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Tripathi O, Posis AIB, Thompson CA, Ferris J, Anuskiewicz B, Nguyen B, Liles S, Berardi V, Zhu SH, Winstock A, Bellettiere J. In-Home Cannabis Smoking Among a Cannabis-Using Convenience Sample from the Global Drug Survey: With Weighted Estimates for U.S. Respondents. Cannabis Cannabinoid Res 2024; 9:353-362. [PMID: 36318789 DOI: 10.1089/can.2022.0139] [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] [Indexed: 06/16/2023] Open
Abstract
Introduction: Secondhand and thirdhand tobacco smoke exposure most often occur at home, but little is known about occurrences of in-home cannabis smoking. We ascertained in-home cannabis smoking reported by all cannabis-using (i.e., used in the last 12 months) respondents to the Global Drug Survey (GDS; international-GDS sample), and among U.S. cannabis-using respondents (US-GDS sample). Materials and Methods: We used data collected November 2019-January 2020 for the 2020 GDS, an annual anonymous, cross-sectional survey; respondents were 16+ years old, from 191 countries. We estimated any and daily in-home cannabis smoking in the last 30 days among international-GDS respondents (n=63,797), using mixed effects logistic regression. US-GDS respondents (n=6,580) were weighted to the covariate distribution of the nationally representative 2018 National Survey on Drug Use and Health cannabis-using sample, using inverse odds probability weighting, to make estimates more generalizable to the U.S. cannabis-using population. Results: For the international-GDS cannabis-using respondents, any in-home cannabis smoking was reported by 63.9% of men, 61.9% of women, and 68.6% of nonbinary people; and by age (<25 years old=62.7%, 25-34 years old=65.0%, and 35+ years old=62.8%). Daily in-home cannabis smoking was highest among nonbinary (28.7%) and respondents 35+ years of age (28.0%). For the weighted US-GDS cannabis-using respondents, any in-home cannabis smoking was reported by 49.8% of males and 61.2% of females; and by age (<25 years old=62.6%, 25-34 years old=41.8%, 35+ years old=57.9%). Weighted daily in-home smoking was 23.2% among males and 37.1% among females; by age (<25 years old=34.8%, 25-34 years old=27.8%, and 35+ years old=21.6%). Conclusions: There was high daily cannabis smoking in homes of international-GDS and US-GDS respondents who used cannabis in the last 12 months. In part, due to cannabis legalization, the number of users worldwide has increased over the past decade. Criminal stigma historically associated with cannabis continues to drive those users indoors. In this context, our findings support further investigation of cannabis use behavior to understand how often people are exposed to secondhand and thirdhand cannabis smoke and the consequences of that exposure.
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Affiliation(s)
- Osika Tripathi
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
- San Diego State University School of Public Health, San Diego, California, USA
| | - Alexander Ivan B Posis
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
- San Diego State University School of Public Health, San Diego, California, USA
| | - Caroline A Thompson
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
- San Diego State University School of Public Health, San Diego, California, USA
| | - Jason Ferris
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Blake Anuskiewicz
- San Diego State University School of Public Health, San Diego, California, USA
| | - Benjamin Nguyen
- San Diego State University School of Public Health, San Diego, California, USA
| | - Sandy Liles
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
- San Diego State University School of Public Health, San Diego, California, USA
| | - Vincent Berardi
- Crean College of Health and Behavioral Sciences, Psychology, Chapman University, Orange, California, USA
| | - Shu-Hong Zhu
- San Diego State University School of Public Health, San Diego, California, USA
| | - Adam Winstock
- Institute of Epidemiology and Health Care, University College, London, United Kingdom
| | - John Bellettiere
- San Diego State University School of Public Health, San Diego, California, USA
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Liu J, Tan ASL, Winickoff JP, Rees VW. Correlates of adolescent sole-, dual- and poly-use of cannabis, vaped nicotine, and combusted tobacco. Addict Behav 2023; 146:107804. [PMID: 37478525 PMCID: PMC10528055 DOI: 10.1016/j.addbeh.2023.107804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/01/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Compared to single substance use, adolescents' use of multiple substances is associated with more severe dependence, cessation outcomes, and health risks. This study examined correlates of use and co-use of e-cigarettes, combusted tobacco, and cannabis among high school-aged (9th-12th grade, approximately aged 14-18) adolescents. METHODS We analyzed the 2019 Massachusetts Youth Health Survey (MYHS) data to calculate the weighted means of any past 30-day sole-use of e-cigarettes, sole-use of combusted tobacco, sole-use of cannabis, dual-use of two of the above substances, and poly-use of all three substances. We then used weighted multinomial logistic regression to examine the associations between demographic, social and behavioral factors and sole-, dual-, and poly-use (vs. no use) of these substances. RESULTS Among N = 1614 respondents, any past 30-day dual-use of e-cigarettes and cannabis was the most prevalent (17.2%, SE: 1.3%). Sole-use of combusted tobacco was less than 1%, whereas 4.5% (SE: 0.7%) of respondents reported poly-use of e-cigarettes, cannabis, and combusted tobacco. Lower academic grades and self-reported depression (1 item on persistent feelings of sadness or hopelessness) were associated with increased odds of dual-use of e-cigarettes and cannabis and poly-use (vs. sole-use of any substance). Adolescents who self-reported having "any long-term emotional problems or learning disabilities" had greater odds of poly-use. CONCLUSION Different sets of correlates were associated with sole-, dual-, and poly-use, suggesting that certain adolescents may be more vulnerable than others to multiple substance use. Future research should examine potentially modifiable upstream influences, such as the home environment and socioeconomic factors that may affect the relationship between adolescent mental health, school performance, and multiple addictive substance use.
