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Mantey DS, Omega-Njemnobi O, Montgomery L, Kelder SH. Racial and Ethnic Disparities in Adolescent Combustible Tobacco Smoking From 2014 to 2020: Declines Are Lagging Among Non-Hispanic Black Youth. Nicotine Tob Res 2024; 26:940-947. [PMID: 38181207 PMCID: PMC11190047 DOI: 10.1093/ntr/ntae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/20/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, and then compared these trends across racial and ethnic categories. We also tested the effect of e-cigarette use on these trends for all-youth and across racial and ethnic categories. AIMS AND METHODS We pooled and analyzed seven years of National Youth Tobacco Survey data for n = 124 151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (ie cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All-models controlled for sex, grade level, and past 30-day e-cigarette use. RESULTS Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, the odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p = .025), NHOs (15.4% per year; p = .01), and NHBs (5.1% per year; p < .001), adjusting for sex, grade, and e-cigarette use. Trends and disparities in trends by race and ethnicity were observed independent of e-cigarette use. CONCLUSIONS Combustible tobacco smoking declined for all-youth but at significantly different rates across races and ethnicities. Notably, declines in combustible tobacco smoking are lagging among NHB youth. Interventions are critically needed to address this disparity. IMPLICATIONS A direct, evidence-based intervention to reduce combustible tobacco smoking among NHB youth is critically needed. Such tobacco control initiatives should follow the Best Practices for Comprehensive Tobacco Control Framework, incorporating sustainable funding for school-based intervention, public health education, and adult cessation.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, UTHealth University of Texas School of Public Health, Houston, TX, USA
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
| | - Onyinye Omega-Njemnobi
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth University of Texas School of Public Health, Houston, TX, USA
| | - LaTrice Montgomery
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Steven H Kelder
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth University of Texas School of Public Health, Houston, TX, USA
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Ma H, Daisy Dai H. Factors associated with intentions to quit vaping and quit attempts among Adolescents: A structural equation modeling approach. Addict Behav 2024; 157:108074. [PMID: 38852380 DOI: 10.1016/j.addbeh.2024.108074] [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: 02/02/2024] [Revised: 05/05/2024] [Accepted: 05/23/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES Previous youth tobacco research has identified multiple factors relating to intentions to quit vaping and quit attempts among current e-cigarette users in adolescents. The pathways in the complex associations with vaping cessation behaviors remain unclear. METHODS Using data from the 2022 National Youth Tobacco Survey (NYTS) (grades 6-12), structural equation models (SEMs) are developed to examine the associations of social environment, vaping risk perceptions, e-cigarette marketing, vaping characteristics, and demographics with two outcome measures - intentions to quit vaping and past year quit attempts among current e-cigarette users. RESULTS The national sample of current e-cigarette users (n = 2,701) consisted of 52.7 % females, 47.0 % non-Hispanic Whites, 80.1 % high school students, and 56.2 % heterosexual individuals. Among them, 70.2 % reported intentions to quit vaping and 66.3 % reported past year quit attempts. The protective factor for quit intentions was vaping risk perceptions (p < 0.001). Risk factors included e-cigarette marketing (p = 0.04), dual use of e-cigarettes and other tobacco products (p = 0.003), vaping due to feeling anxious or stressed (p = 0.01), vaping for nicotine buzz (p = 0.002), nicotine dependence (p = 0.02), identifying as Gay or Lesbian (p < 0.001), bisexual (p = 0.03), or Hispanic (p = 0.04). Similar associations were observed with quit attempts except that e-cigarette marketing, vaping due to feeling anxious or stressed, vaping dependence, and identifying as Hispanic were not significant. Besides, high vaping frequency (p < 0.001), grade level (p < 0.001) and not sure about sexual orientation (p = 0.01) were also negatively associated with quit attempts. CONCLUSIONS This study provided insights into factors influencing vaping cessation outcomes among adolescent current e-cigarette users. Developing tailored vaping cessation programs based on these findings could enhance quit success.
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Affiliation(s)
- Haijing Ma
- College of Liberal Arts and Social Sciences, University of Houston-Victoria, Victoria, TX 77901, USA.
| | - Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
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Tashakkori NA, Park-Lee E, Roh EJ, Christensen CH. Multiple Tobacco Product Use Among Youth E-Cigarette Users: National Youth Tobacco Survey, 2020. J Adolesc Health 2023; 73:769-775. [PMID: 37410002 DOI: 10.1016/j.jadohealth.2023.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/24/2023] [Accepted: 05/24/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Limited information exists on multiple tobacco product use, particularly among youth. This study assessed the prevalence of current youth use of e-cigarettes with other tobacco products and their associated characteristics using 2020 National Youth Tobacco Survey data. METHODS Prevalence estimates were calculated for current e-cigarette users, by multiple tobacco product use status and product combination. Demographic characteristics, e-cigarette use behaviors, age at first combustible tobacco use, and tobacco dependence symptoms were compared between current users of both e-cigarettes and combustible tobacco (dual users) and current exclusive e-cigarette users. RESULTS In 2020, 61.1% of all current e-cigarette users reported exclusive e-cigarette use, and 38.9% used e-cigarettes with other tobacco products. Among those who used e-cigarettes with other tobacco products, 85.0% used combustible tobacco, with cigarettes being the most commonly used other tobacco product. Compared with current exclusive e-cigarette users, higher proportions of dual users reported the following: frequent e-cigarette use; obtaining e-cigarettes from gas stations, persons other than a family member/friend, vape shops, or the internet; and having any tobacco dependence symptoms. Among dual users, 31.2% reported first combustible product use after e-cigarette initiation, and 34.3% reported first combustible product use prior to e-cigarette initiation. DISCUSSION Approximately four in 10 youth current e-cigarette users reported using multiple tobacco products, with a majority using combustible tobacco. Frequent e-cigarette use and tobacco dependence symptoms were more prevalent among dual users of e-cigarettes and combustible tobacco.
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Affiliation(s)
- Nicole A Tashakkori
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Eunice Park-Lee
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Esther J Roh
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Carol H Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
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Kramer RD, Park-Lee E, Marynak KL, Jones JT, Sawdey MD, Cullen KA. Nicotine Pouch Awareness and Use Among Youth, National Youth Tobacco Survey, 2021. Nicotine Tob Res 2023; 25:1610-1613. [PMID: 37279928 PMCID: PMC10961705 DOI: 10.1093/ntr/ntad080] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION This manuscript examines prevalence of awareness and use of nicotine pouches among U.S. middle and high school students by sociodemographic characteristics and other tobacco product use and characterizes nicotine pouch and other tobacco product use behaviors among current nicotine pouch users. AIMS AND METHODS Data are from the 2021 National Tobacco Youth Survey, a cross-sectional, school-based survey of middle and high school students (N = 20 413; overall response rate: 44.6%), which included questions on nicotine pouches in 2021 for the first time. Prevalence estimates, 95% confidence intervals, and estimated population counts were assessed for nicotine pouch awareness, ever use, and current (past 30 days) use, and for use behaviors related to nicotine pouches (frequency of use, flavor(s) used) and other tobacco products (ever, current, frequency of use) among current nicotine pouch users. RESULTS Over one-third of students (35.5%) had ever heard of nicotine pouches. An estimated 1.9% (490 000) reported ever using them, while 0.8% (200 000) reported current use. Among current nicotine pouch users, 61.6% reported flavored nicotine pouch use, 64.2% reported current e-cigarette use, and 52.6% used multiple (≥2) tobacco products. Current use of nicotine pouches was common among current smokeless tobacco users (41.3%). CONCLUSIONS Overall, in 2021, while relatively few students had ever tried nicotine pouches or currently used them, more than one-third had heard of them. Current nicotine pouch users tended to use other tobacco products, particularly e-cigarettes and smokeless tobacco. Given previous rapid increases in youth uptake of e-cigarettes, it is important to continue monitoring nicotine pouch use among young people. IMPLICATIONS This study's findings provide an important baseline for future monitoring of nicotine pouch awareness and use among middle and high school students. Emerging tobacco products, particularly those that are flavored, widely available, discreet, and inexpensive have the potential to attract youth. Given the potential of these products to appeal to young people, ongoing monitoring of nicotine pouch use behaviors is important to inform public health and regulatory efforts.
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Affiliation(s)
- Renee D. Kramer
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Eunice Park-Lee
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Kristy L. Marynak
- Office on Smoking and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jamal T. Jones
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Michael D. Sawdey
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Karen A. Cullen
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Erhabor J, Boakye E, Osuji N, Obisesan O, Osei AD, Mirbolouk H, Stokes AC, Dzaye O, El-Shahawy O, Rodriguez CJ, Hirsch GA, Benjamin EJ, DeFilippis AP, Robertson RM, Bhatnagar A, Blaha MJ. Patterns of tobacco product use and substance misuse among adolescents in the United States. Prev Med Rep 2023; 33:102207. [PMID: 37223579 PMCID: PMC10201858 DOI: 10.1016/j.pmedr.2023.102207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 05/25/2023] Open
Abstract
Among adolescents, sole use is the most common pattern of e-cigarette use. However, concurrent use of e-cigarettes with other tobacco products is not uncommon and may be associated with high-risk behaviors. We used data from 12,767 participants in the 2019 Youth Risk Behavior Survey to examine the patterns of tobacco product use among youth in the US. First, we examined the prevalence of e-cigarette-specific patterns of tobacco use (nonuse[no tobacco product use], sole use[sole e-cigarette use], dual-use[e-cigarette and one other tobacco product], and poly use[e-cigarette and two or more other tobacco products]). Then, using multivariable Poisson regression, we assessed how the tobacco use patterns were associated with the misuse of nine substances of abuse (alcohol, marijuana, cocaine, ecstasy, hallucinogens, heroin, inhalants, injectables, and methamphetamines). 62.9% of youth reported nonuse of any tobacco product. The weighted prevalence of sole e-cigarette use, dual use, and poly use was 23.2%, 4.2%, and 3.3%, respectively. Across all the substances explored, the prevalence was highest among poly users, followed by dual users, sole users, and non-users. Compared to non-users, sole, dual, and poly users had 7.8(95 %CI:6.1-10.0), 14.3(95 %CI:10.8-18.8), and 19.7(95 %CI:15.0-25.9) times higher adjusted prevalence of reporting past-30-day binge drinking, after adjusting for age, sex, race/ethnicity, sexual orientation, and depressive symptoms. This pattern was seen across all the different substances explored. These findings highlight the high prevalence of substance misuse among youth who use tobacco products and the need to educate and counsel on substances of abuse among this population, particularly among poly-tobacco users.
