1
|
Springer AE, Mantey DS, Omega-Njemnobi O, Ruiz F, Attri S, Chen B, Marshall A, Kelder SH. School Connectedness and E-cigarette Susceptibility/ Ever Use in Texas 6 th-Grade Students. Am J Health Behav 2022; 46:673-682. [PMID: 36721289 DOI: 10.5993/ajhb.46.6.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objectives: We examined the association between school connectedness (SC) and e-cigarette susceptibility/ ever use in a diverse sample of Texas 6th graders, with a secondary aim to explore the association stratified by gender and classroom setting (in-person vs remote). Methods: A cross-sectional analysis was conducted of CATCH My Breath baseline data, representing 985 6th -graders from 21 public schools. SC was based on National Longitudinal Study of Adolescent Health measures; e-cigarette susceptibility/ever use was based on the FDA's definition of "at-risk" for long-term use. We conducted multi-level logistic regression analyses.Results: Over half the sample was Hispanic (57.6%), with 36.2% reporting susceptibility/ever use. Lower SC was associated with increased odds of e-cigarette susceptibility/ever use (low SC: aOR: 5.17, 95% CI: 3.54, 7.55; medium SC: aOR: 2.15, 95% CI: 1.44, 2.91; high SC= referent). The association held across gender groups, with low SC girls reporting the highest odds of susceptibility/ever use (aOR: 7.83, 95% CI: 4.51, 13.61). Low SC in- person and remote students were 6 and 4 times, respectively, more likely to report susceptibility/ever use as high SC students (p<.05). Conclusion: SC protected against e-cigarette susceptibility/ever use in this sample.
Collapse
Affiliation(s)
- Andrew E Springer
- Andrew E. Springer, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States;,
| | - Dale S Mantey
- Dale S. Mantey, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Onyinye Omega-Njemnobi
- Onyinye Omega-Njemnobi, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Felisa Ruiz
- Felisa Ruiz, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Sarina Attri
- Sarina Attri, University of Texas at Austin, Austin, TX, United States
| | - Baojiang Chen
- Baojiang Chen, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Allison Marshall
- Allison Marshall, UTHealth Czik School of Nursing, Houston, TX, United States
| | - Steven H Kelder
- Steven H. Kelder, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| |
Collapse
|
2
|
Tehrani H, Rajabi A, Ghelichi- Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80:240. [PMID: 36415010 PMCID: PMC9682677 DOI: 10.1186/s13690-022-00998-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping. METHOD The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author. RESULTS In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively. CONCLUSIONS Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.
Collapse
Affiliation(s)
- Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Environmental Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| |
Collapse
|
3
|
Simpson EEA, Davison J, Doherty J, Dunwoody L, McDowell C, McLaughlin M, Butter S, Giles M. Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools. BMC Public Health 2022; 22:276. [PMID: 35144592 PMCID: PMC8832682 DOI: 10.1186/s12889-022-12674-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/25/2022] [Indexed: 12/01/2022] Open
Abstract
Background An extended version of the theory of planned behaviour (TPB) was used to inform the design of a framework for an educational resource around e-cigarette use in young people. Methods A sequential exploratory design was employed. In Phase 1, elicited behavioural, normative and control beliefs, via 7 focus groups with 51 participants, aged 11–16 years, identified salient beliefs around e-cigarette use. These were used to construct a questionnaire administered to 1511 young people aged 11–16 years, which determined predictors of e-cigarette use and ever use. In Phase 2, sociodemographic variables, e-cigarette knowledge, access, use, marketing and purchasing of e-cigarettes and smoking behaviour were also gathered. The composite findings from Phase 1 and 2 informed the design of a post primary educational resource in Phase 3 around e-cigarette use. Results Current e-cigarette use was 4%, with almost 23% reporting ever use, suggesting current use is stable but experimentation may be increasing in this cohort. Sociodemographic variables, knowledge of e-cigarettes, smoking behaviour and TPB variables (direct and indirect measures of attitudes, subjective norm, and perceived behavioural control) accounted for 17% of the variance in current e-cigarette use, with higher intentions to use e-cigarettes within the next month, having the strongest impact on use (p < 0.001), followed by self-efficacy (p = 0.016). Sociodemographic and TPB variables accounted for 65% of the variance in intentions to use e-cigarettes in the next month; current e-cigarette use (p < 0.001), more positive attitudes (p < 0.001), stronger social influence (p < 0.001), higher self-efficacy (p < 0.001), higher control beliefs (p < 0.001) and greater motivation to use e-cigarettes (p < 0.001) were the main predictors of intentions. Phases 1 and 2 informed the mapping of key predictors of intentions and use of e-cigarettes onto the Theoretical Domains Framework, which identified appropriate intervention functions and behaviour change techniques. Conclusions This paper is the first to bridge the theoretical-practice gap in an area of significant public health importance through the development of a framework for a novel theory driven school-based educational resource aimed at reducing experimentation and uptake of e-cigarette use in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12674-3.
