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Augenstein JA, Smaldone AM, Usseglio J, Bruzzese JM. Electronic Cigarette Use and Academic Performance Among Adolescents and Young Adults: A Scoping Review. Acad Pediatr 2024; 24:228-242. [PMID: 37748535 DOI: 10.1016/j.acap.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND There are documented links between substance use and poor educational outcomes. However, less is known about electronic cigarette (e-cigarette) use in relation to academics. Therefore, this scoping review aimed to synthesize associations between e-cigarette use and academic performance among adolescents and young adults. METHODS Seven electronic databases were searched. Original research articles were included if associations between e-cigarette use and academic performance among adolescents and young adults aged 11 to 25 years were examined. Extracted data included study and participant descriptors, measures of e-cigarette use and academic performance, key findings, and study limitations. Measures of academic performance were grouped as academic achievement, academic behaviors, or cognitive attitudes. RESULTS Thirty-three studies met inclusion criteria. Most were cross-sectional (n = 28). Significant associations to e-cigarette use were identified across all categories: academic achievement (ie, school grades (n = 24)), academic behaviors (ie, school difficulties (n = 1), time spent on homework (n = 1), school suspension (n = 1), and truancy (n = 3)), and cognitive attitudes (ie, school stress (n = 1), school alienation (n = 1), and school engagement (n = 2)). Longitudinal associations were also identified in 5 prospective cohort studies: among adolescents, poor academic grades (n = 4), and truancy (n = 1) predicted future e-cigarette use, and e-cigarette use predicted future lower school grades (n = 1). CONCLUSIONS E-cigarette use during adolescence and young adulthood is associated with poor academic achievement. There is some evidence that academic achievement may predict future e-cigarette use; less evidence supports the opposite direction. Study designs are needed to support a causal connection. Investigators should consider moving from studying associations and instead look for causal evidence.
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Affiliation(s)
- Jacqueline A Augenstein
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,.
| | - Arlene M Smaldone
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,; Columbia University College of Dental Medicine (AM Smaldone), New York, NY
| | - John Usseglio
- Augustus C. Long Health Sciences Library (J Usseglio), Columbia University Irving Medical Center, New York, NY
| | - Jean-Marie Bruzzese
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY
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Kang H, Yoon W, Seo HG, Lee S, Lim S, Kim GY, Kim SY, Xu SS, Yan M, Quah ACK, Chung-Hall J, Craig LV, Gartner CE, Fong GT, Cho SI. Public support for tobacco endgame policies in South Korea: Findings from the 2020 International Tobacco Control Korea Survey. Tob Control 2024:tc-2023-058454. [PMID: 38383153 DOI: 10.1136/tc-2023-058454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Strong public support can increase the likelihood of adopting tobacco control policies. We assessed support for six commercial tobacco endgame policies in South Korea: limiting the nicotine in cigarettes, banning all additives in cigarettes, restricting the number of places where cigarettes are sold, and banning the manufacture and sales of cigarettes (unconditionally, with the provision of cessation support and with alternative tobacco products available). METHODS Data were obtained from 4740 adults who completed the 2020 International Tobacco Control Korea Survey. Participants were categorised based on their nicotine use: (1) did not use any products, (2) vaped and/or used heated tobacco products (HTPs) but did not smoke cigarettes, (3) smoked cigarettes only and (4) smoked cigarettes and vaped and/or used HTPs. Attitudes towards the policies were classified as supportive, undecided or opposed. Weighted multinomial logistic regression models assessed support levels according to nicotine use. RESULTS Support was highest for limiting the nicotine content in cigarettes (68.4%; 95% CI 64.6% to 72.3%) and restricting the number of retailers (68.1%; 95% CI 64.5% to 71.7%), and lowest for banning cigarette sales if alternative products are made available (45.0%; 95% CI 40.9% to 49.1%). People who did not use any products were most likely to support endgame policies, except for banning cigarette sales with alternatives available. The proportion of undecided participants exceeded 10% (range 13%-25%) for all policies. CONCLUSION There is a strong public support for tobacco endgame policies in South Korea. Further research should prioritise the development of strategies to ensure the effective implementation of highly supported policies.
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Affiliation(s)
- Heewon Kang
- Institute of Health and Environment, Seoul National University, Seoul, Korea (the Republic of)
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Wonjeong Yoon
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea (the Republic of)
| | - Hong Gwan Seo
- Department of Family Medicine, National Cancer Center, Goyang-si, Gyeonggi-do, Korea (the Republic of)
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Korea (the Republic of)
| | - Sungkyu Lee
- Korea Center for Tobacco Control Research and Education, Seoul, Korea (the Republic of)
| | - Sujin Lim
- National Tobacco Control Center, Korea Health Promotion Institute, Seoul, Korea (the Republic of)
| | - Gil-Yong Kim
- National Tobacco Control Center, Korea Health Promotion Institute, Seoul, Korea (the Republic of)
| | - Su Young Kim
- National Tobacco Control Center, Korea Health Promotion Institute, Seoul, Korea (the Republic of)
| | - Steve S Xu
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Janet Chung-Hall
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Lorraine V Craig
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Sung-Il Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea (the Republic of)
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea (the Republic of)
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Adzrago D, Sulley S, Williams F. Immigration status-related exclusive e-cigarette use and cannabis use and their dual use disparities associated with mental health disorder symptoms. Drug Alcohol Depend 2024; 255:111083. [PMID: 38215510 PMCID: PMC10866552 DOI: 10.1016/j.drugalcdep.2024.111083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/14/2024]
Abstract
INTRODUCTION E-cigarette and cannabis use has been linked to various health risks, including respiratory and cardiovascular conditions. Yet, extant knowledge about the risk factors for exclusive and dual use of e-cigarettes and cannabis is limited, especially among immigrants. We examined exclusive e-cigarette and cannabis use and their dual use associated with mental health disorders among immigrants and U.S.-born. METHODS We analyzed national cross-sectional data collected between May 13, 2021, and January 9, 2022, among adults aged >18 years (n= 4766) living in U.S. Multinomial logistic regression analyses were conducted to model the associations of exclusivity and dual-use (reference group= non-use) with anxiety/depression. RESULTS The dual-use prevalence was higher than exclusive e-cigarette and cannabis use, especially among U.S.-born (dual use= 14.79% vs. cannabis use= 13.53% vs. e-cigarette use= 7.11%) compared to immigrants (dual use= 8.23% vs. cannabis use= 5.03% vs. e-cigarette use= 6.31%). Immigrants had lower risks of exclusive cannabis and dual use compared to U.S.-born. Anxiety/depression was associated with higher risks of exclusive cannabis use and dual use across immigration status, but was associated with exclusive e-cigarette use among only immigrants. While effect sizes of dual-use associated with anxiety/depression were higher among U.S.-born, the effect sizes of exclusive e-cigarette and cannabis use associated with anxiety/depression were higher among immigrants. CONCLUSIONS The findings revealed significant mental health risks for e-cigarette, cannabis, and their dual use among immigrants and U.S.-born, especially among U.S.-born. These findings highlight the need for public health research and interventions to consider immigration status-related disparities in substance use.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
| | - Saanie Sulley
- National Healthy Start Association, Washington, DC, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Mzhavanadze G. Perceived relative harm of e-cigarettes among Ukrainian adults. Cent Eur J Public Health 2023; 31:271-278. [PMID: 38309705 DOI: 10.21101/cejph.a7963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/15/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Emerging evidence suggests that the use of safer nicotine products (SNPs), such as e-cigarettes and heated tobacco products (HTPs) poses significantly lower health risks than continued smoking, particularly over the short and medium term. However, it remains uncertain whether the public has been adequately informed about these relative risks. This study assesses the perceived relative harm of e-cigarettes compared to conventional cigarettes in Ukraine. METHODS Two nationally representative surveys were conducted in February 2021 and December 2022. Participants, irrespective of their smoking status, were asked whether they agreed with the statement that "using e-cigarettes is more harmful than smoking conventional cigarettes". The surveys also included questions about tobacco product usage, the most dangerous substances in cigarettes, and smoking cessation methods. The data were statistically analysed by deriving design-based weighted point estimates and 95% confidence intervals for the proportions within each response category. RESULTS In 2022, 38.1% (95% CI: 35.3-40.9) of adults believed that e-cigarettes were more harmful than cigarettes and the perception of relative harm remained relatively unchanged between the two surveys. Furthermore, 56.2% (95% CI: 50.0-62.2) of current cigarette smokers agreed with this statement, while only a small percentage of vapers (e-cigarette users) 7.4% (95% CI: 1.5-30.0) perceived e-cigarettes as more harmful than conventional cigarettes. Among non-smokers and dual users the share was 33.4% (95% CI: 30.0-36.9) and 32.7% (95% CI: 25.1-41.5), respectively. CONCLUSION Our findings indicate that in Ukraine the perception that e-cigarettes are more harmful than cigarettes, or the lack of knowledge regarding relative risks, prevails. This highlights the importance of accurate risk communication to promote a harm reduction approach to tobacco use.