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Affiliation(s)
- Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Andy S L Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, United States; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, United States; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, United States
| | - Jonathan P Winickoff
- MassGeneral Hospital Division of General Academic Pediatrics, Boston, MA, United States; MGH Tobacco Research and Treatment Center, Boston, MA, United States; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, United States
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Glasser AM, Nemeth JM, Quisenberry AJ, Shoben AB, Trapl ES, Klein EG. The Role of Cigarillo Flavor in the Co-Use of Cigarillos and Cannabis among Young Adults. Subst Use Misuse 2023; 58:717-727. [PMID: 36861952 PMCID: PMC10081100 DOI: 10.1080/10826084.2023.2184206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background: Research suggests flavor facilitates cigarillo use, but it is unknown if flavor impacts patterns of co-use of cigarillos and cannabis ("co-use"), which is common among young adult smokers. This study's aim was to determine the role of the cigarillo flavor in co-use among young adults. Methods: Data were collected (2020-2021) in a cross-sectional online survey administered to young adults who smoked ≥2 cigarillos/week (N = 361), recruited from 15 urban areas in the United States. A structural equation model was used to assess the relationship between flavored cigarillo use and past 30-day cannabis use (flavored cigarillo perceived appeal and harm as parallel mediators), including several social-contextual covariates (e.g., flavor and cannabis policies). Results: Most participants reported usually using flavored cigarillos (81.8%) and cannabis use in the past 30 days ("co-use") (64.1%). Flavored cigarillo use was not directly associated with co-use (p = 0.90). Perceived cigarillo harm (β = 0.18, 95% CI = 0.06, 0.29), number of tobacco users in the household (β = 0.22, 95% CI = 0.10, 0.33), and past 30-day use of other tobacco products (β = 0.23, 95% CI = 0.15, 0.32) were significantly positively associated with co-use. Living in an area with a ban on flavored cigarillos was significantly negatively associated with co-use (β = -0.12, 95% CI = -0.21, -0.02). Conclusions: Use of flavored cigarillos was not associated with co-use; however, exposure to a flavored cigarillo ban was negatively associated with co-use. Cigar product flavor bans may reduce co-use among young adults or have a neutral impact. Further research is needed to explore the interaction between tobacco and cannabis policy and use of these products.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Amanda J. Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, 14263, USA
| | - Abigail B. Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Erika S. Trapl
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, 44106, USA
| | - Elizabeth G. Klein
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, 43210, USA
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Hinds JT, Chow S, Loukas A, Perry CL. Exploring Transgender and Gender Diverse Young Adult Tobacco Use. JOURNAL OF HOMOSEXUALITY 2022; 69:2188-2208. [PMID: 34370630 DOI: 10.1080/00918369.2021.1935621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Aside from prevalence estimates and comparisons to heterosexual and presumed cisgender (i.e., not transgender) samples, little is known about transgender and gender diverse (TGD) young adult tobacco use. This study explored reasons and contexts TGD young adults used a variety of tobacco products through 25 one-on-one semi-structured qualitative interviews in 2018. Thematic analysis yielded four themes: (1) smoking in response to anxiety, depression, or stress, (2) social smoking, (3) accepting smoking-related norms, and (4) appealing aspects of tobacco. The first three themes contained elements specifically tied to TGD identity; the final theme related to perceptions of tobacco unrelated to identity. Findings suggest reasons for smoking that are unique to TGD young adults, who frequently reported smoking cigarettes as a coping response to an amalgam of stressors. Accounting for unique stressors related to TGD identity will assist in developing culturally relevant interventions to reduce the disproportionate tobacco burden in TGD communities.