Collapse
Affiliation(s)
- E E A Simpson
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK.
| | - J Davison
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - J Doherty
- School of Nursing and Midwifery, Queens University of Belfast, Belfast, UK
| | - L Dunwoody
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - C McDowell
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M McLaughlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - S Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M Giles
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| |
Collapse
|
4
|
Williams GC, Cole AG, de Groh M, Jiang Y, Leatherdale ST. More support needed: Evaluating the impact of school e-cigarette prevention and cessation programs on e-cigarette initiation among a sample of Canadian secondary school students. Prev Med 2022; 155:106924. [PMID: 34929224 DOI: 10.1016/j.ypmed.2021.106924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
Given the recent increase in e-cigarette use among adolescents, there is a need to further explore how school programs are associated with e-cigarette initiation. The objective of this quasi-experimental study was to evaluate the impact of multiple school-based e-cigarette prevention and cessation programs on e-cigarette initiation among Canadian adolescents. This study used data from Year 6 (2017/18) and Year 7 (2018/19) of the COMPASS study in British Columbia, Alberta, Ontario, and Quebec, Canada. Students in grades 9 to 11 who had never tried e-cigarettes at baseline were included (n = 13,269). Schools (n = 88) reported whether they added programming that addressed e-cigarette or tobacco prevention or cessation. Generalized estimating equations were used to identify how added programs were associated with e-cigarette initiation at follow-up. At one-year follow-up (2018/19), 23% of schools added programs. Our evaluation results suggest that none of the activities taken by schools to prevent or reduce vaping among students significantly prevented vaping onset. In fact, female students at schools that reported adding a theme week had higher odds of e-cigarette initiation (OR 1.68 [95% CI 1.31-2.16]) and male students at schools that reported a cessation program had higher odds of e-cigarette initiation (OR 1.20 [95% CI 1.01-1.44]). These results suggest that schools may not know how to address e-cigarette use and that there can be risks to students if programs are not carefully implemented. Results point to the need for additional support to ensure that schools are taking evidence-based approaches that support all students.
Collapse
Affiliation(s)
- Gillian C Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
5
|
Cahn Z, Drope J, Douglas CE, Henson R, Berg CJ, Ashley DL, Eriksen MP. Applying the Population Health Standard to the Regulation of Electronic Nicotine Delivery Systems. Nicotine Tob Res 2021; 23:780-789. [PMID: 32960217 PMCID: PMC8095236 DOI: 10.1093/ntr/ntaa190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 09/18/2020] [Indexed: 12/20/2022]
Abstract
Regulatory authorities have devoted increasing attention and resources to a range of issues surrounding the regulation of novel nicotine and tobacco products. This review highlights the inherent complexity of evaluating prospective policies that pertain to products that heat solutions containing nicotine, but not tobacco leaf, sometimes referred to as electronic nicotine delivery systems (ENDS). The US Food and Drug Administration (FDA) is compelled to incorporate a set of public health criteria in their decision making, collectively referred to as the Population Health Standard. Adherence to this standard is necessary to estimate the impact of prospective ENDS policy decisions on net population harm associated with nontherapeutic nicotine products. For policies that are expected to decrease or increase ENDS use, application of the Population Health Standard requires a comprehensive assessment of the status quo impact of ENDS use on population health. Accordingly, this review first assesses the state of the evidence on the direct harms of ENDS and the indirect effects of ENDS use on smoking, particularly rates of initiation and cessation. After that, the example of flavor restrictions is used to demonstrate the further considerations that are involved in applying the Population Health Standard to a prospective ENDS policy. Implications: This narrative review aims to inform regulatory considerations about ENDS through the prism of the Population Health Standard. More specifically, this review (1) describes and explains the importance of this approach; (2) provides guidance on evaluating the state of the evidence linking ENDS to the net population harm associated with nontherapeutic nicotine products; and (3) illustrates how this framework can inform policymaking using the example of flavor restrictions.
