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Leavens EL, Meier E, Brett EI, Stevens EM, Tackett AP, Villanti AC, Wagener TL. Polytobacco use and risk perceptions among young adults: The potential role of habituation to risk. Addict Behav 2019; 90:278-284. [PMID: 30472536 DOI: 10.1016/j.addbeh.2018.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Polytobacco use and experimentation is common among young adults. Additional research is needed to determine how these patterns of use impact perceptions of tobacco-related harm and risk. The current study examined whether a relationship exists between an increased number of tobacco products used and decreases in perceptions of harmfulness and health risk. METHOD Participants (N = 792) completed a survey assessing current/lifetime tobacco use, perceived absolute harmfulness of tobacco/nicotine products and perceived health risk of smoking. For some analyses, participants were grouped by polytobacco use status. RESULTS Among participants who ever tried a tobacco product, a greater number of products tried was associated with lower perceptions of harm (all p < .05). For e-cigarettes and hookah, nonusers rated tobacco products as more harmful compared to single product, dual, and poly users (all p < .05). Number of products tried predicted perceived harmfulness above and beyond demographic characteristics and polytobacco use status across all products. Similarly, number of products tried predicted perceived health risk above and beyond demographic characteristics and polytobacco use status for both lung cancer and heart disease risk. DISCUSSION Trying a greater number of tobacco products is associated with lower perceived harmfulness of tobacco products. Prospective studies are needed to determine if experimentation with more tobacco products leads to reductions in perceived risk of tobacco use and subsequent sustained use of tobacco.
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Hookah Use among Russian adolescents: Prevalence and correlates. Addict Behav 2019; 90:258-264. [PMID: 30471554 DOI: 10.1016/j.addbeh.2018.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/09/2018] [Accepted: 11/15/2018] [Indexed: 11/23/2022]
Abstract
Hookah use among adolescents is increasing globally. No prior studies in the published literature have examined hookah use among youth in the Russian Federation. We assessed demographic, psychological and behavioral factors associated with lifetime and past 30-day hookah use among Russian youth. This cross-sectional study was conducted in three areas of Bashkortostan, Russia. In 2015, we surveyed Russian high school students (n = 716) on socio-demographic characteristics, tobacco (cigarettes, e-cigarettes, hookah) and drug use (alcohol, marijuana, and other illicit drugs), coping strategies, and getting in trouble (self and/or family). We estimated hookah use prevalence and performed bivariate analyses prior to fitting two multilevel models evaluating lifetime and past 30-day hookah use. Within this sample, 34.92% and 9.36% were lifetime and last 30-day hookah users, respectively. Lifetime hookah use was associated with older age (OR = 1.29), higher anger coping (OR = 1.41), school troubles (OR = 2.30), lifetime cigarette (OR = 1.59), e-cigarette (OR = 4.62), alcohol (OR = 5.61), and marijuana use (OR = 8.05). Additionally, past 30-day hookah use was associated with older age (OR = 1.71), lifetime use of alcohol (OR = 5.39), school troubles (OR = 5.82), and anger coping strategies (OR = 1.40). Hookah use is currently high among Russian youth in Bashkortostan and is associated with other risky behaviors. Effective interventions targeting multiple substances and coping strategies are needed. Social media campaigns encouraging cessation and advocating against its use at home may be beneficial in curbing hookah use among youth.
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Salloum RG, Lee J, Mostafa A, Abu-Rmeileh NME, Hamadeh RR, Darawad MW, Kheirallah KA, Salama M, Maziak W, Nakkash R. Waterpipe Tobacco Smoking among University Students in Three Eastern Mediterranean Countries: Patterns, Place, and Price. Subst Use Misuse 2019; 54:2275-2283. [PMID: 31347433 DOI: 10.1080/10826084.2019.1645177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: The objective of this study was to examine waterpipe tobacco smoking patterns, places of smoking, and prices paid among university students in the Eastern Mediterranean Region. Methods: A cross-sectional online survey was administered to a convenience sample of university students in three countries. Participants were young adults (18-29 years) who were ever waterpipe smokers, from Egypt (n = 728), Jordan (n = 790), and Palestine (n = 722). Measures included past-30-day waterpipe smoking, frequency, intensity, place of smoking, and prices paid per waterpipe smoking session and for packaged waterpipe tobacco. Logistic regression models evaluated the factors associated with past-30-day waterpipe smoking. Results: Past-30-day waterpipe smoking (prevalence) was observed among 60.7%, 67.7% and 63.1% of students from Egypt, Jordan, and Palestine, respectively. Among past-30-day smokers, past-5-day waterpipe smoking (frequency) was observed among 28.9%, 51.5%, and 48.6% of participants, respectively. Smoking in a café was highest among participants from Egypt (74.0%), followed by those from Palestine (44.8%), and Jordan (43.0%). Mean price paid per session was USD 0.99 (Egypt), USD 8.07 (Jordan), USD 6.05 (Palestine). The corresponding mean prices per packet were USD 0.86, USD 4.96, and USD 5.55, respectively. Predictors of past-30-day waterpipe smoking included younger age of initiation, male gender, employment, and smoking waterpipe alone. Conclusions: This study contributes to our understanding of waterpipe smoking patterns, places of smoking, and prices paid among young adults in a region with alarmingly high smoking rates. Understanding waterpipe smoking behaviors can inform the design of policy and educational interventions to curb its rising threat.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.,Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - JuHan Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Aya Mostafa
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamed Salama
- Medical Experimental Research Center, Mansoura University, Mansoura, Egypt
| | - Wasim Maziak
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Parker MA, Villanti AC, Quisenberry AJ, Stanton CA, Doogan NJ, Redner R, Gaalema DE, Kurti AN, Nighbor T, Roberts ME, Cepeda-Benito A, Higgins ST. Tobacco Product Harm Perceptions and New Use. Pediatrics 2018; 142:peds.2018-1505. [PMID: 30397167 PMCID: PMC6317771 DOI: 10.1542/peds.2018-1505] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5839992833001PEDS-VA_2018-1505Video Abstract BACKGROUND: Researchers in several studies have examined correlations between tobacco harm perceptions and tobacco use in youth, but none have prospectively addressed the association between harm perceptions and subsequent new use across multiple noncigarette products. METHODS Product-specific absolute and relative harm perceptions for cigarettes, electronic cigarettes (e-cigarettes), cigars, pipes, hookah, and smokeless tobacco were collected at wave 1 (W1) (2013-2014) among youth in the nationally representative US Population Assessment of Tobacco and Health Study (12-17 years of age; n = 10 081). At wave 2 (W2) (2014-2015), product-specific new use was calculated. Adjusted relative risks were used to estimate if harm perceptions at W1 predicted W2 new tobacco use. RESULTS The proportion of youth who endorsed "a lot of harm" was highest for cigarettes (84.8%) and lowest for e-cigarettes (26.6%); the proportion of youth who thought products were "more harmful" than cigarettes was highest for cigars (30.6%) and lowest for e-cigarettes (5.1%). Among youth who had not used those products at W1, product-specific new use at W2 ranged from 9.1% (e-cigarettes) to 0.6% (pipes). Youth who believed that noncombustible tobacco products posed "no or little harm" at W1 were more likely to have tried those products at W2 (P < .05). Youth who viewed e-cigarettes, hookah, and smokeless tobacco as "less harmful" than cigarettes at W1 were more likely to try those tobacco products at W2 (P < .05). CONCLUSIONS Low harm perceptions of noncigarette tobacco products predict new use of these products by youth within the next year. Targeting product-specific harm perceptions may prevent new tobacco use among youth.
