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Buta E, Gueorguieva R, Simon P, Garrison KA. Behavioral Precursors of Nicotine Product Use Trajectories Among Youth. Am J Prev Med 2024; 67:360-369. [PMID: 38782105 DOI: 10.1016/j.amepre.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Preventing nicotine use among youth is a public health priority. Nicotine use emerges from complex relationships between numerous factors. This project used network analysis to model behavioral precursors of nicotine use (knowledge, attitudes, perceptions, intentions) among youth who had never used nicotine and determine which predicted future trajectories of use across multiple nicotine products. METHODS Data were from the Population Assessment of Tobacco and Health study (2013-2018; analyzed 2023-2024), youth ages 12-17, who reported never using nicotine at Wave 1. Network structure was determined for behavioral precursors at Wave 1 and central network nodes were identified (N=5,087). Central nodes were then tested as predictors of trajectories of use across multiple nicotine products during Waves 1-4 (N=3,851). RESULTS Central nodes of the Wave 1 network were harm perception, expectancy that tobacco would calm anger/reduce stress, and intention to try. Those with lower intent to try at Wave 1 had lower odds of being in an Experimentation or Use class versus a Nonuse class during Waves 1-4 (p<0.0001). Those with more accurate harm perception had lower odds of being in an Experimentation versus Nonuse class (p=0.004). Those with positive expectancies had higher odds of being in an Experimentation versus Nonuse or Use class (p=0.04, 0.02). CONCLUSIONS Findings suggest a network model of behavioral precursors of nicotine use that can be tested, including central nodes that predicted trajectories of use across multiple nicotine products, and therefore may be priority intervention targets.
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Affiliation(s)
- Eugenia Buta
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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2
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Deng H, Fang L, Zhang L, Li J, Wang J, Wang F, Zheng P. Susceptibility to e-cigarette among high school students: a study based on the ecological model of health behavior. Front Public Health 2024; 12:1395717. [PMID: 39056081 PMCID: PMC11269252 DOI: 10.3389/fpubh.2024.1395717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Introduction Youth e-cigarette (EC) use has rapidly increased in the last few years. It is crucial to identify the susceptible youth and prevent them from EC uptake. This study was conducted to investigate factors that affect youth susceptibility to EC use. Methods This study employed a cross-sectional survey design, utilizing multi-center stratified cluster sampling method to select two junior high schools and two senior high schools in Shanghai, Guangzhou, and Chengdu. One-third of classes of each grade in the selected schools were involved in this survey. After obtaining the informed consent of parents, an anonymous and self-administered questionnaire was distributed to students. Questionnaire was designed based on the Ecological Models of Health Behavior. Associations between EC susceptibility and covariates were identified using multivariate logistic regression. Results Among 2,270 students who had never vaped, 38.0% were susceptible to ECs. Logistic regression analysis identified factors on different levels affecting the susceptibility. Individual factors included senior high school students (OR = 1.34, 95% CI: 1.08-1.65), sensation seeker (OR = 1.11, 95%CI: 1.08-1.14), poor academic performance (OR = 1.24, 95% CI: 1.01-1.54), ever cigarette user (OR = 2.27, 95% CI: 1.29-4.01), unaware of the second-hand smoke from vaping (OR = 1.56, 95% CI: 1.25-1.96), agreeable with "I do not want to hang around vapers" (OR = 0.79, 95% CI: 0.64-0.97), agreeable with "ECs are more fashionable than cigarette" (OR = 2.50, 95% CI: 1.72-3.62) and favorable attitudes toward vaping (OR = 5.09, 95% CI: 3.78-6.85) were significantly associated with susceptibility to ECs. At interpersonal level, students who believe they would not be punished by parents for vaping increased susceptibility (OR = 1.27, 95% CI:1.01-1.59). At community level, exposure of EC advertising (OR = 1.81, 95% CI:1.46-2.25), exposure to hazard information (OR = 0.76, 95% CI: 0.59-0.97) and seeing vaping in daily life (OR = 2.11, 95% CI: 1.62-2.74), were statistically significantly associated with youth susceptibility to ECs. Conclusion EC susceptibility was observed in a substantial proportion of adolescents who had never vaped, influenced by factors on different levels. This research underscores the urgent need for comprehensive intervention strategies to prevent the youth susceptibility to ECs.
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Affiliation(s)
- Hui Deng
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ling Fang
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Lingyun Zhang
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jie Li
- School of Journalism and Communication/National Media and Experimental Teaching Center, Jinan University, Guangzhou, Guangdong, China
| | - Jing Wang
- General office, Pudong New Area Center for Patriotic Sanitation Campaign and Health Promotion Counsel, Shanghai, China
| | - Fan Wang
- Fudan Development Institute, Fudan University, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Institute of Health Communication, Key Lab of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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Zulkiewicz BA, Winickoff JP, Gottlieb MA, Emmons KM, Tan AS. "Tobacco-free nicotine" electronic cigarette perceptions and use among adolescents and adults in five New England states. Addict Behav Rep 2024; 19:100524. [PMID: 38226008 PMCID: PMC10788778 DOI: 10.1016/j.abrep.2024.100524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/08/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
Introduction More brands are using tobacco-free nicotine (TFN) in electronic cigarettes (e-cigarettes) and these products are becoming increasingly popular. The term TFN and claims about its properties can mislead consumers about the harms and addictiveness of TFN e-cigarettes, which may increase initiation of these products among non-smokers or influence current smokers' decisions to adopt TFN e-cigarettes as a harm reduction measure. Methods We conducted an observational, cross-sectional survey of 777 adolesc aged 13-17 and 655 current adult cigarette smokers residing in Massachusetts, Connecticut, New Hampshire, Rhode Island, or Vermont about their TFN e-cigarette awareness, use, perceptions, and susceptibility. We examined the association between prior awareness of TFN and use, perceptions, and susceptibility. Results One-third of adolescents and adults reported being aware of TFN. TFN e-cigarette use was less common than tobacco-derived nicotine (TDN) e-cigarette use among adolescents (8.9 % vs. 30.5 %) and adults (21.1 % vs. 79.4 %). Compared to unaware adolescents, adolescents who were aware of TFN more frequently reported being more likely to use TFN compared to TDN e-cigarettes and that TFN e-cigarettes are more addictive than those containing TDN. Aware adult smokers more frequently reported that TFN e-cigarettes are more addictive than TDN e-cigarettes, TFN e-cigarettes cause some harm, TDN e-cigarettes cause little harm, and that TFN and TDN e-cigarettes are equally harmful than those who were unaware previously. Conclusion Public health education campaigns are needed to educate consumers about the harms and addictiveness of TFN e-cigarettes.
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Affiliation(s)
- Brittany A. Zulkiewicz
- University of Pennsylvania Annenberg School for Communication, 3620 Walnut St, Philadelphia, PA 19104, United States
| | - Jonathan P. Winickoff
- Massachusetts General Hospital, Division of General Academic Pediatrics, Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States
| | - Mark A. Gottlieb
- Northeastern University School of Law, Public Health Advocacy Institute, 360 Huntington Ave, Suit 1170CU, Boston, MA 02115, United States
| | - Karen M. Emmons
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Andy S.L. Tan
- University of Pennsylvania Annenberg School for Communication, 3620 Walnut St, Philadelphia, PA 19104, United States
- University of Pennsylvania Leonard Davis Institute of Health Economics, 3641 Locust Walk #210, Philadelphia, PA 19104, United States
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4
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Yan R, Liu Y, Huang L, Li Y, Huang Y, Tong J, Deng Y, Yuan Q. Susceptibility to e-cigarette adoption among tobacco-naïve youths: a cross-sectional study in Shenzhen, China. Front Public Health 2024; 12:1320863. [PMID: 38818444 PMCID: PMC11137244 DOI: 10.3389/fpubh.2024.1320863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Background The rise in e-cigarette use among youth is a significant global public health issue. It is important to identify those at increased risk and implement effective strategies to reduce e-cigarette popularity among the youth. Objective This study aims to identify predictors of e-cigarette uptake in youths with no prior tobacco use, considering individual, familial and the broader societal environmental factors. Methods For this investigation, a group of 2,487 tobacco-free youths was selected from 15 high schools in Shenzhen, China. Susceptibility to e-cigarettes was determined by assessing the possibility of future use and the openness to trying e-cigarettes if presented by friends. Both chi-square tests and logistic regression were applied to identify factors linked to susceptibility to e-cigarette use. Results Among the respondents, 5.5% (n = 136) were found to be susceptible to e-cigarette use. The analysis revealed factors tied to this risk: perceptions of e-cigarettes, the impact of vaping peers, paternal parenting styles, the extent of social support, exposure to messages both for and against e-cigarettes use, and secondhand smoke (SHS) exposure. Youths who downplayed the addictive nature of e-cigarettes (aOR = 2.01; 95% CI: 1.14-3.55; p = 0.016), those with friends who engaged in vaping (aOR = 3.43-7.64; 95%CI: 2.36-20.42; p < 0.001), those experiencing over-protective or rejective maternal parenting (aOR = 1.68-3.01; 95%CI: 1.11-5.77; p = 0.001-0.014) or rejective paternal parenting (aOR = 3.63; 95%CI: 1.99-6.59; p < 0.001), those aware of e-cigarette advertisements (aOR = 1.82; 95%CI: 1.28-2.60; p = 0.001), and those exposed to SHS at home (aOR = 1.68; 95%CI: 1.17-2.41; p = 0.005) or at public places (aOR = 1.72-1.79; 95%CI: 1.21-2.57; p = 0.002-0.003) were more prone to e-cigarettes. In contrast, youths who believed using e-cigarettes reduces one's attractiveness (aOR = 0.34; 95%CI: 0.16-0.72; p = 0.005) or perceived that vaping made social interactions less enjoyable (aOR = 0.26; 95%CI: 0.12-0.58; p = 0.001), those who benefited from high social support (aOR = 0.30-0.60; 95%CI: 0.17-0.97; p < 0.001), and those who noticed message about e-cigarettes' adverse consequence (aOR = 0.54; 95%CI: 0.38-0.77; p = 0.001) were less likely to be inclined toward e-cigarette use. Conclusion The propensity of the youth to e-cigarette usage is shaped by a multiple element. An all-encompassing strategy that addresses the individual, familial, and the broader societal aspects is imperative for the effective prevention of e-cigarette initiation among youth.
