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Wang N, Dove MS, Tong EK. Serious psychological distress and higher associations with tobacco and cannabis use among college students in the United States. Prev Med 2024; 185:108041. [PMID: 38866211 DOI: 10.1016/j.ypmed.2024.108041] [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: 02/12/2024] [Revised: 05/10/2024] [Accepted: 06/10/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To examine associations between serious psychological distress (SPD) and tobacco and cannabis use among college students in the United States. METHODS This cross-sectional study included 257,626 college students from the 2019-2022 National College Health Assessment survey. SPD was defined as having symptoms in the past month. Current tobacco (i.e., cigarettes, e-cigarettes) and cannabis use was defined as past month use. Multiple product use was categorized for single, dual, or triple products. Adjusted logistic regression models were used to examine associations between SPD, tobacco, cannabis, and multiple product use. RESULTS SPD increased over time (18.4% to 23.8%) among students and nearly 30% of tobacco or cannabis users reported SPD. Cigarette, e-cigarette, or cannabis use was associated with about a 50-60% increased likelihood of reporting SPD than non-current use of each product, with the highest associations in Fall 2020. Triple product users had double the likelihood of reporting SPD, followed by dual users at 70% and single users at 47%, relative to non-current users. Daily users also had nearly twice the likelihood of reporting SPD, followed by non-daily users at 13-35%, relative to non-current users. CONCLUSIONS College students have an increasing burden of SPD which is significantly associated with tobacco and cannabis use. There is a dose-response relationship between the number of tobacco and cannabis products used, as well as the frequency of use, and SPD among U.S. college students. Colleges addressing student mental health should prioritize the implementation of screening and treatment support for tobacco, cannabis, and multiple product use.
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Affiliation(s)
- Nan Wang
- Department of Public Health Sciences, University of California Davis, Davis, USA
| | - Melanie S Dove
- Department of Public Health Sciences, University of California Davis, Davis, USA; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, USA
| | - Elisa K Tong
- Department of Internal Medicine, University of California Davis, 4150 V Street Suite 2400, Sacramento, CA 95817, USA; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, USA.
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Do VV, Ling PM, Chaffee BW, Nguyen N. Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths. JAMA Netw Open 2024; 7:e2419976. [PMID: 38958977 PMCID: PMC11222996 DOI: 10.1001/jamanetworkopen.2024.19976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/01/2024] [Indexed: 07/04/2024] Open
Abstract
Importance Little is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths. Objective To examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths. Design, Setting, and Participants This cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024. Exposure Past 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse. Main Outcomes and Measures Self-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs-Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms). Results A total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone. Conclusions and Relevance In this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.
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Affiliation(s)
- Vuong V. Do
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- School of Dentistry, University of California, San Francisco
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Adzrago D, Sulley S, Williams F. Immigration status-related exclusive e-cigarette use and cannabis use and their dual use disparities associated with mental health disorder symptoms. Drug Alcohol Depend 2024; 255:111083. [PMID: 38215510 PMCID: PMC10866552 DOI: 10.1016/j.drugalcdep.2024.111083] [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: 08/01/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/14/2024]
Abstract
INTRODUCTION E-cigarette and cannabis use has been linked to various health risks, including respiratory and cardiovascular conditions. Yet, extant knowledge about the risk factors for exclusive and dual use of e-cigarettes and cannabis is limited, especially among immigrants. We examined exclusive e-cigarette and cannabis use and their dual use associated with mental health disorders among immigrants and U.S.-born. METHODS We analyzed national cross-sectional data collected between May 13, 2021, and January 9, 2022, among adults aged >18 years (n= 4766) living in U.S. Multinomial logistic regression analyses were conducted to model the associations of exclusivity and dual-use (reference group= non-use) with anxiety/depression. RESULTS The dual-use prevalence was higher than exclusive e-cigarette and cannabis use, especially among U.S.-born (dual use= 14.79% vs. cannabis use= 13.53% vs. e-cigarette use= 7.11%) compared to immigrants (dual use= 8.23% vs. cannabis use= 5.03% vs. e-cigarette use= 6.31%). Immigrants had lower risks of exclusive cannabis and dual use compared to U.S.