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Affiliation(s)
- Maria A. Parker
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Andrea C. Villanti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Amanda J. Quisenberry
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Cassandra A. Stanton
- Center for Evaluation and Coordination of Training
and Research in Tobacco Regulatory Science, Westat, Rockville, Maryland;,Department of Oncology, Georgetown University Medical
Center, Washington, District of Columbia; and
| | - Nathan J. Doogan
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Ryan Redner
- Rehabilitation Institute, Southern Illinois
University, Carbondale, Illinois
| | - Diann E. Gaalema
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Allison N. Kurti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Tyler Nighbor
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Megan E. Roberts
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | | | - Stephen T. Higgins
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
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Bashirian S, Barati M, Mohammadi Y, Mahmoodi H. Factors associated with intention of hookah and tobacco supply in Iran: Application of the theory of planned behavior. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1546339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Saeed Bashirian
- Health Education, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Health Education and Promotion, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Epidemiology, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hassan Mahmoodi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Kimber C, Frings D, Cox S, Albery I, Dawkins L. The effects of the European e-cigarette health warnings and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions. BMC Public Health 2018; 18:1259. [PMID: 30428933 PMCID: PMC6236990 DOI: 10.1186/s12889-018-6161-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Article 20 of the EU Tobacco Products Directive [TPD] stipulates that e-cigarette packets and refill products must carry a nicotine addiction health warning. Although previous studies conducted in North America have found that perceived harm, addictiveness and intention to use declined following exposure to e-cigarette health warnings, possible effects of the TPD health warnings on smokers and non-smokers has not been studied. This study will investigate the effects of the EU TPD e-cigarette health warnings and a comparative harm message (COMP; developed specifically for this study) on smokers' and non-smokers' perceptions of harm, addictiveness and social acceptability of e-cigarettes. Additionally, the potential effects of the TPD warnings and the COMP on smokers' intentions to purchase and use e-cigarettes will be explored. METHODS/DESIGN A sample of 2400 UK residents will be recruited in this experimental, randomised design, with Smoking status (Smoker vs. Non-smoker), TPD presence (TPD1 vs. TPD2 vs. No-TPD) and COMP presence (Presence vs. Absence) as between subjects independent variables, and Time (pre-post exposure of images) as a within subjects factor. Dependent variables comprise self-reported perceived harm, addictiveness, social acceptability, e-cigarettes' effectiveness, intentions to purchase and use e-cigarettes. Cigarette dependence, previous e-cigarette exposure, and baseline intentions to quit will be measured as covariates. DISCUSSION Health warnings, such as those implemented by the TPD, may help to prevent non-smokers from e-cigarettes use, but it is possible that they may inadvertently deter smokers from initiating use and substituting their tobacco smoking for e-cigarettes use if their content is deemed too negative. It is hoped that this study will help identify the most effective message or combination of messages that encourage use among smokers without promoting use among non-smokers. TRIAL REGISTRATION ISRCTN registry ISRCTN76967031 ; date of registration: 23/10/18.
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Affiliation(s)
- Catherine Kimber
- Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA UK
| | - Daniel Frings
- Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA UK
| | - Sharon Cox
- Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA UK
| | - Ian Albery
- Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA UK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA UK
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57
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Kothari S, Berg CJ. Reasons for use, potential use, or discontinued use of hookah among US young adult college students. Tob Prev Cessat 2018; 4. [PMID: 30272038 PMCID: PMC6159938 DOI: 10.18332/tpc/81860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Given the increase in hookah use among young adults, characteristics of hookah use/users, as well as reasons for its use or discontinuation among young adults, are critical to understand. METHODS Data from a study of 18–25 year olds from seven Georgia colleges/universities (n=2865) were analyzed to examined: 1) differences in socio-demographics and other substance use among current (past 4 months), never, and former hookah users; 2) use characteristics among current users (e.g. device types/flavors used, quit intentions); and 3) reasons for use, potential use, and discontinued use among current, never, and former users. RESULTS Of the students, 56.3% were never users, 12.4% were current, and 31.3% former users. Correlates of being a current (vs never) user included being ‘other race’ (vs White), attending a historically black college/university (HBCU vs technical college), and use of other substances. Correlates of being a former (vs never) hookah user included being older (vs younger), being ‘other race’ (vs White), attending an HBCU (vs technical college), and use of other tobacco products, marijuana, or alcohol. Among current users, 73.7% reported no intention to quit; 26.2% attempted to quit in the past year. Two factors were identified regarding reasons for current use (flavors, social reasons): one factor regarding potential use among never users (related to flavors and social factors), and three factors regarding discontinued use (inconvenience, anti-tobacco attitude, social reasons). CONCLUSIONS Findings indicate the risk factors for hookah use and the importance of particular factors (e.g. flavors, social influences) relevant to regulation/policy.
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Affiliation(s)
- Shreya Kothari
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, United States
| | - Carla J Berg
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, United States.,Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, United States.,Winship Cancer Institute, Emory University, Atlanta, United States
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58
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Soulakova JN, Pham T, Owens VL, Crockett LJ. Prevalence and factors associated with use of hookah tobacco among young adults in the U.S. Addict Behav 2018; 85:21-25. [PMID: 29803099 PMCID: PMC7227083 DOI: 10.1016/j.addbeh.2018.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/03/2018] [Accepted: 05/11/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Among young adults, use of hookah tobacco (HT) is an emerging health-risk behavior. The goals were to demonstrate that (1) the prevalence of ever-use and current use of HT increased among U.S. young adults (18-30 years old) in the period from 2010 to 2015 and (2) the patterns of HT use differed across diverse demographic subpopulations of young adults. METHODS We merged and analyzed data from the 2010-2011 and 2014-2015 Tobacco Use Supplement to the Current Population Survey. The sample (n = 55,352) was representative of the young adult population in the U.S. Two binary measures were the ever and current use of HT. The significance level was 5%. RESULTS The rate of current use of HT increased from 1% in 2010-11 to 2% in 2014-15 (CI = 0.6%:1.1%). The rate of ever-use increased from 7% to 12% (CI = 4.2%:5.6%). The over-time increase was not uniform: the increase was most rapid among 26-30 year-old adults, non-Hispanic Black and African American adults, and in Northeastern and Midwestern U.S. regions. HT ever-use, overall, was associated (all p's < 0.001) with many sociodemographic factors and current tobacco-use behaviors. The rate of HT ever-use was 16% for daily and 23% for occasional cigarette smokers, 23% for users of smokeless tobacco products, 37% for cigar smokers, and 55% for smokers of regular pipe (filled with tobacco). DISCUSSION/CONCLUSION HT use is becoming increasingly more popular among young adults in the U.S. Methods should target not only cessation of cigarette smoking but use of all tobacco products.
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Stroud LR, McCallum M, Salisbury AL. Impact of maternal prenatal smoking on fetal to infant neurobehavioral development. Dev Psychopathol 2018; 30:1087-1105. [PMID: 30068428 PMCID: PMC6541397 DOI: 10.1017/s0954579418000676] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite recent emphasis on the profound importance of the fetal environment in "programming" postnatal development, measurement of offspring development typically begins after birth. Using a novel coding strategy combining direct fetal observation via ultrasound and actocardiography, we investigated the impact of maternal smoking during pregnancy (MSDP) on fetal neurobehavior; we also investigated links between fetal and infant neurobehavior. Participants were 90 pregnant mothers and their infants (52 MSDP-exposed; 51% minorities; ages 18-40). Fetal neurobehavior at baseline and in response to vibro-acoustic stimulus was assessed via ultrasound and actocardiography at M = 35 weeks gestation and coded via the Fetal Neurobehavioral Assessment System (FENS). After delivery, the NICU Network Neurobehavioral Scale was administered up to seven times over the first postnatal month. MSDP was associated with increased fetal activity and fetal limb movements. Fetal activity, complex body movements, and cardiac-somatic coupling were associated with infants' ability to attend to stimuli and to self-regulate over the first postnatal month. Furthermore, differential associations emerged by MSDP group between fetal activity, complex body movements, quality of movement, and coupling, and infant attention and self-regulation. The present study adds to a growing literature establishing the validity of fetal neurobehavioral measures in elucidating fetal programming pathways.
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60
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Bashirian S, Barati M, Abasi H, Sharma M, Karami M. The role of sociodemographic factors associated with waterpipe smoking among male adolescents in western Iran: A cross-sectional study. Tob Induc Dis 2018; 16:29. [PMID: 31516429 PMCID: PMC6659475 DOI: 10.18332/tid/91601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/12/2018] [Accepted: 05/24/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Waterpipe smoking (WPS) is an increasingly popular leisure activity among young people in Iran. The purpose of this study was to identify the role of sociodemographic factors associated with WPS among male adolescents in Iran. METHODS The study used a cross-sectional design. It included 730 high school male students (Grades 10–12) recruited through multistage random sampling conducted in 2017 in Hamadan city, western Iran. The self-administered questionnaires included information on demographic variables and behavioral risk factors related to WPS. Descriptive statistics and multinomial logistic regression modeling were conducted using SPSS. RESULTS The student mean age, and standard deviation (SD), and age at WPS initiation were 16.41 (0.84) and 13.31 (2.43) years, respectively. The percentages of never, former and current WPS were 37.3%, 36.4% and 26.3%, respectively. We found that ever cigarette smoking (OR=5.14, 95% CI: 2.56–10.32) and WPS family (OR=2.55, 95% CI: 1.40–4.64) were significantly associated with former WPS. Furthermore, being 18 years, studying in technical fields, reporting ever and current smoking of cigarettes and family usage of WP were significantly associated with current WPS. Friends with WPS (OR= 0.50, 95% CI: 0.34–0.72) however played a protective role on former WPS. CONCLUSIONS The results indicate that the prevalence of former and current WPS was high in Hamadan city. Thus, designing and implementing interventions for increasing students’, friends’ and family’s awareness regarding the harms of WPS and cigarette smoking are necessary to facilitate behavior change.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Abasi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- Behavioral & Environmental Health School of Public Health, Jackson State University, Jackson, United States
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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61
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Ganz O, Johnson AL, Cohn AM, Rath J, Horn K, Vallone D, Villanti AC. Tobacco harm perceptions and use among sexual and gender minorities: findings from a national sample of young adults in the United States. Addict Behav 2018; 81:104-108. [PMID: 29454177 DOI: 10.1016/j.addbeh.2018.01.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/22/2018] [Accepted: 01/22/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In the United States, the prevalence of tobacco use among sexual and gender minorities (SGM) is higher compared to their non-SGM counterparts. Tobacco harm perceptions have gone largely unexamined as a potential mechanism supporting disproportionate tobacco use among this population. The purpose of this study was to examine differences between SGM and non-SGM young adults in harm perceptions of various tobacco products and tobacco use behavior and whether low tobacco-related harm perceptions moderate the relationship between identifying as a SGM and tobacco use behavior. METHODS This study used data from Wave 10 of the Truth Initiative Young Adult Cohort Study, a sample of U.S. young adults (ages 18-34). Data were collected from September to October 2016 and the study sample included 3089 individuals. Demographics, past 30-day use of cigarettes, little cigars/cigarillos/bidis and electronic cigarettes were assessed. Absolute and relative harm perceptions of these products were also examined. RESULTS Identifying as a SGM and low tobacco harm perceptions were found to be positively associated with past 30-day tobacco use. There was no interaction between SGM status and harm perceptions on past 30-day tobacco use CONCLUSIONS: Findings confirm that SGM young adults continue to disproportionately use tobacco products, compared to non-SGM young adults. More research is needed to understand moderators of the relationship between SGM status and tobacco use in young adults.
