Results Many of these packaging design elements, including package size and package style, primary and secondary hue, color saturation, use of variant label names, and use of iconography have systematically varied in response to regulatory changes in Canada. For example, we observed increases in the use of flip-top (vs slide and shell) packaging, the use of yellow, black and white as the focal color, incidence of color-themed variant names, and the use of female and crest-related logos. Conclusions The evidence suggests that many packaging design elements have varied systematically along with regulatory changes in Canada.Introduction Given the relatively limited literature regarding risk factors for progression of alternative tobacco and marijuana use, this study examined initially-used tobacco or marijuana products and psychosocial risk factors such as adverse childhood events (ACEs), mental health (depression, ADHD), and parental substance use, in relation to young adult lifetime and current (past 30-day) tobacco and marijuana use. Methods Using cross-sectional data from a 2014-2016 study of 3418 young adult college students in Georgia, we analyzed lifetime and current use of various tobacco products (cigarettes, cigar products, smokeless tobacco, e-cigarettes, hookah) and marijuana among lifetime tobacco or marijuana users (N=1451) in relation to initially-used product as well as sociodemographic characteristics and psychosocial risk factors. Results Multivariable analyses indicated that more products ever used correlated with cigarettes being first used (vs cigars, B=-0.66; e-cigarettes, OR=-1.33; hookah, B=-0.99; and marijuana, B=-1.05; p less then 0.001), as well as being older (B=0.06), male (B=-0.72) and White (vs Black, B=-0.30; or Asian, B=-0.60), more adverse childhood events (ACEs, B=0.07), and parental marijuana use (B=0.47; p less then 0.05). Currently-used products correlated with cigarettes being first used (vs cigars, B=-0.18; e-cigarettes, B=-0.37; and hookah, B=-0.18; p less then 0.05), being younger (B=-0.04), male (B=-0.15), more depressive symptoms (B=0.01), and parental marijuana use (B=0.40; p less then 0.05). Selleck BAY-805 Current cigarette, smokeless tobacco, hookah and marijuana use demonstrated specificity to initially-used products. Conclusions Initially-used products, specifically cigarettes, with well-documented and communicated risks, correlated with using more products subsequently among young adults, underscoring needed research on such risks and risk communication, and early intervention strategies.Introduction Smokeless tobacco (SLT) jeopardizes periodontal health and also produces an imbalance between reactive oxygen species (ROS) and antioxidants (AO) such as glutathione. Glutathione is an important redox regulator in saliva and its maintenance is essential for periodontal health. Periodontitis patients have a reduced total AO capacity in whole saliva, and periodontal therapy restores the redox balance. Hence, the purpose of this study was to investigate the effects of smokeless tobacco use on saliva glutathione levels in patients with chronic periodontitis and to evaluate these effects after non-surgical periodontal therapy. Methods The study included 100 subjects in four groups; healthy, gingivitis, and chronic periodontitis (CP) patients with and without SLT use. Saliva samples were collected, and clinical periodontal parameters were recorded at baseline and at one month after non-surgical periodontal therapy. Glutathione levels were analyzed using spectrophotometry at 412 nm. Statistical analysis was carried out using paired t-test, chi-squared, and analysis of variance (ANOVA). Results Mean glutathione values in saliva were found to be lower in periodontitis patients compared to SLT users at baseline and at 1 month post non-surgical periodontal therapy (p less then 0.001) In addition, non-surgical therapy leads to a highly significant improvement in the glutathione levels in gingivitis, in the CP with and without ST groups (p less then 0.001). Conclusions Successful non-surgical periodontal therapy leads to considerable progress in the redox balance, thus regulating glutathione levels and reducing the effects of SLT on the periodontium. This emphasises the importance of non-surgical therapy, especially among SLT users.Introduction Topiramate is an antiepileptic drug that has been used for many labeled and off-labeled indications. It may be useful in reducing withdrawal symptoms of various addictive agents such as alcohol, cocaine, cannabis and smoking. To date, some studies have examined the effectiveness of topiramate for smoking cessation. The present review aims to synthesize the results from those studies and determine topiramate effectiveness in smoking cessation. Methods A comprehensive search was conducted in the databases PubMed/Medline, Cochrane, Egyptian Knowledge Bank, and Google Scholar. All clinical trials that examined the effect of topiramate, compared with the placebo, on smoking cessation rate were included. Statistical analysis using fixed effect models, heterogeneity and sensitivity analysis were conducted using RevMan 5.3. Results Five trials met the inclusion criteria and were included in the meta-analysis. Topiramate non-significantly increased prolonged smoking abstinence rate (OR=1.19, 95% CI 0.57-2.5) compared with the placebo. On the other hand, topiramate significantly increased the abstinence rate at weeks 4, 6, 8 and 12 (OR=3.07, 95% CI 1.19-7.93; OR=4.03, 95% CI 1.98-8.2; OR=2.29, 95% CI 1.23-4.28; and OR=2.45, 95% CI 1.37-4.39; respectively) compared with the placebo. Conclusions Based on the five trials, where publication bias cannot be excluded, the current evidence is not sufficient to show a significant difference to favor topiramate in prolonged smoking cessation over the placebo, although the 12th week point prevalence favored topiramate.Introduction Approximately 3.1 million people use tobacco in Nigeria contributing to the burden of tobacco-related morbidity and mortality. However, many tobacco users who have tried to quit have been unable to do so at the first try, but may succeed or give up after multiple attempts. The transtheoretical model helps by classifying those with quit intentions into preparation, contemplation and precontemplation stages. These assist in the development of targeted interventions towards smokers in each stage for more effective results. There is limited evidence about cessation and quitting behaviour in the Nigerian context. This study aimed to explore the factors related to the intention to quit among current tobacco smokers in Nigeria using the transtheoretical model. Methods The study was a secondary data analysis of the Nigeria 2012 Global Adult Tobacco Survey (GATS). The survey included non-institutionalized men and women aged ≥15 years. Data were analysed using SPSS version 21. The primary outcome variable was smoking quit intention.