Collapse
Affiliation(s)
- Zachary Cahn
- Economic and Health Policy Research, American Cancer Society, Inc., Atlanta, GA, USA
| | - Jeffrey Drope
- Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Clifford E Douglas
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rosemarie Henson
- Emory Global Health Institute, Emory University, Atlanta, GA, USA
| | - Carla J Berg
- Department of Prevention and Community Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA
- George Washington Cancer Center, Washington, DC, USA
| | - David L Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Michael P Eriksen
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| |
Collapse
|
6
|
Rocheleau GC, Vito AG, Intravia J. Peers, Perceptions, and E-Cigarettes: A Social Learning Approach to Explaining E-Cigarette Use Among Youth. JOURNAL OF DRUG ISSUES 2020. [DOI: 10.1177/0022042620921351] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study uses social learning theory to examine whether differential associations with e-cigarette-using peers is related to personal e-cigarette use among youth, and the extent to which this relationship is explained by personal risk perceptions of e-cigarettes. Moreover, this study tests whether the mediation process is moderated by type of e-cigarette user. This study uses a sample of high school seniors from the 2016 Monitoring the Future Study ( N = 2,100), and a subsample of e-cigarette users ( n = 523). Analyses are carried out using OLS and logistic regression. Findings demonstrate that higher levels of peer e-cigarette use are related to higher odds of personal e-cigarette use, but that risk perceptions of e-cigarettes only explain a modest portion of that relationship (about 10%). Furthermore, the mediation process does not appear to vary by type of e-cigarette user. Future directions and policy implications are discussed.
Collapse
|
7
|
Lippert AM, Corsi DJ, Venechuk GE. Schools Influence Adolescent E-Cigarette use, but when? Examining the Interdependent Association between School Context and Teen Vaping over time. J Youth Adolesc 2019; 48:1899-1911. [DOI: 10.1007/s10964-019-01106-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/02/2019] [Indexed: 12/31/2022]
|
8
|
Cole AG, Aleyan S, Leatherdale ST. Exploring the association between E-cigarette retailer proximity and density to schools and youth E-cigarette use. Prev Med Rep 2019; 15:100912. [PMID: 31198662 PMCID: PMC6556619 DOI: 10.1016/j.pmedr.2019.100912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/02/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022] Open
Abstract
Limited evidence exists examining the association between e-cigarette retailer density and e-cigarette use among youth. This study explored whether e-cigarette retailer proximity and density to schools were associated with youth use of e-cigarettes in 4 Canadian provinces. Between October and December 2017, an online search identified e-cigarette retailers within 500 m, 1000 m, and 1500 m circular buffer zones around high schools (N = 122) that participated in the COMPASS study in 2017–18. Retailer proximity/density data were linked to student-level data (N = 63,400 students). Multilevel regression models examined the association between e-cigarette retailer proximity and density and ever and current e-cigarette use, controlling for relevant covariates. Results indicated the average school had <1 e-cigarette retailer within 500 m, 1000 m, and 1500 m. Significant between-school variability in the likelihood of ever [σ2μ0 = 0.215 (0.030), p < .0001] and current [σ2μ0 = 0.258 (0.036), p < .0001] e-cigarette use was found among students. However, after controlling for relevant covariates, e-cigarette retailer proximity and density surrounding a school were not significantly associated with the likelihood of ever or currently using e-cigarettes. These findings suggest that students are accessing e-cigarettes through other sources.