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Affiliation(s)
- Ollie Ganz
- Schroeder Institute at Truth Initiative, Washington, DC, United States; Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States.
| | - Amanda L Johnson
- Schroeder Institute at Truth Initiative, Washington, DC, United States
| | - Amy M Cohn
- Schroeder Institute at Truth Initiative, Washington, DC, United States; Department of Oncology, Georgetown Medical Center, Cancer Prevention and Control Program, Washington, DC, United States
| | - Jessica Rath
- Schroeder Institute at Truth Initiative, Washington, DC, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kimberly Horn
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, DC, United States
| | - Donna Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; College of Global Public Health, New York University, New York, NY, United States
| | - Andrea C Villanti
- Schroeder Institute at Truth Initiative, Washington, DC, United States; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, United States
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Abstract
Objectives To inform targeted prevention efforts, it is important to understand which tobacco products are used first and associations by demographic characteristics. Methods We conducted a nationally-representative random digit-dial telephone survey of 1125 adolescents ages 13-17. Adolescents reported the first tobacco product they tried, and we analyzed associations with demographic variables. Results Two-hundred nineteen (18.6%) adolescents reported ever using a tobacco product. The most common first product tried was cigarettes (35.4%), followed by electronic nicotine delivery systems (24.3%), smokeless tobacco (17.7%), cigars (11.4%), and waterpipe (11.2%). Weighted multivariable logistic regression analyses showed girls were 2.7 times more likely than boys to report cigarettes as their first product, Hispanic/Latinos were 5.0 times more likely than non-Hispanic/Latinos to report cigarettes, and those whose mothers had at least a 4-year college degree were 6.1 times more likely to report waterpipe compared to those whose mothers had less than a 4-year college degree. Conclusions Nearly one in 5 adolescents had tried a tobacco product. Although cigarettes were the most frequently reported product, most youth initiated with a non-cigarette tobacco product, and demographic differences were found. These findings point towards potential regulatory policies, including targeted campaigns, which might deter adolescents from initiating tobacco use.
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63
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Abudayyeh HS, Glasser AM, Johnson AL, Cohn AM, Wagener TL, Mays D, Villanti AC. Social and substance use correlates of adult hookah use, 2016. Addict Behav 2018; 79:39-44. [PMID: 29245025 PMCID: PMC5807119 DOI: 10.1016/j.addbeh.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/24/2022]
Abstract
Introduction Hookah prevalence has been increasing in U.S. adults. This study examines correlates and frequency of hookah use in a national sample of U.S. adults (18–44 years). Methods Data were drawn from Wave 10 (October 2016) respondents aged 18–44 years from the Truth Initiative Young Adult Cohort Study (n=4,085). Weighted bivariate analyses were used to estimate correlates and frequency of hookah use, and differences between past 30-day and noncurrent hookah users on social and substance use (alcohol, marijuana, and other drugs) correlates. Results Twenty percent of the sample ever used hookah, and 2% used hookah in the past 30 days. Compared to never users and non-current users, a significantly greater proportion of ever and past 30-day hookah users reported past 30-day e-cigarette, tobacco, and substance use (p’s<0.01). Eighty-one percent of past 30-day hookah users had at least one close friend who also used hookah, and 35% self-identified as social/occasional smokers. The majority (68%) of past 30-day users reported hookah use on fewer than five of the past 30 days, and 58% engaged in two or more hookah sessions on those days. Conclusions Ever and past 30-day hookah use are associated with concurrent tobacco, e-cigarette, and substance use. They are also correlated with peer hookah use and self-identification as a social/occasional smoker. Even infrequent hookah sessions can expose users to health risks. Research identifying contexts in which hookah is used and how it is used with other substances is needed to inform interventions to reduce hookah use.
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Affiliation(s)
- Haneen S Abudayyeh
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA.
| | - Allison M Glasser
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amanda L Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA
| | - Amy M Cohn
- Battelle Memorial Institute, 2111 Wilson Blvd, #1000, Arlington, VA 22201, USA; Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Theodore L Wagener
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children's Ave, Suite 14000, Oklahoma city, OK 73104, USA; Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, 655 Research Pkwy #400, Oklahoma City, OK 73104, USA
| | - Darren Mays
- Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 3800 Reservoir Road NW, Washington, DC 20057, USA
| | - Andrea C Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G St NW, Fourth Floor, Washington, DC 20001, USA; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect Street, MS 482, Burlington, VT 05401, USA
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Nicksic NE, Ly C, Loukas A, Perry CL. Hookah Use and Perceptions among Young Adult Hookah Users. ACTA ACUST UNITED AC 2018; 7. [PMID: 31692999 DOI: 10.4172/2324-9005.1000178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Despite declining cigarette use, hookah use has increased substantially among youth and young adults. This is alarming, as hookah can lead to the same health risks as cigarettes and expose users to a high amount of smoke, nicotine, and toxicants. Determining patterns of hookah use and perceptions in young adults is important in prevention efforts. Methods Structured in-person interviews were conducted for this qualitative study in June 2016. Twenty-three hookah users between the ages of 18 and 29 years living in Austin, TX who were not currently enrolled in a college or university completed the interview. NVivo 11 Pro was utilized to code transcribed transcripts for common themes among participants. Results When trying hookah for the first time, all participants had used flavored tobacco, with fruit flavors being most popular at initiation and for current use. Many participants initiated hookah use under the age of 18 years old. While only one participant initiated hookah use alone, one-third of participants had smoked hookah alone, not in the company of others. The majority of participants owned or previously owned their own hookah device. Common motivational factors for hookah use involved being social, taste, and the calming/relaxation effect. Participants perceived hookah use to be both harmful and addictive; however, many participants were unsure if hookah was more harmful to health than cigarettes. Conclusion Young adults who are not currently enrolled in college may have similar hookah use behaviors and risk perceptions as do college students, yet non-college students in this sample are using hookah alone and report owning a hookah device. This study supports the need for research on the effect of policy changes on hookah use, receptivity to warning labels, and programs to correct misperceptions.