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Santiago-Torres M, Mull KE, Sullivan BM, Bricker JB. Use of e-Cigarettes in Cigarette Smoking Cessation: Secondary Analysis of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e48896. [PMID: 37943594 PMCID: PMC10667975 DOI: 10.2196/48896] [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: 05/10/2023] [Revised: 08/18/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Many adults use e-cigarettes to help them quit cigarette smoking. However, the impact of self-selected use of e-cigarettes on cigarette smoking cessation, particularly when concurrently receiving app-based behavioral interventions, remains unexplored. OBJECTIVE This study used data from a randomized trial of 2 smartphone apps to compare 12-month cigarette smoking cessation rates between participants who used e-cigarettes on their own (ie, adopters: n=465) versus those who did not (ie, nonadopters: n=1097). METHODS The study population included all participants who did not use e-cigarettes at baseline. "Adopters" were those who self-reported the use of e-cigarettes at either 3- or 6-month follow-ups. "Nonadopters" were those who self-reported no use of e-cigarettes at either follow-up time point. The primary cessation outcome was self-reported, complete-case, 30-day point prevalence abstinence from cigarette smoking at 12 months. Secondary outcomes were missing-as-smoking and multiple imputation analyses of the primary outcome, prolonged abstinence, and cessation of all nicotine and tobacco products at 12 months. In logistic regression models, we first examined the potential interaction between e-cigarette use and treatment arm (iCanQuit vs QuitGuide) on the primary cessation outcome. Subsequently, we compared 12-month cigarette smoking cessation rates between adopters and nonadopters separately for each app. RESULTS There was suggestive evidence for an interaction between e-cigarette use and treatment arm on cessation (P=.05). In the iCanQuit arm, 12-month cigarette smoking cessation rates were significantly lower among e-cigarette adopters compared with nonadopters (41/193, 21.2% vs 184/527, 34.9%; P=.003; odds ratio 0.55, 95% CI 0.37-0.81). In contrast, in the QuitGuide arm, 12-month cigarette smoking cessation rates did not differ between adopters and nonadopters (46/246, 18.7% vs 104/522, 19.9%; P=.64; odds ratio 0.91, 95% CI 0.62-1.35). CONCLUSIONS The use of e-cigarettes while concurrently receiving an app-based smoking cessation intervention was associated with either a lower or an unimproved likelihood of quitting cigarette smoking compared to no use. Future behavioral treatments for cigarette smoking cessation should consider including information on the potential consequences of e-cigarette use. TRIAL REGISTRATION ClinicalTrials.gov NCT02724462; https://clinicaltrials.gov/study/NCT02724462.
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Affiliation(s)
| | - Kristin E Mull
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Seattle, WA, United States
- Department of Psychology, University of Washington, Seattle, WA, United States
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Pederson LL, Koval JJ, Vingilis E. E-cigarette use by Ontario public elementary school and secondary school students: Has the use among sociodemographic groups changed from 2017 to 2019? Prev Med Rep 2023; 34:102257. [PMID: 37273527 PMCID: PMC10236451 DOI: 10.1016/j.pmedr.2023.102257] [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: 07/29/2022] [Revised: 03/27/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023] Open
Abstract
This project examined e-cigarette use among Elementary School (ES) (grades 7 and 8) and Secondary School (SS) (grades 9-12) students in Ontario, Canada, for 2017 and 2019 and relationships with sociodemographic variables and traditional cigarette use. The data came from the Ontario Student Drug Use and Health Survey OSDUHS (2017, 2019). Socio-demographics included grade, school performance, sex, race, years in Canada, living arrangements and language spoken at home. E-cigarette use and cigarette smoking were any past year use. For 2017, there are a greater percentage of ES males than females who used e-cigarettes, older students, those living in more than one home and those smoking cigarettes. For SS students a greater percentage for those of older age, higher grades, living in Canada all their lives, using only English language at home, self-identified as white, with lower school performance, those with multiple household living arrangements and who reported smoking traditional cigarettes reported using e-cigarettes. Use was lower among females in 2017 (OR = 0.63, 95% CI = 0.46, 0.86, p = 0.002), but by 2019 use was higher among females, which resulted in a non-significant difference between males and females (OR = 0.91, 95% CI = 0.77, 1.09). Greater use of e-cigarettes was found among students who smoked traditional cigarettes compared to those who did not smoke in both years. Monitoring the trends, patterns and trajectories of use and variables related to use needs to be continued which may help inform the development of further legislative and educational measures.