Collapse
Affiliation(s)
- Adam G. Cole
- Moores Cancer Center, University of California San Diego, San Diego, CA, USA
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Corresponding author at: Moores Cancer Center, University of California San Diego, 9500 Gilman Dr, MC 0905, La Jolla, CA 92093-0905, USA.
| | - Sarah Aleyan
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
9
|
Tobacco Use as a Health Disparity: What Can Pediatric Clinicians Do? CHILDREN-BASEL 2019; 6:children6020031. [PMID: 30791653 PMCID: PMC6406965 DOI: 10.3390/children6020031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/05/2019] [Accepted: 02/12/2019] [Indexed: 01/12/2023]
Abstract
Tobacco use is a global health crisis, and has a tremendous and negative impact on health and wellbeing. Tobacco use disproportionately affects members of vulnerable populations, and by acting on multiple socioecological levels, serves to perpetuate and reinforce cycles of poverty. Members of the pediatric medical community can play a key role in interrupting cycles of tobacco use. Providers can serve as powerful allies to vulnerable communities by treating tobacco use in caregivers, counseling youth against using tobacco products, protecting children from the impact of secondhand smoke exposure, and advocating for economic, social, and health policies to disrupt intergenerational smoking.
Collapse
|
10
|
Chen J, Ho SY, Leung LT, Wang MP, Lam TH. School-level electronic cigarette use prevalence and student-level tobacco use intention and behaviours. Sci Rep 2019; 9:1690. [PMID: 30737443 PMCID: PMC6368577 DOI: 10.1038/s41598-018-38266-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/20/2018] [Indexed: 11/10/2022] Open
Abstract
Prevalent electronic cigarette (e-cigarette) use in schools may undermine tobacco denormalisation, and thus increase tobacco use in students. We investigated the associations of school-level e-cigarette use prevalence with student-level intention and behaviours related to e-cigarettes, cigarettes, and other tobacco products. In a 2014-15 school-based cross-sectional survey of 41035 secondary school students (grade 7–12; age 11–18 years) in Hong Kong, information was collected on the use of e-cigarettes, cigarettes, and non-cigarette tobacco products (NCTPs), susceptibility to e-cigarette and cigarette use, intention to quit cigarette smoking, and sociodemographic characteristics. The adjusted odds ratio (AOR) of e-cigarette use susceptibility in relation to high (vs low) school-level e-cigarette use prevalence was 1.40 (95% CI 1.05–1.87) in never e-cigarette users. The AORs of cigarette smoking susceptibility in relation to medium and high (vs low) school-level e-cigarette use prevalence were 1.24 (1.01–1.52) and 1.34 (1.02–1.75), respectively, in never cigarette smokers. School-level e-cigarette use prevalence was associated with ever and past 30-day cigarette smoking, but not with intention to quit (in past 30-day cigarette smokers) or past 30-day NCTP use. The findings highlight the importance of strictly banning e-cigarettes in schools, and add to the evidence that prevalent e-cigarette use in adolescents may increase cigarette smoking prevalence.
Collapse
Affiliation(s)
- Jianjiu Chen
- School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China.
| | - Lok Tung Leung
- School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, People's Republic of China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China
| |
Collapse
|
11
|
Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, Jiménez-Ruiz CA, Katsaounou P, Lindberg A, Metz C, Schober W, Spira A, Blasi F. Electronic cigarettes: a task force report from the European Respiratory Society. Eur Respir J 2019; 53:13993003.01151-2018. [PMID: 30464018 DOI: 10.1183/13993003.01151-2018] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/09/2018] [Indexed: 01/10/2023]
Abstract
There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives.ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.
Collapse
Affiliation(s)
- Robert Bals
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | | | - Susanna Esposito
- Pediatric Clinic, Dept of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Robert Foronjy
- Pulmonary and Critical Care Medicine, SUNY Downstate Medical Center, New York, NY, USA
| | - Pieter S Hiemstra
- Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Paraskevi Katsaounou
- 1st ICU Evangelismos Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Anne Lindberg
- Dept of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| | - Carlos Metz
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | - Wolfgang Schober
- Bavarian Health and Food Safety Authority, Dept of Chemical Safety and Toxicology, Munich, Germany
| | - Avrum Spira
- Boston University School of Medicine, Boston, MA, USA
| | - Francesco Blasi
- Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
12
|
Moon G, Barnett R, Pearce J, Thompson L, Twigg L. The tobacco endgame: The neglected role of place and environment. Health Place 2018; 53:271-278. [PMID: 30238907 DOI: 10.1016/j.healthplace.2018.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 06/27/2018] [Accepted: 06/29/2018] [Indexed: 01/10/2023]
Abstract
An increasing number of countries across the world are planning for the eradication of the tobacco epidemic. The actions necessary to realise this ambition have been termed the tobacco endgame. The focus of this paper is on the intersection between the tobacco endgame with place, a neglected theme in recent academic and policy debates. We begin with an overview of the key themes in the literature on endgame strategies before detailing the international landscape of engame initiatives, paying particular attention to the opportunities and challenges of endgame strategies in low and middle income countries. Finally, we critically assess the current endgame debates and suggest a novel agenda for integrating geographical perspectives into research on the endgame that provides enhanced understanding of the challenges associated with this important global health vision.