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Affiliation(s)
- Nicole E Nicksic
- University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, 1616 Guadalupe Suite 6.300, Austin, TX 78701, United States
| | - Christina Ly
- University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, 1616 Guadalupe Suite 6.300, Austin, TX 78701, United States
| | - Alexandra Loukas
- University of Texas at Austin, Department of Kinesiology and Health Education, College of Education, 1912 Speedway, Stop D500, Austin, TX 78712, United States
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, 1616 Guadalupe Suite 6.300, Austin, TX 78701, United States
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Jawad M, Charide R, Waziry R, Darzi A, Ballout RA, Akl EA. The prevalence and trends of waterpipe tobacco smoking: A systematic review. PLoS One 2018; 13:e0192191. [PMID: 29425207 PMCID: PMC5806869 DOI: 10.1371/journal.pone.0192191] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/19/2018] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Waterpipe tobacco smoking is harmful to health however its prevalence estimates remain uncertain. We aimed to systematically review the medical literature on waterpipe tobacco prevalence and trends. METHODS We searched Medline, Embase and ISI Web of Science for 'waterpipe' and its synonyms, without using language or date restrictions. We included any measure of waterpipe tobacco smoking prevalence in jurisdictionally representative populations. We stratified findings by prevalence measure (past 30 day, ever, regular or occasional, daily, other or unspecified) and age (adults or youth). RESULTS We included 129 studies reporting 355 estimates for 68 countries. In general, prevalence estimates among adults were highest in the Eastern Mediterranean, and among youth were about equal between Eastern Mediterranean and European regions. Past 30 day use was highest among Lebanese youth (37.2% in 2008), ever use was highest among Lebanese youth in 2002 and Lebanese university students in 2005 (both 65.3%), regular or occasional use was highest in among Iranian university students (16.3% in 2005), and daily use was highest among Egyptian youth (10.4% in 2005). Trend data were limited but most studies reported increased use over time, ranging from 0.3-1.0% per year among youth in the US to 2.9% per year among youth in Jordan (both for past 30 day use). Results were similar for ever use trends. Turkey (2.3% in 2008 to 0.8% in 2010) and Iraq (6.3% in 2008 and 4.8% in 2012) both witnessed decreased waterpipe use. CONCLUSION Waterpipe tobacco smoking is most prevalent in Eastern Mediterranean and European countries, and appears higher among youth than adults. Continued surveillance will be important to assess and inform policy measures to control waterpipe tobacco use.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, United Kingdom
- * E-mail:
| | - Rana Charide
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Reem Waziry
- Department of Epidemiology Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Andrea Darzi
- AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Rami A. Ballout
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Elie A. Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
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Leavens ELS, Brett EI, Morgan TL, Lopez SV, Shaikh RA, Leffingwell TR, Wagener TL. Descriptive and injunctive norms of waterpipe smoking among college students. Addict Behav 2018; 77:59-62. [PMID: 28963891 PMCID: PMC11152054 DOI: 10.1016/j.addbeh.2017.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/20/2017] [Accepted: 09/14/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Smoking tobacco via a waterpipe (WP) is on the rise, particularly among college students. One reason for this may be normative perceptions of WP tobacco smoking (WTS) among this population. The current study examined the perceived and actual descriptive and injunctive norms of WTS among a college student sample. METHODS Participants were 894 college students enrolled at a large, Midwestern university. Participants completed measures of WTS frequency and quantity and perceived/actual descriptive and injunctive norms of WTS. RESULTS Over one-third of the sample reported ever trying WTS, while only 2% reported current (past month) use. When comparing ever and never WP smokers, ever smokers reported greater perceived peer approval of WTS. Both males and females overestimated WTS frequency of same-sex students at their university. DISCUSSION The current study is one of the first to investigate descriptive and injunctive norms of WTS among college students. Students who report WTS are more likely to overestimate descriptive norms of WTS among their peers, suggesting corrective normative feedback regarding actual use by peers may be an important target for WTS intervention among college students. Future research should investigate the temporal association between normative perceptions and WTS behaviors among college students.
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Affiliation(s)
- Eleanor L S Leavens
- Oklahoma Tobacco Research Center, Oklahoma City, OK, USA; Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Emma I Brett
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Susanna V Lopez
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Raees A Shaikh
- Oklahoma Tobacco Research Center, Oklahoma City, OK, USA
| | - Thad R Leffingwell
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Theodore L Wagener
- Oklahoma Tobacco Research Center, Oklahoma City, OK, USA; Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Mays D, Tercyak KP, Rehberg K, Crane MK, Lipkus IM. Young adult waterpipe tobacco users' perceived addictiveness of waterpipe tobacco. Tob Prev Cessat 2017; 3:133. [PMID: 32432207 PMCID: PMC7232820 DOI: 10.18332/tpc/80133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/13/2017] [Accepted: 11/11/2017] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Young adults generally do not perceive waterpipe tobacco smoking (WTS) to be addictive. Underlying reasons for these false perceptions have received limited research attention and little is known about effective WTS prevention messaging. This study examined perceptions of the addictiveness of WTS among young adults and ascertained their feedback on WTS prevention message content. METHODS Young adult (n=44, Mean [M] age 25.3, SD 2.7, range 18-30) waterpipe tobacco users were recruited online for a cross-sectional survey. Closed-ended measures assessed demographics, waterpipe use, other tobacco consumption, and perceived addictiveness of WTS. Open-ended items assessed perceptions of WTS and ascertained feedback on WTS prevention message content. Quantitative data were analyzed descriptively. Open-ended data were coded to identify emerging themes. RESULTS Participants reported low perceived addictiveness of WTS (Mean 2.0, SD 0.9, range 1- not at all, 4 - very), perceived chances of becoming addicted (Mean 3.0, SD 1.6, range 1- no chance, 7- certain), and desire to quit (Mean 3.0, SD 1.8, range 1- not at all, 7- very). In open-ended responses, participants indicated social WTS does not lead to addiction and believe it is easy to quit. Some expressed concerns that WTS addiction may lead to health harms, social stigma, and financial costs. Participants indicated messages using vivid imagery and conveying negative health effects could motivate cessation. CONCLUSIONS Young adults view that WTS is not addictive, particularly related to use in social settings. Research can build from this study by developing and testing messages to motivate WTS cessation in young adults.
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Affiliation(s)
- Darren Mays
- Georgetown Lombardi Comprehensive Cancer Center, Washington, United States
| | - Kenneth P Tercyak
- Georgetown Lombardi Comprehensive Cancer Center, Washington, United States
| | - Kathryn Rehberg
- Georgetown Lombardi Comprehensive Cancer Center, Washington, United States
| | - Mary-Kate Crane
- Georgetown Lombardi Comprehensive Cancer Center, Washington, United States
| | - Isaac M Lipkus
- Duke University, School of Nursing, Durham, United States
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Park SH, Duncan DT, Shahawy OE, Shearston JA, Lee L, Tamura K, Sherman SE, Weitzman M. Analysis of State-Specific Prevalence, Regional Differences, and Correlates of Hookah Use in U.S. Adults, 2012-2013. Nicotine Tob Res 2017; 19:1365-1374. [PMID: 27613949 PMCID: PMC5896515 DOI: 10.1093/ntr/ntw229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 09/02/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the state-specific prevalence, regional differences, and correlates of hookah use among U.S. adults. METHODS We analyzed the most recent nationally representative data of adults from the National Adult Tobacco Survey (NATS) 2012-2013 (n = 60192). State-specific prevalence of lifetime and current hookah use was calculated and mapped. Multivariate logistic regression was performed to determine the association between sociodemographic characteristics, regional differences, and hookah use. RESULTS Among U.S. adults (≥18 years), overall prevalence of lifetime hookah use was 12.3%, while current use was 3.9%. Mapping of state-specific prevalence revealed that the West tended to have higher rates of use, while the South tended to have lower ones. In the adjusted model, we observed that current hookah use was positively associated with younger adults, males, non-Hispanic adults, those with higher education and income statuses, being single, those living in the West, and current cigarette use. CONCLUSION The prevalence of hookah use varies by state, region, and sociodemographic characteristics among adults. Future research, including longitudinal studies, are needed to identify geographic and sociodemographic characteristics and trends among hookah users, investigate hookah-related health outcomes, and evaluate targeted public health efforts aimed at this emerging threat. IMPLICATIONS This study investigates state-level prevalence, regional differences, and sociodemographic characteristics of hookah use among U.S. adults, using the most recent NATS. Hookah use was positively associated with younger adults and those living in the West. This study adds to the understanding of the geographic and sociodemographic factors underlying hookah use, which can be used to develop much needed evidence-based regulations and programs that are responsive to the needs of different risk groups.
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Affiliation(s)
- Su Hyun Park
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - Omar El Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Jenni A Shearston
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Lily Lee
- Department of Pediatrics, New York University School of Medicine, New York, NY
- Brooklyn College, New York, NY
| | - Kosuke Tamura
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Scott E Sherman
- Department of Population Health, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
| | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, NY
- College of Global Public Health, New York University, New York, NY
- New York University in Abu Dhabi, Public Health Research Center, Abu Dhabi, UAE
- Department of Environmental Medicine, New York University, New York, NY
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Donaldson EA, Hoffman AC, Zandberg I, Blake KD. Media exposure and tobacco product addiction beliefs: Findings from the 2015 Health Information National Trends Survey (HINTS-FDA 2015). Addict Behav 2017; 72:106-113. [PMID: 28390232 DOI: 10.1016/j.addbeh.2017.04.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 03/17/2017] [Accepted: 04/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Addiction beliefs about tobacco use are associated with intentions to use and use of tobacco products. Exposure to information about tobacco products in media sources may affect addiction beliefs. PURPOSE To examine the relationship between media exposure and tobacco product addiction beliefs. METHODS A nationally representative sample of US adults (n=3738) from the 2015 National Cancer Institute's Health Information National Trends Survey was used to examine addiction beliefs about cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah/waterpipe tobacco, and roll-your-own cigarettes. We used logistic regression to examine the relationship between media exposure and addiction beliefs. We defined media exposure by hours exposed, as well as exposure to tobacco use health effects information through media sources including social media. We categorized media sources by whether respondents actively or passively engaged with the source. FINDINGS A majority (60.6% to 87.3%) of respondents believed that cigarettes, cigars, roll-your-own cigarettes and smokeless tobacco are addictive. Less than half of respondents believed that electronic cigarettes or hookah/waterpipes are addictive (45.2% and 49.8%, respectively). Respondents exposed to messages about tobacco use health effects on active media channels (e.g., social media) had greater odds of believing that smokeless tobacco (adjusted odds ratio [AOR]=1.48), hookah/waterpipe (AOR=1.69), and roll-your-own cigarettes (AOR=1.61) are addictive. Respondents exposed to tobacco use health effects messages on passive media channels (e.g., television), had greater odds of believing that cigarettes (AOR=2.76) and electronic cigarettes (AOR=2.12) are addictive. CONCLUSIONS US adult exposure to information about the health effects of tobacco use was associated with addiction beliefs about tobacco products.
