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Ma H, Reynolds-Tylus T. Dynamic Norms and Vaping: A Test of Four Mediators. Subst Use Misuse 2024:1-10. [PMID: 39171828 DOI: 10.1080/10826084.2024.2392535] [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: 08/23/2024]
Abstract
Background: The prevalence of vaping among young people is a public health crisis. Social norms can contribute to the problem, but also to the solution. Objective: The current study examined young adults' responses to anti-vaping messages that varied on two features: social norms and behavioral framing. Methods: College students (N = 270) were randomly assigned to one of five conditions in a 2 (social norm: dynamic norm, static norm) X 2 (behavioral framing: vaping, not vaping) between-subjects factorial design with a no message control condition (n range = 49-58 in each condition). Results: Independent samples t-test, univariate analysis of variance, and structural equation modeling were used to test hypotheses and answer research questions. Results showed main effects of social norm, such that the dynamic (vs. static) norm message led to higher preconformity (p <.001) and self-efficacy (p = .012), and lower freedom threat (p = .040) and reactance (p < .001). There was also an indirect effect of dynamic norm on attitude as mediated by self-efficacy (p = .040). No main effect of behavioral framing was observed. Few interactions between social norm and behavioral framing were observed on preconformity (p < .001), anger (p < .001), and negative cognitions (p = .003). Conclusion: Overall, findings suggest a persuasive advantage for a dynamic norm relative to a static norm. Theoretically, these findings add to the literature suggesting the persuasiveness of dynamic norms. Practically, these results imply anti-vaping campaigns targeting young populations should communicate the changing (dynamic) norms in regard to (not) vaping.
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Affiliation(s)
- Haijing Ma
- College of Liberal Arts and Social Sciences, University of Houston-Victoria, Victoria, Texas, USA
| | - Tobias Reynolds-Tylus
- School of Communication Studies, James Madison University, Harrisonburg, Virginia, USA
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Chaffee BW, Cheng J, Couch ET, Halpern-Felsher B. Engagement, Mental Health, and Substance Use Under In-Person or Remote School Instruction During the COVID-19 Pandemic. THE JOURNAL OF SCHOOL HEALTH 2024; 94:501-508. [PMID: 38086782 PMCID: PMC11088987 DOI: 10.1111/josh.13418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 05/14/2024]
Abstract
BACKGROUND Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID-19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health-related outcomes within an adolescent cohort followed during the pandemic. METHODS During 3 semi-annual follow-up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self-efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting. RESULTS Relative to in-person instruction, students in remote instruction reported lower academic self-efficacy (Beta: -0.11; 95% confidence interval [CI]: -0.22, -0.01) and school connectedness (Beta: -0.37; 95% CI: -0.48, -0.25), greater odds of past 30-day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30-day e-cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86). CONCLUSIONS Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.
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Affiliation(s)
- Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Jing Cheng
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Elizabeth T. Couch
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Stanford University, 770 Welch Road Suite 100, Stanford, CA 94304
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Assaf RD, Hamad R, Javanbakht M, Arah OA, Shoptaw SJ, Cooper ZD, Gorbach PM. Associations of U.S. state-level COVID-19 policies intensity with cannabis sharing behaviors in 2020. Harm Reduct J 2024; 21:82. [PMID: 38622670 PMCID: PMC11020667 DOI: 10.1186/s12954-024-00987-y] [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: 07/27/2023] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Cannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves. METHODS This study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used Poisson regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic. RESULTS Participants (n = 925) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (74.9%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (16.7, IQR 12.3-21.5) compared to those who did not share (18.6, IQR 15.3-25.3). In adjusted models, the prevalence ratio of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score was 0.97 (95% CI 0.93, 1.01). CONCLUSIONS Fewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.
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Affiliation(s)
- Ryan D Assaf
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
- Department of Medicine, Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, University of California, San Francisco, CA, USA.
| | - Rita Hamad
- Department of Medicine, Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, University of California, San Francisco, CA, USA
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Statistics, University of California, Los Angeles, CA, USA
| | - Steven J Shoptaw
- Center for Behavioral and Addiction Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Family Medicine and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ziva D Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Pamina M Gorbach
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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4
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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.
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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.