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Affiliation(s)
- John Erhabor
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
| | - Ellen Boakye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
| | - Ngozi Osuji
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | | | - Albert D. Osei
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Hassan Mirbolouk
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Andrew C. Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Omar El-Shahawy
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Carlos J. Rodriguez
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Albert Einstein College of Medicine, Bronx, New York, NY, USA
| | - Glenn A. Hirsch
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Emelia J. Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Andrew P. DeFilippis
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA
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Jebai R, Osibogun O, Li W, Gautam P, Bursac Z, Ward KD, Maziak W. Temporal Trends in Tobacco Product Use Among US Middle and High School Students: National Youth Tobacco Survey, 2011-2020. Public Health Rep 2023; 138:483-492. [PMID: 35684996 PMCID: PMC10240886 DOI: 10.1177/00333549221103812] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Despite significant declines in cigarette smoking during the past decade, other tobacco products gained popularity among middle and high school students. This study examined temporal trends in exclusive and concurrent use of tobacco products among middle and high school students in the United States from 2011 through 2020. METHODS We used multiple annual datasets from the National Youth Tobacco Survey from 2011 through 2020 (N = 193 350) to examine trends of current (past 30 days) exclusive, dual, and poly use of tobacco products (ie, cigarettes, electronic cigarettes [e-cigarettes], cigars, hookahs, and smokeless tobacco). We used joinpoint regression models to calculate log-linear trends in annual percentage change (APC). RESULTS During 2011-2020, exclusive use of any tobacco product decreased significantly, except for e-cigarettes, which increased significantly at an APC of 226.8% during 2011-2014 and 14.6% during 2014-2020. This increase was more pronounced among high school students (APC = 336.6% [2011-2014] and 15.7% [2014-2020]) than among middle school students (APC = 10.4% [2014-2020]) and among male students (APC = 252.8% [2011-2014] and 14.8% [2014-2020]) than among female students (APC = 13.6% [2014-2020]). During 2011-2020, we also found upward trends in dual use of e-cigarettes and cigarettes (APC = 17.3%). Poly use of e-cigarettes, cigarettes, and any other tobacco products increased significantly at an APC of 57.1% during 2011-2014. CONCLUSIONS The emergence of new tobacco products such as e-cigarettes in the US market has shifted the landscape of tobacco use among adolescents in the last decade toward poly product use, in which e-cigarettes are a prominent component. Our findings underscore the increasing complexity of tobacco use among adolescents in the United States and the need for strong policies and regulations adapted to evolving trends in cigarette and noncigarette tobacco products.
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Affiliation(s)
- Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Kenneth D. Ward
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Zanlorenci S, Gonçalves L, de Lima TR, Silva DAS. Individual and Combined Association between Unhealthy Lifestyle Behaviors and Body Weight Dissatisfaction in a Sample of Adolescents from Southern Brazil. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050821. [PMID: 37238369 DOI: 10.3390/children10050821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
The individual and combined association between unhealthy lifestyle behaviors and body weight dissatisfaction in adolescents was investigated. This cross-sectional research used data from 676 students (348 female), aged between 14 and 19 years old (mean of 14.6 years old) from southern Brazil. Unhealthy lifestyle behaviors and body weight dissatisfaction were assessed through a questionnaire. Unhealthy lifestyle behaviors included smoking, excessive alcohol consumption, sedentary lifestyle, and poor diet, and were analyzed as individual factors and as combinations of behaviors. For males, smoking (OR: 2.6; 95% CI: 1.6-4.0) and the combination of smoking/excessive consumption of alcoholic beverages (OR: 2.5; 95% CI: 1.1-5.8) were directly associated with the desire to reduce body weight, whereas the combination of smoking/inadequate diet (OR: 1.3; 95% CI: 1.0-1.6) was associated with the desire to increase body weight. For females, the combinations of inadequate diet/physical inactivity (OR: 1.6; 95% CI: 1.0-2.5) and of smoking/excessive consumption of alcoholic beverages (OR: 1.9; 95% CI: 1.4-2.8) were directly associated with the desire to reduce body weight. The presence of simultaneous unhealthy lifestyle behaviors is associated with bodyweight dissatisfaction in adolescents.