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Affiliation(s)
- Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA.
| | - Allison C Hoffman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, USA
| | - Kelly D Blake
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, USA
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Majeed BA, Sterling KL, Weaver SR, Pechacek TF, Eriksen MP. Prevalence and harm perceptions of hookah smoking among U.S. adults, 2014-2015. Addict Behav 2017; 69:78-86. [PMID: 28161620 DOI: 10.1016/j.addbeh.2017.01.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
This study aimed to determine the prevalence and factors associated with hookah smoking and perceptions of harm among U.S. adults. Data were pooled from the Tobacco Products and Risk Perceptions Surveys conducted separately in the summers of 2014 and 2015, among a probability sample selected from an online research panel. Descriptive, logistic regression, and multinomial logistic regression analyses were conducted. In 2014/2015, prevalence of ever and past 30-day hookah smoking among U.S. adults were 15.8% (95% C.I.: 15.0%, 16.7%) and 1.5% (95% C.I.: 1.2%, 1.8%), respectively. Adults who used other alternative tobacco products had a higher odds of hookah smoking than those who did not. Adults with some college education (AOR, 1.53) and with a college degree or more (AOR, 2.21), those identified as non-Hispanic other (AOR, 1.38) were more likely to be ever hookah smokers. Being a young adult (AOR, 2.7), college-educated (AOR, 2.3), never smoker (AOR, 2.1), and an ever hookah smoker (AOR, 2.8) were associated with lower perceptions of harm. Findings suggest that young college students are at higher risk of smoking hookah and that hookah smoking is more prevalent among individuals who use other tobacco products, such as little cigars and cigarillos, traditional cigars, and e-cigarettes, indicating a distinct group of users of alternative tobacco products. Regarding potential harm of hookah, the study highlights a knowledge gap and misperception especially among young, college-educated, and never smokers. Public health interventions should target these subpopulations to provide them with accurate information on hookah smoking.
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71
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Cohn AM, Ehlke SJ, Cobb CO, Soule EK. Hookah tobacco smoking in a large urban sample of adult cigarette smokers: Links with alcohol and poly-tobacco use. Addict Behav 2017; 68:1-5. [PMID: 28086138 PMCID: PMC5293175 DOI: 10.1016/j.addbeh.2016.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/15/2016] [Accepted: 12/23/2016] [Indexed: 10/20/2022]
Abstract
Hookah tobacco smoking (HTS) has been increasing, particularly among young adults and has similar health effects compared to cigarette smoking. The link between HTS and poly-tobacco use is well documented, but fewer show an association between HTS and alcohol use. It is essential to identify factors that increase the risk for or addictiveness and consequences of HTS, given its growing prevalence. This study examined whether the association between HTS and poly-tobacco use differed as a function of age and alcohol consumption within in a sample of 1223 adult cigarette smokers. Approximately 20% of participants reported HTS. Compared to non-users, hookah users were more likely to be male, highly educated, and to report drug and alcohol use, binge drinking, and poly-tobacco use but were less likely to be heavy smokers (≥10 cigarettes per day). Regression analyses predicting number of tobacco products used (excluding cigarettes and HTS) indicated a three-way interaction of HTS, frequency of alcohol use, and age such that the association between HTS and number of tobacco products used was strongest for younger respondents who consumed alcohol more frequently. As observed in previous studies, alcohol is an important risk factor in the relationship between HTS and poly-tobacco use, particularly among younger cigarette smokers. The links between alcohol, HTS, and poly-tobacco use should be considered when developing HTS education and prevention materials directed toward younger cigarette smokers. Findings provide information relevant to FDA's interest in the addiction potential of HTS and its link to poly-tobacco use.
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Affiliation(s)
- Amy M Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA; Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, 3970 Reservoir Road NW, Washington, DC, USA.
| | - Sarah J Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, 4th Floor, Washington, DC, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Eric K Soule
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Prokhorov AV, Machado TC, Calabro KS, Vanderwater EA, Vidrine DJ, Pasch KP, Marani SK, Buchberg M, Wagh A, Russell SC, Czerniak KW, Botello GC, Dobbins MH, Khalil GE, Perry CL. Developing mobile phone text messages for tobacco risk communication among college students: a mixed methods study. BMC Public Health 2017; 17:137. [PMID: 28143432 PMCID: PMC5282879 DOI: 10.1186/s12889-017-4027-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging young adults for the purpose of communicating health risks associated with nicotine and tobacco use can be challenging since they comprise a population heavily targeted with appealing marketing by the evolving tobacco industry. The Food and Drug Administration seeks novel ways to effectively communicate risks to warn about using these products. This paper describes the first step in developing a text messaging program delivered by smartphones that manipulate three messaging characteristics (i.e., depth, framing, and appeal). METHODS Perceptions of community college students were described after previewing text messages designed to inform about risks of using conventional and new tobacco products. Thirty-one tobacco users and nonusers, aged 18-25 participated in five focus discussions held on two community college campuses. Attendees reviewed prototype messages and contributed feedback about text message structure and content. Qualitative data were coded and analyzed using NVivo Version 10. RESULTS Most participants were female and two-thirds were ethnic minorities. A variety of conventional and new tobacco products in the past month were used by a third of participants. Three identified domains were derived from the qualitative data. These included perceived risks of using tobacco products, receptivity to message content, and logistical feedback regarding the future message campaign. CONCLUSION Overall, participants found the messages to be interesting and appropriate. A gap in awareness of the risks of using new tobacco products was revealed. Feedback on the prototype messages was incorporated into message revisions. These findings provided preliminary confirmation that the forthcoming messaging program will be appealing to young adults.
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Affiliation(s)
- Alexander V. Prokhorov
- The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Tamara C. Machado
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Karen S. Calabro
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Elizabeth A. Vanderwater
- Population Research Center, University of Texas at Austin, 305 E. 23rd Street, Austin, TX 78712 USA
| | - Damon J. Vidrine
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104 USA
| | - Keryn P. Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 1 University Station, D 3700, Austin, TX 78712 USA
| | - Salma K. Marani
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Meredith Buchberg
- Department of Periodontics, The University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249 USA
| | - Aditya Wagh
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Sophia C. Russell
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Katarzyna W. Czerniak
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Gabrielle C. Botello
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Mackenzie H. Dobbins
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Georges E. Khalil
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Cheryl L. Perry
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701 USA
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Sidani JE, Shensa A, Naidu MR, Yabes JG, Primack BA. Initiation, Progression, and Sustained Waterpipe Use: A Nationally Representative Longitudinal Study of U.S. Young Adults. Cancer Epidemiol Biomarkers Prev 2017; 26:748-755. [PMID: 28082346 DOI: 10.1158/1055-9965.epi-16-0687-t] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/28/2016] [Accepted: 12/13/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Waterpipe tobacco smoking (WTS) is increasing in popularity despite evidence of harm and potential for dependence. Intervention development has been hampered by a lack of longitudinal, nationally representative data on usage patterns and factors independently associated with WTS initiation. Therefore, we aimed to characterize key transitions between WTS states in a nationally representative group of young adults, with particular attention to factors independently associated with initiation.Methods: Participants were randomly selected from a national probability-based panel representing 97% of the United States. A total of 1,785 adults ages 18 to 30 at baseline completed two Web-based surveys 18 months apart in 2013 and 2014. Assessments included knowledge of waterpipe tobacco smoke composition, positive and negative attitudes toward WTS, normative beliefs, intention to use waterpipe, and WTS behavior. We used multivariable logistic regression to assess the association between predictive factors and subsequent WTS initiation.Results: In fully adjusted models, overall knowledge about toxicants associated with WTS was not associated with subsequent WTS initiation. Similarly, negative attitudes and normative beliefs were not associated with WTS uptake. However, baseline positive attitudes were strongly and significantly associated with WTS initiation [adjusted OR (AOR) = 1.7; 95% confidence interval (CI), 1.2-2.3]. Similarly, baseline intention to use WTS was strongly associated with subsequent initiation (AOR = 7.0; 95% CI, 3.5-13.7).Conclusions: Prevention efforts may be most successful if they target individuals with clear intentions to use WTS and challenge positive attitudes surrounding WTS.Impact: Surveillance of WTS trajectories will help inform health care and policy surrounding this emerging risk behavior among U.S. young adults. Cancer Epidemiol Biomarkers Prev; 26(5); 748-55. ©2017 AACR.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania. .,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maharsi R Naidu
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan G Yabes
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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74
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Leavens EL, Brett EI, Frank S, Shaikh RA, Leffingwell TR, Croff JM, Wagener TL. Association between breath alcohol concentration and waterpipe lounge patrons' carbon monoxide exposure: A field investigation. Drug Alcohol Depend 2017; 170:152-155. [PMID: 27918950 DOI: 10.1016/j.drugalcdep.2016.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/09/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Concurrent alcohol use and waterpipe (WP) smoking is common among young adults. WP smokers are more than twice as likely to use alcohol as non-users and frequently consume alcohol immediately before and during a WP smoking session. It is unclear what impact alcohol has on WP smoking patterns and resultant exposure to tobacco-related toxicants. The current research aimed to understand the association between alcohol consumption and WP smoke exposure among WP lounge patrons. METHODS Seventy-one lounge patrons (66.2% male; Mage=27.03, SD=5.32) completed pre- and post-WP session self-report measures and biomarkers of smoking (expired carbon monoxide; eCO) and alcohol consumption (breath alcohol concentration; BrAC) upon entering and exiting the WP lounge. RESULTS After controlling for number of bowls and charcoals smoked, greater consumption of alcohol was associated with greater smoke exposure among WP lounge patrons (p<0.05), such that a 0.1 unit increase in BrAC was associated with an eCO increase of 19.44ppm. This relationship was mediated by time spent in the WP lounge. CONCLUSIONS Concurrent alcohol use resulted in greater eCO, likley due to participants spending a greater amount of time in the WP lounge and experiencing longer sustained exposure to secondhand smoke. These findings illustrate a need for further research on the impact of alcohol consumption on WP smoking to assess the potential need for regulation of these products in WP lounges.