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Affiliation(s)
- Ruilin Yan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanhong Liu
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Li Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yanrou Li
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Yun Huang
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Jing Tong
- Bao'an Public Health Service Center of Shenzhen, Shenzhen, China
| | - Yongzheng Deng
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
| | - Qing Yuan
- Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen, China
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Hernández-Torres R, Wang H, Orfin R, Castro-Figueroa EM, Freeman J, Cupertino AP, Ossip DJ, Wilson KM, Cartujano-Barrera F. Exposure to E-Cigarette Marketing and Susceptibility to Future Vaping among Black and Latino Adolescents in the United States. CHILDREN (BASEL, SWITZERLAND) 2024; 11:465. [PMID: 38671682 PMCID: PMC11049197 DOI: 10.3390/children11040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Evidence suggests an association between exposure to electronic cigarette (e-cigarette) marketing and e-cigarette use (vaping) among adolescents. However, there is limited evidence on exposure to e-cigarette marketing and susceptibility to future vaping, especially among Black and Latino adolescents. This study aimed to examine associations between exposure to e-cigarette marketing and susceptibility to future vaping among Black and Latino adolescents in the United States (US). Participants (N = 362; equal representation between Black and Latino adolescents) completed a baseline assessment (available in English and Spanish) including sociodemographic characteristics (e.g., racial/ethnic group, age, gender, sexual orientation, etc.), exposure to e-cigarette marketing, and susceptibility to future vaping. Exposure to e-cigarette marketing was recoded and organized into two categories (high exposure = 2 to 3; low exposure = 0 to 1). Cochran-Mantel-Haenszel tests were used to evaluate the association between exposure to e-cigarette marketing and susceptibility to future vaping, stratified by racial/ethnic group. Multiple logistic regressions assessed the association between exposure to e-cigarette marketing and susceptibility to future vaping, controlling for gender, sexual orientation, grade, and academic performance within each racial/ethnic group. Black adolescents reported significantly higher frequencies of exposure to e-cigarette marketing (p = 0.005). A significant interaction was found between exposure to e-cigarette marketing and racial/ethnic group (X2 (1) = 6.294, p = 0.012). Among Black adolescents, high exposure to e-cigarette marketing (vs. low exposure) was associated with a higher probability of susceptibility to future vaping (OR: 2.399, 95% CI 1.147-5.021, p = 0.020). For Latino adolescents, exposure to e-cigarette marketing was not associated with susceptibility to future vaping (OR: 0.503, 95% CI 0.245-1.03, p = 0.062). Future studies should evaluate how and where adolescents are exposed to e-cigarette marketing. Prevention efforts must include the implementation of effective counter-marketing campaigns and the reduction of exposure to e-cigarette marketing among Black and Latino adolescents.
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Affiliation(s)
- Ruthmarie Hernández-Torres
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Rafael Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
| | - Eida M. Castro-Figueroa
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
| | | | - Ana Paula Cupertino
- Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Karen M. Wilson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
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James SA, White AH, Kahn FF, Mushtaq N, Chen S, Beebe LA. Susceptibility to e-cigarette use and associated factors in high school youth, Oklahoma Youth Tobacco Survey, 2021-2022. Front Public Health 2024; 12:1348926. [PMID: 38362222 PMCID: PMC10867248 DOI: 10.3389/fpubh.2024.1348926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/19/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Susceptibility predicts subsequent uptake of e-cigarettes (EC) by youth. This study identified factors associated with EC susceptibility among high school students who have never used a tobacco/nicotine product. Methods The Oklahoma Youth Tobacco Survey was administered to a random sample of 36 Oklahoma High Schools during the 2021-2022 school year (n = 1,220 participating students). Associations between EC susceptibility and covariates were identified using stepwise logistic regression for weighted survey data. Results More than one third of Oklahoma high school students who had never used tobacco or nicotine products (36.4%) were susceptible, and males had higher susceptibility than females (38.8 and 33.9%, respectively). In males, EC susceptibility was associated with race (Black, American Indian, and other were less susceptible), psychological distress (aOR = 2.4, 95% CI = 1.1, 4.8), disagreement that all tobacco products are dangerous (aOR = 3.1, 95% CI = 1.2, 7.9), and perception of little/no harm from secondhand vapor (aOR = 3.4, 95% CI = 2.1, 5.3). In females, identifying as gay, lesbian, or bisexual (aOR = 2.1, 95% CI = 1.1, 3.9), poor academic performance (aOR = 4.5, 95% CI = 1.6, 12.6), psychological distress (aOR = 2.6, 95% CI = 1.2, 5.5) and interacting with EC content on social media (aOR = 5.9, 95% CI = 1.9, 18.1) were associated with EC susceptibility. Conclusion Males and females had different patterns of susceptibility to EC use. Understanding groups of adolescents most susceptible to using nicotine products can help target prevention efforts at home, in schools, and within communities.
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Affiliation(s)
- Shirley A. James
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ashley H. White
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Fahad F. Kahn
- Oklahoma State Department of Health, Oklahoma City, OK, United States
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Laura A. Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Jongenelis MI, Thoonen KAHJ. Factors associated with susceptibility to e-cigarette use among Australian adolescents. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104249. [PMID: 37918316 DOI: 10.1016/j.drugpo.2023.104249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/05/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Preventing uptake of e-cigarette use among adolescents is critical to minimizing vaping-related harms. To inform the development of effective prevention programs and policies, this study explored potential determinants of susceptibility to e-cigarette use among young Australians. METHODS A cross-sectional online survey was administered to 12- to 17-year-old Australians who had never smoked nor vaped (N = 973; 53 % women). The survey assessed susceptibility to e-cigarette use (curiosity about use, willingness to use, and intentions to use) and a comprehensive range of potential correlates that included individual, social, and environmental factors. Regression analyses were conducted to identify factors significantly correlated with each of the dependent variables. RESULTS Susceptibility to e-cigarette use was observed in 45 % of respondents. Individual factors associated with susceptibility included respondents' (i) overall opinion of e-cigarettes, (ii) attitudes toward e-cigarettes, (iii) affect regulation expectancies, and (iv) quitting perceptions. Significant social factors included both descriptive and injunctive norms, specifically: perceiving that use is ok for people of one's age, approval from important others to use, and having at least one family member or close friend who vapes. CONCLUSION Susceptibility to vaping was observed in a substantial proportion of adolescents who have never smoked. Shifting attitudes and social norms around e-cigarette use appears critical to reducing susceptibility. Recommended prevention efforts include the development of communications addressing misperceptions about the benefits of vaping on affect regulation and stricter regulations on e-cigarette advertising to reduce young Australians' exposure to claims that may result in favourable attitudes to e-cigarette use.
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Affiliation(s)
- Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
| | - Karlijn A H J Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
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Pettigrew S, Santos JA, Li Y, Jun M, Anderson C, Jones A. Short report: Factors contributing to young people's susceptibility to e-cigarettes in four countries. Drug Alcohol Depend 2023; 250:109944. [PMID: 37316389 DOI: 10.1016/j.drugalcdep.2023.109944] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/21/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Identifying young people who are susceptible to e-cigarettes is important for developing interventions designed to discourage uptake. Current evidence in a broader range of national contexts is needed given recent surges in youth e-cigarette use in many countries and the constantly evolving nature of vaping products and the promotional strategies used by the industry to increase their appeal. METHODS A cross-sectional online survey was administered to around 1000 15-30 year olds in each of four countries: Australia, China, India, and the United Kingdom (total n = 4007). The survey assessed demographic characteristics, e-cigarette and tobacco use, exposure to e-cigarette advertising, and number of friends and family members who vape. Those who had never used e-cigarettes (n = 1589) were assessed for susceptibility (curiosity about e-cigarettes, intentions to use in the next 12 months, and likely use if offered by a friend). Mixed effects logistic regression analysis was used to identify factors associated with susceptibility to e-cigarette use. RESULTS Susceptibility to e-cigarette use was apparent among 54% of respondents from Australia, 61% from India, 62% from the UK, and 82% from China. Factors positively associated with susceptibility were tobacco use, exposure to advertising, higher income, and having friends and family members who vape. Factors negatively associated with susceptibility were perceptions of harmfulness and education. CONCLUSION The results indicate the need across a diverse range of countries for interventions designed to address substantial proportions of young people who are likely to be susceptible to e-cigarette use.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Yuan Li
- The George Institute for Global Health, Beijing, China.
| | - Min Jun
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Craig Anderson
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
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Boakye E, Erhabor J, Obisesan O, Tasdighi E, Mirbolouk M, Osuji N, Osei AD, Lee J, DeFilippis AP, Stokes AC, Hirsch GA, Benjamin EJ, Robertson RM, Bhatnagar A, El Shahawy O, Blaha MJ. Comprehensive review of the national surveys that assess E-cigarette use domains among youth and adults in the United States. LANCET REGIONAL HEALTH. AMERICAS 2023; 23:100528. [PMID: 37497394 PMCID: PMC10366460 DOI: 10.1016/j.lana.2023.100528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 07/28/2023]
Abstract
Surveillance of e-cigarette use among different population groups is important for the timely implementation and evaluation of tobacco regulatory policies. In this review, we identified 13 nationally representative, repeatedly conducted epidemiologic surveys that assess e-cigarette use among U.S. youth and/or adults and have been instrumental in e-cigarette surveillance. These surveys included National Youth Tobacco Survey, Youth Risk Behavior Surveillance System, Monitoring the Future Survey, International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, Tobacco Use Supplement of the Current Population Survey, Health Information National Trends Survey, Tobacco Products and Risk Perception Surveys, ITC Four Country Smoking and Vaping Survey, National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, and Population Assessment of Tobacco and Health. These surveys vary in scope and detail, with their unique strengths and the regulatory questions that can be answered using each survey data. We also highlighted the gaps in these surveys and made recommendations for improvement.
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Affiliation(s)
- Ellen Boakye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
| | - John Erhabor
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
| | | | - Erfan Tasdighi
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | | | - Ngozi Osuji
- Department of Internal Medicine, University of Pittsburg Medical Center, Pittsburg, PA, USA
| | - Albert D. Osei
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Jieun Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew P. DeFilippis
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew C. Stokes
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Glenn A. Hirsch
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Emelia J. Benjamin
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Rose Marie Robertson
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aruni Bhatnagar
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Omar El Shahawy
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
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Fox KR, Ferketich AK, Groner JA, Rausch JR, Garg V, Grant VR, Neville SP, Cua CL, Jackson JL. The Association of Global and Disease-Related Stress With Susceptibility to and Use of E-Cigarettes and Marijuana Among Adolescents With Congenital Heart Disease. J Pediatr Psychol 2023; 48:458-467. [PMID: 36810676 PMCID: PMC10199730 DOI: 10.1093/jpepsy/jsad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Adolescents with congenital heart disease (CHD) are exposed to disease-related stressors and have elevated risk for cardiovascular and cognitive complications that are exacerbated by e-cigarettes and marijuana. The aims of this cross-sectional study are to: (1) identify the association between perceived global and disease-related stress and susceptibility to e-cigarettes and marijuana, (2) determine if the association between stress and susceptibility differs by gender, and (3) explore the association between stress and ever use of e-cigarettes and marijuana among adolescents with CHD. METHODS Adolescents with CHD (N = 98; aged 12-18 years) completed self-report measures of susceptibility to/ever use of e-cigarettes and marijuana and global and disease-related stress. RESULTS Susceptibility to e-cigarettes and marijuana was reported by 31.3% and 40.2% of adolescents, respectively. Ever use of e-cigarettes and marijuana was reported by 15.3% and 14.3% of adolescents, respectively. Global stress was associated with susceptibility to and ever use of e-cigarettes and marijuana. Disease-related stress was associated with susceptibility to marijuana. Females reported more global and disease-related stress than males, but the association of stress with susceptibility to e-cigarettes and marijuana did not differ by gender. CONCLUSIONS Susceptibility to e-cigarettes and marijuana is common among adolescents with CHD and is associated with stress. Future work to examine the longitudinal associations between susceptibility, stress, and use of e-cigarettes and marijuana is warranted. Global stress may be an important consideration in the development of strategies to prevent these risky health behaviors among adolescents with CHD.
