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Garcia BDFS, Nascimento BDB, Marques EF, Jesus CBDD, Santana Neto IC, Rocha LST, Oliveira GMSD, Bazaglia da Silva MI, Kasai MLHI, Takahama Junior A. The use of electronic cigarettes and other tobacco products among university students and their potential relationship with oral health: A cross-sectional study. J Am Dent Assoc 2024; 155:647-656. [PMID: 38878025 DOI: 10.1016/j.adaj.2024.04.012] [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: 09/19/2023] [Revised: 03/20/2024] [Accepted: 04/19/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND The aim of this study was to evaluate oral alterations among university students and explore possible associations with tobacco consumption in its various forms. METHODS A cross-sectional study was conducted in 2 phases: the first phase involved administering an electronic questionnaire to participants determine the prevalence of tobacco use and the second phase involved a physical examination of the participants. The participants were grouped on the basis of their reported habits and compared using statistical analysis (P < .05). RESULTS Of the 620 participants, 57.1% reported using tobacco in some form, with 47.4% reporting electronic cigarette (e-cigarette) use. In the clinical phase, comparing the presence of oral changes in tobacco users vs nonusers, e-cigarette users had a higher proportion of white-spot caries lesions (P = .041) and gingivitis (P = .012). When e-cigarette use was combined with other forms of tobacco use, additional oral changes were more prevalent, including coated tongue and nicotinic stomatitis (P < .05). CONCLUSIONS The use of alternative forms of tobacco consumption is common among university students, with e-cigarette use being the most prevalent form, and may lead to detrimental effects on the oral cavity, such as caries and gingivitis, particularly when used in conjunction with other tobacco products. PRACTICAL IMPLICATIONS The use of tobacco in alternative forms, such as e-cigarettes, can affect oral health directly or indirectly. Dentists should be familiar with the characteristics of this population and the potential oral repercussions associated with tobacco use to address the impact on health and raise awareness of the associated risks.
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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.
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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
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Awua J, Tuliao AP, Gabben-Mensah D, Kanjor F, Botor NJB, Ohene L, Meisel MK. Interpersonal communication and perceived norms as social influence mechanisms of e-cigarette use among adults: a systematic review. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:291-304. [PMID: 38832973 DOI: 10.1080/00952990.2024.2346928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 06/06/2024]
Abstract
Background: Given the increasing popularity of e-cigarette use among adults and the ongoing debate about the benefits and the potential adverse health risks associated with e-cigarette use, it is critical to identify the correlates of e-cigarette use. Prior research has found associations between interpersonal communication, perceived norms, and adults' e-cigarette use, but the evidence has yet to be summarized and synthesized.Objectives: This paper reviewed empirical studies examining the relationship between interpersonal communication, perceived norms, and e-cigarette use among adults.Methods: Following PRISMA guidelines, articles were searched on DOAJ, EMBASE, Europe PubMed Central, Google Scholar, PsychINFO, PubMed, Web of Science, and the reference list of the retrieved studies for studies that examined social influence on e-cigarette use. Three reviewers independently screened 1,713 non-duplicate papers and further screened the full text of 195 articles for inclusion.Results: Thirty studies (30), consisting of quantitative (n = 25) and qualitative (n = 5) data, were included in this review. The twenty-five (25) quantitative studies consisted of both cross-sectional (n = 20) and longitudinal (n = 5) studies. Interpersonal communication portraying e-cigarettes as beneficial or harmful was found to increase e-cigarette use and quit attempts, respectively. Across study designs, greater perceptions of others' e-cigarette use or approval were related to more frequent e-cigarette use.Conclusions: The findings highlight that e-cigarette-related interpersonal communication and perceived norms are associated with e-cigarette use. These factors may be useful targets in brief interventions. However, most of the included studies were cross-sectional, limiting the ability to establish clear cause-and-effect relationships; therefore, more longitudinal studies are needed.
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Affiliation(s)
- Joshua Awua
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Antover P Tuliao
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Francis Kanjor
- Counseling Department, Bantuk Rehabilitation and Recovery Centre, Accra, Ghana
| | - Nephtaly Joel B Botor
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Lilian Ohene
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Matthew K Meisel
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
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Boutouis S, Wymbs F, Franz B. The association between marijuana and e-cigarette use and exercise behavior among adults. Prev Med Rep 2024; 40:102668. [PMID: 38469398 PMCID: PMC10926305 DOI: 10.1016/j.pmedr.2024.102668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 03/13/2024] Open
Abstract
Background As the prevalence of marijuana and e-cigarette use among American adults rises and the perceived risk decreases, more information is needed on the potential costs and benefits of marijuana and e-cigarette use, including patterns of exercise. Prior studies have found mixed results, lacked data on types of exercise, and involved only adolescents and young adults. Thus, the current study explored whether marijuana and e-cigarette use are associated with strength training, walking for exercise, or general physical activity among adults in the United States. Method 2,591 adults from Wave V of the National Longitudinal Study of Adolescent to Adult Health (2016-2018) comprised the sample. Separate one-way analyses of variance (ANOVAs) and post hoc tests examined whether participants' marijuana and e-cigarette use predicted their exercise, while follow-up analyses of covariance (ANCOVAs) probed significant effects. Results Results indicated that participants' marijuana and e-cigarette use predicted their walking for exercise, with marijuana users walking the highest number of times per week, followed by non-users, e-cigarette users, and dual users. However, this effect only approached significance after controlling for covariates. There were no significant differences in strength training or general exercise between groups. Conclusion These findings challenge the stereotype that marijuana and e-cigarette users are less active than non-users, and future research should examine the potential mechanisms of these findings.
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Zou W, Wang X, Yang N, Ni X, Zhao Z, Meng R, Ma H. The intention of college students to use electronic cigarettes: A study based on the theory of innovation diffusion. Tob Induc Dis 2024; 22:TID-22-53. [PMID: 38496253 PMCID: PMC10941754 DOI: 10.18332/tid/185644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The purpose of this study is to examine the use of electronic cigarettes (e-cigarettes) among college students in Hangzhou, and to analyze the influencing factors of their intention to use e-cigarettes. METHODS Using a stratified cluster sampling method, 775 students from two universities in Hangzhou were selected for an on-site questionnaire survey from March to April 2022. Adjusted logistic regression analysis was conducted on the influencing factors of use intention, based on innovation diffusion theory. RESULTS Within our sample of college students, 16.5% of students had tried e-cigarettes; 6.32% had used e-cigarettes in the past month, and 8.0% had the intention to use e-cigarettes. There were significant differences in willingness to use e-cigarettes among different genders, economic status, smoking status of close friends around them, and their own use of tobacco and alcohol (p<0.05). The logistic regression model showed that the observability of e-cigarettes (AOR=1.28; p<0.05), personal factors (AOR=1.39; p<0.05), and social systems (AOR=1.63; p<0.05), were all influencing factors of intention to use e-cigarettes. CONCLUSIONS College students in Hangzhou have a high intention to use e-cigarettes, and the impacts of the product itself, individual characteristics and the living environment are crucial. It is necessary to strengthen the promotion of tobacco knowledge at the social and family levels to reduce the occurrence of vaping.
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Affiliation(s)
- Wenjing Zou
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaowen Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaoqing Ni
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhaoyang Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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Nabil AK, Barry AE, Kum HC, Ohsfeldt RL. Actual and perceived E-cigarettes behaviors among a national sample of U.S. college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:109-117. [PMID: 35025725 DOI: 10.1080/07448481.2021.2024209] [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: 03/03/2021] [Revised: 10/21/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Objective: Electronic cigarette use represents an important college health concern. This investigation assessed demographic and behavioral correlates associated with actual and perceived e-cigarette use among a national sample of American college students. Methods: Respondents (n = 19,861) comprised college students from over 40 distinct American higher education institutions. Multivariable logistic regression assessed whether (1) alcohol, tobacco or marijuana use were associated with e-cigarette use; (2) perceived peer use of alcohol, tobacco or marijuana were associated with perceived e-cigarette use. Results: Approximately 5% of survey respondents self-reported using e-cigarettes within the past month. More than 7 out of every 10 respondents, however, thought the 'typical student' was an e-cigarette user. As perceptions of typical student substance use increased, respondents were far more likely to contend the typical student used e-cigarettes. Discussion: In addition to adopting smoke-free campus policies, university officials should disseminate accurate information regarding e-cigarette behaviors of students.
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Affiliation(s)
- Anas Khurshid Nabil
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Hye-Chung Kum
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Robert L Ohsfeldt
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
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Marx JM, Miller A, Windsor A, Locke J, Frazier E. Perceptions of cigarettes and e-cigarettes: does health literacy matter? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2595-2603. [PMID: 34635027 DOI: 10.1080/07448481.2021.1979008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 06/01/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study assessed the relationship between health literacy, perceptions of traditional and electronic cigarettes, and smoking status among college students. PARTICIPANTS Participants (N = 150; Mage= 20.41 years, SD 3.48), included nonsmokers (78%) and smokers (21%) of traditional (12%) and e-cigarettes (17%). METHOD Participants completed a novel questionnaire to assess perceptions of traditional and e-cigarettes, and the Health Literacy Skills Instrument to evaluate health literacy. RESULTS Traditional cigarettes were perceived as having a greater negative impact on physical health than e-cigarettes, whereas e-cigarettes were perceived as having a greater positive impact on social-emotional health than traditional cigarettes. Most participants (57%) had below basic health literacy skills. CONCLUSIONS This study did not find a relationship between health literacy skills and smoking status or smoking perceptions. Further research is needed to investigate correlates of smoking status and perceptions to inform prevention and cessation efforts.
