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Barnes C, Turon H, McCrabb S, Mantach S, Janssen L, Duffy M, Groombridge D, Hodder R, Meharg D, Robinson E, Bialek C, Wallace S, Leigh L, Wolfenden L. Factorial randomised controlled trial to examine the potential effect of a text message-based intervention on reducing adolescent susceptibility to e-cigarette use: a study protocol. BMJ Open 2024; 14:e083251. [PMID: 39153795 PMCID: PMC11331865 DOI: 10.1136/bmjopen-2023-083251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/19/2024] [Indexed: 08/19/2024] Open
Abstract
INTRODUCTION Adolescent e-cigarette use, globally and within Australia, has increased in recent years. In response, public health agencies have called for the development of education and communication programmes targeting adolescents. Despite such recommendations, few rigorous evaluations of such interventions currently exist. The main objective of this study is to examine the potential effect of a text message intervention targeting parents and adolescents on adolescent susceptibility to e-cigarette use (eg, intentions towards using e-cigarettes). Secondary objectives are to (1): examine the effect of the intervention on adolescent e-cigarette and combustible tobacco use and (2) examine the acceptability of the intervention. METHODS AND ANALYSIS A randomised controlled trial employing a 2×2 factorial design will be conducted with parent-adolescent dyads (aged 12-15 years). Dyads will be randomly allocated to one of four arms: arm 1-a text message intervention delivered to adolescents only; arm 2-a text message intervention delivered to the parents of adolescents only; arm 3-a text message intervention delivered to both the parents and adolescents; and arm 4-an information only control, consisting of an e-cigarette factsheet provided to parents only. Participant recruitment commenced in March 2023 with the aim to recruit 120 parent-adolescent dyads. Data collection to assess study outcomes will occur at baseline, 6, 12 and 24 months post the commencement of the intervention. The primary endpoint will be 6-month follow-up. The primary outcome will be adolescent susceptibility to e-cigarette use, assessed using validated items. Analyses of trial outcomes will be undertaken under an intention-to-treat framework, with all participants included in the analysis in the group they were allocated. ETHICS AND DISSEMINATION Ethics approval has been obtained from the human research ethics committee of the University of Newcastle (H-2022-0340). Findings will be disseminated in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER The trial was registered prospectively with Australian New Zealand Clinical Trials Registry (ACTRN12623000079640).
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Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Heidi Turon
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Sam McCrabb
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Stephanie Mantach
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lisa Janssen
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Megan Duffy
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Daniel Groombridge
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Rebecca Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - David Meharg
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Elly Robinson
- Parenting Research Centre, East Melbourne, Victoria, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Seaneen Wallace
- Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, New South Wales, Australia
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Pbert L, Dubé CE, Nagawa CS, Simone DP, Wijesundara JG, Sadasivam RS. Vaping cessation support recommendations from adolescents who vape: a qualitative study. BMC Public Health 2024; 24:1615. [PMID: 38886719 PMCID: PMC11181636 DOI: 10.1186/s12889-024-19036-1] [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: 03/11/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Youth vaping is a serious public health concern, being more prevalent than any other tobacco use. To inform cessation interventions, we explored what adolescents perceive as their reasons for quitting and strategies to help them quit. METHOD Semi-structured interviews were conducted with a convenience sample of 11 adolescents reporting vaping in the past 90 days and recruited from a high school in Massachusetts. Interviews were transcribed and dual-coded. Inductive thematic analysis was employed, and thematic summaries were prepared. RESULTS Reasons adolescents reported for quitting included cost, experiencing "nic-sick" from nicotine withdrawal or excess intake, negative impacts on mood, concentration, or health, and experiencing symptoms of nicotine dependence. Nearly all tried to quit multiple times. Barriers to quitting included exposure to vaping, access to vape products, stress, and "cool" new products or flavors. Quit strategies included avoiding others vaping, seeking social support to quit, addressing peer pressure to continue vaping, learning successful quit strategies from peers, and using distraction strategies or alternatives to vaping. CONCLUSION Many adolescents who vape want to quit, and most have tried multiple times. Interventions need to engage adolescents with varying reasons to quit, barriers, and quit strategy preferences. CLINICAL TRIAL REGISTRATION This study is registered through ClinicalTrials.gov. The trial registration number is NCT05140915. The trial registration date is 11/18/2021.
