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Yan R, Liu Y, Huang L, Li Y, Huang Y, Tong J, Deng Y, Yuan Q. Susceptibility to e-cigarette adoption among tobacco-naïve youths: a cross-sectional study in Shenzhen, China. Front Public Health 2024; 12:1320863. [PMID: 38818444 PMCID: PMC11137244 DOI: 10.3389/fpubh.2024.1320863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Background The rise in e-cigarette use among youth is a significant global public health issue. It is important to identify those at increased risk and implement effective strategies to reduce e-cigarette popularity among the youth. Objective This study aims to identify predictors of e-cigarette uptake in youths with no prior tobacco use, considering individual, familial and the broader societal environmental factors. Methods For this investigation, a group of 2,487 tobacco-free youths was selected from 15 high schools in Shenzhen, China. Susceptibility to e-cigarettes was determined by assessing the possibility of future use and the openness to trying e-cigarettes if presented by friends. Both chi-square tests and logistic regression were applied to identify factors linked to susceptibility to e-cigarette use. Results Among the respondents, 5.5% (n = 136) were found to be susceptible to e-cigarette use. The analysis revealed factors tied to this risk: perceptions of e-cigarettes, the impact of vaping peers, paternal parenting styles, the extent of social support, exposure to messages both for and against e-cigarettes use, and secondhand smoke (SHS) exposure. Youths who downplayed the addictive nature of e-cigarettes (aOR = 2.01; 95% CI: 1.14-3.55; p = 0.016), those with friends who engaged in vaping (aOR = 3.43-7.64; 95%CI: 2.36-20.42; p < 0.001), those experiencing over-protective or rejective maternal parenting (aOR = 1.68-3.01; 95%CI: 1.11-5.77; p = 0.001-0.014) or rejective paternal parenting (aOR = 3.63; 95%CI: 1.99-6.59; p < 0.001), those aware of e-cigarette advertisements (aOR = 1.82; 95%CI: 1.28-2.60; p = 0.001), and those exposed to SHS at home (aOR = 1.68; 95%CI: 1.17-2.41; p = 0.005) or at public places (aOR = 1.72-1.79; 95%CI: 1.21-2.57; p = 0.002-0.003) were more prone to e-cigarettes. In contrast, youths who believed using e-cigarettes reduces one's attractiveness (aOR = 0.34; 95%CI: 0.16-0.72; p = 0.005) or perceived that vaping made social interactions less enjoyable (aOR = 0.26; 95%CI: 0.12-0.58; p = 0.001), those who benefited from high social support (aOR = 0.30-0.60; 95%CI: 0.17-0.97; p < 0.001), and those who noticed message about e-cigarettes' adverse consequence (aOR = 0.54; 95%CI: 0.38-0.77; p = 0.001) were less likely to be inclined toward e-cigarette use. Conclusion The propensity of the youth to e-cigarette usage is shaped by a multiple element. An all-encompassing strategy that addresses the individual, familial, and the broader societal aspects is imperative for the effective prevention of e-cigarette initiation among youth.
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Affiliation(s)
- Ruilin Yan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanhong Liu
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Li Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanrou Li
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yun Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Jing Tong
- Bao'an Public Health Service Center of Shenzhen, Shenzhen, China
| | - Yongzheng Deng
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Qing Yuan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
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Hernández-Torres R, Wang H, Orfin R, Castro-Figueroa EM, Freeman J, Cupertino AP, Ossip DJ, Wilson KM, Cartujano-Barrera F. Exposure to E-Cigarette Marketing and Susceptibility to Future Vaping among Black and Latino Adolescents in the United States. CHILDREN (BASEL, SWITZERLAND) 2024; 11:465. [PMID: 38671682 PMCID: PMC11049197 DOI: 10.3390/children11040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Evidence suggests an association between exposure to electronic cigarette (e-cigarette) marketing and e-cigarette use (vaping) among adolescents. However, there is limited evidence on exposure to e-cigarette marketing and susceptibility to future vaping, especially among Black and Latino adolescents. This study aimed to examine associations between exposure to e-cigarette marketing and susceptibility to future vaping among Black and Latino adolescents in the United States (US). Participants (N = 362; equal representation between Black and Latino adolescents) completed a baseline assessment (available in English and Spanish) including sociodemographic characteristics (e.g., racial/ethnic group, age, gender, sexual orientation, etc.), exposure to e-cigarette marketing, and susceptibility to future vaping. Exposure to e-cigarette marketing was recoded and organized into two categories (high exposure = 2 to 3; low exposure = 0 to 1). Cochran-Mantel-Haenszel tests were used to evaluate the association between exposure to e-cigarette marketing and susceptibility to future vaping, stratified by racial/ethnic group. Multiple logistic regressions assessed the association between exposure to e-cigarette marketing and susceptibility to future vaping, controlling for gender, sexual orientation, grade, and academic performance within each racial/ethnic group. Black adolescents reported significantly higher frequencies of exposure to e-cigarette marketing (p = 0.005). A significant interaction was found between exposure to e-cigarette marketing and racial/ethnic group (X2 (1) = 6.294, p = 0.012). Among Black adolescents, high exposure to e-cigarette marketing (vs. low exposure) was associated with a higher probability of susceptibility to future vaping (OR: 2.399, 95% CI 1.147-5.021, p = 0.020). For Latino adolescents, exposure to e-cigarette marketing was not associated with susceptibility to future vaping (OR: 0.503, 95% CI 0.245-1.03, p = 0.062). Future studies should evaluate how and where adolescents are exposed to e-cigarette marketing. Prevention efforts must include the implementation of effective counter-marketing campaigns and the reduction of exposure to e-cigarette marketing among Black and Latino adolescents.
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Affiliation(s)
- Ruthmarie Hernández-Torres
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Rafael Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
| | - Eida M. Castro-Figueroa
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
| | | | - Ana Paula Cupertino
- Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Karen M. Wilson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
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Vázquez AL, Navarro Flores CM, Garcia BH, Barrett TS, Domenech Rodríguez MM. An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic. PLoS One 2024; 19:e0287878. [PMID: 38354165 PMCID: PMC10866513 DOI: 10.1371/journal.pone.0287878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.
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Affiliation(s)
- Alejandro L. Vázquez
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Cynthia M. Navarro Flores
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Byron H. Garcia
- Department of Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Tyson S. Barrett
- Highmark Health, Pittsburg, Pennsylvania, United States of America
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Wilhelm AK, Evans MD, Xiong Z, Ortega L, Vock DM, Maruyama G, Allen ML. School Connectedness and Adolescent E-cigarette Susceptibility in an Urban Sample of Middle and High School Students. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01643-4. [PMID: 38244166 DOI: 10.1007/s11121-024-01643-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
Adolescent school connectedness generally protects from risk behaviors such as tobacco use; however, its relationship to e-cigarette use is unclear. This study examines the relationship between adolescent school connectedness and e-cigarette susceptibility in a diverse longitudinal sample. This secondary analysis of a school-based intervention surveyed 608 middle (66%) and high school (34%) students from 10 schools at 3 time points over 1 year. At baseline, respondents had a mean age of 14 years, 54% were female, and 71% were BIPOC (Black, Indigenous, People of Color). Logistic regression models examined unadjusted and adjusted associations between school connectedness (both baseline and concurrent) and e-cigarette susceptibility over time. E-cigarettes represented the most prevalent form of current nicotine-containing product use in spring 2019 (2.3%), and most respondents reported no e-cigarette susceptibility (69%). E-cigarette susceptibility remained relatively stable during the study. Higher baseline school connectedness levels were associated with lower odds of e-cigarette susceptibility over time. Similarly, higher concurrent school connectedness scores were associated with lower odds of e-cigarette susceptibility over time: spring 2019 (OR, 0.39; 95% CI, 0.32, 0.47), fall 2019 (OR, 0.49; 95% CI, 0.34, 0.72), and spring 2020 (OR, 0.64; 95% CI, 0.47, 0.87). Findings were similar for middle and high school students and did not differ significantly after adjusting for other covariates. Adolescents' school connectedness appears to protect from e-cigarette susceptibility over time, underscoring the importance of promoting positive school experiences to reduce adolescent risk e-cigarette use.
