Prenatal Tobacco Exposure, Brain Subcortical Volumes, and Gray-White Matter Contrast
Puga TB, et al. Prenatal Tobacco Exposure, Brain Subcortical Volumes, and Gray-White Matter Contrast. JAMA Netw Open. 2024;7(12):e2451786. doi:10.1001/jamanetworkopen.2024.51786
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828263
“In this cohort study of 11 448 participants, adolescents exposed to maternal tobacco use during pregnancy (MTDP), compared with those unexposed, had smaller caudate nucleus volumes and lower gray-white matter contrast across widespread regions of the frontal, parietal, and temporal lobes—regions that support higher-order cognitive processing.
These findings suggest MTDP exposure had negative associations with childhood brain structures involved with key cognitive functions, which further signifies the need for interventions to prevent MTDP.”
TRC Research Commentary
Brouwer AF, et al. Potential Policy Targets to Reduce Vaping Among Youths. JAMA Netw Open. 2024;7(12):e2451685. doi:10.1001/jamanetworkopen.2024.51685
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828226
“If RCT evidence generalizes, regulations restricting ENDS characteristics to protect youths might reduce smoking cessation among the 14.5% of adults smoking combustible tobacco. Clarifying differential preferences for ENDS characteristics—particularly flavors and device types—by age may help policymakers identify policy targets that align with their goals, whether targeting the maximum number of vaping youths, minimizing the ratio of adults to youths targeted, or meeting another objective.”
Comment: Authors note that ENDS “effectiveness outside research contexts remains contested.” Thus, RCT evidence does not generalize in real-world situations. Still, they suggest ENDS can help adults quit combustible tobacco but seem more concerned about 14% of adults quitting compared to the 20+% initiation of e-cigarette use by youth (common in Asian countries where tobacco company interests have affected health policy). They also ignore the fact that many adults who switch to e-cigarettes are dual users, while conventional (non-ENDS) cessation methods result in limited dual use. Dual use is known to be more hazardous than either combustible or e-cigarette use alone. It is disturbing to see policymakers willing to accept ENDS cessation for adults, which is questionable in real-world situations and leads to dual use while contemplating reducing stronger policies that protect youth from lifelong addiction and disease. Stephen Hamann
