1
|
Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021. Tob Control 2024:tc-2023-058453. [PMID: 39174323 DOI: 10.1136/tc-2023-058453] [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: 10/20/2023] [Accepted: 08/03/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the lung injuries outbreak, flavour bans, Tobacco 21 and the COVID-19 pandemic. METHODS Using the Population Assessment of Tobacco and Health Study, we applied a multistate transition model to 28 061 adults in waves 4-5 (2017-2019) and 24 584 adults in waves 5-6 (2019-2021), estimating transition rates for initiation, cessation and switching products for each period overall and by age group. RESULTS Cigarette initiation among adults who never used either product decreased from 2017-2019 to 2019-2021, but ENDS initiation did not significantly change. The persistence of ENDS-only use remained high (75%-80% after 1 year). Cigarette-only use transitions remained similar (88% remaining, 7% to non-current use and 5% to dual or ENDS-only use). In contrast, dual use to ENDS-only transitions increased from 9.5% (95% CI 7.3% to 11.7%) to 20.0% (95% CI 17.4% to 22.6%) per year, decreasing the persistence of dual use. The dual to cigarette-only use transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use. CONCLUSIONS The persistence of ENDS use among adults remained high in 2019-2021, but a larger fraction of dual users transitioned to ENDS-only use compared with 2017-2019. Because the fraction of cigarette-only users switching to dual use remained low, especially among older adults, the public health implications of this change are minimal.
Collapse
Affiliation(s)
| | - Jihyoun Jeon
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stephanie R Land
- Tobacco Control Research Branch, National Cancer Institute Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
| | | | - Abigail S Friedman
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Jamie Tam
- Health Management and Policy, Yale University, New Haven, Connecticut, USA
| | - Ritesh Mistry
- Health Behavior Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Rafael Meza
- Integrative Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| |
Collapse
|
2
|
Liao LL, Chang LC, Lee CK, Lai IJ. College students' perceptions of electronic cigarette risks and benefits: a concept mapping study. HEALTH EDUCATION RESEARCH 2024; 39:398-408. [PMID: 38776131 DOI: 10.1093/her/cyae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/17/2024] [Accepted: 05/09/2024] [Indexed: 07/20/2024]
Abstract
The use of electronic cigarettes (e-cigarettes) is on the rise among young adults, with higher public acceptance than traditional tobacco. A study in Taiwan employed concept mapping to explore risk and benefit perceptions of e-cigarette use among college students. The study involved 100 college students from 11 Taiwanese universities, with 50 being e-cigarette users and 50 non-users. Data collection and analysis were done with the GroupWisdom™ platform. Participants engaged in brainstorming, rating and sorting their perceptions, which were analyzed using multidimensional scaling and hierarchical cluster analyses. The participants' mean age was 19.24 years, and 55% were male. This process resulted in the identification of 10 clusters encompassing 64 statements, with 3 clusters focused on risk perceptions, 6 on benefit perceptions, and 1 dealing with e-cigarette regulations. Notably, risk perceptions were rated higher than benefit perceptions. Non-users held significantly higher risk perceptions and lower benefit perceptions across the nine clusters related to e-cigarette use. Concept mapping proved to be an effective tool for understanding college students' perceptions. These findings can assist health educators in comprehending college students' viewpoints on e-cigarette use and in developing targeted interventions. Additionally, exploring benefit perceptions may enhance students' critical thinking skills regarding e-cigarette advertising.
Collapse
Affiliation(s)
- Li-Ling Liao
- Department of Public Health, College of Health Science, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1st Road, Guishan Dist., Taoyuan City 33303, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, No. 1, University Road, East Dist., Tainan City 70101, Taiwan
| | - I-Ju Lai
- Department of Nutrition, I-Shou University, No. 8, Yida Road, Jiaosu Village Yanchao Dist., Kaohsiung City 82445, Taiwan
| |
Collapse
|
3
|
Ross JA, Minegishi M, Brogna M, Subramaniam G, Levy S, Weitzman E. Identifying Adolescent Vaping With Screening to Brief Intervention and Brief Screener for Tobacco, Alcohol, and Drugs Screening Tools. J Adolesc Health 2024; 75:196-199. [PMID: 38727658 PMCID: PMC11268875 DOI: 10.1016/j.jadohealth.2024.02.038] [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: 10/05/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE This study aimed to determine whether the modified Screening to Brief Intervention (S2BI) and Brief Screener for Tobacco, Alcohol, and Drugs (BSTAD) that included e-cigarettes/vaping as examples could identify all nicotine and cannabis use or whether additional questions specifically about vaping are needed. METHODS Between July 2020 and February 2022, adolescents recruited from primary care or an outpatient adolescent substance use disorder program were randomized to complete S2BI or BSTAD followed by specific questions about vaping. Screen questions were updated to include "vaping" in the parenthetical examples of nicotine and cannabis use. RESULTS Data from 502 adolescent participants who completed both the S2BI or BSTAD and vaping questions were analyzed. The S2BI and BSTAD identified 92% (23/25) and 100% (16/16) of nicotine vaping and 100% (16/16) and 95.5% (21/22) of cannabis vaping, respectively. DISCUSSION The S2BI and BSTAD tools accurately identify nicotine and cannabis use without specific questions about vaping.
Collapse
Affiliation(s)
- Jennifer A Ross
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts; Division of Addiction Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
| | - Machiko Minegishi
- Division of Addiction Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Melissa Brogna
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts; Division of Addiction Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Geetha Subramaniam
- Center for Clinical Trials Network, National Institute on Drug Abuse, Bethesda, Maryland
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, Massachusetts; Division of Addiction Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Elissa Weitzman
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
| |
Collapse
|
4
|
Mohapatra S, Wisidagama S, Schifano F. Exploring Vaping Patterns and Weight Management-Related Concerns among Adolescents and Young Adults: A Systematic Review. J Clin Med 2024; 13:2896. [PMID: 38792437 PMCID: PMC11122629 DOI: 10.3390/jcm13102896] [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: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Electronic cigarettes or vapes are battery-operated devices that heat a liquid, often containing nicotine and flavouring substances, to produce an inhalable aerosol. Despite being used as an alternative to traditional smoking, many studies have reported their health risks and ineffectiveness in smoking cessation. The impact of e-cigarettes on weight control behaviours, a known effect of traditional cigarette smoking, is unclear. Herein, a systematic review was conducted to explore the relationship between e-cigarette use and body weight changes in adolescents and young adults. Methods: The existing literature from databases such as PubMed, Cochrane Library, Embase, Science Direct, Web of Science, Scopus, and Google Scholar until October 2023 was searched and included in the review. The methodological quality of all selected studies was assessed using the Joanna Briggs Institute's (JBI) Critical Appraisal Checklists for Studies. Results: Out of 5117 citations, 20 publications featuring cross-sectional studies with adolescent participants were qualitatively analysed. The high rates of e-cigarette usage seemed to correlate with increased weight concerns, particularly among females. Regular e-cigarette users who reported being overweight and used calorie restriction for weight reduction were more likely to view vaping as a weight loss or control strategy. Young adults (<24 years) may consume more flavoured e-cigarettes than older users (>25 years). Conclusions: This study revealed a significant use of e-cigarettes among high school students, driven by taste preferences, weight management, and perceived harm reduction. Particularly among girls facing body image pressures, vaping serves as a weight control method. This highlights the need to assess cardiovascular risks and advocate for further research, including longitudinal studies, to inform public health strategies effectively.