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Affiliation(s)
- Jenna M Marx
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Alyssa Miller
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Alexa Windsor
- Loyola University of Maryland, Baltimore, Maryland, USA
| | - Jasmine Locke
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
| | - Emily Frazier
- Department of Psychology, Lebanon Valley College, Annville, Pennsylvania, USA
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Kim K. Scanned information exposure and support for tobacco regulations among US youth and young adult tobacco product users and non-users. HEALTH EDUCATION RESEARCH 2023; 38:426-444. [PMID: 37565566 PMCID: PMC10516358 DOI: 10.1093/her/cyad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023]
Abstract
The influences of information exposure on youth and young adults' (YYA) support for smoking/vaping regulations have been understudied. This study examines (i) the relationships between routine exposure to (i.e. scanning) anti-smoking/pro-vaping information and YYA support for anti-smoking/vaping regulations and (ii) whether these relationships differ across YYA users and non-users of tobacco products. We analyzed the data from a nationally representative two-wave rolling cross-sectional survey of YYA in the United States, collected from 2014 to 2017 (baseline n = 10 642; follow-up n = 4001). Less than 5% of the participants ever scanned pro-smoking and anti-vaping information. Scanning anti-smoking information had significant positive relationships with support for all anti-smoking policies cross-sectionally, and this pattern was longitudinally significant in two anti-smoking policy contexts. Scanning pro-vaping information had significant negative associations with support for anti-vaping policies cross-sectionally, but not longitudinally. The lagged positive relationships between scanning anti-smoking information and support for anti-smoking regulations were stronger among YYA smokers than among YYA non-smokers, whereas evidence from adult data suggested the opposite pattern. The findings suggest that scanning information can affect YYA support for tobacco regulations. Future efforts are required to investigate mechanisms underlying the influences of scanned information on YYA support for tobacco regulations.
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Affiliation(s)
- Kwanho Kim
- Department of Communication, Cornell University, 494 Mann Library Building, Ithaca, NY 14853, USA
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Pebley K, Mallawaarachchi I, Krukowski RA, Morris JD, Little MA. Sexy, trashy, cool: Perceptions of electronic cigarette users across sociodemographic groups and E-cigarette use among United States Air Force Airmen. Prev Med Rep 2023; 34:102250. [PMID: 37252065 PMCID: PMC10209875 DOI: 10.1016/j.pmedr.2023.102250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
E-cigarette use has increased in recent years. Military personnel have higher rates of e-cigarette use than civilian populations, with 15.3% of Air Force recruits using e-cigarettes. The current study assessed associations between perceptions of e-cigarette users and current use of e-cigarettes, and differences in sociodemographic characteristics to determine if there were different beliefs among different groups to inform intervention development among these straight-to-work young adults. Participants (N = 17,314) were United States Air Force Airmen (60.7% White, 29.7% women) who completed a survey during their first week of Technical Training. Regression results indicated that identifying as a man (B = 0.22, SE = 0.02), identifying as Black (B = 0.06, SE = 0.02), reporting younger age (B = -0.15, SE = 0.02), having less education (B = -0.04, SE = 0.02), and current e-cigarette use (B = 0.62, SE = 0.02) were associated with endorsing more positive e-cigarette user perceptions. Identifying as a woman (B = -0.04, SE = 0.02) and being younger (B = -0.06, SE = 0.02) were associated with endorsing more negative perceptions of e-cigarette users. Current e-cigarette use was inversely associated with negative e-cigarette user perceptions (B = -0.59, SE = 0.02). Differences across groups were found for individual e-cigarette user characteristics. Future intervention strategies among Airmen may benefit from addressing e-cigarette user perceptions to change use behaviors, as these perceptions may result in stigmatized beliefs related to e-cigarette users.
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Affiliation(s)
- Kinsey Pebley
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN 38152, United States
| | - Indika Mallawaarachchi
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA 22903, United States
| | - Rebecca A. Krukowski
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA 22903, United States
| | - James D. Morris
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN 38152, United States
| | - Melissa A. Little
- University of Virginia, School of Medicine Department of Public Health Sciences, 560 Ray C. Hunt Drive, Charlottesville, VA 22903, United States
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Tran DD, Morrell HER. E-Cigarette Use: The Effects of Psychological Vulnerabilities, Perceptions, and Intentions to Use E-Cigarettes. Psychol Rep 2023:332941231161277. [PMID: 36869868 DOI: 10.1177/00332941231161277] [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: 03/05/2023]
Abstract
Little research has examined the effects that psychological vulnerabilities (i.e., difficulty with emotion regulation, depressed mood, distress tolerance) have on the perceptions of e-cigarettes, intent to use e-cigarettes, and actual e-cigarette use. Data were collected via an online survey from 837 adults (55.6% male, Mage = 29.2, 71.7% Caucasian). The two path analytic models predicting lifetime and current use fit the data well. Difficulty with emotion regulation was positively associated with depressed mood and negatively associated with distress tolerance, while distress tolerance was negatively associated with depressed mood. Depressed mood was positively associated with perceived benefits of e-cigarette use, and perceived benefits was positively associated with intent to use. Perceived benefits and intent to use were significantly associated with both lifetime and current use. Findings enhance our understanding of the effects that mood and emotion-related factors have on perceptions of, intent to use, and actual use of e-cigarettes, which may have important implications for prevention and cessation.
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Affiliation(s)
- Denise D Tran
- Department of Psychology, 166486Loma Linda University, Loma Linda, CA, USA
| | - Holly E R Morrell
- Department of Psychology, 166486Loma Linda University, Loma Linda, CA, USA
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Sheer VC. The State of Norm-Based Antismoking Research: Conceptual Frameworks, Research Designs, and Implications for Interventions. HEALTH COMMUNICATION 2023; 38:310-325. [PMID: 34256674 DOI: 10.1080/10410236.2021.1950296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This synthesis review examined 189 qualified studies on norms and smoking in terms of conceptual frameworks, types of social norms, research designs, dependent variables, independent variables and covariates, and findings related to norms. Results show that 7.9% were experimental, and the remaining were cross-sectional. By far, the reasoned action approach (RAA) was the most-cited theory, but RAA was not used to guide experimental designs. The social norms approach, norm focus theory, social cognitive theory guided the intervention experiments. Harmful norms were more frequently examined than healthful norms. Pro-smoking norms positively predicted smoking intentions and behaviors, whereas antismoking norms positively predicted antismoking intentions and behaviors. The over-application of RAA in cross-sectional antismoking research has yielded repetitive findings. Norm-based experiments can adopt other theoretical perspectives to offer insights into antismoking interventions. The RAA constructs are still applicable and can be integrated into intervention designs.
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Affiliation(s)
- Vivian C Sheer
- Department of Communication Studies, Hong Kong Baptist University
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13
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Yang M, Russell AM, Barry AE, Merianos AL, Lin HC. Stealth vaping and associated attitudes, perceptions, and control beliefs among US college students across four tobacco-free campuses. Addict Behav 2023; 136:107490. [PMID: 36113279 DOI: 10.1016/j.addbeh.2022.107490] [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: 05/21/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Stealth vaping gained popularity among college students in recent years. It may undermine the benefits introduced by tobacco-free policies. Yet, no studies have investigated attitude and belief factors associated with stealth vaping. The objective of the study was to explore the relationship between attitudes toward on-campus tobacco regulations, normative perceptions of stealth vaping behaviors, and control beliefs with on-campus stealth vaping among U.S. college students. METHODS Participants from four large, public universities with policies prohibiting use of all forms of tobacco (including e-cigarettes) on campus (N = 863) completed an online survey in Fall 2020. On-campus stealth vaping behavior was captured by past 30-day stealth vaping status and frequency. Hurdle models with logistic and negative binomial regressions were conducted, where stealth vaping status was treated as a binary variable based on the non-zero and zero frequency, and stealth vaping frequency was treated as a count variable. Multiple imputation by chained equations was employed to handle the missing data. RESULTS Participants with more positive attitudes toward regulating on-campus tobacco use were less likely to practice stealth vaping on campus (OR = 1.16, p < 0.01 [predicting zero]). Those with higher perceptions of stealth vaping among other students were more likely to stealth vape more frequently (IRR = 1.03, p < 0.01). CONCLUSION Our results highlight the need for interventions to address students' attitudes and normative beliefs about stealth vaping. Efforts are needed to educate college students about the risk of e-cigarettes and to enhance enforcement of campus tobacco-free policies.
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Affiliation(s)
- Meng Yang
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47405, USA
| | - Alex M Russell
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA
| | - Adam E Barry
- Department of Health Behavior, Texas A&M University, College Station, TX 77843, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47405, USA.
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Le HTT, Tran ATV, Nguyen AQ, Tran TTT. E-Cigarette Use among University Students from One University in Hanoi, Vietnam, and Associated Factors. Asian Pac J Cancer Prev 2022; 23:3649-3655. [PMID: 36444576 PMCID: PMC9930945 DOI: 10.31557/apjcp.2022.23.11.3649] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Describe the use of e-cigarettes and factors associated with e-cigarette use among university students from one university in Vietnam in 2021. METHODS This cross-sectional study was conducted with a total of 554 full-time undergraduate students recruiting for the study. Data was collected using a structured self-administered questionnaire. A logistic regression analysis was performed to identify factors with significant association with students' use of e-cigarettes. RESULTS The study revealed that 13.2% of students were current users. Students who had e-cigarette smokers in the family (aOR=6.1, 95% CI: 2.5-15.4; p<0.001), used traditional cigarettes (aOR=23.6, 95% CI: 10.5-53.4; p<0.001), consumed alcohol (aOR=5, 95%CI: 1.6 - 15.9; p<0.01), were exposed to e-cigarette advertising (aOR=2.6; 95%CI: 1.1-5.9; p<0.01), and had inadequate knowledge about e-cigarettes (aOR=2.2; 95%CI: 1-4.7; p<0.01) were more likely to use e-cigarettes. CONCLUSION This study updates the status of e-cigarette use among students in one university in Vietnam, thereby suggesting strategies to reduce the use of e-cigarettes among university students.