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Affiliation(s)
- Lori Pbert
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA.
| | - Catherine E Dubé
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Catherine S Nagawa
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, 100 Cambridge Street, Boston, MA, 02114, USA
| | - Dante P Simone
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Jessica G Wijesundara
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
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de Andrés-Sánchez J, Belzunegui-Eraso A, Valls-Fonayet F. The significance of information variables in polydrug use by adolescents: insights from a cross-sectional study in Tarragona (Spain). PeerJ 2024; 12:e16801. [PMID: 38259667 PMCID: PMC10802159 DOI: 10.7717/peerj.16801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Substance use, especially among adolescents, is a significant public health concern, with profound implications for physical and psychological development. This study aimed to evaluate the quantity and sources of information available to adolescents regarding polydrug use. A cross-sectional survey was conducted in Tarragona involving adolescents with an average age of 16.44 years. This study assessed the number of substances used (alcohol, cigarettes, and cannabis) in the past month, along with information sources related to substance use. Monitored sources (e.g., schools, parents, and mass media) and unmonitored sources (e.g., peers, siblings, internet) were distinguished. In addition, four individual and four environmental control variables were considered. Multinomial logistic regression analysis revealed that incorporating variables related to adolescents' substance use information and its sources enhanced the explanatory model, surpassing control variables. The degree of information about substance use did not significantly explain consumption patterns, but the number of information sources, both monitored and unmonitored, did. The unmonitored sources were associated with increased polydrug use. Conversely, greater reliance on supervised sources for information was linked to reduced single-substance and polydrug use. This protective effect increased with an increase in the number of substances used. In conclusion, information obtained from monitored sources acts as a deterrent to substance consumption, consistent with findings suggesting that greater health literacy among adolescents discourages substance use. Conversely, this study suggests that information from more informal sources may encourage heavier polydrug use, aligning with reports indicating that adolescents with a more comprehensive understanding of substance use consequences tend to engage in heavier drug use.
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Le TTT. Key Risk Factors Associated With Electronic Nicotine Delivery Systems Use Among Adolescents. JAMA Netw Open 2023; 6:e2337101. [PMID: 37862018 PMCID: PMC10589803 DOI: 10.1001/jamanetworkopen.2023.37101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/28/2023] [Indexed: 10/21/2023] Open
Abstract
Importance The prevalence of electronic nicotine delivery systems (ENDS) use among US youths has increased significantly during the past decade. Identifying key factors highly associated with ENDS use is essential in monitoring and preventing this harmful behavior among youths. Objective To identify the most important risk factors in wave 4.5 (ie, December 2017 to December 2018) of the Population Assessment of Tobacco and Health Study (PATH) data that are associated with ENDS use in wave 5 (ie, December 2018 to November 2019) among adolescents who were tobacco-naive at baseline. Design, Setting, and Participants This prognostic study examined data from waves 4.5 and 5 of the PATH youth data set using machine learning techniques. The PATH study is a nationally representative longitudinal cohort study of tobacco use and health in the United States among individuals aged 12 years and older. The data analysis was carried out between January and April 2023. Main Outcomes and Measures Wave 5 current ENDS use status of wave 4.5 adolescents who were tobacco-naive. Results The analyzed data set comprised 7943 individuals who were tobacco-naive in wave 4.5. Among this group, 332 participants (4.2%) indicated their present use of ENDS in wave 5, 5047 (63.5%) were aged 12 to 14 years, 4066 (51.2%) were male, and 2455 (30.9%) were Hispanic. The most important risk factors of ENDS use in wave 5 among adolescents who were tobacco-naive in wave 4.5 were the likelihood of using ENDS if offered by a best friend (mean SHAP value, 0.184), the number of best friends using e-cigarettes (mean SHAP value, 0.167), household tobacco usage (mean SHAP value, 0.161), curiosity about ENDS use (mean SHAP value, 0.088), future intention to use ENDS (mean SHAP value, 0.068), youth's total average weekly earnings (mean SHAP value, 0.060), and perceptions of tobacco product safety (mean SHAP value, 0.026). Conclusions and Relevance The findings of this study suggest that family and friends play an important role in ENDS use among adolescents. The top-ranking factors associated with ENDS use in this study are areas for further exploration, given the increasing prevalence of ENDS use among youths in recent years. Additionally, these findings highlight the important role of families and schools in shaping adolescents' tobacco-related knowledge, which can protect them from using ENDS.
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Affiliation(s)
- Thuy T. T. Le
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
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Cheng HG, Lizhnyak PN, Richter N. Mutual pathways between peer and own e-cigarette use among youth in the United States: a cross-lagged model. BMC Public Health 2023; 23:1609. [PMID: 37612711 PMCID: PMC10463603 DOI: 10.1186/s12889-023-16470-5] [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: 12/09/2022] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have become the most common tobacco product used among adolescents in the United States (US). Prior research has shown that peer e-cigarette use was associated with increased risk of own e-cigarette use. Nonetheless, there is little empirical evidence on the directionality of these associations-if peer use predicts own use (peer influence) or if own use predicts peer use (peer selection). METHODS We estimated the association between peer and own e-cigarette use among US adolescents 12-17 years of age. We used the cross-lagged model to investigate the mutual relationship between peer and own e-cigarette use over time using data from a population-based longitudinal study, Population Assessment of Tobacco and Health. Stratified analyses were conducted by sex and age subgroups. RESULTS Results from a cross-lagged model showed a statistically significant predicting path leading from peer use at the prior time point to own use at the following time point, but not vice versa. CONCLUSIONS We found strong relationships between peer e-cigarette use and own e-cigarette use at within-individual levels. Peer influence paths were more robust than peer selection paths for e-cigarette use. Incorporating peers into prevention and intervention programs may help enhance these strategies.