Collapse
Affiliation(s)
- Srishti Mohapatra
- General Internal Medicine Doctorate Programme, University of Hertfordshire, Hatfield AL10 9AB, UK
| | | | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK;
| |
Collapse
|
5
|
Galper EF, Gottfredson O'Shea N, Ritchie C, Kresovich A, Ma H, Sutfin EL, Sheeran P, Noar SM. Identifying promising themes and messages for youth vaping prevention: A national study. Soc Sci Med 2024; 348:116864. [PMID: 38608483 PMCID: PMC11056295 DOI: 10.1016/j.socscimed.2024.116864] [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: 07/12/2023] [Revised: 10/29/2023] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Use of e-cigarettes and vapes among adolescents continues to be a major public health concern. Health communication efforts can discourage e-cigarette use among adolescents by influencing beliefs and behavior. However, to do so, studies need to identify the most promising themes and messages based on the latest evidence about the harms of e-cigarettes and vaping. Participants were a nationally representative sample of 1,603 US adolescents aged 13-17 years, recruited in the summer of 2022. Adolescents were randomly assigned to view 7 vaping prevention statements (one from each theme: nicotine addiction, chemical harms, health symptoms, mental health, organ effects, cosmetic effects, and monetary cost) and 1 control statement (vape litter theme) from a pool of 46 statements that were developed through a systematic process. Participants rated each statement on perceived message effectiveness (PME), awareness, and believability. Results of linear mixed models indicated that all vaping prevention themes out-performed control messages on PME, with chemical harms and organ effects having the largest effects, followed by nicotine addiction and then other themes. For most message themes, PME effects were stronger for youth susceptible to vaping compared to non-susceptible youth and users. Both awareness and believability predicted higher levels of PME. In secondary analyses, we found that statements specifying the target ("you") and longer statements were also rated higher on PME. Results suggests that the most potent vaping prevention messages for adolescents are those that focus on vape chemicals and the potential of vaping to damage organs and increase disease risk.
Collapse
Affiliation(s)
- Emily F Galper
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | - Caroline Ritchie
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alex Kresovich
- Public Health Department, NORC at the University of Chicago, Chicago, IL, USA
| | - Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
6
|
Rams A, D. Kowitt S, Ritchie C, Sutfin EL, Sheeran P, Noar SM. Awareness and Perceptions of US Food and Drug Administration's JUUL Marketing Denial Order: A National Study of US Adolescents. Nicotine Tob Res 2024; 26:467-473. [PMID: 37813094 PMCID: PMC10959063 DOI: 10.1093/ntr/ntad191] [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: 04/27/2023] [Revised: 08/18/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION We examined awareness and perceptions of the US Food and Drug Administration (FDA) JUUL marketing denial order (MDO) that occurred in June 2022 among a nationally representative sample of US adolescents. AIMS AND METHODS Data were collected in August 2022 via an online survey (n = 1603). Adolescents were asked whether they had heard about the JUUL MDO, and, if yes, where they heard the news. Those who had heard were asked about the MDO's impact on their harm beliefs about JUUL and vape products in general. We examined correlates of awareness of the MDO and of increased JUUL and vape harm perceptions. RESULTS Twenty-seven percent of adolescents had heard about the MDO. Older adolescents (adjusted odds ratio [aOR] = 1.13) and LGBTQ+ adolescents (aOR = 2.05) had significantly higher odds of having heard the news, while those who identified as Black or African American had significantly lower odds of having heard (aOR = 0.56). Most participants who were aware of the MDO indicated that they had higher harm perceptions about JUUL itself (77.9%) and vapes in general (79.6%). Youths susceptible to vaping and current users were less likely to report increased harm perceptions about JUUL (B = -0.34 and -0.46, respectively) and vapes in general (B = -0.27 and -0.43) compared with youth not susceptible to vaping. CONCLUSIONS The results of this nationally representative survey demonstrate that over one-quarter of US youth heard about the JUUL MDO and the vast majority of those indicated increased harm perceptions about vapes. Large-scale news events about vaping can reach youth audiences and may impact what youth think about the harms of vaping. IMPLICATIONS Analysis of a nationally representative survey of adolescents aged 13-17 revealed that more than 25% had heard about the marketing denial order issued to JUUL Labs by the FDA in June of 2022. We also found that the vast majority of adolescents reported increased JUUL and vape harm perceptions in response to hearing about the MDO. This indicates that news coverage about vaping-including coverage of regulatory actions-can reach and potentially impact adolescents. It is therefore important to monitor news coverage about vaping, how it is framed and discussed across media platforms, and its reach among priority populations.
Collapse
Affiliation(s)
- Alissa Rams
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah D. Kowitt
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline Ritchie
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill
| |
Collapse
|
7
|
Zuckerman G, Kamke K, Sabado-Liwag M, Pérez-Stable EJ, El-Toukhy S. Noncigarette Tobacco Product Use Among Smoking-Susceptible and Nonsusceptible Adolescent Never Smokers, 2009-2021. J Adolesc Health 2024; 74:466-478. [PMID: 38099902 PMCID: PMC10872544 DOI: 10.1016/j.jadohealth.2023.09.021] [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: 02/06/2023] [Revised: 08/23/2023] [Accepted: 09/12/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE Examine trends in noncigarette tobacco use among smoking susceptible and nonsusceptible adolescents from 2009-2021. METHODS Data came from cross-sectional samples of the National Youth Tobacco Survey (N = 183,198). Using Pierce's smoking susceptibility scale, participants were classified as either susceptible or nonsusceptible to cigarette smoking. Their use of noncigarette tobacco products was classified into four mutually exclusive categories: nonuse, noncigarette combustibles use, noncombustibles use, and noncigarette combustibles and noncombustibles dual use. We produced covariate-adjusted predicted marginal proportions of noncigarette tobacco use for 12 National Youth Tobacco Survey years, which were entered into Joinpoint trend analysis software to determine (a) trends in noncigarette tobacco use from 2009-2021 using the average annual percent changes (AAPCs) and (b) changes in each time segment using the average percent change. Models were fitted by smoking susceptibility, sex, and race/ethnicity. RESULTS Nonuse was lower among susceptible (vs. nonsusceptible) adolescents whereas noncigarette tobacco use was higher. Trends show significant declines in nonuse (nonsusceptible: AAPC = -0.3%) and noncigarette combustibles use (susceptible: AAPC = -12%) between 2009-2021, increases in noncombustibles use (susceptible: AAPC = 18%, nonsusceptible: AAPC = 19%) between 2009 and 2019, and steadiness in dual use. Parallel trends were observed when stratified by sex and race/ethnicity with notable increases in noncombustibles use among females and Latinos. DISCUSSION Noncigarette tobacco use differed by smoking susceptibility. Observed trends, especially when stratified by sex and race/ethnicity, raise concerns about tobacco use disparities among females and Latinos. Smoking susceptibility can help identify at-risk adolescents for current or future tobacco use.