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Affiliation(s)
- Josephine T Hinds
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
| | - Sherman Chow
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Cheryl L Perry
- The Michael & Susan Dell Center for Health Living, UTHealth School of Public Health, Austin Campus, Austin, Texas, USA
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Picanço JMA, Limberger RP, Apel MA. Where should I start? A scoping review about the publications on clove cigarettes. Crit Rev Toxicol 2022; 52:259-293. [PMID: 35971813 DOI: 10.1080/10408444.2022.2097053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The general lack of knowledge about the composition of clove cigarettes and the large number of terms that can be used to define different types of cigarettes that contain cloves makes it difficult to find scientific articles focused on the subject. We reviewed the publications that cited clove cigarettes to assess their relevance. METHODS We searched publications on Scopus, ScienceDirect, PubMed, and Portal CAPES during the first semester of 2021, without date restrictions. Through a quality assessment, the studies found were assorted in ten different categories. RESULTS Indonesian clove cigarettes-also known as kretek-are a mixture of tobacco and cloves rolled in a cigarette and sprayed with oils, plant extract, and food flavorings, in an unknown quantity and composition, different from each brand, which is usually kept in secret. Due to the relatively low prevalence of use in the general population, most publications on tobacco products tend to ignore clove cigarettes or place them in an existing category. Clove cigarettes can be hand-rolled, machine-made, filtered, unfiltered, and each form can be named differently. The interchangeable use of each term, sometimes grouping conventional cigarettes in the mix, can lead the researcher to consider a publication that should be excluded. CONCLUSION The existing regulations on flavored cigarettes, although well-intentioned, are still somewhat vague and broad, leaving possible loopholes that can be exploited by the tobacco industries. Fully understanding the precise effects caused by clove cigarettes can be an important tool in future discussions about tobacco control.
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Affiliation(s)
| | | | - Miriam Anders Apel
- Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Shi M, Littlefield AK, Stevens AK. Investigating differences in sex, race/ethnicity, and impulsivity across substance user profiles: a person-centered approach. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:725-733. [PMID: 31944909 DOI: 10.1080/07448481.2019.1706532] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 10/09/2019] [Accepted: 12/15/2019] [Indexed: 06/10/2023]
Abstract
Although substance use is considered normative in college, continued examination of factors associated with problematic use is merited. This study identified latent substance user classes and examined their relations with sex, race/ethnicity, impulsivity-like facets, and substance use outcomes among 702 undergraduate students. Non-Alcohol Abstaining Users (NAA), Minimal Users (MU), and Polysubstance Users (PSU) emerged from latent class analysis. Variable-centered analyses indicated that substance user classes did not differ by sex. Students in the Asian and Other groups were at greater odds of being in the MU class than either NAA or PSU class, compared to White students. Differential patterns of impulsigenic trait levels emerged across latent classes. The present study highlights the utility of integrating person- and variable-centered approaches in studying heterogeneous substance use behaviors among college students. College PSU are particularly at risk for problematic outcomes, thus warranting preventive intervention that may target impulsigenic traits or polysubstance use.