Collapse
Affiliation(s)
- Graham Moon
- School of Geography and Environmental Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, England, United Kingdom.
| | - Ross Barnett
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch 8020, New Zealand.
| | - Jamie Pearce
- School of GeoSciences, Drummond Street, University of Edinburgh, Edinburgh EH8 9XP, Scotland, United Kingdom.
| | - Lee Thompson
- Department of Population Health, University of Otago Christchurch, PO Box 4345, Christchurch 8140, New Zealand.
| | - Liz Twigg
- Department of Geography, University of Portsmouth, Buckingham Building, Lion Terrace, PO1 3HE England, United Kingdom.
| |
Collapse
|
13
|
Springer AE, Davis C, Van Dusen D, Grayless M, Case KR, Craft M, Kelder SH. School socioeconomic disparities in e-cigarette susceptibility and use among central Texas middle school students. Prev Med Rep 2018; 11:105-108. [PMID: 30023161 PMCID: PMC6047056 DOI: 10.1016/j.pmedr.2018.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/02/2022] Open
Abstract
Social-ecological theory posits that health-related behavior is shaped by the environments and settings that surround us. We examined e-cigarette susceptibility and ever use prevalence among central Texas middle school students by the level of economic disadvantage (ED) of their school. As a secondary aim, we explored gender and ethnic differences (Hispanic vs. White) in e-cigarette susceptibility across school ED levels. A cross-sectional analysis was conducted of baseline data collected in 2017 as part of the CATCH My Breath study. Participants (n = 5278) were 6th grade students from 23 central Texas public middle schools. E-cigarette susceptibility/use and demographics were self-reported; school ED was determined by Texas Education Agency. Analyses included chi-square tests and multi-level logistic regression. E-cigarette susceptibility and use varied by school ED for total sample (p < .0001) and by ethnicity (p ≤ .003). While e-cigarette susceptibility was higher in boys (p < .001), no gender differences were found for e-cigarette use. Students in the highest school ED quartile (Q4) (lowest SES) had significantly higher odds of e-cigarette susceptibility (AOR = 2.01; 95% CI: 1.49–2.71) and use (AOR = 8.12, 95% CI: 2.58–26.30) compared with Q1 students. Significant gender differences in e-cigarette susceptibility persisted within school ED quartiles 1–3 (p ≤ .001); no gender differences were found for Q4 (p = .537). Despite overall higher e-cigarette susceptibility for Hispanic students, they had similar prevalence as White students within three school ED quartiles. Findings underscore a higher risk for e-cigarette susceptibility/use among central Texas sixth graders attending high ED schools and provide foundation for further exploration of the school socioeconomic context in adolescent e-cigarette use.
Collapse
Affiliation(s)
- Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | - Cassie Davis
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | | | - Megan Grayless
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | - Kathleen R Case
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | | | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| |
Collapse
|
14
|
Kong G, Kuguru KE, Krishnan-Sarin S. Gender Differences in U.S. Adolescent E-Cigarette Use. CURRENT ADDICTION REPORTS 2017; 4:422-430. [PMID: 29545987 DOI: 10.1007/s40429-017-0176-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose of Review This study aims to review the recent (2012-2017) available gender difference data on e-cigarette use among adolescents. Recent Findings E-cigarettes are the most commonly used tobacco product among adolescents, and recent study findings showed that e-cigarette use can lead to cigarette smoking. However, gender differences in e-cigarette use among adolescents are relatively unknown. Summary We used the search terms "adolescents" and "e-cigarettes" on PubMed and identified 652 articles. Of these, 16 articles (2.5%) examined gender differences in adolescent e-cigarette use. Boys appear to have greater use of e-cigarettes, but girls may be at increased risk if e-cigarettes are targeted to them, as it has been for cigarettes. Data on gender differences are limited, and future research should continue to examine gender differences in e-cigarette use. Trends in use rates could evolve with new regulations and innovations in e-cigarette marketing and product features.
