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Pasch KE, Thomas JE, North C, Marti CN, Loukas A. Exposure to tobacco retail outlet tobacco marketing and initiation of cigarette and e-cigarette use: Depressive symptoms as a moderator. Drug Alcohol Depend 2023; 248:109935. [PMID: 37230003 PMCID: PMC11214589 DOI: 10.1016/j.drugalcdep.2023.109935] [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: 01/03/2023] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION While tobacco retail outlet (TRO) marketing exposure has been associated with tobacco use, little research has explored how this relationship may vary by the experience of depressive symptoms. The purpose of this study was to examine if the relationship between TRO tobacco marketing exposure and tobacco use initiation is moderated by depressive symptoms among young adults. METHODS Participants were drawn from 24 colleges in Texas who were participating in a multi-wave cohort study (2014-2019). The present study included 2020 cigarette or ENDS naïve participants at wave 2 (69.2% female; 32.1% white; m age=20.6 [SD=2.0] at wave 1). Generalized mixed-effects logistic regression analyses were used to examine the association between cigarette and ENDS TRO marketing exposure and subsequent initiation for both products with depressive symptoms as a moderator. RESULTS The interaction between cigarette marketing and depressive symptoms was significant (OR=1.38 95% CI=[1.04,1.83]). Cigarette marketing did not impact cigarette initiation among participants with low depressive symptoms (OR=0.96 95% CI= [0.64,1.45]), but did impact cigarette initiation among participants with high depressive symptoms (OR=1.83 95% CI=[1.23,2.74]). There was no interaction effect for ENDS initiation. Main effects showed that ENDS marketing exposure predicted ENDS initiation (OR=1.43 95% CI=[1.10,1.87]). CONCLUSIONS Exposure to tobacco marketing at TROs is an important risk factor for initiation of cigarette and ENDS use, particularly for cigarette initiation among those who experience greater levels of depressive symptoms. Future work is needed to better understand why this type of marketing is influential for this group.
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Affiliation(s)
- Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
| | - Jacob E Thomas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Caroline North
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - C Nathan Marti
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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Lund L, Bast LS, Rubæk M, Andersen S. Exploring factors associated with smokeless tobacco use among young people: A systematic scoping review. Drug Alcohol Depend 2022; 240:109627. [PMID: 36167002 DOI: 10.1016/j.drugalcdep.2022.109627] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE While smoking is declining among young people, smokeless tobacco use is increasing. Identifying who is using smokeless tobacco and why is essential in preventing smokeless tobacco use. This study aimed to comprehensively explore the factors of young people's use of smokeless tobacco in western countries and identify research gaps. METHODS We conducted a systematic scoping review of studies that examined factors associated with smokeless tobacco use among young people (ages 13-29) from western countries published between January 2011 and September 2021. Searches were conducted in CINAHL, Medline, and Scopus. Studies on adults, total tobacco use (i.e., did not differentiate between tobacco product types), dual and multiple uses of tobacco, and studies on smokeless tobacco cessation programs were excluded. RESULTS A total of 160 studies were included in this scoping review. The studies were primarily undertaken in the US and the Scandinavian countries, and the majority explored smokeless tobacco use without distinguishing between the specific types. Smokeless tobacco users were more likely to be male, non-Hispanic white, engaging in physical activity, and using other substances, including cigarettes and alcohol. The role of friends and family were identified as critical factors that were related to the use of smokeless tobacco. CONCLUSIONS This scoping review suggests that preventative measures against smokeless tobacco use should focus on peer and family members' roles and that these measures may benefit from targeting males. Additional research, including systematic reviews on this area to validate the identified associated factors, would improve the understanding of smokeless tobacco use.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Mette Rubæk
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
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Nagawa CS, Wang B, Davis M, Pbert L, Cutrona SL, Lemon SC, Sadasivam RS. Examining pathways between family or peer factors and smoking cessation in a nationally representative US sample of adults with mental health conditions who smoke: a structural equation analysis. BMC Public Health 2022; 22:1566. [PMID: 35978318 PMCID: PMC9382825 DOI: 10.1186/s12889-022-13979-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Supportive family or peer behaviors positively impact smoking cessation in people with mental health problems who smoke. However, the limited understanding of the pathways through which family or peer factors impact quitting limits the development of effective support interventions. This study examined pathways through which family or peer views on tobacco use, family or peer smoking status, and rules against smoking in the home influenced quitting in adults with mental health problems who smoke. Methods We used data from the Population Assessment of Tobacco and Health Study, a national longitudinal survey. Baseline data were collected in 2015, and follow-up data in 2016. We included adults’ current smokers who had experienced two or more mental health symptoms in the past year (unweighted n = 4201). Structural equation modeling was used to test the relationships between family and peer factors, mediating factors, and smoking cessation. Results We found that having family or peers with negative views on tobacco use had a positive indirect effect on smoking cessation, mediated through the individual’s intention to quit (regression coefficient: 0.19) and the use of evidence-based approaches during their past year quit attempt (regression coefficient: 0.32). Having rules against smoking in the home (regression coefficient: 0.33) and having non-smoking family members or peers (regression coefficient: 0.11) had a positive indirect effect on smoking cessation, mediated through smoking behaviors (regression coefficient: 0.36). All paths were statistically significant (p < 0.01). The model explained 20% of the variability in smoking outcomes. Conclusion Family or peer-based cessation interventions that systematically increase intentions to quit and monitor smoking behavior may be able to assess the efficacy of family and peer support on quitting in people with mental health problems who smoke. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13979-z.