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Affiliation(s)
- Molin Shi
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Angela K Stevens
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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7
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Andersen A, Gerrard M, Gibbons FX, Beach SRH, Philibert R. An Examination of Risk Factors for Tobacco and Cannabis Smoke Exposure in Adolescents Using an Epigenetic Biomarker. Front Psychiatry 2021; 12:688384. [PMID: 34504443 PMCID: PMC8421639 DOI: 10.3389/fpsyt.2021.688384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/23/2021] [Indexed: 01/23/2023] Open
Abstract
Objective: Evolving patterns of nicotine and cannabis use by adolescents require new tools to understand the changing epidemiology of these substances. Here we describe the use of a novel epigenetic biomarker sensitive to both tobacco and cannabis smoke in a longitudinal sample of high-risk adolescents. We examine risk factors for positivity for this epigenetic biomarker in comparison to positivity for conventional serum biomarkers of nicotine and cannabis use. Method: Eastern Iowa 10th graders who had a friend or family member who smoked were eligible to participate in a longitudinal study over 10-12th grades. Subjects provided self-report data on nicotine, tobacco, and cannabis use patterns as well as blood samples that were used for serum cotinine and THC assays. DNA was prepared for analysis of methylation at the CpG cg05575921, a sensitive indicator of smoke exposure. Relationships between positivity for each these biomarkers and a variety of risk factors, including demographics, family and peer relationships, psychopathology, willingness to smoke, and perceptions of typical cigarette and cannabis users, were examined at the 10th (n = 442), 11th (n = 376), and 12th (n = 366) grade timepoints. Results: A increasing proportion of subjects were positive for cotinine (5-16%), THC (3-10%), and cg05575921 methylation (5-7%) across timepoints, with some overlap. Self-reported combusted tobacco and cannabis use was strongly correlated with all biomarkers, whereas cg05575921 methylation was not correlated with reported e-cigarette use. Dual users, defined as those positive for nicotine and THC in the 12th grade showed the greatest cumulative smoke exposure, indicated by cg05575921 methylation. Subjects reported more positive attitudes toward cannabis users than cigarette smokers, and willingness to smoke and positive perceptions of tobacco and cannabis smokers were significant risk factors for biomarker positivity across timepoints. Conclusion: We conclude that measurement of cg05575921 methylation in adolescents is a useful tool in detecting tobacco smoking in adolescents, and may be a novel tool for the detection of cannabis smoking and cannabis and tobacco co-use, though non-combusted forms of nicotine use do not appear to be detectable by this method.
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Affiliation(s)
- Allan Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Meg Gerrard
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Frederick X. Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States
| | - Steven R. H. Beach
- Center for Family Research, University of Georgia, Athens, GA, United States
- Department of Psychological Sciences, University of Georgia, Athens, GA, United States
| | - Robert Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- Behavioral Diagnostics, Coralville, IA, United States
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De Genna NM, Goldschmidt L, Richardson GA, Cornelius MD, Day NL. Prenatal exposure to tobacco and cannabis, early cannabis initiation, and daily dual use of combustible cigarettes and cannabis during young adulthood. Addict Behav 2021; 116:106820. [PMID: 33516042 PMCID: PMC7953574 DOI: 10.1016/j.addbeh.2021.106820] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Daily combustible cigarette use is common among cannabis users, and dual use of cigarettes and cannabis is associated with detrimental outcomes. This study addresses gaps in the literature by examining data from the prenatal and adolescent phases of a prospective, longitudinal study to predict adult daily dual use. METHODS Young adult offspring (M age = 22.8 years, 53% female) from a prenatal cohort reported on combustible cigarette and cannabis use (N = 500, 58% Black, 42% White). Pathways to daily dual use were modeled using variables from the gestational and adolescent phases of the study including prenatal tobacco, alcohol, and cannabis exposures; ages at initiation of cigarettes and cannabis; and adolescent learning/memory, impulsivity, and behavior problems. RESULTS Prenatal cannabis and tobacco use were not directly linked to adult daily dual use of cannabis and tobacco. However, structural equation modeling revealed three significant indirect pathways from prenatal cigarette and cannabis exposures to adult daily dual use of cigarettes and cannabis via early cigarette initiation, early cannabis initiation, and adolescent behavior problems. CONCLUSIONS This study identified pathways from prenatal cannabis and tobacco exposure to adult daily dual use, in addition to clarifying adolescent outcomes that may be part of the pathways. In a climate of growing acceptance of cannabis use and increasing legalization of recreational use, these findings serve as a warning that early exposure to cannabis may have an important role in shaping long-term dual use of tobacco and cannabis.
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Affiliation(s)
- Natacha M De Genna
- Department of Psychiatry at the University of Pittsburgh School of Medicine and Department of Epidemiology in the Graduate School of Public Health, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
| | - Lidush Goldschmidt
- UPMC Western Psychiatric Hospital, 817 Bellefield Towers, 100 N. Bellefield Ave, Pittsburgh PA 15213, USA.