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Affiliation(s)
- Suellem Zanlorenci
- Research Center in Kinanthropometry and Human Performance, Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus-Trindade-n. 476, Florianópolis 88040-900, Santa Catarina, Brazil
| | - Leticia Gonçalves
- Research Center in Kinanthropometry and Human Performance, Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus-Trindade-n. 476, Florianópolis 88040-900, Santa Catarina, Brazil
| | - Tiago Rodrigues de Lima
- Research Center in Kinanthropometry and Human Performance, Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus-Trindade-n. 476, Florianópolis 88040-900, Santa Catarina, Brazil
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus-Trindade-n. 476, Florianópolis 88040-900, Santa Catarina, Brazil
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Lee H, Lee BG. Associations between the Frequency and Quantity of Heated Tobacco Product Use and Smoking Characteristics among Korean Smoking Adolescents. J Korean Acad Nurs 2023; 53:155-166. [PMID: 37164344 DOI: 10.4040/jkan.22125] [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: 10/07/2022] [Revised: 01/06/2023] [Accepted: 02/13/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Although heated tobacco product (HTP) use among adolescents is an emerging public health problem, little is known about the frequency and quantity of HTP use. Thus, we investigated the associations between the frequency and quantity of HTP use and smoking characteristics (i.e., combustible cigarette [CC] and electronic cigarette [EC] use, and attempts to quit smoking) among CC-smoking adolescents. METHODS We analyzed nationally representative data from 2,470 Korean adolescents who were current CC smokers. To investigate our aim, we conducted multinomial logistic and logistic regression analyses. RESULTS We found that daily and heavier CC users had greater likelihoods of more frequent and heavier HTP use. In addition, dual users of CCs and ECs were more likely to use HTPs more frequently and heavily than CC users who did not use ECs. Moreover, daily EC users had the highest risk of frequent and heavy HTP use. The frequency and quantity of HTP use were not associated with attempts to quit smoking. Compared to CC-only use, dual use of CCs and HTPs was not associated with quitting attempts, and triple use of CCs, ECs, and HTPs was associated with a lower likelihood of quitting attempts. CONCLUSION HTP use was less likely to displace CC use and promote attempts to quit smoking. Thus, strict regulations are required to prevent the promotion of HTPs as a substitute for CCs or as a means of quitting smoking. Additionally, health professionals should consider preventive interventions for HTP, as well as CC and EC use among adolescents.
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Affiliation(s)
- Haein Lee
- College of Nursing, Daegu Catholic University, Daegu, Korea
| | - Bo Gyeong Lee
- College of Nursing, Daegu Catholic University, Daegu, Korea.
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Blank MD, Romm KF, Childers MG, Douglas AE, Dino G, Bray BC. Longitudinal transitions in adolescent polytobacco use across waves 1-4 of the Population Assessment of Tobacco and Health study. Addiction 2023; 118:727-738. [PMID: 36401561 PMCID: PMC9992106 DOI: 10.1111/add.16095] [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: 04/14/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
AIMS This study aims to identify adolescent patterns of polytobacco use and measure transitions between patterns over time. DESIGN Longitudinal analysis using data derived from waves 1-4 (2013-18) of the Population Assessment of Tobacco and Health (PATH) study. Transitions in tobacco use patterns were examined via latent transition analysis, and then, socio-demographic characteristics were used to predict transitions via logistic regression. SETTING United States. PARTICIPANTS Participants included 975 adolescents who used at least one tobacco product at any wave (W1 mean age = 13.29, standard deviation = 0.86; W4 54.2% male; 54.5% white, 25.9% Hispanic). MEASUREMENTS Measurements included past 30-day use of cigarettes, electronic cigarettes (e-cigs), traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco (SLT) or hookah. FINDINGS Six latent classes were identified. Cigarette users (43.5-58.8%) and SLT users (50.8-79.6%) tended to persist in their use over time. E-cig users began to probably transition to non-users (80.0%), but became more likely to persist in this use over time (31.1%). Non-users at a given wave were most likely to transition to e-cig users (8.5-43.7%) or cigarette users (6.7-28.6%). Cigarillo/poly-users and hookah/poly-users displayed more variable transition patterns. Adolescents were more likely to transition to non-use (versus become/remain e-cig users) if they were older (cigarette users, SLT users), younger (e-cig users), other race (SLT users), male (SLT users) or had less-educated parents (SLT users) compared with their counterparts. Hispanic (versus white) cigarette users were more likely to transition to non-users than to persist in this use. CONCLUSIONS Among adolescents in the United States, patterns of tobacco use characterized by the use, mainly, of single, specific products appear to be stable, particularly by late adolescence. In contrast, patterns characterized by polytobacco use appear to be more variable and may represent experimentation without specialization.