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Affiliation(s)
- Kristen R Fox
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Judith A Groner
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Vidu Garg
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
- The Heart Center and Center for Cardiovascular Research, Nationwide Children's Hospital, Columbus, OH, USA
| | - Victoria R Grant
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Steven P Neville
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jamie L Jackson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
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11
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Herzig SE, Albers L, Soto D, Lee R, Ramirez C, Rahman T, Unger JB. Pandemic-related life changes and adolescent initiation of cannabis and tobacco/nicotine use. Addict Behav 2023; 144:107724. [PMID: 37087769 PMCID: PMC10103764 DOI: 10.1016/j.addbeh.2023.107724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic required the public to alter their daily lives drastically. For adolescents, school closures and social isolation added further challenges to a stressful stage of life, potentially increasing the likelihood of substance use initiation. This study explored the relationship between adolescent substance use initiation and negative life changes due to COVID-19. METHODS Students from 9 high schools (N = 2478) in Los Angeles County were surveyed as 9th graders in the 2019-2020 school year and re-surveyed in 10th and 11th grades as part of an ongoing longitudinal study. Two logistic regression models were conducted to test hypotheses that negative life changes due to the COVID-19 pandemic increases the odds of initiation of both tobacco/nicotine products and cannabis products, controlling for sex, age, and race/ethnicity. RESULTS The final analytic sample included adolescents in 10th grade who were never-users of tobacco/nicotine (N = 809) and cannabis (N = 837). The odds of initiating cannabis use increased by 6.42% for every 1 standard deviation increase in the COVID-19 negative daily life changes index [AOR: 1.063; 95% CI: 1.010, 1.121]. The association between the COVID-19 negative daily life changes index and tobacco/nicotine use initiation was not significant. DISCUSSION Adolescents who experienced life changes due to COVID-19 were more likely to initiate cannabis use, but not tobacco/nicotine use. Results identify a need for early intervention efforts to promote effective coping skills and prevent cannabis initiation among adolescents during a wide-scale stressor, such as COVID-19.
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Affiliation(s)
- Shirin Emma Herzig
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Larisa Albers
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Daniel Soto
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Ryan Lee
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Carla Ramirez
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Tahsin Rahman
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
| | - Jennifer B Unger
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, 2001 N Soto Street, Los Angeles, CA 90089-9239, USA.
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12
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Venrick SJ, Margolis KA, Bernat JK, Pepper JK, Nonnemaker JM, Eggers ME. Youth and adult understanding of public displays of information about harmful constituents in cigarette smoke. Prev Med 2023; 169:107458. [PMID: 36813248 PMCID: PMC10023421 DOI: 10.1016/j.ypmed.2023.107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
The U.S. FDA is required by law to publicly display a list of harmful and potentially harmful constituents (HPHCs) "by brand and by quantity in each brand and subbrand" in a format that is "understandable and not misleading to a lay person." An online experiment examined youth and adult understanding of which HPHCs are present in cigarette smoke, understanding of health effects of smoking cigarettes, and endorsement of misleading information after viewing HPHC information displayed in one of six formats. We recruited youth (N = 1324) and adults (N = 2904) from an online panel and randomized them to one of six formats of presenting HPHC information. Participants responded to survey items before and after exposure to an HPHC format. Understanding of HPHCs in cigarette smoke and understanding of health effects of cigarette smoking significantly increased pre- to post-exposure for all formats. Respondents (20.6% to 73.5%) endorsed misleading beliefs after exposure to information about HPHCs. Endorsement of the one misleading belief that was measured pre- and post-exposure significantly increased for viewers of four formats. All formats increased understanding of HPHCs in cigarette smoke and the health effects of smoking cigarettes, but some participants endorsed each misleading belief after exposure to HPHC information.
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Affiliation(s)
- Samantha J Venrick
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA.
| | - Katherine A Margolis
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jennifer K Bernat
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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13
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Atuegwu NC, Mortensen EM, Krishnan-Sarin S, Laubenbacher RC, Litt MD. Prospective predictors of electronic nicotine delivery system initiation in tobacco naive young adults: A machine learning approach. Prev Med Rep 2023; 32:102148. [PMID: 36865398 PMCID: PMC9971268 DOI: 10.1016/j.pmedr.2023.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/11/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
The use of electronic nicotine delivery systems (ENDS) is increasing among young adults. However, there are few studies regarding predictors of ENDS initiation in tobacco-naive young adults. Identifying the risk and protective factors of ENDS initiation that are specific to tobacco-naive young adults will enable the creation of targeted policies and prevention programs. This study used machine learning (ML) to create predictive models, identify risk and protective factors for ENDS initiation for tobacco-naive young adults, and the relationship between these predictors and the prediction of ENDS initiation. We used nationally representative data of tobacco-naive young adults in the U.S drawn from the Population Assessment of Tobacco and Health (PATH) longitudinal cohort survey. Respondents were young adults (18-24 years) who had never used any tobacco products in Wave 4 and who completed Waves 4 and 5 interviews. ML techniques were used to create models and determine predictors at 1-year follow-up from Wave 4 data. Among the 2,746 tobacco-naive young adults at baseline, 309 initiated ENDS use at 1-year follow-up. The top five prospective predictors of ENDS initiation were susceptibility to ENDS, increased days of physical exercise specifically designed to strengthen muscles, frequency of social media use, marijuana use and susceptibility to cigarettes. This study identified previously unreported and emerging predictors of ENDS initiation that warrant further investigation and provided comprehensive information on the predictors of ENDS initiation. Furthermore, this study showed that ML is a promising technique that can aid ENDS monitoring and prevention programs.
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Affiliation(s)
- Nkiruka C. Atuegwu
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Corresponding author at: University of Connecticut, Department of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Eric M. Mortensen
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA
| | - Reinhard C. Laubenbacher
- Laboratory for Systems Medicine, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Mark D. Litt
- Division of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington, CT 06030, USA
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Mendelsohn CP, Hall W, Borland R, Wodak A, Beaglehole R, Benowitz NL, Britton J, Bullen C, Etter JF, McNeill A, Rigotti NA. A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes. Addiction 2023; 118:1184-1192. [PMID: 36808672 DOI: 10.1111/add.16143] [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: 11/09/2022] [Accepted: 01/13/2023] [Indexed: 02/23/2023]
Abstract
This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e-cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e-cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e-cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e-cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body.
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Affiliation(s)
| | - Wayne Hall
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Alex Wodak
- Emeritus Consultant, Alcohol and Drug Service, St Vincents' Hospital, Sydney, Australia
| | | | - Neal L Benowitz
- Department of Medicine, University of California San Francisco, California, USA
| | - John Britton
- University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Chris Bullen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Jean-François Etter
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nancy A Rigotti
- Harvard Medical School, Director, Tobacco Research and Treatment Center, Massachusetts General Hospital, Massachusetts, Boston, USA
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15
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Cartujano-Barrera F, Hernández-Torres R, Chávez-Iñiguez A, Orfin RH, Fernandez ID, Rivera PM, Cupertino AP. Spanish version of the susceptibility to e-cigarettes scale among Latino adolescents. Tob Prev Cessat 2023; 9:01. [PMID: 36643821 PMCID: PMC9813784 DOI: 10.18332/tpc/156461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/11/2022] [Indexed: 01/07/2023]
Affiliation(s)
| | | | - Arlette Chávez-Iñiguez
- UR Medicine, University of Rochester Medical Center, University of Rochester, Rochester, United States
| | - Rafael H. Orfin
- UR Medicine, University of Rochester Medical Center, University of Rochester, Rochester, United States
| | - Isabel D. Fernandez
- UR Medicine, University of Rochester Medical Center, University of Rochester, Rochester, United States
| | - Patricia M. Rivera
- UR Medicine, University of Rochester Medical Center, University of Rochester, Rochester, United States
| | - Ana P. Cupertino
- UR Medicine, University of Rochester Medical Center, University of Rochester, Rochester, United States
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16
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Bluestein MA, Kuk AE, Harrell MB, Chen B, Hébert ET, Pérez A. Longitudinal Transition Patterns of Tobacco Use Among Youth and Young Adults Never Tobacco Product Users: Findings From the Population Assessment of Tobacco and Health Study, 2014-2019. Tob Use Insights 2023; 16:1179173X231161314. [PMID: 36923154 PMCID: PMC10009036 DOI: 10.1177/1179173x231161314] [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: 03/11/2023] Open
Abstract
Aims To identify, visualize, and describe the prevalence of within-product patterns of tobacco use behaviors for e-cigarettes, cigarettes, and hookah (TP) by 3 age groups (ie, 12-14-year-old, 15-17-year-old, and 18-20-year-old) with U.S. nationally representative data. Methods In 2014-2015, never users of each (TP) and age group were followed-up longitudinally between 2015-2019 using five transition states: non-susceptible to (TP) use, susceptible to (TP) use, ever (TP) use, past 30-day (TP) use, and discontinued past 30-day (TP) use. Sankey diagrams were used to graphically visualize patterns in tobacco use behaviors across time. Results Among 12-14-year-old who were never users and susceptible to each TP from 2014-2017, 7% initiated ever e-cigarette use and 9.4% first reported past 30-day use by 2018-2019; 5.8% initiated ever cigarette use and 3% first reported past 30-day cigarette use by 2018-2019; and, 4.5% initiated ever hookah use and 1.0% first reported past 30-day hookah use by 2018-2019. Among 15-17-year-old who were never users and susceptible to each TP from 2014-2017, 4.2% initiated ever e-cigarette use and 9.0% first reported past 30-day use by 2018-2019; 4.5% initiated ever cigarette use and 3% first reported past 30-day cigarette use by 2018-2019; and, 4.5% initiated ever hookah use and 2.4% first reported past 30-day hookah use by 2018-2019. Among 18-20-year-old who were never users and susceptible to each TP from 2014-2017, 3.2% initiated ever e-cigarette use and 3.6% first reported past 30-day e-cigarette use by 2018-2019; 3.0% initiated ever cigarette use and 2.3% first reported past 30-day cigarette use; and, 2.8% initiated ever hookah use and 1.0% first reported past 30-day hookah use by 2018-2019. Conclusions From 2014 to 2019, onset and progression of e-cigarette, cigarette, and hookah use occurred more frequently in 12-14 and 15-17-year-old than in young adults 18-20-year-old.