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Nghiem VT, Jin J, Mennemeyer ST, Wong FL. Health-related risk behaviors among U.S. childhood cancer survivors: a nationwide estimate. BMC Cancer 2024; 24:180. [PMID: 38321375 PMCID: PMC10845633 DOI: 10.1186/s12885-024-11894-7] [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: 09/05/2023] [Accepted: 01/17/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Childhood cancer survivors (CCS) are subject to a substantial burden of treatment-related morbidity. Engaging in health protective behaviors and eliminating risk behaviors are critical to preventing chronic diseases and premature deaths. This study is aimed to provide updated information on currently smoking, physical inactivity, binge drinking patterns and associated factors among CCS using a nationwide dataset. METHODS We constructed a sample of CCS (cancer diagnosis at ages < 21y) and healthy controls (matched on age, sex, residency, race/ethnicity) using 2020 Behavioral Risk Factor Surveillance System. We used Chi-square tests and Wilcoxon rank-sum test to examine differences in sociodemographics and clinical characteristics between two groups. Logistic, ordinal regression and multivariable models (conditional models for matching) were used to determine factors associated with risk behaviors. RESULTS The final sample (18-80y) included 372 CCS and 1107 controls. Compared to controls, CCS had a similar proportion of binge drinking (~ 18%) but higher prevalence of currently smoking (26.6% vs. 14.4%, p < 0.001), physical inactivity (23.7% vs. 17.7%, p = 0.012), and of having 2-or-3 risk behaviors (17.2% vs. 8.1%, p < 0.001). Younger age, lower educational attainment, and having multiple chronic health conditions were associated with engaging in more risk behaviors among CCS. Females, compared to male counterparts, had lower odds of binge drinking (adjusted odds ratio (aOR) = 0.30, 95% confidence interval (CI): 0.16-0.57) among CCS but not in all sample. Having multiple chronic health conditions increased odds of both currently smoking (aOR = 3.52 95%CI: 1.76-7.02) and binge drinking (aOR = 2.13 95%CI: 1.11-4.08) among CCS while it only increased odds of currently smoking in all sample. DISCUSSION Our study provided risk behavior information for wide age-range CCS, which is currently lacking. Every one in four CCS was currently smoking. Interventions targeting risk behavior reduction should focus on CCS with multiple chronic health conditions.
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Affiliation(s)
- Van T Nghiem
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
| | - Jing Jin
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Stephen T Mennemeyer
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - F Lennie Wong
- Department of Population Sciences, City of Hope, Duarte, CA, USA
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Peña S, Ilmarinen K, Kestilä L, Ruokolainen O, Ollila H, Parikka S, Karvonen S. Changes in prevalence and sociodemographic correlates of tobacco and nicotine use in Finland during the COVID-19 pandemic. Eur J Public Health 2023; 33:844-850. [PMID: 37400989 PMCID: PMC10567130 DOI: 10.1093/eurpub/ckad104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on tobacco and nicotine use remains debated. We examined whether the prevalence of tobacco and nicotine use and nicotine-replacement therapy (NRT) changed during the COVID-19 pandemic and whether changes differed by sociodemographic groups. METHODS Repeated cross-sectional study of three national surveys in Finland (2018, 2019 and 2020; n = 58 526 adults aged 20 and over). Outcomes were daily and occasional smoking, smokeless tobacco (snus) use, e-cigarettes use, total tobacco or nicotine use and NRT use. We examined changes for each outcome by sex, age, educational tertiles, marital status, mother tongue and social participation. RESULTS Daily smoking decreased among males by 1.15 percentage points (pp) [95% confidence interval (CI) -2.10 to -0.20] between 2018 and 2020 and 0.86 pp among females (95% CI -1.58 to -0.15). Daily snus use remained stable in both sexes. Daily e-cigarette use was below 1% and remained stable. We found weak evidence of a reduction in total tobacco or nicotine use between 2018 and 2020 (males -1.18 pp, 95% CI -2.68 to 0.32 and females -0.8 pp, 95% CI -1.81 to 0.22). NRT use remained stable. Snus and NRT use decreased among 60- to 74-year-olds but remained stable in other age groups. We did not find evidence of interactions by subgroup for other outcomes. CONCLUSIONS Daily smoking decreased in Finland between 2018 and 2020, but other forms of tobacco use did not experience a reduction. The COVID-19 pandemic does not seem to have altered the sustained reduction of smoking in Finland, although substantial sociodemographic differences persist.
