Fall health and well-being protocols

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Biomedical and Health Sciences

Rutgers has received $2.6 million to evaluate cigarette relighting – the practice of smoking a cigarette, extinguishing it, and lighting it again to smoke – and the consequences these behaviors have on health and efforts to quit smoking.

The four-year study, which will be done at the Center for Tobacco Studies at Rutgers and funded through the National Cancer Institute (NCI), will examine a variety of factors in over 6,000 adults ages 21 and older throughout the United States. 

“We have very little evidence as to how common relighting is, why people might relight their cigarettes, what exposure and toxins people who relight their cigarettes might be experiencing, and how relighting cigarettes might affect their success in trying to quit smoking. The study is about exploring all of those aspects,” said Michael Steinberg, professor and chief of general internal medicine at Rutgers Robert Wood Johnson Medical School and medical director of the Center for Tobacco Studies at Rutgers Biomedical and Health Sciences.

Steinberg said the Rutgers Tobacco Dependence Program, part of the Center for Tobacco Studies, has been providing treatment to nearly 10,000 tobacco users in New Jersey and beyond since 2000, and noticed that a significant number of smokers, nearly half of their patients, were relighting their cigarettes.

Carolyn Heckman, associate professor of medicine at Rutgers Robert Wood Johnson Medical School and co-leader of the Cancer Prevention and Control Program at Rutgers Cancer Institute of New Jersey, said the study may help medical professionals determine whether current national surveys and treatment protocols underestimate the exposure patients are experiencing because they aren’t asking the right questions.

“We will be surveying patients about their relighting behavior, their attempts to quit, and what medications they are using, because we think relighting may be associated with difficulty in quitting,” said Heckman.

There are three phases of the study, according to researchers. The first will include a national survey of smokers that will investigate relighting behavior, determine how common a habit relighting is, and what demographic and other factors may play a role in the behavior. The second phase will look at biological factors, such as levels of toxins found in relit cigarette smoke and the topography of smoking. Topography of smoking is the way in which people smoke cigarettes and includes measurements such as the number of puffs per cigarette, how deeply people inhale, and how many sessions it takes to smoke a single cigarette. This will be examined through a lab study involving participants at the University of Minnesota conducted by Irina StepanovMayo professor of public health in the division of environmental health sciences and director of the Institute for Global Cancer Prevention Research, Masonic Cancer Center, at the University of Minnesota. The third phase of the study will collect information about how the behavior may impact types of treatment in smokers who relight and how it affects the success of patients who are trying to quit smoking. 

Based on the outcome, researchers say, they may propose that national surveys be based more around how many smoking sessions do smokers have per day.

“We dose our medications based on how many cigarettes are smoked a day and use that as a marker of how dependent people are. If it turns out that we are getting an underestimation of how dependent someone might be, we might be under dosing their treatment and that might make it more difficult for people to quit smoking,” Steinberg said.

The team of researchers in this study will look to determine if income, education, employment status, or other factors make a smoker more likely to engage in relighting behavior. Researchers will also examine what the health implications of relighting are, how the behavior may play a role in a smoker’s treatment protocol, and how it may affect a person’s ability to quit smoking.

The Center for Tobacco Studies has been in existence for nearly two decades. The center evaluates tobacco control initiatives and strategies at the local, state, and national levels, conducts tobacco monitoring and surveillance, engages in research to improve tobacco monitoring and surveillance, and translates and disseminates research findings to practitioners and policymakers.