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Affiliation(s)
- April K Wilhelm
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota Health, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA.
| | - Michael D Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Health, Minneapolis, USA
| | - Zong Xiong
- Department of Biochemistry, Molecular Biology, and Biophysics, College of Biological Sciences, University of Minnesota Twin Cities, Minneapolis, USA
| | - Luis Ortega
- SoLaHmo Partnership for Health and Wellness, Inc, Community University Health Care Center, Minneapolis, USA
| | - David M Vock
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Health, Minneapolis, USA
- Division of Biostatistics, School of Public Health, University of Minnesota Health, Minneapolis, USA
| | - Geoffrey Maruyama
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota Twin Cities, Minneapolis, USA
| | - Michele L Allen
- Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota Health, 717 Delaware St. SE, Suite 166, Minneapolis, MN, 55414, USA
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Jongenelis MI, Thoonen KAHJ. Factors associated with susceptibility to e-cigarette use among Australian adolescents. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104249. [PMID: 37918316 DOI: 10.1016/j.drugpo.2023.104249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Preventing uptake of e-cigarette use among adolescents is critical to minimizing vaping-related harms. To inform the development of effective prevention programs and policies, this study explored potential determinants of susceptibility to e-cigarette use among young Australians. METHODS A cross-sectional online survey was administered to 12- to 17-year-old Australians who had never smoked nor vaped (N = 973; 53 % women). The survey assessed susceptibility to e-cigarette use (curiosity about use, willingness to use, and intentions to use) and a comprehensive range of potential correlates that included individual, social, and environmental factors. Regression analyses were conducted to identify factors significantly correlated with each of the dependent variables. RESULTS Susceptibility to e-cigarette use was observed in 45 % of respondents. Individual factors associated with susceptibility included respondents' (i) overall opinion of e-cigarettes, (ii) attitudes toward e-cigarettes, (iii) affect regulation expectancies, and (iv) quitting perceptions. Significant social factors included both descriptive and injunctive norms, specifically: perceiving that use is ok for people of one's age, approval from important others to use, and having at least one family member or close friend who vapes. CONCLUSION Susceptibility to vaping was observed in a substantial proportion of adolescents who have never smoked. Shifting attitudes and social norms around e-cigarette use appears critical to reducing susceptibility. Recommended prevention efforts include the development of communications addressing misperceptions about the benefits of vaping on affect regulation and stricter regulations on e-cigarette advertising to reduce young Australians' exposure to claims that may result in favourable attitudes to e-cigarette use.
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Affiliation(s)
- Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
| | - Karlijn A H J Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
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Pettigrew S, Santos JA, Li Y, Jun M, Anderson C, Jones A. Short report: Factors contributing to young people's susceptibility to e-cigarettes in four countries. Drug Alcohol Depend 2023; 250:109944. [PMID: 37316389 DOI: 10.1016/j.drugalcdep.2023.109944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/21/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Identifying young people who are susceptible to e-cigarettes is important for developing interventions designed to discourage uptake. Current evidence in a broader range of national contexts is needed given recent surges in youth e-cigarette use in many countries and the constantly evolving nature of vaping products and the promotional strategies used by the industry to increase their appeal. METHODS A cross-sectional online survey was administered to around 1000 15-30 year olds in each of four countries: Australia, China, India, and the United Kingdom (total n = 4007). The survey assessed demographic characteristics, e-cigarette and tobacco use, exposure to e-cigarette advertising, and number of friends and family members who vape. Those who had never used e-cigarettes (n = 1589) were assessed for susceptibility (curiosity about e-cigarettes, intentions to use in the next 12 months, and likely use if offered by a friend). Mixed effects logistic regression analysis was used to identify factors associated with susceptibility to e-cigarette use. RESULTS Susceptibility to e-cigarette use was apparent among 54% of respondents from Australia, 61% from India, 62% from the UK, and 82% from China. Factors positively associated with susceptibility were tobacco use, exposure to advertising, higher income, and having friends and family members who vape. Factors negatively associated with susceptibility were perceptions of harmfulness and education. CONCLUSION The results indicate the need across a diverse range of countries for interventions designed to address substantial proportions of young people who are likely to be susceptible to e-cigarette use.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Yuan Li
- The George Institute for Global Health, Beijing, China.
| | - Min Jun
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Craig Anderson
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
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Tilton G, Huston S, Albert P. Risk and Protective Factors for Vaping and Smoking Among High School Students in Maine. Prev Chronic Dis 2023; 20:E28. [PMID: 37079753 PMCID: PMC10159338 DOI: 10.5888/pcd20.220307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Vaping rates are rising among adolescents across the country, and smoking rates remain high. Understanding risk and protective factors associated with vaping and smoking can guide public health interventions. This study examined risk and protective factors associated with vaping and smoking among high school students in Maine. METHODS We used 2019 Maine Integrated Youth Health Survey (MIYHS) data to examine risk and protective factors for vaping and smoking among Maine high school students. Our analytic sample consisted of 17,651 Maine high school students. In addition to bivariate analyses, we used unadjusted and adjusted logistic regression models to assess risk and protective factors. RESULTS Factors with the greatest effect on students' likelihood to vape, smoke, or do both were parental attitude toward adolescent smoking and depressive symptoms. Students who reported their parents feel it is a little wrong or not wrong at all if they smoked had 4.9 times higher adjusted odds of smoking and 4.6 times higher adjusted odds of vaping and smoking compared with students who said their parents feel it would be wrong or very wrong if they smoked. Students who reported depressive symptoms had 2.1 times higher adjusted odds of vaping, 2.7 times higher adjusted odds of smoking, and 3.0 times higher adjusted odds of vaping and smoking compared with students who did not report depressive symptoms. CONCLUSION Understanding risk and protective factors for smoking and vaping among high school students can help tailor adolescent-focused vaping and smoking public health interventions to increase effectiveness.
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Affiliation(s)
- Gabriel Tilton
- University of Southern Maine, Portland, Maine
- 439 Runaround Pond Rd, Durham, ME 04222
| | - Sara Huston
- University of Southern Maine, Portland, Maine
- Maine Center for Disease Control and Prevention, Augusta, Maine
| | - Pamela Albert
- University of Southern Maine, Portland, Maine
- Maine Center for Disease Control and Prevention, Augusta, Maine
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Clendennen SL, Smith J, Sumbe A, Chen B, Wilkinson AV, Harrell MB. Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes. Subst Use Misuse 2023; 58:591-600. [PMID: 36912516 PMCID: PMC10155290 DOI: 10.1080/10826084.2023.2177110] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes. METHODS Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES. RESULTS Participants were 16-23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later. CONCLUSIONS Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.
