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McCausland K, Booth S, Leaversuch F, Freeman B, Wolf K, Leaver T, Jancey J. Socio-ecological factors that influence youth vaping: perspectives from Western Australian school professionals, parents and young people. Int J Qual Stud Health Well-being 2024; 19:2322753. [PMID: 38416991 PMCID: PMC10903751 DOI: 10.1080/17482631.2024.2322753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/20/2024] [Indexed: 03/01/2024] Open
Abstract
PURPOSE To understand from the perspectives of school professionals, parents and young people the socio-ecological factors that may facilitate and prevent e-cigarette use among young people in Perth, Western Australia. METHODS Purposive sampling was used to recruit school professionals, parents and young people for one-on-one (n = 35) or joint (n = 3) interviews (in-person n = 11 or online n = 27). Data were analysed using thematic analysis and classified into four domains based on the socio-ecological model: i) individual, ii) interpersonal, iii) organizational/community and iv) societal/policy. RESULTS Factors that were found to support vaping among young people included sensation-seeking and risk-taking behaviour; a low-risk perception of vapes; attractive characteristics of vapes; ease of access; perception vaping is a social activity; and lack of knowledge about vaping among parents and school professionals. Vaping prevention messages originating from the familial, educational and community spheres are lacking but wanted by adults and young people. CONCLUSIONS The pervasiveness of the e-cigarette trade and persistent challenges related to surveillance and enforcement need to be addressed to reduce exposure and access to e-cigarettes. A mixture of "hard" and "soft" public policy tools involving key stakeholders in a range of settings is needed to prevent e-cigarette access and uptake by young people.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Sue Booth
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Francene Leaversuch
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Becky Freeman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Bentley, Western Australia, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Western Australia, Australia
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Stockings EA, Gardner LA, Newton NC. Vaping among young people-Our best defence is self-defence. Drug Alcohol Rev 2024; 43:355-358. [PMID: 37782572 DOI: 10.1111/dar.13746] [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: 05/11/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023]
Abstract
Use of electronic cigarettes (e-cigarettes or 'vapes') has risen rapidly among young Australians in recent years. To combat this, on 2 May 2023, the Albanese Government announced a suite of reforms to reduce the desirability and accessibility of e-cigarettes to young people-including a ban on disposable e-cigarettes, restricting flavours, colours and nicotine content and requiring pharmaceutical-like packaging. While many have welcomed this announcement, the efficacy of such reforms in reducing the availability of e-cigarettes to young people remain to be seen, particularly given the current prescription-only model has done little to curb youth vaping. We argue that, in an uncertain landscape where e-cigarettes will likely remain accessible and desirable to young people, it is critical that we also upskill, empower and arm our young people with the skills, resilience, resources and knowledge to make informed and positive health decisions so that: (i) fewer young people opt to take up vaping (primary prevention); and (ii) among those who already do vape, more seek help earlier on to reduce or cease their use before dependency develops (secondary prevention). Schools are an ideal setting for the delivery of these programs, where they can be delivered en masse, integrated into existing alcohol and other drug programs and aligned with school curricula. Skills-based school prevention programs have demonstrated significant and sustained reductions in drug-related harms up to 7 years post-intervention. For as long as vapes remain widely available, desirable and purposefully marketed towards young people, we believe our best defence is self-defence.
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Affiliation(s)
- Emily A Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Wang S, Nandy RR, Rossheim ME. Associations between e-cigarette use and sleep health among adults in the United States, NHANES 2015-2018. Sleep Med 2024; 114:220-228. [PMID: 38232605 DOI: 10.1016/j.sleep.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/01/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To examine the associations between e-cigarette use or dual (e-cigarette and combustible cigarette) use and short sleep duration and trouble sleeping among U.S. adults. METHODS We used 2015-2018 data from the National Health and Nutrition Examination Survey (NHANES) (n = 11,659). E-cigarette use and dual use were categorized as current, former, and never use. Short sleep duration was defined as sleep duration ≤6 h. Trouble sleeping was self-reported. Weighted logistic regression analyses were performed. RESULTS Among those with current e-cigarette use, 53.9 % were with current dual use and 23.8 % were with former dual use. Compared to never e-cigarette use, current e-cigarette use was associated with significantly higher odds of trouble sleeping (OR = 2.16, 95 % CI: 1.49-3.13), adjusting for potential confounders. Significant associations were also observed for former e-cigarette use versus never use with trouble sleeping (OR = 1.54, 95 % CI: 1.15-2.07) after full adjustment. Current cigarette use was associated with both short sleep duration (OR = 1.65, 95 % CI: 1.28-2.14) and trouble sleeping (OR = 1.36, 95 % CI: 1.03-1.79) after full adjustment. Additionally, the fully adjusted ORs for short sleep duration and trouble sleeping were 1.64 (95 % CI: 1.06-2.54) and 2.14 (95 % CI: 1.34-3.42) among those with current dual use, and 1.46 (95 % CI: 1.17-1.81) and 2.11 (95 % CI: 1.66-2.67) among those with former dual use, compared to those without dual use. CONCLUSIONS Current cigarette use or dual use is associated with significantly higher odds of short sleep duration and trouble sleeping. Moreover, former e-cigarette use or dual use is associated with increased odds of trouble sleeping.
