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Mantey DS, Omega-Njemnobi O, Montgomery L, Kelder SH. Racial and Ethnic Disparities in Adolescent Combustible Tobacco Smoking From 2014 to 2020: Declines Are Lagging Among Non-Hispanic Black Youth. Nicotine Tob Res 2024; 26:940-947. [PMID: 38181207 PMCID: PMC11190047 DOI: 10.1093/ntr/ntae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/20/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, and then compared these trends across racial and ethnic categories. We also tested the effect of e-cigarette use on these trends for all-youth and across racial and ethnic categories. AIMS AND METHODS We pooled and analyzed seven years of National Youth Tobacco Survey data for n = 124 151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (ie cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All-models controlled for sex, grade level, and past 30-day e-cigarette use. RESULTS Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, the odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p = .025), NHOs (15.4% per year; p = .01), and NHBs (5.1% per year; p < .001), adjusting for sex, grade, and e-cigarette use. Trends and disparities in trends by race and ethnicity were observed independent of e-cigarette use. CONCLUSIONS Combustible tobacco smoking declined for all-youth but at significantly different rates across races and ethnicities. Notably, declines in combustible tobacco smoking are lagging among NHB youth. Interventions are critically needed to address this disparity. IMPLICATIONS A direct, evidence-based intervention to reduce combustible tobacco smoking among NHB youth is critically needed. Such tobacco control initiatives should follow the Best Practices for Comprehensive Tobacco Control Framework, incorporating sustainable funding for school-based intervention, public health education, and adult cessation.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, UTHealth University of Texas School of Public Health, Houston, TX, USA
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
| | - Onyinye Omega-Njemnobi
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth University of Texas School of Public Health, Houston, TX, USA
| | - LaTrice Montgomery
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Steven H Kelder
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin Campus, Austin, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth University of Texas School of Public Health, Houston, TX, USA
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Fox KR, Rausch JR, Grant VR, Ferketich AK, Groner JA, Garg V, Cua CL, Jackson JL. Associations of Impulsivity and Risky Decision-Making with E-Cigarette-Related Outcomes Among Adolescents with Congenital Heart Disease: Variable- and Person-Oriented Approaches. Behav Med 2024:1-12. [PMID: 38706412 DOI: 10.1080/08964289.2024.2347226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/01/2024] [Indexed: 05/07/2024]
Abstract
Adolescents with congenital heart disease (CHD) have elevated risk for acquired cardiovascular complications, increasing their vulnerability to e-cigarette-related health harms. Impulsivity and risky decision-making have been associated with adolescent substance use, but the relationships between these factors and e-cigarette-related outcomes among cardiovascular at-risk adolescents with CHD are unknown. This cross-sectional study aimed to (a) determine the associations of impulsivity and risky decision-making with e-cigarette-related outcomes (i.e. susceptibility, ever use, perceptions of harm and addictiveness) via variable-oriented analysis (logistic regression), (b) identify groups of adolescents with similar profiles of impulsivity and risky decision-making via exploratory person-oriented analysis (latent profile analysis; LPA), and (c) examine differences on e-cigarette-related outcomes between profile groups. Adolescents aged 12 to 18 years with CHD (N = 98) completed a survey assessing impulsivity facets (Short UPPS-P) and e-cigarette-related outcomes and were administered a risky decision-making task (Iowa Gambling Task, Version 2; IGT2). In variable-oriented analyses, impulsivity facets (negative urgency, positive urgency, lack of premeditation) but not risky decision-making were associated with e-cigarette susceptibility and ever use. The exploratory LPA identified two groups with similar patterns of responding on the Short UPPS-P and IGT2 labeled "Low Impulsivity" and "High Impulsivity," which were primarily characterized by significant differences in negative and positive urgency. Adolescents in the High Impulsivity group had increased odds of e-cigarette susceptibility but not ever use compared to the Low Impulsivity group. This work indicates that strategies to prevent e-cigarette use among adolescents with CHD may be enhanced by addressing impulsivity, particularly negative and positive urgency.
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Affiliation(s)
- Kristen R Fox
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Victoria R Grant
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Judith A Groner
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vidu Garg
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jamie L Jackson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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Herrmann AK, Ferullo SL, Hernandez M, Barriga VA, Leggis B, Ruiz J, Glenn BA, Bastani R. Adapting E-cigarette prevention programming to reach the latinx community. Cancer Causes Control 2024; 35:405-416. [PMID: 37812335 PMCID: PMC10838817 DOI: 10.1007/s10552-023-01796-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/06/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE E-cigarettes are the most commonly used tobacco product among youth in the United States. Yet evidence-based prevention programming is limited due to the rapid onset of this threat. Community-based efforts to address vaping largely target youth in school settings. Although parents can play an important role in youth tobacco control efforts, messages about the dangers of vaping, use among adolescents, and strategies for intervening have not reached many Spanish-speaking parents in low-income Latinx communities. Our community-academic team developed e-cigarette prevention programming for use by promotor/as de salud to address this unmet need. METHODS During the 1-year project, the team worked closely with a Project Advisory Committee to: review existing evidence-informed materials; conduct focus groups with parents, youth and promotor/as to guide program development; develop a curriculum to prepare promotor/as to educate low-literacy, Spanish-speaking parents about vaping; craft Spanish language resources for promotor/as to use in community education sessions; train 61 promotor/as to deliver the program; and support program delivery to 657 community members. RESULTS Focus groups with promotor/as and community members, key-informant interviews, and brief surveys informed program development and assessment. Community member feedback was essential to development of appropriate materials. Promotor/as demonstrated significant pre- to post- training increases in e-cigarette knowledge and confidence in delivering vaping prevention education. Community members demonstrated a mastery of basic e-cigarette concepts and expressed intention to discuss vaping with their children. CONCLUSIONS Promotor/a-led programming for parents represents a promising approach to vaping prevention and control in the Latinx community.
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Affiliation(s)
- Alison K Herrmann
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA.
| | - Sylvia Lopez Ferullo
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Miriam Hernandez
- Visión y Compromiso, 1000 Alameda Street, Los Angeles, CA, 90012, USA
| | | | - Bernadett Leggis
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Julissa Ruiz
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Beth A Glenn
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Roshan Bastani
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
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Chido-Amajuoyi OG, Osaghae I, Agaku IT, Chen B, Mantey DS. Exposure to school-based tobacco prevention interventions in low-income and middle-income countries and its association with psychosocial predictors of smoking among adolescents: a pooled cross-sectional analysis of Global Youth Tobacco Survey data from 38 countries. BMJ Open 2024; 14:e070749. [PMID: 38413149 PMCID: PMC10900417 DOI: 10.1136/bmjopen-2022-070749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES To describe the prevalence of school-based tobacco prevention programme exposure among adolescents in low-income and middle-income countries (LMICs) and its association with psychosocial predictors of smoking. DESIGN Analysis of pooled cross-sectional data. SETTING Global Youth Tobacco Survey (GYTS), conducted in 38 LMICs. PARTICIPANTS This was a pooled analysis of data involving a total of 132 755 adolescent respondents to GYTS in 38 LMICs across Africa, Europe and Central/South America between 2014 and 2017. EXPOSURE AND OUTCOME MEASURES The primary independent variable for this study was self-reported exposure to school-based tobacco prevention programmes in the past year. Five psychosocial determinants of smoking were explored as outcomes: perceived addictiveness of nicotine, perceived harm of secondhand smoke exposure, support for restricting cigarette smoking at public indoor locations, support for restricting cigarette smoking at public outdoor areas and self-reported prediction of enjoying cigarette smoking. Multivariable logistic regression models were used to examine the relationship between exposure to school-based tobacco prevention programmes and study outcomes, controlling for sociodemographic and smoking-related characteristics of respondents. RESULTS Overall, 59.1% of adolescents in LMICs self-reported exposure to school-based tobacco prevention programmes. The country-specific prevalence of adolescent exposure to school-based tobacco interventions ranged from 24.9% in the Comoros to 99.3% in Turkmenistan. Exposure to school-based tobacco interventions was significantly associated with greater secondhand smoke harm perceptions (adjusted OR (AOR): 1.69; 95% CI: 1.69 to 1.70), perceptions of addictiveness (AOR: 1.37; 95% CI: 1.36 to 1.37) and supporting tobacco use restrictions indoors (AOR: 1.70; 95% CI: 1.69 to 1.70) and outdoors (AOR: 1.59; 95% CI: 1.59 to 1.60). Exposure to school-based tobacco interventions was associated with lower odds of anticipating enjoying cigarette smoking (AOR: 0.76; 95% CI: 0.76 to 0.76). CONCLUSION Exposure to tobacco prevention programmes in schools is suboptimal in LMICs. Given the protective associations described in this study from school-based tobacco prevention programme exposure, it is imperative that national governments implement school-based programmes into ongoing tobacco control measures.