-born. Anxiety/depression was associated with higher risks of exclusive cannabis use and dual use across immigration status, but was associated with exclusive e-cigarette use among only immigrants. While effect sizes of dual-use associated with anxiety/depression were higher among U.S.-born, the effect sizes of exclusive e-cigarette and cannabis use associated with anxiety/depression were higher among immigrants. CONCLUSIONS The findings revealed significant mental health risks for e-cigarette, cannabis, and their dual use among immigrants and U.S.-born, especially among U.S.-born. These findings highlight the need for public health research and interventions to consider immigration status-related disparities in substance use.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Mattingly DT, Mezuk B, Elliott MR, Neighbors HW, Fleischer NL. Racial and Ethnic Disparities in Mental Health Problems and Tobacco and Cannabis Use Among US Emerging Adults. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01822-z. [PMID: 37828404 DOI: 10.1007/s40615-023-01822-z] [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] [Received: 07/13/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear. METHODS We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and cannabis use indicators (i.e., cigarettes, electronic nicotine delivery systems (ENDS), cigars, blunts, cannabis vaping, other cannabis). We estimated associations between past 30-day internalizing and externalizing (i.e., low (referent), moderate, high) problems and latent classes of tobacco/cannabis use (vs. never/former use) using adjusted multinomial logistic regression. We explored whether associations varied by race and ethnicity through stratification. RESULTS We identified four exclusive use latent classes and two dual/poly use latent classes for both youth and young adult samples. Race/ethnicity-stratified models identified associations between internalizing/externalizing problems and most use classes for Hispanic and non-Hispanic White youth/young adults, with mixed results for non-Hispanic Black youth/young adults. For example, Hispanic (OR: 2.50, 95% CI: 1.09-5.74) and non-Hispanic White (OR: 1.90, 95% CI: 1.18-3.06) youth with high internalizing problems had higher odds of ENDS + cannabis vaping. Externalizing problems were not associated with use among non-Hispanic Black youth while internalizing problems were not associated with use among non-Hispanic Black young adults. CONCLUSION We observed racial/ethnic variation in mental health problems and tobacco and cannabis use. Understanding mental health problem and tobacco product and cannabis use comorbidity may better inform culturally relevant interventions aimed to prevent and reduce use.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
- Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
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Wang Y, Duan Z, Weaver SR, Self-Brown SR, Ashley DL, Emery SL, Pechacek TF, Huang J. Cigarette Coupon Receipt and Smoking Relapse by Duration of Smoking Abstinence. Am J Prev Med 2023; 65:485-496. [PMID: 36918321 PMCID: PMC10440251 DOI: 10.1016/j.amepre.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 03/13/2023]
Abstract
INTRODUCTION It is unknown whether and to what extent the duration of smoking abstinence may modify the association between receiving cigarette coupons and smoking relapse in the U.S. This study aims to fill this gap. METHODS Data were from the Population Assessment of Tobacco and Health study Wave 4 (December 2016-January 2018, baseline) and Wave 5 (December 2018-November 2019, follow-up) surveys. Analysis was conducted in May 2022. The study sample was participants who formerly smoked cigarettes at baseline (N=5,186). The exposure was past 12-month receipt of cigarette coupons (yes/no) at baseline, and the outcome was cigarette smoking relapse (yes/no) at follow-up. A potential modifier was the duration of smoking abstinence (within/>1 year) at baseline. Baseline single-wave weights were applied, and a multivariable logistic regression model was used to estimate the adjusted association. Interaction between cigarette coupon receipt and duration of smoking abstinence was examined to explore potential modification effects. RESULTS Participants who received cigarette coupons at baseline were more likely to relapse at follow-up (AOR=1.63, 95% CI=1.15, 2.32). This association was significantly stronger among participants who quit within 1 year than among participants who quit >1 year at baseline (AOR for the interaction term=2.77, 95% CI=1.22, 6.25). Subgroup analysis shows that receipt of cigarette coupons was significantly associated with smoking relapse among participants who quit within 1 year (AOR=2.10, 95% CI=1.39, 3.17), and this association was not statistically significant among participants who quit >1 year (AOR=0.76, 95% CI=0.36, 1.63). CONCLUSIONS Policies restricting cigarette coupons may help adults who recently quit sustain abstinence.
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Affiliation(s)
- Yu Wang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Scott R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Shannon R Self-Brown
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - David L Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | | | - Terry F Pechacek
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Jidong Huang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia.