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Affiliation(s)
- Meagan A Bluestein
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA
| | - Arnold E Kuk
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA
| | - Melissa B Harrell
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA.,Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health in Austin Campus, Austin, TX, USA
| | - Baojiang Chen
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA
| | - Emily T Hébert
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA.,Department of Health Promotion and Behavioral Sciences, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, USA
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17
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Morean ME, Bold KW, Davis DR, Kong G, Krishnan-Sarin S, Camenga DR. Awareness, susceptibility, and use of oral nicotine pouches and comparative risk perceptions with smokeless tobacco among young adults in the United States. PLoS One 2023; 18:e0281235. [PMID: 36716297 PMCID: PMC9886243 DOI: 10.1371/journal.pone.0281235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Oral nicotine pouches (NPs) that contain nicotine but no tobacco leaves are rapidly gaining popularity. However, there is limited research on NPs, including within priority populations. In the current study, we examined awareness of, susceptibility to, and use of NPs in young adults as well as comparative risk perceptions with smokeless tobacco. METHODS In 2021, 609 young adults (18-25 years) completed an online survey. Participants reported on NP awareness, susceptibility, and use as well as on comparative product perceptions for NPs versus smokeless tobacco. We ran unadjusted between-groups comparisons and an adjusted multinomial logistic regression to identify relationships between product perceptions and NP susceptibility and use. RESULTS 41.5% of participants had heard of NPs before. Participants were non-susceptible (66.2%), susceptible (23.5%), or had used NPs (10.3%). Comparative product perceptions between NPs and smokeless tobacco suggested that young adults, as a whole, expressed uncertainty about the relative risk/benefit of using NPs versus smokeless tobacco. However, as expected, unadjusted and adjusted findings indicated that favorable perceptions of NPs versus smokeless tobacco were disproportionately observed among susceptible participants and NP users compared to non-susceptible individuals. Demographic differences were also observed (e.g., NP users were more likely than non-susceptible and susceptible individuals to have used smokeless tobacco). CONCLUSIONS Young adults reported awareness of, susceptibility to, and use of NPs, with findings indicating that favorable perceptions of NPs versus smokeless tobacco may contribute to NP susceptibility and use beyond known correlates like smokeless tobacco use. However, further research is needed to understand the full range of factors that are associated with NP susceptibility and use. It will be important to disentangle factors that are associated with potential positive public health impacts (e.g., switching from smokeless tobacco to exclusive NP use) from those associated with negative public health impacts (e.g., initiation among nicotine naïve individuals).
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Affiliation(s)
- Meghan E. Morean
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
- * E-mail:
| | - Krysten W. Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Danielle R. Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | | | - Deepa R. Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
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Sleep troubles in adolescence relate to future initiation of ENDS USE: A longitudinal cohort design using the PATH study waves 4.5–5 (2017–2019). Prev Med Rep 2022; 30:102000. [PMID: 36203945 PMCID: PMC9530947 DOI: 10.1016/j.pmedr.2022.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/22/2022] Open
Abstract
First longitudinal study on the association between sleep trouble and ENDS use. Past year sleep trouble increased risk of initiating ENDS use in following year. Healthy sleep serves as a protective factor against ENDS uptake for youth. Nearly half of youths aged 12–17, experienced sleep troubles during wave 4.5. Sleep classes for youth/delayed school start times may help deter future ENDS use.
In a recent study, we demonstrated a relationship between self-reported sleep deprivation and youth susceptibility to initiate electronic nicotine delivery systems (ENDS) use; however, we were hampered by cross-sectional data. This study builds on our previous work by performing secondary analysis using the nationally representative Population Assessment of Tobacco and Health study datasets from wave 4.5 (2017–2018) and wave 5 (2018–2019) among respondents aged 12–17. Using a longitudinal cohort design, we assessed the extent self-reported sleep troubles at wave 4.5 related to transition from never-to-ever ENDS use by wave 5. We assessed youth who reported never having used any type of tobacco previously and who reported not using alcohol or other illicit substances the previous year. We ran four Poisson regression models on the dependent variable never-to-ever ENDS users at wave 5 and self-reported sleep troubles in the past year at wave 4.5. We controlled for demographic and sociographic factors and, in our final model, tobacco availability in home, exposure to ENDS advertising on social media, past year anxiety, depression, body mass index, physical activity, close friends that use ENDS, perceived harm of ENDS, school performance, sensation seeking, and the susceptibility of youth to initiate ENDS. Even when controlling for these factors, sleep troubles at wave 4.5 significantly and positively related to ENDS initiation by wave 5 (Past year sleep trouble: RR = 1.48 95 % CI = [1.14–1.93]). This key and novel finding has important implications for preventing youth ENDS use via protective self-care and social-environmental approaches.
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19
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Doherty J, Davison J, McLaughlin M, Giles M, Dunwoody L, McDowell C, Butter S, Wilmont E, Simpson EE. Prevalence, knowledge and factors associated with e-cigarette use among parents of secondary school children. PUBLIC HEALTH IN PRACTICE 2022; 4:100334. [DOI: 10.1016/j.puhip.2022.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/05/2022] Open
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Addo Ntim S, Martin B, Termeh-Zonoozi Y. Review of Use Prevalence, Susceptibility, Advertisement Exposure, and Access to Electronic Nicotine Delivery Systems among Minorities and Low-Income Populations in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13585. [PMID: 36294164 PMCID: PMC9603140 DOI: 10.3390/ijerph192013585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Increased use of electronic nicotine delivery systems (ENDS) and improper disposal after use pose a public health and an environmental justice (EJ) concern if use prevalence is disproportionately high among minorities and people of low socioeconomic status (SES) (broadly termed "EJ populations" for the purposes of this review). This review synthesizes literature on demographic patterns of use prevalence, susceptibility, advertisement exposure, and access to ENDS, and extrapolates environmental tobacco exposure (ETE) from ENDS among EJ populations. Seven electronic databases were searched using ENDS-related terms. We included studies published between 2017 and May 2020 that described ENDS use prevalence, susceptibility to ENDS use, advertisement exposure, and access to ENDS by race, ethnicity, or SES. Data synthesis was based on the assumptions that ETE increases with high use prevalence, susceptibility may influence future use, and advertisement exposure and access may impact demographic differences in use. We identified 32 studies describing use prevalence, susceptibility, advertisement exposure, or access to vape shops and other tobacco retail outlets by race/ethnicity or SES. We found higher prevalence of ENDS use among non-Hispanic Whites and inconclusive use patterns by SES. Patterns of susceptibility to use, advertisement exposure, and access were also mixed, with slightly higher outcomes observed among low SES youth. However, the evidence base on advertisement exposure was limited, with limited generalizability. Our findings indicate low prevalence of ENDS use among EJ populations. While this suggests low potential ETE among these groups, mixed outcomes on susceptibility, advertisement exposure, and access to ENDS among low SES groups may affect future ENDS use and ETE. Educational campaigns that discourage ENDS uptake should target EJ youth. Initiatives aimed at managing vape shop presence in EJ communities and monitoring targeted advertisement are also needed.
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Olonoff M, Niaura RS, Ciecierski CC, Ciolino JD, Hitsman B. Electronic nicotine delivery systems: use, knowledge, and attitudes among diverse college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2159-2167. [PMID: 33759696 DOI: 10.1080/07448481.2020.1846044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 06/07/2020] [Indexed: 06/12/2023]
Abstract
ObjectiveThe purpose of this study was to examine Electronic Nicotine Delivery Systems (ENDS) use among nonusers in diverse college students. Participants: Participants were college students enrolled at a Hispanic-Serving University in Chicago, IL, USA in December 2017. Methods: An online survey was administered using questions about ENDS-use behaviors, device characteristics, and knowledge of their own device, and ENDS attitudes. ENDS attitudes included questions about health, susceptibility, and quit characteristics. Results: The prevalence rate of ENDS use was 7%, and 39% of ENDS users identified all device characteristics. Nonusers categorize ENDS as a healthier alternative to cigarettes and as quit devices. Finally, cigarette use, age, health factor, and social proximity are correlated with ENDS susceptibility. Conclusions: These ENDS users lack awareness of their devices and tobacco use plays a key role in ENDS susceptibility. Future studies should continue to study the role ENDS has in dependence and cigarette use.
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Affiliation(s)
- Matthew Olonoff
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Raymond S Niaura
- Department of Population Health, New York University, New York, New York, USA
| | | | - Jody D Ciolino
- Department of Preventive Medicine, Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Cartujano-Barrera F, Hernández-Torrez R, Cai X, Orfin RH, Azogini C, Chávez-Iñiguez A, Santa Cruz E, Bansal-Travers M, Wilson KM, McIntosh S, Ossip DJ, Cupertino AP. Evaluating the Immediate Impact of Graphic Messages for Vaping Prevention among Black and Latino Adolescents: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10026. [PMID: 36011661 PMCID: PMC9407748 DOI: 10.3390/ijerph191610026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 05/10/2023]
Abstract
The purpose of this pilot study was to assess the immediate impact of vaping prevention graphic messages on the susceptibility to future vaping among Black and Latino adolescents (ages 12 to 17). Graphic messages (available in English and Spanish) were developed using participatory research procedures with Black and Latino adolescents. Recruitment was conducted by a team of diverse, bilingual (English and Spanish), trained recruiters. Participants (n = 362) were randomized in a 1:1:1:1 schema to receive one of four graphic messages (health rewards, financial rewards, autonomy, and social norms). Overall, all graphic messages but one showed a slight decrease in the number of participants susceptible to future vaping, though none of these differences was statistically significant. The graphic message on health rewards decreased the number of participants susceptible to future vaping the most (55.7% vs. 50%, at pre- vs. post-viewing, p = 0.125), followed by the graphic messages on social norms and autonomy (55.1% vs. 52.8%, p = 0.687; 55.4% vs. 52.2%, p = 0.435; respectively). The graphic message on financial rewards increased the number of participants susceptible to future vaping slightly (52.7% vs. 53.8%, p = 1.00). Future research is needed to evaluate susceptibility to future vaping before and after exposure to different and/or repeated vaping prevention graphic messages.