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Affiliation(s)
- Linda L. Pederson
- Department of Epidemiology and Biostatistics Department of Family Medicine The Western Centre for Family Medicine and Public, Health University of Western University, 1839 Aldersbrook Road, London, Ontario N6G 3S3, Canada
| | - John J. Koval
- Department of Epidemiology and Biostatistics The Western Centre for Family Medicine and Public, Health University of Western Ontario London Ontario, N6G 2M1, Canada
| | - Evelyn Vingilis
- Department of Family Medicine The Western Centre for Public Health and Family Medicine University of Western Ontario London, ON N6G 2M1, Canada
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Wamba A, Pourchez J, Masson J, Denis-Vatant C, Leclerc L, Nekaa M. Impact of e-cigarette experimentation and use on smoking behavior among adolescents aged 15-16 years in the Loire department, France. Tob Prev Cessat 2023; 9:21. [PMID: 37363269 PMCID: PMC10286514 DOI: 10.18332/tpc/163416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/16/2023] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION We describe the vaping and smoking habits of French adolescents aged 15-16 years in the Loire department with a view to assess the impact of e-cigarette experimentation and use on their smoking behavior. METHODS This quantitative, cross-sectional, single-center and observational study conducted from January to July 2019 targeted 6622 students aged 15-16 years attending public high school in the Loire department, France. RESULTS A total of 4937 (74.6%) adolescents were included. Of these, 73.2% were non-vapers and 72.2% non-smokers; 66.0% of adolescents were non-vapers and non-smokers. Slightly less than half of adolescents had experimented with e-cigarettes (44.6%), more than half of whom (26.8%) continued to use vaping products, with 6.02% vaping daily. Likewise, a little less than half of adolescents had experimented with smoked tobacco (42.4%), more than half of whom (27.8%) continued to use smoking products, with 10.3% smoking daily. Vapers and smokers (20.6%) tended to begin with the use of smoked tobacco and to progress to the dual use of vaping and smoked tobacco products. Vaping had a positive effect, as 71.8% of vapers who smoked tobacco before initiating vaping stopped or reduced smoking following their progression to this double use. More than half of tobacco users are daily users while this daily use affects only 1/3 boys and 1/6 girls for vape. Finally, nearly 80.7% of adolescents who had never smoked before vaping did not smoke at the time of the study. CONCLUSIONS Our data suggest that vaping has a rather marginal impact on smoking initiation among French adolescents aged 15-16 years in the Loire department. They therefore neither confirm nor completely disprove the gateway effect theory, relating to use of tobacco subsequent to vaping.
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Affiliation(s)
- André Wamba
- École normale supérieure de Yaoundé, Département des sciences de l’éducation, Université de Yaoundé I, Yaoundé, Cameroun
- École Mines de Saint-Étienne, Université Jean Monnet Saint-Etienne, INSERM, Saint-Etienne, France
- Institut national supérieur du professorat et de l’éducation, Université Claude Bernard Lyon 1, INSPÉ, Laboratoire Parcours Santé Systémique P2S, Lyon, France
| | - Jérémie Pourchez
- École Mines de Saint-Étienne, Université Jean Monnet Saint-Etienne, INSERM, Saint-Etienne, France
| | - Julien Masson
- Institut national supérieur du professorat et de l’éducation, Université Claude Bernard Lyon 1, INSPÉ, Laboratoire Parcours Santé Systémique P2S, Lyon, France
| | | | - Lara Leclerc
- UCT pôle DocP2 CHU Saint-Étienne, Saint-Étienne, France
| | - Mabrouk Nekaa
- Laboratoire ECP, Éducation, Cultures, Politiques, Université Jean Monnet, Saint-Etienne, France
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Seale E, Sturrock SL, Widener MJ, Myran DT. The availability and distribution of vaping retailers across Ontario neighbourhoods, 2016-2019. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:493-501. [PMID: 36574202 PMCID: PMC10283501 DOI: 10.17269/s41997-022-00718-5] [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: 02/10/2022] [Accepted: 11/03/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To characterize the distribution of vaping retailers and examine the association between neighbourhood income and vaping retailer availability in Ontario prior to and after regulatory changes to the vaping market in 2018. METHODS We quantified vaping access by number of vaping retailers for 19,964 dissemination areas (DAs) in Ontario and percentage of schools near a vaping retailer. We used mixed-effects regression models to examine the associations between vaping access and neighbourhood income in 2018 and 2019. RESULTS Between 2016 and 2019, the number of vaping retailers in Ontario increased by 22.6% (5999 to 7355), despite a mild drop from 2016 to 2018. In 2019, 59.7% of urban neighbourhoods had one or more vaping retailers within 1000 m of their geographic centre, and 79.4% of elementary, 82.8% of secondary, and 84.2% of post-secondary schools had at least one within 1000 m. Neighbourhood income was associated with access to vaping retailers, with a greater number in low-income regions. In 2019, neighbourhoods in the lowest income quintile had over twice the number of vaping retailers per capita within 1000 m compared to the highest income quintile (adjusted incidence rate ratio 2.40; 95% CI 2.24-2.58). Increases over time in access to vaping retailers did not differ by geographic region, neighbourhood income quintile, or school type. CONCLUSION We observed a substantial increase in access to vaping retailers in Ontario including proximity to elementary and secondary schools following the 2018 provincial marketing regulations and federal nicotine regulations. Access to vaping was greatest in low-income neighbourhoods and may contribute to established inequities in vaping-related adverse events.
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Affiliation(s)
- Emily Seale
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Shelby L Sturrock
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michael J Widener
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON, Canada
| | - Daniel T Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
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Mzhavanadze G, Yanin D. The Potential Impact of E-cigarettes on the Life-Years Lost from Conventional Smoking in the Russian Federation. JOURNAL OF CONSUMER POLICY 2023; 46:253-274. [PMID: 37274086 PMCID: PMC10159831 DOI: 10.1007/s10603-023-09540-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 04/04/2023] [Indexed: 06/06/2023]
Abstract
This study analyses the potential impact of e-cigarettes on the death toll of cigarette smoking in the Russian Federation by working under a variety of assumptions pertaining to how much vaping might affect smoking cessation and initiation, and its adverse impacts on health in comparison to conventional smoking. Within this study, each combination of these assumptions generates a single vaping scenario (210 in total). A dynamic population simulation model, specifically for the Russian Federation, that is tailoured to tobacco control policy analysis, is built for estimation purposes. Considering the toll of smoking on cumulative life-years saved via the inclusion of vaping across a period of 80 years, the simulation analysis produces positive results in 88.1% of e-cigarette scenarios, ranging from - 3.3 million to 38.5 million life-years saved. In relative terms, the estimated life-years saved from vaping varies from - 1.6 to 18.6% of the predicted life-years lost from smoking. Most of the model scenarios involve a significant number of individuals who stopped smoking in favour of vaping. These results suggest that vaping has great potential to reduce the prevalence of smoking and the related death toll in the Russian Federation. Supplementary Information The online version contains supplementary material available at 10.1007/s10603-023-09540-z.
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Affiliation(s)
- G. Mzhavanadze
- Healthy Initiatives, Machavariani 63, 0159 Tbilisi, Georgia
- TSU: Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - D. Yanin
- Healthy Initiatives, Rustaveli 36, Kyiv, 01033 Ukraine
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Navarro MA, Malterud A, Cahn ZP, Baum L, Bukowski T, Kery C, Chew RF, Kim AE. An Investigation of Age-Differentiated Conversations About Electronic Nicotine Delivery Systems on Reddit. AJPM FOCUS 2023; 2:100045. [PMID: 37789939 PMCID: PMC10546597 DOI: 10.1016/j.focus.2022.100045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction This study analyzes age-differentiated Reddit conversations about ENDS. Methods This study combines 2 methods to (1) predict Reddit users' age into 2 categories (13-20 years [underage] and 21-54 years [of legal age]) using a machine learning algorithm and (2) qualitatively code ENDS-related Reddit posts within the 2 groups. The 25 posts with the highest karma score (number of upvotes minus number of downvotes) for each keyword search (i.e., query) and each predicted age group were qualitatively coded. Results Of 9, the top 3 topics that emerged were flavor restriction policies, Tobacco 21 policies, and use. Opposition to flavor restriction policies was a prominent subcategory for both groups but was more common in the 21-54 group. The 13-20 group was more likely to discuss opposition to minimum age laws as well as access to flavored ENDS products. The 21-54 group commonly mentioned general vaping use behavior. Conclusions Users predicted to be in the underage group posted about different ENDS-related topics on Reddit than users predicted to be in the of-legal-age group.