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Affiliation(s)
- Hui G Cheng
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA.
| | - Pavel N Lizhnyak
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| | - Nadja Richter
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
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Li W, Osibogun O, Gautam P, Li T, Cano MÁ, Maziak W. Effect of harm perception on ENDS initiation among US adolescents and young adults: Longitudinal findings from the population assessment of tobacco and health (PATH) study, 2013-2018. Drug Alcohol Depend 2023; 244:109784. [PMID: 36706674 DOI: 10.1016/j.drugalcdep.2023.109784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND This study investigates how ENDS harm perception influences ENDS initiation over time among US young people. METHODS Data were from the sample of the Population Assessment of Tobacco and Health (PATH) Study conducted from 2013 to 2018. The Cox proportional hazards regression models were used to assess the relationship between absolute (the perception of harm from ENDS only) and relative harm perception (ENDS' harm relative to cigarettes) and ENDS initiation among adolescents (12-17 years) and young adults (18-24 years) separately. Harm perception was assessed at the wave before ENDS initiation in a subsequent wave. Weighted results were reported. RESULTS Of the 11,633 adolescents and 5089 young adults from baseline, 17.1% and 25.5% initiated ENDS use across four waves, respectively. Among adolescents (HR=2.31; 95%CI: 1.95-2.73) and young adults (HR=1.97; 95%CI: 1.69-2.30), perceiving lower relative harm of ENDS significantly predicted ENDS initiation in subsequent waves. Among adolescents, perceiving lower absolute harm of ENDS (HR=2.18; 95%CI: 1.83-2.60) predicted ENDS initiation in subsequent waves. Additionally, adolescents and young adults who ever used any other tobacco products or alcohol and lived with anyone who used tobacco were more likely to initiate ENDS use. CONCLUSIONS Among a representative longitudinal cohort of adolescents and young adults who had never used ENDS at baseline, perceiving ENDS as reduced or low-harm products significantly predicted ENDS initiation in subsequent waves. These findings underscore the importance of ENDS harm perception and the central role of risk communication strategies that need to target those young people at particular risk of unwarranted ENDS use.
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Affiliation(s)
- Wei Li
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA; Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
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A systematic review of socio-ecological factors influencing current e-cigarette use among adolescents and young adults. Addict Behav 2022; 135:107425. [DOI: 10.1016/j.addbeh.2022.107425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 12/22/2022]
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Relationships between ENDS-Related Familial Factors and Oral Health among Adolescents in the United States. Healthcare (Basel) 2022; 10:healthcare10020402. [PMID: 35207015 PMCID: PMC8871736 DOI: 10.3390/healthcare10020402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
The influence of familial and social environments plays a significant role in Electronic Nicotine Delivery System (ENDS) use and may contribute to poor oral health among adolescents. This study utilized the Population Assessment of Tobacco and Health (PATH) database and included youths aged 12 to 17 years who reported no history of dental health issues at baseline. Adjusted odds ratios (AOR) were used to examine the association between END-related familial factors and oral health among adolescents in the United States, with statistical significance set at p < 0.05. The sample consisted of 3892 adolescents (weighted N = 22,689,793). Parents’ extremely negative reaction towards ENDS when they found their children using ENDS (AOR = 0.309) was connected to a lower risk of oral health issues. The findings suggest that clinicians and policymakers need to consider the roles of these factors when developing strategies to improve oral health outcomes.
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Erinoso O, Oyapero A, Amure M, Osoba M, Osibogun O, Wright K, Osibogun A. Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use. PLoS One 2021; 16:e0258850. [PMID: 34679087 PMCID: PMC8535460 DOI: 10.1371/journal.pone.0258850] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have emerged in the Nigerian market, and if used without supervision, may have damaging effects on the physical and mental health of users. Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria. METHOD An online cross-sectional study among participants aged between 15-35 years. The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a 7-item Generalized Anxiety Disorder (GAD-7) scale. Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use. P-values <0.05 were considered significant. Statistical analysis was done using STATA-15.0 software. RESULTS Data from a total of 949 respondents was analysed. Participants had a mean age of 23.36 years (±3.97) and were predominantly female (55.64%). The prevalence of e-cigarette ever-use was 7.9% (95% CI: 5.8,10.0). Older age and being male were independently associated with higher odds of e-cigarette use. After adjusting for age and sex, alcohol use (p<0.001), friend's use (p<0.001), and other tobacco product or substance use (p:0.05) remained significantly associated with higher odds of e-cigarette use. There was no association between anxiety levels and e-cigarette use. CONCLUSION These findings suggest a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who use e-cigarettes. Health providers and policy makers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years.
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Affiliation(s)
- Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Afolabi Oyapero
- Department of Preventive Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Mary Amure
- Department of Preventive Dentistry, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Moyosoore Osoba
- African Center of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun State, Nigeria
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, United States of America
| | - Kikelomo Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Akin Osibogun
- Department of Community Health and Primary Health Care, College of Medicine, University of Lagos, Lagos, Nigeria
- * E-mail:
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