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Affiliation(s)
- Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Ashley E Douglas
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Geri Dino
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Bethany C Bray
- Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, IL, USA
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Dai HD, Leventhal AM. Use of Traditional Smokeless, Snus, and Dissolvable Tobacco Among U.S. Youth. Am J Prev Med 2023; 64:204-212. [PMID: 36335080 PMCID: PMC10019526 DOI: 10.1016/j.amepre.2022.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Snus, dissolvable, and traditional smokeless tobacco product use is often amalgamated in youth epidemiologic research despite differences across these products. Prevalence, trends, and correlates of U.S. youth use across different classes of oral tobacco products are unknown. METHODS Using 2011-2020 National Youth Tobacco Survey (N=193,933) data, the authors tested for cross-year linear and quadratic trends in the weighted prevalence of ever and current use of traditional smokeless tobacco, snus, and dissolvable tobacco. Multivariable logistic regressions estimated the demographic and tobacco use factors associated with the use of different oral tobacco products in 2020. Analyses were conducted in 2022. RESULTS During 2011-2020, there were declines in the prevalence of ever use of traditional smokeless tobacco (11.0% to 5.6%; linear trend, p<0.0001) and snus (5.2% to 2.4%; p<0.0001) but no change in ever dissolvable tobacco use (0.8%-1.2%). In 2020, an estimated 1,546,000 U.S. youth ever used traditional smokeless tobacco (7.7% high school, 3.0% middle school), 662,000 ever used snus (high school: 3.5%, middle school: 1.0%), and 326,000 ever used dissolvables (high school: 1.5%, middle school: 0.8%). In 2020, females and non-Hispanic Blacks and Hispanics had lower smokeless or snus ever use odds than males and non-Hispanic Whites, respectively, whereas sexual minorities (than heterosexuals) or those speaking a language other than English at home were more likely to report ever use of dissolvable tobacco. Flavored tobacco use was common, particularly for dissolvable current users (72.8% used any flavor). CONCLUSIONS Differences in the epidemiology of oral tobacco use across product types among U.S. youth suggest that oral tobacco products should be disaggregated in future research and policy strategies.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California.
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Parms TA, Valverde R, Park-Lee E, Graham-Glover BS, Cunningham CS, Sawdey MD, Cullen KA. Symptoms of tobacco dependence among middle and high school tobacco users - Data from the 2019-2020 National Youth Tobacco Survey. Addict Behav 2023; 137:107537. [PMID: 36332518 PMCID: PMC9712249 DOI: 10.1016/j.addbeh.2022.107537] [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: 11/16/2021] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Previous studies have indicated that youth who use tobacco products, including cigarettes, cigars, and smokeless tobacco, demonstrate dependence symptoms. However, the tobacco marketplace has expanded dramatically in recent years, and few studies have examined dependence symptoms among youth who use novel products. This study combined 2019-2020 National Youth Tobacco Survey data to report the prevalence and determinants of tobacco dependence symptoms among U.S. middle and high school current (past 30-day) tobacco users. METHODS Prevalence estimates were calculated to examine dependence outcomes and other covariates by user groups (single product users and multiple product users). Multivariable logistic regression analyses were used to identify independent predictors of tobacco dependence among current users of cigarettes, cigars (regular cigars, cigarillos, and little cigars), e-cigarettes, heated tobacco products, hookah, pipe tobacco, bidis, and smokeless tobacco products (chew, snuff, dip, snus, and dissolvables). RESULTS Among current tobacco users, 15.7 % (95 % CI: 14.2-17.3) reported wanting to use tobacco within 30 min of waking and 28.3 % (95 % CI: 26.3-30.5) reported strong cravings for tobacco in the past 30 days. Nearly-two-thirds of current users were single product users, of which 80.5 % reported using e-cigarettes. Reporting of dependence symptoms was generally associated with multiple product use, higher frequency of use, earlier initiation age, and use of flavored products. CONCLUSIONS Among U.S. adolescents, a considerable amount of current tobacco product users, even infrequent users, reported symptoms of dependence. These findings highlight the continued importance of prevention strategies for youth tobacco experimentation and progression to regular use.