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Affiliation(s)
- Mario A. Navarro
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Andrea Malterud
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Zachary P. Cahn
- Office of Health Communication and Education, Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, Maryland
| | - Laura Baum
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, North Carolina
| | - Thomas Bukowski
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, North Carolina
| | - Caroline Kery
- Center for Data Science, RTI International, Research Triangle Park, North Carolina
| | - Robert F. Chew
- Center for Data Science, RTI International, Research Triangle Park, North Carolina
| | - Annice E. Kim
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, North Carolina
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Association between e-cigarette use behaviors and perceived harmfulness of e-cigarettes and anxiety/depression symptoms among Black/African American Adults. Prev Med Rep 2023; 31:102080. [DOI: 10.1016/j.pmedr.2022.102080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/14/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
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Adzrago D, Harrell MB, Fujimoto K, Jones A, Wilkerson JM. Association between E-Cigarette Use Behaviors and Anxiety/Depression among Black/African American Adults Based on Sexual Identity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2078. [PMID: 36767446 PMCID: PMC9915158 DOI: 10.3390/ijerph20032078] [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: 11/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Limited studies have examined disparities in e-cigarette use among Black/African American adults by sexual identity and whether the relationship between symptoms of anxiety/depression and e-cigarette use varies by sexual identity. We examined the association between e-cigarette use behaviors (never, former, and current use) and anxiety/depression among a nationally representative sample of Black/African American adults who identified as a sexual minority (lesbian/gay, bisexual, and others) or heterosexual individuals. We combined cross-sectional data from the 2011 to 2020 Health Information National Trends Survey (n = 6267), which is a nationally representative data set. We computed weighted e-cigarette use prevalence and multinomial logistic regression results (never use compared with former and current use, respectively). Among Blacks/African Americans, a larger percentage of sexual minority individuals compared with heterosexual individuals reported former and current e-cigarette use. Among sexual minorities, lesbian/gay individuals reported higher former e-cigarette use, whereas bisexual individuals reported higher current e-cigarette use. Among sexual minority individuals, moderate symptoms of anxiety/depression, compared with no symptoms of anxiety/depression, were associated with a higher likelihood of former e-cigarette use. Among heterosexuals, moderate symptoms of anxiety/depression were also associated with a higher likelihood of former e-cigarette use, while mild and severe symptoms of anxiety/depression were associated with current e-cigarette use compared with no symptoms of anxiety/depression. The intersection between sexual identity and anxiety/depression influenced e-cigarette use behaviors in different ways among Black/African Americans. The findings reinforce the heterogeneity within the Black/African American population, indicating the dangers of not considering subgroup differences as a standard part of public health research practice.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth Austin School of Public Health, Austin, TX 78701, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
| | - Antwan Jones
- Department of Sociology, and Department of Epidemiology, The George Washington University, Washington, DC 20052, USA
| | - J. Michael Wilkerson
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
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Leung T, Kasson E, Singh AK, Ren Y, Kaiser N, Huang M, Cavazos-Rehg PA. Topics and Sentiment Surrounding Vaping on Twitter and Reddit During the 2019 e-Cigarette and Vaping Use-Associated Lung Injury Outbreak: Comparative Study. J Med Internet Res 2022; 24:e39460. [PMID: 36512403 PMCID: PMC9795395 DOI: 10.2196/39460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/16/2022] [Accepted: 10/29/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) to explore the context surrounding vaping during the 2019 EVALI outbreak and to support the feasibility of using data from both social platforms to develop in-depth and intelligent vaping detection models on social media. METHODS Data were extracted from both Twitter (316,620 tweets) and Reddit (17,320 posts) from July 2019 to September 2019 at the peak of the EVALI crisis. High-throughput computational analyses (sentiment analysis and topic analysis) were conducted. In addition, in-depth manual content analyses were performed and compared with computational analyses of content on both platforms (577 tweets and 613 posts). RESULTS Vaping-related posts and unique users on Twitter and Reddit increased from July 2019 to September 2019, with the average post per user increasing from 1.68 to 1.81 on Twitter and 1.19 to 1.21 on Reddit. Computational analyses found the number of positive sentiment posts to be higher on Reddit (P<.001, 95% CI 0.4305-0.4475) and the number of negative posts to be higher on Twitter (P<.001, 95% CI -0.4289 to -0.4111). These results were consistent with the clinical content analyses results indicating that negative sentiment posts were higher on Twitter (273/577, 47.3%) than Reddit (184/613, 30%). Furthermore, topics prevalent on both platforms by keywords and based on manual post reviews included mentions of youth, marketing or regulation, marijuana, and interest in quitting. CONCLUSIONS Post content and trending topics overlapped on both Twitter and Reddit during the EVALI period in 2019. However, crucial differences in user type and content keywords were also found, including more frequent mentions of health-related keywords on Twitter and more negative health outcomes from vaping mentioned on both Reddit and Twitter. Use of both computational and clinical content analyses is critical to not only identify signals of public health trends among vaping-related social media content but also to provide context for vaping risks and behaviors. By leveraging the strengths of both Twitter and Reddit as publicly available data sources, this research may provide technical and clinical insights to inform automatic detection of social media users who are vaping and may benefit from digital intervention and proactive outreach strategies on these platforms.
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Affiliation(s)
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Avineet Kumar Singh
- Department of Integrated Information Technology, University of South Carolina, Columbia, SC, United States
| | - Yang Ren
- Department of Integrated Information Technology, University of South Carolina, Columbia, SC, United States
| | - Nina Kaiser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, United States
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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Packer J, Croker H, Goddings AL, Boyland EJ, Stansfield C, Russell SJ, Viner RM. Advertising and Young People's Critical Reasoning Abilities: Systematic Review and Meta-analysis. Pediatrics 2022; 150:e2022057780. [PMID: 36377381 PMCID: PMC9724173 DOI: 10.1542/peds.2022-057780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Young people are exposed to an abundance of advertising for unhealthy products (eg, unhealthy foods, tobacco, alcohol). Because of their developing cognition, children may not be able to understand the intent of advertising. However, advertising restrictions often assume that adolescents have critical reasoning capacity and can resist the effects of advertising. This review seeks to assess whether the evidence supports this assumption. METHODS Ten databases were searched in December 2020. Inclusion criteria were participants aged 6 to 17 years, any advertising exposure, objectively measured understanding or attitudinal outcome, a comparison, control, and between-group comparison. This study included all languages and excluded studies published pre-2010. Two reviewers independently extracted data and assessed study quality. RESULTS Thirty-eight articles were included. Meta-analysis of 9 studies with attitudinal outcomes indicated that unhealthy product advertising generated more positive brand or product attitudes compared with neutral or no advertising control in all ages. There were significant effects for digital and nondigital advertising formats. We found greater understanding did not protect against the impact of advertising on brand or product attitudes. Limitations include the inability to meta-analyze the impact of advertising on understanding or the influence of age. CONCLUSIONS Evidence shows that the attitudes of young people were influenced by advertising. Critical reasoning abilities did not appear to be fully developed during adolescence and not found to be protective against the impact of advertising. Policymakers should ensure regulations to restrict marketing of unhealthy commodities protects adolescents as well as younger children.