Collapse
Affiliation(s)
- Grace Kong
- Yale School of Medicine, 34 Park Street, Room S-211, New Haven, CT 06519, USA
| | - Karissa E Kuguru
- Yale School of Medicine, 34 Park Street, Room S-211, New Haven, CT 06519, USA
| | | |
Collapse
|
15
|
Eggers ME, Lee YO, Jackson K, Wiley JL, Porter L, Nonnemaker JM. Youth use of electronic vapor products and blunts for administering cannabis. Addict Behav 2017; 70:79-82. [PMID: 28214740 DOI: 10.1016/j.addbeh.2017.02.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND The positive association between youth use of cannabis and tobacco is well-established, and reports show that some youth are using electronic vapor products (EVPs) to administer cannabis. This study examines the prevalence and correlates of youth consumption of cannabis via EVP and how this compares with co-use of cannabis with cigars (blunts) among a large statewide sample of youth. METHODS We used data from the Florida Youth Tobacco Survey (FYTS), a school-based, pencil-and-paper questionnaire given to Florida middle and high school students (N=12,320). We conducted weighted descriptive analyses and logistic regressions examining prevalence and correlates of EVP/cannabis and blunt use. RESULTS Ever EVP/cannabis use was lower among middle school students (3.4%) than high school students (11.5%). Blunt use was reported by 6.0% of middle school and 24.1% of high school students. Approximately one-third of youth who had ever administered cannabis via either mode reported using both EVP/cannabis and blunts. EVP/cannabis and blunt use were both associated with lower school performance and use of other tobacco products. EVP/cannabis use did not vary by race/ethnicity, but blunt use was higher among black and Hispanic youth than white, non-Hispanic youth. DISCUSSION A substantial percentage of youth in a statewide sample are using EVPs and blunts to administer cannabis, and overlap between these use patterns is common. Differences in the demographic risk profile for EVP/cannabis and blunt use suggest that EVPs may provide a novel route of administration for delivering cannabis that appeals to groups not otherwise susceptible to using cannabis via blunts.
Collapse
|
16
|
Yu E, Lippert AM. Race/ethnicity modifies the association between school prevalence of e-cigarette use and student-level use: Results from the 2014 US National Youth Tobacco Survey. Health Place 2017; 46:114-120. [PMID: 28527326 DOI: 10.1016/j.healthplace.2017.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 05/05/2017] [Indexed: 11/28/2022]
Abstract
This study assessed racial/ethnic moderation of the association between school prevalence of lifetime e-cigarette use and students' use. Using multilevel regression methods and data from the 2014 US National Youth Tobacco Survey, we found attending schools with high rates of e-cigarette use was positively associated with students' lifetime use of e-cigarettes, especially for white students. A cross-level interaction term indicated a weaker association between non-Hispanic black race and attending high-use schools (odds ratio [OR] =0.61, 95% confidence interval [CI] =0.39, 0.95). Results implicate race/ethnicity as an important effect modifier in the link between school contexts and teenage e-cigarette use.
Collapse
Affiliation(s)
- Edward Yu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02130, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02130, United States
| | - Adam M Lippert
- Department of Sociology, University of Colorado Denver, Campus Box 105, PO Box 173364 Denver, CO 80217, United States.
| |
Collapse
|
17
|
Wilson FA, Wang Y. Recent Findings on the Prevalence of E-Cigarette Use Among Adults in the U.S. Am J Prev Med 2017; 52:385-390. [PMID: 27988090 DOI: 10.1016/j.amepre.2016.10.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 09/29/2016] [Accepted: 10/20/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study uses a recent source of nationally representative data from in-person surveys to examine national estimates of e-cigarette use among adults and their relationship with demographic, socioeconomic, and health behavior measures. METHODS Data were provided by the National Health Interview Survey, conducted by the Centers for Disease Control and Prevention. A total of 34,356 respondents aged ≥18 years were examined for 2014, the most recent and only year in which the National Health Interview Survey included questions on e-cigarette use. E-cigarette information included ever and current use. Univariate and multivariable logistic regression analyses were performed, adjusting for age, sex, race/ethnicity, education level, marital status, poverty, and smoking status. Analyses were conducted in 2016. RESULTS Compared with those who had never tried e-cigarettes, e-cigarette users were more likely to be younger, male, non-Hispanic white, non-married, poorer, and current smokers. Multivariable logistic regression suggested that respondents with high school or some college education had significantly higher adjusted odds of ever using e-cigarettes relative to those with less than high school education. However, the adjusted odds were not significantly different for college or graduate school education. CONCLUSIONS The results suggest that, unlike tobacco use, ever using e-cigarettes is positively related to income. Interestingly, e-cigarette use exhibits a non-linear relationship with education. Reasons for the relationship of e-cigarettes with education are unclear and warrant further research.