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Affiliation(s)
- Shanshan Wang
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Rajesh R Nandy
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Phiri D, Amelia VL, Muslih M, Dlamini LP, Chung MH, Chang PC. Prevalence of sleep disturbance among adolescents with substance use: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:100. [PMID: 37633926 PMCID: PMC10464186 DOI: 10.1186/s13034-023-00644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/24/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE Sleep disturbance has become a major challenge among adolescents worldwide. Substance use is among the most common factors contributing to sleep disturbance. This systematic review and meta-analysis examined the prevalence and categories of sleep disturbance among adolescents with substance use. METHODS We comprehensively searched for relevant studies published in the following databases from inception to August 2022: CINHAL (via EBSCOhost), PubMed, Scopus, Ovid Medline, Embase, ProQuest, and Web of Science. Data analysis was performed using Comprehensive Meta-Analysis version 3 software. We used a random-effects model to pool prevalence rates with 95% confidence intervals (CIs). Forest plots and p values for the Cochran Q statistic were used to evaluate heterogeneity among studies. Subgroup and meta-regression analyses were performed to compare the groups and identify the sources of heterogeneity. RESULTS We examined 18 studies that reported insomnia, hypersomnolence, sleep-related breathing disorders as sleep disturbances among adolescents with the use of alcohol, smoking, marijuana, and coffee. The total sample was 124,554. The overall prevalence rate of sleep disturbance was 29% (95% CI: 0.201-0.403). Subgroup analysis revealed that the prevalence rates of insomnia and hypersomnolence were higher among alcohol users (31%; 95% CI: 0.100-0.654) and smokers (46%; 95% CI: 0.232-0.700). The study design and method of assessment groups were the significant moderators that showed the source of variation in the included studies. CONCLUSION Sleep disturbance is highly prevalent among adolescents with substance use. Insomnia and hypersomnolence are more prevalent among alcohol users and smokers, respectively. On the basis of our findings, health-care providers can develop effective targeted interventions to reduce substance use, prevent sleep disturbance, and promote healthy sleep habits among adolescents.
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Affiliation(s)
- Doreen Phiri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Vivi Leona Amelia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Universitas Muhammadiyah Purwokerto, Purwokerto, Central Java, Indonesia
| | - Muhammad Muslih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- School of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Indonesia
| | | | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
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Kreski NT, Ankrum H, Cerdá M, Chen Q, Hasin D, Martins SS, Olfson M, Keyes KM. Nicotine Vaping and Co-occurring Substance Use Among Adolescents in the United States from 2017-2019. Subst Use Misuse 2023; 58:1075-1079. [PMID: 37198725 PMCID: PMC10277150 DOI: 10.1080/10826084.2023.2188462] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Background: The use of electronic cigarettes (or "vaping") among adolescents remains a public health concern given exposure to harmful substances, plus potential association with cannabis and alcohol. Understanding vaping as it intersects with combustible cigarette use and other substance use can inform nicotine prevention efforts. Methods: Data were drawn from 51,872 US adolescents (grades 8, 10, 12, years: 2017-2019) from Monitoring the Future. Multinomial logistic regression analyses assessed links of past 30-day nicotine use (none, smoking-only, vaping-only, and any smoking plus vaping) with both past 30-day cannabis use and past two-week binge drinking. Results: Nicotine use patterns were strongly associated with greater likelihood of cannabis use and binge drinking, particularly for the highest levels of each. For instance, those who smoked and vaped nicotine had 36.53 [95% CI:16.16, 82.60] times higher odds of having 10+ past 2-week binge drinking instances compared to non-users of nicotine. Discussion: Given the strong associations between nicotine use and both cannabis use and binge drinking, there is a need for sustained interventions, advertising and promotion restrictions, and national public education efforts to reduce adolescent nicotine vaping, efforts that acknowledge co-occurring use.