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Affiliation(s)
- Jessica Packer
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Helen Croker
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Anne-Lise Goddings
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Emma J. Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Claire Stansfield
- EPPI-Centre, UCL Social Research Institute, University College London, United Kingdom
| | - Simon J. Russell
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Russell M. Viner
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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15
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Polosa R, Casale TB, Tashkin DP. A Close Look at Vaping in Adolescents and Young Adults in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2831-2842. [PMID: 35718259 DOI: 10.1016/j.jaip.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Vaping by adolescents and young adults is a legitimate concern as there is a risk that some may start smoking and that electronic cigarette (EC) use may have adverse effects in the developing lungs of adolescents. This commentary provides updated information on vaping patterns among adolescents and young adults in the United States, as well as the impact of EC usage on respiratory health. EC use has surged greatly among high school students and young adults over the last decade but fortunately has declined significantly since its peak in 2019. During the same time period, smoking rates have constantly fallen to new low record levels. These trends argue against EC use as a gateway to smoking. Most EC usage is infrequent and unlikely to increase a person's risk of negative health consequences. Furthermore, the majority of EC usage has happened among those who have previously smoked. There is a dearth of data on the long-term health implications of EC usage in adolescents and young adults. We do not know whether short-term or intermittent use of EC in youth can lead to negative health outcomes in adulthood, and long-term high-quality studies in well-defined groups are needed. Although vaping has been linked to respiratory symptoms, they tend to be transient and of uncertain significance. This commentary provides up-to-date information so health care providers can give objective and responsible medical advice on EC usage.
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Affiliation(s)
- Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Università di Catania, Catania, Italy; Center for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico V. Emanuele," University of Catania, Catania, Italy; ECLAT Srl, Spin-off of the University of Catania, Catania, Italy; Institute of Internal Medicine, AOU "Policlinico V. Emanuele-S. Marco," Catania, Italy.
| | - Thomas B Casale
- Department of Medicine, Division of Allergy/Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, UCLA Health Sciences, Los Angeles, Calif
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Chadwick G, Dobbs PD, Gluesenkamp K, Vinzant D, Everett KD. Components in tobacco-free school policies-A coding tool for assessment. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35930361 DOI: 10.1080/07448481.2022.2103374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To develop an instrument to examine tobacco-free campus policy components. PARTICIPANTS Missouri two- and four-year, specialized/technical, and religious colleges and universities (N = 76). Methods: The instrument was informed via literature review and expert interviews. Coder agreement was strong (κ = .80). Qualitative policy language examples were identified. RESULTS Model policy components including consideration for population, prohibited products, location restrictions, enforcement, consequences, promotions, communications, cessation, designated smoking areas and exemptions; comprehensive policies included all populations, for all tobacco products, and at all locations on the campus. Nineteen campuses had comprehensive tobacco-free policies, five had comprehensive smoke-free policies (cigarettes and e-cigarettes), and no policy included all model components. Fifty-two were non-comprehensive. CONCLUSIONS This instrument can allow campuses to identify components for comprehensive and model tobacco-free campus policies and assist officials in improving policy language. Future research can use this instrument to examine the effectiveness of components and their impact on tobacco use outcomes.
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Affiliation(s)
- Ginny Chadwick
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Page D Dobbs
- Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Kathryn Gluesenkamp
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Delanie Vinzant
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Kevin D Everett
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
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17
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Pettigrew S, Miller M, Kannan A, Raj TS, Jun M, Jones A. School staff perceptions of the nature and consequences of students’ use of e‐cigarettes. Aust N Z J Public Health 2022; 46:676-681. [DOI: 10.1111/1753-6405.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/01/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Mia Miller
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Anjali Kannan
- School of Medical Sciences University of New South Wales Sydney New South Wales
| | | | - Min Jun
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Alexandra Jones
- The George Institute for Global Health University of New South Wales Sydney New South Wales
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18
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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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Virgili F, Nenna R, Ben David S, Mancino E, Di Mattia G, Matera L, Petrarca L, Midulla F. E-cigarettes and youth: an unresolved Public Health concern. Ital J Pediatr 2022; 48:97. [PMID: 35701844 PMCID: PMC9194784 DOI: 10.1186/s13052-022-01286-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/25/2022] [Indexed: 11/11/2022] Open
Abstract
The use of electronic cigarettes (e-cigarette) and vaping devices started as a potential aid for cessation and reducing the harmful consequences of cigarette smoking, mainly in the adult population. Today e-cigarette use is highly increasing in vulnerable populations, especially young and pregnant women, due to the misconception of its harmless use. Despite the growing acknowledgment in e-cigarette as a potential harmful device, and due to mixed information found concerning its beneficial aid for smokers, along with an insufficient clinical study done in human models, it is important to further evaluate the possible benefits and risks of non-combusting, vaping nicotine or non-nicotine delivery devices. In this review we tried to summarize the latest updated information found in the literature, concentrating mainly in the variety of adverse effects of e-cigarette use and its contribution for recent and future health concerns.
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Affiliation(s)
- Fabrizio Virgili
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Shira Ben David
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Kennedy LJ, Walls RA, Hart R, Al-Hamdani M. Vaping control in Nova Scotia: using research to catalyze change. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:417-421. [PMID: 35316526 PMCID: PMC9043068 DOI: 10.17269/s41997-022-00620-0] [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: 08/31/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022]
Abstract
The tobacco, and now vaping, industries are skilled at creating falsification campaigns that leave policymakers and the public confused and distracted. As Nova Scotia saw youth vaping rates rise, a non-profit conducted a youth and young adult survey to discover why, what, and how often youth and young adults vape. They discovered that almost 96% of youth prefer flavours, and 48% believed they would quit if flavours were removed. This research was pivotal in capturing the voices of youth, gathering stakeholders, and countering industry opposition. On April 1, 2020, the Nova Scotian government implemented Canada's first ban on flavoured vaping products. This was followed by a nicotine cap of 20 mg/ml and a revamped taxation structure. The survey allowed non-profits to band together and align messages. It also provided government with information to take actions that reduce the prevalence and potential harms of vaping among youth. This commentary describes the advocacy process and opposition faced when advocating for vaping control measures. This approach can serve as a guide for assisting other jurisdictions in advocating for policy changes.