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Affiliation(s)
| | - Ikponmwosa Osaghae
- Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA
| | - Israel Terungwa Agaku
- Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Baojiang Chen
- Biostatistics, The University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Dale S Mantey
- Health Promotion/Behavioral Science, The University of Texas Health Science Center at Houston, Austin, Texas, USA
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Stockings EA, Gardner LA, Newton NC. Vaping among young people-Our best defence is self-defence. Drug Alcohol Rev 2024; 43:355-358. [PMID: 37782572 DOI: 10.1111/dar.13746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023]
Abstract
Use of electronic cigarettes (e-cigarettes or 'vapes') has risen rapidly among young Australians in recent years. To combat this, on 2 May 2023, the Albanese Government announced a suite of reforms to reduce the desirability and accessibility of e-cigarettes to young people-including a ban on disposable e-cigarettes, restricting flavours, colours and nicotine content and requiring pharmaceutical-like packaging. While many have welcomed this announcement, the efficacy of such reforms in reducing the availability of e-cigarettes to young people remain to be seen, particularly given the current prescription-only model has done little to curb youth vaping. We argue that, in an uncertain landscape where e-cigarettes will likely remain accessible and desirable to young people, it is critical that we also upskill, empower and arm our young people with the skills, resilience, resources and knowledge to make informed and positive health decisions so that: (i) fewer young people opt to take up vaping (primary prevention); and (ii) among those who already do vape, more seek help earlier on to reduce or cease their use before dependency develops (secondary prevention). Schools are an ideal setting for the delivery of these programs, where they can be delivered en masse, integrated into existing alcohol and other drug programs and aligned with school curricula. Skills-based school prevention programs have demonstrated significant and sustained reductions in drug-related harms up to 7 years post-intervention. For as long as vapes remain widely available, desirable and purposefully marketed towards young people, we believe our best defence is self-defence.
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Affiliation(s)
- Emily A Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Mylocopos G, Wennberg E, Reiter A, Hébert-Losier A, Filion KB, Windle SB, Gore G, O'Loughlin JL, Grad R, Eisenberg MJ. Interventions for Preventing E-Cigarette Use Among Children and Youth: A Systematic Review. Am J Prev Med 2024; 66:351-370. [PMID: 37802308 DOI: 10.1016/j.amepre.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Many nonregulatory interventions targeting children and youth have been implemented at three levels: directed at the individual (e.g., interactive video games), delivered to students at school (e.g., campus bans), and launched in the community (e.g., mass media campaigns). This systematic review aims to synthesize the evidence on the effectiveness of interventions aimed at preventing e-cigarette initiation among children and youth. METHODS MEDLINE, CINAHL, Embase, APA PsycINFO, and Web of Science Core Collection were searched for papers published between January 1, 2004 and September 1, 2022 that reported more than one outcome on vaping prevention among individuals aged less than 21-years-old: vaping prevalence/incidence, initiation intentions, knowledge/attitudes, and other tobacco product use prevalence/initiation intentions. Interventions were at the individual, school, or community level. The risk of bias was assessed using ROBINS-I and RoB 1. RESULTS Thirty-nine publications met the eligibility criteria. Fourteen individually-based (4 parental monitoring, 3 video games, 2 text messages, 3 graphic message themes, 2 healthcare), 19 school-based (14 educational and skill interventions, 5 vape-free policies/bans), and 6 community-based (3 social media, 3 mass media campaigns) interventions were reported. E-cigarette initiation prevention was observed with high perceived parental monitoring; however, the cross-sectional study designs precluded causal claims. There was promising but limited evidence that social-emotional skills curricula and peer leader programming prevented vaping initiation. DISCUSSION Some individual- and school-based interventions showed promise for preventing e-cigarette initiation among children and youth.
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Affiliation(s)
- Genevieve Mylocopos
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Erica Wennberg
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anna Reiter
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andréa Hébert-Losier
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Kristian B Filion
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; Departments of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Sarah B Windle
- Departments of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Jennifer L O'Loughlin
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Roland Grad
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada; Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Mark J Eisenberg
- Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; Departments of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada.
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Russell AJ, Shishani K, Hurst S. The Role of the School Nurse in E-Cigarette Prevention and Cessation: A Scoping Review. J Sch Nurs 2024:10598405231225976. [PMID: 38233367 DOI: 10.1177/10598405231225976] [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: 01/19/2024] Open
Abstract
E-cigarettes have rapidly gained popularity among youth in recent years. This scoping review identifies opportunities for school nurses to incorporate e-cigarette prevention strategies into their practice and identifies gaps for future research in school nursing evidence-based practice. Using the methodological framework developed by Arksey and O'Malley and advanced by Levac et al., a literature review was conducted using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), and Education Resources Information Center (ERIC) databases. A total of 15 articles were included in the final review. Articles for inclusion addressed interventions aimed at reducing e-cigarette use in K-12 schools. The results highlight two general types of school-based interventions: (1) universal e-cigarette prevention education and (2) targeted e-cigarette use-cessation programs. Each of these types of interventions presents a leadership opportunity for school nurses to engage within all domains of their scope of practice.
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Affiliation(s)
- Alanna J Russell
- Department of Nursing, Washington State University, Spokane, WA, USA
| | - Kawkab Shishani
- Department of Nursing, Washington State University, Spokane, WA, USA
| | - Sheila Hurst
- Department of Nursing, Washington State University, Spokane, WA, USA
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Struik L, Sharma RH, Rodberg D, Christianson K, Lewis S. A Content Analysis of Behavior Change Techniques Employed in North American Vaping Prevention Interventions. AJPM FOCUS 2023; 2:100126. [PMID: 37790953 PMCID: PMC10546602 DOI: 10.1016/j.focus.2023.100126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Vaping among North American youth has surfaced as a concerning public health epidemic. Increasing evidence of harms associated with E-cigarette use, especially among the young, has prompted urgency in addressing vaping. Although a number of individual behavior change campaigns have arisen as a result, little is known about which behavior change techniques are being employed to influence youth vaping behavior. In this study, we aimed to code all North American vaping prevention campaigns using the behavior change technique taxonomy (Version 1) to determine which behavior change techniques are being used. Methods We identified the sample of campaigns through systematic searches using Google. After applying the exclusion criteria, the campaigns were reviewed and coded for behavior change techniques. Results In total, 46 unique vaping prevention campaigns were identified, including 2 federal (1 from Canada, 1 from the U.S.), 43 U.S. state-level, and 1 Canadian provincial-level campaign(s). The number of behavior change technique categories and behavior change techniques in a campaign ranged from 0 to 5 (mean=1.56) and 0 to 6 (mean=2.13), respectively. Of the 16 possible behavior change technique categories, 4 were utilized across the campaigns, which included 5. Natural consequences (89%), 6. Comparison of behavior (22%), 13. Identity (20%), and 3. Social support (11%). Conclusions Only a small number of behavior change techniques were used in North American vaping prevention campaigns, with a heavy and often sole reliance on communicating the health consequences of use. Incorporating other promising behavior change techniques into future campaigns is likely a productive way forward to tackling the complex and multifaceted issue of youth vaping.
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Affiliation(s)
- Laura Struik
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Ramona H. Sharma
- Department of Health and Exercise Sciences, School of Social Work, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Danielle Rodberg
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyla Christianson
- Department of Health and Exercise Sciences, School of Nursing, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
| | - Shannon Lewis
- Department of Health and Exercise Sciences, School of Social Work, The University of British Columbia Okanagan Campus, Kelowna, British Columbia, Canada
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Barnes C, Turon H, McCrabb S, Hodder RK, Yoong SL, Stockings E, Hall AE, Bialek C, Morrison JL, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2023; 11:CD015511. [PMID: 37965949 PMCID: PMC10646968 DOI: 10.1002/14651858.cd015511.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND The prevalence of e-cigarette use has increased globally amongst children and adolescents in recent years. In response to the increasing prevalence and emerging evidence about the potential harms of e-cigarettes in children and adolescents, leading public health organisations have called for approaches to address increasing e-cigarette use. Whilst evaluations of approaches to reduce uptake and use regularly appear in the literature, the collective long-term benefit of these is currently unclear. OBJECTIVES The co-primary objectives of the review were to: (1) evaluate the effectiveness of interventions to prevent e-cigarette use in children and adolescents (aged 19 years and younger) with no prior use, relative to no intervention, waitlist control, usual practice, or an alternative intervention; and (2) evaluate the effectiveness of interventions to cease e-cigarette use in children and adolescents (aged 19 years and younger) reporting current use, relative to no intervention, waitlist control, usual practice, or an alternative intervention. Secondary objectives were to: (1) examine the effect of such interventions on child and adolescent use of other tobacco products (e.g. cigarettes, cigars types, and chewing tobacco); and (2) describe the unintended adverse effects of the intervention on individuals (e.g. physical or mental health of individuals), or on organisations (e.g. intervention displacement of key curricula or learning opportunities for school students) where such interventions are being implemented. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Clarivate Web of Science Core Collection from inception to 1 May 2023. Additionally, we searched two trial registry platforms (WHO International Clinical Trials Registry Platform; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov), Google Scholar, and the reference lists of relevant systematic reviews. We contacted corresponding authors of articles identified as ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, factorial RCTs, and stepped-wedge RCTs. To be eligible, the primary targets of the interventions must have been children and adolescents aged 19 years or younger. Interventions could have been conducted in any setting, including community, school, health services, or the home, and must have sought to influence children or adolescent (or both) e-cigarette use directly. Studies with a comparator of no intervention (i.e. control), waitlist control, usual practice, or an alternative intervention not targeting e-cigarette use were eligible. We included measures to assess the effectiveness of interventions to: prevent child and adolescent e-cigarette use (including measures of e-cigarette use amongst those who were never-users); and cease e-cigarette use (including measures of e-cigarette use amongst children and adolescents who were e-cigarette current-users). Measures of e-cigarette use included current-use (defined as use in the past 30 days) and ever-use (defined as any lifetime use). DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of references, with any discrepancies resolved through consensus. Pairs of review authors independently assessed the full-text articles for inclusion in the review. We planned for two review authors to independently extract information from the included studies and assess risk of bias using the Cochrane RoB 2 tool. We planned to conduct multiple meta-analyses using a random-effects model to align with the co-primary objectives of the review. First, we planned to pool interventions to prevent child and adolescent e-cigarette use and conduct two analyses using the outcome measures of 'ever-use' and 'current-use'. Second, we planned to pool interventions to cease child and adolescent e-cigarette use and conduct one analysis using the outcome measure of 'current-use'. Where data were unsuitable for pooling in meta-analyses, we planned to conduct a narrative synthesis using vote-counting approaches and to follow the Cochrane Handbook for Systematic Reviews of Interventions and the Synthesis Without Meta-analysis (SWiM) guidelines. MAIN RESULTS The search of electronic databases identified 7141 citations, with a further 287 records identified from the search of trial registries and Google Scholar. Of the 110 studies (116 records) evaluated in full text, we considered 88 to be ineligible for inclusion for the following reasons: inappropriate outcome (27 studies); intervention (12 studies); study design (31 studies); and participants (18 studies). The remaining 22 studies (28 records) were identified as ongoing studies that may be eligible for inclusion in a future review update. We identified no studies with published data that were eligible for inclusion in the review. AUTHORS' CONCLUSIONS We identified no RCTs that met the inclusion criteria for the review, and as such, there is no evidence available from RCTs to assess the potential impact of interventions targeting children and adolescent e-cigarette use, tobacco use, or any unintended adverse effects. Evidence from studies employing other trial designs (e.g. non-randomised) may exist; however, such studies were not eligible for inclusion in the review. Evidence from studies using non-randomised designs should be examined to guide actions to prevent or cease e-cigarette use. This is a living systematic review. We search for new evidence every month and update the review when we identify relevant new evidence. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Heidi Turon
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Caitlin Bialek
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Jacob L Morrison
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
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Kim J, Lee S. Factors associated with Korean adolescent's e-cigarette use by the severity level of generalized anxiety disorder (GAD-7). J Affect Disord 2023; 340:129-138. [PMID: 37544484 DOI: 10.1016/j.jad.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The use of e-cigarette among Korean adolescents is spreading with alarming rapidity, but it has not been studied along with the severity level of GAD-7. This study aims to identify adolescents' e-cigarette use and its associated factors among four different anxiety groups using the problem behavioral theory (PBT). METHODS A cross-sectional secondary dataset was retrieved from the 2020 Korea Youth Risk Behavior Survey. Of the total sample of 54,948, four anxiety groups were formed: minimal (score 0-4; n = 36,711), mild (score 5-9; n = 12,138), moderate (score 10-14; n = 4143), and severe (score above 15; n = 1965). A total of 11 variables were selected based on the PBT domains. Descriptive analysis, Chi-square, ANOVA, univariate analysis, and multiple linear regression analysis were performed. RESULTS E-cigarette use was the highest in the order of severe, mild, moderate, and minimal. While cigarette use was associated with vaping in all anxiety groups, adolescents with minimal or mild anxiety levels were more likely to be influenced by tobacco accessibility and other behavior system factors such as sexual intercourse, alcohol use, and smartphone addiction. Meanwhile, secondhand smoke exposure in public areas was only associated with those with severe anxiety levels, and secondhand smoke exposure at school was a significant factor in all anxiety groups except for those with moderate anxiety levels. LIMITATION Due to the nature of cross-sectional dataset, the study could not draw causal links between vaping and other identified factors, include all the necessary PBT components. CONCLUSION These findings underscore the need to consider different levels of anxiety when addressing the problems related to vaping among Korean adolescents.
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Affiliation(s)
- Jinyung Kim
- University of Maryland, School of Social Work, United States of America
| | - Serim Lee
- Department of Social Welfare, Ewha Womans University, Republic of Korea.
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11
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Dai HD, Hanh P, Guenzel N, Morgan M, Kerns E, Winickoff JP. Adoption of Vaping Cessation Methods by US Adolescent E-Cigarette Users. Pediatrics 2023; 152:e2023062948. [PMID: 37781732 PMCID: PMC10995917 DOI: 10.1542/peds.2023-062948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND A large number of adolescent e-cigarette users intend to quit vaping or have past-year quit attempts. However, it remains unknown which methods they use in their vaping cessation efforts. METHODS We analyzed current (past 30-day) e-cigarette users who made ≥1 quit attempt in the past 12 months from the 2021 National Youth Tobacco Survey (NYTS) to examine the prevalence and associations of sociodemographic factors, vaping behaviors, and harm perception with the adoption of different vaping cessation methods. RESULTS In the 2021 NYTS, there were 1436 current vapers, and 889 (67.9%) had made a past-year quit attempt. Of those, 575 (63.7%) (weighted N = 810 000) reported they did not use any resources (unassisted quitting). Peer support (14.2%), help on the Internet (6.4%), a mobile app or text messaging (5.9%), and parent support (5.8%) were the top 4 cessation methods. Female (versus male) vapers were less likely to solicit parent support (adjusted odds ratio [AOR], 0.2; 95% confidence interval [95% CI], 0.1-0.5), whereas Hispanic (versus White) vapers were more likely to seek friend support (AOR, 2.1; 95% CI, 1.1-3.9) and parent support (AOR, 2.7, 95% CI, 1.2-6.3). Those who perceived vaping to be harmful were less likely to get friend support, but more likely to use a mobile app or text messaging program. Dual users of e-cigarettes and any other tobacco product were more likely to get help from a teacher/coach or a doctor/health care provider and treatment from medical facilities than sole e-cigarette users. CONCLUSIONS There were different correlates with the adoption of vaping cessation methods, highlighting the need for tailored approaches to meet the cessation needs and preferences of the adolescent vaping population.
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Affiliation(s)
| | - Pham Hanh
- College of Public Health, University of Nebraska Medical Center, Omaha
- College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri
| | - Nick Guenzel
- College of Nursing, University of Nebraska Medical Center, Omaha
| | - Mathuri Morgan
- College of Public Health, University of Nebraska Medical Center, Omaha
- College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri
| | - Ellen Kerns
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
- Department of Pediatrics, Children’s Hospital & Medical Center, Omaha, Nebraska
| | - Jonathan P. Winickoff
- Department of Pediatrics, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
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12
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Yaugher AC, Pay CC, Hawks J, Meier CL. Evaluating a Multicomponent e-Cigarette Prevention Program in the Rural Northwest: Teacher and Parent/Guardian Program Outcomes. J Sch Nurs 2023:10598405231198020. [PMID: 37644848 DOI: 10.1177/10598405231198020] [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: 08/31/2023] Open
Abstract
There are effective prevention strategies to combat increasing rates of youth e-cigarette use. This study assessed the outcomes of an e-cigarette prevention program with teachers and parents/guardians across a three-county rural area. Researchers assessed teachers' and parent/guardians' increased knowledge and confidence in implementing vape prevention after receiving evidence-based trainings. Pre- and post-surveys demonstrated that teachers had a statistically significant increase in knowledge gain across all eight vape-specific domains assessed as expected. The parent/guardian pre- and post-survey results also show that knowledge and confidence increased significantly across seven domains. Findings suggest that multicomponent e-cigarette education and prevention programs better prepare teachers and parents/guardians to intervene with youth e-cigarette use and initiation, including being more likely to talk to youth about the risks of tobacco and vaping. Recommendations for school nurses are discussed and include educating youth, families, and staff for positive impacts.
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Affiliation(s)
- Ashley C Yaugher
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Christina C Pay
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Jenna Hawks
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Cristian L Meier
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
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13
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Rose JJ, Krishnan-Sarin S, Exil VJ, Hamburg NM, Fetterman JL, Ichinose F, Perez-Pinzon MA, Rezk-Hanna M, Williamson E. Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association. Circulation 2023; 148:703-728. [PMID: 37458106 DOI: 10.1161/cir.0000000000001160] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Vaping and electronic cigarette (e-cigarette) use have grown exponentially in the past decade, particularly among youth and young adults. Cigarette smoking is a risk factor for both cardiovascular and pulmonary disease. Because of their more limited ingredients and the absence of combustion, e-cigarettes and vaping products are often touted as safer alternative and potential tobacco-cessation products. The outbreak of e-cigarette or vaping product use-associated lung injury in the United States in 2019, which led to >2800 hospitalizations, highlighted the risks of e-cigarettes and vaping products. Currently, all e-cigarettes are regulated as tobacco products and thus do not undergo the premarket animal and human safety studies required of a drug product or medical device. Because youth prevalence of e-cigarette and vaping product use was as high as 27.5% in high school students in 2019 in the United States, it is critical to assess the short-term and long-term health effects of these products, as well as the development of interventional and public health efforts to reduce youth use. The objectives of this scientific statement are (1) to describe and discuss e-cigarettes and vaping products use patterns among youth and adults; (2) to identify harmful and potentially harmful constituents in vaping aerosols; (3) to critically assess the molecular, animal, and clinical evidence on the acute and chronic cardiovascular and pulmonary risks of e-cigarette and vaping products use; (4) to describe the current evidence of e-cigarettes and vaping products as potential tobacco-cessation products; and (5) to summarize current public health and regulatory efforts of e-cigarettes and vaping products. It is timely, therefore, to review the short-term and especially the long-term implications of e-cigarettes and vaping products on cardiopulmonary health. Early molecular and clinical evidence suggests various acute physiological effects from electronic nicotine delivery systems, particularly those containing nicotine. Additional clinical and animal-exposure model research is critically needed as the use of these products continues to grow.