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Affiliation(s)
- Eleanor L Leavens
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States; Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Emma I Brett
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Summer Frank
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States
| | - Raees A Shaikh
- Oklahoma Tobacco Research Center, Oklahoma City, OK, United States
| | - Thad R Leffingwell
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Julie M Croff
- School of Applied Health and Educational Psychology, Oklahoma State University, Stillwater, OK, United States
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75
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Pearson JL, Johnson A, Villanti A, Glasser AM, Collins L, Cohn A, Rose SW, Niaura R, Stanton CA. Misperceptions of harm among Natural American Spirit smokers: results from wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014). Tob Control 2016; 26:e61-e67. [PMID: 27924008 DOI: 10.1136/tobaccocontrol-2016-053265] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/05/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This study estimated differences in cigarette harm perceptions among smokers of the Natural American Spirit (NAS) brand-marketed as 'natural', 'organic' and 'additive-free'-compared to other smokers, and examined correlates of NAS use. METHODS Data were drawn from wave 1 of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of US adults (2013-2014). Weighted analyses using a subset of current adult smokers (n=10 565) estimated the prevalence of NAS use (vs all other brands) and examined associations between NAS use and sociodemographics, tobacco/substance use, tobacco harm perceptions, quit intentions, quit attempts and mental/behavioural health. RESULTS Overall, 2.3% of adult smokers (920 000 people in the USA) reported NAS as their usual brand. Nearly 64% of NAS smokers inaccurately believed that their brand is less harmful than other brands compared to 8.3% of smokers of other brands, after controlling for potential confounders (aOR 22.82). Younger age (18-34 vs 35+; aOR 1.54), frequent thinking about tobacco harms (aOR 1.84), past 30-day alcohol use (aOR 1.57), past 30-day marijuana use (aOR 1.87) and sexual orientation (lesbian, gay, bisexual, 'other' or 'questioning' vs heterosexual; aOR 2.07) were also associated with increased odds of smoking NAS. CONCLUSIONS The majority of NAS smokers inaccurately believes that their cigarettes are less harmful than other brands. Given the brand's rapid growth and its more common use in vulnerable groups (eg, young adults, lesbian, gay, bisexual, 'other' or 'questioning' adults), corrective messaging and enforcement action are necessary to correct harm misperceptions of NAS cigarettes.
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Affiliation(s)
- Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amanda Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Andrea Villanti
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Allison M Glasser
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Lauren Collins
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Amy Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Shyanika W Rose
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Raymond Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cassandra A Stanton
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.,Westat, Rockville, Maryland, USA
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76
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Derici Eker E, Koyuncu H, Şahin NÖ, Yüksel A, Berköz M, Budak Diler S, Altan Akgül S. Determination of Genotoxic Effects of Hookah Smoking by Micronucleus and Chromosome Aberration Methods. Med Sci Monit 2016; 22:4490-4494. [PMID: 27869111 PMCID: PMC5120646 DOI: 10.12659/msm.898593] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Use of a hookah (a type of water pipe) is a traditional way of smoking tobacco, particularly in the Middle East. In Turkey, its popularity has been growing in recent years, especially among young people. It is known that cigarette smoking has genotoxic effects and causes mutations, but no comprehensive study has been done on the genotoxic effects of hookah usage, particularly in Turkey. MATERIAL AND METHODS We collected peripheral blood/buccal smear samples from 30 subjects who did not smoke cigarettes but who regularly smoke a hookah an average of 2 times per week, and from 30 control subjects who had never smoked cigarettes or a hookah. Chromosome analyses were performed on the samples obtained from peripheral blood of each individual, 25 metaphase plaques were counted for each, and chromosome/chromatid breakage/gap parameters were evaluated. Micronucleus analysis was done on buccal smear samples and micronucleus/binucleus parameters were investigated by counting 2000 cells of each individual. RESULTS Chromosome breakage ratios were found to be 0.64±0.86 and 0.46±0.71 in the study and control groups, respectively, while chromatid breakage ratios were 0.53±0.83 and 0.53±0.71; fragment ratios were 0.82±1.24 and 0.21±0.49 (p<0.05); and gap ratios were 0.57±0.83 and 0.18±0.53 (p<0.05), respectively. Micronucleus ratio was 6.03±2.06 and 4.43±2.27 (p<0.05) in the study and control groups, respectively, and binucleus ratios were 8.53±3.23 and 12.15±5.18, respectively (p<0.05). CONCLUSIONS Results of our study reveal significant statistical differences between the individuals who smoked hookah and those who did not in terms of fragment, gap, micronucleus, and binucleus parameters, suggesting that smoking a hookah may cause genotoxic effects.
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Affiliation(s)
- Ebru Derici Eker
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Mersin University, Mersin, Turkey
| | - Hayri Koyuncu
- Pharmacy of Hayribey, Tozkoparan Street, Mersin, Turkey
| | - Nefise Özlen Şahin
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Mersin University, Mersin, Turkey
| | - Altan Yüksel
- Pharmacy of Bilgi, Cumhuriyet Street, Mersin, Turkey
| | - Mehmet Berköz
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Yüzüncüyıl University, Van, Turkey
| | - Songul Budak Diler
- Department of Biology, Faculty of Art and Sciences, Niğde University, Niğde, Turkey
| | - Sema Altan Akgül
- Boehringer Ingelheim Site Coordinator, Mersin University, Mersin, Turkey
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77
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Weitzman M, Yusufali AH, Bali F, Vilcassim MJR, Gandhi S, Peltier R, Nadas A, Sherman S, Lee L, Hong Z, Shearston J, Park SH, Gordon T. Effects of hookah smoking on indoor air quality in homes. Tob Control 2016; 26:586-591. [PMID: 27798320 DOI: 10.1136/tobaccocontrol-2016-053165] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/24/2016] [Accepted: 09/07/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hookahs (water pipes) are rapidly increasing in popularity worldwide. Evidence suggests that although perceived as safer than cigarette smoke, hookah smoke may be as, or even more, dangerous as cigarette smoke. METHODS Air samples from 33 homes-11 where only hookah-smoking occurred, 12 with only cigarettes and 10 with no smoking-were collected to analyse concentrations of particulate matter (PM2.5), black carbon, elemental and organic carbon and carbon monoxide (CO). Air quality was assessed in rooms where smoking occurred and in an adjacent room. RESULTS Hookah and cigarette smoking impaired home air quality. The rooms in which hookahs were smoked showed the highest concentrations for all pollutants. CO was significantly greater in the rooms where hookahs were smoked than in the cigarette-smoking rooms and the non-smoking households (p<0.05). In addition, CO levels in the rooms adjacent to where hookah was smoked were 2.5-fold to 4-fold greater than those in the smoking and non-smoking rooms of the cigarette homes (p<0.05). PM2.5 levels were also elevated in hookah homes compared to cigarette and non-smoking homes, although not significantly different. CONCLUSIONS This study, the first of its kind, demonstrates potentially hazardous levels of home air pollution in rooms where hookahs are being smoked as well as in adjacent rooms. These levels were greater than those in cigarette smoking homes, raising concerns about potential negative health effects on all individuals living in homes where hookahs are smoked.