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Affiliation(s)
- Laura J Kennedy
- Mental Health & Addictions - Health Promotion, Nova Scotia Health Authority, 300 Pleasant St, Dartmouth, NS, B2Y 3S3, Canada.
| | - Róisín Anne Walls
- Mental Health & Addictions - Health Promotion, Nova Scotia Health Authority, 300 Pleasant St, Dartmouth, NS, B2Y 3S3, Canada
| | - Rowan Hart
- School of Health and Human Performance, Dalhousie University, 6299 South St, Halifax, NS, B3H 4R2, Canada
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21
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Are French adolescents ready to adopt the electronic cigarette? A qualitative study of their knowledge and representations. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01326-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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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: 1] [Impact Index Per Article: 0.5] [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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Tarasenko Y, Ciobanu A, Fayokun R, Lebedeva E, Commar A, Mauer-Stender K. Electronic cigarette use among adolescents in 17 European study sites: findings from the Global Youth Tobacco Survey. Eur J Public Health 2022; 32:126-132. [PMID: 34694383 PMCID: PMC8807119 DOI: 10.1093/eurpub/ckab180] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND As new findings on public health implications of electronic cigarette (e-cigarette) use emerge, its surveillance remains of utmost importance. This study examined the latest state of e-cigarette use in youth in 17 European study sites (i.e. 16 countries and the Federation of Bosnia and Herzegovina) using the Global Youth Tobacco Survey (GYTS). METHODS This was an observational study. Cross-sectional data on students aged 11-17 years from the latest available GYTS round completed in 17 study sites were used to estimate crude and adjusted prevalence of e-cigarette use by sex and pocket money. Panel GYTS data from five countries were used for the trend analyses. All analyses were weighted to account for the survey design and non-response. RESULTS Compared to 2014, the age-adjusted prevalence of e-cigarette use more than doubled in Georgia and Italy, and nearly doubled in Latvia. Significantly more male than female students aged 11-17 years reported use of e-cigarettes, with little to no confounding by age, grade and pocket money across countries. Youth with medium or higher amount of pocket money was 20-200% more likely to use e-cigarettes than those with fewer to no pocket money in 14 study sites. DISCUSSION As e-cigarette use is becoming widespread throughout the world, there is variation in use among and between countries. Expanded and consistent surveillance of e-cigarette use by all World Health Organization member states is essential to generate data on the extent and correlates of youth e-cigarette use for evidence-based planning and evaluation of the electronic nicotine delivery systems and electronic non-nicotine delivery systems national and global control programmes.
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Affiliation(s)
- Yelena Tarasenko
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Angela Ciobanu
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ranti Fayokun
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Elizaveta Lebedeva
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Alison Commar
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Kristina Mauer-Stender
- Division of Country Support and Emergencies, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
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Adzrago D, Shi Y, Fujimoto K. Association between perceived health risks of e-cigarettes and actual e-cigarette use, based on cigarette smoking status and sexual and gender minority status among U.S. adults. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-11. [PMID: 35036291 PMCID: PMC8747865 DOI: 10.1007/s10389-021-01674-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/07/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a lack of consensus in the literature about the association between the perceived health risks of e-cigarettes and their actual use, an association that may be based on cigarette smoking status or sexual and gender minority status. This study examined the moderating effect of these variables as well as differences in e-cigarette use between and within perceived harmfulness of e-cigarettes and cigarette smoking among U.S. adults. METHODS The data were drawn from the 2020 and 2019 Health Information National Trends Survey (HINTS 5), Cycles 4 and 3, on adults (N = 9303). We estimated weighted multivariable logistic regression models and conducted marginal analyses based on perceived harmfulness of e-cigarettes. RESULTS Of the study population, 30.75% currently used e-cigarettes daily or some days. No significant difference in e-cigarette use was found between sexual minorities and heterosexuals, but there was a significant interaction between sexual identity and perceived harmfulness of e-cigarettes. Compared to non-smokers, current daily or some days cigarette smokers were more likely to use e-cigarettes (AOR = 3.48, 95% CI = 1.25, 9.72). Those who perceived e-cigarettes to be just as harmful as actual cigarettes (AOR = 0.13, 95% CI = 0.06, 0.27) or more harmful (AOR = 0.03, 95% CI = 0.01, 0.10), or were uncertain (AOR = 0.18, 95% CI = 0.08, 0.45), were less likely to use e-cigarettes compared to those who perceived e-cigarettes to be less harmful. Former and current cigarette smokers who perceived e-cigarettes as less harmful had a higher probability of using e-cigarettes daily or some days than did non-cigarette smokers. For the current and former cigarette smoking groups, those who perceived e-cigarettes as less harmful had the highest probability of current e-cigarette use than did those who were uncertain or perceived e-cigarettes as just as harmful, whereas the probability was not significant for those who perceived e-cigarettes as more harmful. CONCLUSION Current daily or some days use of e-cigarettes is associated with current daily or some days cigarette smoking and lowered perceived harmfulness of e-cigarettes among the U.S. adult population. Tailored health promotion and intervention efforts may reduce the potential perceived health and behavioral/lifestyle risks related to the use of tobacco products, especially the use of e-cigarettes daily among former and current cigarette smokers as well as those who perceive e-cigarettes as less harmful.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, 7000 Fannin, Suite 2502A, Houston, TX 77030 USA
| | - Yue Shi
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, 7000 Fannin, Suite 2502A, Houston, TX 77030 USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, 7000 Fannin, Suite 2502A, Houston, TX 77030 USA
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Adzrago D, Tami-Maury I, Schick V, Wilkerson JM. Co-occurring substance use and psychological distress among exclusive e-cigarette use and other tobacco use among sexual and gender minorities in Texas. Drug Alcohol Depend 2021; 229:109135. [PMID: 34773886 DOI: 10.1016/j.drugalcdep.2021.109135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/04/2021] [Accepted: 09/27/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is a dearth of literature on sexual and gender minority (SGM) only data that examines the association between tobacco use, co-occurring substance use, and psychological distress. METHODS Using SGM-only primary data collected between March 2016 and January 2017, participants were categorized based on recent tobacco use and prevalence estimates were calculated for exclusive e-cigarette use and use of other tobacco products. The strength of the association between tobacco use, recent hazardous alcohol use, illicit substance use, and having a diagnosis for depression, anxiety, or PTSD was estimated. Bivariate and adjusted multinomial logistic regression analyses were used to obtain estimates. RESULTS A third of participants (32.91%) reported recent tobacco use. Of these, 8.79% were exclusive e-cigarette users and 24.12% used other tobacco products. Compared to non-tobacco users, e-cigarette users were more likely to have recently used illicit drugs (RRR= 3.00 [1.89, 4.77]) and participated in a substance use treatment program (RRR= 7.98 [1.76, 36.15]). Participants categorized as using other tobacco products, when compared to non-tobacco users, were more likely to have recently used illicit drugs (RRR= 2.05 [1.46, 2.86]), engaged in hazardous drinking (RRR= 2.27 [1.63, 3.16]), and participated in a substance use treatment program (RRR= 9.53 [3.14, 28,88]). They were also more likely to have been recently diagnosed with PTSD (RRR= 3.40 [1.82, 6.34]). CONCLUSIONS SGM tobacco users are more likely to engage in hazardous drinking and illicit substance use and access substance use treatment services. There is an opportunity to reduce tobacco use among SGM individuals by developing, implementing, and evaluating tailored tobacco cessation interventions within substance use treatment facilities.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Irene Tami-Maury
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Vanessa Schick
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA; Department of Management, Policy and Community Health, UTHealth School of Public Health, Houston, TX, USA
| | - J Michael Wilkerson
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
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Chadi N, Vyver E, Bélanger RE. La protection des enfants et des adolescents contre les risques du vapotage. Paediatr Child Health 2021; 26:358-374. [PMID: 34552677 PMCID: PMC8448502 DOI: 10.1093/pch/pxab038] [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: 09/20/2020] [Accepted: 02/26/2021] [Indexed: 11/14/2022] Open
Abstract
Le vapotage chez les jeunes comporte des risques importants pour la santé et la sécurité des enfants et des adolescents canadiens. Le présent document de principes fournit de l'information générale sur le vapotage et les produits et dispositifs qui y sont liés, traite des méfaits à court et à long terme associés à leur utilisation et propose des stratégies de prévention et d'abandon pour les jeunes vapoteurs ou ceux qui sont à risque de commencer à vapoter. Le vapotage chez les jeunes est associé à un risque accru d'usage de tabac et de substances psychoactives, de troubles de santé mentale, de pneumopathie, de cardiopathie et de blessures accidentelles. Le vapotage ne doit pas servir d'outil d'abandon du tabac chez les jeunes, en raison de son manque d'efficacité et des données probantes sur les méfaits qu'il occasionne. De nombreuses stratégies préventives et thérapeutiques utilisées pour l'abandon du tabac, y compris les stratégies comportementales et pharmacologiques, peuvent être adaptées pour aider les jeunes à arrêter de vapoter. Des recommandations sont formulées pour les intervenants communautaires et les décideurs.