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Affiliation(s)
- Huong Thi Thanh Le
- Nguyen Quynh Anh, Hanoi University of Public Health, 1A Duc Thang, Duc Thang Ward, North Tu Liem District, Hanoi 100000, Vietnam.
| | - Anh Thi Van Tran
- The University of North Carolina at Chapel Hill, Hanoi 100000 Viet Nam.
| | - Anh Quynh Nguyen
- Nguyen Quynh Anh, Hanoi University of Public Health, 1A Duc Thang, Duc Thang Ward, North Tu Liem District, Hanoi 100000, Vietnam. ,For Correspondence:
| | - Thuy Thi Thu Tran
- Nguyen Quynh Anh, Hanoi University of Public Health, 1A Duc Thang, Duc Thang Ward, North Tu Liem District, Hanoi 100000, Vietnam.
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15
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Katz SJ, Cohen EL, Kinzer HT. "Can I hit that?" Vaping knowledge, attitudes and practices of college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1778-1787. [PMID: 33048639 DOI: 10.1080/07448481.2020.1820512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/27/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Objective: Vaping rates among college students have been increasing significantly in recent years, due in large part to the diffusion of pod vaping devices (i.e., JUUL, Suorin) on American college campuses. In this study, we explore the ecological system of knowledge, attitudes, and practices in regards to this trend. Participants: Participants were 26 undergraduate students at the University of Minnesota. Method: Following a KAP (knowledge, attitudes, practices) approach, 8 focus groups were conducted in April/ May 2019. Results: Knowledge themes include awareness of the addictiveness of the devices and uncertainty regarding the health risks. Attitudinal themes include a dual perspective, wherein social use is acceptable, but everyday use is stigmatized. Practice themes included three evident stages: social connection, wherein the devices were used to achieve social advantage with peers; addiction, characterized by solitary, habitual use; and detachment, sometimes marked by a dramatic, public action filmed for social media. Conclusions: As we consider intervention points on college campuses, an understanding of knowledge, attitude, and practice themes can guide our approach. Recommendations for college vaping campaigns are discussed.
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Affiliation(s)
- Sherri Jean Katz
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN
| | - Elisia L Cohen
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN
| | - Hannah T Kinzer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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16
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Greer AE, Morgan K, Samuolis J, Diaz G, Merighi J, Mahoney P. An examination of electronic nicotine delivery system use among college students using social cognitive theory. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1839-1847. [PMID: 33253007 DOI: 10.1080/07448481.2020.1835922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/02/2020] [Accepted: 02/29/2020] [Indexed: 06/12/2023]
Abstract
Objective: Using social cognitive theory as a framework, this study examined electronic nicotine delivery systems (ENDS) use, related cognitions, and context among college students. Participants: Respondents were 1229 students attending a mid-sized, northeastern university. Methods: A cross-sectional survey was administered and SPSS was used for analysis. Results: Almost 41% of respondents reported ENDS use in the prior month (past-month user), 26.8% reported trying ENDS but no use in the prior month (occasional user), and 32.3% reported never trying ENDS. The results highlight significant associations in past-month versus occasional use and reasons for initation, location for ENDS use, perceived norms for ENDS use, and outcome expectations for ENDS use. Conclusions: This study highlights a need for theory-based, multi-level strategies to reduce ENDS use. Interventions should increase awareness about the risks of ENDS, include peer-based interventions to foster health-promoting campus social environments, and explore the use of policies restricting campus ENDS use.
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Affiliation(s)
- Anna E Greer
- Department of Public Health, Sacred Heart University, Fairfield, Connecticut, USA
| | - Kerry Morgan
- Department of Health Science, Sacred Heart University, Fairfield, Connecticut, USA
| | - Jessica Samuolis
- Department of Psychology, Sacred Heart University, Fairfield, Connecticut, USA
| | - Gabrielle Diaz
- Department of Public Health, Sacred Heart University, Fairfield, Connecticut, USA
| | - Julianna Merighi
- Department of Exercise Science, Sacred Heart University, Fairfield, Connecticut, USA
| | - Patrick Mahoney
- Department of Biology, Sacred Heart University, Fairfield, Connecticut, USA
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17
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Moustafa AF, Rodriguez D, Pianin SH, Testa SM, Audrain-McGovern JE. Dual Use of Nicotine and Cannabis Through Vaping Among Adolescents. Am J Prev Med 2022; 63:60-67. [PMID: 35365396 PMCID: PMC9232951 DOI: 10.1016/j.amepre.2021.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study seeks to identify adolescent nicotine and cannabis vaping patterns and the characteristics of those adolescents who comprised each pattern. METHODS This prospective longitudinal survey study measured the relationship between nicotine and cannabis vaping among 1,835 adolescents from 4 public high schools outside of Philadelphia, Pennsylvania. Adolescents completed in-classroom surveys, including questions of lifetime and past 30-day nicotine and cannabis vaping, at Wave 1 (fall 2016, ninth grade) and 6-month intervals for the following 36 months (fall 2019, 12th grade). Data were analyzed in 2021. RESULTS A sequential processes growth mixture model revealed 4 latent conjoint classes of nicotine and cannabis vaping: early, declining dual use (Class 1: n=259); rapidly increasing dual use (Class 2: n=128); later, slower dual use (Class 3: n=313); and no use (Class 4: n=1,136). Increased odds of belonging to Class 1 and Class 2 versus belonging to Class 4 were significantly associated with cigarette smoking (OR=3.71, OR=2.21), alcohol use (OR=2.55, OR=4.39), peer vaping (OR=1.24, OR=1.20), sensation seeking (OR=1.03, OR=1.11), positive E-cigarette expectations (OR=1.21, OR=1.17), and cigar smoking (OR=2.39 Class 2 only). Increased odds of belonging to Class 3 versus Class 4 were significantly associated with alcohol use (OR=1.66), perceived benefits of E-cigarette use (OR=1.03), positive E-cigarette expectations (OR=1.08), depressive symptoms (OR=1.02), and sensation seeking (OR=1.03). CONCLUSIONS From middle to late adolescence, vaping of nicotine and cannabis develop in close parallel. Regulatory policy and prevention interventions should consider the interplay between these 2 substances during this period of adolescence.
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Affiliation(s)
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Stephen H Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shannon M Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Janet E Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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18
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Support for 100% Tobacco-Free Policy on a College Campus in New Jersey: Differences between students and faculty/staff. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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19
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Russell AM, Yang M, Barry AE, Merianos AL, Lin HC. Stealth Vaping Among College Students on Four Geographically Distinct Tobacco-Free College Campuses: Prevalence and Practices. Nicotine Tob Res 2022; 24:342-348. [PMID: 34297130 DOI: 10.1093/ntr/ntab153] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/21/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION To offset tobacco use among college students, many universities have implemented tobacco-free campus policies. Given how easily e-cigarette users can discreetly vape in places where it is prohibited without being detected (ie, stealth vape), it is important to assess whether students are subverting these policies. This study examined the prevalence of stealth vaping on-campus among students at multiple universities, including frequency and methods for stealth vaping. AIMS AND METHODS A convenience sample of college students was obtained from four geographically distinct, large, public universities with established policies prohibiting all forms of tobacco use on campus. Participants (N = 863 current e-cigarette users) reported on demographics and e-cigarette use. Those who previously stealth vaped on-campus (n = 422) completed additional questions, including common locations, techniques, and devices/e-liquids used for stealth vaping. RESULTS Nearly half (48.9%) of past 30-day e-cigarette users reported previously stealth vaping on-campus. Among stealth vapers, 48.1% owned a smaller device for stealth vaping and 38.9% used e-liquids with low visibility vapors. Common on-campus stealth vaping locations included bathrooms, libraries, parking garages, and classrooms. Techniques used for stealth vaping included deep inhale, blowing a hit into one's clothes, and swallowing a hit. CONCLUSIONS A large percentage of respondents commonly violated campus tobacco-free policies by stealth vaping. For such policies to be effective at reducing on-campus e-cigarette use, there is a need for enhanced monitoring and enforcement. More research is needed to better understand factors influencing stealth vaping behaviors and public health implications. IMPLICATIONS This sample of college student e-cigarette users commonly violated campus smoke- and tobacco-free policies by stealth vaping on campus. Respondents used a range of methods (eg, smaller device and low visibility e-liquids) and locations (eg, bathrooms, libraries, and parking garages) for stealth vaping. If campus policies are to be effective at reducing on-campus e-cigarette use, there is a need for enhanced monitoring and enforcement. E-cigarette devices specifically designed and marketed to facilitate stealth vaping (eg, resembling USB flash drives and pens) may require regulatory action. More research is needed to better understand factors influencing stealth vaping behaviors and public health implications.