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Affiliation(s)
| | | | | | | | | | - Michael D. Sawdey
- Corresponding author at: Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States. (M.D. Sawdey)
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12
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Gonçalves L, Zanlorenci S, Borges LL, de Lima TR, Silva DAS. Body Weight Dissatisfaction and Health Risk Behaviors in Adolescents. Percept Mot Skills 2023; 130:340-363. [PMID: 36330766 DOI: 10.1177/00315125221137678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Body weight dissatisfaction has been described as a marker for various health diseases, given its direct association with social, physical, and emotional suffering. We investigated the association between body weight dissatisfaction and health risk behaviors in adolescents. This was a cross-sectional study conducted with 668 adolescents aged 14-19 years in the city of São José, southern Brazil. Body weight satisfaction/dissatisfaction was assessed using a questionnaire validated for the investigated population. Health risk behaviors included smoking, alcohol, illicit drugs, medication, non-prescription anabolic steroids, not using seatbelt, unsafe sexual behavior and not knowing how to deal with day-to-day stress. Among males, 66.1% were dissatisfied with their body weight (32.1% due to thinness and 34.0% due to overweight). Among females, 80.0% were dissatisfied with their body weight (24.5% due to thinness and 55.5% due to overweight). There were no significant differences regarding health risk behaviors according to body weight satisfaction/dissatisfaction and sex. Compared to males who were satisfied with their body weight, those who were dissatisfied due to being overweight were more likely to be using tobacco (OR: 2.9; 95% CI: 2.1-4.2), alcohol (OR: 1.7; 95% CI: 1.5-1.9) and anabolic steroids (OR: 2.7; 95% CI: 1.2-5.7). Compared to females who were satisfied with their body weight, those who were dissatisfied due to thinness were more likely to be consuming alcoholic beverages (OR: 1.6; 95% CI: 1.2-2.0) and less likely to be consuming illicit drugs (OR: 0.5; 95% CI: 0.3-0.8). Interventions aimed at health education regarding the non-adoption of risk behaviors such as alcohol and tobacco use, as well as the non-use of anabolic steroids, and favoring the maintenance of general health, may be important for adolescents with body dissatisfaction. These data suggest that health risk behaviors such as adolescent male use of tobacco, alcohol, and anabolic steroids and the use of alcohol and drugs by female adolescents can be related to body weight dissatisfaction.
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Affiliation(s)
- Leticia Gonçalves
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Suellem Zanlorenci
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Leandro Lima Borges
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Tiago Rodrigues de Lima
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil
| | - Diego Augusto Santos Silva
- Department of Physical Education, 28117Federal University of Santa Catarina - Sports Center, Santa Catarina, Brazil.,Faculty of Health Sciences, Universidad Autnoma de Chile, Providencia, Chile
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Park-Lee E, Ren C, Cooper M, Cornelius M, Jamal A, Cullen KA. Tobacco Product Use Among Middle and High School Students - United States, 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:1429-1435. [PMID: 36355596 PMCID: PMC9707354 DOI: 10.15585/mmwr.mm7145a1] [Citation(s) in RCA: 92] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Tobacco use* is the leading cause of preventable disease, disability, and death among adults in the United States (1). Youth use of tobacco products in any form is unsafe, and nearly all tobacco use begins during youth and young adulthood (2). The Food and Drug Administration (FDA) and CDC analyzed data from the 2022 National Youth Tobacco Survey (NYTS) to estimate current (past 30-day) use of eight tobacco products among U.S. middle (grades 6-8) and high school (grades 9-12) students. In 2022, approximately 11.3% of all students (representing 3.08 million persons) reported currently using any tobacco product, including 16.5% of high school and 4.5% of middle school students (2.51 million and 530,000 persons, respectively). Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among high school (14.1%; 2.14 million) and middle school (3.3%; 380,000) students. Approximately 3.7% of all students (representing 1 million persons) reported currently smoking any combustible tobacco product. Current use of any tobacco product was higher among certain population groups, including 13.5% of non-Hispanic American Indian or Alaska Native (AI/AN)† students; 16.0% of students identifying as lesbian, gay, or bisexual (LGB); 16.6% of students identifying as transgender; 18.3% of students reporting severe psychological distress; 12.5% of students with low family affluence; and 27.2% of students with low academic achievement. Implementation of comprehensive evidence-based tobacco control strategies, combined with FDA regulation, is important for preventing and reducing youth tobacco product use (1,2).
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Glasser AM, Hinton A, Wermert A, Macisco J, Nemeth JM. Characterizing tobacco and marijuana use among youth combustible tobacco users experiencing homelessness - considering product type, brand, flavor, frequency, and higher-risk use patterns and predictors. BMC Public Health 2022; 22:820. [PMID: 35468777 PMCID: PMC9036780 DOI: 10.1186/s12889-022-13244-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention. METHODS This study included 96 youth (ages 14-24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana. RESULTS Most youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one's housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors. CONCLUSIONS Young combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.