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Affiliation(s)
- Sebastián Peña
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Ilmarinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Kestilä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Parikka
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sakari Karvonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Kaur N, Stephens C. An Examination of Coping Strategies that Moderated the Effects of COVID-19-Related Stress on Anxiety Among Older Adults in Aotearoa/NZ. J Aging Health 2023:8982643231199141. [PMID: 37655482 PMCID: PMC11287957 DOI: 10.1177/08982643231199141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Objectives: 1. To describe perceived stress and changes in anxiety and coping among older adults between 2018 and 2020. 2. To examine the moderating roles of social support, exercise, alcohol use, and smoking on the relationship between perceived stress and anxiety. Methods: Longitudinal data collected from 3275 participants (M = 68.1 years) as part of the NZ Health, Work, and Retirement study's 2018 and 2020 biennial surveys, were analyzed using hierarchical regression. Results: Older adults perceived COVID-19 as a low-level source of stress. Social support and alcohol use moderated the relationship between perceived mental stress and anxiety. At high-stress levels, only social support exerted a protective effect against the negative impact of stress on anxiety. Discussion: These findings support the general resilience of many older adults and highlight the effectiveness of coping strategies used by those groups who are more likely to be vulnerable to mental stress during a pandemic.
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Affiliation(s)
- Navneet Kaur
- School of Psychology, Massey University, Palmerston North, New Zealand
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van Walbeek C, Hill R, Filby S. Quitting behavior during the tobacco sales ban in South Africa: Results from a broadly nationally representative survey. Tob Induc Dis 2023; 21:102. [PMID: 37551390 PMCID: PMC10398832 DOI: 10.18332/tid/168594] [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: 10/30/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION In response to COVID-19, the South African government banned the sale of tobacco products for 20 weeks. Before the ban, the illicit cigarette market was well-entrenched and smoking cessation services were not widely available. Several surveys conducted to ascertain cigarette smokers' responses to the ban reported substantial differences in the proportion of smokers who quit. This study provides a broadly nationally representative ex-post investigation into cigarette smokers' quitting behavior related to the sales ban. METHODS We used data from wave three of NIDS-CRAM (the National Income Dynamics Study-Coronavirus Rapid Mobile Survey) conducted in November-December 2020. We first investigated the proportion of people who quit and who continued smoking during and after the sales ban. We subsequently linked the NIDS-CRAM survey to the fifth wave of NIDS (2017) to identify a subset of established smokers, and considered whether their quitting behavior differed from that of all smokers who smoked at the start of the sales ban. RESULTS The cross-sectional analysis showed that 7.8% of cigarette smokers quit during the sales ban, but that 55% of these quitters relapsed after it was lifted. Of the pre-ban smokers, 3.5% indicated that they did not smoke both during and after the sales ban, and 3.7% quit after the ban was lifted. The longitudinal analysis showed that 7% of people who were smoking in 2017, quit smoking cigarettes during the tobacco sales ban, but that >70% of quitters relapsed after it was lifted. Only 2% of pre-ban established smokers indicated that they did not smoke during or after the ban. CONCLUSIONS The sales ban did not have the intended objective of encouraging large-scale smoking cessation. This reflects policy failures to provide smokers with appropriate cessation support and to effectively control the illicit market both prior to and during the sales ban.
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Affiliation(s)
- Corné van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Robert Hill
- Development Policy Research Unit, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Samantha Filby
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
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Assaf RD, Hamad R, Javanbakht M, Arah OA, Shoptaw SJ, Cooper ZD, Gorbach PM. Associations of U.S. state-level COVID-19 policies intensity with cannabis sharing behaviors in 2020. RESEARCH SQUARE 2023:rs.3.rs-3211086. [PMID: 37577641 PMCID: PMC10418562 DOI: 10.21203/rs.3.rs-3211086/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Cannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves. Methods This study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used logistic regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic. Results Participants (n = 975) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (75.1%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (15.3, IQR 11.3-19.0) compared to those who did not share (16.3, IQR 13.7-22.7). In adjusted models, the odds of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score were 0.78 (95% CI 0.58, 1.04). Conclusions Fewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.