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Affiliation(s)
- Alex M Russell
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA
| | - Meng Yang
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47405, USA
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47405, USA
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20
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Aqeeli AA, Makeen AM, Al Bahhawi T, Ryani MA, Bahri AA, Alqassim AY, El-Setouhy M. Awareness, knowledge and perception of electronic cigarettes among undergraduate students in Jazan Region, Saudi Arabia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:706-713. [PMID: 32974976 DOI: 10.1111/hsc.13184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The use of electronic cigarettes (e-cigarettes) has steadily grown over the past few years, rising in popularity amongst young adults, especially. Owing to the perception that e-cigarettes are less harmful than conventional cigarettes, some people have resorted to using them as a means of quitting cigarette smoking. This study aimed to assess the awareness, knowledge, perception and use of e-cigarettes among Jazan University students in Saudi Arabia. An observational cross-sectional study was conducted with 775 students. Using stratified random sampling to recruit study participants, the dataset tabling the use of e-cigarettes, as well as knowledge, perception and awareness was collected using a translated and culturally adapted structured Arabic questionnaire. Our results showed that 21.0% of the participants used e-cigarettes and 35.1% of them used them to quit smoking. E-cigarette use was mostly reported by students from the College of Medical Applied Sciences (31.7%). The overall knowledge score was 3.9, with a standard deviation of 1.3 for the score range from zero to seven. About half of the participants correctly identified e-cigarettes as not less addictive' than cigarettes. However, 70.2% of students failed to identify e-cigarettes as a source of second-hand exposure to nicotine. About two-thirds of the sample believed that e-cigarettes could adversely affect health. The perception of using e-cigarettes for smoking cessation was not significantly associated with e-cigarette use. In conclusion, the prevalence of e-cigarette use was similar to that reported in the literature. However, Jazan University students failed to identify the health risks associated with e-cigarette use. Therefore, a strategy to enhance students' awareness of the benefits and harms of e-cigarettes is needed.
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Affiliation(s)
- Abdulwahab A Aqeeli
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tariq Al Bahhawi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Majed A Ryani
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmed A Bahri
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Y Alqassim
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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21
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Fang J, Ren J, Ren L, Max W, Yao T, Zhao F. Electronic cigarette knowledge, attitudes and use among
students at a university in Hangzhou, China. Tob Induc Dis 2022; 20:09. [PMID: 35125992 PMCID: PMC8796848 DOI: 10.18332/tid/144230] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/24/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarettes are increasingly popular worldwide, especially among youth. There is growing evidence of the negative health consequences of vaping. Our objective was to assess university students’ knowledge and attitudes regarding electronic cigarettes (e-cigarettes), their use, as well as the associated influencing factors for their use. METHODS The study involved an online cross-sectional survey conducted between November 2019 and March 2020 in a university in Hangzhou, China. A total of 563 students completed the questionnaire. Descriptive statistics were used to assess characteristics, knowledge, and attitudes; t-tests, χ2-tests and logistic regression models were used to identify factors associated with ever e-cigarette use. RESULTS In all, 59.9% of respondents were female and the average age was 20.38 years (SD=1.32). Only 42.6% of the respondents thought that e-cigarettes contain nicotine, 31.1% thought e-cigarettes are tobacco products, and 8.2% of the students reported being ever e-cigarettes users. In regard to attitude, the average score of the students in the Safety dimension was 3.34 (SD=0.64), followed by the Restriction dimension (Mean=2.66, SD=0.83). Correlates of ever use included regions, friends’ and roommates’ ever e-cigarette use, and higher attitude score in the Supervision dimension. CONCLUSIONS The university students’ level of knowledge regarding e-cigarettes was not high, and their attitudes regarding e-cigarettes were not that supportive. Students’ ever use of e-cigarettes at a university in Hangzhou was higher than for university students in other cities in China, but lower than for those in foreign countries.
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Affiliation(s)
- Juan Fang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jianping Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Lixian Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California San Francisco, San Francisco, United States
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California San Francisco, San Francisco, United States
| | - Falin Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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22
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Ajumobi O, Jami W, Kemmelmeier M, Devereux P. A Brief Intervention on E-Cigarette, Regular Cigarette, and Marijuana Use Results in Generalization Effects: Lateral Attitude Change among College Students. Subst Use Misuse 2022; 57:1434-1441. [PMID: 35689376 DOI: 10.1080/10826084.2022.2086697] [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: 10/18/2022]
Abstract
OBJECTIVE We hypothesized (1) perceived harm beliefs and intention to use e-cigarette attitudes will become more negative post-exposure to the intervention (2) this change will generalize to more negative beliefs and intention toward regular cigarettes and marijuana. METHODS MANOVAs of students' perceptions of harm beliefs and intention toward the use of e-cigarettes and regular cigarettes, and marijuana were performed to ascertain change in harm beliefs before (t1) to after the intervention (t2) for 188 nonwhite Hispanic and White college students who viewed educational material (informational text + video), the intervention, during an online experimental survey. RESULTS The first MANOVA yielded main effect with significant differences for substances, Wilks' Lambda (Λ) = 0.254, F = 234.920 (2, 160), p < 0.001, ηp2 =0.746 and by time (Λ = 0.740, F = 56.684 (1, 161), p < 0.001, ηp2 = 0.260). E-cigarettes, regular cigarettes, and marijuana were perceived more harmful for one's health and for the health of others at t2. The MANOVA on peer influence and intention to use (Λ = 0.277, F = 222.890 (2, 171), p < 0.001), ηp2 = 0.723) and by time (Λ = 0.922, F = 14.514 (1, 172), p < 0.001), ηp2 = 0.078) was significant. Respondents were less likely to use any of the substances if their best friend offered at t2. Intent for future use was also reduced at t2. CONCLUSION A brief intervention potentiated favorable change in harm beliefs and intention to focal object (e-cigarettes) and lateral objects (regular cigarettes and marijuana).
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Affiliation(s)
- Olufemi Ajumobi
- School of Public Health, University of Nevada, Reno, NV, USA
| | - Waleed Jami
- Interdisciplinary Social Psychology Ph.D. Program, University of Nevada, Reno, NV, USA
| | - Markus Kemmelmeier
- Interdisciplinary Social Psychology Ph.D. Program, University of Nevada, Reno, NV, USA
| | - Paul Devereux
- School of Public Health, University of Nevada, Reno, NV, USA.,Interdisciplinary Social Psychology Ph.D. Program, University of Nevada, Reno, NV, USA
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Patil S, Fageeh HN, Mushtaq S, Ajmal M, Chalikkandy SN, Ashi H, Ahmad ZH, Khan SS, Khanagar S, Varadarajan S, Sarode SC, Sarode GS. Prevalence of electronic cigarette usage among medical students in Saudi Arabia – A systematic review. Niger J Clin Pract 2022; 25:765-772. [DOI: 10.4103/njcp.njcp_2006_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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24
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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.
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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
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25
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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.
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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
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26
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Omoike OE, Johnson KR. Prevalence of Vaping and Behavioral Associations of Vaping Among a Community of College Students in the United States. J Community Health 2021; 46:190-194. [PMID: 32583359 DOI: 10.1007/s10900-020-00868-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the prevalence of vaping among college students in South-central Appalachia in the United States and explored factors which were associated with and could predict vaping among the college students. A sample of 498 enrolled students voluntarily completed a self-report REDCap health survey questionnaire in 2018. Outcome variable was use of electronic cigarettes categorized as yes/no. Independent variables included risky behaviors such as texting or emailing while driving, riding in a car with someone who had been drinking, history of protected and unprotected sexual intercourse, age at first intercourse, and type of contraceptive used. Covariates were age, gender, ethnicity/race and high school location. The first category was used as reference. Binary logistic regression was used to identify factors associated with and predicting vaping. Mean age of participants was 20.93(± 8.26), 62.9% were female, a majority (76.5%) were non-Hispanic White, and 43.2% reported vaping at some point in their lives. Initial univariate analysis showed gender (p < 0.0001), seat belt usage (p = 0.002), texting or emailing while driving (p = 0.002), riding in a car with someone who had been drinking (p = 0.001), history of sexual intercourse (p < 0.001), coitarche (p = 0.026), use of birth control pills and withdrawal method were associated with vaping. Adjusting for co-variates, gender (p < 0.002), county of high school (p < 0.009) and texting and e-mailing while driving (0.05), seat belt usage (0.04) remained significant. Vaping was highly prevalent (43.2%) among our participants. Gender, location of high school, texting/emailing while driving and seat belt usage are predictors of vaping among these students.
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Affiliation(s)
- Ogbebor E Omoike
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, 37604, USA.
| | - Kiana R Johnson
- Department of Pediatrics, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, 37604, USA
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Alber JM, Ganjooi K, Gibbs S, Almeida R, Jackson LD. E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After EVALI Outbreak. Am J Health Promot 2021; 35:1071-1077. [PMID: 33977783 DOI: 10.1177/08901171211016327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults. DESIGN This study used a successive independent samples design. SETTING Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536). SUBJECTS Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S. MEASURES The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support. ANALYSIS Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support. RESULTS Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R2 = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R2 = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R2 = .277. CONCLUSION Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.