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Cole AG, Gohari MR, Leatherdale ST. Evaluating the One-Year Impact of School e-Cigarette Use Interventions among Current Youth e-Cigarette Users in the COMPASS Study, 2017/18-2018/19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6353. [PMID: 37510585 PMCID: PMC10379233 DOI: 10.3390/ijerph20146353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
There is a lack of evidence for the impact of school-based e-cigarette interventions among current e-cigarette users. This natural experimental evaluation study evaluated the one-year impact of various school-based e-cigarette prevention/cessation programs among a sample of current youth e-cigarette users. The COMPASS study sample included n = 3586 current e-cigarette users from n = 90 schools with data collected between 2017 and 2019. Student e-cigarette use patterns were categorized as "escalated", "maintained", and "reduced" based on the change in past 30-day e-cigarette use between baseline and follow-up. Intervention schools added e-cigarette use "prevention", "cessation", or "protection" programs, while control schools did not make any changes. Logistic regression models identified how each category of added programs was associated with e-cigarette use patterns. About one quarter of schools added an e-cigarette use prevention/cessation program over one year. Student e-cigarette use patterns between control and intervention groups differed in proportion ranging from a decrease of 3.35% to an increase of 5.80%. Regression models did not identify any significant differences in the odds of escalating or reducing e-cigarette use in intervention relative to control schools. While many schools implemented new e-cigarette programs over one year, none of the interventions led to significant changes in e-cigarette escalation or reduction among current youth e-cigarette users. Additional studies are needed to evaluate the impact of e-cigarette interventions among current e-cigarette users.
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Affiliation(s)
- Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada
| | - Mahmood R Gohari
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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15
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Bteddini DS, LeLaurin JH, Chi X, Hall JM, Theis RP, Gurka MJ, Lee JH, Mobley EM, Khalil GE, Polansky CJ, Kellner AM, Fahnlander AM, Kelder SH, Fiellin LE, Gutter MS, Shenkman EA, Salloum RG. Mixed methods evaluation of vaping and tobacco product use prevention interventions among youth in the Florida 4-H program. Addict Behav 2023; 141:107637. [PMID: 36753933 DOI: 10.1016/j.addbeh.2023.107637] [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: 07/06/2022] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Novel prevention programs are developed to address the increase in e-cigarette use (vaping) among children. However, it remains paramount to test their feasibility in rural settings. This pilot study implemented and evaluated the feasibility and outcomes of two innovative programs, CATCH My Breath and smokeSCREEN, among youth in rural settings in Florida. METHODS We conducted four focus groups with youth aged 11-17 recruited from 4-H rural clubs in Florida. In a subsequent randomized trial, we recruited 82 youth participants and assigned them to one of three arms: CATCH My Breath, smokeSCREEN, or control. CATCH My Breath and smokeSCREEN participants attended online group intervention sessions while the control group received educational material. Pre- and post-surveys were administered to all participants to assess knowledge, susceptibility, perceived positive outcomes and risk perceptions related to tobacco and e-cigarette use. Other feasibility parameters were also assessed. RESULTS Focus group discussions provided insights about feasibility and informed the implementation of both interventions in terms of delivery format, scheduling of sessions and incentives. After the intervention, CATCH My Breath participants significantly improved their general tobacco-related knowledge (post-pre = 16.21-12.92 = 3.3, p <.01) and risk perceptions towards other flavored tobacco products (post-pre = 19.29-17.71 = 1.6, p <.05). smokeSCREEN participants significantly improved their general tobacco knowledge (post-pre = 18.77-13.77 = 5.0, p <.01), knowledge about e-cigarettes (post-pre = 9.08-6.31 = 2.8, p <.01) and risk perception towards e-cigarettes (post-pre = 24.69-21.92 = 2.8, p <.05). CONCLUSIONS This study demonstrated feasibility of delivering the interventions via participant engagement, participants' willingness to be randomized, assessment of outcome measures, and exploration of different recruitment methods. Despite the potential positive influence of CATCH My Breath and smokeSCREEN on youth participants, further evaluation with larger samples is needed.
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Affiliation(s)
- Dima S Bteddini
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jennifer H LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jaclyn M Hall
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ryan P Theis
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ji-Hyun Lee
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL 32610, USA; Division of Quantitative Sciences, University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32610, USA
| | - Erin M Mobley
- Department of Surgery, University of Florida College of Medicine, Jacksonville, FL 32209, USA
| | - George E Khalil
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Caroline J Polansky
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Allie M Kellner
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Alexandra M Fahnlander
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center School of Public Health, Austin, TX 78701, USA
| | - Lynn E Fiellin
- play2PREVENT Lab at Yale, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Michael S Gutter
- Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL 32610, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
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Gardner LA, Rowe AL, Stockings E, Champion KE, Hides L, McBride N, Allsop S, O'Dean S, Sunderland M, Lee YY, Mihalopoulos C, Freeman B, Leung J, McRobbie H, Stapinski L, Lee N, Thornton L, Debenham J, Teesson M, Newton NC. Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents. BMC Public Health 2023; 23:683. [PMID: 37046211 PMCID: PMC10090743 DOI: 10.1186/s12889-023-15609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. METHODS A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12-14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. DISCUSSION If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. TRIAL REGISTRATION The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).
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Affiliation(s)
- Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Amy-Leigh Rowe
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Emily Stockings
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Steve Allsop
- National Drug and Research Institute, EnAble Institute, Curtin University, Perth, WA, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Yong Yi Lee
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Cathy Mihalopoulos
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Becky Freeman
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
| | - Hayden McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Lee
- National Drug and Research Institute, Curtin University, Perth, WA, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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McCauley DM, Baiocchi M, Cruse S, Halpern-Felsher B. Effects of a Short School-based Vaping Prevention Program for High School Students. Prev Med Rep 2023; 33:102184. [DOI: 10.1016/j.pmedr.2023.102184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/25/2023] [Accepted: 03/21/2023] [Indexed: 03/28/2023] Open
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Mantey DS, Omega-Njemnobi O, Ruiz FA, Chen B, Springer AE, Kelder SH. Remote Versus In-Person Learning During COVID-19: Comparison of E-Cigarette Susceptibility and Ever Use Among a Diverse Cohort of 6th-Grade Students in Texas. Nicotine Tob Res 2023; 25:254-260. [PMID: 35366321 PMCID: PMC8992352 DOI: 10.1093/ntr/ntac084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND In response to SARS-CoV2 (COVID-19), school districts incorporated remote learning as a mitigation strategy. This study examines the association between classroom setting (ie, on-campus versus remote) and e-cigarette susceptibility or ever use among a sample of Texas public middle school students. METHODS Data from n = 985 students enrolled in the CATCH My Breath E-Cigarette Prevention Program trial were collected in Spring 2021. Participants were 6th-grade students in urban Texas. E-cigarette use was examined using the "at-risk" definition described by FDA, indicating either: (1) susceptible never user; or (2) experimental ever use. A multilevel, logistic regression model examined the association between classroom setting and e-cigarette susceptibility/ever use. Covariates included sex, race/ethnicity, academic achievement, household e-cigarette use, perceived school connectedness, and school-level economic status. Models account for nesting within school district. Analyses stratified by race/ethnicity were also conducted. RESULTS Overall, 36.3% of the sample were susceptible never users or ever e-cigarette users. The sample was comprised of 55.0% on-campus and 45.0% remote learners. On-campus learners had greater odds of reporting e-cigarette susceptibility or ever use (aOR: 1.45; p = .014). These findings were observed among Latino (aOR: 1.77; p = .026) and White (aOR: 2.10; p = .099) but not African American/Black (aOR: 0.86; p = .728) youth. CONCLUSIONS On-campus learning during the Spring 2021 semester was associated with greater risk for e-cigarette susceptibility or ever use among a diverse sample of 6th-grade students. E-cigarette susceptibility and ever use is a risk factor for progression to long-term e-cigarette use in later adolescence. IMPLICATIONS As school districts prepare to return to on-campus learning in 2022, a focused approach to e-cigarette prevention may be needed to prevent widespread e-cigarette initiation and continued use. Further, study findings demonstrate a need for further research on the school environment as a determinant of e-cigarette use.
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Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Felisa A Ruiz
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Baojiang Chen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Andrew E Springer
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
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19
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Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Burrow-Sánchez JJ, R Ratcliff B. The Influence of Risk and Protective Factors on Adolescent Alcohol, Cannabis, and Electronic Cigarette Use. JOURNAL OF PREVENTION (2022) 2022; 43:801-821. [PMID: 36301450 DOI: 10.1007/s10935-022-00700-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/06/2022]
Abstract
The misuse of substances by adolescents is a serious public health concern in the United States, and the three most used substances by adolescents are alcohol, cannabis, and electronic cigarettes. In accordance with the Social Development Model, a better understanding of the risk and protective factors across these three substances can assist in predicting potential substance use as well as strategies for prevention. The purpose of the current study is to examine the similar or differential influence that a specific set of risk and protective factors (i.e., favorable attitudes toward substance use, perceived risk of harm, peer substance use, interaction with prosocial peers, parental favorable attitudes toward substance use, family management, perceived availability substances, and rewards for prosocial involvement) have on past 30-day alcohol, cannabis, and e-cigarette use by adolescents. The present study is based on a secondary data analysis of the 2019 Prevention Needs Assessment Survey, which is administered every two years in the State of Utah to a large sample of students in grades 6, 8, 10, and 12 grades. A subsample of students (n = 44,728) was included in the present analysis. Logistic regression was used to examine the predictive relation for the set of four risk and four protective factors on past 30-day use of alcohol, cannabis, and e-cigarette use. In general, the results indicated that endorsement of the four risk factors predicted increases in the use of each substance whereas endorsement of the four protective factors predicted decreases in use. Implications of these findings suggest that there may be more similarities in risk and protective factors across alcohol, cannabis, and electronic cigarettes than between them. In addition, this study adds to the budding literature on the risk and protective factors associated with adolescent e-cigarette use.