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Affiliation(s)
- Ryan D Assaf
- Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco
| | - Rita Hamad
- Social Policies for Health Equity Research (SPHERE) Program, Department of Social and Behavioral Sciences, Harvard School of Public Health
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Steven J Shoptaw
- Family Medicine and Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Ziva D Cooper
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
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10
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Maheta B, Khan A, Skinner S, Dove M. Initial impacts of the COVID-19 pandemic on tobacco use among college students in California. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-6. [PMID: 37487206 PMCID: PMC10805952 DOI: 10.1080/07448481.2023.2232458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/19/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023]
Abstract
Objective: To evaluate the change in tobacco use by college students in California during the COVID-19 pandemic. Participants: Young adults (18-24 years) currently enrolled in a California college or university (N = 212). Methods: Students recruited through social media posts and by student tobacco advocate members completed an online survey of 59 questions in Spring 2021. Results: Almost 80% of current tobacco users reported a change in tobacco use during the pandemic. Most current tobacco users who changed their tobacco use reported an increase in use during the pandemic (43.2%) and 38.7% reported a decrease in use. Conclusion: As a result of COVID-19, many college students changed their tobacco use. As students return to campus and COVID-19 regulations are lifted, this may be an ideal time for prevention and cessation messages, which could include information on health risks associated with tobacco and e-cigarette use, and healthy methods for stress reduction.
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Affiliation(s)
| | - Afroze Khan
- Department of Molecular and Cell Biology, University of California, Berkeley
| | | | - Melanie Dove
- Department of Public Health Sciences, University of California, Davis
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11
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Cassidy RN, Bello MS, Denlinger-Apte R, Goodwin C, Godin J, Strahley AE, Wiseman KD, Hatsukami D, Donny E, Tidey JW, Colby SM. The impact of the COVID-19 pandemic on a sample of US young adults who smoke cigarettes: A qualitative analysis. Addict Behav 2023; 141:107650. [PMID: 36791643 PMCID: PMC9901227 DOI: 10.1016/j.addbeh.2023.107650] [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: 10/03/2022] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The ongoing COVID-19 pandemic has been associated with increased negative mood in youth, and a few reports of changes in tobacco use. We sought to increase the depth of knowledge on the effects of the pandemic on early young adult mood states, access to tobacco products and tobacco use behaviors, and knowledge of risks associated with tobacco use and COVID-19 by learning more about the lived experience of the pandemic among young adults early in their smoking trajectories. METHODS Semi-structured qualitative interviews were conducted with 25 young adults ages 18-20 (M = 19) who smoked cigarettes daily or nearly every day and had used electronic cigarettes (ECs) on ≥ 2 occasions in their lifetime. RESULTS Our results uncovered several themes: 1) The majority of teens experienced mental health disturbances as a result of the pandemic, which manifested as depression, anxiety, and/or acute loneliness due to social isolation; 2) tobacco purchasing behaviors sometimes changed, with both greater and less access reported among participants; 3) changes in tobacco use were also reported, with some reporting increases in use, others reporting decreases, and a few reporting quitting; and 4) while some youth reported that tobacco use could increase their risk related to COVID-19, the majority reported confusion and uncertainty about how tobacco use impacted their risk. CONCLUSIONS The themes identified specific factors that may account for the heterogeneity of impacts of the pandemic on tobacco use, and highlight the value of qualitative work for centering the lived experience of youth for understanding larger trends in substance use.
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Affiliation(s)
- Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University, United States.