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Affiliation(s)
- Stephanie L. Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Jacob Smith
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
- The University of Texas Rio Grande Valley School of Medicine, 1201 West University Dr., Edinburg, Texas 78541, USA
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Baojiang Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Anna V. Wilkinson
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Lin SY, Wang L, Zhou W, Kitsantas P, Wen X, Xue H. E-cigarette use during pregnancy and its association with adverse birth outcomes in the US. Prev Med 2023; 166:107375. [PMID: 36481272 PMCID: PMC9888444 DOI: 10.1016/j.ypmed.2022.107375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/01/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
The popularity of e-cigarette use among young adults is a growing concern. However, little is known about factors associated with e-cigarette use in pregnant women and birth outcomes. In this retrospective cohort study, we evaluated the influence of several factors on behavioral changes in e-cigarette use before and during pregnancy, and assessed the association between e-cigarette use and subsequent birth outcomes among pregnant women. The Population Assessment of Tobacco and Health (PATH) study, a government-sponsored national longitudinal study based in the US, Waves 1 through 4 (2013-2018) were used. Multivariate logistic regressions were conducted to estimate behavioral changes in e-cigarette use during pregnancy and subsequent influence on high-risk birth (e.g., preterm birth, low birth weight, birth defects, etc.) and fetal death. Although pregnant women who quit vaping before pregnancy (OR = 1.14, 95% CI 0.54-2.40) or had any use during pregnancy (OR = 1.19, 95% CI 0.38-3.73) showed non-differential risk of having a high-risk birth in comparison to women who did not initiate vaping, we observed that the usage of mint/menthol flavor was correlated with higher risk of fetus death (OR = 3.27, 95% CI 1.17-9.19). Healthcare providers should encourage e-cigarette users to quit prior to and during early pregnancy.
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Affiliation(s)
- Shuo-Yu Lin
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Liang Wang
- Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Weiyu Zhou
- Department of Statistics, Volgenau School of Engineering, George Mason University, Fairfax, VA, USA
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Xiaozhong Wen
- Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University of Buffalo, NY, USA.
| | - Hong Xue
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
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Sutherland BD, Viera Perez PM, Crooks KE, Flannery JS, Hill-Bowen LD, Riedel MC, Laird AR, Trucco EM, Sutherland MT. The association of amygdala-insula functional connectivity and adolescent e-cigarette use via sleep problems and depressive symptoms. Addict Behav 2022; 135:107458. [PMID: 35998541 PMCID: PMC9730909 DOI: 10.1016/j.addbeh.2022.107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/16/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adolescent electronic cigarette (e-cigarette) use remains high. Elucidating contributing factors may enhance prevention strategies. Neurobiologically, amygdala-insula resting-state functional connectivity (rsFC) has been linked with aspects of sleep, affect, and substance use (SU). As such, we hypothesized that amygdala's rsFC with the insula would be associated with e-cigarette use via sleep problems and/or depression levels. METHODS An adolescent sample (N = 146) completed a rs-fMRI scan at time 1 and self-reports at time 2 (∼15 months later). Given consistent associations between mental health outcomes and the rsFC of the laterobasal amygdala (lbAMY) with the anterior insula, we utilized a seed region (lbAMY) to region of interest (ROI) analysis approach to characterize brain-behavior relationships. Two serial mediation models tested the interrelations between amygdala's rsFC with distinct anterior insula subregions (i.e., ventral insula [vI], dorsal insula [dI]), sleep problems, depression levels, and days of e-cigarette use. RESULTS An indirect effect was observed when considering the lbAMY's rsFC with the vI. Greater rsFC predicted more sleep problems, more sleep problems were linked with greater depressive symptoms, and greater depressive symptoms were associated with more e-cigarette use (indirect effect = 0.08, CI [0.01,0.21]). Indicative of a neurobiological dissociation, a similar indirect effect linking these variables was not observed when considering the lbAMY's rsFC with the dI (indirect effect = 0.03, CI [-0.001,0.10]). CONCLUSIONS These outcomes highlight functional interactions between the amygdala and insula as a neurobiological contributor to sleep problems, depressive symptoms, and ultimately SU thereby suggesting potential intervention points to reduce teen e-cigarette use.
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Affiliation(s)
| | | | - Katharine E Crooks
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica S Flannery
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States
| | - Lauren D Hill-Bowen
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael C Riedel
- Department of Physics, Florida International University, Miami, FL, United States
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, FL, United States; Addiction Center, University of Michigan, Ann Arbor, MI, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States
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11
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Sleep troubles in adolescence relate to future initiation of ENDS USE: A longitudinal cohort design using the PATH study waves 4.5–5 (2017–2019). Prev Med Rep 2022; 30:102000. [PMID: 36203945 PMCID: PMC9530947 DOI: 10.1016/j.pmedr.2022.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/22/2022] Open
Abstract
First longitudinal study on the association between sleep trouble and ENDS use. Past year sleep trouble increased risk of initiating ENDS use in following year. Healthy sleep serves as a protective factor against ENDS uptake for youth. Nearly half of youths aged 12–17, experienced sleep troubles during wave 4.5. Sleep classes for youth/delayed school start times may help deter future ENDS use.
In a recent study, we demonstrated a relationship between self-reported sleep deprivation and youth susceptibility to initiate electronic nicotine delivery systems (ENDS) use; however, we were hampered by cross-sectional data. This study builds on our previous work by performing secondary analysis using the nationally representative Population Assessment of Tobacco and Health study datasets from wave 4.5 (2017–2018) and wave 5 (2018–2019) among respondents aged 12–17. Using a longitudinal cohort design, we assessed the extent self-reported sleep troubles at wave 4.5 related to transition from never-to-ever ENDS use by wave 5. We assessed youth who reported never having used any type of tobacco previously and who reported not using alcohol or other illicit substances the previous year. We ran four Poisson regression models on the dependent variable never-to-ever ENDS users at wave 5 and self-reported sleep troubles in the past year at wave 4.5. We controlled for demographic and sociographic factors and, in our final model, tobacco availability in home, exposure to ENDS advertising on social media, past year anxiety, depression, body mass index, physical activity, close friends that use ENDS, perceived harm of ENDS, school performance, sensation seeking, and the susceptibility of youth to initiate ENDS. Even when controlling for these factors, sleep troubles at wave 4.5 significantly and positively related to ENDS initiation by wave 5 (Past year sleep trouble: RR = 1.48 95 % CI = [1.14–1.93]). This key and novel finding has important implications for preventing youth ENDS use via protective self-care and social-environmental approaches.