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Moosbrugger M, Losee TM, González-Toro CM, Drewson SR, Stapleton PJ, Ladda S, Cucina I. Pre-Service Teachers’ Perceptions and Experiences Implementing CATCH My Breath. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2142336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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22
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Barnes C, Yoong SL, Hodder RK, Hall AE, Bialek C, Stockings E, Wolfenden L. Interventions to prevent or cease electronic cigarette use in children and adolescents. Cochrane Database Syst Rev 2022. [PMCID: PMC9706500 DOI: 10.1002/14651858.cd015511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Courtney Barnes
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
- Global Centre for Preventive Health and Nutrition, Institute of Health Technology, School of Health and Social Development; Deakin University; Burwood Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Alix E Hall
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
| | - Caitlin Bialek
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
| | - Emily Stockings
- Matilda Centre, Faculty of Medicine and Health; University of Sydney; Sydney Australia
| | - Luke Wolfenden
- School of Medicine and Public Health; University of Newcastle; Callaghan Australia
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
- Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
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Dai HD, Ratnapradipa K, Michaud TL, King KM, Guenzel N, Tamrakar N, Puga T, Sussman S. Vaping Media Literacy, Harm Perception, and Susceptibility of E-Cigarette Use Among Youth. Am J Prev Med 2022; 63:852-860. [PMID: 35931617 DOI: 10.1016/j.amepre.2022.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Exposure to E-cigarette marketing and media advertisements is prevalent among adolescents. A validated vaping media literacy scale is needed to inform effective vaping prevention programs. METHODS A 6-item vaping media literacy scale was adapted from validated smoking and general media literacy scales with an emphasis on marketing influences. A school-based survey (N=856) was conducted to assess the reliability of vaping media literacy and 3 subscales (i.e., authors and audiences [vaping Authors and Audiences], messages and meanings [vaping Messages and Meanings], and representation and reality [vaping Representation and Reality]). Multivariable logistic regression models were performed to examine the associations of vaping media literacy with perceived harmfulness of E-cigarette use and susceptibility to use E-cigarettes. Analyses were conducted in 2021. RESULTS The mean vaping media literacy among students was 2.6 (range=0-6). There were significant disparities with lower vaping media literacy among middle-school (versus high-school, p=0.03) students, males (versus females, p=0.003), and racial/ethnic minority students (Blacks, Hispanics, others versus Whites, p=0.0009). A higher vaping media literacy was significantly associated with increased perceived harmfulness of E-cigarette use (AOR=1.2; 95% CI=1.1, 1.2; p<0.0001). All subscales were also associated with E-cigarette harm perception. Among never E-cigarette users, students with a higher (versus those with a lower) vaping media literacy had lower susceptibility to initiating E-cigarettes (AOR=0.90; 95% CI=0.83, 0.97; p=0.005). Both vaping Messages and Meanings and vaping Representation and Reality subscales were adversely associated with susceptibility to vaping. CONCLUSIONS The vaping media literacy scale may gauge the influence of E-cigarette marketing on adolescents with high reliability and validity. Racial minorities, younger adolescents, and males appear relatively vulnerable to vaping marketing influence. Efforts to increase vaping media literacy are needed to curb youth E-cigarette use.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.
| | - Kendra Ratnapradipa
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Tzeyu L Michaud
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Keyonna M King
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Nicholas Guenzel
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
| | - Niran Tamrakar
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Troy Puga
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Steve Sussman
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
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Harrell MB, Mantey DS, Chen B, Kelder SH, Barrington-Trimis J. Impact of the e-cigarette era on cigarette smoking among youth in the United States: A population-level study. Prev Med 2022; 164:107265. [PMID: 36152819 PMCID: PMC10381788 DOI: 10.1016/j.ypmed.2022.107265] [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: 04/07/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022]
Abstract
To examine and compare trends in past 30-day cigarette smoking among adolescents in the US from 2002 to 2019, before and after the onset of the "e-cigarette era" in 2014. Using National Youth Tobacco Survey (NYTS) data from 2002 to 2019, we modeled the prevalence of past 30-day cigarette smoking over time. A total of n = 274,551 (weighted N = 340,403,754) middle and high school students were included in this study. Interrupted time series analyses were used to examine changes in cigarette smoking over time and compare trends in cigarette smoking pre- and post-2014. Models were applied to the full sample and stratified by middle (6th-8th grade) and high school (9th-12th grade). The observed number of current adolescent cigarette smokers post-2014 was compared to the predicted number, given trends in cigarette smoking prevalence observed pre-2014. Among all students, past 30-day cigarette smoking declined by approximately 0.75% per year from 2002 to 2013 (p < 0.001). Following a significant drop in prevalence from 2013 to 2014 (1.64%; p < 0.001), the decline in past 30-day cigarette smoking slowed significantly to approximately 0.37% per year (p < 0.001), from 2015 to 2019. We estimate that the onset of the "e-cigarette era" in 2014 corresponded to over 1.66 million (95% CI: 1.57 m - 1.75 m) more past 30-day cigarette smokers from 2015 to 2019, cumulatively. The rate of decline in past 30-day cigarette smoking prevalence among adolescents observed since 2002 slowed with the onset of the "e-cigarette era" in 2014, providing evidence at a population-level for the "gateway effect."
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Affiliation(s)
- Melissa B Harrell
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Dale S Mantey
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA.
| | - Baojiang Chen
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Steven H Kelder
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Jessica Barrington-Trimis
- University of Southern California, Keck School of Medicine, Los Angeles, CA, United States of America
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Pettigrew S, Miller M, Kannan A, Raj TS, Jun M, Jones A. School staff perceptions of the nature and consequences of students’ use of e‐cigarettes. Aust N Z J Public Health 2022; 46:676-681. [DOI: 10.1111/1753-6405.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/01/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Mia Miller
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Anjali Kannan
- School of Medical Sciences University of New South Wales Sydney New South Wales
| | | | - Min Jun
- The George Institute for Global Health University of New South Wales Sydney New South Wales
| | - Alexandra Jones
- The George Institute for Global Health University of New South Wales Sydney New South Wales
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Mantey DS, Clendennen SI, Sumbe A, Wilkinson AV, Harrell MB. Perceived stress and E-cigarette use during emerging adulthood: A longitudinal examination of initiation, progression, and continuation. Prev Med 2022; 160:107080. [PMID: 35568160 PMCID: PMC9813969 DOI: 10.1016/j.ypmed.2022.107080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 01/11/2023]
Abstract
E-cigarettes are the most commonly used tobacco product among youth and young adults in the US. Limited research has examined how stress impacts e-cigarette use among young people. We examine the longitudinal associations between perceived stress scale (PSS) score and e-cigarette use behaviors among a diverse cohort of emerging adults. We analyzed two waves of data collected in Fall 2019 (baseline) and Spring 2020 (6-month follow-up) of the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were classified into three mutually exclusive subsamples at baseline: (1) n = 1177 never e-cigarette users; (2) n = 806 ever but not current (past 30-day) e-cigarette users (i.e., ever users); and (3) n = 257 current (past 30-day) e-cigarette users. Three multivariate logistic regression models examined the relationship between PSS at baseline and: (1) initiation among never users; (2) progression to current use among ever users; and (3) continuation among current users, at 6-month follow-up. PSS scores were standardized using z-scores. Models controlled for race/ethnicity, sex, age, ever marijuana use, and ever use of other tobacco products. Mean age ranged from 18.6 to 19.4 among cohorts. Risk for e-cigarette progression among ever users (aOR: 1.30; 95%CI: 1.01-1.69) and e-cigarette continuation among current users (aOR: 1.33 (95%CI: 1.01-1.75) increased with each unit increase in PSS score at baseline. PSS at baseline was not associated with e-cigarette initiation among never users. PSS predicted greater risk of e-cigarette progression and continuation but not initiation among a diverse cohort of emerging adults. E-cigarette prevention and cessation strategies should consider perceived stress an important risk factor for e-cigarette use during emerging adulthood.
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Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
| | - Stephanie I Clendennen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Aslesha Sumbe
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Anna V Wilkinson
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Melissa B Harrell
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Liu J, Gaiha SM, Halpern-Felsher B. School-based programs to prevent adolescent e-cigarette use: A report card. Curr Probl Pediatr Adolesc Health Care 2022; 52:101204. [PMID: 35534403 PMCID: PMC9296568 DOI: 10.1016/j.cppeds.2022.101204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Given high rates and known health consequences of adolescent e-cigarette use as well as adolescents' susceptibility to nicotine addiction, school-based efforts to prevent and reduce adolescent e-cigarette use should continue to be developed, implemented, disseminated, and evaluated. This paper elaborates on best practices for developing and implementing prevention programs, including the importance of grounding programs in theories and frameworks that empower adolescents, including normative and interactive education, and having programs that are easily accessible and free of cost. Programs should also address key factors driving adolescent e-cigarette use, including discussing misperceptions, flavors, nicotine content, addiction, and the role that marketing plays in appealing to adolescents. The paper also discusses the gap areas of currently available prevention programs and highlights the need for evidence-based approaches and the importance of rigorous evaluation of programs.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, United States
| | - Shivani Mathur Gaiha
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States
| | - Bonnie Halpern-Felsher
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States.