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Affiliation(s)
- Julia M Alber
- Department of Kinesiology and Public Health, 7173California Polytechnic State University, San Luis Obispo, CA, USA
| | - Kimiya Ganjooi
- Biological Sciences Department, 7173California Polytechnic State University, San Luis Obispo, CA, USA
| | - Siena Gibbs
- Statistics Department, 7173California Polytechnic State University, San Luis Obispo, CA, USA
| | - Rebeca Almeida
- Department of Kinesiology and Public Health, 7173California Polytechnic State University, San Luis Obispo, CA, USA
| | - Lorraine D Jackson
- Communications Studies Department, 7173California Polytechnic State University, San Luis Obispo, CA, USA
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Moustafa AF, Rodriguez D, Mazur A, Audrain-McGovern J. Adolescent perceptions of E-cigarette use and vaping behavior before and after the EVALI outbreak. Prev Med 2021; 145:106419. [PMID: 33422576 PMCID: PMC8474118 DOI: 10.1016/j.ypmed.2021.106419] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 01/19/2023]
Abstract
This study sought to determine whether adolescents' e-cigarette risk perceptions, perceived benefits, and positive expectations, and vaping behavior changed after the electronic-cigarette or vaping product use-associated lung injury (EVALI) outbreak. This longitudinal survey studied 1539 high school students in suburban Philadelphia, PA in 11th and 12th grade, before and after the outbreak of EVALI cases in 2019. Adolescents who reported current nicotine vaping at baseline (versus those who did not) had a greater increase in risk perceptions (B = -0.31, p = 0.04) and a greater decrease in positive expectations (B = -1.30, p = 0.003) at follow-up. Adolescents who reported current marijuana vaping at baseline (versus those who did not) had greater perceived benefits (B = 2.19, p < 0.001), lower risk perceptions (B = 0.39, p < 0.001), and greater positive expectations of e-cigarette use (B = 1.43, p < 0.001) across time. Odds of current nicotine vaping at follow-up increased (OR = 1.61, 95% CI = 1.08, 2.41) for adolescents who maintained lower risk perceptions. Odds of current nicotine vaping at follow-up decreased (OR = 0.33, 95% CI = 0.21, 0.50) for adolescents whose positive expectations of e-cigarette use decreased. The odds of current marijuana vaping at follow-up decreased (OR = 0.64, 95% CI = 0.42, 0.98) for adolescents whose positive expectations of e-cigarette use decreased. Perceptions of the risks of e-cigarette use increased and positive expectations of e-cigarette use decreased after the EVALI outbreak. Adolescent risk perceptions and positive expectations of e-cigarette use are two potential targets to impact vaping behavior. Emphasizing the risks of e-cigarette use while decreasing positive expectations of use have the potential to reduce vaping behavior, and perhaps subsequent EVALI cases.
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Affiliation(s)
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, LaSalle University, Philadelphia, PA, USA
| | - Alexa Mazur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Hershberger AR, Studebaker A, Whitt ZT, Fillmore M, Kahler CW, Cyders MA. An Experimental Test of the Relationship between Electronic Nicotine Delivery System Use and Alcohol Consumption. Alcohol Clin Exp Res 2021; 45:808-818. [PMID: 33547653 PMCID: PMC8076069 DOI: 10.1111/acer.14566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing research shows that the use of electronic nicotine delivery systems (ENDS) is associated with a higher rate and quantity of alcohol consumption. METHODS The present study used a 2-session, within-subjects design to experimentally examine the relationship between ENDS use and laboratory ad libitum alcohol consumption. A total of N = 31 (mean age = 28.71, SD = 11.17; 45.2% women; 54.8% White/Caucasian) healthy adults from the community who use ENDS and endorsed liking beer completed the study, which included a beer consumption taste-test task that assessed the volume of beer consumed by the participants across 2 counterbalanced sessions: 1 in which concurrent ENDS use was allowed and 1 in which it was not. All analyses controlled for age, race, and gender. RESULTS The effect of ENDS condition on the volume of beer consumed was not statistically significant, F(1, 30) = 0.03, p = 0.86). Results of linear mixed modeling showed that ENDS puffs were significantly related to alcohol sips (estimate = 0.23, SE = 0.07, p = 0.002) across the ad libitum session. CONCLUSIONS Overall, ENDS use did not increase alcohol consumption; however, the data suggest that ENDS puffs might act as a prime for beer sips or that these 2 behaviors are linked through habit. Future studies should more fully measure and compare global and event-level data on ENDS and alcohol use as they might show disparate patterns of relationships.
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Affiliation(s)
| | - Amanda Studebaker
- Department of Psychology, Indiana University Purdue University Indianapolis
| | - Zachary T. Whitt
- Department of Psychology, Indiana University Purdue University Indianapolis
| | - Mark Fillmore
- Departmet of Psychology, University of Kentucky, Lexington, KY
| | - Christopher W. Kahler
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis
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30
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Lotrean LM, Man M, Gavrilescu C, Florea M. Electronic Cigarette Use and Its Relationship with Smoking and Alcohol and Illicit Drug Consumption among Romanian University Students. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:137. [PMID: 33557228 PMCID: PMC7913983 DOI: 10.3390/medicina57020137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. Materials and methods: A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. Results: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. Conclusions: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth.
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Affiliation(s)
- Lucia Maria Lotrean
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.M.L.); (M.F.)
| | - Milena Man
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Cristina Gavrilescu
- First Medical Department, Gr. T. Popa, University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mira Florea
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.M.L.); (M.F.)
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31
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Fauzi R, Areesantichai C. Factors associated with electronic cigarettes use among adolescents in Jakarta, Indonesia. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-01-2020-0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PurposeThis study aimed to examine factors associated with electronic cigarette use among adolescents aged 15–19 in Jakarta, Indonesia.Design/methodology/approachThe study was a school-based survey involving 1,318 students from 14 high schools in Jakarta. A multistage cluster sampling methodology was used. The authors used the chi-square test and multiple logistic regression to examine the association between electronic cigarette use and sociodemographic, social influences, health risk perceptions, availability, affordability and conventional cigarette smoking status.FindingsOverall, 6.3% of females and 29% of males reported ever having used electronic cigarettes. Electronic cigarette use was independently associated with sex, school locations, conventional cigarette smoking status, peer use, availability and perceptions that electronic cigarettes aid conventional cigarette smoking cessation. Compared with non-smokers, lifetime (AOR: 8.740, 95% CI: 5.126–14.901) and current conventional cigarette smokers (AOR: 18.380, 95% CI: 10.577–31.938) were more likely to use electronic cigarettes.Social implicationsThe use of electronic cigarettes among adolescents was considerably high in this study. Therefore, the tobacco control policy should be extended to regulate the marketing and use of all types of tobacco products and not just conventional cigarettes.Originality/valueThe study explored beyond individual lifestyle factors that contributed to electronic cigarette use in Indonesia such as affordability, school locations and availability of electronic cigarettes. These issues have not been specifically discussed in previous studies.
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Naidoo M, Mbonane TP, Mathee A. Risk Factors and Perceptions of E-Cigarette Use Among Selected Users in Johannesburg, South Africa. J Community Health 2020; 46:405-412. [PMID: 33175264 DOI: 10.1007/s10900-020-00948-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 01/10/2023]
Abstract
There is little scientific knowledge about e-cigarette use in South Africa. This study aimed to describe the risk factors and perceptions of selected Johannesburg-based users of e-cigarettes. A self-administered questionnaire was used to collect data from a convenient sample of 188 participants, of which 160 were males and 28 females. The survey results showed that participants used e-cigarettes at home (n = 28/ 14.8%), work (n = 76/ 40.4%), tertiary institutions (n = 50/ 26.5%) and in their vehicles (n = 24/ 12.7%), while (n = 96/ 51%) used the product in the presence of children. 57 participants (30.3%) started using e-cigarettes as a smoking cessation strategy, while 46 (24.4%) used it to manage smoking cravings. Most participants believed that e-cigarettes are addictive (n = 156/ 82.9%) and unhealthy (n = 139/ 73.9%). This study highlights the need and opportunity to improve public health action in the prevention and management of risks posed by e-cigarette products to users and non-users.
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Affiliation(s)
- Mageshree Naidoo
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2000, South Africa
| | - Thokozani P Mbonane
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2000, South Africa.
| | - Angela Mathee
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2000, South Africa.,Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, 2000, South Africa
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33
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Luzius A, Dobbs PD, Jozkowski KN. College students' reasons for using different e-cigarette products: A mixed methods analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:832-838. [PMID: 31157606 DOI: 10.1080/07448481.2019.1618313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
This study examined if college students used particular e-cigarette devices for different reasons. Participants: College students from a large southern university completed an online, close- and open-ended survey. Data were delimited to those 18-25 years of age who had used e-cigarettes (n = 338). Methods: A convergent mixed-methods design was employed by quantifying qualitative responses via an inducting coding method. Next, χ2 analyses examined relationships between use of different products (i.e., cigalikes, vape pens, eGos, mods) and reasons for using e-cigarettes. Results: Emerging themes representing reasons for trying e-cigarettes included: curiosity, peer pressure, recreation, flavors, better than cigarettes, and to quit/reduce tobacco use. Significant relationships existed between use of cigalikes, (p < . 01), eGos (p < . 05), and mods (p < . 05) and use of e-cigarettes to quitting/reducing tobacco use. Conclusions: Health promotion efforts on college campuses should address curiosity about these products and provide scientifically proven therapy to those seeking to quit tobacco.