| | - Gale A Richardson
- Department of Psychiatry at the University of Pittsburgh School of Medicine and Department of Epidemiology in the Graduate School of Public Health, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
| | - Marie D Cornelius
- Department of Psychiatry at the University of Pittsburgh School of Medicine and Department of Epidemiology in the Graduate School of Public Health, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
| | - Nancy L Day
- Department of Psychiatry at the University of Pittsburgh School of Medicine and Department of Epidemiology in the Graduate School of Public Health, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
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Association between Friends' Use of Nicotine and Cannabis and Intake of both Substances among Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020695. [PMID: 33467405 PMCID: PMC7838803 DOI: 10.3390/ijerph18020695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 02/07/2023]
Abstract
Nicotine and cannabis use are common among adolescents and may be associated with behavioral problems, poor academic outcomes and use disorders. The goals of this analysis were the following: (1) Describe the influence of friends’ nicotine and cannabis smoking and vaping on self-reported use. (2) Describe the relationship between friends’ nicotine and cannabis use on participants’ urinary biomarkers of nicotine (cotinine) and cannabis (11-nor-9-carboxy-Δ⁹tetrahydrocannabinol=THC-COOH). This is a secondary analysis of survey and biomarker data collected in adolescents aged 12–21 between April 2017 and April 2018, in Long Island, New York. Bivariate and multivariable analyses were conducted using SPSS 26. A cutoff value of ≥10 ng/mL was used to signify recent usage for urinary cotinine and THC-COOH levels. Over one-third of the 517 surveyed adolescents reported using tobacco and one-third reported using cannabis. A significant relationship between friends’ substance use and self-use was found. For both tobacco and cannabis, over 90% (p < 0.01) of participants with urinary biomarker levels above cutoff had friends who used the respective substance. Friends’ nicotine and friends’ cannabis use were each independently associated with urinary biomarker levels for those substances (for nicotine, beta = 88.29, p = 0.03; for cannabis, beta = 163.58, p = 0.03). Friends’ use of nicotine and cannabis is associated with adolescents’ intake, as well as the physiological exposure to those substances. These findings underscore the importance of including peer influence in the discussion with adolescents about tobacco and cannabis use.
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Ozga-Hess JE, Romm KF, Felicione NJ, Dino G, Blank MD, Turiano NA. Personality and impulsivity as predictors of tobacco use among emerging adults: A latent class analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 163:110076. [PMID: 34321706 PMCID: PMC8313022 DOI: 10.1016/j.paid.2020.110076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The tobacco industry markets their products toward emerging adults (18-29), with the goal of increasing use among this age group. To inform prevention efforts, researchers are investigating how specific demographic and psychological traits may predict tobacco initiation and continuation. Participants were 578 incoming university freshmen from the Appalachian region. Participants provided information on demographics, personality traits, impulsivity characteristics, lifetime use of cigarettes and electronic cigarettes (ECIGs), and current use of cigarettes, ECIGs, small cigars/cigarillos, large cigars, smokeless tobacco, and waterpipe. Latent class analysis identified tobacco-use classes and regressions identified psychological predictors of class membership. Participants were Nonusers, Experimenters, and Polytobacco Users. Lower agreeableness and conscientiousness as well as higher extraversion and neuroticism were associated with being Experimenters or Polytobacco Users. Lower impulsivity was associated with being Nonusers. Distinct types of emerging adults belong to each tobacco use class, suggesting that individual differences be incorporated in prevention efforts.
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Affiliation(s)
| | - Katelyn F. Romm
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | | | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, WV, USA
- WV Clinical and Translational Sciences Institute, West Virginia University, Morgantown, WV, USA
| | - Melissa D. Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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11
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E-cigarette use is prospectively associated with initiation of cannabis among college students. Addict Behav 2020; 106:106312. [PMID: 32120197 DOI: 10.1016/j.addbeh.2020.106312] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/16/2022]
Abstract
E-cigarettes have dramatically increased in popularity among youth. Coincident with expanded legalization, young adults' use of cannabis (marijuana) has also steadily increased in recent years. Use of tobacco products can increase the chances of later cannabis initiation among youth. However, most longitudinal investigations of tobacco and cannabis use patterns have focused on tobacco cigarettes, included adolescents as opposed to young adults, and have only employed two timepoints. The current study examined prospective associations between e-cigarette and cannabis use in a large, diverse college sample assessed over four timepoints (freshman - senior year; N = 4,670). E-cigarette use and cannabis use were modelled in a four-wave cross-lagged model. The results showed significant bidirectional associations between both substances, even after controlling for time-varying levels of depressive symptoms, alcohol use, and polysubstance use, sensation seeking, demographic variables, concurrent associations and previous levels of use. Moreover, the significance of the predictive path from e-cigarette use to later cannabis use remained unchanged when we ran the same model, but restricted the sample to e-cigarette-only users (i.e., never cigarette smokers), whereas only one prospective path from cannabis to e-cigarette use was significant in this subsample. The current findings suggest that the association of e-cigarette use and cannabis use is likely bidirectional, with stronger support for the link from e-cigarette use to later cannabis use, above and beyond cigarette use. As e-cigarettes gain further hold of the tobacco product market share and cannabis legalization continues to expand, data such as these will be critical for informing regulatory decisions for e-cigarettes and cannabis, particularly involving their accessibility to youth and young adults.