Collapse
Affiliation(s)
- Fernando A Wilson
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.
| | - Yang Wang
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| |
Collapse
|
18
|
Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
Collapse
Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
19
|
Fischer F, Kraemer A. Secondhand smoke exposure at home among middle and high school students in the United States - does the type of tobacco product matter? BMC Public Health 2017; 17:98. [PMID: 28103827 PMCID: PMC5248465 DOI: 10.1186/s12889-017-4019-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A decline in the prevalence of secondhand smoke (SHS) exposure has been observed in the United States of America (USA) during the past few decades. Nevertheless, nearly half of non-smoking students are still exposed to SHS. This paper aims to describe the factors associated with SHS exposure stratified by type of exposure (overall, cigarettes and electronic cigarettes). METHODS The analysis is based on secondary data taken from the National Youth Tobacco Survey 2014. Overall, 22,007 middle and high school students from the USA are included in the sample. Descriptive and bivariate statistics as well as binary logistic regression models were performed. RESULTS Overall, 44.5% (n=9,798) of the study participants declared themselves to be exposed to SHS, 29.1% (n=6,394) declared to be exposed to SHS caused by cigarette smoke and 9.4% (n=2,067) claimed that a person who lives with them uses electronic cigarettes. There is a considerable overlap between the two types of SHS exposure, because 74.9% (n=1,548) of students declaring that a person within their household uses electronic cigarettes also declare a person in the household smoking cigarettes. The strengths of association between independent variables and SHS exposure differs by type of exposure and also by smoking status of respondents. CONCLUSIONS Although only small differences are obvious in the factors associated with SHS exposure stratified by the type of tobacco product, there are still some variations which should be considered in policy making to allow for a targeted approach in prevention campaigns or legislation.
Collapse
Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501 Bielefeld, Germany
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501 Bielefeld, Germany
| |
Collapse
|
20
|
Sears C, Hart J, Walker K, Lee A, Keith R, Ridner S. A Dollars and "Sense" Exploration of Vape Shop Spending and E-cigarette Use. Tob Prev Cessat 2016; 2. [PMID: 28758154 DOI: 10.18332/tpc/67435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Across the US, vape shops have emerged to provide e-cigarette users access to products not usually available at gas stations or retail stores. As vape shop sales have steadily increased, so have questions about the impact of marketing and price on e-cigarette use behaviors. In this exploratory analysis, we aim to characterize spending on e-cigarettes and evaluate the association with customer perceptions and use behaviors. METHODS In a cross-sectional survey of vape shop customers (n=78), perceptions and use of e-cigarettes and tobacco products were assessed. Descriptive statistics and multivariate logistic regression were used to evaluate the association between spending and socioeconomic factors, demographics, and use behaviors. RESULTS Overall, spending amounts ranged from less than $10/month to more than $250/month, with a median around $50-75/month. Males spent more than females (p=0.003), but spending did not significantly differ by age (p=0.13). Customers who spent more than $50/month used lower levels of nicotine (mg/ml) (p=0.003) but a greater quantity of e-liquid (ml/month) (p<0.0001) compared to customers who spent under that amount. Mod use and intention to use e-cigarettes as a cessation device were significantly associated with vape shop spending in the regression model (OR= 17.5; 95% CI= (4.3, 70.2) and OR=0.22; 95% CI= (0.06, 0.75), respectively). CONCLUSIONS Spending appears to be significantly associated with e-cigarette use behaviors. Making "sense" of the potential relationships between the dollars spent at vape shops and consumer use behaviors is important as regulations for e-cigarette sales are proposed.