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Affiliation(s)
| | | | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Rafael H. Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Chiamaka Azogini
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Arlette Chávez-Iñiguez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Edgar Santa Cruz
- Social Work Program, Cameron Community Ministries, Rochester, NY 14606, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Karen M. Wilson
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
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23
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Mason TB, Tackett AP, Kechter A, Leventhal AM. Prospective Associations of Tobacco Weight Control Beliefs with E-Cigarette Use Patterns in the PATH Study. Subst Use Misuse 2022; 57:1581-1586. [PMID: 35799480 PMCID: PMC9704110 DOI: 10.1080/10826084.2022.2096240] [Citation(s) in RCA: 2] [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: 10/17/2022]
Abstract
INTRODUCTION Some adolescents report using e-cigarettes (EC) for weight-related reasons, but longitudinal studies are lacking. This study examined associations between tobacco weight control beliefs and body mass index (BMI) with EC use patterns over one year. METHODS Data from Waves 1 and 2 (September 2013 to October 2015) of the Population Assessment of Tobacco and Health (PATH) study were used. Questions about tobacco weight control beliefs, EC use patterns (never, ever, never to current, ever to current, current to current), cigarette and other tobacco product use, demographics, and BMI were examined among adolescent respondents across Wave 1 and Wave 2. RESULTS Most adolescents were never EC users (85.8%). Prevalence of EC use patterns was low across categories of use (0.6%-5.3%). Higher BMI was associated with transition from ever but not current use at Wave 1 to current use at Wave 2. Greater baseline tobacco weight control beliefs and increases in tobacco weight control beliefs were associated with most EC use patterns compared to never use. CONCLUSIONS Greater tobacco weight control beliefs were risk factors for e-cigarette initiation and maintenance among a nationally representative sample of adolescents. BMI was minimally associated with e-cigarette use patterns. Additional studies are needed to replicate and further examine these preliminary prospective associations between weight control beliefs and EC use.
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Affiliation(s)
- Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
| | - Alayna P. Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
| | - Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA
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24
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Harlow AF, Stokes AC, Brooks DR, Benjamin EJ, Barrington-Trimis JL, Ross CS. e-Cigarette Use and Combustible Cigarette Smoking Initiation Among Youth: Accounting for Time-Varying Exposure and Time-Dependent Confounding. Epidemiology 2022; 33:523-532. [PMID: 35394965 PMCID: PMC9156560 DOI: 10.1097/ede.0000000000001491] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Youth e-cigarette use is associated with the initiation of combustible cigarette smoking, but prior studies have rarely accounted for time-varying measures of e-cigarette exposure or time-dependent confounding of e-cigarette use and smoking initiation. METHODS Using five waves of the Population Assessment of Tobacco and Health (2013-2019), we estimated marginal structural models with inverse probability of treatment and censoring weights to examine the association between time-varying e-cigarette initiation and subsequent cigarette smoking initiation among e-cigarette- and cigarette-naïve youth (12-17 years) at baseline. Time-dependent confounders used as predictors in inverse probability weights included tobacco-related attitudes or beliefs, mental health symptoms, substance use, and tobacco-marketing exposure. RESULTS Among 9,584 youth at baseline, those who initiated e-cigarettes were 2.4 times as likely to subsequently initiate cigarette smoking as youth who did not initiate e-cigarettes (risk ratio = 2.4, 95% confidence interval [CI] = 2.1, 2.7), after accounting for time-dependent confounding and selection bias. Among youth who initiated e-cigarettes, more frequent vaping was associated with greater risk of smoking initiation (risk ratio ≥3 days/month = 1.8, 95% CI = 1.4, 2.2; 1-2 days/month = 1.2; 95% CI = 0.93, 1.6 vs. 0 days/month). Weighted marginal structural model estimates were moderately attenuated compared with unweighted estimates adjusted for baseline-only confounders. At the US population level, we estimated over half a million youth initiated cigarette smoking because of prior e-cigarette use over follow-up. CONCLUSIONS The association between youth vaping and combustible cigarette smoking persisted after accounting for time-dependent confounding. We estimate that e-cigarette use accounts for a considerable share of cigarette initiation among US youth. See video abstract at, http://links.lww.com/EDE/B937.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Andrew C. Stokes
- Boston University School of Public Health, Department of Global Health, Boston, MA
| | - Daniel R. Brooks
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Emelia J. Benjamin
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
- Boston University School of Medicine, Department of Medicine, Boston, MA
| | | | - Craig S. Ross
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
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25
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Sun R, Mendez D, Warner KE. Can PATH Study susceptibility measures predict e-cigarette and cigarette use among American youth 1 year later? Addiction 2022; 117:2067-2074. [PMID: 35072302 DOI: 10.1111/add.15808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
AIMS To investigate whether e-cigarette and cigarette susceptibility predict e-cigarette and cigarette use among American youth 1 year later. DESIGN AND SETTING Longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study-a four-stage, stratified probability cohort study of youth (12-17 years old) sampled from the United States civilian, non-institutionalized population. Multivariable logistic regression was used to estimate the association between initial product-specific susceptibility and subsequent cigarette smoking and e-cigarette use while controlling for sociodemographic characteristics, exposure to nicotine users, and behavioral risk factors. PARTICIPANTS The sample included 8841 adolescent never nicotine users at initial survey who participated in both wave 4 (2016-2017) and wave 4.5 (2017-2018) of PATH. MEASUREMENTS We measured cigarette and e-cigarette susceptibility (defined as a lack of a firm commitment to not use cigarettes or e-cigarettes) among never nicotine users at baseline (wave 4) as well as cigarette and e-cigarette use at 12-month follow-up (wave 4.5). FINDINGS Youth e-cigarette susceptibility was statistically significantly (P < 0.05) associated with e-cigarette use 1 year later, for both past 12-month (adjusted odds ratio [aOR], 2.99; 95% CI, 2.29-3.90) and past 30-day e-cigarette use (aOR, 2.73; 95% CI, 1.78-4.16), but not with cigarette smoking (aOR, 1.05; 95% CI, 0.64-1.73 for past 12-month smoking and aOR, 0.65; 95% CI, 0.29-1.45 for past 30-day smoking. Smoking susceptibility predicted subsequent smoking in the past 12 months (aOR, 1.82; 95% CI, 1.09-3.03) and past 30 days (aOR, 3.32; 95% CI (1.33-8.29), but not e-cigarette use in the past 12 months (aOR, 0.96; 95% CI, 0.77-1.19) or past 30 days (aOR, 1.11; 95% CI, 0.82-1.51). CONCLUSION E-cigarette and cigarette susceptibility measures appear to predict product-specific use among youth 1 year later.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - David Mendez
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Kenneth E Warner
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
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26
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Sun R, Mendez D, Warner KE. Is Adolescent E-Cigarette Use Associated With Subsequent Smoking? A New Look. Nicotine Tob Res 2022; 24:710-718. [PMID: 34897507 PMCID: PMC8962683 DOI: 10.1093/ntr/ntab243] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/29/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Prospective studies have consistently reported a strong association between e-cigarette use and subsequent cigarette smoking, but many failed to adjust for important risk factors. METHODS Using longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, we employed multivariable logistic regressions to assess the adolescent vaping-to-smoking relationship, with four regressions (Models 1-4) sequentially adding more risk factors.Our sample included all waves (waves 1-5) of the PATH Study. RESULTS The association between ever e-cigarette use and subsequent cigarette smoking decreased substantially in magnitude when adding more control variables, including respondents' sociodemographic characteristics, exposure to tobacco users, cigarette susceptibility, and behavioral risk factors. Using the most recent data (waves 4-4.5 and waves 4.5-5), this association was not significant in the most complete model (Model 4). Using wave 4.5-5 data, the adjusted odds ratio (aOR) for ever e-cigarette use at initial wave and subsequent past 12-month smoking declined from 4.07 (95% confidence interval [CI, 2.86-5.81) in Model 1, adjusting only for sociodemographic characteristics, to 1.35 (95% CI, 0.84-2.16) in Model 4, adjusting for all potential risk factors. Similarly, the aOR of ever e-cigarette use and past 30-day smoking at wave 5 decreased from 3.26 (95% CI, 1.81-5.86) in Model 1 to 1.21 (95% CI, 0.59-2.48) with all covariates (Model 4). CONCLUSIONS Among adolescent never cigarette smokers, those who had ever used e-cigarettes at baseline, compared with never e-cigarette users, exhibited modest or non-significant increases in subsequent past 12-month or past 30-day smoking when adjusting for behavioral risk factors.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Mendez
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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27
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Gaiha SM, Lempert LK, McKelvey K, Halpern-Felsher B. E-cigarette devices, brands, and flavors attract youth: Informing FDA's policies and priorities to close critical gaps. Addict Behav 2022; 126:107179. [PMID: 34861522 PMCID: PMC8712419 DOI: 10.1016/j.addbeh.2021.107179] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Identify e-cigarette devices, brands, and flavor types used by adolescents and young adults soon after the enactment of flavor restrictions, youth access laws, FDA's enforcement prioritization against some flavored pod/cartridge-based e-cigarettes, and during COVID-19 pandemic-related school closures. METHODS National cross-sectional online survey (N = 4,351) in May 2020 assessed popularity, ever- and past-30-day use of e-cigarette device types (pod/cartridge-based, disposables, others), brands, flavor types and flavor-enhancers, by age group (under age 21 and 21 and over). RESULTS While pod/cartridge-based e-cigarettes had the highest ever-use (82.7% <21; 69.8% ≥21) and were most often-used (41.9% <21; 41.4% ≥21), most past 30-day-users (50.8% <21; 61.9% ≥21) and 7-day-users (36.0% <21; 56.7% ≥21) used disposables. Mint/menthol was the most-used flavor type (pod/cartridge-based: 48.2% <21, 48.1% ≥21; disposables: 51.6% <21, 56.4% ≥21), followed by fruit (pod/cartridge-based: 37.4% <21, 35.5%≥ 21; disposables: 51.6% >21, 46.2% ≥ 21), and sweet/dessert/candy flavor types (pod/cartridge-based: 24.4% <21, 24.7% ≥21; disposables: 29.7% <21, 33.8% ≥21). Participants reported using add-on e-cigarette flavor-enhancers (pod/cartridge-based: 24.6%; disposables: 31.3%). CONCLUSION Soon after FDA's January 2020 announcement of prioritized enforcement against flavored pod/cartridge-based e-cigarettes and during the pandemic lockdown, adolescents' and young adults' past 30-day use included mostly flavored disposables rather than pod/cartridge-based e-cigarettes, mint/menthol flavors, and some used add-on flavor enhancers. To reduce youth use, comprehensive regulation of e-cigarette devices and flavors should be enacted and enforced at federal, state, and local levels.
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Affiliation(s)
- Shivani Mathur Gaiha
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA
| | - Lauren Kass Lempert
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA; Center for Tobacco Control Research and Education, University of California, San Francisco, USA
| | - Karma McKelvey
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA
| | - Bonnie Halpern-Felsher
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, USA.