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Akasaki M, Ploubidis GB, Dodgeon B, Bonell CP. The clustering of risk behaviours in adolescence and health consequences in middle age. J Adolesc 2019; 77:188-197. [PMID: 31770671 DOI: 10.1016/j.adolescence.2019.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 01/24/2023]
Abstract
INTRODUCTION There is increasing interest in the clustering of risk behaviours in adolescence. However, few studies have examined what clusters of risk behaviours exist among adolescents, their early-life predictors, and their associations with later health. METHODS We analysed data derived from 8754 participants (women 53.3%) in the 1970 British Cohort Study. Latent class analysis was used to identify clusters of risk behaviours at age 16. Regression modelling was then used to examine predictors of clusters and their consequences of risk behaviours and health outcomes at age 42. RESULTS We identified two latent classes: a risky-behaviour (men: 20.0%, women: 23.6%) and less-risky-behaviour class. Among men, those in the risky-behaviour class were more likely to report smoking, multiple binge drinking, sexual debut before 16, involvement in fights and delinquency than were women. Membership in risky-behaviour class was mainly predicted by sociodemographic and parental risk behaviours and monitoring. The risky-behaviour class at age 16 was associated with the following outcome age 42: smoking status (more strongly among women), excessive alcohol consumption (more strongly among men), worse self-rated health (more strongly among men), and psychological distress (only among women). CONCLUSIONS Engagement in multiple risk behaviours in adolescence is an important driver of health inequalities later in life. Early life intervention, for example via school-based interventions, may be warranted for favourable lifelong health.
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Affiliation(s)
- Mifuyu Akasaki
- Centre for Longitudinal Studies, Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, United Kingdom.
| | - George B Ploubidis
- Centre for Longitudinal Studies, Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, United Kingdom
| | - Brian Dodgeon
- Centre for Longitudinal Studies, Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, United Kingdom
| | - Chris P Bonell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom
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13
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Tucker JS, Rodriguez A, Dunbar MS, Pedersen ER, Davis JP, Shih RA, D’Amico EJ. Cannabis and tobacco use and co-use: Trajectories and correlates from early adolescence to emerging adulthood. Drug Alcohol Depend 2019; 204:107499. [PMID: 31479864 PMCID: PMC6878180 DOI: 10.1016/j.drugalcdep.2019.06.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/13/2019] [Accepted: 06/09/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cannabis and tobacco co-use is a growing concern, yet little is known about its developmental course or associated outcomes during emerging adulthood. This study examines developmental trajectories of cannabis and tobacco co-use from adolescence to emerging adulthood, associations of co-use trajectories with four domains of functioning, and differences across racial/ethnic groups. METHODS Survey data come from a racially/ethnically diverse and predominantly California-based cohort that completed 10 surveys from 2008 (wave 1: mean age 11.5; n = 6,509) to 2018 (wave 10: mean age 20.7; n = 2,429). Co-use was defined as use of both cannabis and tobacco (cigarettes or smokeless tobacco) in the past 30 days. Trajectories of use were examined using latent growth modeling in a structural equation modeling framework. RESULTS Prevalence of cannabis and tobacco co-use increased from 0.3% at wave 1 to 9.5% at wave 10, with average probabilities of co-use higher among non-Hispanic white versus Hispanic or Asian participants. Higher average probability of co-use was associated with greater delinquency, more mental health symptoms, and poorer physical health during emerging adulthood. Higher rate of change in the probability of co-use over time was associated with greater delinquency, but better social functioning and less physical ailments. There was some evidence of racial/ethnic disparities in functioning, even at similar levels of co-use. CONCLUSIONS Cannabis and tobacco co-use deserves greater attention, especially regarding its effects on functioning during emerging adulthood. Results also emphasize the need for future research to focus on racial/ethnic disparities related to co-use and associated outcomes.