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12
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Doherty J, Davison J, McLaughlin M, Giles M, Dunwoody L, McDowell C, Butter S, Wilmont E, Simpson EE. Prevalence, knowledge and factors associated with e-cigarette use among parents of secondary school children. PUBLIC HEALTH IN PRACTICE 2022; 4:100334. [DOI: 10.1016/j.puhip.2022.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
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Gaddy MY, Vasquez D, Brown LD. Predictors of e-cigarette initiation and use among middle school youth in a low-income predominantly Hispanic community. Front Public Health 2022; 10:883362. [PMID: 36238238 PMCID: PMC9551350 DOI: 10.3389/fpubh.2022.883362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction E-cigarette use among middle and high school youth increased from 2. 5 million in 2014 to 9.2 million in 2019, becoming the most common tobacco product used among youth. Hispanic youth, the largest ethnic minority in the United States, have higher rates of tobacco use, including e-cigarettes, than non-Hispanics. Identifying factors that put youth at risk for future e-cigarette use is vital to focusing prevention efforts. Informed by social cognitive theory, this study identifies predictors of e-cigarette uptake among e-cigarette naïve youth in a predominantly low-income Hispanic community. Methods 1,249 students (6-8th grades) from two middle schools in El Paso, Texas consented to participate in this longitudinal survey during the 2016-2017 school year. The study sample for analysis was restricted to e-cigarette naïve students (n = 862). Outcome measures were e-cigarette initiation and current use at follow-up. Logistic regression models tested six hypotheses about predictors of e-cigarette initiation and current use: (1) intention, (2) outcome expectations, (3) knowledge, (4) friendship network exposure, (5) normative beliefs, and (6) social acceptability. Results Among e-cigarette naïve students at baseline, 8% (n = 71) reported initiation at follow-up; of these, 3% (n = 23) reported current use. Significant predictors of initiation were intention (AOR = 2.46; 95% CI 1.69-3.59; p < 0.001), outcome expectations (AOR = 1.73; 95% CI 1.14-2.61; p = 0.009), friendship network exposure (AOR = 1.53; 95% CI 1.11-2.11; p =0.01), normative beliefs (AOR = 2.12; 95% CI 1.47-3.08; p < 0.001), and social acceptability (AOR = 1.91; 95% CI 1.28-2.85; p = 0.002). Significant predictors of current use were intention (AOR = 1.98; 95% CI 1.07-3.69; p = 0.03) and friendship network exposure (AOR = 1.69; 95% CI 1.06-2.70; p = 0.03). Conclusions With the increasing popularity of e-cigarettes, age appropriate and culturally sensitive prevention strategies tailored at altering these predictive factors are essential in preventing future e-cigarette use.
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Affiliation(s)
- M. Yvonne Gaddy
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, El Paso, TX, United States
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14
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Kim J, Lee S, Chun J. An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11570. [PMID: 36141845 PMCID: PMC9517489 DOI: 10.3390/ijerph191811570] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 06/06/2023]
Abstract
While the prevalence of young people's conventional cigarette use has decreased in many countries, the use of e-cigarettes has risen. To effectively counteract the growing popularity of e-cigarettes among young people internationally, researchers should know the exact prevalence as well as the protective and risk factors associated with vaping. Based on five eligibility criteria, 53 articles were chosen and analyzed by general characteristics, prevalence, sample characteristics, gender difference, protective factors, and risk factors. In this study, the international pooled prevalence of young people's lifetime e-cigarette use was 15.3%, the current use was 7.7%, and dual use was 4.0%. While the highest lifetime, current, and dual prevalence were found in Sweden, Canada, and the United Kingdom, respectively, the lowest prevalence was found in Germany, followed by South Korea and Sweden. Some protective and risk factors include perceived cost and danger of vaping, parental monitoring, internal developmental assets, cigarette use, family and peer smoking, exposure to online advertisements, and the presence of nearby retail stores. Based on this review, researchers and practitioners can develop different intervention programs and strategies for young smokers.
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Affiliation(s)
| | | | - JongSerl Chun
- Department of Social Welfare, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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Holtz KD, Simkus AA, Twombly EC, Fleming ML, Wanty NI. Sleep deprivation and adolescent susceptibility to vaping in the United States. Prev Med Rep 2022; 26:101756. [PMID: 35359801 PMCID: PMC8961460 DOI: 10.1016/j.pmedr.2022.101756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/19/2022] Open
Abstract
Adolescent sleep deprivation is associated with susceptibility to ENDS use. Less than 6 h sleep relates to higher perceived likelihoods of trying ENDS. ENDS prevention efforts may benefit by incorporating sleep hygiene measures.
Sleep deprivation may be a contributing factor to adolescents’ willingness to experiment with substance use, including electronic nicotine devices (ENDS). While it is generally accepted that nicotine has a negative overall effect on sleep, no studies have yet explored whether sleep deprivation may contribute to adolescents’ initiation of ENDS use. The purpose of this study is to explore whether sleep deprivation is associated with adolescents’ self-reported susceptibility to initiating ENDS use in the next month. Respondents were 1,100 adolescents aged 13–17 across the United States who participated in the Vaping Attitudes Youth Perspectives Survey (VAYPS). We used logistic regression to examine cross-sectional associations between self-reported average sleep duration and self-reported likelihood of trying ENDS in the future. Results of the three logistic regression models show that adolescents who reported getting less than six hours of sleep per night were associated with greater odds of reporting any likelihood to try a vape in the next 30 days even when controlling for demographics and potential confounders (<6hrs sleep: OR = 2.63, 95% CI 1.30–5.31). Future research on the association between sleep deprivation and ENDS use among adolescents will benefit from using longitudinal approaches to better understand causality.
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Affiliation(s)
| | - Andrew A. Simkus
- Corresponding author at: KDH Research & Communication, 145 15th Street, NE, Suite 831, Atlanta, GA 30309, USA.
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Baker KA, Campbell NJ, Noonan D, Thompson JA, Derouin A. Vaping Prevention in a Middle School Population Using CATCH My Breath. J Pediatr Health Care 2022; 36:90-98. [PMID: 34620523 DOI: 10.1016/j.pedhc.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The number of teens using electronic cigarettes in the United States has reached epidemic proportions. One in 20 middle school youth currently vapes regularly (Wang et al., 2020), supporting the need for e-cigarette education and prevention programs in this vulnerable population. METHOD The evidence-based youth vaping prevention program, CATCH My Breath, was implemented and evaluated in a small, private, parochial middle school using a quasi-experimental, within-subjects, longitudinal design. RESULTS Students' e-cigarette knowledge significantly improved postintervention (p < .001) and was sustained at 3 months follow-up. Attitudes about vaping remained stable after postintervention and at 3 months follow-up (p > .05). Susceptibility toward vaping increased or remained consistent despite increased knowledge (p = .096). DISCUSSION CATCH My Breath is an effective school-based resource to educate middle school youth about the dangers of vaping. Additional research is needed to evaluate the intervention's impact on e-cigarette attitudes and the measurement of susceptibility in teens.
