumstan...

Importance: The use of electronic cigarettes (e-cigarettes) has rapidly increased among youth and young adults, but knowledge gaps exist on the potential health effects of using recently introduced pod-based e-cigarettes. Objective: To conduct a systematic review of recent peer-reviewed scientific literature on pod-based e-cigarettes. Evidence Re...

Cigarette smoking is one of the leading causes of chronic disease morbidity and mortality across the world. In the U.S., Latinos have a lower prevalence of smoking when compared to other ethnic/racial groups, but when disaggregated there exist significant differences within Latino subgroups (Bandeira et al., 2015). In the scientific literature, lit...

Objectives: The addition of tiny rows of holes in the tipping paper (filter ventilation) of cigarettes allows air to mix with the smoke, which can change risk perceptions. In this study, we examine smokers' knowledge and beliefs about filter ventilation. Methods: Web-based panel surveys conducted in 2016 and 2017 of current adult cigarette smokers...

Objective: The 12-month impact of federally-mandated smoke free housing (SFH) policy adoption (July 2018) was assessed using two markers of ambient secondhand smoke (SHS): airborne nicotine and particulate matter at the 2.5 micrometer threshold (PM2.5). Methods: We measured markers of SHS in Norfolk, VA from December 2017 to December 2018 in six...

Significance The epidemic of deaths attributable to addictive substances, including tobacco, highlights the need to better understand ways in which emotions drive substance craving and consumption. In a test of alternative theories of emotion and decision making, we found that sadness, specifically, rather than negative mood, generally, increased a...

Background: Injection drug use is on the rise in the USA, and skin and soft tissue infections (SSTI) are a common complication, resulting in significant morbidity and mortality. Due to structural barriers to care-seeking, many people who inject drugs avoid formal care and resort to self-care techniques, but little is known about the nature of thes...

Environmental Tobacco Smoke (ETS) is a major, preventable cause of morbidity and mortality, disproportionately impacting vulnerable populations. Policy measures, guided by the WHO’s Framework Convention of Tobacco Control, have focused on the broad adoption of smoke-free laws. While smoke-free policies are effective in reducing ETS exposure, limite...

Objectives. To examine the association between neighborhood socioeconomic status (SES) and alcohol availability before and after deregulation in 2015 of the alcohol market in Ontario, Canada. Methods. We quantified alcohol access by number of alcohol outlets and hours of retail for all 19 964 neighborhoods in Ontario. We used mixed effects regressi...

Background and Aims The availability of alcohol through retail outlets is associated with alcohol‐related harms, but few studies have demonstrated a causal relationship. We investigated the association between alcohol availability and alcohol‐attributable emergency department (ED) visits in the province of Ontario during a period of deregulation of...

Background: The rapid increase in prevalence of e-cigarette (EC) use may lead to widespread exposure to secondhand emissions among nonsmokers, but evidence on the potential cardiovascular health risks is limited. We aimed to investigate effect of short-term secondhand exposure to nicotine from e-cigarette (EC) emissions on cardiac autonomic functi...

Introduction: Earlier cannabis initiation is associated with more severe neuropsychiatric and social consequences. The authors investigated whether mothers' cannabis use is associated with earlier cannabis initiation by their children. Methods: Mother and child data were from the National Longitudinal Survey of Youth 1979 (1980-1998 waves) and C...

Background: Skin and soft tissue infections (SSTIs) are prevalent among people who inject heroin (PWIH). Delays in seeking health care lead to increased costs and potential mortality, yet the barriers to accessing care among PWIHs are poorly understood. Methods: We administered a quantitative survey (N = 145) and conducted qualitative interviews...

Purpose: As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Design: Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Setting: Four low-income housing...

Introduction: Anti-vaping public service announcements (PSAs) are intended to discourage vaping or use of electronic nicotine delivery systems (ENDS). However, vaping portrayals in PSAs may have unintended effects if they increase smoking or vaping urges. This study examined benefits and unintended effects of anti-vaping PSAs with vapor portrayals...

he 2014 Surgeon General's Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public...

Background: Lower rates of smoking cessation are a major reason for the higher prevalence of smoking among socioeconomically disadvantaged adults. Because barriers to quitting are both more numerous and severe, socioeconomically disadvantaged smokers may benefit from more intensive intervention. We sought to determine whether a smoking cessation i...

Introduction: Understanding factors associated with increased use of nicotine replacement therapy (NRT) is critical to implementing cessation interventions for low-income individuals yet the factors associated with NRT use among low-income smokers are poorly understood. Aims: Assess factors associated with NRT use among low-income public housing re...

