(1) Background: Psychological flexibility, the ability to adapt to changing demands while staying true to personal values, is linked to better health behaviors. However, its relationship with cardiovascular health behaviors, particularly in Filipino populations, remains underexplored. (2) Aim: This study aimed to examine the relationship between psychological flexibility and cardiovascular health behaviors among outpatients in Rizal, Philippines, focusing on BMI, smoking, physical activity, and dietary habits. (3) Methods: A cross-sectional, descriptive-correlational design was used with 100 outpatient participants from selected hospitals. Psychological flexibility was measured using the Acceptance and Action Questionnaire-II (AAQ-II), and cardiovascular health behaviors were assessed using a modified version of the American Heart Association’s Life Simple 7 tool. Descriptive statistics and Pearson’s correlation were applied. (4) Results: The findings showed that respondents had neutral levels of psychological flexibility. While most exhibited intermediate BMI and physical activity, dietary habits varied. A significant positive correlation was found between psychological flexibility and whole grain consumption. However, no significant associations were found with BMI, smoking, or physical activity. (5) Conclusions: Psychological flexibility appears to influence specific health behaviors, such as dietary choices, but does not strongly correlate with other cardiovascular health behaviors. Further research is needed to explore its broader role in cardiovascular disease prevention.

Background: Tobacco control policies nationwide have contributed to a substantial decline in cigarette and tobacco use, with particularly sharp reductions observed in states such as California that have implemented restrictive bans, strong prevention measures, and high excise taxes. While these policies have led to overall decreases in tobacco use, progress has not necessarily been distributed equally across racial groups. Understanding long-term trends by race is critical for addressing equity gaps in tobacco prevention and control. Evidence suggests that some racialized groups may experience slower or delayed declines, raising concerns about equity in public health gains. Methods: We analyzed data from the California Health Interview Survey (CHIS) spanning 2003–2023. Trends in current smoking were examined separately for non-Latino Black and non-Latino White adults. We also assessed current use of flavored tobacco products, given California’s statewide ban enacted in 2021. Changes were evaluated in both absolute terms (percentage point declines) and relative terms (percent reduction from baseline). Results: Smoking prevalence declined from 17.2% in 2003 to 5.2% in 2023 among White adults and from 19.9% to 9.0% among Black adults. This represents a 12.0 percentage point (69.8%) decline for Whites compared with a 10.9 percentage point (54.8%) decline for Blacks. For flavored tobacco use, prevalence decreased from 8.0% to 4.7% among White adults but only from 11.9% to 10.8% among Black adults. This corresponds to a 3.3 percentage point (41.3%) decline for Whites compared with a 1.1 percentage point (9.2%) decline for Blacks. Conclusions: Although both Black and White adults in California experienced reductions in smoking over the past two decades, White adults showed larger declines in both absolute and relative terms. Disparities were even more pronounced for flavored tobacco use, where declines were minimal among Black adults despite the statewide ban. These findings suggest that Black populations in California may have been left behind by tobacco control progress, especially regarding flavored products. Given the history of targeted marketing by the tobacco industry, the role of flavors in increasing dependence, and reduced access to cessation resources in Black communities, targeted policies and culturally tailored interventions are needed to ensure equitable reductions in tobacco use. Greater attention to flavored tobacco in Black communities may help narrow these disparities and advance California’s tobacco endgame goals.

Smoking is a well-documented risk factor of cardiovascular diseases (CVD) and premature death. Previous studies have focused on smoking duration and total cigarette consumption, but a 2024 paper by Li et al. highlights the time between waking up and smoking the first cigarette as a risk factor of mortality, noting that smoking ≤5 minutes after waking is strongly linked to a higher risk of mortality and a higher chance of incident myocardial infarction or stroke, and may be a sign of nicotine dependence. Another study by Hu et al. (2024) states that early-morning smoking more strongly correlates with incident type 2 diabetes than total cigarette consumption, adding to preceding evidence that early-morning smoking is linked to type 2 diabetes and chronic obstructive pulmonary disease (COPD). The demonstrated association with adverse health outcomes and early-morning smoking suggests delayed time to first cigarette can be a useful target as part of smoking interventions. These findings indicate the necessity of public health policies targeting smoking behaviour in addition to cessation as a way to decrease the associated disease burden.