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28
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Simpson EEA, Davison J, Doherty J, Dunwoody L, McDowell C, McLaughlin M, Butter S, Giles M. Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools. BMC Public Health 2022; 22:276. [PMID: 35144592 PMCID: PMC8832682 DOI: 10.1186/s12889-022-12674-3] [Citation(s) in RCA: 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.
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Affiliation(s)
- E E A Simpson
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK.
| | - J Davison
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - J Doherty
- School of Nursing and Midwifery, Queens University of Belfast, Belfast, UK
| | - L Dunwoody
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - C McDowell
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M McLaughlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - S Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M Giles
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
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29
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Sociodemographic Factors Associated with Adolescents' and Young Adults' Susceptibility, Use, and Intended Future Use of Different E-Cigarette Devices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041941. [PMID: 35206132 PMCID: PMC8872322 DOI: 10.3390/ijerph19041941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 12/10/2022]
Abstract
Numerous studies have identified sociodemographic factors associated with susceptibility, ever-use and past-30-day use of e-cigarettes, including JUUL. However, it remains unknown which sociodemographic factors are associated with adolescents’ and young adults’ (AYA) use of the entire spectrum of different types of e-cigarette devices (e.g., disposables, pod/cartridge-based, and other e-cigarettes, like mods or tanks). The aim of this study was to examine the relationship between sociodemographic factors and use, future use intent and susceptibility to use different e-cigarette device types. We conducted a national online survey using a convenience sample of 13–24-year-olds, 50:50 e-cigarette ever- to never-users and sex and race/ethnicity balanced per the U.S. Census (n = 4351). Sociodemographic factors were not associated with ever use of disposables among AYAs or generally with intent to use e-cigarette devices in the future. However, sociodemographic factors were related to the use of pod/cartridge-based and other e-cigarette devices. LGBTQ+ AYAs were more likely to use pod/cartridge-based devices and to be susceptible to using all device types compared to other AYAs. Young adults, males, and other/multiracial non-Hispanic AYAs were more likely to report past-30-day-use of all devices and AA/Black non-Hispanic AYAs were more likely to report past-30-day use of pod/cartridge-based and other devices compared to former users. AA/Black non-Hispanic AYAs were more likely to be susceptible to using all devices and other/multiracial non-Hispanic AYAs were susceptible to using other devices (compared to White non-Hispanic AYAs). AYAs under 21 who were former users were more likely to intend using other devices in the future compared to AYAs 21 years or above. These findings may inform targeted prevention efforts to curb the growing popularity of different devices among AYAs.
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30
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Enlow PT, Williford DN, Romm KF, Dino GA, Blank MD, Murray PJ, Banvard CA, Duncan CL. Predicting Adolescent Electronic Cigarette Use: Differences by Never, Ever, and Current Users. J Pediatr Psychol 2022; 47:1-11. [PMID: 34524431 PMCID: PMC9125499 DOI: 10.1093/jpepsy/jsab082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Rising rates of adolescent electronic cigarette (ECIG) use is concerning because it can lead to adverse health outcomes and increased risk behavior. There are known predictors of ever versus never ECIG use, but less are known about risk factors for ever versus current use of ECIGs. Problem behavior theory (PBT) was used to evaluate possible risk factors for different ECIG use status. METHODS Participants were 573 high school students who completed questionnaires measuring ECIG use, as well as constructs within the Social Environment, Perceived Environment, Personality, and Behavior domains of PBT. Multinomial logistic regression was used to evaluate how predictor variables differentiated between participants who reported (a) never use, (b) ever ECIG use, or (c) current ECIG use. RESULTS Adolescents were more likely to endorse ever ECIG use than never use if they reported peer ECIG use, perceived more benefits and fewer costs (e.g., health) of ECIG use, higher extraversion, alcohol and cigarette use (never vs. ever vs. past 30 days), or attended a school with a higher percentage of socioeconomically disadvantaged students. Adolescents were more likely to report current ECIG use than ever ECIG use if they perceived fewer costs of ECIG use or used cannabis in their lifetime (yes/no). CONCLUSIONS PBT variables differentiated between ever ECIG use and never ECIG use. However, these variables did not differentiate between ever and current ECIG use. Identifying unique risk factors for current versus ever ECIG use is important to understanding persistent ECIG use and subsequent targeted prevention and intervention programs.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE, USA
- Department of Pediatrics, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, PA, USA
| | | | - Katelyn F Romm
- Milken Institute of Public Health, George Washington University, Washington, DC, USA
| | - Geri A Dino
- WV Prevention and Research Center, Department of Social and Behavioral Sciences, WVU School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- WV Prevention and Research Center, Department of Social and Behavioral Sciences, WVU School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Pamela J Murray
- Department of Pediatrics, Section of Adolescent Medicine, West Virginia University, Morgantown, WV, USA
| | - Christine A Banvard
- Department of Pediatrics, Section of Adolescent Medicine, West Virginia University, Morgantown, WV, USA
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Pérez A, Bluestein MA, Kuk AE, Chen B, Sterling KL, Harrell MB. Age of Onset of Susceptibility to Different Tobacco Products Among Non-Susceptible US Young Adults: Findings from the Population Assessment of Tobacco and Health Study Waves 2-4 (2014-2017). Tob Use Insights 2021; 14:1179173X211065643. [PMID: 34924777 PMCID: PMC8671673 DOI: 10.1177/1179173x211065643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Initiation of tobacco products is increasing in young adulthood. This study prospectively estimated the age of onset of susceptibility to cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos among young adults, which is a cognitive precursor to initiation. METHODS Secondary data analyses of the Population Assessment of Tobacco and Health (PATH) study, a nationally representative longitudinal cohort study of US adults. Young adults (18-24 years) who were non-susceptible to each tobacco product (cigarettes, e-cigarettes, hookah, smokeless tobacco, and cigarillos) at waves 2 or 3 were followed-up into waves 3-4 to prospectively estimate the age of onset of susceptibility to each tobacco product. Weighted interval-censored survival methods and interval-censored Cox regression models were implemented to estimate the age of onset of susceptibility, and to estimate differences in the hazard function by sex and by race/ethnicity, while controlling for the total number of other tobacco products ever used at their first wave of participation in PATH. RESULTS By age 21, 16.5%, 16.0%, 12.6%, 12.4%, and 5.9% of young adults reported onset of susceptibility to hookah, e-cigarettes, cigarillos, cigarettes, and smokeless tobacco, respectively. Among young adults who were non-susceptible to each tobacco product at waves 2 or 3, the highest increase in onset of susceptibility occurred between ages 18 and 19 for cigarettes, e-cigarettes, and hookah, while the highest increase in onset of susceptibility occurs between ages 22 and 23 for cigarillos. Young adult males had increased risk of onset of susceptibility to cigarillos and smokeless tobacco at earlier ages than young adult females. Differences in onset of susceptibility to each tobacco product were also observed by race/ethnicity among young adults. CONCLUSIONS With the changing landscape of tobacco products, monitoring the age of onset of susceptibility of tobacco product use among non-susceptible young adults longitudinally is critical to prevent initiation. Communication and education campaigns tailored to address differences in susceptibility among young adults by tobacco product and sociodemographic factors will be useful.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, School of Public Health, Austin Campus, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA,Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA,Adriana Pérez, Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX 78701, USA.
| | - Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Arnold E. Kuk
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, Austin Campus, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA,Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Kymberle L. Sterling
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, TX, USA
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA,Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in Austin, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
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Heng PP, Daud F, Yusoff MFM, Lim KH. Susceptibility to e-cigarette initiation among tobacco product naïve adolescents in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian adolescents (TECMA). Tob Induc Dis 2021; 19:89. [PMID: 34887718 PMCID: PMC8611510 DOI: 10.18332/tid/142900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Predicting susceptibility to e-cigarette (EC) initiation among adolescents is crucial to optimize preventive measures before the health risk behavior persists through adulthood. The identification of susceptible groups is needed in response to the surge of EC use. This study aimed to determine the prevalence and determinants associated with EC susceptibility among tobacco product naïve (never users of any single tobacco product) school-going adolescents in Malaysia. METHODS Data were derived from the Tobacco and EC Survey among Malaysians (TECMA), which recruited a total of 13162 school-going adolescents aged 10– 19 years from 138 randomly selected schools via a two-stage stratified cluster sampling design. A validated self-administered questionnaire adapted from the Global Youth Tobacco Survey was utilized as the study instrument. The data were analyzed using SPSS version 22.0 descriptively and with multivariable logistic regression to determine the associated factors of EC susceptibility. RESULTS About 15.7% of the tobacco naïve adolescents were susceptible to EC initiation, with the proportion of susceptibility significantly higher among males, mid-adolescents, rural adolescents, those reporting exposure to tobacco advertisement and those not taught in school about the danger of tobacco use. Multivariable logistic regression revealed that the male students (AOR=2.20; 95% CI: 1.86–2.59) from a rural locality (AOR=1.45; 95% CI: 1.23–1.71), those reporting no lessons on the danger of tobacco use at school (AOR=1.66; 95% CI: 1.39–1.99) and those exposed to tobacco advertisement (AOR=1.67; 95% CI: 1.07–2.61), were more susceptible to EC initiation, while no significant association was found between secondhand smoke exposure and EC susceptibility. CONCLUSIONS Comprehensive EC preventive strategies are critically needed together with the implementation of targeted, gender, and culturally impressionable interventions. In addition, future studies should focus on the evaluation of the impacts of the preventive and control efforts to ensure their effectiveness in preventing EC initiation among Malaysian adolescents.
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Affiliation(s)
- Pei Pei Heng
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.,Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
| | - Faiz Daud
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Kuang Hock Lim
- Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
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Cheng HG, Lizhnyak PN, Knight NA, Vansickel AR, Largo EG. Youth susceptibility to tobacco use: is it general or specific? BMC Public Health 2021; 21:1913. [PMID: 34674687 PMCID: PMC8532300 DOI: 10.1186/s12889-021-11956-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Susceptibility to tobacco use predicts tobacco use onset among youth. The current study aimed to estimate the extent of overlap in susceptibilities across various tobacco products, investigate sociopsychological correlates with susceptibilities, and examine whether the relationship linking susceptibility with the onset of use is product-specific or is accounted for by a general susceptibility-onset relationship. METHODS The study population consisted of US youth 12-17 years old who had never used a tobacco product, sampled in the longitudinal Population Assessment of Tobacco and Health study wave 4 (Dec. 2016-Jan. 2018; n = 10,977). Tobacco product-specific susceptibility at wave 4 was assessed via questions about curiosity, likelihood to try, and likelihood of use if a best friend offered. The onset of use of various tobacco products was defined as first use occurring between the wave 4 and wave 4.5 (Dec. 2017-Dec. 2018) assessments (n = 8841). Generalized linear regression and structural equation models were used for data analysis. RESULTS There is a large degree of overlap in susceptibilities across tobacco products (65% of tobacco-susceptible youth were susceptible to more than one tobacco product). Tobacco-susceptible youths were more likely to have recently used cannabis, consumed alcohol, or to have been associated with tobacco-using peers. Structural equation models suggest that the susceptibility-onset relationship largely operates in a non-product-specific manner after accounting for the general susceptibility-to-tobacco-onset relationship. CONCLUSIONS Youth susceptibility to tobacco use overlaps widely across different tobacco products and other risky behaviors. Findings from this study support a holistic approach towards the prevention of risk behaviors, supplemented by product-specific strategies when needed.