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Gaiha SM, Epperson AE, Halpern-Felsher B. Youth perceptions of e-cigarette-related risk of lung issues and association with e-cigarette use. Health Psychol 2022; 41:417-422. [PMID: 35157478 PMCID: PMC9133038 DOI: 10.1037/hea0001146] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE E-cigarette use is associated with increased risk of negative health outcomes, including respiratory problems such as Coronavirus Disease 2019 (COVID-19). Nevertheless, adolescents and young adults (AYAs) continue to use e-cigarettes at alarming rates. We examined AYA's perceptions of the health harms of e-cigarettes in relation to respiratory problems and the associations between these perceptions and e-cigarette use. METHOD In May 2020, we conducted an online, national cross-sectional survey of AYAs aged 13 to 24 years old (N = 4,315; 65% female; 50% ever-users, 50% never-users) to assess e-cigarette use and perceptions of the risk of respiratory problems, COVID-19, and severe lung disease for AYAs with different levels of e-cigarette use. RESULTS In comparisons between AYAs with different levels of e-cigarette use, e-cigarette-related health risk perceptions were lower among ever-users compared to never-users and among ever-users who used e-cigarettes in the past 30 days compared to ever-users who did not use in the past 30 days. After controlling for demographics, AYAs were less likely to have used in the past 30 days if they agreed that young people are at risk of respiratory problems due to e-cigarette use (adjusted Odds Ratio [aOR] = .68, 95% confidence interval [CI; .59, .78]) and e-cigarettes are harmful for their health (aOR = .52, 95% CI [.30, .90]). AYAs were more likely to have used in the past 30 days if they believed that there is no hard evidence that e-cigarette use with nicotine increases risk of severe lung disease (aOR = 1.61, 95% CI [1.42, 1.82]) and that e-cigarette use is safer than smoking cigarettes (aOR = 1.26, 95% CI [1.11, 1.42]). CONCLUSIONS Among AYAs who had ever used e-cigarettes, those who did not believe that e-cigarette use increases the risks of respiratory problems were more likely to have used e-cigarettes in the past month. To bridge the gap between youth perceptions and emerging scientific evidence on e-cigarette-related health risks, prevention messaging should seek to explain how e-cigarette use is linked to respiratory problems and could affect COVID-19 outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Shivani M. Gaiha
- Reach lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University
| | - Anna E. Epperson
- Department of Psychological Sciences, School of Social Sciences, Humanities and Arts, University of California, Merced
| | - Bonnie Halpern-Felsher
- Reach lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University
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Abstract
PURPOSE OF REVIEW Puff Bars, a brand of disposable e-cigarettes, have skyrocketed in popularity recently, presenting significant health and safety risks to adolescents. Puff Bars and other disposable e-cigarette products are attractive to children and teenagers because of their vibrant colors and flavors, low cost, and ease of access. This review examines the rise in Puff Bar popularity, describes notable health and safety concerns, and provides advice for parents and pediatricians in identifying and preventing adolescent Puff Bar use. RECENT FINDINGS Puff Bars have increased in popularity as their product design evaded strict regulations imposed on alternate e-cigarette products, such as Juul. In addition, Puff Bars' sweet and fruit flavors and marketing on social media have made their use pervasive among youth. Puff Bar use can lead to increased risk of e-cigarette product use-associated lung injury (EVALI) and potential exposure to carcinogens. Furthermore, the developmental risks of nicotine use during adolescence include negative effects on cognitive function and detriments to short-term memory. SUMMARY Puff Bars present a significant danger to adolescents, and it is imperative that parents and pediatricians are aware of the health risks involved with vaping. Pediatricians should explore e-cigarette use during patient visits, and parents must communicate these dangers to their children and be able to identify these products to regulate their use.
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Livingston JA, Chen CH, Kwon M, Park E. Physical and mental health outcomes associated with adolescent E-cigarette use. J Pediatr Nurs 2022; 64:1-17. [PMID: 35121206 DOI: 10.1016/j.pedn.2022.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Use of electronic cigarettes (e-cigarette) and other electronic nicotine delivery systems (ENDS) among adolescents has increased dramatically, creating a need for research to examine the consequences of e-cigarette use on adolescent health. Given the emergent state of the research literature, this integrative review sought to summarize what is currently known about the physical and mental health outcomes associated with e-cigarette use in an adolescent population, and to identify directions for future research. METHOD The methodology for this integrative review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A methodical search was conducted in February 2020 in PubMed, CINAHL, and Web of Science databases. To be eligible for inclusion, studies had to address e-cigarette use, have samples that were between 13 and 24 years of age, be published in a peer-reviewed journal, and examine health outcomes associated with e-cigarette use. After the screening process, 18 studies were included. RESULTS Physical health outcomes associated with e-cigarette use included oral health and respiratory problems as well as nicotine dependence. Mental health outcomes included depression and suicidal ideation. In studies that compared e-cigarette use to conventional cigarette use and non-use, e-cigarettes tended to be associated with more problems than non-use, but fewer problems than conventional cigarette use. Dual use, that is, use of both conventional cigarettes and e-cigarettes, was associated with the greatest harm. CONCLUSION Although somewhat less harmful than conventional cigarettes, e-cigarette use is related to a variety of negative physical and mental health outcomes among adolescent users.
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Affiliation(s)
- Jennifer A Livingston
- School of Nursing, University at Buffalo, State University of New York, United States of America.
| | - Chia-Hui Chen
- School of Nursing, University at Buffalo, State University of New York, United States of America
| | - Misol Kwon
- School of Nursing, University at Buffalo, State University of New York, United States of America
| | - Eunhee Park
- School of Nursing, University at Buffalo, State University of New York, United States of America
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Lyzwinski LN, Naslund JA, Miller CJ, Eisenberg MJ. Global youth vaping and respiratory health: epidemiology, interventions, and policies. NPJ Prim Care Respir Med 2022; 32:14. [PMID: 35410990 PMCID: PMC9001701 DOI: 10.1038/s41533-022-00277-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/17/2022] [Indexed: 01/02/2023] Open
Abstract
AbstractE-cigarette usage (also known as e-cigarettes or vaping products) has increasingly been recognized as a global public health problem. One challenge in particular involves their marketing to minors (teenagers and children) and the rising prevalence of use in this population. E-cigarettes unnecessarily expose minors to health risks, these include respiratory health problems, such as exacerbations of asthma, bronchitis, and respiratory-tract irritation. Nicotine, commonly found in e-cigarettes, is also associated with cognitive impairment and neurodevelopmental problems. E-cigarettes are also risk factors for downstream substance use, including cigarettes and cannabis initiation (the gateway hypothesis), which compounds health risks in dual users. Current public health preventative and intervention studies are limited, and there is a clear need for more interventions that may prevent usage and assist with cessation in this vulnerable population. Physician education and screening uptake should also be enhanced. Stricter public health policy and protection measures are also needed on a global scale to limit e-cigarette exposure in minors.
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Baker KA, Campbell NJ, Noonan D, Thompson JA, Derouin A. Vaping Prevention in a Middle School Population Using CATCH My Breath. J Pediatr Health Care 2022; 36:90-98. [PMID: 34620523 DOI: 10.1016/j.pedhc.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/20/2021] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The number of teens using electronic cigarettes in the United States has reached epidemic proportions. One in 20 middle school youth currently vapes regularly (Wang et al., 2020), supporting the need for e-cigarette education and prevention programs in this vulnerable population. METHOD The evidence-based youth vaping prevention program, CATCH My Breath, was implemented and evaluated in a small, private, parochial middle school using a quasi-experimental, within-subjects, longitudinal design. RESULTS Students' e-cigarette knowledge significantly improved postintervention (p < .001) and was sustained at 3 months follow-up. Attitudes about vaping remained stable after postintervention and at 3 months follow-up (p > .05). Susceptibility toward vaping increased or remained consistent despite increased knowledge (p = .096). DISCUSSION CATCH My Breath is an effective school-based resource to educate middle school youth about the dangers of vaping. Additional research is needed to evaluate the intervention's impact on e-cigarette attitudes and the measurement of susceptibility in teens.
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Simpson EEA, Davison J, Doherty J, Dunwoody L, McDowell C, McLaughlin M, Butter S, Giles M. Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools. BMC Public Health 2022; 22:276. [PMID: 35144592 PMCID: PMC8832682 DOI: 10.1186/s12889-022-12674-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/25/2022] [Indexed: 12/01/2022] Open
Abstract
Background An extended version of the theory of planned behaviour (TPB) was used to inform the design of a framework for an educational resource around e-cigarette use in young people. Methods A sequential exploratory design was employed. In Phase 1, elicited behavioural, normative and control beliefs, via 7 focus groups with 51 participants, aged 11–16 years, identified salient beliefs around e-cigarette use. These were used to construct a questionnaire administered to 1511 young people aged 11–16 years, which determined predictors of e-cigarette use and ever use. In Phase 2, sociodemographic variables, e-cigarette knowledge, access, use, marketing and purchasing of e-cigarettes and smoking behaviour were also gathered. The composite findings from Phase 1 and 2 informed the design of a post primary educational resource in Phase 3 around e-cigarette use. Results Current e-cigarette use was 4%, with almost 23% reporting ever use, suggesting current use is stable but experimentation may be increasing in this cohort. Sociodemographic variables, knowledge of e-cigarettes, smoking behaviour and TPB variables (direct and indirect measures of attitudes, subjective norm, and perceived behavioural control) accounted for 17% of the variance in current e-cigarette use, with higher intentions to use e-cigarettes within the next month, having the strongest impact on use (p < 0.001), followed by self-efficacy (p = 0.016). Sociodemographic and TPB variables accounted for 65% of the variance in intentions to use e-cigarettes in the next month; current e-cigarette use (p < 0.001), more positive attitudes (p < 0.001), stronger social influence (p < 0.001), higher self-efficacy (p < 0.001), higher control beliefs (p < 0.001) and greater motivation to use e-cigarettes (p < 0.001) were the main predictors of intentions. Phases 1 and 2 informed the mapping of key predictors of intentions and use of e-cigarettes onto the Theoretical Domains Framework, which identified appropriate intervention functions and behaviour change techniques. Conclusions This paper is the first to bridge the theoretical-practice gap in an area of significant public health importance through the development of a framework for a novel theory driven school-based educational resource aimed at reducing experimentation and uptake of e-cigarette use in young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12674-3.