| | - Mariel S Bello
- Center for Alcohol and Addiction Studies, Brown University, United States
| | - Rachel Denlinger-Apte
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, United States
| | - Christine Goodwin
- Center for Alcohol and Addiction Studies, Brown University, United States
| | - Julissa Godin
- Center for Alcohol and Addiction Studies, Brown University, United States
| | - Ashley E Strahley
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, United States
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, United States
| | | | - Eric Donny
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, United States
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, United States
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, United States
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12
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Ovung S, Nair S, Hijam M, Alee NT, Aheibam S, Singh SR, Da Costa EL, Siddiqui S, Sharma S, Singh L, Singh KJ, Haobijam N, Kaur H, Rao MVV. Smokeless Tobacco Use and Cessation Attempts during COVID-19 Lockdown: A Qualitative Study. Asian Pac J Cancer Prev 2023; 24:1979-1985. [PMID: 37378927 PMCID: PMC10505867 DOI: 10.31557/apjcp.2023.24.6.1979] [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: 01/31/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Smokeless tobacco (SLT) use among women is widely prevalent in Manipur state accounting for 45% users as per Global Adult Tobacco Survey (GATS)-2 India. Studies from India and elsewhere indicate changes in the way people used SLT during COVID-19 lockdown. This study explores individual and economic influences on SLT consumption and cessation attempts by tribal women in Manipur during the first COVID-19 lockdown (March-June, 2020) in India. METHODS Twenty in-depth interviews, both in-person and telephonically, were conducted among tribal women from Imphal west, Manipur, India, who used any SLT, from April to September 2020. Objective of the study was to understand the use, factors associated with consumption, purchasing behaviors, and cessation attempts of SLT during the lockdown. Thematic content analysis was used to identify core themes and codes. RESULTS Study participants reported of changes in current SLT use during restrictions imposed to contain COVID-19 pandemic in India. Majority reported of reduction or quit attempts in SLT use. Reasons included inaccessibility due to travel restrictions, limited availability and price rise of SLT products, fear of COVID-19, and disposable income for purchase of SLT products. However, a few women reported of increased consumption due to bulk purchasing, or switching to other SLT products as a result of unavailability or price rise of preferred products or to cope up with social isolation caused by the lockdown. CONCLUSION Study findings on factors influencing quit attempts and strategies used for reducing SLT use by tribal women in Imphal, Manipur provide valuable insights for development of appropriate intervention for prevention of SLT use among women.
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Affiliation(s)
- Senthanro Ovung
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Saritha Nair
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Meena Hijam
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | | | - Sharmila Aheibam
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Sagolsem Roshan Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Elsa Lumia Da Costa
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Saher Siddiqui
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Saurabh Sharma
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Lucky Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Kh. Jitenkumar Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
| | - Nirendra Haobijam
- Department of Community Medicine, Jawaharlal Institute of Medical Sciences, Imphal, Manipur, India.
| | - Harpreet Kaur
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
| | - M. Vishnu Vardhana Rao
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi, India.
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13
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Griffin S, DeFoor MG, Bail JR, Prevost S. Commentary on "Increased nicotine vaping due to the COVID-19 pandemic among US young adults: Associations with nicotine dependence, vaping frequency, and reasons for use". Prev Med 2023; 169:107410. [PMID: 36849055 PMCID: PMC9968474 DOI: 10.1016/j.ypmed.2022.107410] [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: 12/08/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 02/27/2023]
Abstract
This manuscript is a correspondence referencing an article published in Preventive Medicine.
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Affiliation(s)
- Sam Griffin
- Joint Nursing Science PhD Program, University of Alabama (UA)/University of Alabama in Huntsville (UAH), United States.
| | - Melissa G DeFoor
- University of North Alabama Anderson, College of Nursing and Health Professions, 147 Laura M. Harrison Hall, Florence, AL 35632, United States
| | - Jennifer R Bail
- University of Alabama in Hunstville, College of Nursing, 1610 Ben Graves Dr NW, Huntsville, AL 35816, United States
| | - Suzanne Prevost
- University of Alabama, Capstone College of Nursing, 650 University Blvd E, Tuscaloosa, AL 35401, United States
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14
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Do EK, Aarvig K, Donovan EM, Schillo BA, Vallone DM, Hair EC. Underage Youth Continue to Obtain E-Cigarettes from Retail Sources in 2022: Evidence from the Truth Continuous Tracking Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1399. [PMID: 36674152 PMCID: PMC9859475 DOI: 10.3390/ijerph20021399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: This study aims to describe the primary sources of e-cigarettes among young people and to explore how these sources may differ by individual-level characteristics. (2) Methods: Data were obtained from a cross-sectional, continuous tracking survey of participants. The analytic sample includes current e-cigarette users (aged 15-20 years) surveyed from January to August 2022 (N = 1296). Respondents provided information on e-cigarette source of acquisition, device type, and flavors used, as well as sociodemographic and residential characteristics. Chi-square tests were used to determine differences in source of acquisition by age, gender, race/ethnicity, United States (US) census region, urban-rural classification, flavors used, and device type. (3) Results: Although most current e-cigarette users obtained their devices through a social source (56.9%), a considerable proportion obtained e-cigarettes from a retail source (43.1%). The primary retail sources of e-cigarette acquisition were vape shops (22.0%) and gas station/convenience stores (15.9%). Source of e-cigarette acquisition differed by age, gender, US census region, flavors used, and device type, such that a lower proportion of those who were younger, female, residing in the West, and used vape pens had reported obtaining e-cigarettes via retail sources. (4) Conclusions: Results indicate that a significant proportion of youth report obtaining e-cigarettes from retail sources, despite the federal, state, and local policies that prohibit the sale of any tobacco products to those under the age of 21. Comprehensive retail regulations to help restrict tobacco product access are needed to reduce e-cigarette use among young people.