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Affiliation(s)
- Abbie Luzius
- Hope Cancer Resources, Outreach and Development Department, Springdale, USA
| | - Page D Dobbs
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Kristen N Jozkowski
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, USA
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Peltier MR, Waters AF, Roys MR, Stewart SA, Waldo KM, Copeland AL. Dual users of e-cigarettes and cigarettes have greater positive smoking expectancies than regular smokers: a study of smoking expectancies among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:782-787. [PMID: 30908173 PMCID: PMC11013953 DOI: 10.1080/07448481.2019.1590373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/06/2018] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
Objective: In the present study, we sought to determine the differences among college students using e-cigarettes, cigarettes, or both products (dual users) on smoking outcome expectancies and the role of smoking expectancies and e-cigarette use in cessation attempts. Participants: We surveyed 1,370 undergraduate college students from November 2014 to November 2016. Methods: Participants completed questionnaires regarding demographics, smoking status/history, and expectancies. Results: Dual users reported significantly longer smoking histories and more past quit attempts than other smoking groups. Those reporting dual use reported higher expectancies on positive/negative reinforcement and appetite/weight control subscales of the SCQ. E-cigarette use was a negative predictor of cessation attempts. Conclusions: College students appear to be less motivated to use e-cigarettes for cessation and dual users endorsed higher levels of smoking expectancies previously shown to negatively impact treatment outcomes. Students, especially dual users, need targeted interventions to address the dangers of using tobacco products.
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Affiliation(s)
| | - Aaron F. Waters
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70802
| | - Melanie R. Roys
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70802
| | - Shelby A. Stewart
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70802
| | - Krystal M. Waldo
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70802
| | - Amy L. Copeland
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70802
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Groom AL, Vu THT, Kesh A, Hart JL, Walker KL, Giachello AL, Sears CG, Tompkins LK, Mattingly DT, Landry RL, Robertson RM, Payne TJ. Correlates of youth vaping flavor preferences. Prev Med Rep 2020; 18:101094. [PMID: 32373447 PMCID: PMC7191037 DOI: 10.1016/j.pmedr.2020.101094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/31/2020] [Accepted: 04/04/2020] [Indexed: 12/02/2022] Open
Abstract
Among youth who use electronic nicotine delivery systems (ENDS), e-cigarettes are often the first tobacco product tried. Flavor is a common reason for experimentation with e-cigarettes. This study assessed flavor preferences and the choice of ENDS as an initial product among youth by selected demographic characteristics. The analysis sample included 1549 participants who had ever tried ENDS, drawn from a national online survey of youth aged 13-18 in 2017. Fruit was the most common favorite flavor among ENDS users, followed by menthol/mint/wintergreen. Preference for flavor varied by age, sex and racial/ethnic background. ENDS were the tobacco products most likely to be tried first, particularly among participants under age 17. Those who preferred fruit flavor were twice as likely to have tried ENDS first, compared to those with other flavor preferences, while those who preferred menthol/mint/wintergreen flavor were half as likely to have tried ENDS first. Our findings support an association between flavor and ENDS use. Our research supports previous findings indicating that: 1) flavor is one of the primary reasons for experimentation with ENDS among youth; 2) fruit flavor is strongly associated with use of ENDS as the first tobacco product; and 3) preference of fruit flavor varies by age, sex and racial/ethnic background. These findings have relevance for developing targeted messages for specific youth audiences and implications for tobacco regulatory policies. In addition to January 2020 federal regulations, the authors recommend tighter restrictions, specifically that the marketing and sale of all e-cigarette flavors other than tobacco be eliminated.
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Affiliation(s)
- Allison L. Groom
- American Heart Association Tobacco Regulation and Addiction Center, 7272 Greenville Avenue, Dallas, TX 75231, USA
| | - Thanh-Huyen T. Vu
- Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Dr, Ste 1400, Chicago, IL 60611, USA
| | - Anshula Kesh
- American Heart Association Tobacco Regulation and Addiction Center, 7272 Greenville Avenue, Dallas, TX 75231, USA
| | - Joy L. Hart
- University of Louisville, Department of Communication, Louisville, KY 40292, USA
| | - Kandi L. Walker
- University of Louisville, Department of Communication, Louisville, KY 40292, USA
| | - Aida L. Giachello
- Northwestern University, Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Dr, Ste 1400, Chicago, IL 60611, USA
| | - Clara G. Sears
- University of Louisville, Department of Communication, Louisville, KY 40292, USA
| | - Lindsay K. Tompkins
- University of Louisville, Department of Communication, Louisville, KY 40292, USA
| | - Delvon T. Mattingly
- University of Louisville, Department of Communication, Louisville, KY 40292, USA
| | - Robyn L. Landry
- American Heart Association Tobacco Regulation and Addiction Center, 7272 Greenville Avenue, Dallas, TX 75231, USA
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center, 7272 Greenville Avenue, Dallas, TX 75231, USA
| | - Thomas J. Payne
- University of Mississippi Medical Center, Department of Otolaryngology and Communicative Sciences, 2500 North State Street, Jackson, MS 39216, USA
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Shilco P, Golshan T, Lande S, Nickfardjam K, Roitblat Y, Morgan A, Nehuliaieva L, Shterenshis M. Knowledge and attitudes of adolescents to e-cigarettes: an international prospective study. Int J Adolesc Med Health 2020; 34:/j/ijamh.ahead-of-print/ijamh-2019-0210/ijamh-2019-0210.xml. [PMID: 32474455 DOI: 10.1515/ijamh-2019-0210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/21/2019] [Indexed: 11/15/2022]
Abstract
Purpose The aim of the study was to assess the familiarity of adolescents with e-cigarettes. We performed a survey to investigate the frequency of their contact with e-cigarettes, beliefs about this sort of smoking (vaping), and their real knowledge of its effects. Methods The survey was carried out among 1600 high school students in the USA, Israel, Ukraine and Australia. The questionnaire comprised three parts, each with five questions. The first part was designed to assess the frequency of contact with the phenomenon. The second part assessed misconceptions and opinions concerning vaping. The third part questioned the participants' real knowledge of the subject. Results Out of a maximum score of 5, the average score of 4.25 for Part 1 indicated that the participants had frequent contact with e-cigarettes. The score of 3.65 for Part 2 showed that adolescents have both right and wrong beliefs on the subject. Part 3 was completed by 1224 participants (76.5%) while 376 (23.5%) reported a lack of any specific knowledge about vaping. The average score of 3.33 demonstrated that adolescents who completed Part 3 of the survey have incomplete knowledge about e-cigarettes. For the whole cohort of 1600 participants, the average score was 2.80. No significant sex differences were detected. The Ukranian participants had poor knowledge about the dangers of vaping in comparison with the participants in the USA and Australia (p = 0.03). Conclusion While the contact of adolescents with e-cigarettes users is extensive, their actual knowledge remains inadequate. Various school-based smoking risk campaigns face a necessity for further adjustments and improvements.
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Affiliation(s)
- Phillip Shilco
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Aliyat HaNoar 9, Hod HaSharon45102,Israel, Phone: +97254-337-9865
| | - Taylor Golshan
- Science Research Department, Milken Community High School, Los Angeles, CA, USA
| | - Sarah Lande
- Science Research Department, Milken Community High School, Los Angeles, CA, USA
| | - Kaitlyn Nickfardjam
- Science Research Department, Milken Community High School, Los Angeles, CA, USA
| | - Yulia Roitblat
- Department of Sciences, Belkind School for Special Education, Rishon-LeZion, Israel
| | - Antony Morgan
- Faculty of Medicine, Griffith University, Gold Coast, Australia
| | - Liliia Nehuliaieva
- Department of Pediatrics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Michael Shterenshis
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Aliyat HaNoar 9, Hod HaSharon45102,Israel, Phone: +97254-337-9865
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37
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Zvolensky MJ, Mayorga NA, Garey L. Positive Expectancies for E-Cigarette Use and Anxiety Sensitivity Among Adults. Nicotine Tob Res 2020; 21:1355-1362. [PMID: 29800464 DOI: 10.1093/ntr/nty106] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/22/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Although e-cigarette use is on the rise among youth and adults, there is little understanding of the individual difference factors at a cognitive level of analysis for e-cigarette beliefs and quit behavior. METHOD The present investigation sought to test a theoretically driven interactive model of positive expectancies for e-cigarettes and anxiety sensitivity (fear of the consequences of anxiety) among 551 adult e-cigarette users (50.6% female, Mage = 35.2 years, SD = 10.1). RESULTS Results indicated a significant interaction between positive expectancies for e-cigarette use and AS was significantly related to greater perceived benefits of e-cigarette use, greater perceived risk of e-cigarette use, and more serious attempts for trying to quit e-cigarettes. The significant interaction effect for each dependent variable was evident over and above the main effects as well as the covariates of sex, income, education, and concurrent combustible cigarette use. The form of this interaction indicated that e-cigarette users higher in AS who also maintained more positive outcome expectancies for e-cigarette use reported more perceived benefits as well as more perceived risk of e-cigarette use and engaged in more (failed) attempts to quit e-cigarettes. CONCLUSIONS Overall, the current data suggest that individual differences in AS and positive expectancies may represent two important factors to consider in e-cigarette beliefs and quit attempts. IMPLICATIONS This study provides the first empirical evidence of a transdiagnostic construct (anxiety sensitivity) in relation to e-cigarette use and how it interplays with positive expectancies for e-cigarette use beliefs and behavior. These novel data suggest that future clinical research may benefit by understanding the potential therapeutic role of anxiety sensitivity and expectancies for e-cigarette use behavior.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX.,Health Institute, University of Houston, Houston, TX
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX
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Khanagar SB, Siddeeqh S, Khinda V, Khinda P, Divakar DD, Jhugroo C. Impact of electronic cigarette smoking on the Saudi population through the analysis of literature: A systematic review. J Oral Maxillofac Pathol 2020; 23:473. [PMID: 31942135 PMCID: PMC6948040 DOI: 10.4103/jomfp.jomfp_141_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Tobacco usage is harming the health, the treasury and the spirit of Saudi Arabia. Every year, more than 7000 of its people are killed by tobacco-caused diseases. Still, more than 20,000 children and 3,352,000 adults continue to use tobacco each day. Likewise, the usage of electronic (e)-cigarette is also increasing; this could be because of the publicity and marketing strategies adopted by the manufacturers of these products which are attracting the younger population. This review was taken up to determine the usage and attitude toward e-cigarette smoking among the Saudi population through the analysis of literature. This review identified peer-reviewed articles using several search terms and databases from 2010 to 2018. PubMed, ISI-Web of Science, Medline and Google Scholar were searched using the following alternate terms for e-cigarettes: electronic cigarettes, electronic nicotine delivery systems following which hand search was conducted through the reference list of articles. The search results only found descriptive data on these e-cigarettes among the Saudi population. This literature review reported that the usage of these e-cigarettes was high among this population and recorded a wide variety of reasons for using e-cigarettes. Reducing tobacco use, considering e-cigarette as less harmful, less addictive, for pleasure and peer influence, lower cost and curiosity were the most commonly reported reasons. Recognizing the dangerous impact of smoking and usage of other type of tobacco, the aggressive marketing of these e-cigarettes needs to be controlled.