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Simpson EEA, Davison J, Doherty J, Dunwoody L, McDowell C, McLaughlin M, Butter S, Giles M. Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools. BMC Public Health 2022; 22:276. [PMID: 35144592 PMCID: PMC8832682 DOI: 10.1186/s12889-022-12674-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/25/2022] [Indexed: 12/01/2022] Open
Abstract
Background An extended version of the theory of planned behaviour (TPB) was used to inform the design of a framework for an educational resource around e-cigarette use in young people. Methods A sequential exploratory design was employed. In Phase 1, elicited behavioural, normative and control beliefs, via 7 focus groups with 51 participants, aged 11–16 years, identified salient beliefs around e-cigarette use. These were used to construct a questionnaire administered to 1511 young people aged 11–16 years, which determined predictors of e-cigarette use and ever use. In Phase 2, sociodemographic variables, e-cigarette knowledge, access, use, marketing and purchasing of e-cigarettes and smoking behaviour were also gathered. The composite findings from Phase 1 and 2 informed the design of a post primary educational resource in Phase 3 around e-cigarette use. Results Current e-cigarette use was 4%, with almost 23% reporting ever use, suggesting current use is stable but experimentation may be increasing in this cohort. Sociodemographic variables, knowledge of e-cigarettes, smoking behaviour and TPB variables (direct and indirect measures of attitudes, subjective norm, and perceived behavioural control) accounted for 17% of the variance in current e-cigarette use, with higher intentions to use e-cigarettes within the next month, having the strongest impact on use (p < 0.001), followed by self-efficacy (p = 0.016). Sociodemographic and TPB variables accounted for 65% of the variance in intentions to use e-cigarettes in the next month; current e-cigarette use (p < 0.001), more positive attitudes (p < 0.001), stronger social influence (p < 0.001), higher self-efficacy (p < 0.001), higher control beliefs (p < 0.001) and greater motivation to use e-cigarettes (p < 0.001) were the main predictors of intentions. Phases 1 and 2 informed the mapping of key predictors of intentions and use of e-cigarettes onto the Theoretical Domains Framework, which identified appropriate intervention functions and behaviour change techniques. Conclusions This paper is the first to bridge the theoretical-practice gap in an area of significant public health importance through the development of a framework for a novel theory driven school-based educational resource aimed at reducing experimentation and uptake of e-cigarette use in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12674-3.
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Affiliation(s)
- E E A Simpson
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK.
| | - J Davison
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - J Doherty
- School of Nursing and Midwifery, Queens University of Belfast, Belfast, UK
| | - L Dunwoody
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - C McDowell
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M McLaughlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - S Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M Giles
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
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18
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Mantey DS, Clendennen SL, Sumbe A, Wilkinson AV, Harrell MB. Positive Affect and Multiple-tobacco Product Use among Youth: A 3-year Longitudinal Study. Am J Health Behav 2021; 45:849-855. [PMID: 34702432 DOI: 10.5993/ajhb.45.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Multiple-tobacco product (MTP) use is common among adolescent tobacco users. Low positive affect is a risk factor for e-cigarette use and combustible tobacco smoking. In this study, we examine the longitudinal relationship between positive affect and MTP use in a diverse cohort of adolescents in Texas. Methods: We analyzed 6 waves of biennial data (fall 2014-spring 2017) from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were 3868 sixth-, eighth-, and tenth-grade students in urban Texas, at enrollment. Multinomial logistic regression models examined the longitudinal relationship between positive affect and categories of MTP use, controlling for sex, race/ethnicity, past 30-day alcohol use, cohort, survey wave, and peer tobacco use. Results: The sample was comprised of 4.6% single-product users, 1.7% dual-users, and 0.7% poly-users. Each unit decrease in positive affect was associated with increased risk for single- (RRR: 1.29; 95% CI: 1.16-1.44), dual- (RRR: 1.35; 95% CI: 1.11-1.64), and poly- (RRR: 1.98; 95% CI: 1.54-2.54) use, relative to non-use. Similarly, each unit decrease in positive affect was also associated with increased risk for poly-tobacco use relative to single- (RRR: 1.53; 95% CI: 1.19-1.97) and dual- (RRR: 1.47; 95% CI: 1.11-1.95) use. Positive affect did not differentiate between single- and dual-use. Conclusion: We observed a gradient relationship between low positive affect and greater number of tobacco products used. Findings reinforce the association between poor mental health and tobacco use during adolescence. Prevention efforts may need to incorporate methods of addressing low positive affect.
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Affiliation(s)
- Dale S. Mantey
- Dale S. Mantey, NCI Postdoctoral Fellow, Department of Health Promotion and Behavioral Science, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth)
School of Public Health in Austin, TX, United States
| | - Stephanie L. Clendennen
- Stephanie L. Clendennen, Postdoctoral Fellow, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin,
TX, United States
| | - Aslesha Sumbe
- Aslesha Sumbe, Doctoral Candidate, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States
| | - Anna V. Wilkinson
- Anna V. Wilkinson, Associate Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United
States
| | - Melissa B. Harrell
- Melissa B. Harrell, Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States;,
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Coleman M, Donaldson CD, Crano WD, Pike JR, Stacy AW. Associations Between Family and Peer E-Cigarette Use With Adolescent Tobacco and Marijuana Usage: A Longitudinal Path Analytic Approach. Nicotine Tob Res 2021; 23:849-855. [PMID: 33038257 PMCID: PMC8628870 DOI: 10.1093/ntr/ntaa204] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/01/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents' expectations and willingness to initiate CTC use, and subsequent CTC and marijuana use. AIMS AND METHODS Relationships were examined in a secondary analysis of a 3-year longitudinal cohort subsample involving adolescents enrolled in alternative California high schools (N = 1025). Analyses examined responses over three yearly observations. Family, peer, and respondents' e-cigarette use, respondents' positive cigarette expectancies and willingness to use CTCs were assessed in the study's first year (T1). CTC use in the survey's second year (T2) and marijuana use in the third year (T3) were assessed via path analysis. RESULTS Respondents reporting at least one family member or peer using e-cigarettes were more likely to use e-cigarettes at T1 than those whose peers/family members did not. They reported more positive expectancies about CTCs and greater willingness to initiate use. These variables predicted CTC use at T2, which directly anticipated marijuana use in the survey's third year (T3), as did adolescents' use of e-cigarettes at T1. All model relations were statistically significant. CONCLUSIONS Analysis demonstrated the strong association of family members' and peers' behaviors with adolescent e-cigarette use, and the temporal precedence of e-cigarette use with subsequent CTC and marijuana uptake. The predictive implications of e-cigarettes for other dangerous substance use should be examined in future prevention campaigns. IMPLICATIONS The presented study expands upon existing literature connecting adolescent e-cigarette use and later CTC and marijuana use. The findings indicate the significant implications of exposure to e-cigarette use by parents and peers and demonstrate in a longitudinal 4-year panel survey the direct and indirect predictive implications of e-cigarette use for CTC and marijuana uptake. The research illustrates the utility of programs and campaigns that target peer and family groups to maximize impacts on adolescent willingness to try CTCs, positive expectancies, and possible onset of CTC and marijuana use.