Collapse
Affiliation(s)
- Gabrielle Zuckerman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, Maryland
| | - Kristyn Kamke
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, Maryland
| | - Melanie Sabado-Liwag
- Department of Public Health, California State University-Los Angeles, Los Angeles, California
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, Maryland.
| |
Collapse
|
8
|
James SA, White AH, Kahn FF, Mushtaq N, Chen S, Beebe LA. Susceptibility to e-cigarette use and associated factors in high school youth, Oklahoma Youth Tobacco Survey, 2021-2022. Front Public Health 2024; 12:1348926. [PMID: 38362222 PMCID: PMC10867248 DOI: 10.3389/fpubh.2024.1348926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/19/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Susceptibility predicts subsequent uptake of e-cigarettes (EC) by youth. This study identified factors associated with EC susceptibility among high school students who have never used a tobacco/nicotine product. Methods The Oklahoma Youth Tobacco Survey was administered to a random sample of 36 Oklahoma High Schools during the 2021-2022 school year (n = 1,220 participating students). Associations between EC susceptibility and covariates were identified using stepwise logistic regression for weighted survey data. Results More than one third of Oklahoma high school students who had never used tobacco or nicotine products (36.4%) were susceptible, and males had higher susceptibility than females (38.8 and 33.9%, respectively). In males, EC susceptibility was associated with race (Black, American Indian, and other were less susceptible), psychological distress (aOR = 2.4, 95% CI = 1.1, 4.8), disagreement that all tobacco products are dangerous (aOR = 3.1, 95% CI = 1.2, 7.9), and perception of little/no harm from secondhand vapor (aOR = 3.4, 95% CI = 2.1, 5.3). In females, identifying as gay, lesbian, or bisexual (aOR = 2.1, 95% CI = 1.1, 3.9), poor academic performance (aOR = 4.5, 95% CI = 1.6, 12.6), psychological distress (aOR = 2.6, 95% CI = 1.2, 5.5) and interacting with EC content on social media (aOR = 5.9, 95% CI = 1.9, 18.1) were associated with EC susceptibility. Conclusion Males and females had different patterns of susceptibility to EC use. Understanding groups of adolescents most susceptible to using nicotine products can help target prevention efforts at home, in schools, and within communities.
Collapse
Affiliation(s)
- Shirley A. James
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ashley H. White
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Fahad F. Kahn
- Oklahoma State Department of Health, Oklahoma City, OK, United States
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Laura A. Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
9
|
Liao LL, Chang LC, Lai IJ, Lee CK. College Students' E-health Literacy, Social Media Use, and Perceptions of E-cigarettes in Taiwan. J Community Health 2024; 49:52-60. [PMID: 37420015 DOI: 10.1007/s10900-023-01255-z] [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] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
This study aimed to examine the relationship between social media use, e-health literacy, and the risk and benefit perceptions of e-cigarettes among college students in Taiwan. A cross-sectional online survey was conducted with 1,571 Taiwanese college students, which included four questionnaires to assess participants' perceptions, social media use behavior, e-health literacy, and sociodemographic factors. The data were presented in terms of means, standard deviations, and percentages. Stepwise regression was used to identify factors associated with the participants' perceptions. The study found that 75.01% of the participants were exposed to e-cigarette information on social media, with 31.26% actively searching for it and 15.95% sharing it. Participants had a high e-cigarette risk perception, indicating low benefit perception, but acceptable e-health literacy. Factors such as current e-cigarette and tobacco use, e-health literacy, academic achievement, and sex significantly predicted e-cigarette risk perception, while sharing e-cigarette related information, sex, age, academic achievement, and current e-cigarette use significantly predicted its benefit perception. Thus, implementing effective e-health literacy programs to enhance college students' e-cigarette risk perception is recommended along with a proactive approach to tackle e-cigarette advertising messages on social media, minimizing their sharing behavior to decrease their perception of associated benefits.
Collapse
Affiliation(s)
- Li-Ling Liao
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - I-Ju Lai
- Department of Nutrition, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 70101, Taiwan.
| |
Collapse
|
10
|
Selya A, Kim S, Shiffman S, Gitchell J, Foxon F. What Substances Are Adolescents Vaping? Estimating Nicotine-Specific and Cannabis-Specific Vaping from US National Youth Surveys. Subst Use Misuse 2023; 59:218-224. [PMID: 37838985 DOI: 10.1080/10826084.2023.2267114] [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] [Indexed: 10/17/2023]
Abstract
BACKGROUND Youth use of electronic cigarettes ("e-cigarettes") is an ongoing concern. Vaping is usually assumed to be of nicotine, but survey responses may also include vaping of non-nicotine substances (particularly cannabis), which can impose different risks. The current study quantifies the proportions of nicotine-specific and cannabis-specific vaping among adolescents. METHODS Data from the Monitoring the Future (MTF) 2021 survey were analyzed with respect to the substance vaped: nicotine, cannabis, or flavoring only. Past-30-day (P30D) nicotine-specific vaping (exclusively, or also having vaped other substances) and cannabis-specific vaping were calculated. Results were also broken down by grade level, cigarette smoking history (current, former, or never), and frequency of e-cigarette use (<20 vs. 20+ days in P30D). RESULTS Among 4706 P30D e-cigarette users, 84.2% vaped nicotine; the remaining 15.8% reported not vaping any nicotine in P30D. Cannabis vaping was reported by 48.4% of P30D vapers. Vaping both nicotine and cannabis in P30D was more common in current and former smokers than in never-smokers, and in frequent vapers (of any substance). Conversely, never-smokers were more commonly vaping cannabis but not nicotine, compared to current and former smokers. Supplementary NYTS 2022 analyses were consistent with these findings. CONCLUSIONS A notable proportion of self-reported P30D vapers reported not vaping nicotine; nearly half vaped cannabis. Capturing the variety of substances used in vaping devices is imperative for accurate public health surveillance of both nicotine and cannabis vaping among US adolescents, considering their different respective harms and regulatory frameworks.