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Affiliation(s)
- Joan S. Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138
| | | | - Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | | | | | - Regina A. Shih
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138
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14
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Lee Y, Lee KS. Association of alcohol and drug use with use of electronic cigarettes and heat-not-burn tobacco products among Korean adolescents. PLoS One 2019; 14:e0220241. [PMID: 31365564 PMCID: PMC6668800 DOI: 10.1371/journal.pone.0220241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/11/2019] [Indexed: 12/26/2022] Open
Abstract
Background The tobacco industry has aggressively introduced new and diverse products in the market, including electronic cigarettes (e-cigarettes) and heat-not-burn (HNB) tobacco products, to which adolescents are readily susceptible. Conventional cigarettes have a well-established relationship with adolescent risky behaviors such as alcohol and drug use; however, no studies exist on the association between alcohol consumption and use of e-cigarettes or HNB tobacco products among Korean adolescents. This study evaluated alcohol-related behaviors and drug use in relation to whether a Korean nationally representative adolescent sample had ever used e-cigarettes and HNB tobacco products. Methods Data from the 2018 Korean Youth Risk Behavior Web-based Survey were analyzed. The final study sample comprised 60,040 adolescents. Chi-square and logistic regression were used to examine whether the ever having used e-cigarettes and HNB tobacco products was associated with alcohol-related behaviors and drug use. P-values for trends were calculated to examine the dose-response relationship for each variable. Results Respondents with higher drinking frequency, drinking quantity, alcohol intoxication, alcohol availability, and drug use were more likely to report having used e-cigarettes and HNB tobacco products, thus implying a significant relationship between substance use and novel tobacco product (P < .001). Conclusions Our findings suggest that at-risk adolescents who are engaged in other forms of risk-taking behaviors are prone to attract the experimentation with e-cigarettes or HNB tobacco products. Thus, smoking cessation programs related to substance use should be implemented, and there is an urgent need to monitor and regulate these products effectively.
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Affiliation(s)
- Yeji Lee
- Department of Public Health, Graduate School, The Catholic University of Korea, Seocho-gu, Seoul, Korea
| | - Kang-Sook Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, Korea
- * E-mail:
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15
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John WS, Zhu H, Mannelli P, Subramaniam GA, Schwartz RP, McNeely J, Wu LT. Prevalence and patterns of opioid misuse and opioid use disorder among primary care patients who use tobacco. Drug Alcohol Depend 2019; 194:468-475. [PMID: 30513477 PMCID: PMC6329633 DOI: 10.1016/j.drugalcdep.2018.11.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/11/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Current data suggest that opioid misuse or opioid use disorder (OUD) may be over represented among tobacco users. However, this association remains understudied in primary care settings. A better understanding of the extent of heterogeneity in opioid misuse among primary care patients who use tobacco may have implications for improved primary care-based screening, prevention, and intervention approaches. METHODS Data were derived from a sample of 2000 adult (aged ≥18) primary care patients across 5 distinct clinics. Among past-year tobacco users (n = 882), we assessed the prevalence of opioid misuse and OUD by sociodemographic characteristics and past-year polysubstance use. Latent class analysis (LCA) was used to identify heterogeneous subgroups of tobacco users according to past-year polysubstance use patterns. Multinomial logistic regression was used to examine variables associated with LCA-defined class membership. RESULTS Past-year tobacco use was reported by >84% of participants who reported past-year opioid misuse or OUD. Among those reporting past-year tobacco use, the prevalence of past-year opioid misuse and OUD was 14.0% and 9.5%, respectively. The prevalence of opioid misuse or OUD was highest among tobacco users who were male or unemployed. Three LCA-defined classes among tobacco users were identified including a tobacco-minimal drug use group (78.0%), a tobacco-cannabis use group (10.1%), and a tobacco-opioid/polydrug use group (11.9%). Class membership differed by sociodemographic characteristics. CONCLUSIONS Results from this study support the benefit of more comprehensive assessment of and/or monitoring for opioid misuse among primary care patients who use tobacco, particularly for those who are male, unemployed, or polydrug users.
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Affiliation(s)
- William S. John
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA,Corresponding authors: William S. John, Ph.D., Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry, Duke University Medical Center, Durham, NC 27710, Phone: (336) 624-7212,
| | - He Zhu
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Paolo Mannelli
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | | | | | - Jennifer McNeely
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USA.
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