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Affiliation(s)
- Michael Weitzman
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA.,College of Global Public Health, New York University, New York, New York, USA.,Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA.,New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE
| | - Afzal Hussein Yusufali
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,Hatta Hospital, Dubai Health Authority, Dubai, UAE
| | - Fatma Bali
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,Hatta Hospital, Dubai Health Authority, Dubai, UAE
| | - M J Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA
| | - Shashank Gandhi
- Department of Biology, New York University, New York, New York, USA
| | - Richard Peltier
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Arthur Nadas
- Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA
| | - Scott Sherman
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,College of Global Public Health, New York University, New York, New York, USA.,Department of Population Health, New York University, School of Medicine, New York, New York, USA
| | - Lily Lee
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA.,Brooklyn College, Brooklyn, New York, USA
| | - Zhang Hong
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA
| | - Jenni Shearston
- Department of Population Health, New York University, School of Medicine, New York, New York, USA
| | - Su Hyun Park
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA
| | - Terry Gordon
- College of Global Public Health, New York University, New York, New York, USA.,Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA.,New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE
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78
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Cohn AM, Johnson AL, Rath JM, Villanti AC. Patterns of the co-use of alcohol, marijuana, and emerging tobacco products in a national sample of young adults. Am J Addict 2016; 25:634-640. [PMID: 27706885 DOI: 10.1111/ajad.12456] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 09/07/2016] [Accepted: 09/11/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Emerging tobacco product use is on the rise in young adults and has been linked to alcohol and marijuana use. Little is known about which patterns of alcohol, marijuana, and emerging tobacco product co-use are most popular in this age group. OBJECTIVES This study examined the prevalence of a broad spectrum of marijuana, alcohol, and tobacco co-use patterns across a variety of tobacco products in a national sample of young adults. METHODS Data were analyzed from a sub-set of 18-24 year olds (unweighted n = 3,940) from five waves of the Truth Initiative Young Adult Cohort, a national sample of 18-34 year olds. A user-generated statistical program in R was used to assess all possible patterns of past 30-day use of alcohol, marijuana, cigarettes, cigars, e-cigarettes, little cigars/cigarillos, hookah, and other tobacco (pipe, chew, dip, snus, dissolvables). RESULTS No past 30-day use of any substance emerged as the most popular pattern across all years (42%), followed by exclusive past 30-day alcohol use (31%), and past 30-day alcohol use with cigarettes (5%) or marijuana (4%). The popularity of exclusive marijuana use increased over time, but only 1% reported exclusive marijuana use without the combination of either alcohol or a tobacco product. E-cigarette use only emerged in combination with alcohol and was the least popular pattern of co-use relative to other patterns. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Patterns stress the importance of alcohol among young people. Successful substance use prevention should focus on alcohol's co-use with a variety of substances of abuse, rather than focus on a single behavior. (Am J Addict 2016;25:634-640).
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Affiliation(s)
- Amy M Cohn
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.,Department of Oncology, Georgetown University Medical Center, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Amanda L Johnson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jessica M Rath
- Department of Evaluation Science and Research at Truth Initiative, Washington, District of Columbia.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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79
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Allem JP, Unger JB. Emerging adulthood themes and hookah use among college students in Southern California. Addict Behav 2016; 61:16-9. [PMID: 27208879 DOI: 10.1016/j.addbeh.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/22/2016] [Accepted: 05/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hookah (or waterpipe) use is increasing worldwide with implications for public health. Emerging adults (ages 18 to 25) have a higher risk for hookah use relative to younger and older groups. While research on the correlates of hookah use among emerging adults begins to accumulate, it may be useful to examine how transition-to-adulthood themes, or specific thoughts and feelings regarding emerging adulthood, are associated with hookah use. This study determined which transition-to-adulthood themes were associated with hookah use to understand the risk and protective factors for this tobacco-related behavior. METHODS Participants (n=555; 79% female; mean age 22) completed surveys on demographic characteristics, transition-to-adulthood themes, hookah, and cigarette use. RESULTS Past-month hookah use was more common than past-month cigarette use (16% versus 12%). In logistic regression analyses, participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report hookah use. However, transition-to-adulthood themes were not statistically significantly related to cigarette use. CONCLUSIONS The profile for hookah use may differ from that of cigarettes among emerging adults. Themes of experimentation/possibility should be addressed in prevention programs on college campuses and popular recreational spots where emerging adults congregate. These findings can inform future studies of risk and protective factors for hookah use among emerging adults.
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80
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Wackowski OA, O'Connor RJ, Strasser AA, Hammond D, Villanti AC, Delnevo CD. Smokers' and e-cigarette users' perceptions of modified risk warnings for e-cigarettes. Prev Med Rep 2016; 4:309-12. [PMID: 27486560 PMCID: PMC4960008 DOI: 10.1016/j.pmedr.2016.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/21/2016] [Accepted: 07/08/2016] [Indexed: 11/16/2022] Open
Abstract
The 2009 Family Smoking Prevention and Tobacco Control Act opened the possibility for tobacco companies to apply to market their products as having “modified” or reduced risks. However, research on how to communicate comparative tobacco risks and how such messages are interpreted is limited. This study aimed to qualitatively examine perceptions of potential modified risk statements presented as warning labels for e-cigarettes. We conducted six focus groups between 2014 and 2015 with 27 adult e-cigarette users and cigarette-only smokers who provided comments on two versions of a modified risk warning for e-cigarettes: 1) “WARNING: No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes” (as proposed by two companies for their smokeless tobacco products) and 2) “WARNING: This product may be harmful to health, but is substantially less harmful than cigarettes” (an alternative developed by our team). Although most personally believed that e-cigarettes are safer than cigarettes and some thought the messages were true and accurate, many were skeptical and uncomfortable with the warnings because they did not “seem like a warning” and because use of the phrase “substantially lower risks” could be misleading and difficult to understand. Several thought the second warning was stronger (e.g., more active, more specific). Modified risk messages about e-cigarettes may impact perceptions and use of the product. More research is needed to identify the framing, wording and placement (e.g. within or in addition to a warning) that could potentially increase population-level benefits and minimize harms.
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Affiliation(s)
- Olivia A. Wackowski
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 335 George Street, Suite 2100, New Brunswick, NJ 08901, United States
- Corresponding author.
| | - Richard J. O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, United States
| | - Andrew A. Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Andrea C. Villanti
- Schroeder Institute for Tobacco Research and Policy Studies, 900 G Street, NW, Fourth Floor, Washington, DC 20001, United States
| | - Cristine D. Delnevo
- Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 335 George Street, Suite 2100, New Brunswick, NJ 08901, United States
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81
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Abstract
Tobacco use is a pervasive public health problem and the leading cause of preventable morbidity and mortality in the United States. This article reviews the epidemiology of tobacco use in youth, with a description of cigarettes, alternative tobacco product, and polytobacco use patterns among the general population and among adolescents with psychiatric and/or substance use disorders. The article also provides an update on the diagnosis and assessment of tobacco use disorder in adolescents, with a particular focus on the clinical management of tobacco use in adolescents with co-occurring disorders.
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Affiliation(s)
- Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, USA.
| | - Jonathan D Klein
- American Academy of Pediatrics, Julius B. Richmond Center, Elk Grove Village, IL 60007, USA
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82
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Ramôa CP, Shihadeh A, Salman R, Eissenberg T. Group Waterpipe Tobacco Smoking Increases Smoke Toxicant Concentration. Nicotine Tob Res 2016; 18:770-6. [PMID: 26659913 PMCID: PMC5896837 DOI: 10.1093/ntr/ntv271] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/03/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking is a global health concern. Laboratory research has focused on individual waterpipe users while group use is common. This study examined user toxicant exposure and smoke toxicant yield associated with individual and group waterpipe smoking. METHODS Twenty-two pairs of waterpipe smokers used a waterpipe individually and as a dyad. Before and after smoking, blood was sampled and expired carbon monoxide (CO) measured; puff topography was recorded throughout. One participant from each pair was selected randomly and their plasma nicotine and expired air CO concentrations were compared when smoking alone to when smoking as part of a dyad. Recorded puff topography was used to machine-produce smoke that was analyzed for toxicant content. RESULTS There was no difference in mean plasma nicotine concentration when an individual smoked as part of a dyad (mean = 14.9 ng/ml; standard error of the mean [SEM] = 3.0) compared to when smoking alone (mean = 10.0 ng/ml; SEM = 1.5). An individual smoking as part of as a dyad had, on average, lower CO (mean = 15.8 ppm; SEM = 2.0) compared to when smoking alone (mean= 21.3 ppm; SEM = 2.7). When two participants smoked as a dyad they took, on average, more puffs (mean = 109.8; SEM = 7.6) than a singleton smoker (mean = 77.7; SEM = 8.1) and a shorter interpuff interval (IPI; dyad mean = 23.8 seconds; SEM = 1.9; singleton mean = 40.8 seconds; SEM = 4.8). Higher concentrations of several toxicants were observed in dyad-produced smoke. DISCUSSION Dyad smoking may increase smoke toxicant content, likely due to the dyad's shorter IPIs and greater puff number. More work is needed to understand if group waterpipe smoking alters the health risks of waterpipe tobacco smoking. IMPLICATIONS This study is the first to measure toxicants in smoke generated from a waterpipe when used by a dyad. Relative to smoke generated by a singleton, dyad smoke had higher concentration of some toxicants. These differences may be attributed to differences in puffing behavior, specifically the shorter IPI and greater puff number observed in the dyad condition. Relative to singleton smokers, dyad smokers were exposed to less CO, but nicotine exposure did not differ. More work is needed to assess the health effects of inhalation of more toxicant-laden smoke during group waterpipe use.