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Affiliation(s)
- Noah T Kreski
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Hadley Ankrum
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Deborah Hasin
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
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Pan Z, Wang Q, Guo Y, Xu S, Pan S, Xu S, Zhou Q, Li L. Association of dual electronic cigarettes and marijuana use with sleep duration among adults from the United States, NHANES 2015–2018. Prev Med Rep 2023; 33:102190. [DOI: 10.1016/j.pmedr.2023.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
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Baiden P, Spoor SP, Nicholas JK, Brown FA, LaBrenz CA, Spadola C. Association between use of electronic vaping products and insufficient sleep among adolescents: Findings from the 2017 and 2019 YRBS. Sleep Med 2023; 101:19-27. [PMID: 36334497 DOI: 10.1016/j.sleep.2022.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/13/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Although studies have investigated the association between cigarette smoking and sleep outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) use and insufficient sleep among adolescents. The objective of this study was to investigate the cross-sectional association between the use of EVPs and insufficient sleep among adolescents. METHODS Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The dependent variable investigated was insufficient sleep, and the main independent variable was the use of EVPs. RESULTS Of the 28,135 adolescents, 22.6%, 19.2%, and 58.2% were current, former, and never users of EVPs, respectively. More than three in four adolescents (76.5%) did not obtain the recommended 8 h of sleep on an average school night. Controlling for demographic factors and other covariates, adolescents who currently used EVPs had 1.33 times higher odds of having insufficient sleep (AOR = 1.33, p < .001, 95% CI = 1.16-1.52), and adolescents who previously used EVPs had 1.29 times higher odds of having insufficient sleep (AOR = 1.29, p < .001, 95% CI = 1.15-1.44) when compared to adolescents who had never used EVPs. Adolescents were more likely to get insufficient sleep if they were older, non-Hispanic Black, had symptoms of depression, experienced suicidal ideation, engaged in excessive screen-time behaviors, or currently used alcohol. Physical activity had a protective effect on insufficient sleep. CONCLUSION This study found that EVPs use was associated with insufficient sleep among adolescents over and above demographic and other covariates. As EVP use increases among adolescents, it is important to consider the potential impact on multiple domains, including sleep. Future studies that employ longitudinal designs may offer additional insight into the mechanisms underlying the association between EVPs use and insufficient sleep.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA.
| | - Samantha P Spoor
- University of Wyoming, Department of Psychology, 1000 E. University Ave, Laramie, WY, 82071, USA
| | - Julia K Nicholas
- University of Louisville, Department of Psychological and Brain Sciences, Room 307 Life Sciences Building, Louisville, KY, 40292, USA
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX, 76019, USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
| | - Christine Spadola
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
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Sutherland BD, Viera Perez PM, Crooks KE, Flannery JS, Hill-Bowen LD, Riedel MC, Laird AR, Trucco EM, Sutherland MT. The association of amygdala-insula functional connectivity and adolescent e-cigarette use via sleep problems and depressive symptoms. Addict Behav 2022; 135:107458. [PMID: 35998541 PMCID: PMC9730909 DOI: 10.1016/j.addbeh.2022.107458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/16/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adolescent electronic cigarette (e-cigarette) use remains high. Elucidating contributing factors may enhance prevention strategies. Neurobiologically, amygdala-insula resting-state functional connectivity (rsFC) has been linked with aspects of sleep, affect, and substance use (SU). As such, we hypothesized that amygdala's rsFC with the insula would be associated with e-cigarette use via sleep problems and/or depression levels. METHODS An adolescent sample (N = 146) completed a rs-fMRI scan at time 1 and self-reports at time 2 (∼15 months later). Given consistent associations between mental health outcomes and the rsFC of the laterobasal amygdala (lbAMY) with the anterior insula, we utilized a seed region (lbAMY) to region of interest (ROI) analysis approach to characterize brain-behavior relationships. Two serial mediation models tested the interrelations between amygdala's rsFC with distinct anterior insula subregions (i.e., ventral insula [vI], dorsal insula [dI]), sleep problems, depression levels, and days of e-cigarette use. RESULTS An indirect effect was observed when considering the lbAMY's rsFC with the vI. Greater rsFC predicted more sleep problems, more sleep problems were linked with greater depressive symptoms, and greater depressive symptoms were associated with more e-cigarette use (indirect effect = 0.08, CI [0.01,0.21]). Indicative of a neurobiological dissociation, a similar indirect effect linking these variables was not observed when considering the lbAMY's rsFC with the dI (indirect effect = 0.03, CI [-0.001,0.10]). CONCLUSIONS These outcomes highlight functional interactions between the amygdala and insula as a neurobiological contributor to sleep problems, depressive symptoms, and ultimately SU thereby suggesting potential intervention points to reduce teen e-cigarette use.