Objectives The US Food and Drug Administration (FDA) has regulatory authority for modified risk tobacco product advertising claims. To guide future regulatory efforts, we investigated how variations in modified risk claim advertisements influence consumer perceptions of product risk claims for Camel Snus. Methods Young people and adults (15–65), i...

Introduction: Scientific discoveries over the past few decades have provided significant insight into the abuse liability and negative health consequences associated with tobacco and nicotine-containing products. While many of these advances have led to the development of policies and laws that regulate access to and formulations of these products...

Background: Reducing the social acceptability of smoking is associated with lowered smoking prevalence. However, denormalization strategies can also contribute to the stigmatization that some smokers may feel about their smoking. Smoking stigma may be more acute if smokers are also members of other stigmatized groups, such as racial/ethnic minorit...

Background: Injection-site vein loss and skin abscesses impose significant morbidity on people who inject drugs (PWID). The two common forms of street heroin available in the USA include black tar and powder heroin. Little research has investigated these different forms of heroin and their potential implications for health outcomes. Methods: A m...

Introduction: Snus may present lower health risks than cigarettes, but its harm reduction potential may be undermined if used dually with cigarettes. The likelihood of exclusive snus use compared with dual use may depend in part on the capacity of snus to deliver nicotine in doses that are satisfactory to smokers. We examined characteristics of "A...

Objectives: As tobacco use becomes increasingly concentrated in communities of low socio-economic position (SEP), scalable cessation interventions are needed. Head Start programs offer one setting in which a family-focused intervention can be implemented in low SEP communities. We assessed the experiences of Head Start (HS) staff who received trai...

Secondhand smoke exposure (SHS) causes a disproportionate health burden for children, yet existing smoke-free laws are often poorly enforced. We monitored air quality while observing children and adult nonsmokers present in public venues during Ramadan, a period of Muslim religious observance marked by family and social gatherings, in Jakarta, Indo...

Objective: Measures of consumer perceptions of emerging tobacco products are needed for understanding the potential for product adoption and use. The purpose of this research was to evaluate the applicability of the Smokeless Tobacco Expectancies Questionnaire to snus, and examine its association with interest in using snus. Methods: We recruite...

Introduction: The cigarette purchase task (CPT) is a method that can be used to assess the relative value of cigarettes. Based on cigarettes purchased across a price range, five derived metrics (Omax, Pmax, breakpoint, intensity, and elasticity) can assess cigarette demand. A study with adolescent smokers found that these could be reduced to two l...

Implementation of a smoke-free policy presents both an unparalleled opportunity and a duty to help low-income smokers quit and so narrow the gap in smoking rates that contributes to the higher burden of poor health outcomes experienced by this population. As a matter of equity, resources must be made available to help smokers quit. These resources...

Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the...

INTRODUCTION: Attempts to validate the Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM) have produced mixed results. The objectives for the current research were to (1) evaluate the test-retest reliability, internal consistency, and concurrent validity for each of the motive scales (2) evaluate 3 models to determine fit based on prev...

Objective: Evidence-based tobacco regulation requires a comprehensive scientific framework to guide the evaluation of new tobacco products and health-related claims made by product manufacturers. Methods: The Tobacco Product Assessment Consortium (TobPRAC) employed an iterative process involving consortia investigators, consultants, a workshop o...

Background Exposure to the emissions of a tobacco waterpipe is associated with increased health risks among its users as well as those exposed to its secondhand smoke. Waterpipe use is an emerging concern to the tobacco control community, particularly among countries of the Eastern Mediterranean Region. In 2002, Qatar adopted legislation that prohi...

Objectives: We assessed current home smoking behaviors and secondhand smoke (SHS) levels among parents of children in low-income, racial/ethnic minority communities in Massachusetts. Methods: We used a cross-sectional design to assess home smoking rules, smoking status, cigarettes smoked in the home, and barriers and benefits to attaining a smok...

Second-hand smoke is a major cause of preventable disease and death in the Eastern Mediterranean Region. To assess how second-hand smoke impacts air quality, respirable suspended particles (PM2.5) which are emitted during cigarette and waterpipe smoking, were measured inside and outside of 18 smoking and 5 nonsmoking public venues in Gaza city. Med...

Objectives: We compared multiple measures of surveillance of "light" cigarette use, including population use, sales, and design features. Measures were obtained before the 2010 descriptors ban to establish a baseline for future evaluation of the effect of the ban. Methods: We examined light cigarette use, sales, and design using 3 data sets from...

Background The question of whether mentholation of cigarettes enhances tobacco dependence has generated conflicting findings. Potential mediating factors in a putative relationship between menthol use and tobacco dependence may include race and gender. While an association between menthol use and dependence is mixed, research on the role of race so...