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Affiliation(s)
- Michael Coleman
- Department of Psychology, School of Social Science, Policy, and
Evaluation, Claremont Graduate University, Claremont, CA
| | - Candice D Donaldson
- Department of Psychology, School of Social Science, Policy, and
Evaluation, Claremont Graduate University, Claremont, CA
| | - William D Crano
- Department of Psychology, School of Social Science, Policy, and
Evaluation, Claremont Graduate University, Claremont, CA
| | - James R Pike
- Department of Biostatistics, Gillings School of Global Public
Health, Chapel Hill, NC
| | - Alan W Stacy
- School of Community and Global Health, Claremont Graduate
University, Claremont, CA
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Tackett AP, Keller-Hamilton B, Hébert ET, Smith CE, Wallace SW, Stevens EM, Johnson AL, Wagener TL. Adolescent Susceptibility to E-Cigarettes: An Update From the 2018 National Youth Tobacco Survey. Am J Health Promot 2021; 35:551-558. [PMID: 33167676 PMCID: PMC8496989 DOI: 10.1177/0890117120971121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE Examine correlates of e-cigarette susceptibility among adolescents. DESIGN Secondary data analyses using the 2018 National Youth Tobacco Survey, excluding participants under 12 and over 17. SETTING United States middle and high schools. SUBJECTS Never e-cigarette users (n = 12,439) ages 12-17. MEASURES Relationships between e-cigarette susceptibility and age, sex, race/ethnicity, ever tobacco use, perceived ease of purchasing tobacco products, perceived harm, relative addictiveness, household use of e-cigarettes/tobacco were examined. ANALYSIS Odds of susceptibility were modeled with weighted multivariable logistic regressions. RESULTS Thirty-five percent (unweighted n = 4,436) of adolescents were susceptible to e-cigarettes. Adolescents who were female (aOR = 1.2), Hispanic (aOR = 1.3), perceived e-cigarettes as anything less than "a lot of harm" (aOR = 2.2-4.9) and "easy" to purchase (aOR = 1.4), had ever used combustible tobacco (aOR = 2.9), or reported household use of e-cigarettes (aOR = 1.5) were susceptible. Non-Hispanic black respondents (vs. non-Hispanic white; aOR = 0.72) had significantly lower odds of susceptibility to e-cigarettes. CONCLUSION In the 2018 NYTS adolescent sample, perceptions of harm and ease of tobacco product purchase appear to be significantly related to higher odds of e-cigarette susceptibility, in addition to other demographic factors. Longitudinal data, particularly cohort data following adolescents from susceptible to actual or no use, are needed to assess predictors of e-cigarette use initiation.
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Affiliation(s)
- Alayna P. Tackett
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, CA, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Emily T. Hébert
- School of Public Health Austin, University of Texas Health Sciences Center, Houston, TX, USA
| | - Caitlin E. Smith
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Elise M. Stevens
- Harvard T. H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard University, Boston, MA, USA
| | - Amanda L. Johnson
- Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Epstein M, Bailey JA, Kosterman R, Rhew IC, Furlong M, Oesterle S, McCabe SE. E-cigarette use is associated with subsequent cigarette use among young adult non-smokers, over and above a range of antecedent risk factors: a propensity score analysis. Addiction 2021; 116:1224-1232. [PMID: 33140475 PMCID: PMC8043961 DOI: 10.1111/add.15317] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/18/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS There is a public health concern that the use of e-cigarettes among non-smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi-experimental test of the relationship between e-cigarette use and subsequent combustible cigarette use among young adult non-smokers, accounting for a wide range of common risk factors. DESIGN Logistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e-cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables. SETTING Data were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. states PARTICIPANTS: Youth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825). MEASUREMENTS Age 21 use of e-cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11-19 measures of 22 common predictors of both e-cigarette and combustible cigarette use (e.g. pro-cigarette attitudes, peer smoking, family monitoring) were used to create IPWs. FINDINGS After applying IPW, e-cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79). CONCLUSIONS Among previously never-smoking US young adults, e-cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.
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Affiliation(s)
- Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington
| | - Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington
| | - Rick Kosterman
- Social Development Research Group, School of Social Work, University of Washington
| | - Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Madeline Furlong
- Social Development Research Group, School of Social Work, University of Washington
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, Institute for Research on Women and Gender, and Center for Human Growth and Development, University of Michigan
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22
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Rogers SM, Harrell MB, Chen B, Springer A, Loukas A, Perry CL. Multi-directional pathways of tobacco and marijuana use, including comorbid use, among a population-based cohort of adolescents in Texas: A six-wave cross-lagged model. Addict Behav 2021; 115:106771. [PMID: 33387975 PMCID: PMC8686621 DOI: 10.1016/j.addbeh.2020.106771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Past 30-day tobacco and marijuana use commonly occur among adolescents. It is unclear whether use of one product precedes the other, especially given the new climate surrounding marijuana legalization and the increasing popularity of e-cigarettes. METHODS Six-panel cross-lagged regression models, with six months between each panel/Wave (2014-17), were used to model stability paths, bi-directional paths, and comorbid paths (i.e., correlations) between past 30-day use of marijuana and tobacco products. Data were derived from three cohorts of adolescents (n = 3907; weighted N = 461,069) in 6th, 8th, and 10th grades at baseline. RESULTS Few bidirectional relationships between past 30-day tobacco and marijuana use were observed in early adolescence (6th grade). During the middle adolescence developmental period (8th grade), past 30-day marijuana use was prospectively associated with greater risk of past 30-day tobacco use. In late adolescence (10th grade), increased odds of past 30-day marijuana use given prior past 30-day e-cigarette use, and vice versa, were observed. For all cohorts, stability paths were common, especially for past 30-day marijuana use. Comorbid use was common in middle adolescence (8th grade) but small in magnitude. CONCLUSIONS This is the first study to longitudinally situate comorbid, past 30-day use of tobacco and marijuana and simultaneously examine bi-directional past 30-day use of these products for adolescents. Marijuana use more often and more strongly predicted subsequent tobacco use than the reverse, especially during middle adolescence (13-15 years old). Marijuana use should be considered when creating interventions that address adolescent e-cigarette use in the U.S.
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Affiliation(s)
- Shannon M Rogers
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Andrew Springer
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
| | - Alexandra Loukas
- Health Behavior and Health Education in the Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA
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Audrain-McGovern J, Rodriguez D, Testa S, Alexander E, Pianin S. Adolescent E-Cigarette Onset and Escalation: Associations With Internalizing and Externalizing Symptoms. J Adolesc Health 2021; 68:801-807. [PMID: 33158686 PMCID: PMC8012221 DOI: 10.1016/j.jadohealth.2020.09.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE We sought to evaluate if internalizing symptoms (i.e., anxiety and depression) and/or externalizing symptoms (i.e., impulsivity, sensation seeking, and substance use) were risk factors for the onset of 30-day e-cigarette use and escalation in the number of days used across the following 30 months among adolescents. METHODS Adolescents (N = 1,808) from public high schools outside Philadelphia, PA, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 30 months (spring 2019, end of 11th grade). RESULTS A two-part latent growth curve model of e-cigarette use revealed significant positive associations between externalizing factors, past 30-day e-cigarette use, and the number of days of e-cigarette use only at wave 1 (p values <.05). Cigarette smoking was associated with a slowing in the rate of onset of 30-day e-cigarette use across the 30-month follow-up (β = -.24, z = -2.41, p = .02). Depression was associated with an increased rate of escalation in the number of days of e-cigarette use across the following 30 months (β = .01, z = 2.52, p = .01), whereas anxiety was associated with a decreased rate (β = -.72, z = -2.36, p = .02). CONCLUSIONS The findings highlight two groups of adolescents at risk for e-cigarette use: adolescents whose e-cigarette use reflects a higher-risk profile with early e-cigarette onset, and adolescents who have a lower-risk profile, at least initially, with later e-cigarette use onset. The timing and content of prevention efforts should be tailored to each group.
