World vaping update

Predictors of polysubstance vaping in emerging adults

BACKGROUND

Polysubstance use, which increases the risk for negative consequences of substance use, is common among emerging adults who regularly consume substances by vaping. Examining predictors of polysubstance vaping is crucial for understanding whether this novel form of substance consumption lends itself equally efficaciously to established forms of intervention for smoked substances.

OBJECTIVE

The current study aimed to examine whether modifiable cognitive risk factors for increased vaping in the form of attitudes, expectancies and norms can predict co-use of nicotine and cannabis among vapers over and above the effect of demographics, personality risk factors and anxiety, depression symptoms.

METHODS

Regular nicotine and cannabis vapers between 18 and 30 years were recruited online in Canada via a Qualtrics panel. Hierarchical binary logistic regression was used to predict membership in a polysubstance or a single substance vaping group. Demographics, personality risk factors, depression and anxiety symptoms were included as predictors in block 1; attitudes, expectancies and perceived norms of vaping were added in block 2.

RESULTS

Attitudes, expectancies and norms predicted polysubstance use over and above the effect of demographics, personality risk factors and anxiety, depression symptoms. Positive expectancies played a uniquely significant role in the prediction of polysubstance vaping.

CONCLUSIONS

Cognitive interventions targeting attitudes, expectancies and norms may be effective in prevention of polysubstance vaping, although positive expectancies appear to be the main unique factor that has an influence above and beyond all other cognitive factors related to vaping. Treatment and prevention programs should put special focus on lowering positive expectancies.

Physical Violence Perpetration Among College Students: Prevalence and Associations With Substance Use and Mental Health Symptoms

The aims of this study were to, first, report the prevalence of physical violence perpetration among a sample of college students and, second, to identify associations between physical violence perpetration, substance use, and mental health symptoms. We analyzed survey data from the Healthy Minds Study. We examined the 12-month prevalence of physical violence perpetration by gender identity from 2014-2019 (n = 181,056). We used multivariable logistic regression analyses to estimate associations between physical violence perpetration, substance use, and mental health symptoms from the 2018-2019 survey year (n = 43,563). Results revealed that 12-month prevalence rates of physical violence perpetration increased from 2014-2019 among male, female, and transgender/gender nonconforming college students. Results from multivariable logistic regression analyses using the 2018-2019 survey year revealed higher odds of physical violence perpetration in the previous 12 months among students who reported substance use and mental health symptoms, including vaping or e-cigarette use, illicit drug use, and nonsuicidal self-injury, among others. Our findings highlight steadily rising prevalence of physical violence perpetration from 2014-2019 among college students, indicating a growing need for more research and prevention efforts to address this problem in higher education settings. Efforts to prevent violence on college campuses should consider how to reduce substance use and improve mental health to reduce this form of violence.

E-cigarettes and non-suicidal self-injury: Prevalence of risk behavior and variation by substance inhaled

BACKGROUND

Nicotine and cannabis inhalation through vaping or electronic delivery systems has surged among young adults in the United States, particularly during the coronavirus disease pandemic. Tobacco and marijuana use are associated with select adverse mental health outcomes, including symptoms of major depressive disorder and suicidal behaviors. Given the need for addiction specialists to treat problematic substance use with an integrated approach, the association between non-suicidal self-injury (NSSI) and use of e-cigarettes, tobacco, marijuana, and alcohol was examined among a diverse sample of college students.

METHODS

Healthy Minds Study data from 47,016 weighted observations, collected from college students in the 2018-2019 academic year, was used to explore associations between NSSI-related behaviors and past 30-day use of a vaping product (nicotine or marijuana). These relationships were assessed among those using vaping products only, and then among individuals using vaping products and alcohol, conventional cigarettes, and/or marijuana. Hierarchical logistic regression models estimating the relationship between vaping and NSSI were computed to adjust for the effects of demographic factors, symptomatology of psychiatric disorders, and concurrent use of other substances.

RESULTS

A fifth (22.9%) of respondents disclosed past 12-month NSSI; they were significantly more likely to screen positive for depression or anxiety compared to young adults without NSSI. Rates of using vaping products, conventional cigarettes, marijuana, or other substances were higher among students with NSSI even after controlling for potential cofounders. Additionally, students who used a THC-based liquid in their e-cigarettes were more likely to endorse NSSI in comparison to those who used "just flavoring." However, young adults who vaped were less likely to disclose frequent NSSI-related behaviors than their peers who did not vape.

CONCLUSIONS

These findings revealed an association between past 12-month NSSI and past 30-day vaping in a sample of young adults. Further surveillance among college populations and examination of potential sociodemographic confounders is necessary to confirm these findings and advance the substance use and addiction field.

Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction

Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.

An Observational Study of Vaping Knowledge and Perceptions in a Sample of U.S. Adults

Background

Vaping is the use of e-cigarettes that contain inhalants such as nicotine, tetrahydrocannabinol, and cannabidiol. Vaping is associated with e-cigarette or vaping product use associated lung injury (EVALI) and is a recognized public health crisis. Despite rising numbers of hospitalizations due to EVALI, public knowledge and perceptions of the dangers of vaping require further investigation.

Objectives

This exploratory study assessed knowledge and perceptions of vaping in U.S. adults.

Methods

This study was approved by an ethical board, and informed consent was obtained from all participants. A cohort of U.S. adults was recruited by shared links on social media. Participants completed an anonymous online survey that contained vaping knowledge and perceptions items. An a priori power analysis was conducted at 95% power and alpha = 0.05. Statistics were calculated using IBM SPSS Statistics Version 26 (IBM Corp., Armonk, NY, USA).

Results

A sample of 413 (N = 413) U.S. adults participated in the survey. The majority of participants (79.18%) were females, and 65.62% were between 18 and 24 years of age. Over half (62.71%) of participants were never asked about vaping use by a clinician at any visit, and 56.51% agreed that vaping can reduce stress. Of all participants, 70.91% agreed that drinking alcohol makes someone more inclined to vape. Significant positive Spearman’s rho correlations were found between vaping and the use of cannabis, cocaine, ecstasy, hallucinogens, and inhalants (p < 0.05).

Conclusions

We found a significant correlation between vaping and drug use. We also found that if the dangers of vaping are discussed by their health care providers, participants are more inclined to quit vaping. Unfortunately, many physicians report that they avoid discussing vaping with their patients due to lack of vaping knowledge. Our results illuminate the communication gap between patients and physicians. All clinicians need to counsel patients on the dangers of vaping, which might help prevent EVALI and related conditions.