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Affiliation(s)
- E E A Simpson
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK.
| | - J Davison
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - J Doherty
- School of Nursing and Midwifery, Queens University of Belfast, Belfast, UK
| | - L Dunwoody
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - C McDowell
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M McLaughlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - S Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - M Giles
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
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Williams GC, Cole AG, de Groh M, Jiang Y, Leatherdale ST. More support needed: Evaluating the impact of school e-cigarette prevention and cessation programs on e-cigarette initiation among a sample of Canadian secondary school students. Prev Med 2022; 155:106924. [PMID: 34929224 DOI: 10.1016/j.ypmed.2021.106924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
Given the recent increase in e-cigarette use among adolescents, there is a need to further explore how school programs are associated with e-cigarette initiation. The objective of this quasi-experimental study was to evaluate the impact of multiple school-based e-cigarette prevention and cessation programs on e-cigarette initiation among Canadian adolescents. This study used data from Year 6 (2017/18) and Year 7 (2018/19) of the COMPASS study in British Columbia, Alberta, Ontario, and Quebec, Canada. Students in grades 9 to 11 who had never tried e-cigarettes at baseline were included (n = 13,269). Schools (n = 88) reported whether they added programming that addressed e-cigarette or tobacco prevention or cessation. Generalized estimating equations were used to identify how added programs were associated with e-cigarette initiation at follow-up. At one-year follow-up (2018/19), 23% of schools added programs. Our evaluation results suggest that none of the activities taken by schools to prevent or reduce vaping among students significantly prevented vaping onset. In fact, female students at schools that reported adding a theme week had higher odds of e-cigarette initiation (OR 1.68 [95% CI 1.31-2.16]) and male students at schools that reported a cessation program had higher odds of e-cigarette initiation (OR 1.20 [95% CI 1.01-1.44]). These results suggest that schools may not know how to address e-cigarette use and that there can be risks to students if programs are not carefully implemented. Results point to the need for additional support to ensure that schools are taking evidence-based approaches that support all students.
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Affiliation(s)
- Gillian C Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Mantey DS, Clendennen SL, Springer AE, Harrell MB. Perceived Parental Knowledge Reduces Risk for Initiation of Nicotine and Cannabis Vaping: A Longitudinal Study of Adolescents. Am J Health Promot 2022; 36:623-632. [PMID: 35030966 DOI: 10.1177/08901171211061941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study examines the role of perceived parental knowledge on initiation of nicotine and cannabis vaping among youth. DESIGN Longitudinal study from a self-administered online survey. Three waves of data collected in 6-month intervals. SETTING 79 public and private schools in Texas. PARTICIPANTS Adolescents who self-reported never using e-cigarette to vape nicotine (n=1907; weighted sample [N] = 304371) or vape cannabis (n=2212; N=351955) at baseline. Participants were in 8th, 10th, and 12th grade at baseline. MEASURES Self-reported measures of nicotine and cannabis vaping. ANALYSES Weighted multivariate logistic regression models examined role of perceived parental knowledge at baseline (Spring 2016) as a predictor of nicotine and cannabis vaping initiation at 6-month (Fall 2016) and 12 month (Spring 2017) follow-up. Covariates were age, sex, race/ethnicity, and other tobacco use. RESULTS Initiation rates were 5.9% for nicotine vaping and 8.6% for cannabis vaping, at 12-month follow-up overall. Higher perceived parental knowledge was associated with lower odds of nicotine vaping initiation at 6 months (adj OR: .69; 95% CI: .50-.93) and 12 months (adj OR: .68; 95% CI: .50-.92). Similarly, higher perceived parental knowledge was associated with lower odds of cannabis vaping initiation at 6 months (adj OR: .58; 95% CI: .38-.87) and 12 months (adj OR: .53; 95% CI: .38-.74). CONCLUSION E-cigarette prevention efforts directed at adolescents should incorporate parent engagement strategies as a method of increasing actual and perceived parental knowledge of their child's location, activities and peer groups.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Stephanie L Clendennen
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
| | - Melissa B Harrell
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin, TX, USA
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Walsh BE, Williams CM, Zale EL. Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults. Subst Use Misuse 2022; 57:2101-2109. [PMID: 36331140 DOI: 10.1080/10826084.2022.2136495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Young adults' use of alcohol and e-cigarettes are of public health concern, as they report among the highest prevalence for use of both substances. Many young adults use alcohol and e-cigarettes simultaneously (i.e., at the same time with overlapping effects) despite heightened risk for adverse effects. Objectives: This study assessed simultaneous use expectancies and changes in pleasure from e-cigarettes as a function of alcohol consumption and simultaneous use frequency. Participants (N = 408; Mage = 23.64 years; 52.7% female) recruited through Amazon MTurk completed measures of alcohol and e-cigarette use, and expectancies, pleasure and frequency of simultaneous use. Results: Separate linear regression models revealed that alcohol consumption was positively associated with expectancies for simultaneous use of e-cigarettes/alcohol and pleasure from simultaneous use (ps ≤ .015). As individuals engaged in simultaneous use more frequently, they also reported greater expectancies for, and increased pleasure from, simultaneous use (ps < .001). Conclusions/Importance: Expectancies for simultaneous use may be greatest among young adults who consume more alcohol and engage in simultaneous use more frequently. Increased pleasure from e-cigarettes while drinking suggests that positive reinforcement may be implicated in simultaneous use patterns. Future research should examine the role of pleasure in simultaneous use trajectories.
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Affiliation(s)
- Brendan E Walsh
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Callon M Williams
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
| | - Emily L Zale
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
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Weser VU, Duncan LR, Sands BE, Schartmann A, Jacobo S, François B, Hieftje KD. Evaluation of a virtual reality E-cigarette prevention game for adolescents. Addict Behav 2021; 122:107027. [PMID: 34225030 DOI: 10.1016/j.addbeh.2021.107027] [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: 03/19/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To test preliminary efficacy and acceptability of Invite Only VR: A Vaping Prevention Game (Invite Only VR), an electronic cigarette (e-cigarette) prevention game that uses virtual reality (VR) hardware. METHODS 285 adolescents (146 boys; ages 11-14; M = 12.45 years; SD = 0.57) were enrolled in this non-equivalent control groups design through their middle school. Participants who played Invite Only VR for 1.5 h were compared to treatment as usual at 4 timepoints: baseline, post gameplay, 3 and 6 months. Evidence of the efficacy of the game to influence e-cigarette use, e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceived likelihood of using e-cigarettes, perceptions of harm, self-efficacy to refuse, social approval of e-cigarettes, and e-cigarette social perceptions was assessed using mixed between-within subjects ANOVAS. Intervention acceptability was indicated by measures of gameplay experience/satisfaction, VR experience, and perceived responsibility for game-based decisions. RESULTS From baseline to 6 months, Invite Only VR players improved in e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceptions of harm, and social perceptions about e-cigarette use compared to the control group. No significant changes were observed for the other dependent variables, including e-cigarette use. Ratings of gameplay experience and satisfaction, VR experience, and game-based decisions were high. CONCLUSIONS Invite Only VR may help players develop knowledge about e-cigarettes and nicotine addiction, as well as encourage the development of healthy harm and social perceptions regarding e-cigarette use that persist 6 months beyond gameplay. Adolescents' satisfaction with the VR gameplay indicates preliminary intervention acceptability.