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Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, LaSalle University, 1900 West Olney Avenue, Philadelphia, PA 19141, United States of America
| | - Shannon Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States of America
| | - Emily Alexander
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States of America
| | - Stephen Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States of America
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Burnley A, Bold KW, Kong G, Wu R, Krishnan-Sarin S. E-cigarette use perceptions that differentiate e-cigarette susceptibility and use among high school students. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:238-246. [PMID: 33058696 DOI: 10.1080/00952990.2020.1826501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND E-cigarette use among adolescents is increasingly popular and a growing public health concern. OBJECTIVES To examine how individual e-cigarette use perceptions differ between adolescents based on e-cigarette use status and susceptibility to future use of e-cigarettes. METHODS Data were collected using surveys administered across eight Connecticut high schools (grades 9-12), Spring 2015. N = 2592 students (Mage = 16.01, SD = 1.28, Female = 51.7%) reported e-cigarette use and susceptibility and were categorized into non-susceptible never-users (57.8%), susceptible never-users (16.9%) and ever-users (25.4%). Youth also responded to 12 e-cigarette use perceptions describing perceived benefits and risks of e-cigarette use. RESULTS A multinomial logistic regression model was used. Eight use perceptions were related to susceptibility or use of e-cigarettes. The benefit-related use perception "feel relaxed" was the only item associated with greater odds of being both susceptible (vs. non-susceptible, p <.001) and an ever-user (vs. susceptible; p <.05). Two other benefit-related use perceptions were related to higher odds of being susceptible to e-cigarette use ("control your weight"; AOR = 1.82, p <.05; "look cool"; AOR = 3.13, p <.05). Results also identified key risk-related use perceptions that related to lower odds of either being susceptible to e-cigarette use ("have a heart attack"; AOR =.43, p <.001) or of ever-use ("have bad breath"; AOR =.28, p <.001; "get lung cancer"; AOR =.58, p <.05). CONCLUSION E-cigarette use perceptions among youth differ by e-cigarette use and susceptibility status. Findings could help identify youth who are vulnerable to e-cigarette use and inform prevention, for example by developing counter-messaging for benefit perceptions associated with susceptibility and ever-use.
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Affiliation(s)
- Annabel Burnley
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Krysten W Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ran Wu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Abstract
Electronic cigarettes (EC) are battery-operated devices that heat and aerosolize a liquid solution that typically contains nicotine. ECs have become commonly used among youth and may pose substantial risks of future addiction and health problems in this population. However, ECs are far less toxic per puff compared with combustible cigarettes, and as a result, might present an important harm reduction opportunity for cigarette smokers who cannot stop smoking by traditional means. The long-term health effects of ECs on individuals and the net effect on public health will remain unknown for many years.
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Margolis KA, Thakur SK, Nguyen Zarndt A, Kemp CB, Glover-Kudon R. E-cigarette susceptibility among U.S. middle and high school students: National Youth Tobacco Survey Data Trend Analysis, 2014-2018. Prev Med 2021; 143:106347. [PMID: 33271235 PMCID: PMC10515727 DOI: 10.1016/j.ypmed.2020.106347] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022]
Abstract
Youth e-cigarette use has rapidly increased in the last few years. Susceptibility is a validated measure associated with future tobacco use. We examined trends in e-cigarette susceptibility across five years (2014-2018) of the National Youth Tobacco Survey among youth e-cigarette never users. We observed increases in overall e-cigarette susceptibility from 2014 to 2016 and decreases from 2016 to 2018. Generally, sociodemographic variables were not associated with trend effects; however, there was an interaction between linear trends with both race/ethnicity and other tobacco product (OTP) use. The percentage of youth who were susceptible to using e-cigarettes ranged from 32.9% in 2014 to 33.2% in 2018 with a high of 36.7% in 2016. We also examined the prevalence of e-cigarette susceptibility by race/ethnicity, sex, school level, OTP use, and e-cigarette harm perception. E-cigarette susceptibility was associated with race, school level, OTP ever use, and e-cigarette harm perceptions. Hispanic youth, those in high school, and OTP ever users were more likely to be susceptible to e-cigarette use compared to their counterparts across all years. E-cigarette susceptibility was most prevalent among those who perceived e-cigarettes to pose "no harm" in 2014 and "little harm" in 2018 when compared to other item response options in 2014 and 2018, respectively. This study is the first to document trends in e-cigarette susceptibility among youth. Understanding antecedents of e-cigarette use and identifying youth subgroups vulnerable to e-cigarette use is valuable to developing effective prevention efforts. Disclaimer: The findings and conclusions in this publication are those of the authors and do not necessarily represent the official position of the Food and Drug Administration or the Centers for Disease Control and Prevention.
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Affiliation(s)
- Katherine A Margolis
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America.
| | - Sapna K Thakur
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Anh Nguyen Zarndt
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Catherine B Kemp
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Rebecca Glover-Kudon
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, United States of America
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Obinwa U, Clendennen SL, Rangwalam S, Sumbe A, Case KR, Harrell MB. Comparing Risk Factors for Past 30-day E-cigarette and Combustible Tobacco Use: A Longitudinal Analysis of the Texas Adolescent Tobacco and Marketing Surveillance Study (2014-2017). TEXAS PUBLIC HEALTH JOURNAL 2021; 73:25-32. [PMID: 35759323 PMCID: PMC9232195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Youth use of e-cigarettes is reaching 'epidemic proportions,' even as combustible tobacco use is declining. Comparison of risk factors that are uniquely associated with e-cigarette and combustible tobacco use among adolescents is warranted. METHODS Six waves of data from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) study (n=3907; N=461,069; 2014-2017) were used in this analysis. A random intercept logistic regression model was used to compare intrapersonal, interpersonal, and environmental risk factors for use of both products based on the Social Ecological Model. RESULTS Risk factors that were significantly associated with both past 30-day use of e-cigarette and combustible tobacco products over time included past 30-day use of marijuana and alcohol, social acceptability of product use, having friends and family members who used the products, and male gender. Increasing age, worse academic performance, higher sensation seeking score, higher recall of social media promotion in the past 30 days, and lower positive affect score were associated with past 30-day use of combustible tobacco only. White race was associated with past-30 day use of e-cigarettes only. CONCLUSION Involving peers and parents in preventive interventions designed to reduce uptake of these products is paramount, as is the need to address other substance use, like alcohol and marijuana. Efforts should also be made to create a social climate that makes tobacco use (e-cigarettes and combustible products) less acceptable and desirable.