Background: Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward e-cigarettes and influencing use behaviors. However, the relative influence of different social ties—parents, siblings, and friends—on e-cigarette attitudes and use remains unclear. Objective: This study utilizes data from the SMOKES study to compare the influence of e-cigarette use within different social network sections—parents, friends, and siblings—on personal e-cigarette attitudes and use among college and university students. Methods: Using a cross-sectional survey of college and university students, we examined the associations between e-cigarette use within different social networks and individual e-cigarette attitudes and use. Multivariate regression models assessed the strength of these associations, adjusting for key demographic and behavioral covariates. Results: Findings indicate that among college and university students, the strongest influence on both e-cigarette attitudes and use comes from friends who use e-cigarettes. In contrast, parental and sibling e-cigarette use showed weak or non-significant effects. These results suggest that peer influence, rather than family influence, plays a dominant role in shaping e-cigarette-related behaviors and perceptions in young adults. Conclusion: This study underscores the importance of peer influence in e-cigarette uptake and attitudes among college and university students. Public health interventions aimed at reducing e-cigarette use in this population should consider targeting peer networks rather than focusing solely on family-based influences.

Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study aimed to examine whether college students who use tobacco exhibit lower support for tobacco control policies compared to their non-user counterparts. Methods: We conducted a multi-center, cross-sectional study involving 2403 college students from various provinces in Iran. Tobacco use was ascertained based on self-reported consumption of cigarettes, electronic cigarettes, and hookah. Attitudes toward tobacco control policies were evaluated using a structured survey instrument, and comparative analyses were performed to assess differences in policy support between tobacco users and non-users. Results: The analysis revealed that tobacco users demonstrated significantly lower support for tobacco control policies compared to non-users. This association was consistently observed across users of cigarettes, electronic cigarettes, and hookah, suggesting a systematic pattern irrespective of the type of tobacco product used. Conclusion: These findings indicated a clear association between tobacco use and reduced endorsement of tobacco control policies among Iranian college students. These results have potential implications for public health policy, emphasizing the importance of addressing individual tobacco use behaviors in the development and implementation of tobacco control strategies. Further research is needed to elucidate the underlying mechanisms of this relationship.

Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study (Study of Measurement of Knowledge and Examination of Support for tobacco control policies), which is conducted to evaluate tobacco use, tobacco-related knowledge and attitude, as well as support for tobacco control policies among college and university students. Methods: The SMOKES Study was designed to address significant gaps in literature by focusing on college and university students in a non-Western context. A multi-center, cross-sectional design was employed to collect data from a diverse sample of college and university students across different geographical provinces in Iran. The survey instrument incorporated a range of measures covering socio-demographic characteristics, university-related variables, family tobacco use status, personal tobacco consumption behaviors (including detailed assessments of cigarette, hookah, and electronic cigarette use), and attitudinal as well as knowledge-based assessments related to vaping. Support for tobacco control policies is also measured. Data were collected using an online survey that included self-administered questionnaires, enabling access to a large diverse sample. This study may be used to determine the prevalence of ever and current use of cigarettes, electronic cigarettes, and hookah, as well as examining the correlates of single, dual, and poly-tobacco use. The study also aims to assess the role of social determinants, attitudes, and ethnic/geographic differences in shaping these outcomes. Results: The study sample consisted of 2403 college and university students, including undergraduates enrolled in different academic programs from all faculties and disciplines. Participants were drawn from universities across 15 provinces, and 11 ethnic groups, ensuring a heterogeneous sample with respect to socio-demographic background, ethnicity, and institutional affiliation. This diversity enhances the generalizability of the findings and allows for the exploration of subgroup differences in tobacco use patterns and policy support. Conclusions: The SMOKES Study offers a framework for examining tobacco-related knowledge and the acceptability of tobacco control policies among a key part of the population, being college and university students. By providing detailed insights into the prevalence and correlates of tobacco knowledge, attitude, use, as well as the tobacco control policy support, the study lays the groundwork for tailored public health interventions and more effective tobacco regulation strategies particularly for college campuses in a non-Western setting.

Background: While the link between depression and smoking is known, less is known about the relationship between hopelessness and smoking in large national community-based sample of Black people. Aims: This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically diverse nationally representative sample of Black adults. Methods: Data from the NSAL were analyzed. Hopelessness and smoking status were assessed using structured interviews. Logistic regression was employed to assess the link between hopelessness and smoking status, controlling for potential confounders such as demographic factors and socioeconomic indicators as well as depression. Results: 4,939 participants entered our analysis. Hopelessness was significantly associated with higher odds of smoking status. This association remained robust after adjusting for confounders such as demographic factors, socioeconomic status, and depression. Conclusions: Hopelessness may be a critical risk factor for smoking in Black adults. Promoting hope as a component of targeted tobacco cessation programs may help reduce tobacco use of Black populations.

Background: Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. Aims: This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. Methods: Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. Results: Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. Conclusions: Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.