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Affiliation(s)
| | | | - Katharine E Crooks
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica S Flannery
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, United States
| | - Lauren D Hill-Bowen
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael C Riedel
- Department of Physics, Florida International University, Miami, FL, United States
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, FL, United States; Addiction Center, University of Michigan, Ann Arbor, MI, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States
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Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013687. [PMID: 36294263 PMCID: PMC9603628 DOI: 10.3390/ijerph192013687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND A high prevalence of dual use of e-cigarettes and conventional cigarettes has been reported across the world. METHODS A systematic search was carried out. We included original articles on any topic relevant to health, excluding mental health, in all languages. The PRISMA guidelines were followed. Both reviewers independently screened and read all publications. We compared dual use with exclusive smoking of conventional cigarettes (ESCC). RESULTS Fifty-two publications (49 studies) were included. Thirteen papers/10 studies were prospective. There was great heterogeneity across studies. Many methodological weaknesses, such as inaccurate exposure measurement, lack of adjustment for former tobacco consumption, and lack of significance testing were identified. Most prospective studies found dual use to be at least as harmful as ESCC. The longest follow-up was six years. Most of the best available cross-sectional studies found dual use associated with the same and, in several studies, significantly higher risk of self-reported symptoms/disease than in ESCC. The intensity of cigarette smoking seems associated with worse health. CONCLUSION Existing studies indicate that dual use is at least as, or probably even more, harmful than ESCC. Due to the predominance of cross-sectional studies and the methodological weaknesses we judged the overall certainty of the evidence as "low certainty".
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Affiliation(s)
- Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
- Danish Heart Foundation, 1120 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Sofie K. Bergman Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
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Gunge D, Marganski J, Advani I, Boddu S, Chen YJE, Mehta S, Merz W, Fuentes AL, Malhotra A, Banks SJ, Alexander LEC. Deleterious Association of Inhalant Use on Sleep Quality during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413203. [PMID: 34948812 PMCID: PMC8703610 DOI: 10.3390/ijerph182413203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic generated large amounts of stress across the globe. While acute stress negatively impacts health, defining exact consequences and behavioral interventions can be difficult. We hypothesized that a generalized increase in stress and anxiety caused by continuation of the global pandemic would negatively impact sleep quality and that ever users of e-cigarettes and conventional tobacco would have more profound alterations over time. Participants were recruited via social media to complete an online survey in April 2020 (n = 554). Inhalant use was assessed through the UCSD Inhalant Questionnaire and sleep quality was gauged through the Pittsburgh Sleep Quality Index (PSQI). A set of participants (n = 217) retook the survey in June 2020. Inhalant users—historical or current e-cigarette vapers, conventional tobacco smokers, and dual users—had higher PSQI scores than never smoker/never vapers, demonstrating worse sleep quality in inhalant users. Non-smoking/non-vaping subjects who retook the survey in June 2020 had improvement in their PSQI scores by paired t test, indicating better sleep quality as the pandemic continued, while inhalant users of all types had persistently high PSQI scores (poor sleep quality). These data suggest that ever users of tobacco products may be susceptible to overall diminished sleep quality in the setting of stressful life circumstances. These data also suggest that pandemic-initiated lifestyle changes may have led to improvements in sleep quality. Finally, these findings raise concerns for correlations between either past or active e-cigarette use on sleep, and thus overall health.
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Affiliation(s)
- Deepti Gunge
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Jordan Marganski
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Ira Advani
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Shreyes Boddu
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Yi Jan Ella Chen
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Sagar Mehta
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - William Merz
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Ana Lucia Fuentes
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Atul Malhotra
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
| | - Sarah J. Banks
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
- Department of Neurosciences, Division of Pulmonary, University of California San Diego (UCSD), La Jolla, CA 92093, USA
| | - Laura E. Crotty Alexander
- Department of Medicine, Pulmonary Critical Care Section, Veterans Affairs (VA) San Diego Healthcare System, La Jolla, CA 92161, USA; (D.G.); (I.A.); (Y.J.E.C.); (S.M.); (W.M.); (A.L.F.); (A.M.); (S.J.B.)
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA; (J.M.); (S.B.)
- Correspondence: ; Tel.: +1-619-438-4207
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