Objective: New tobacco control policies have been introduced in Massachusetts which restrict tobacco product sales in pharmacies. The purpose of this investigation was to outline the scope of pharmacy involvement in the tobacco market by assessing the availability and range of tobacco products sold in Massachusetts pharmacies. Methods: Public li...

Introduction: The tobacco industry has developed technologies to reduce the aversive qualities of cigarette smoke, including secondhand smoke (SHS). While these product design changes may lessen concerns about SHS, they may not reduce health risks associated with SHS exposure. Tobacco industry patents were reviewed to understand recent industry st...

Secondhand smoke levels were assessed among a convenience sample of 15 public venues in Amman, Jordan, during Ramadan. PM(2.5) measurements were taken inside each venue pre- and post-'iftar', when daily smoking abstinence can be broken at sundown. Cigarette smoking was observed in all venues post-iftar, and the median PM(2.5) level among the 15 ven...

Smokeless tobacco (SLT) use among white adolescent males has increased in recent years, and prevalence of SLT use among adolescent males exceeds that for smoking in several U.S. states. Recent reports have described the presence of cigarette-related content on social media Web sites popular among youth; however, little has been reported on SLT cont...

Human puffing topography promotes tobacco dependence by ensuring nicotine delivery, but the factors that determine puffing behavior are not well explained by existing models. Chemosensory cues generated by variations in cigarette product design features may serve as conditioned cues to allow the smoker to optimize nicotine delivery by adjusting puf...

Objectives Protection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who number almost 2 million in the USA. Self-reported SHS exposure, SHS mitigation strategies and suggestions for further SHS exposure reduc...

In 2009, RJ Reynolds (RJR) introduced dissolvable tobacco products in three test markets in the USA (figure 1A). ‘Camel Dissolvables,’ which come in the form of orbs, strips and sticks, are made from finely milled tobacco and are intended to dissolve in the mouth without expectoration.1 Figure 1 Dissolvable tobacco products manufactured by RJ Rey...

Several US jurisdictions have adopted policies prohibiting pharmacies from selling tobacco products. Little is known about how pharmacies contribute to total cigarette sales. Pharmacy and total cigarette sales in the USA were tabulated from AC Nielsen and Euromonitor, respectively, for the years 2005-2009. Linear regression was used to characterise...

While cigarette puffing style, measured by smoking topography, is highly variable between individuals, smoking behavior or style tends to vary relatively little within individuals. Recent research has demonstrated that certain situational factors may produce variation in smoking topography, including location of smoking. Smoking topography directly...

Changes in cigarette design to meet mandated fire safety standards may have unintended effects on smoker responses by diminishing the consumer's perceptions of product acceptability, smoking and increasing fire-risk behaviours. To address these concerns, population-level data are needed from a jurisdiction where reduced ignition propensity (RIP) ci...

Since 2004, several jurisdictions have mandated that cigarettes show reduced ignition propensity (RIP) in laboratory testing. RIP cigarettes may limit fires caused by smoldering cigarettes, reducing fire-related deaths and injury. However, some evidence suggests that RIP cigarettes emit more carbon monoxide and polycyclic aromatic hydrocarbons, and...

In a press release dated April 6, 2009, Swedish Match North America announced the launch of a new website promoting its General Snus brand.1 Included with this release was a link to a professionally made video hosted on the YouTube website. Entitled ‘General Snus Is The Less Harmful Alternative. Do You SNUS,’ the video described General Snus flavou...

Electronic cigarettes (e-cigarettes) have gained considerable attention since their introduction into European and American markets in 2006 and 2007, respectively. Research to date has focused on acute exposure,1 2 nicotine delivery1–3 and consumer response,4 yet little information has so far been available on this new and rapidly developing indust...

Cigarette-ignited fires are a leading cause of fire death and injury throughout the world and remain a global public health and safety problem. To reduce this harm, a small number of countries now require cigarettes to have reduced ignition propensity (RIP). It is not known if cigarette manufacturers are voluntarily introducing RIP cigarettes in ot...

Tobacco manufacturers have targeted youth and ethnic/racial minorities with tailored advertising. Less is known about how characteristics of storefront tobacco advertisements, such as location, position, size, and content, are used to appeal to demographic subgroups. The occurrence and characteristics of storefront cigarette advertising were observ...

To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While...

Methods to assess reduced exposure products should include those that aid in determining likely patterns of human use and exposure. Tobacco industry clinical trial methods may provide insight into strategies to assess potential reduced exposure products (PREP) for public health purposes. Internal tobacco industry documents detailing human clinical...

Internal tobacco industry documents and the mainstream literature are reviewed to identify methods and measures for evaluating tobacco consumer response. The review aims to outline areas in which established methods exist, identify gaps in current methods for assessing consumer response, and consider how these methods might be applied to evaluate p...