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Affiliation(s)
- Udoka Obinwa
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Stephanie L. Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Shazia Rangwalam
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Kathleen R. Case
- The University of Texas Health Science Center at Houston (UT Health), School of Public Health in San Antonio
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
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29
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Affiliation(s)
- John P. Hoffmann
- Department of Sociology, Brigham Young University, Provo, UT, USA
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30
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Barnes AJ, Bono RS, Rudy AK, Hoetger C, Nicksic NE, Cobb CO. Effect of e-cigarette advertisement themes on hypothetical e-cigarette purchasing in price-responsive adolescents. Addiction 2020; 115:2357-2368. [PMID: 32285978 PMCID: PMC7554057 DOI: 10.1111/add.15084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/02/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022]
Abstract
AIMS To examine the effect on adolescents of exposure to different e-cigarette advertisement themes on reported likelihood of purchasing e-cigarettes in a hypothetical scenario. DESIGN Between-subjects design of four randomly assigned thematic conditions derived from a content analysis of 350 e-cigarette advertisements: general, flavor- and taste-themed, people- and product use-themed or control advertisements for bottled water. SETTING Virginia, USA. PARTICIPANTS Of 1360 adolescents (13-18 years old) participating, 1063 had complete data (519 current cigarette smokers, 544 tobacco-susceptible non-smokers). MEASUREMENTS Participants completed an e-cigarette purchase task, reporting the likelihood of buying an e-cigarette at various prices. Indices of abuse liability included price responsiveness (whether likelihood of purchase decreased with increasing prices) and, among price-responsive adolescents, breakpoint (highest price before definitely would not buy), maximum probability-weighted expenditure (Omax ) and price elasticity (how quickly willingness to purchase decreases as prices increase). Regressions controlled for demographics, prior tobacco ad exposure, tobacco/substance use and sensation-seeking. FINDINGS Prior advertisement exposure was positively associated with being price-responsive [odds ratio (OR) = 1.12, 95% confidence interval (CI) = 1.03, 1.22; P < 0.05]. Among price-responsive adolescents (n = 579), breakpoints were 58% higher in the flavor- and taste-themed condition (β = 0.46, 95% CI = <0.01, 0.92) and 75% higher in the people- and product use-themed condition (β = 0.56, 95% CI = 0.10, 1.03) compared with control (Ps < 0.05). Exposure to people- and product use-themed advertisements was associated with a 60% higher Omax (β = 0.47, 95% CI = 0.01, 0.93; P < 0.05). The general and people- and product use-themed conditions were associated with 19% (β = -0.21, 95% CI = -0.38, -0.04) and 21% (β = -0.24, 95% CI = -0.42, -0.06) lower elasticity, respectively (Ps < 0.05). CONCLUSIONS E-cigarette advertising exposure may increase reported likelihood of purchasing e-cigarettes, with effects differing by advertisement content. People- and product use-themed e-cigarette advertisements increased reported likelihood of purchasing in price-responsive adolescents.
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Affiliation(s)
- Andrew J. Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond VA, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond VA, USA
| | - Rose S. Bono
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond VA, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond VA, USA
| | - Alyssa K. Rudy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
| | - Cosima Hoetger
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
| | - Nicole E. Nicksic
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond VA, USA,Cancer Support Community, New York NY, USA
| | - Caroline O. Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
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Fite PJ, Cushing C, ODell C. Examination of the links between functions of aggression and risk for e-cigarette use among middle school-age youth: a comparison with risk for alcohol use. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1784302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paula J. Fite
- Clinical Child Psychology Program, University of Kansas, Lawrence, USA
| | | | - Chloe ODell
- Clinical Child Psychology Program, University of Kansas, Lawrence, USA
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32
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Fite PJ, Cushing C, Ortega A. Three year trends in e-cigarettes among Midwestern middle school age youth. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1725163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Paula J. Fite
- Clinical Child Psychology Program and Life Span Institute, University of Kansas, Lawrence, Kansas, USA
| | - Cristopher Cushing
- Clinical Child Psychology Program and Life Span Institute, University of Kansas, Lawrence, Kansas, USA
| | - Adrian Ortega
- Clinical Child Psychology Program and Life Span Institute, University of Kansas, Lawrence, Kansas, USA
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33
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Evaluating Evidence to Underscore Health Promotion Activities to Prevent Teenage Vaping. J Addict Nurs 2020; 31:134-136. [PMID: 32487940 DOI: 10.1097/jan.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Electronic Nicotine Delivery Systems (ENDS) are a new form of tobacco and marijuana administration that obscures the dangers of substance use and can be appealing to adolescents with a multitude of adolescent appeals and the use of electronic technology. As adolescent incidence of ENDS uses increases, health providers stand to lose ground with the past successes of tobacco- and substance-related health promotion as adolescents are initiated with the new technology. These risks identify the need for quality screening or the specific inclusion of ENDS products into our established screening methods. In addition, those who screen positive are provided quality interventions, such as motivational interviewing, that are effective and developmentally appropriate. By increasing our knowledge of ENDS, including them specifically in our regular screenings, and supporting adolescents in positive health choices, successful aversion of lifelong health risks can be overcome.
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35
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Abstract
Purpose of the review The purpose of this review is to describe current trends in e-cigarette use, provide an overview of the potential health risks and benefits, and discuss tobacco policy and regulatory considerations. Recent Findings E-cigarette use is popular among youth and adults, despite limited evidence about the long-term risks or benefits. Internationally there is wide variability in how e-cigarettes are classified, which has also led to large differences in regulations on these products. Regulatory policies that strike a balance between the potential benefit of these devices for adult smokers who are trying to quit smoking with reducing the appeal and addictive potential for youth are critically needed. Summary Continued research on the health effects and consequences of e-cigarette use will be essential to inform e-cigarette product standards and tobacco regulatory policies as scientific research strives to keep pace with the ever-changing landscape of e-cigarette technology.
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Affiliation(s)
- Krysten W Bold
- Yale University School of Medicine, 34 Park Street CMHC, New Haven, CT 06519
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36
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Nicksic NE, Barnes AJ. Is susceptibility to E-cigarettes among youth associated with tobacco and other substance use behaviors one year later? Results from the PATH study. Prev Med 2019; 121:109-114. [PMID: 30776386 PMCID: PMC6594855 DOI: 10.1016/j.ypmed.2019.02.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 01/25/2019] [Accepted: 02/07/2019] [Indexed: 01/07/2023]
Abstract
E-cigarettes are the most commonly used tobacco product among youth. In addition to harm potential, e-cigarette use is associated with initiating cigarette smoking. Limited research exists whether susceptibility to e-cigarette use is a risk factor for future tobacco and other substance use initiation. This study examined associations between baseline e-cigarette susceptibility and initiation and past 30-day use of e-cigarettes and cigarettes as well as initiation of marijuana and alcohol one year later, after adjusting for other risk factors and sociodemographic confounders. The study sample consisted of 5156 nationally representative youth (12-17 years) who completed both waves 1 (2013-2014) and 2 (2014-2015) of the Population Assessment of Tobacco and Health (PATH) study and were never users of tobacco, marijuana, and alcohol in Wave 1. Youth who were susceptible to e-cigarettes had increased odds of initiating e-cigarettes (adjusted OR: 2.22, 95% CI: 1.55-3.18), marijuana (aOR: 1.66, 95% CI: 1.12-2.46), and alcohol (aOR: 1.61, 95% CI: 1.26-2.06) between waves, as well as past reporting 30-day e-cigarette use (aOR: 3.64, 95% CI: 1.93-6.89) in Wave 2. Additionally, cigarette susceptibility, but not e-cigarette susceptibility, was associated with cigarette initiation (aOR: 3.36, 95% CI: 1.95-5.82) and past 30-day use (aOR: 2.83, 95% CI: 1.34-5.97). Prevention policies, as well as future research, could target youth susceptible to e-cigarettes to reduce the current trends on the use of these alternative tobacco products. Such efforts may also reduce the use of cigarettes and other substances.
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Affiliation(s)
- Nicole E Nicksic
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, United States of America; Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States of America.
| | - Andrew J Barnes
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, United States of America; Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States of America
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37
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McKelvey K, Halpern-Felsher B. From tobacco-endgame strategizing to Red Queen's race: The case of non-combustible tobacco products. Addict Behav 2019; 91:1-4. [PMID: 30642577 PMCID: PMC6541479 DOI: 10.1016/j.addbeh.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
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