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Affiliation(s)
- Hui G Cheng
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA.
| | - Pavel N Lizhnyak
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| | - Natasha A Knight
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| | | | - Edward G Largo
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Larry Davidson
- Department of Psychiatry, School of Medicine at Yale University, New Haven, CT, USA
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Mathur Gaiha S, Halpern-Felsher B, Feld AL, Gaber J, Rogers T, Henriksen L. JUUL and other e-cigarettes: Socio-demographic factors associated with use and susceptibility in California. Prev Med Rep 2021; 23:101457. [PMID: 34194963 PMCID: PMC8227835 DOI: 10.1016/j.pmedr.2021.101457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 11/25/2022] Open
Abstract
This study examined which socio-demographic factors are associated with susceptibility (lack of commitment to avoid future use), past-12-month and past-30-day use of JUUL and other e-cigarettes, and reasons for and against using JUUL. An online survey of 3,075 Californians ages 15-29, including 24.3% who identified as LGBTQ, were recruited via social media in January-March 2019. Multi-level weighted logistic regression models suggest that LGBTQ participants were more likely to be susceptible to JUUL [AOR = 2.11 (1.60, 2.79) (parentheses include 95% Confidence Intervals)] and other e-cigarettes [AOR = 2.31 (1.75, 3.05)], and more likely to use JUUL [AOR = 1.27 (1.02, 1.58)] and other e-cigarettes [AOR = 1.66 (1.35, 2.05)] in the past 12 months. Susceptibility to using JUUL was more likely among adolescents (ages 15-17) [AOR = 1.72 (1.30, 2.28)] and young adults (ages 18-20) [AOR = 1.26 (1.00,1.58)] than adults (ages 21-29). At the community level, living in jurisdictions with higher median household income was associated with a higher likelihood of being susceptible to using JUUL and other e-cigarettes. Compared to non-Hispanic Whites, Asian/Pacific Islanders were less likely to use JUUL [AOR = 0.68 (0.54, 0.86)] and other e-cigarettes [AOR = 0.60 (0.48, 0.76)] in the past 12 months. Past-30-day JUUL use was more likely among males than females [AOR = 1.44 (1.11, 1.88)]. Common reasons for using JUUL were: friends' use, flavors, "safer" than cigarettes, no one will notice, and nicotine rush is greater than other devices. Common reasons against using JUUL were: harmful to self/others, contains nicotine and is addictive. E-cigarette prevention and cessation efforts should include tailored messaging for people who identify as LGBTQ and reinforce reasons for not vaping nicotine.
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Affiliation(s)
| | | | - Ashley L. Feld
- RTI International, Research Triangle Park, NC, United States
| | - Jennifer Gaber
- RTI International, Research Triangle Park, NC, United States
| | - Todd Rogers
- RTI International, Research Triangle Park, NC, United States
| | - Lisa Henriksen
- Stanford University School of Medicine, Palo Alto, CA, United States
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Coreas SI, Rodriquez EJ, Rahman SG, El-Toukhy S, Compton WM, Blanco C, Kimmel HL, Pérez-Stable EJ. Smoking Susceptibility and Tobacco Media Engagement Among Youth Never Smokers. Pediatrics 2021; 147:e2020017921. [PMID: 33941582 PMCID: PMC8331193 DOI: 10.1542/peds.2020-017921] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Susceptibility to future smoking among youth never smokers has not changed in the past 20 years, although experimental cigarette smoking has decreased. We assessed how smoking susceptibility and tobacco industry-related marketing influenced smoking initiation. METHODS Four waves (2013-2018) of the Population Assessment of Tobacco and Health Study data were analyzed among youth aged 12 to 17 years at wave 1 who completed wave 4. Susceptibility was assessed by 4 items (openness to curiosity, try soon, try in the next year, and if your best friend offered) and categorized into 4 levels (0 = definitely no to all; 1 = yes to 1; 2 = yes to 2; and 3 + 4 = yes to 3 or 4 susceptibility items). Multivariable logistic regression evaluated how susceptibility levels, electronic cigarette use, and tobacco-related media activity predicted future experimental (≥1 puff), current (past 30 days), or established (≥100 cigarettes) smoking. RESULTS Among 8899 never smokers at wave 1, 16.4% became experimental smokers, 7.6% current smokers, and 1.8% established smokers at wave 4. Black and Latino/a youth were less likely to experiment. Youth who endorsed 3 or 4 susceptibility items at wave 1 were more likely to be experimental (adjusted odds ratio [aOR] = 6.0; confidence interval [CI] = 4.8-7.4), current (aOR = 4.2; CI = 3.2-5.4), or established (aOR = 4.4; CI = 2.4-7.9) smokers at wave 4. Exposure to tobacco marketing, using tobacco-related apps, seeing social media content posted about tobacco, and ever use of electronic cigarettes also predicted experimental smoking. CONCLUSIONS Smoking susceptibility and exposure to tobacco industry-related marketing were predictive of cigarette smoking. Clinicians should consider screening adolescents for smoking susceptibility and tobacco-related media exposure.
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Affiliation(s)
- Saida I Coreas
- Division of Intramural Research, National Heart, Lung, and Blood Institute
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung, and Blood Institute
| | - Sana G Rahman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, and
| | - Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, and
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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D'Angelo H, Patel M, Rose SW. Convenience Store Access and E-cigarette Advertising Exposure Is Associated With Future E-cigarette Initiation Among Tobacco-Naïve Youth in the PATH Study (2013-2016). J Adolesc Health 2021; 68:794-800. [PMID: 33039271 PMCID: PMC8317228 DOI: 10.1016/j.jadohealth.2020.08.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/04/2020] [Accepted: 08/28/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE The association between e-cigarette marketing exposure and youth e-cigarette initiation is not well understood. This study examines whether convenience store access, exposure to retail e-cigarette marketing, and having a favorite e-cigarette ad before e-cigarette use is associated with susceptibility to use and future e-cigarette initiation in a national longitudinal study of youth. METHODS A nationally representative longitudinal cohort of youth in the Population Assessment of Tobacco and Health study (12-17 years) was followed up over three waves of annual data collection (2013-2016). Tobacco-naïve (wave 1) and e-cigarette-naïve (wave 2) youth (n = 6,470) were included. Marketing exposure at wave 2 was examined in association with e-cigarette susceptibility (wave 2) and e-cigarette initiation (wave 3) using adjusted logistic regression models. Analysis occurred in 2019. RESULTS Youth visiting convenience stores at least weekly (vs. never) had 1.51 times the odds of e-cigarette susceptibility (95% confidence interval [CI]: 1.25, 1.81) and 1.79 times the odds of e-cigarette initiation (95% CI: 1.29, 2.48). Noticing a retail e-cigarette ad (vs. not noticing) was associated with e-cigarette susceptibility (adjusted odds ratio [AOR] 1.36, 95% CI: 1.18, 1.57), but not initiation. Youth reporting a favorite branded e-cigarette ad had greater odds of both susceptibility (AOR 1.31, 95% CI, 1.10, 1.56) and e-cigarette initiation (AOR 1.60, 95% CI: 1.18, 2.17) compared to youth without a favorite ad. CONCLUSIONS Tobacco-naïve youth with frequent convenience store access and exposure to e-cigarette marketing were at greater risk of e-cigarette susceptibility and progression to e-cigarette initiation over a 2-year period. Policies to restrict retailer locations and e-cigarette marketing could enhance youth e-cigarette use prevention efforts.
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Affiliation(s)
- Heather D'Angelo
- School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin. heather.d'
| | - Minal Patel
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| | - Shyanika W Rose
- College of Medicine, Department of Behavioral Science, and Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, Lexington, Kentucky
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38
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Bentivegna K, Atuegwu NC, Oncken C, DiFranza JR, Mortensen EM. Electronic Cigarettes Associated With Incident and Polysubstance Use Among Youth. J Adolesc Health 2021; 68:123-129. [PMID: 32641242 DOI: 10.1016/j.jadohealth.2020.05.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE Electronic cigarette (e-cigarette) use has increased exponentially among the youth in the United States and may increase the incidence of substance use. METHODS Youth participants (12-17 years) were surveyed through the Population Assessment of Tobacco and Health study over a three-year time period. Youth with any baseline substance use or diagnosis of an attention deficit disorder were excluded from the analysis. Multivariable logistic regressions were used to assess the association between e-cigarette use at Wave 1 and incident substance use (marijuana, painkillers, sedatives, or tranquilizers and Ritalin/Adderall) and polysubstance use at Wave 2 or 3, and marijuana use in the electronic nicotine device at Wave 3. RESULTS Baseline ever e-cigarette users who had no history of marijuana, nonprescribed drugs and illicit substance use in Wave 1 had increased odds of reporting incident use of marijuana (odds ratio 2.59, 95% confidence interval: 1.90-3.52), nonprescribed Ritalin/Adderall use (1.89, 1.09-3.28), or polysubstance use (2.09, 1.43-3.05) in Wave 2 or 3 compared to never e-cigarette users. They were also more likely to report use of marijuana in the electronic nicotine product (2.26, 1.56-3.27) in Wave 3 compared to never e-cigarette users. There was no statistically significant association between baseline e-cigarette use and incident use of painkillers, sedatives, or tranquilizers in Wave 2 or 3 (1.21, .79-1.87). CONCLUSIONS E-cigarette use is associated with incident use of marijuana, marijuana in electronic nicotine devices, Ritalin/Adderall, and polysubstance use but not painkillers, sedatives, or tranquilizers. Results indicate that e-cigarettes are associated with subsequent additional risky health behaviors in youth.
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Affiliation(s)
- Kathryn Bentivegna
- Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut
| | - Nkiruka C Atuegwu
- Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut
| | - Cheryl Oncken
- Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut
| | | | - Eric M Mortensen
- Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut.
