Evidence map›Paper›PMID 34763300›Full record

ArticleAddictive behaviors2022

Internalizing problems are associated with initiation and past 30-Day use of flavored tobacco products.

Ollie Ganz, Amy M Cohn, Renee D Goodwin, Daniel P Giovenco, Olivia A Wackowski, Eugene M Talbot, Cristine D Delnevo

Open access · greenAbstract read
In one paragraph

Article in Addictive behaviors, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. From Menthol Cigarettes to Flavored Hookah: The Urgent Need for Stronger Policies.Iranian journal of psychiatry and behavioral sciences · 2025
    Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Ollie GanzRutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, 683 Hoes Lane W, Piscataway, NJ 08854, USA. Electronic address: ollie.ganz@rutgers.edu.
Amy M CohnHealth Promotion Research Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite400, Oklahoma City, OK 73104, USA; Department of Pediatrics, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, OK, 73104, USA.
Renee D GoodwinDepartment of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, 55 W 125th Street, New York, NY 10027, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA.
Daniel P GiovencoDepartment of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA.
Olivia A WackowskiRutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, 683 Hoes Lane W, Piscataway, NJ 08854, USA.
Eugene M TalbotRutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA.
Cristine D DelnevoRutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, 303 George Street Suite 500, New Brunswick, NJ 08901, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, 683 Hoes Lane W, Piscataway, NJ 08854, USA.
Rutgers, The State University of New Jersey · USCity University of New York · USColumbia University · USUniversity of Oklahoma Health Sciences Center · US

Funding

Tissue Pathology Shared ResourceP30CA225520 · NCI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI ROBERT S. MANNEL · 2018 to 2026
$27.1M
Tobacco Industry Marketing CoreU54CA229973 · NCI · UNIVERSITY OF PENNSYLVANIA · PI STRASSER, ANDREW A · 2018 to 2022
$18.8M
Geographic variation in the diverse tobacco retail environment and its impact on tobacco use disparitiesDP5OD023064 · OD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GIOVENCO, DANIEL PHILIP · 2016 to 2020
$2.0M
NCI NIH HHS P30 CA225520NCI NIH HHS U54 CA229973NIH HHS DP5 OD023064
6 · The paper itself

Abstract

objectiveTobacco use remains disproportionately common among adults with internalizing problems. The rising prevalence of flavored tobacco use among this population may be a contributing factor. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study examined differences across adult ever tobacco users by severity of internalizing problems, in initiation of tobacco use with a flavored product and past 30-day (current) flavored tobacco use (n = 27,425). Severity of internalizing problems was measured using the Global Appraisal of Individual Needs-Short Screener Internalizing Disorder Screener. Tobacco use variables included initiation with or current use of a flavored product, assessed separately for each product. Weighted chi-square tests and multivariable modified Poisson regression models were used to examine the associations between severity of internalizing problems and each outcome.

resultsControlling for covariates, ever users with severe internalizing problems were more likely to have initiated with flavors for cigarettes (adjusted prevalence ratio [aPR]: 1.16, 95% confidence interval [CI]: 1.09,1.24), cigarillos (aPR: 1.09, 95% CI: 1.03, 1.16), electronic nicotine products (aPR: 1.08, 95% CI: 1.03, 1.13) and smokeless tobacco (aPR: 1.15, 95% CI: 1.04, 1.27), relative to those with low internalizing problems. Ever users with severe internalizing problems were more likely to currently use a flavored tobacco product for cigarettes (aPR: 1.15, 95% CI: 1.07, 1.24) and cigarillos (aPR: 1.15, 95% CI: 1.04, 1.28).

conclusionsFlavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.

Indexed as

Electronic Nicotine Delivery SystemsTobacco ProductsTobacco, SmokelessAdultFlavoring AgentsHumansTobacco UseFlavoring AgentsCurrent tobacco useFlavored tobaccoInternalizing problemsMental healthMentholTobacco use initiation

Identifiers

PMID34763300
PMCPMC8637941
OpenAlexW3211004547

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.