Collapse
Affiliation(s)
- Arielle Selya
- Pinney Associates, Inc., Pittsburgh, Pennsylvania, USA
| | - Sooyong Kim
- Pinney Associates, Inc., Pittsburgh, Pennsylvania, USA
| | - Saul Shiffman
- Pinney Associates, Inc., Pittsburgh, Pennsylvania, USA
| | - Joe Gitchell
- Pinney Associates, Inc., Bethesda, Maryland, USA
| | - Floe Foxon
- Pinney Associates, Inc., Pittsburgh, Pennsylvania, USA
| |
Collapse
|
11
|
Pierce JP, Luo M, McMenamin SB, Stone MD, Leas EC, Strong D, Shi Y, Kealey S, Benmarhnia T, Messer K. Declines in cigarette smoking among US adolescents and young adults: indications of independence from e-cigarette vaping surge. Tob Control 2023:tc-2022-057907. [PMID: 37940404 DOI: 10.1136/tc-2022-057907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/17/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To compare trends in cigarette smoking and nicotine vaping among US population aged 17-18 years and 18-24 years. METHODS Regression analyses identified trends in ever and current use of cigarettes and e-cigarettes, using three US representative surveys from 1992 to 2022. RESULTS From 1997 to 2020, cigarette smoking prevalence among those aged 18-24 years decreased from 29.1% (95% CI 27.4% to 30.7%) to 5.4% (95% CI 3.9% to 6.9%). The decline was highly correlated with a decline in past 30-day smoking among those aged 17-18 years (1997: 36.8% (95% CI 35.6% to 37.9%; 2022: 3.0% (95% CI 1.8% to 4.1%). From 2017 to 2019, both ever-vaping and past 30-day nicotine vaping (11.0% to 25.5%) surged among those 17-18 years, however there was no increase among those aged 18-24 years. Regression models demonstrated that the surge in vaping was independent of the decline in cigarette smoking. In the 24 most populous US states, exclusive vaping did increase among those aged 18-24 years, from 1.7% to 4.0% to equivalent to 40% of the decline in cigarette smoking between 2014-15 and 2018-19. Across these US states, the correlation between the changes in vaping and smoking prevalence was low (r=0.11). In the two US states with >US$1/fluid mL tax on e-cigarettes in 2017, cigarette smoking declined faster than the US average. CONCLUSIONS Since 1997, a large decline in cigarette smoking occurred in the US population under age 24 years, that was independent of the 2017-19 adolescent surge in past 30-day e-cigarette vaping. Further research is needed to assess whether the 2014-15 to 2018-19 increase in exclusive vaping in those aged 18-24 years is a cohort effect from earlier dependence on e-cigarette vaping as adolescents.
Collapse
Affiliation(s)
- John P Pierce
- Division of Health Policy, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Man Luo
- Division of Biostatistics, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Sara B McMenamin
- Division of Health Policy, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
| | - Matthew D Stone
- Division of Health Policy, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Eric C Leas
- Division of Health Policy, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
| | - David Strong
- Division of Health Behavior, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Yuyan Shi
- Division of Health Policy, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA
| | - Sheila Kealey
- Cancer Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
| | - Karen Messer
- Division of Biostatistics, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA
- Biostatistics Shared Resource, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
12
|
Psonka Y, Vannimenus C. [Perception of ENDS among French high school students in Nord and Pas-de-Calais]. Rev Mal Respir 2023; 40:743-750. [PMID: 37633810 DOI: 10.1016/j.rmr.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/13/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) have been gaining popularity for over a decade, particularly among young people. The aim was to understand how these devices were perceived, in general and according to different characteristics: gender, smoking status, experimentation or possession of SEDEN. METHODS A cross-sectional observational study was conducted by an online questionnaire to 15 high schools between 14 May and 23 October 2021. Perception was assessed by a constructed score. RESULTS In total, 772 responses from 10 high schools were analysed; 44.7% had already experimented with ENDS. The main reason for use was pleasure (33.8%). Only 15% of smokers or former smokers reported using ENDS to stop smoking as their main reason. The majority of ENDS (72.8%) are perceived as harmful. This negative perception is more important among women, non-smokers, non-experimenters and non-owners of ENDS. More than 50% of the respondents consider ENDS as distinct from tobacco. CONCLUSIONS ENDS are perceived as potentially harmful and their use is often motivated by pleasure. Their perception as a practice distinct from smoking, combined with unknown long-term consequences, justifies increased vigilance in the face of the emergence of these new uses.
Collapse
Affiliation(s)
- Y Psonka
- Unité tabacologie, clinique de pneumologie, institut cœur-poumon, CHU de Lille, boulevard du Pr-Jules-Leclercq, 59000 Lille, France.
| | - C Vannimenus
- Unité tabacologie, clinique de pneumologie, institut cœur-poumon, CHU de Lille, boulevard du Pr-Jules-Leclercq, 59000 Lille, France
| |
Collapse
|
13
|
Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.20.23297320. [PMID: 37905028 PMCID: PMC10614990 DOI: 10.1101/2023.10.20.23297320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Introduction The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the outbreak of lung injuries related to vaping THC, flavor bans, and the COVID pandemic. We analyzed patterns of initiation, cessation, and transitions between cigarettes, ENDS, and dual use before and after 2019. Methods Using the Population Assessment of Tobacco and Health (PATH) Study, we applied a multistate transition model to 28,061 adults in Waves 4-5 (2017-19) and 24,751 adults in Waves 5-6 (2019-21), estimating transition rates for initiation, cessation, and switching products for each period overall and by age group. Results Cigarette initiation among adults who never used either product decreased from 2017-19 to 2019-21, but ENDS initiation did not significantly change. Persistence of ENDS-only use remained high, with 75-80% still using ENDS only after 1 year. Cigarette-only use transitions remained similar, with about 88% remaining, 7% transitioning to non-current use, and 5% transitioning to dual or ENDS-only use. In contrast, dual use to ENDS-only transitions increased from 9.5% (95%CI: 7.3-11.7%) to 20.1% (95%CI: 17.5-22.7%) per year from 2017-19 to 2019-21, decreasing the persistence of dual use. The dual use to cigarette-only transition remained at about 25%. These changes were qualitatively similar across adult age groups, though adults ages 18-24 years exhibited the highest probability of switching from cigarette-only use to dual use and from dual use to ENDS-only use. Conclusions Persistence of ENDS use among adults remained high in 2019-21, but a larger fraction of dual users transitioned to ENDS-only use compared to 2017-19. Because the fraction of cigarette-only users switching to dual use remained low, the public health implications of the increased dual use to ENDS-only transition are minimal.