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Affiliation(s)
- Sanjeev Balappa Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Salman Siddeeqh
- Maxillofacial Surgery and Diagnostic Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Science, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Vineet Khinda
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Paramjit Khinda
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Chitra Jhugroo
- Public Health Department, Texila American University, Guyana, South America, Guyana
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The role of flavors in vaping initiation and satisfaction among U.S. adults. Addict Behav 2019; 99:106077. [PMID: 31437770 DOI: 10.1016/j.addbeh.2019.106077] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The prevalence of electronic cigarette use has grown over the past decade, with some users reportedly initiating e-cigarette use primarily due to flavors. This study examined the role of flavors in initiation among adult e-cigarette users, as well as the association of flavors with satisfaction and perceived addiction to vaping. METHODS The analysis sample consisted of 1492 current e-cigarette users aged 18 or older, drawn from an online quantitative survey conducted in 2016. Multivariable logistic regression and general linear models were used. RESULTS Most current e-cigarette users (62.9%) typically used flavors other than tobacco (including fruit, mint/menthol, sweet, candy, coffee and other), 24.2% typically used tobacco flavors, and 12.9% typically used non-flavored e-cigarettes. Flavor was a common reason for vaping initiation, selected by 29.5% of the sample. Flavor, particularly fruit flavor, was more likely to motivate young adults 18-24 to initiate vaping compared adults 35-44. Those who used flavors, particularly mint/menthol and flavors other than tobacco flavor, had higher odds of reporting high satisfaction with vaping and had higher odds of perceived addiction to vaping than respondents who did not use flavored e-cigarettes. CONCLUSIONS Users of flavored e-cigarettes reported greater satisfaction and self-perceived addiction than users of non-flavored e-cigarettes. The appeal of flavors, particularly among young adults, has implications for regulatory policy regarding the marketing and promotion of flavored products. These findings may provide direction for the Food and Drug Administration's plans to restrict flavors other than menthol, mint, and tobacco.
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Kinouani S, Leflot C, Vanderkam P, Auriacombe M, Langlois E, Tzourio C. Motivations for using electronic cigarettes in young adults: A systematic review. Subst Abus 2019; 41:315-322. [PMID: 31638872 DOI: 10.1080/08897077.2019.1671937] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: The most common reasons why adults use e-cigarettes are to stop or reduce tobacco smoking. However, it is unclear if this reason is evenly distributed between young and older adults. Objectives: describe the motivations for e-cigarette use amongst young adults aged 18-25 and compare the reasons for using e-cigarettes of people who currently or formerly used tobacco products to those who had never smoked tobacco prior e-cigarette use. Methods: PubMed®, Scopus®, Cochrane Library®, SocINDEX®, PsycARTICLES®, Psychology and Behavioral Sciences Collection® and PsycINFO® databases were used. English written articles were screened up to March 2018. Depending on study design, quality was assessed using The STROBE or RATS checklists. Results: Six articles were included in the review, all with a moderate quality of evidence. Independently of smoking status, curiosity was the most frequently reported reason for initiating the use of e-cigarettes in young adults. Reasons for continuing to use e-cigarettes were various. The continued use of e-cigarettes could be either a means to replicate smoking habits, or a way for a different and personalized use of nicotine by inhalation. Conclusions: Reasons for using e-cigarettes in young adults are varied and are not limited to stopping smoking.
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Affiliation(s)
- Shérazade Kinouani
- University Bordeaux, Bordeaux, France.,Inserm, Bordeaux Population Health Research Center, Team HEALTHY, University Bordeaux, Bordeaux, France.,Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Chloé Leflot
- University Bordeaux, Bordeaux, France.,Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Paul Vanderkam
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Marc Auriacombe
- University Bordeaux, Bordeaux, France.,SANPSY, Bordeaux, France.,Pôle Addictologie, Bordeaux, France
| | - Emmanuel Langlois
- University Bordeaux, Bordeaux, France.,Centre Émile Durkheim, University Bordeaux, Bordeaux, France
| | - Christophe Tzourio
- University Bordeaux, Bordeaux, France.,Inserm, Bordeaux Population Health Research Center, Team HEALTHY, University Bordeaux, Bordeaux, France
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Le D, Moran MB, Atnafou R, Matson PA, Jones MR, D'Souza G. E-cigarette Use, Tobacco Product Polyuse, and Motivations for Use among Baltimore Young Adults. HEALTH BEHAVIOR AND POLICY REVIEW 2019; 6:427-437. [PMID: 32490030 PMCID: PMC7266135 DOI: 10.14485/hbpr.6.5.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting. METHODS Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessation interest, and beliefs and risk perceptions about tobacco use were explored. RESULTS All participants had a history of polyuse, and 85% were current polyusers. Stress was the primary reason reported for tobacco use. Compared to single-product users, current polyusers also were more likely to mention environment and cheap cost as reasons for use. Most participants perceived cigarettes to be as addictive as cocaine or heroin, although this perception was less common among e-cigarette users than non-users. Among study participants, 59% reported wanting to stop using tobacco completely. Among current polyusers, those that used e-cigarettes were more likely to report cessation attempts during the past year and express interest in enrolling in a quit smoking text messaging program. CONCLUSION In our sample there was a high prevalence of polytobacco product use and complex tobacco use patterns among young adults, both in and out of college, from an urban community.
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Affiliation(s)
- Daisy Le
- The George Washington University School of Nursing, Washington, DC
| | - Meghan B Moran
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Miranda R Jones
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Roys MR, Peltier MR, Stewart SA, Waters AF, Waldo KM, Copeland AL. The association between problematic alcohol use, risk perceptions, and e-cigarette use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 46:224-231. [DOI: 10.1080/00952990.2019.1654486] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Melanie R. Roys
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Shelby A. Stewart
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Aaron F. Waters
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Krystal M. Waldo
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Amy L. Copeland
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Fadus MC, Smith TT, Squeglia LM. The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects. Drug Alcohol Depend 2019; 201:85-93. [PMID: 31200279 PMCID: PMC7183384 DOI: 10.1016/j.drugalcdep.2019.04.011] [Citation(s) in RCA: 212] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/15/2019] [Accepted: 04/05/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) were first introduced in the U.S. market in 2006, with the more recent evolution of "pod-mod" e-cigarettes such as JUUL introduced in 2015. Although marketed as a smoking cessation tool, e-cigarettes are rarely used for this purpose in youth. This review aims to synthesize the literature regarding e-cigarette use among youth, and provides a resource for clinicians, educators, and families that helps answer commonly asked questions about e-cigarettes. METHODS PubMed, Scopus, and PsycINFO search was performed using search terms "Electronic Nicotine Delivery Systems," "e cigarettes," "e-cigarettes," "electronic cigarettes," "vaping," "JUUL," "e-cigs," and "vape pens." Search results were filtered to only include those related to adolescents and young adults. RESULTS E-cigarette use among youth is common, with rates of use increasing from 1.5% in 2011 to 20.8% in 2018. Pod mod devices such as JUUL have gained favor among youth for their sleek design, user-friendly function, desirable flavors, and ability to be used discreetly in places where smoking is forbidden. Adolescents are often uninformed about the constituents of e-cigarettes, and little is known about the long-term effects of e-cigarettes. Studies have suggested a "gateway" effect for combustible cigarettes and cannabis use. CONCLUSIONS E-cigarette use is becoming increasingly common among youth, leading to a myriad of questions and concerns from providers, educators, and family members. More research is needed to determine the ultimate public health impact of e-cigarette use. The authors provide a summary table of frequently asked questions in order to help clarify these common concerns.