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Affiliation(s)
- Elizabeth K. Do
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Kathleen Aarvig
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
| | - Emily M. Donovan
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
| | | | - Donna M. Vallone
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Global Public Health, New York University, New York, NY 10003, USA
| | - Elizabeth C. Hair
- Schroeder Institute, Truth Initiative, Washington, DC 20001, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- School of Global Public Health, New York University, New York, NY 10003, USA
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15
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Adzrago D, Sulley S, Mamudu L, Ormiston CK, Williams F. The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms. Behav Sci (Basel) 2022; 12:453. [PMID: 36421749 PMCID: PMC9687156 DOI: 10.3390/bs12110453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although several studies examined the association between e-cigarettes, substance use, and mental health conditions, there is limited research on whether COVID-19-related stress and health outcomes, mental health symptoms, and substance use differ by the frequency of e-cigarette use during the COVID-19 pandemic. We assessed the association of past 30-day frequent use of e-cigarettes with alcohol, cannabis, anxiety/depression, and COVID-19 impact. METHODS We conducted a national online cross-sectional survey among a random sample of US adults aged 18 years or older (N = 5065) between 13 May 2021, and 9 January 2022. A multinomial logistic regression analysis was performed to assess the study aims. RESULTS Of the participants, 7.17% reported once to several times per month (OSTPM), 6.95% reported once to several times per week (OSTPW), and 6.57% reported every day to several times per day (ESTPD) use of e-cigarettes in the past month. Alcohol and cannabis use ESTPD and once to several times per week/month (OSTPW/M) were associated with a higher likelihood of e-cigarette use ESTPD and OSTPW/M, respectively. Anxiety/depression was associated with e-cigarette use ESTPD and OSTPW. Individuals who considered social distancing to be stressful were more likely to use e-cigarettes ESTPD and OSTPW/M compared to those that considered social distancing as not stressful. CONCLUSION Individuals who engaged in the frequent use of alcohol or cannabis, had depression/anxiety, and considered social distancing to be stressful were more likely to engage in frequent e-cigarette use. Improving efforts geared toward reducing the use of substances may help decrease the health risks associated with e-cigarette use.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Saanie Sulley
- National Healthy Start Association, 1325 G Street, Washington, DC 20005, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, 800 N. State College Boulevard, Fullerton, CA 92831, USA
| | - Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
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Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study. Addict Behav Rep 2022; 16:100470. [PMCID: PMC9661417 DOI: 10.1016/j.abrep.2022.100470] [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: 06/13/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in California in April 2021 were held to discuss tobacco and cannabis use patterns, adverse events, and the effect of COVID-19 on tobacco and cannabis product use. Factors affecting changes in use were largely similar between tobacco products and cannabis products. Drivers of increased cannabis use distinct from tobacco or nicotine product use included feeling greater freedom to disengage and perceptions of less harm. Increases in product use were a result of changing social environment, coping with emotional and psychological distress, and product related factors. Decreases in product use were a result of social isolation, COVID-19-related health concerns, disruptions in daily patterns of living, and reduced access. Improved understanding of how the pandemic has affected tobacco and cannabis use can inform tailored interventions to both support those who have decreases or quit and assist those who have increased use during the pandemic to reduce or cease their consumption.
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Wang X, Ma Z, Wang C. A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105979. [PMID: 35627516 PMCID: PMC9141667 DOI: 10.3390/ijerph19105979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China;
| | - Zaifei Ma
- School of Statistics, Renmin University of China, Beijing 100872, China;
| | - Chunan Wang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beihang Hangzhou Innovation Institute Yuhang, Hangzhou 310023, China
- MoE Key Laboratory of Complex System Analysis and Management Decision, Beijing 100191, China
- Correspondence:
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