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Affiliation(s)
- Carolina P Ramôa
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Rola Salman
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA;
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83
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Weaver SR, Majeed BA, Pechacek TF, Nyman AL, Gregory KR, Eriksen MP. Use of electronic nicotine delivery systems and other tobacco products among USA adults, 2014: results from a national survey. Int J Public Health 2016; 61:177-88. [PMID: 26560309 PMCID: PMC4819498 DOI: 10.1007/s00038-015-0761-0] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study assessed the awareness and use of traditional and novel tobacco products and dual use of cigarettes with electronic nicotine delivery systems (ENDS) among USA adults. METHODS Data were obtained from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 USA adults conducted June-November, 2014. RESULTS Use of ENDS varied by demography and by cigarette and other tobacco use. Adults aged 25-34, non-heterosexual adults, and those reporting poorer health reported higher rates of current ENDS use. Current cigarette smokers had much greater odds of ENDS ever use than never smokers, with one-half of all cigarette smokers having used ENDS and 20.7 % currently using them. However, 22.0 % of current ENDS users were former cigarette smokers, and 10.0 % were never cigarette smokers. CONCLUSIONS Patterns of ENDS use are evolving rapidly and merit continued surveillance. Nearly 10 % of adult ENDS usage is among never smokers. The public health challenge is how to enhance the potential that ENDS can replace combusted tobacco products without expanding nicotine use among youth, long-term ex-smokers, and other vulnerable populations.
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Affiliation(s)
- Scott R Weaver
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - Ban A Majeed
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Terry F Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
- Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Amy L Nyman
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Kyle R Gregory
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
- Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, USA
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84
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Jiang N, Ho SY, Wang MP, Leung LT, Lam TH. Waterpipe smoking among secondary school students in Hong Kong. Int J Public Health 2016; 61:427-34. [PMID: 26873908 DOI: 10.1007/s00038-016-0796-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/28/2015] [Accepted: 01/27/2016] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To examine the prevalence of waterpipe smoking and its associated factors among adolescents in Hong Kong. METHODS We analyzed data of the School-based Survey on Smoking among Students 2012/2013 from a representative sample of 45,857 secondary school students in Hong Kong (mean age 14.8, SD 1.9). We conducted Chi-square tests and t test to compare current (past 30 days) waterpipe users and nonusers by sociodemographic variables and other covariates. Univariate and multivariable logistic regression models were used to examine the factors associated with current waterpipe smoking. RESULTS Overall, 1.2 % of students reported current waterpipe smoking, of whom 43 % reported concurrent use of cigarettes. Waterpipe was the most popular alternative tobacco product (non-cigarette) used by students. Current waterpipe smoking was associated with older age, male sex, higher self-perceived family financial status, poor knowledge about the harm of cigarette smoking, positive attitudes toward smoking, current cigarette smoking, other tobacco use, and alcohol consumption. CONCLUSIONS Waterpipe smoking was the most popular alternative tobacco product among Hong Kong adolescents. Despite the low prevalence, it should be routinely monitored. Education programs and cessation interventions need to address waterpipe smoking in addition to cigarette smoking.
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Affiliation(s)
- Nan Jiang
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Lok Tung Leung
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
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85
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Mays D, Tercyak KP, Lipkus IM. The Effects of Brief Waterpipe Tobacco Use Harm and Addiction Education Messages Among Young Adult Waterpipe Tobacco Users. Nicotine Tob Res 2015; 18:777-84. [PMID: 26438650 DOI: 10.1093/ntr/ntv223] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/23/2015] [Indexed: 01/02/2023]
Abstract
INTRODUCTION This study investigated the immediate effects of brief education messages delivered online about harms and addictiveness of waterpipe tobacco use among young adult waterpipe users aged 18 to 30 years. METHODS Participants (n = 327, mean age 24.8 years, 62.1% male, 77.6% white, 67.8% used waterpipe monthly, 26.4% weekly, 5.8% daily) were recruited online and randomized to one of three experimental conditions: (1) Control condition viewing no messages; (2) Harms condition viewing messages about harms of waterpipe tobacco; (3) Harms and addiction condition viewing messages about harms and addictiveness of waterpipe tobacco. Outcomes included perceived harm and addictiveness of waterpipe, worry about harm and addiction, and desire to quit. RESULTS Compared to the control condition, participants in the harms condition reported significantly greater perceived harm and addictiveness of waterpipe relative to cigarettes, perceived risk of harm and addiction, worry about harm and addiction, and desire to quit. There were few significant differences in these outcomes between participants in the harms condition and the harms and addiction condition. Mediation analyses suggest waterpipe tobacco use harm messages may increase desire to quit by producing greater worry about harm and addiction. CONCLUSIONS Brief education messages about waterpipe tobacco use harm increased young adult's perceptions of harm and addictiveness of waterpipe tobacco use and generated stronger desire to quit. The waterpipe tobacco use addiction messages tested had little added impact. Studies should prospectively examine the real-world impact of waterpipe tobacco use harm messages and investigate more effective strategies for designing addiction messages. IMPLICATIONS This study demonstrates that brief education messages about waterpipe tobacco use harm can increase young adult waterpipe tobacco user's perceptions of harm and addictiveness of waterpipe tobacco use and generate stronger desire to quit. The findings indicate messages on addictiveness of waterpipe tobacco use have no added impact on these outcomes.
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Affiliation(s)
- Darren Mays
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC;
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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86
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Cohn A, Villanti A, Richardson A, Rath JM, Williams V, Stanton C, Mermelstein R. The association between alcohol, marijuana use, and new and emerging tobacco products in a young adult population. Addict Behav 2015; 48:79-88. [PMID: 26042613 DOI: 10.1016/j.addbeh.2015.02.005] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/27/2015] [Accepted: 02/11/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Young adults have the highest rates of alcohol, tobacco, and other drug use relative to any other age group. Few studies have examined the co-occurrence of substance use with new and emerging tobacco products in this vulnerable group, or the underlying personality factors that may explain these associations. To address this gap, this study examined the association of current alcohol and marijuana use with the use of cigarettes and emerging tobacco products in a nationally representative sample of young adults. METHODS Data were drawn from 18 to 24year olds in Wave 4 (January 2013; n=1609) of the Legacy Young Adult Cohort, a nationally-representative sample of men and women. Never, ever (lifetime), and past 30-day use of little cigars/cigarillos (LCCs), hookah, e-cigarettes, and cigarettes were assessed separately in current (everyday or some days) alcohol and marijuana users. RESULTS Using weighted estimates, multivariable multinomial logistic regression models showed that current alcohol and marijuana use were associated with lifetime and past 30-day use of cigarettes, LCCs, e-cigarettes, and hookah, with different magnitudes of association found across each product. Post-hoc exploratory analyses showed that sensation-seeking traits moderated the relationship of alcohol (but not marijuana) use to current use of select tobacco products. DISCUSSION Marijuana and alcohol use may enhance risk for emerging tobacco products use in young adulthood. Prevention and intervention programs may need to target poly-use of alcohol, marijuana, and tobacco rather than focusing on a single risk behavior during these critical years.
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87
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Martinasek MP, Gibson-Young LM, Davis JN, McDermott RJ. Waterpipe tobacco smoking impact on public health: implications for policy. Risk Manag Healthc Policy 2015; 8:121-9. [PMID: 26346473 PMCID: PMC4556249 DOI: 10.2147/rmhp.s68267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods Identification of Clean Indoor Air Acts (CIAAs) from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.
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Affiliation(s)
- Mary P Martinasek
- Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, USA
| | - Linda M Gibson-Young
- College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, USA
| | - Janiece N Davis
- Department of Health - Palm Beach County, West Palm beach, FL, USA
| | - Robert J McDermott
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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