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Affiliation(s)
- Catherine S Nagawa
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Maryann Davis
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Sarah L Cutrona
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.,Health Services Research & Development, Center of Innovation Edith Nurse Rogers Memorial Hospital Veterans Health Administration, Bedford, USA
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Internalizing problems are associated with initiation and past 30-Day use of flavored tobacco products. Addict Behav 2022; 125:107162. [PMID: 34763300 PMCID: PMC8637941 DOI: 10.1016/j.addbeh.2021.107162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Tobacco use remains disproportionately common among adults with internalizing problems. The rising prevalence of flavored tobacco use among this population may be a contributing factor. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study examined differences across adult ever tobacco users by severity of internalizing problems, in initiation of tobacco use with a flavored product and past 30-day (current) flavored tobacco use (n = 27,425). Severity of internalizing problems was measured using the Global Appraisal of Individual Needs-Short Screener Internalizing Disorder Screener. Tobacco use variables included initiation with or current use of a flavored product, assessed separately for each product. Weighted chi-square tests and multivariable modified Poisson regression models were used to examine the associations between severity of internalizing problems and each outcome. RESULTS Controlling for covariates, ever users with severe internalizing problems were more likely to have initiated with flavors for cigarettes (adjusted prevalence ratio [aPR]: 1.16, 95% confidence interval [CI]: 1.09,1.24), cigarillos (aPR: 1.09, 95% CI: 1.03, 1.16), electronic nicotine products (aPR: 1.08, 95% CI: 1.03, 1.13) and smokeless tobacco (aPR: 1.15, 95% CI: 1.04, 1.27), relative to those with low internalizing problems. Ever users with severe internalizing problems were more likely to currently use a flavored tobacco product for cigarettes (aPR: 1.15, 95% CI: 1.07, 1.24) and cigarillos (aPR: 1.15, 95% CI: 1.04, 1.28). CONCLUSIONS Flavored tobacco use seems disproportionately common among tobacco users with severe internalizing problems, across a variety of measures.
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Yang Q, Yang F, Zhang K. Influence of Psychological Factors on College Students' Smoking Behavior: Moderating Role of Tobacco Advertising Receptivity and Health Behavior. Am J Health Behav 2022; 46:12-28. [PMID: 35227366 DOI: 10.5993/ajhb.46.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: The main objective of this study was to examine the role of psychological factors affecting college students' smoking behavior. We considered 3 psychological factors in this study - depressive symptoms, novelty seeking personality, and stress, which are common among learners in institutions of higher learning. Furthermore, we also considered the moderating effect of tobacco advertising receptivity and health behavior. Methods: In this study, we used a cross-sectional research design, wherein data were collected through a survey questionnaire, designed on a Likert scale. We received 160 responses for data analysis. Our primary analysis used partial least squares (PLS). Results: Depressive symptoms, novelty seeking personality, stress, and tobacco advertising receptivity had significant positive relationships with college students' smoking behavior; however, pro-health behavior had a negative effect on smoking behavior. Conclusion: Our results reveal a major role of depressive symptoms, novelty seeking personality and stress in shaping the smoking behavior of college students in China. Additionally, the moderating variables of tobacco advertising receptivity and health behavior showed considerable impact, as both showed a positive influence on psychological factors and smoking behavior of college students. Finally, our results provide insights for practitioners to devise strategies to address smoking behavior in college students.
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Affiliation(s)
- Qianqian Yang
- Qianqian Yang, College of Education, Hebei Normal University of Science & Technology, Hebei, China;,
| | - Fei Yang
- Fei Yang, College of Education, Hebei Normal University of Science &Technology, Hebei, China
| | - Kuo Zhang
- Kuo Zhang, College of Education, Hebei Normal University of Science & Technology, Hebei, China
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Becker TD, Arnold MK, Ro V, Martin L, Rice TR. Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults. Nicotine Tob Res 2020; 23:415-425. [DOI: 10.1093/ntr/ntaa171] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022]
Abstract
Abstract
Introduction
The prevalence of electronic cigarette (EC) use has risen dramatically among adolescents and young adults (AYA, ages 12–26) over the past decade. Despite extensive established relationships between combustible cigarette use and mental health problems, the mental health comorbidities of EC use remain unclear.
Aims and Methods
To provide a systematic review of existing literature on mental health comorbidities of EC use among AYA. Database searches using search terms related to EC, AYA, and mental health identified 1168 unique articles, 87 of which prompted full-text screening. Multiple authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings.
Results
Forty articles met eligibility criteria (n = 24 predominantly adolescent and 16 predominantly young adult). Analyses yielded three main categories of focus: internalizing disorders (including depression, anxiety, suicidality, eating disorders, post-traumatic stress disorder), externalizing disorders (attention-deficit/hyperactivity disorder and conduct disorder), and transdiagnostic concepts (impulsivity and perceived stress). Significant methodological limitations were noted.
Conclusions
Youth EC use is associated with greater mental health problems (compared with nonuse) across several domains, particularly among adolescents. Because many existing studies are cross-sectional, directionality remains uncertain. Well-designed longitudinal studies to investigate long-term mental health sequelae of EC use remain needed.
Implications
Forty recent studies demonstrate a variety of mental health comorbidities with AYA EC use, particularly among adolescents. Mental health comorbidities of EC use generally parallel those of combustible cigarette use, with a few exceptions. Future EC prevention and treatment strategies may be enhanced by addressing mental health.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Melanie K Arnold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vicky Ro
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Lily Martin
- Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
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