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Affiliation(s)
- Matthew C Fadus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA.
| | - Tracy T Smith
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
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Hefner KR, Sollazzo A, Mullaney S, Coker KL, Sofuoglu M. E-cigarettes, alcohol use, and mental health: Use and perceptions of e-cigarettes among college students, by alcohol use and mental health status. Addict Behav 2019; 91:12-20. [PMID: 30396534 PMCID: PMC6358487 DOI: 10.1016/j.addbeh.2018.10.040] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 10/01/2018] [Accepted: 10/28/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are popular among college students, who display risky alcohol use patterns. However, little is known about patterns of co-use of e-cigarettes and alcohol. Further, relationships between e-cigarette use and mental illness among college students are unclear. METHODS College student participants (N = 631) at a northeastern U.S. university were invited via email to participate in a survey about e-cigarettes and alcohol use. Mental health was self-reported diagnosis of psychiatric (depression, bipolar disorder, schizophrenia, PTSD, anxiety disorder, personality disorder), and substance (alcohol and other drug) use disorders. Current use of e-cigarette, combustible cigarette, and other tobacco products were assessed via self-reported past 30-day use frequency. Alcohol consumption was assessed via number of self-reported standard alcoholic beverages consumed during a typical drinking episode. Participants also reported regarding co-use of alcohol, e-cigarettes and/or combustible cigarettes. Participants were categorized as non-drinkers, moderate drinkers or binge drinkers, and associations between e-cigarette use, drinking patterns and mental health diagnoses were examined. RESULTS E-cigarette use was associated with drinking alcohol χ2 = 18.62, p < .001, and binge drinking (vs. moderate drinking) χ2 = 12.20, p < .001. Students who had tried e-cigarettes reported drinking more alcohol per episode (χ2 = 15.94, p < .001). E-cigarette use was more prevalent among those with psychiatric and substance use disorders χ2 = 11.65, p < .001. CONCLUSIONS Drinking college students (especially binge drinkers) and those with mental illness may have heightened risks for e-cigarette use. More research is needed to elucidate relationships between risky alcohol and/or nicotine use and mental illness, and to guide appropriate prevention and intervention efforts for vulnerable college students.
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Affiliation(s)
- Kathryn R Hefner
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, United States; Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, CT, United States; Uniformed Services University of the Health Sciences, Department of Psychiatry, Center for the Study of Traumatic Stress, Bethesda, MD, United States.
| | - Antonietta Sollazzo
- University of New Haven, Department of Psychology, West Haven, CT, United States.
| | - Sean Mullaney
- University of New Haven, Department of Criminal Justice, West Haven, CT, United States.
| | - Kendell L Coker
- University of New Haven, Department of Psychology, West Haven, CT, United States; University of New Haven, Department of Criminal Justice, West Haven, CT, United States.
| | - Mehmet Sofuoglu
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, United States; Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, CT, United States.
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Mayorga NA, Garey L, Zvolensky MJ. Differences in perceptions of e-cigarettes across daily and non-daily users. Addict Behav 2019; 90:415-420. [PMID: 30537655 DOI: 10.1016/j.addbeh.2018.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/18/2018] [Accepted: 12/04/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE E-cigarette use has increased significantly over the past decade. Among the growing population of e-cigarette users, several pattern-based subgroups have emerged, including daily and non-daily users. Daily users are at greater risk for experiencing negative health consequences from use. Yet, little is understood about underlying e-cigarette processes that may be related to daily use relative to non-daily use. METHOD The present study sought to investigate differences in three clinically-relevant e-cigarette processes, including perceived risks (including both absolute and comparable risks to combustible cigarettes), benefits, and innovation of e-cigarettes between daily and non-daily users. The study included 564 adult current e-cigarette users (51.1% female, Mage = 35.1 years, SD = 10.2). RESULTS Results indicated a significant difference in levels of perception for all three dependent variables, such that daily users reported a higher level of perceived risks, benefits, and innovation for e-cigarettes. CONCLUSIONS Overall, the current study provides empirical evidence that perceived risks, benefits and innovations may be more strongly endorsed by more daily e-cigarette uses. Importantly, this study adds to evolving, but thus far limited, knowledge of e-cigarettes by highlighting how frequency of e-cigarette use relates to beliefs about e-cigarette use.
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Walter N, Demetriades SZ, Murphy ST. Just a Spoonful of Sugar Helps the Messages Go Down: Using Stories and Vicarious Self-Affirmation to Reduce e-Cigarette Use. HEALTH COMMUNICATION 2019; 34:352-360. [PMID: 29236554 PMCID: PMC6113127 DOI: 10.1080/10410236.2017.1407275] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
While prior research has demonstrated the benefits of self-affirming individuals prior to exposing them to potentially threatening health messages, the current study assesses the feasibility of inducing self-affirmation vicariously through the success of a character in a narrative. In Study 1, college-age participants who regularly use e-cigarettes (N = 225) were randomly assigned to read one of two versions of a story depicting a college student of their own gender. The versions were identical except in the vicarious self-affirmation (VSA) condition, the main character achieves success (i.e., honored with a prestigious award) before being confronted by a friend about the dangers associated with their e-cigarette use; whereas in the vicarious control condition, the achievement is mentioned after the risk information. Results of the posttest and 10-day follow-up demonstrated that VSA reduced messages derogation, while increasing self-appraisal and perceived risk. The effect of VSA on e-cigarette outcomes was moderated by frequency of use, with heavier users benefiting the most. Study 2 (N = 152) confirmed that traditional value affirmation works with our stimuli on a comparable population.
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Affiliation(s)
- Nathan Walter
- Annenberg School for Communication and Journalism, University of Southern California
| | | | - Sheila T. Murphy
- Annenberg School for Communication and Journalism, University of Southern California
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Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, Jiménez-Ruiz CA, Katsaounou P, Lindberg A, Metz C, Schober W, Spira A, Blasi F. Electronic cigarettes: a task force report from the European Respiratory Society. Eur Respir J 2019; 53:13993003.01151-2018. [PMID: 30464018 DOI: 10.1183/13993003.01151-2018] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/09/2018] [Indexed: 01/10/2023]
Abstract
There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives.ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.
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Affiliation(s)
- Robert Bals
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | | | - Susanna Esposito
- Pediatric Clinic, Dept of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Robert Foronjy
- Pulmonary and Critical Care Medicine, SUNY Downstate Medical Center, New York, NY, USA
| | - Pieter S Hiemstra
- Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Paraskevi Katsaounou
- 1st ICU Evangelismos Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Anne Lindberg
- Dept of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| | - Carlos Metz
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | - Wolfgang Schober
- Bavarian Health and Food Safety Authority, Dept of Chemical Safety and Toxicology, Munich, Germany
| | - Avrum Spira
- Boston University School of Medicine, Boston, MA, USA
| | - Francesco Blasi
- Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Abstract
Background: Rates of electronic cigarettes (e-cigarette) use (vaping) have increased among college students over the past decade. Objectives: The current study sought to provide an in-depth examination of college students' beliefs about and attitudes toward cigarettes and e-cigarettes that may influence support/non-support of tobacco-free policies on college campuses and within their communities. Methods: Between August and December 2015, five focus groups (n = 22) were conducted at a large Southern University. Focus group discussions addressed social acceptance and areas where students commonly smoked/vaped on campus. Sessions were transcribed verbatim. Two researchers independently coded the transcripts and identified themes. A third researcher independently reviewed the coding and thematic analysis process (triangulation of researchers). Results: Participants expressed positive attitudes toward smoke-free policies that did not target college students, especially those that protected vulnerable populations (e.g., children). However, some were skeptical of tobacco-free policies that included e-cigarettes. Participants believed the campus tobacco-free policy had moved smokers' behavior off campus, but many reported seeing people vape in locations where smoking was not allowed (i.e., library, dorm rooms). Most perceived smoking to be less acceptable than vaping; smoking was described as 'dirty', while vaping was glamorized as a cultural trend. Conclusions/Importance: Findings from our qualitative study suggest that college students are supportive of smoke-free policies, but they are less supportive of comprehensive tobacco-free policies that include e-cigarettes. College campuses and surrounding communities should plan for education about policy protection via communication channels viewed frequently by students when including vaping devices in their comprehensive tobacco-free policies/ordinances.
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Affiliation(s)
- Page D Dobbs
- Department of Health and Exercise Science, University of Oklahoma , Norman , Oklahoma , USA
| | - David T Rolfe
- Department of Physical Education, School Health, and Movement Studies, Central Washington University , Ellensburg , Washington , USA
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma , Norman , Oklahoma , USA
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Ridner SL, Keith RJ, Walker KL, Hart JL, Newton KS, Crawford TN. Differences in quality of life among college student electronic cigarette users. AIMS Public Health 2018; 5:454-462. [PMID: 30631786 PMCID: PMC6323002 DOI: 10.3934/publichealth.2018.4.454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/22/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study was to explore an association between e-cigarette use and Quality of Life (QOL) among college students. METHODS During February 2016, 1,132 students completed an online survey that included measures of tobacco use and the WHOQOL-BREF instrument. Differences were tested using Chi-square, Fisher's exact test, and ANOVA, and regression was used to assess possible relationships. RESULTS E-cigarettes were used by 6.97% of the participants, either solo or along with traditional cigarettes. Bivariate analyses suggest that male college students are more likely than females to use e-cigarettes, either solo or in combination with traditional cigarettes (χ2 =19.4, P < .01). Lesbian, gay, and bisexual students are more likely than heterosexual students to use traditional cigarettes, either solo or in combination with e-cigarettes (χ2 = 32.9, P < .01). Multivariate models suggest that for every 10-unit increase in overall QOL, psychological well-being, social relations or environmental health the adjusted odds of being a sole cigarette user were significantly lower (all, P < .01), respectively. For every 10-unit increase in psychological well-being the adjusted odds of being a dual user was significantly lower (OR = .83, P = .026). CONCLUSIONS Findings indicate that lower quality of life appears to be connected to tobacco use.
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Affiliation(s)
- S. Lee Ridner
- College of Nursing, East Tennessee State University, Johnson City, TN, USA
| | - Rachel J. Keith
- School of Medicine, University of Louisville, Louisville, KY, USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
| | - Karen S. Newton
- Campus Health Services, University of Louisville, Louisville, KY USA
| | - Timothy N. Crawford
- Department of Population and Public Health Sciences, Wright State University, Dayton, OH, USA
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