Collapse
Affiliation(s)
- Andrew F. Brouwer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Stephanie R. Land
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD, United States
| | | | - Abigail S. Friedman
- Department of Health Management and Policy, Yale University, New Haven, CT, United States
| | - Jamie Tam
- Department of Health Management and Policy, Yale University, New Haven, CT, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, United States
| | - David T. Levy
- Department of Oncology, Georgetown University, Washington, DC, United States
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| |
Collapse
|
14
|
Ma H, Gaudiello E, Sheeran P, Sanzo N, Sutfin EL, Noar SM. National Youth tobacco surveys (2014-2019) show increasing beliefs in the harm and relative addiction of e-cigarettes but decreasing associations between those beliefs and e-cigarette use. Addict Behav 2023; 144:107713. [PMID: 37086609 PMCID: PMC10330167 DOI: 10.1016/j.addbeh.2023.107713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND To evaluate the potential efficacy of increasing harm and relative addiction beliefs in discouraging e-cigarette use, we examined how adolescents' beliefs about e-cigarettes have changed over 6 years and how the predictive validity of these beliefs has changed over time. METHODS Using data from the 2014-2019 National Youth Tobacco Survey (NYTS) (grades 6-12; N = 117,472), we evaluated the association between adolescents' beliefs about the harm and relative addiction of e-cigarettes and current e-cigarette use, as well as susceptibility to use. Logistic regressions and pairwise contrasts were used to analyze changes in these beliefs and determine how well these beliefs predict ever use, current use, and susceptibility to use over time. RESULTS E-cigarette harm and relative addiction beliefs tended to increase over time. In most years, these beliefs were negatively associated with e-cigarette use, including ever use, current use, and susceptibility to use. Interactions between these beliefs were also observed in some years such that harm belief better predicted use when e-cigarettes were also perceived as more addictive. Survey year also interacted with health harm and relative addiction beliefs such that the predictive validity of these beliefs for e-cigarette use decreased over time. CONCLUSIONS Beliefs about e-cigarette harm and relative addiction have increased over time and predict use of, and susceptibility to, e-cigarettes among US adolescents. However, the predictive validity of these beliefs has decreased over time. Future research should explore the reasons for the decreased predictive validity of health beliefs in e-cigarette use and identify constructs that predict adolescent e-cigarette use over and above general harm and relative addiction beliefs.
Collapse
Affiliation(s)
- Haijing Ma
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Eric Gaudiello
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Nora Sanzo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; Hussman School of Journalism and Media, University of North Carolina, Chapel Hill, NC 27514, USA.
| |
Collapse
|
15
|
Wackowski OA, Gratale SK, Jeong M, Delnevo CD, Steinberg MB, O'Connor RJ. Over 1 year later: smokers' EVALI awareness, knowledge and perceived impact on e-cigarette interest. Tob Control 2023; 32:e255-e259. [PMID: 35228318 PMCID: PMC9420160 DOI: 10.1136/tobaccocontrol-2021-057190] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/14/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The e-cigarette or vaping product use-associated lung injury (EVALI) outbreak caused serious lung injuries in over 2800 people in the USA in 2019. By February 2020, most cases were determined as linked with vaping tetrahydrocannabinol (THC), including black market products using vitamin E acetate. This study examined smokers' EVALI awareness, knowledge and perceived impact on their e-cigarette interest approximately 16 months after its peak. DESIGN Between January and February 2021, we surveyed 1018 adult current smokers from a nationally representative US research panel. Participants were asked if they had heard about EVALI prior to COVID-19, knew its main cause, and if EVALI had impacted their interest in future e-cigarette use. RESULTS Approximately 54% of smokers had heard of EVALI. Among those who had heard of EVALI (n=542), 37.3% believed its main cause was e-cigarettes used to vape nicotine, like JUUL. Fewer (16.6%) thought the main cause was products for vaping marijuana/THC, and 20.2% did not know. About 29% had heard vitamin E acetate was associated with EVALI, and 50.9% indicated EVALI made them less interested in using e-cigarettes in the future. EVALI awareness was significantly associated with e-cigarette risk perceptions (ie, that e-cigarettes are as harmful as smoking). CONCLUSIONS Despite the passage of time, considerable lack of knowledge and misperceptions about EVALI remain among those who smoke. Our findings suggest the need for continued efforts to promote better understanding of EVALI and appropriate behavioural and policy responses.
Collapse
Affiliation(s)
- Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Deptartment of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | | | - Michelle Jeong
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Deptartment of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Deptartment of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Michael B Steinberg
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| |
Collapse
|
16
|
Fairman RT, Churchill V, Garner JB, Brown D, Massey ZB, Ashley DL, Popova L. It's addiction at this Point": A qualitative examination of youth E-cigarette use trajectory in the United States. Tob Use Insights 2023; 16:1179173X231185455. [PMID: 37528837 PMCID: PMC10387766 DOI: 10.1177/1179173x231185455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/14/2023] [Indexed: 08/03/2023] Open
Abstract
E-cigarettes (electronic cigarettes) have been the most used tobacco product among US youth since 2014, reaching a plateau during the COVID-19 pandemic. Youth e-cigarette use is associated with negative health consequences such as impaired cognitive functioning. For many, the COVID-19 pandemic altered social interactions, harm perceptions, and product availability. This changed the frequency and locations in which youth use e-cigarettes. To better understand youth e-cigarette use, we need more information on factors that can alter e-cigarette use, specifically, how the pandemic changed e-cigarette use among youth. In 2020-2021, we conducted online, individual interviews with 19 youth (aged 13-17) e-cigarette users living in the US to explore how COVID-19 impacted their e-cigarette use. Youth described a progression of e-cigarette use from initial experimentation, regular social use, and ultimately to nicotine addiction demonstrated by individual use in isolation. Many youth initiated e-cigarette use due to influences by friends or family members. Youth discussed progression to social use, with social interactions as an important reason for use and an avenue for expanding one's knowledge of e-cigarettes. After a period of time, youth began to recognize that the social interactions mattered less, suggesting to them that they had become addicted. This realization became more apparent during COVID-19, which changed how youth used e-cigarettes, especially around where use was occurring, health concerns, and use behavior and frequency. In our interviews, youth trajectory began with an initiation with family and friends, progressed to social use, and eventually developed to addiction, at which point social use was no longer the primary motivation for e-cigarette use. Understanding the trajectory of e-cigarette use will allow for effective interventions that reduce harm to youth from e-cigarette use.