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Affiliation(s)
- Nicholas Chadi
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
| | - Ellie Vyver
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
| | - Richard E Bélanger
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
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Short M, Cole AG. Factors Associated with E-Cigarette Escalation among High School Students: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10067. [PMID: 34639369 PMCID: PMC8507960 DOI: 10.3390/ijerph181910067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND E-cigarette use has been identified as a behaviour of concern among adolescents, and ever and daily use among this population has increased recently. The purpose of this review was to summarize the relevant studies investigating the frequency and intensity of e-cigarette use in adolescents and the factors associated with these patterns of use. METHODS A scoping search of two databases was conducted to identify longitudinal studies examining escalating e-cigarette use among adolescents. Escalating e-cigarette use could refer to an increasing frequency or intensity of use over time. Articles were screened for relevance. Studies that met inclusion criteria were included for synthesis. RESULTS Five articles were included for synthesis. All five articles were longitudinal studies taking place in the United States between 2013 and 2017. Age, gender, cost of e-cigarettes, use of cigarettes, polysubstance use, and e-liquid nicotine concentration were associated with escalation of e-cigarette use. CONCLUSIONS A paucity of information exists regarding the escalation of e-cigarette use among adolescents. Given the changing popularity of devices, additional updated evidence is needed to understand the factors associated with the escalation of e-cigarette use among adolescents, which can be used to inform local and national programs and policies.
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Affiliation(s)
- Michael Short
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada;
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Chadi N, Vyver E, Bélanger RE. Protecting children and adolescents against the risks of vaping. Paediatr Child Health 2021; 26:358-374. [PMID: 34552676 DOI: 10.1093/pch/pxab037] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
Youth vaping presents significant risks for the health and safety of Canadian children and adolescents. This statement provides background information about vaping, vaping products, and related devices, discusses the short- and long-term harms known to be associated with their use, and offers prevention and cessation strategies for youth who vape or are at risk for starting. Youth vaping is associated with increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries. Vaping should not be used as a smoking cessation tool for youth, due to lack of effectiveness and evidence of harm. Many preventive and treatment strategies used for tobacco cessation, including behavioural and pharmacological options, can be adapted to help youth quit vaping. Recommendations for community stakeholders and policy makers are included.
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Affiliation(s)
- Nicholas Chadi
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
| | - Ellie Vyver
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
| | - Richard E Bélanger
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
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Li L, Borland R, Cummings KM, Fong GT, Gravely S, Smith DM, Goniewicz ML, O'Connor RJ, Thompson ME, McNeill A. How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys. Nicotine Tob Res 2021; 23:1490-1497. [PMID: 33631007 DOI: 10.1093/ntr/ntab033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION There is limited research on the role of flavors in nicotine vaping products (NVPs) in relation to smoking. We examined patterns of flavor use in NVPs in relation to progression toward quitting. AIMS AND METHODS Data come from 886 concurrent users of NVPs (at least weekly) and cigarettes who were first surveyed in 2016 and then successfully recontacted in 2018 as part of the ITC 4CV Surveys conducted in Australia, Canada, England, and the United States. Participants were asked about their main vaping flavor categorized as: (1) tobacco or unflavored, (2) menthol or mint flavored, and (3) "sweet" flavors (eg, fruit or candy). We examined whether flavor was associated with progression toward quitting smoking between survey years. RESULTS Overall, 11.1% of baseline concurrent users quit smoking by 2018. Compared with users of tobacco flavors, those vaping "sweet" flavors were more likely to quit smoking between surveys (13.8% vs. 9.6%; adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI] 1.01-2.58, p < .05), but those using menthol flavors were no more likely to quit smoking (8.3% vs. 9.6%, aOR = 0.87, 95% CI 0.43-1.47, p = .69). Among those who had quit smoking in 2018, 52.0% were still vaping, which was lower than the 65.8% among continuing smokers (aOR = 0.60, 95% CI 0.39-0.92, p = .02). Sweet flavor users were no more likely to continue vaping compared with tobacco flavor users, either for those continuing smoking or those having quit smoking by 2018. There was a net shift away from tobacco flavor among those who continued to vape at follow-up. CONCLUSIONS Use of fruit and other sweet flavored e-liquids is positively related to smokers' transition away from cigarettes. IMPLICATIONS With multiple jurisdictions considering limiting or banning the sale of flavored NVPs, it is important to consider how such policies may impact smokers using NVPs to transition away from cigarette smoking. Our results indicate that vapers who used sweet flavors were more likely to transition away from cigarette smoking and quit cigarette use, at least in the short term, compared with those who used tobacco or unflavored NVPs. Randomized clinical trials are needed to establish if the observed association between use of flavored e-liquids and smoking cessation is due to self-selection or is truly causal.
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Affiliation(s)
- Lin Li
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Kenneth Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.,Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Shaping Public hEalth poliCies To Reduce ineqUalities and harm (SPECTRUM), UK
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Prevalence and correlates of lifetime e-cigarette use among adolescents attending public schools in a low income community in the US. Addict Behav 2021; 114:106738. [PMID: 33341432 DOI: 10.1016/j.addbeh.2020.106738] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The prevalence of e-cigarette use among US adolescents is increasing. However, there is limited research on the prevalence and correlates of e-cigarette use among adolescents in low income and under resourced communities. We report on their e-cigarette susceptibility and use behaviors, and perceived risks of harm and addiction. METHODS Students in grades 7, 9, and 11 from a Title I school district in the northeastern US completed an online survey during a class period. Lifetime e-cigarette use and its correlates were tested in bivariate and logistic regression models. RESULTS Most students were of Latino ethnicity (66%), and 36% identified as Black/African American. Overall, 55% of the full sample were considered 'susceptible' to e-cigarette use: 19% were lifetime e-cigarette users while 6% were lifetime smokers. Students in 11th grade were more likely (OR = 2.5) to have ever used e-cigarettes compared to students in 7th grade. Those that were more curious (OR = 11.8), intended to use e-cigarettes in the next 12 months (OR = 2.8), and would use the product if it was offered by a friend (OR = 2.4) had greater odds of lifetime e-cigarette use. By contrast, students who perceived at least moderate risks of health harm (OR = 0.44) were less likely to have used e-cigarettes. CONCLUSIONS Adolescents from marginalized communities are susceptible to and are using e-cigarettes. Prevention efforts targeting underserved areas may benefit from e-cigarette health education messages that reduce curiosity, interrupt social aspects of initiation, and emphasize health harms.