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Rohde JA, Vereen RN, Noar SM. Adolescents and Young Adults Who Vape or Are Susceptible to Vaping: Characteristics, Product Preferences, and Beliefs. Subst Use Misuse 2021; 56:1607-1615. [PMID: 34233573 DOI: 10.1080/10826084.2021.1942052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined differences among current vapers, those susceptible to vaping, and those non-susceptible to vaping among adolescents and young adults (AYAs) in the U.S. We sought to understand vaping-related characteristics, preferences, and beliefs across these populations to inform prevention efforts. Methods: Participants were N=543 adolescents and N=557 young adults recruited in mid-2019 in the U.S. In two separate cross-sectional surveys, we assessed vaping preferences, tobacco product use, and both health harm and addiction risk beliefs about vaping. We ran separate multivariate logistic regressions to assess differences in risk beliefs across the three distinct e-cigarette groups among AYAs. Results: A majority of AYAs were either current vapers (adolescents: 32%, young adults: 36%) or susceptible to vaping (adolescents: 34%, young adults: 24%). In both samples, pod-based devices were the most common device type used, and fruit and mint/menthol were the most commonly used flavors. In multivariate analyses, adolescent (p<.05) and young adult (p<.05) current vapers both had lower risk beliefs about the health harms of vaping compared to those susceptible to vaping. Susceptible adolescents also had lower health harm risk beliefs compared to those who were non-susceptible (p<.05). Addiction risk beliefs seldom predicted use or susceptibility in multivariate analyses, with only susceptible young adults having lower addiction beliefs than those non-susceptible (p<.05). Conclusion: Results from this study highlight the role of health harm risk beliefs among AYA vapers and those susceptible to vaping. Prevention efforts should examine the most potent ways to communicate vaping health harms to discourage AYA vaping.
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Affiliation(s)
- Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, NC, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, USA
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Tackett AP, Keller-Hamilton B, Smith CE, Hébert ET, Metcalf JP, Queimado L, Stevens EM, Wallace SW, McQuaid EL, Wagener TL. Evaluation of Respiratory Symptoms Among Youth e-Cigarette Users. JAMA Netw Open 2020; 3:e2020671. [PMID: 33048131 PMCID: PMC8094411 DOI: 10.1001/jamanetworkopen.2020.20671] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Use of e-cigarettes (ECs) among youths has increased in recent years. e-Cigarette aerosol contains chemical constituents, such as diacetyl or benzaldehyde, which are known to affect the respiratory system. OBJECTIVE To examine the association between EC use and self-reported wheezing in a cohort of US adolescents. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from waves 3 and 4 (October 19, 2015, to January 3, 2018) of the Population Assessment of Tobacco and Health (PATH) study, a longitudinal, nationally representative cohort survey. Adolescent respondents aged 12 to 17 years who did not have asthma were included. EXPOSURES e-Cigarette use during the previous year. MAIN OUTCOMES AND MEASURES Self-reported wheezing in the past 12 months (yes or no) and EC use (no use in past year or never use, use in past year, use in past 30 days, and use in past 7 days). Survey-weighted logistic regression models adjusted for demographic characteristics and other risk factors. RESULTS Among 7049 adolescents without asthma from waves 3 and 4 of the PATH study, 49.9% were female and 54.4% were non-Hispanic White. In unadjusted models, the odds of wheezing in the past 12 months were higher for youths who had used ECs in the past year compared with those who had not (odds ratio, 1.74; 95% CI, 1.22-2.48; P = .003). In the adjusted model, after controlling for the variables of race/ethnicity, household rules about the use of tobacco, contact with a smoker in the previous 7 days, and current use of combustible tobacco products, the association of EC use with wheezing was not significant (adjusted odds ratio for EC use in the past year, 1.37 [95% CI, 0.91-2.05]; in the past 30 days, 1.35 [95% CI, 0.63-2.88]; in the past 7 days, 0.74 [95% CI, 0.28-1.97]; P = .33). CONCLUSIONS AND RELEVANCE In this cohort study, use of ECs alone was not associated with increased odds of experiencing wheezing episodes. Future studies incorporating the use of objective data appear to be needed to more accurately understand the potential respiratory harms associated with vaping among adolescents.
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Affiliation(s)
- Alayna P. Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | | | | | - Emily T. Hébert
- School of Public Health, The University of Texas Health Science Center, Austin
| | - Jordan P. Metcalf
- Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Lurdes Queimado
- Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Elise M. Stevens
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Elizabeth L. McQuaid
- Bradley/Hasbro Children’s Research Center, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Department of Internal Medicine, The Ohio State University, Columbus
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Sahu KK, Mishra AK, Lal A, Abraham G. A double-edged sword: E-cigarettes, and other electronic nicotine delivery systems (ENDS). Intern Emerg Med 2020; 15:1117-1118. [PMID: 31701318 DOI: 10.1007/s11739-019-02203-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/27/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA, 01608, USA.
| | - Ajay Kumar Mishra
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA, 01608, USA
| | - Amos Lal
- Department of Pulmonary Medicine and Critical Care, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - George Abraham
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA, 01608, USA
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Chudomelka L, Wyatt TA. Cross-fading: The importance of tissue injury research on dual misuse of alcohol and JUUL. Alcohol 2020; 86:43-44. [PMID: 32247033 PMCID: PMC11232529 DOI: 10.1016/j.alcohol.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Lisa Chudomelka
- University of Nebraska Medical Center, Pulmonary, Critical Care, Sleep & Allergy, 985910 Nebraska Medical Center, Omaha, NE 68198-5910, United States
| | - Todd A Wyatt
- University of Nebraska Medical Center, Pulmonary, Critical Care, Sleep & Allergy, 985910 Nebraska Medical Center, Omaha, NE 68198-5910, United States; Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, United States; University of Nebraska Medical Center, Department of Environmental, Agricultural & Occupational Health, Omaha, NE 68198-5910, United States.
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Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145133. [PMID: 32708622 PMCID: PMC7399914 DOI: 10.3390/ijerph17145133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.
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Longitudinal associations between susceptibility to tobacco use and the onset of other substances among U.S. youth. Prev Med 2020; 135:106074. [PMID: 32243937 PMCID: PMC7233357 DOI: 10.1016/j.ypmed.2020.106074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/27/2020] [Accepted: 03/28/2020] [Indexed: 11/23/2022]
Abstract
We examined whether tobacco susceptibility at Wave (W) 1 (2013-2014) predicts the onset of tobacco and other substances at W2 (2014-2015) among 5325 U.S. youth (12-17 years) never substance users at W1 in the Population Assessment of Tobacco and Health (PATH) Study. Tobacco susceptibility was based on curiosity, use intentions, and response to a best friend's offer to use. Onset of use included past 12-month use of a specific substance or group of substances at W2 among those who had never used any substance at W1. Approximately, 31.3% of W1 youth were susceptible to tobacco use. W2 onset was 8.2% (SE = 0.4) for alcohol exclusively, 5.0% (SE = 0.4) for polysubstance including tobacco, 4.4% (SE = 0.3) for tobacco exclusively, 3.1% (SE = 0.3) for other drugs (misused prescription stimulants and painkillers, cocaine, other stimulants, heroin, inhalants, solvents and hallucinogens) exclusively, 1.4% (SE = 0.2) for polysubstance excluding tobacco, and 0.9% (SE = 0.1) for marijuana exclusively. Tobacco-susceptible compared with non-tobacco susceptible youth had higher odds of onset of exclusive tobacco use (AOR: 2.4; 95% CI: 1.7, 3.3), exclusive alcohol use (AOR: 1.5; 95% CI: 1.2, 1.8), and polysubstance use (AOR: 3.9; 95% CI: 2.8, 5.6 including tobacco and AOR: 1.8; 95% CI: 1.1, 3.0 excluding tobacco) compared with W2 never substance use. In this national study, tobacco susceptibility identified U.S. youth at risk for onset of tobacco and other substances, perhaps reflecting common etiology and clustering of substance use in youth. Identifying and preventing tobacco-susceptible youth from progressing to using addictive substances must remain a public health priority.
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Ortega A, Sutton M, McConville A, Cushing CC, Fite PJ. Longitudinal investigation of the bidirectional associations between initiation of e-cigarettes and other substances in adolescents. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1766129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Adrian Ortega
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Moneika Sutton
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Andrew McConville
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Christopher C. Cushing
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
- Schiefelbusch Institute for Life Span Studies, University of Kansas, Lawrence, Kansas, USA
| | - Paula J. Fite
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
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Nicksic NE, Do EK, Barnes AJ. Cannabis legalization, tobacco prevention policies, and Cannabis use in E-cigarettes among youth. Drug Alcohol Depend 2020; 206:107730. [PMID: 31759233 PMCID: PMC6980691 DOI: 10.1016/j.drugalcdep.2019.107730] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND E-cigarettes are the most popular tobacco product among youth. As more states adopt cannabis legalization policies, youth cannabis use in e-cigarettes is a mounting concern. METHODS Data were from the 2016 and 2017 National Youth Tobacco Survey, a nationally-representative repeated cross-sectional survey administered to US middle and high school students. Ever use groups were categorized into e-cigarette ever users, cannabis in e-cigarette ever users, other tobacco ever users, and never users. Weighted multinomial logistic regression compared ever use groups, while controlling for state-level cannabis legalization and tobacco prevention polices, tobacco perceptions and exposures, and sociodemographic variables. Weighted prevalence of ever and current, or past 30 day, tobacco product use was determined by ever use groups. RESULTS Compared to e-cigarette ever users, cannabis in e-cigarette ever users increased (Adjusted Relative Risk Ratio (ARRR) = 1.65; p < 0.01) from 2016 to 2017. Medical-only and medical and recreational cannabis laws, and no e-cigarette minimum legal sales age (MLSA) and increased e-cigarette MLSA at 19 or 21 were positively associated with cannabis in e-cigarette ever users (ARRR = 1.34-1.85; p < 0.01, each). Ever and current use of all individual tobacco products was highest among cannabis in e-cigarette ever users compared to e-cigarette and other tobacco ever users. CONCLUSIONS Cannabis use in e-cigarettes has increased among youth, and these trends will likely continue as e-cigarettes continue to gain popularity and cannabis legalization policies proliferate. Targeted tobacco and cannabis prevention strategies are needed for youth, especially in states that have implemented cannabis 'medical and recreational laws.
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Affiliation(s)
- Nicole E Nicksic
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA.
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Abstract
Alcohol use during adolescence is an important and modifiable health risk behavior given the significant acute consequences and long-term impacts on the developing brain. Alcohol is the most common substance used by young adults 12 to 17 years old, with binge drinking, polysubstance use, and co-occurring mental health disorders posing particular concerns in this age group. Physicians can play a crucial role in screening and responding to alcohol use, with targeted brief interventions designed to delay or decrease use.
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Affiliation(s)
- Sarah M Bagley
- Boston Medical Center, 801 Massachusetts Avenue, 2nd floor, Boston, MA 02118, USA.
| | - Sharon Levy
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
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Predictors of E-Cigarette Use Susceptibility-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203935. [PMID: 31623178 PMCID: PMC6843563 DOI: 10.3390/ijerph16203935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022]
Abstract
Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.
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