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Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Alice Hinton
- Division of Biostatistics, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Joseph Macisco
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
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Huh Y, Min Lee C, Cho HJ. Comparison of nicotine dependence between single and
multiple tobacco product users among South Korean adults. Tob Induc Dis 2022; 20:22. [PMID: 35291560 PMCID: PMC8879064 DOI: 10.18332/tid/145899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/16/2021] [Accepted: 01/16/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The relationship between nicotine dependence and the use of multiple tobacco products, such as heated tobacco products (HTPs), electronic cigarettes (ECs), and combustible cigarettes (CCs), is not well investigated. We evaluated nicotine dependence symptoms among South Korean adults among single and multiple tobacco product users. METHODS We conducted an online survey involving 7000 adults aged 20–69 years in November 2018 and compared the nicotine dependence among single, dual, and triple use of tobacco products. Nicotine dependence was measured for ‘time to the first use of tobacco products within 5 min’, ‘awaking at night’, ‘strong craving’, ‘uncontrollable urge to smoke’, and ‘irritability or restlessness’. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for nicotine dependence symptoms based on the number of tobacco products were estimated using multivariable logistic regression analysis. RESULTS The current prevalence of use of tobacco products was 27.5%. Proportion of dual and triple uses were: 28.3%, 13.7% for CCs; 36.5%, 50.2% for ECs; and 54.0%, 33.1% for HTPs. Nicotine dependence tended to be higher as the number of tobacco products used increased for most measures, except for ECs with the measure ‘time to first use of tobacco products within 5 min’. The ORs of ‘awaking at night’ increased approximately three times for dual users (OR=2.87; 95% CI: 1.29–6.39, for current EC users) and seven times for triple users (OR=7.24; 95% CI: 3.66–14.31, for current HTP users) compared to that for single users. CONCLUSIONS Multiple tobacco product users reported higher nicotine dependence symptoms than single users. High nicotine dependence of multiple tobacco product users may hamper the future cessation of tobacco products, which can be challenging for future tobacco control policies in South Korea.
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Affiliation(s)
- Youn Huh
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Cheol Min Lee
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Parms TA, Head SK, Sawdey MD, Rostron BL, Cullen KA. Characteristics of Past 30-Day Cigar Smoking, U.S. Adolescents, 2020. Am J Prev Med 2022; 62:e39-e44. [PMID: 34497029 DOI: 10.1016/j.amepre.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/13/2021] [Accepted: 06/10/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Data from the 2019 National Youth Tobacco Survey indicated that cigars were the most commonly used combustible tobacco product in the past 30 days among youth. This study uses 2020 National Youth Tobacco Survey data to report the prevalence estimates and characteristics of current cigar use, overall and by cigar type, among middle- and high-school students in the U.S. METHODS Weighted prevalence estimates and 95% CIs were calculated in 2020 for overall cigar use and by cigar type. RESULTS In 2020, current cigar smoking was reported by 3.5% of students (1.5% middle school and 5.0% high school). Cigarillos (44.1%) were the most reported cigar type smoked, followed by regular (33.1%) and little (22.6%) cigars; 21.8% did not know the cigar type. Most cigar smokers were in high school (81.2%) and were male (52.4%), and 42.3% were non-Hispanic White. More than half of cigar smokers reported smoking flavored cigars (58.3%), with fruit (61.5%), candy/desserts/other sweets (34.0%), and mint (30.4%) as the most frequently reported flavor categories. Approximately 1 in 5 current cigar smokers (18.4%) smoked on ≥20 days in the past 30 days, and 78.8% reported multiple tobacco product use. CONCLUSIONS Cigar smoking was highest among non-Hispanic Black and Hispanic youth. More than half of youth cigar smokers reported using flavored cigars, and most were also currently using other tobacco products. Cigarillos were the most reported cigar type used by youth, followed by regular cigars. These findings highlight the continued importance of youth tobacco use reduction strategies and can inform policy development.
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Affiliation(s)
- Tiffany A Parms
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland.
| | - Sara K Head
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Michael D Sawdey
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Brian L Rostron
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Karen A Cullen
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, Maryland
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Zhang L, Gentzke A, Trivers KF, VanFrank B. Tobacco Cessation Behaviors Among U.S. Middle and High School Students, 2020. J Adolesc Health 2022; 70:147-154. [PMID: 34930566 PMCID: PMC11093620 DOI: 10.1016/j.jadohealth.2021.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/17/2021] [Accepted: 07/12/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE The landscape of youth tobacco product use has changed dramatically in recent years; however, little is known about current youth cessation behaviors. This study aims to assess prevalence and correlates of quit intentions and past-year quit attempts among U.S. middle and high school students who report current use of any tobacco product, cigarettes, and e-cigarettes. METHODS Data came from the 2020 National Youth Tobacco Survey, a nationally representative cross-sectional school-based survey of students in grades 6-12. Weighed prevalence estimates of quit intentions and past-year quit attempts among users of any tobacco product, cigarettes, and e-cigarettes are presented. Multivariable-adjusted logistic regression with predictive marginals was used to assess sociodemographic correlates of quit intentions and quit attempts for each tobacco product user group. RESULTS Quit intentions were reported by 62.5% of current users of any tobacco product, 68.1% of cigarette smokers, and 63.9% of e-cigarette users. Similarly, past-year quit attempts were reported by 65.4% of current users of any tobacco product, 65.8% of cigarettes smokers, and 67.4% for e-cigarette users. Harm perceptions toward tobacco, nicotine dependency, and the use of ≥2 tobacco products were significantly correlated with quit intentions, quit attempts, or both among different tobacco product user groups. CONCLUSIONS Most students who use tobacco products want to quit and have attempted to do so. Development of youth-focused cessation interventions, particularly those addressing the most commonly used products, could potentially accelerate progress in a comprehensive approach to youth tobacco prevention and control.