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Gallus S, Borroni E, Odone A, van den Brandt PA, Gorini G, Spizzichino L, Pacifici R, Lugo A. The Role of Novel (Tobacco) Products on Tobacco Control in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1895. [PMID: 33669394 PMCID: PMC7920305 DOI: 10.3390/ijerph18041895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
In Italy, electronic cigarettes have spread since 2010 and heated tobacco products (HTP) since 2016. We investigated their public health consequences on conventional cigarette smoking, taking advantage of a series of cross-sectional studies annually conducted between 2001 and 2019 in Italy. Every year, the sample, including around 3000 individuals, was representative of the general Italian population aged ≥15 years. In Italy, smoking prevalence steadily declined from 29.1% in 2001 to 20.6% in 2013, then increased to 22.0% in 2019. In 2017-2019, current electronic cigarette users were 2.1% and in 2019 current HTP users were 1.1%. Among 498 ever electronic cigarette users, 23.2% started or re-started smoking and 15.7% quit smoking after electronic cigarette use; of 49 ever HTP users, 19.1% started or re-started smoking combusted cigarettes and 14.6% quit smoking after HTP use. The availability of novel products in Italy resulted in a halt of the decreasing trend in smoking prevalence. For the first time, we observed an increase of Italians inhaling nicotine, concurrently with the spread of novel (tobacco) products. More importantly, the use of novel products appears to increase-rather than decrease-the likelihood of smoking conventional cigarettes. Considering this evidence, we see no argument to justify the huge fiscal and regulatory benefits these products continue to have, at least in Italy.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Elisa Borroni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Piet A. van den Brandt
- Department of Epidemiology, CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands;
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), 50139 Florence, Italy;
| | - Lorenzo Spizzichino
- Italian Ministry of Health, Center for Disease Prevention and Control, 00144 Rome, Italy;
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
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Young-Wolff KC, Adams SR, Sterling SA, Tan ASL, Salloum RG, Torre K, Carter-Harris L, Prochaska JJ. Nicotine and cannabis vaping among adolescents in treatment for substance use disorders. J Subst Abuse Treat 2021; 125:108304. [PMID: 34016296 DOI: 10.1016/j.jsat.2021.108304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/07/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022]
Abstract
This study examined nicotine and cannabis vaping among adolescents in treatment for substance use disorders. Participants were 363 adolescents aged 12-17 (66% male, mean age = 15.5 [SD = 1.3], 46% non-Hispanic white) seen for a specialty addiction intake evaluation between 2017 and 2019 at one of six medical offices of a large, integrated health care system in Northern California. Multivariable logistic regression models tested for associations of sociodemographics, cigarette smoking, and substance use disorders with vaping behaviors. A majority of adolescents reported ever (68%) or current vaping (60%) of nicotine and/or cannabis; current vaping was similar for nicotine (50%) and cannabis (51%); 40% reported current vaping of both. Current smokers (6% of the sample) had higher odds of ever vaping (aOR = 3.95, 95%CI: 1.04-14.95). Black (versus non-Hispanic white) adolescents had lower odds of current nicotine vaping (aOR = 0.08, 95%CI: 0.02-0.37) and current vaping of both nicotine and cannabis (aOR = 0.12, 95%CI: 0.03-0.60). Having an alcohol use disorder was associated with current vaping (aOR = 2.14, 95%CI: 1.06-4.33). Those who endorsed that most friends get drunk/high (aOR = 1.87, 95%CI: 1.02-3.42) or that cannabis was their substance of choice (aOR = 2.36, 95%CI: 1.16-4.81) had higher odds of current cannabis vaping. Higher neighborhood household income ($80,000-$120,000 and >$120,000 vs. <$80,000, aORs = 2.05-9.48), never versus ever blunt use (aORs = 2.47-8.68), and intakes in 2018 and 2019 versus 2017 (aORs = 2.18-5.38) were associated with higher odds of all vaping outcomes. Vaping was common among adolescents in addiction treatment and varied with sociodemographics and substance-related factors. Research should assess how vaping impacts the development of substance use disorders and whether it interferes with addiction treatment.
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Affiliation(s)
| | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA
| | - Kira Torre
- Addiction Medicine and Recovery Services, Kaiser Permanente Northern California, USA
| | - Lisa Carter-Harris
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
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A review of tobacco abuse and its epidemiological consequences. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:1485-1500. [PMID: 33425659 PMCID: PMC7786188 DOI: 10.1007/s10389-020-01443-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022]
Abstract
Aim The economic burden caused by death and disease in the world is credited mainly to tobacco use—currently linked to approximately 8,000,000 deaths per year with approximately 80% of these faralities reported in low and middle income economies. The World Health Organization (WHO) estimates that nearly 7,000,000 deaths are attributed to direct tobacco use, while approximately 1,200,000 non-smokers exposed to second hand cigarette smoke die every year. Accordingly, tobacco use is a major threat to the public health infrastructure; therefore, proper cessation interventions must be put in place to curb tobacco abuse and ease economic and social burdens caused by the tobacco epidemic. Methods A systematic review was conducted to investigate how scientific efforts have been advanced towards harm reduction among smokers and non-smokers. Relevant articles published during the period 2010–2020 in PubMed, Crossref, Google scholar, and Web of Science were used in this study. The articles were selected based on health impacts of cigarette smoking, tobacco cessation and emerging diseases, including Covid−19. Various cessation strategies have been identified although their efficiency is yet to match the desired results. Results A series of carcinogenic chemicals are generated during cigarette smoking resulting in serious health complications such as cancer and mutagenesis. The precursors for tobacco induced diseases are toxic and carcinogenic chemicals of the nitrosamine type, aldehydes, polonium-210 and benzo[a]pyrene, which bio-accumulate in the body system during cigarette smoking to cause disease. Rehabilitation facilities, use of drugs to diminish the desire to smoke, heavy taxation of tobacco products and warning labels on cigarettes are some of the cessation strategies employed towards curbing tobacco abuse. Conclusion The need for further research to develop better methods and research based policies for safe cigarette smoking and workable cessation strategies must be a priority in order to deal with the tobacco epidemic. Campaigns to promote tobacco cessation and abstinence are recommended in this review as a sure measure to mitigate against the deleterious impacts caused by cigarette smoking and tobacco abuse.
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Meacham MC, Vogel EA, Thrul J. Vaping-Related Mobile Apps Available in the Google Play Store After the Apple Ban: Content Review. J Med Internet Res 2020; 22:e20009. [PMID: 33185565 PMCID: PMC7695530 DOI: 10.2196/20009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/01/2020] [Accepted: 09/24/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely. OBJECTIVE Understanding the types of nicotine and cannabis vaping-related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers. METHODS In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app's purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale. RESULTS Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping. CONCLUSIONS The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple's ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.
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Affiliation(s)
- Meredith C Meacham
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Erin A Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, United States
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Abstract
The prevalence of e-cigarette use among youth has risen dramatically over the past several years. Many concerns have been raised by this epidemic, including the increased likelihood that those adolescents who "vape" will also go on to smoke conventional cigarettes and use illicit drugs. Pediatricians are appropriately positioned to discuss vaping with patients and provide further education to families. This article aims to provide clinicians with a better understanding of vaping products and terminology, as well as the prevalence and potential harms of e-cigarette use. [Pediatr Ann. 2020;49(9):e365-e368.].
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