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Wang Y, Duan Z, Weaver SR, Self-Brown SR, Ashley DL, Emery SL, Huang J. The Short-Term and Long-Term Associations Between Receiving Tobacco Discounts or Coupons and Smoking Cessation Among U.S. Adult Cigarette Smokers With Intention to Quit. Nicotine Tob Res 2023; 25:699-708. [PMID: 36124654 PMCID: PMC10032185 DOI: 10.1093/ntr/ntac216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/31/2022] [Accepted: 09/15/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To examine the associations between baseline receipt of cigarette and non-cigarette tobacco discounts or coupons and smoking cessation at follow-up among US adult cigarette smokers with the intention to quit at baseline. AIMS AND METHODS Data were from the Population Assessment of Tobacco and Health (PATH) study wave 3 (October 2015-October 2016), wave 4 (December 2016-January 2018), and wave 5 (December 2018-November 2019) surveys. Two separate sets of analyses were conducted using wave 3-4 data (N = 3707) and wave 4-5 data (N = 6251). Specifically, wave 4 was used as the 1-year follow-up of wave 3 to examine the short-term association, and wave 5 was used as the 2-year follow-up of wave 4 to examine the longer-term association. Study population were current established cigarette smokers with the intention to quit (within 1 year for wave 3-4 data) at baseline. Exposure was self-reported past 12-month receipt of discounts or coupons for cigarettes and non-cigarette tobacco products at baseline, and outcome was self-reported completely quitting cigarette smoking at follow-up. Baseline single-wave weights were applied, and multivariate logistic regressions were used to estimate the adjusted associations. RESULTS Participants who received cigarette discounts or coupons at baseline were less likely to quit completely for both 1-year follow-up (aOR = 0.66, 95% CI: 0.48 to 0.90) and 2-year follow-up (aOR = 0.74, 95% CI: 0.61 to 0.90). Baseline receipt of discounts or coupons for non-cigarette tobacco products were not consistently associated with cigarette smoking cessation at follow-up. CONCLUSIONS Receipt of cigarette discounts or coupons was associated with a reduced likelihood of successful quitting among cigarette smokers with intention to quit. Policies restricting cigarette coupons may help them quit completely. IMPLICATIONS This study found that among baseline current established cigarette smokers with intention to quit in the United States, baseline receipt of cigarette discounts or coupons was negatively associated with cigarette smoking cessation for both 1-year follow-up and 2-year follow-up. Baseline receipt of discounts or coupons for e-cigarettes, cigars, and other tobacco products were not consistently significantly associated with cigarette smoking cessation at follow-up. Our study results indicated that policies restricting cigarette coupons may help increase the likelihood of successful smoking cessation for smokers with intention to quit.
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Affiliation(s)
- Yu Wang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Scott R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Shannon R Self-Brown
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - David L Ashley
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Jidong Huang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Khan AM, Ahmed S, Sarfraz Z, Farahmand P. Vaping and Mental Health Conditions in Children: An Umbrella Review. Subst Abuse 2023; 17:11782218231167322. [PMID: 37124582 PMCID: PMC10134143 DOI: 10.1177/11782218231167322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023]
Abstract
The e-cigarette (EC) epidemic began in the United States (US) in 2007; since 2014 EC is the most commonly used form of tobacco. However, the mental health implications of vaping are grossly unknown. The aim of this umbrella review is to provide astate-of-the-art summary of existing research concerning vaping and mental health conditions in children. Following the PRISMA Statement 2020 guidelines, a systematic search was conducted across PubMed, Cochrane Library, and Google Scholar up to April 15th, 2022 to locate relevant studies. The Joana Briggs Institute (JBI) methodology for umbrella reviews and quality appraisal tool was utilized. Six studies, pooling a total of 846,510 adolescents aged 21 years or below, were included by collating 85 primary clinical studies. Of these, 58.8% of the primary clinical studies originated in the US, with 4.7% from Canada, South Korea, and the United Kingdom each; 3.5% each from England and Taiwan; 2.4% each from Australia, France, Hawaii, Mexico, and Russia; and 1.2% each from Denmark, Greece, Hong Kong, Iceland, New Zealand, Poland, and Switzerland. Overall, significant associations were found between mental health outcomes, including depression and suicidality, among current EC users and those who had ever used EC. Compared to adolescents who had never used EC, both depression and anxiety were reportedly higher among EC users. Impulsive behaviors, reported as impulsivity, were also found to be correlated with the adoption of EC use. However, there is a lack of evidence regarding the impact of EC use on mental health outcomes in children. This umbrella review highlights the urgent need to further explore the effects of current EC use from a psychiatric and public health perspective.