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Affiliation(s)
- Lei Zhang
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Andrea Gentzke
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katrina F Trivers
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brenna VanFrank
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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E8-LWDS: Factorial Structure and Psychometric Properties of the Lebanese Waterpipe Dependence Scale-11 in 1490 Egyptian Waterpipe Tobacco Smokers-A Critical Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136741. [PMID: 34201512 PMCID: PMC8269008 DOI: 10.3390/ijerph18136741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There is no universal scale for assessing waterpipe tobacco (WT) dependence. We examined the factorial structure and psychometric properties of the Waterpipe Dependence Scale-11 (LWDS-11) among Egyptian WT smokers. METHODS We administered the LWDS-11 during face-interview questionnaires in two cross-sectional surveys among 1490 current WT smokers recruited via purposive quota sampling. Exploratory factor analysis was performed on half of the sample. Confirmatory factor analysis of the resulting model was done using structural equation modelling on the other half. Scale reliability was examined. We assessed convergent construct validity using regression models to examine the association between the adapted dependence scale and factors conceptually expected to be associated with WT dependence. RESULTS Exploratory factor analysis of the scale yielded eight items (E8-LWDS) supporting a three-factor structure: physical dependence (three items); psychological dependence (three items); and psychological craving (two items). Cronbach's α were 0.635 for the total scale and 0.823, 0.654, and 0.785 for the three subscales. E8-LWDS was confirmed to have good model fit (comparative fit index = 0.995; root mean squared error of approximation = 0.027). E8-LWDS was independently associated with daily WT smoking, rural residence, being a skilled worker, non-exclusive WTS, smoking ≥ eight WT hagars/day, and measures of perceived behavioral control (self-reported addiction to WT, perceived ability to quit, and previous quit attempts). CONCLUSION E8-LWDS showed adequate psychometric properties among this sample of Egyptian current WT smokers, which makes it appropriate for use by researchers and practitioners. Adding items related to perceived behavioral control might enhance the scale robustness.
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Cwalina SN, Pacek LR, Barrington-Trimis JL, Tackett AP, Pentz MA. Cross-Sectional Associations of Multiple Tobacco Product Use with Depressive and Anxiety Symptoms among Young Adult E-Cigarette Users. Subst Use Misuse 2021; 56:1807-1814. [PMID: 34320919 PMCID: PMC9153521 DOI: 10.1080/10826084.2021.1954026] [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] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tobacco users with mental health conditions are a vulnerable population in tobacco research, yet few studies have evaluated the association of depressive and anxiety symptoms with multiple tobacco product (MTP) use among young adult electronic cigarette (ENDS) users. METHODS Cross-sectional survey data on U.S. young adult past 30-day ENDS users (N = 2348) were collected via Amazon MTurk from May-July 2019. Binary logistic regressions evaluated the association of tobacco use pattern (exclusive ENDS use, ENDS + one other tobacco product [OTP; dual use], ENDS + two or more OTPs [poly-use]) with depressive (PHQ-9) and anxiety (GAD-7) symptoms. Among MTP users (n = 1736), we evaluated the association of ENDS use relative to OTP use and same-day MTP use with depressive and anxiety symptoms. RESULTS The sample included 26% exclusive ENDS, 27% dual, and 47% poly-users. We observed a gradient-relationship for depressive and anxiety symptoms: poly-users had greater odds of depressive and anxiety symptoms compared to dual users (aOR = 1.86 [95%CI:1.50-2.30] and aOR = 1.61 [95%CI:1.30-2.01], respectively), and dual users had greater odds of depressive and anxiety symptoms compared to exclusive ENDS users (aOR = 1.42 [95%CI:1.11-1.81] and aOR = 1.56 [95%CI:1.20-2.02], respectively). MTP users who used ENDS more often than OTPs (vs. less often than OTPs) had greater odds of depressive (aOR = 1.38 [95%CI:1.06-1.80]) and anxiety (aOR = 1.37 [95%CI:1.04-1.79]) symptoms. CONCLUSIONS The majority of young adult past 30-day ENDS users in this sample reported OTP use. Future research on MTP use should distinguish between dual and poly-use. Tobacco prevention efforts for young adults with mental health symptoms are needed.
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Affiliation(s)
- Sam N Cwalina
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mary Ann Pentz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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