Collapse
Affiliation(s)
| | - Victoria Churchill
- Morehouse School of Medicine, Cancer Health Equity Institute, Atlanta, GA, USA
| | - Jamani B. Garner
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Devon Brown
- JSI Research and Training Institute, Inc., Atlanta, GA, USA
| | | | - David L. Ashley
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, GA, USA
| |
Collapse
|
17
|
Yousufzai SJ, Cole AG, Nonoyama M, Barakat C. Changes in Quantity Measures of Various Forms of Cannabis Consumption among Emerging Adults in Canada in Relation to Policy and Public Health Developments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6213. [PMID: 37444061 PMCID: PMC10341313 DOI: 10.3390/ijerph20136213] [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: 05/02/2023] [Revised: 06/10/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
Limited research examines changes in quantities of various forms of smoked/vaped cannabis among regular consumers, including emerging adults (EAs; 18 to 29) in Canada. This information is particularly relevant in the current context of emerging cannabis behaviors among EAs related to political amendments (legalization of cannabis), vaping-related lung illnesses (EVALI), and unprecedented pandemics (COVID-19). This study investigated the impact of legalizing recreational cannabis use in Canada, the EVALI epidemic, and the COVID-19 pandemic on the quantity of smoked/vaped forms of cannabis in relation to gender differences. EAs retrospectively self-reported the quantity of herb, hash, concentrates, joint size, and the number of joints and vaping cartridges in relation to three consecutive developments: pre-legalization, post-legalization; pre-EVALI, post-EVALI, pre-COVID-19, and during COVID-19. The quantity of herb use significantly increased among heavy users, and vaping quantity significantly increased among light users. Overall, an increasing incremental trend was observed in the average quantity of cannabis forms used over time. Males consumed higher quantities of all cannabis forms than females. More males than females reported using concentrates (p < 0.05). These findings reveal unique aspects of the amount of various cannabis forms smoked/vaped in relation to gender and provides preliminary evidence of cannabis consumption behaviors in relation to changing social and cultural contexts.
Collapse
Affiliation(s)
- Susan J. Yousufzai
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1H 7K4, Canada; (A.G.C.); (M.N.); (C.B.)
| | | | | | | |
Collapse
|
18
|
Abstract
Widespread uptake of vaping has signaled a sea change in the future of nicotine consumption. Vaping has grown in popularity over the past decade, in part propelled by innovations in vape pen design and nicotine flavoring. Teens and young adults have seen the biggest uptake in use of vape pens, which have superseded conventional cigarettes as the preferred modality of nicotine consumption. Relatively little is known, however, about the potential effects of chronic vaping on the respiratory system. Further, the role of vaping as a tool of smoking cessation and tobacco harm reduction remains controversial. The 2019 E-cigarette or Vaping Use-Associated Lung Injury (EVALI) outbreak highlighted the potential harms of vaping, and the consequences of long term use remain unknown. Here, we review the growing body of literature investigating the impacts of vaping on respiratory health. We review the clinical manifestations of vaping related lung injury, including the EVALI outbreak, as well as the effects of chronic vaping on respiratory health and covid-19 outcomes. We conclude that vaping is not without risk, and that further investigation is required to establish clear public policy guidance and regulation.
Collapse
Affiliation(s)
- Andrea Jonas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
19
|
East K, Reid JL, Burkhalter R, Wackowski OA, Thrasher JF, Tattan-Birch H, Boudreau C, Bansal-Travers M, Liber AC, McNeill A, Hammond D. Exposure to negative news stories about vaping, and harm perceptions of vaping, among youth in England, Canada, and the US before and after the outbreak of E-cigarette or Vaping-Associated Lung Injury (EVALI). Nicotine Tob Res 2022; 24:1386-1395. [PMID: 35368062 PMCID: PMC9356695 DOI: 10.1093/ntr/ntac088] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 02/02/2023]
Abstract
Introduction Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’) on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16–19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the ‘EVALI’ outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and February–March 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the United States (18.0% to 64.6%), accelerating during (2019) and immediately after (February–March 2020) the outbreak (p < .001) before returning to 2019 levels by August 2020. Similarly, the accurate perception that vaping is less harmful than smoking declined between 2017 and February–March 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the United States (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p < .001). The perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p ≤ .001). Time trends were most pronounced in the United States. Exposure to negative news stories predicted the perception that vaping takes less than a year to harm health (Adjusted Odds Ratio = 1.55, 1.48-1.61) and worry that vaping will damage health (Adjusted Odds Ratio = 1.32, 1.18-1.48). Conclusions Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the United States. Implications This is the first study examining changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the United States before, during, and after ‘EVALI’. Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of the three harm perception measures. Overall, findings suggest that ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.
Collapse
Affiliation(s)
- Katherine East
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jessica L Reid
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Olivia A Wackowski
- School of Public Health, Rutgers, The State University of New Jersey, NJ, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alex C Liber
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Hammond
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| |
Collapse
|
20
|
Denlinger-Apte R, Suerken CK, Ross JC, Reboussin BA, Spangler J, Wagoner KG, Sutfin EL. Decreases in smoking and vaping during COVID-19 stay-at-home orders among a cohort of young adults in the United States. Prev Med 2022; 156:106992. [PMID: 35149114 PMCID: PMC8824729 DOI: 10.1016/j.ypmed.2022.106992] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/12/2021] [Accepted: 02/06/2022] [Indexed: 11/26/2022]
Abstract
In Spring 2020, most US states and territories implemented stay-at-home orders to slow transmission of the novel coronavirus SARS-CoV2, the cause of COVID-19. Little is known about the impact of stay-at-home orders on tobacco and nicotine use including among young adults. The current study examined participants (N = 1727) completing three recent survey waves from a longitudinal cohort of young adults recruited in 2010 from North Carolina and Virginia, USA: Wave 13 (Spring 2019), Wave 14 (Fall 2019), and Wave 15 (Spring 2020) to assess changes in cigarette and e-cigarette use. We conducted logistic regression analyses to compare the odds that participants reported smoking or vaping in Wave 14 relative to Wave 13 to establish if there was a trend of use pre-pandemic. Then, we conducted logistic regression analyses to compare the odds that participants reported smoking or vaping in Wave 15 relative to Wave 14 to determine the impact of COVID-19 stay-at-home orders. When comparing the odds of reporting tobacco use at Wave 14 to Wave 13, no differences emerged (p > 0.05). However, when comparing tobacco use at Wave 15 to Wave 14, participants had 40% lower odds of reporting past 30-day cigarette use (p = 0.02) and 50% lower odds of reporting past 30-day e-cigarette use (p < 0.01). The current study provides initial evidence that young adults may have reduced their tobacco and nicotine use during the stay-at-home orders. However, more work is needed to determine the long-term impact of the COVID-19 pandemic on tobacco use and cessation in this population.