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Affiliation(s)
- Ali Mahmood Khan
- Department of Child & Adolescent Psychiatry, NYU Langone School of Medicine, New York, NY, USA
- Ali Mahmood Khan, Department of Child & Adolescent Psychiatry, NYU Langone School of Medicine, One Park Avenue, 7th Floor, New York, NY 10016, USA.
| | - Saeed Ahmed
- Rutland Regional Medical Center, Rutland, VT, USA
| | - Zouina Sarfraz
- Department of Research and Publications, Fatima Jinnah Medical University, Lahore, PB, Pakistan
| | - Pantea Farahmand
- Department of Child and Adolescent Psychiatry, NYU Langone School of Medicine, New York, NY, USA
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Wang Y, Duan Z, Weaver SR, Self-Brown SR, Ashley DL, Emery SL, Huang J. Association of e-Cigarette Advertising, Parental Influence, and Peer Influence With US Adolescent e-Cigarette Use. JAMA Netw Open 2022; 5:e2233938. [PMID: 36173633 PMCID: PMC9523494 DOI: 10.1001/jamanetworkopen.2022.33938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Little is known about the roles of advertising and parental and peer influence in e-cigarette use among US adolescents in recent years, hindering efforts to address the increasing rate of youth vaping. OBJECTIVE To examine how e-cigarette advertising exposure and parental and peer e-cigarette use were associated with e-cigarette use among US adolescents. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from waves 4 (December 2016 to January 2018), 4.5 (December 2017 to December 2018), and 5 (December 2018 to November 2019) of the Population Assessment of Tobacco and Health study, an on-going cohort study representative of the noninstitutionalized US population. Sample weights were applied to generate nationally representative estimates. Data were analyzed in January 2022. EXPOSURES Past 30-day e-cigarette advertising exposure, past 30-day parental e-cigarette use, and the number of best friends using e-cigarettes (none, a few, some, most, and all). MAIN OUTCOMES AND MEASURES Outcomes were contemporary curiosity about using e-cigarettes and e-cigarette initiation at follow-up. Generalized estimating equations were used to estimate the weighted adjusted associations. RESULTS Wave 4 included 8548 adolescents; wave 4.5, 10 073 adolescents; and wave 5, 11 641 adolescents. Among adolescents in the wave 4 survey, 4425 (51.1%) were boys, 1935 (24.9%) were aged 12 years, 1105 (13.0%) were Black, 2515 (24.4%) were Hispanic, and 3702 (52.3%) were White. More than 60% of adolescents reported past 30-day e-cigarette advertising exposure at each survey. Among adolescents who had never used e-cigarettes, those who reported e-cigarette advertising exposure were more likely to feel curious about using e-cigarettes (adjusted odds ratio [aOR], 1.56 [95% CI, 1.43-1.70]) and were more likely to become ever e-cigarette users (aOR, 1.21 [95% CI, 1.05-1.41]) and current e-cigarette users (aOR, 1.42 [95% CI, 1.16-1.75]) at follow-up. Adolescents who reported having best friends using e-cigarettes were more likely to feel curious about using e-cigarettes (eg, all best friends: aOR, 4.13 [95% CI, 2.35-7.26]) and initiate e-cigarette use at follow-up (eg, among adolescents reporting all best friends use e-cigarettes, risk of ever use: aOR, 4.08 [95% CI, 1.44-11.59]; risk of current use aOR, 5.42 [95% CI, 1.49-19.72]) than adolescents who reported having no best friends using e-cigarettes. CONCLUSIONS AND RELEVANCE This cohort study of US adolescents found that e-cigarette advertising and peer influence were significantly associated with e-cigarette initiation. Efforts to address youth vaping need to consider peer influence and incorporate measures reducing e-cigarette advertising exposure.
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Affiliation(s)
- Yu Wang
- School of Public Health, Georgia State University, Atlanta
| | - Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Scott R Weaver
- School of Public Health, Georgia State University, Atlanta
| | | | - David L Ashley
- School of Public Health, Georgia State University, Atlanta
| | | | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta
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Kaliamurthy S, Camenga DR. Clinical approach to the treatment of e-cigarette use among adolescents. Curr Probl Pediatr Adolesc Health Care 2022; 52:101203. [PMID: 35534404 DOI: 10.1016/j.cppeds.2022.101203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
E-cigarette use remains a serious public health threat for adolescents in the United States. Pediatric providers can intervene early to prevent the adverse, and sometimes life-long, health consequences of e-cigarette use. This article reviews the clinical management of e-cigarette use among adolescents using the "Ask-Counsel-Treat" model. This model was recently introduced by the American Academy of Pediatrics to help pediatric healthcare providers manage e-cigarette screening, counseling, and treatment. Behavioral treatments for e-cigarette cessation can be delivered via multiple formats, including via text, in-person, or online. Additionally, pediatric healthcare providers may consider the off-label use of nicotine replacement therapy in individuals less than 18 years of age to alleviate some of the symptoms of nicotine withdrawal. Further research is needed to inform the design and implementation of effective e-cigarette cessation strategies for adolescents.
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Affiliation(s)
- Sivabalaji Kaliamurthy
- Children's National Hospital, Washington, DC, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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