Collapse
Affiliation(s)
- C Sears
- University of Louisville, Kentucky, USA
| | - J Hart
- University of Louisville, Kentucky, USA
| | - K Walker
- University of Louisville, Kentucky, USA
| | - A Lee
- University of Louisville, Kentucky, USA
| | - R Keith
- University of Louisville, Kentucky, USA
| | - S Ridner
- University of Louisville, Kentucky, USA
| |
Collapse
|
21
|
Hilton S, Weishaar H, Sweeting H, Trevisan F, Katikireddi SV. E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers' views. BMJ Open 2016; 6:e013271. [PMID: 27852721 PMCID: PMC5128897 DOI: 10.1136/bmjopen-2016-013271] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Concerns exist that e-cigarettes may be a gateway to traditional cigarettes and/or (re)normalise teenage smoking. This qualitative study explores how teenagers in the UK currently perceive e-cigarettes and how and why they do or do not use them. DESIGN 16 focus groups were conducted across the UK between November 2014 and February 2015, with 83 teenagers aged 14-17. All discussions were digitally recorded, transcribed verbatim, imported into NVivo 10 and thematically analysed. RESULTS Teenagers generally agreed that e-cigarettes are useful products for smokers, including teenage smokers, to quit or reduce traditional cigarette use. Concerns were expressed about lack of information on their precise ingredients and any unknown risks for users and bystanders. However, teenagers typically viewed e-cigarettes as substantially less harmful than traditional cigarettes. They perceived e-cigarettes as attractive, with products described as 'fun' and having 'great flavourings'. Seeing websites or social media featuring e-cigarettes, especially YouTube 'vaping tricks', prompted some experimentation and imitation. E-cigarettes were used in a variety of situations, including at parties or when they could not smoke traditional cigarettes. A very few participants suggested covert use was a possibility and that e-cigarettes might help maintain a fledgling nicotine habit. CONCLUSIONS Teenagers support the use of e-cigarettes as smoking cessation aids for established adult smokers. However, they engage with these products differently from adults, with the novel hypothesis that covert use could potentially reinforce traditional cigarette smoking requiring further investigation. Policy responses should more clearly meet the needs of young people, as well as helping established adult smokers.
Collapse
Affiliation(s)
- Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
| | - Heide Weishaar
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
| | - Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
| | - Filippo Trevisan
- American University, School of Communication, Washington, District of Columbia, USA
| | | |
Collapse
|
22
|
Bostean G, Crespi CM, Vorapharuek P, McCarthy WJ. E-cigarette use among students and e-cigarette specialty retailer presence near schools. Health Place 2016; 42:129-136. [PMID: 27770669 PMCID: PMC5126978 DOI: 10.1016/j.healthplace.2016.09.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/03/2016] [Accepted: 09/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examined the association between presence of e-cigarette specialty retailers near schools and e-cigarette use among middle and high school students in Orange County (OC), CA. METHODS The OC subsample of the 2013-2014 California Healthy Kids Survey (N=67,701) was combined with geocoded e-cigarette retailers to determine whether a retailer was present within one-quarter mile of each public school in OC. Multilevel logistic regression models evaluated individual-level and school-level e-cigarette use correlates among middle and high school students. RESULTS Among middle school students, the presence of an e-cigarette retailer within one-quarter mile of their school predicted lifetime e-cigarette use (OR=1.70, 95% CI=1.02, 2.83), controlling for confounders but no effect for current use. No significant effect was found for high school students. CONCLUSIONS E-cigarette specialty retailers clustered around schools may be an environmental influence on student e-cigarette experimentation.
Collapse
Affiliation(s)
- Georgiana Bostean
- Department of Sociology, Environmental Science & Policy Program, Chapman University, One University Drive, Orange, CA 92866, (714) 516-5910; fax: (714) 997-6823
| | - Catherine M. Crespi
- Department of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South, 51-254 CHS, Los Angeles, CA 90095-1772
| | - Patsornkarn Vorapharuek
- Environmental Management, University of San Francisco, Harney Science Center, 2130 Fulton Street, San Francisco, CA 94117-1080
| | - William J. McCarthy
- UCLA Fielding School of Public Health, Center for Cancer Prevention & Control Research, A2-125 CHS, 650 Charles Young Drive, Los Angeles 90095-6900; (310) 794-7587; fax: 310-206-3566
| |
Collapse
|