Collapse
Affiliation(s)
- Rachel Denlinger-Apte
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Cynthia K Suerken
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - John Spangler
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Kimberly G Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| |
Collapse
|
21
|
Do EK, Tulsiani S, Vallone DM, Hair EC. Transitions in Frequent to Daily Tobacco and Nicotine Use among Youth and Young Adults. Subst Use Misuse 2022; 57:1681-1687. [PMID: 35938747 DOI: 10.1080/10826084.2022.2107674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Objective: To examine use and frequency patterns across e-cigarettes, cigarettes, and little cigars, cigarillos, and cigars (LCCs) over time. Methods: Data were obtained from the Truth Longitudinal Cohort (TLC), a nationally representative longitudinal cohort of youth and young adults. Latent class analysis was conducted to classify participants (n = 5274) into subgroups based upon frequency of use of cigarettes, e-cigarettes, and little cigars, cigarillos, and cigars (LCCs) in the past 30 days. Latent transition analysis was used to estimate the probability of use pattern transitions across 23 months (February 2018 to December 2019), adjusted for the effects of gender, race/ethnicity, financial situation, sensation seeking, parent education, and household smoking. Findings: Findings reveal four groups of tobacco product users: (1) frequent to daily cigarette users (9%), (2) frequent to daily cigarette and LCC users (3%), (3) frequent to daily e-cigarette users (10%), and (4) former or noncurrent tobacco users (78%). Although most respondents (69-94%) retained their initial user patterns during the observation period, results also indicate shifts between user groups. Notably, 14% of frequent to daily cigarette and LCC users transitioned to frequent to daily cigarette use, while 6% of frequent to daily cigarette and LCC users, 9% of frequent to daily cigarette users, and 4% of former or noncurrent tobacco users transitioned to frequent to daily e-cigarette use. Conclusion: Although most frequent to daily tobacco users stay with their primary product, there are transitions between frequent to daily cigarette, e-cigarette, and LCC use. Transition patterns may influence risk for nicotine addiction among youth and young adults. Thus, policies focused on preventing and reducing all tobacco use are needed to curb the risk of nicotine addiction among youth and young adults.
Collapse
Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Epidemiology, George Washington University Milken Institute of Public Health, Washington, DC, USA
| | | | - Donna M Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
22
|
Abstract
Purpose of Review The purpose of this review was to describe the state-of-the-literature on research specific to cannabis vaping among youth and young adults. Recent Findings Out of 1801 records identified, a total of 202 articles met eligibility criteria for inclusion in this review. Most of this literature (46.0% of studies) was specific to the health effects of cannabis vaping, particularly EVALI (e-cigarette and vaping associated lung injury). Other research areas identified in the review included the etiology (24.3%) and epidemiology (24.8%) of cannabis vaping, in addition to articles on regulation (8.4%) and marketing (5.5%) of the same. Summary Cannabis vaping is increasingly common among youth and young adults and more prevalent is settings where recreational use for adults has been legalized. The literature documents a number of negative health effects of cannabis vaping for young people, along with risk factors and reasons for the same. Supplementary Information The online version contains supplementary material available at 10.1007/s40429-022-00413-y.
Collapse
|
23
|
Audrain-McGovern J, Rodriguez D, Testa S, Pianin S. The Indirect Effect of Cigarette Smoking on e-Cigarette Progression via Substitution Beliefs. J Adolesc Health 2022; 70:140-146. [PMID: 34420821 PMCID: PMC8692338 DOI: 10.1016/j.jadohealth.2021.07.007] [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: 03/12/2021] [Revised: 06/14/2021] [Accepted: 07/01/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE This study sought to evaluate whether associations between adolescent combustible cigarette smoking and e-cigarette progression were explained by beliefs that e-cigarettes substitute for cigarettes in nonsmoking situations. METHODS Adolescents (N = 1,799) from public high schools outside of Philadelphia, PA, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade). RESULTS A parallel process latent growth curve model revealed that the pathway from baseline smoking to e-cigarette use trend through baseline e-cigarette substitution beliefs was significant (B = .02, z = 2.16, p = .03), indicating that the positive effect of greater baseline cigarette smoking on the rate of e-cigarette progression was channeled through e-cigarette substitution beliefs. The indirect effect from baseline smoking to e-cigarette use trend via e-cigarette substitution beliefs trend was also significant, albeit negative (B = -.05, z = -2.61, p = .009). The negative indirect effect suggested that the strong positive effect of baseline cigarette smoking on baseline substitution beliefs was followed by a slowing of the overall rate of change from baseline. Given that the total effect from baseline smoking to e-cigarette trend was not significant (p = .91), the results suggested complete mediation. CONCLUSIONS Among adolescents with greater use of combustible cigarettes, beliefs regarding the substitutability of e-cigarettes in nonsmoking situations appear to foster progression in e-cigarette use. Addressing these beliefs in the school setting and through media campaign messaging early in adolescence may help to prevent the use of e-cigarettes and combustible cigarettes.
Collapse
Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, LaSalle University, Philadelphia, Pennsylvania
| | - Shannon Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephen Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
24
|
Vogel EA, Henriksen L, Schleicher NC, Prochaska JJ. Young people's e-cigarette risk perceptions, policy attitudes, and past-month nicotine vaping in 30 U.S. cities. Drug Alcohol Depend 2021; 229:109122. [PMID: 34695673 PMCID: PMC8671354 DOI: 10.1016/j.drugalcdep.2021.109122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study examined young people's e-cigarette risk perceptions, policy attitudes, and past-month nicotine vaping in 30 US cities in relation to city e-cigarette retail policy. METHODS Participants ages 13-20 were recruited online September-November 2020 (N = 900, approximately 30 per city). Cities (median population = 688,531) were in 23 states. Ever e-cigarette users were oversampled. A multilevel generalized estimating equations (GEE) model compared past-month nicotine vaping as a function of local e-cigarette retail policy. Among ever-users, multilevel bivariate GEE models examined associations of participant characteristics with past-month vaping (yes/no) and, among past-month nicotine vapers, purchase of vaping products at a retail location (yes/no). RESULTS The sample (age M = 17.7 [SD = 1.8]) was 60.2% female and 29.3% Black. Minimal city-level variation was observed in e-cigarette risk perceptions or policy attitudes (ICCs < 0.001). Nearly half the sample (44.6%) reported ever e-cigarette use; 11.8% reported past-month nicotine vaping. Past-month nicotine vaping was associated with older age, being non-Hispanic white, living with someone who vapes, having friends who vape, greater exposure to retail e-cigarette ads, lower e-cigarette risk perceptions, and lower perceived efficacy of flavored tobacco policy. Among ever-users, past-month nicotine vaping was not significantly associated with city e-cigarette flavor policy (p = .784). Most participants reporting past-month nicotine vaping purchased products in-store (58.5%). CONCLUSIONS Among young people surveyed in US cities, e-cigarette risk perceptions and policy attitudes showed minimal between-city variation. Past-month vaping among ever-users did not differ significantly by local flavor policies. A majority of past-month users, regardless of city policies, reported underage access to flavored products in retail locations.
Collapse
|
25
|
Audrain-McGovern J, Rodriguez D, Pianin S, Testa S. Conjoint Developmental Trajectories of Adolescent E-cigarette and Combustible Cigarette Use. Pediatrics 2021; 148:peds.2021-051828. [PMID: 34635583 DOI: 10.1542/peds.2021-051828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In this study, we sought to identify which adolescents progress to regular electronic cigarette (e-cigarette) use (without cigarette smoking), which adolescents become dual users of both types of cigarettes, and how dual use develops across time. METHODS Adolescents (N = 1808) from public high schools outside Philadelphia, Pennsylvania, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade). RESULTS A sequential processes growth mixture model identified 4 conjoint latent classes: later, rapid e-cigarette uptake (class 1: n = 230); no use of e-cigarettes or combustible cigarettes (class 2: n = 1141); earlier, steady e-cigarette uptake (class 3: n = 265); and dual use of e-cigarettes and combustible cigarettes (class 4: n = 204). Using a rich set of potential risk factors, multinomial logistic regression assessed the likelihood of belonging to each conjoint class compared with the comparison class (dual use). Adolescents in the dual use class were characterized by a greater number and severity of e-cigarette and combustible cigarette risk factors. Adolescents in the 2 e-cigarettes-only classes were characterized by either e-cigarette-specific risk factors (earlier onset) or no risk factors (later onset). The no use class had an absence of risk factors for e-cigarette and cigarette use. CONCLUSIONS This study provides new prospective evidence for distinct patterns and profiles of adolescents who progress to current e-cigarette use, including adolescents who were initially cigarette smokers. The findings have implications for prevention intervention timing, tobacco product focus, content, and the adolescent subgroups to target.
Collapse
Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel Rodriguez
- Department of Public Health, School of Nursing and Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Stephen Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shannon Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
26
|
Adolescent depression symptoms and e-cigarette progression. Drug Alcohol Depend 2021; 228:109072. [PMID: 34571288 PMCID: PMC8595844 DOI: 10.1016/j.drugalcdep.2021.109072] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Depression symptoms are associated with the initiation of cigarette smoking and progression to regular use. Whether similar relationships exist between depression symptoms and adolescent e-cigarette progression has not been firmly established. METHODS This prospective longitudinal survey study measured the relationship between depression symptoms and e-cigarette use among 1822 adolescents from four public high schools outside of Philadelphia, PA. Adolescents completed in-classroom surveys at wave 1 (fall 2016, 9th grade) and 6-month intervals for the following 36 months (fall 2019, 12th grade). E-cigarette use, depression symptoms, and potential covariates were measured at each wave. A latent growth curve model was used to assess the longitudinal relationship between e-cigarette use and depression symptoms. RESULTS Baseline depressive symptoms had a significant effect on e-cigarette use trend (b = 0.01, z = 4.29, p < 0.0001) while holding other variables constant. A standard deviation increase in depressive symptoms at baseline was associated with a 0.25 standard deviation increase in the rate of e-cigarette progression across the following 36 months. By contrast, the path from baseline e-cigarette use to depressive symptoms trend was not significant (p = 0.74). CONCLUSIONS The present study provides new evidence for the effects of depression symptoms on adolescent e-cigarette progression. Greater depressive symptoms at age 14 years old were associated with a faster rate of e-cigarette escalation. However, e-cigarette use was not related to the development of depression symptoms over time. It will be important to examine whether adolescents with elevated depression symptoms respond similarly to e-cigarette prevention campaigns as adolescents in general.
Collapse
|
27
|
Fairman RT, Weaver SR, Akani BC, Dixon K, Popova L. "You have to vape to make it through": E-cigarette Outcome Expectancies among Youth and Parents. Am J Health Behav 2021; 45:933-946. [PMID: 34702440 DOI: 10.5993/ajhb.45.5.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objectives: Outcome expectancies are central to explaining health behavior and have been shown to predict tobacco use. Research on outcome expectancies for e-cigarette use among youth is scarce but increasingly important given the growing rates of use, particularly of high-nicotine pod devices and the recent outbreak of e-cigarette related lung disease. Methods: In 2019, we conducted 3 focus groups with middle school youth (N=25), 5 with high school youth (N=38), and 4 with parents (N=27). Youth and parents were not related and groups included both users and non-users. Participants discussed reasons for e-cigarette use and bad and good things that might happen to a person who vapes. Results: Participants described positive and negative psychoactive/sensory, social, and health-related outcome expectancies. Both youth and parents mentioned stress relief and appearing older as positive outcome expectancies, and e-cigarette flavors, acting rebellious, and structural opportunities as other reasons for initiating e-cigarette use. Social consequences and health outcomes were negative outcome expectancies deterring use. Conclusions: Regulations and public communication campaigns can counteract the positive outcome expectancies (flavor regulation, providing stress reduction tips) and capitalize on negative ones (communicating negative health outcomes) to decrease youth e-cigarette use.
Collapse
Affiliation(s)
- Robert T. Fairman
- Robert T. Fairman, Second Century Initiative Fellow, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Scott R. Weaver
- Scott R. Weaver, Associate Professor, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Bangaman C. Akani
- Bangaman C. Akani, Graduate Research Assistant, School of Public Health, Georgia State University, Atlanta, GA, United States. Also Assistant Lecturer, Department of Public Health, Felix Houphouet Boigny University, Abidjan,
Cote d'Ivoire
| | - Kristin Dixon
- Kristin Dixon, Health Promotion Director, Fulton County Board of Health, Atlanta, GA, United States
| | - Lucy Popova
- Lucy Popova, Associate Professor, School of Public Health, Georgia State University, Atlanta, GA, United States;,
| |
Collapse
|