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Affiliation(s)
- Veronica U Weser
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States.
| | - Lindsay R Duncan
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Brandon E Sands
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States
| | - Andrew Schartmann
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; Department of Music Theory, New England Conservatory, Boston, MA, United States
| | - Sandra Jacobo
- play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States; University of California, Berkeley, United States
| | | | - Kimberly D Hieftje
- Department of General Medicine, Yale School of Medicine, New Haven, CT, United States; play4REAL XR Lab at the Yale School of Medicine, New Haven, CT, United States
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Mantey DS, Case KR, Omega-Njemnobi O, Springer AE, Kelder SH. Use frequency and symptoms of nicotine dependence among adolescent E-cigarette users: Comparison of JUUL and Non-JUUL users. Drug Alcohol Depend 2021; 228:109078. [PMID: 34614433 PMCID: PMC8595823 DOI: 10.1016/j.drugalcdep.2021.109078] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nicotine exposure among adolescent e-cigarette users remains a public health concern. JUUL, a popular e-cigarette brand among youth, is particularly alarming given the high nicotine delivery (59 mg/mL). This study compares e-cigarette use frequency and symptoms of nicotine dependence among adolescent JUUL and non-JUUL users. METHODS We analyzed data from the 2020 National Youth Tobacco Survey. Participants were n = 1713 U.S. middle and high school students who reported past 30-day e-cigarette use. We compared adolescent e-cigarette users who reported JUUL use to those who did not. Outcomes were: (1) symptoms of nicotine dependence (i.e. nicotine cravings; use within 30 min of waking); (2) past 30-day e-cigarette use frequency, categorized as 1-5 days, 6-19 days, and 20-30 days. Covariates were sex, race/ethnicity, other tobacco product use, primary e-cigarette device type (i.e., disposable; pod; mod/tank). RESULTS Overall, 49.5% of adolescent e-cigarette users reported using JUUL in the past 30 days, 40.1% reported symptoms of nicotine dependence, and 36.2% reported using an e-cigarette on 20-30 days. JUUL users were 1.77 (95% CI: 1.36-2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02-2.01) time as likely to report using e-cigarettes on 20-30 days, compared to 1-5 days, relative to non-JUUL users, controlling for covariates. CONCLUSION JUUL use was associated with greater odds of nicotine dependence and more frequent e-cigarette use among adolescents. Greater prevention and regulatory efforts should be made to prevent adolescent use of high dose nicotine devices such as JUUL.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Kathleen R Case
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229, United States.
| | - Onyinye Omega-Njemnobi
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, United States.
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Steven H Kelder
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
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Mantey DS, Case KR, Chen B, Kelder S, Loukas A, Harrell MB. Subjective experiences at e-cigarette initiation: Implications for e-cigarette and dual/poly tobacco use among youth. Addict Behav 2021; 122:107028. [PMID: 34186298 PMCID: PMC8498802 DOI: 10.1016/j.addbeh.2021.107028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Subjective experiences (SEs) at initiation of cigarettes, cigars, and smokeless tobacco have been established as predictors of continued use. To date, less is known about the relationships between SEs at e-cigarette initiation and subsequent e-cigarette use behaviors. METHODS This study used data from Waves 1-6 of the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system; a population-based rapid response study of adolescents in major metropolitan areas of Texas. Participants were adolescents who self-reported ever using e-cigarettes across all 6 waves (n = 1,104; N = 460,069). Factor analyses examined structure of SEs at e-cigarette initiation. Weighted, multilevel, multivariate regression models examined role of SEs at e-cigarette initiation on subsequent past 30-day e-cigarette use behaviors. RESULTS Factor analyses identified a positive (i.e., euphoria, relaxation) and a negative (i.e., dizziness, cough, nausea) domain of SEs. Positive SEs at e-cigarette initiation predicted 1.20 (95% CI: 1.02-1.42) greater odds of subsequent past 30-day e-cigarette use. Similarly, positive SEs at e-cigarette initiation predicted greater relative risk of dual/poly e-cigarette use, relative to non-use (RRR: 1.61; 95% CI: 1.24-2.10) and exclusive e-cigarette use (RRR: 1.68; 95% CI: 1.26-2.24). CONCLUSION This is the first study to observe longitudinal relationships between SEs at e-cigarette initiation and subsequent e-cigarette use behaviors. Findings highlight the importance of preventing initial e-cigarette use among adolescents.
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Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
| | - Kathleen R Case
- UT Health San Antonio, Center for Research to Advance Community Health, 7411 John Smith Dr, Suite 1050, San Antonio, TX 78229, USA
| | - Baojiang Chen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Alexandra Loukas
- University of Texas at Austin, Department of Kinesiology & Health Education, University 2109 San Jacinto, D3700, Austin, TX 78712, USA
| | - Melissa B Harrell
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Mantey DS, Clendennen SL, Sumbe A, Wilkinson AV, Harrell MB. Positive Affect and Multiple-tobacco Product Use among Youth: A 3-year Longitudinal Study. Am J Health Behav 2021; 45:849-855. [PMID: 34702432 DOI: 10.5993/ajhb.45.5.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Multiple-tobacco product (MTP) use is common among adolescent tobacco users. Low positive affect is a risk factor for e-cigarette use and combustible tobacco smoking. In this study, we examine the longitudinal relationship between positive affect and MTP use in a diverse cohort of adolescents in Texas. Methods: We analyzed 6 waves of biennial data (fall 2014-spring 2017) from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system. Participants were 3868 sixth-, eighth-, and tenth-grade students in urban Texas, at enrollment. Multinomial logistic regression models examined the longitudinal relationship between positive affect and categories of MTP use, controlling for sex, race/ethnicity, past 30-day alcohol use, cohort, survey wave, and peer tobacco use. Results: The sample was comprised of 4.6% single-product users, 1.7% dual-users, and 0.7% poly-users. Each unit decrease in positive affect was associated with increased risk for single- (RRR: 1.29; 95% CI: 1.16-1.44), dual- (RRR: 1.35; 95% CI: 1.11-1.64), and poly- (RRR: 1.98; 95% CI: 1.54-2.54) use, relative to non-use. Similarly, each unit decrease in positive affect was also associated with increased risk for poly-tobacco use relative to single- (RRR: 1.53; 95% CI: 1.19-1.97) and dual- (RRR: 1.47; 95% CI: 1.11-1.95) use. Positive affect did not differentiate between single- and dual-use. Conclusion: We observed a gradient relationship between low positive affect and greater number of tobacco products used. Findings reinforce the association between poor mental health and tobacco use during adolescence. Prevention efforts may need to incorporate methods of addressing low positive affect.
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Affiliation(s)
- Dale S. Mantey
- Dale S. Mantey, NCI Postdoctoral Fellow, Department of Health Promotion and Behavioral Science, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth)
School of Public Health in Austin, TX, United States
| | - Stephanie L. Clendennen
- Stephanie L. Clendennen, Postdoctoral Fellow, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin,
TX, United States
| | - Aslesha Sumbe
- Aslesha Sumbe, Doctoral Candidate, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States
| | - Anna V. Wilkinson
- Anna V. Wilkinson, Associate Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United
States
| | - Melissa B. Harrell
- Melissa B. Harrell, Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, TX, United States;,
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Ickes MJ, Zidzik O, Vanderford NL. Engaging Rural High School Youth in E-cigarette Prevention and Advocacy. ONLINE JOURNAL OF INTERPROFESSIONAL HEALTH PROMOTION 2021; 3:3. [PMID: 35814171 PMCID: PMC9256968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Leavens ELS, Carpenter MJ, Smith TT, Nollen NL. Exploratory evaluation of online brief education for JUUL pod-mod use and prevention. Addict Behav 2021; 119:106942. [PMID: 33866224 DOI: 10.1016/j.addbeh.2021.106942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Initiation of e-cigarette use by young adults is a significant public health issue within the debate on vaping. The current study is an exploratory evaluation of brief educational information among young adults and investigated outcomes as a function of JUUL use and smoking status. METHODS Participants (N = 947) were young adults (<30 years old) recruited from Amazon's Mechanical Turk based on smoking and JUUL use status. Participants completed baseline assessments, viewed a brief JUUL educational handout, and completed post-assessments. RESULTS There was a significant Time X Group interaction for JUUL-related knowledge (p < .001), with never JUUL/never smokers showing the greatest increase in knowledge. Brief education increased JUUL-related knowledge and risk perceptions and had a modest impact on commitment to quitting and readiness to quit JUUL (all p ≤ 0.001; ds = 0.06-0.74; time × group p > .05 for all contrasts except JUUL-related knowledge). Participants showed modest decreases in interest in future JUUL use, interest in purchasing, and interest in future regular use (all p ≤ 0.001; ds = 0.07-0.08; time × group p > .05 for all contrasts). In terms of smoking outcomes, participants reported reduced perceived harm to others (p < .001; d = 0.09) and decreased intentions to smoke regularly (p = .001; d = 0.07). CONCLUSIONS Brief education was effective in increasing knowledge and risk perceptions while showing a modest effect on intentions for future use. The information was most effective in increasing knowledge among non-users, suggesting that brief education may be useful for preventing initiation. Analysis of group differences suggest current JUUL use status is more important in informing JUUL-related attitudes than smoking status.
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Affiliation(s)
- Eleanor L S Leavens
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, United States; University of Kansas School of Medicine, Department of Population Health, United States.
| | - Matthew J Carpenter
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, United States
| | - Tracy T Smith
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, United States
| | - Nicole L Nollen
- University of Kansas School of Medicine, Department of Population Health, United States
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Patanavanich R, Aekplakorn W, Glantz SA, Kalayasiri R. Use of E-Cigarettes and Associated Factors among Youth in Thailand. Asian Pac J Cancer Prev 2021; 22:2199-2207. [PMID: 34319044 PMCID: PMC8607077 DOI: 10.31557/apjcp.2021.22.7.2199] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The study explored e-cigarette use among youth and associated factors in Thailand. METHODS This was a cross sectional study of 6,045 seventh grade students selected using a multistage design. Self-administered questionnaires relating to the socio-demographic characteristics, history of cigarette and e-cigarette uses, friends' and family's use of e-cigarettes, knowledge and perception of e-cigarette use, history of alcohol uses, and life assets were gathered. Multivariate logistic regression models were used to examine the variables and their association with e-cigarette use. RESULTS Prevalence of ever e-cigarette use was 7.2% and current e-cigarette use was 3.7%. We found that current cigarette smoking (AOR 4.28, 95% CI: 2.05-8.94), parental e-cigarette use (AOR 6.08, 95% CI: 2.81-13.17), peer e-cigarette use (AOR 3.82, 95% CI: 2.19-6.65), peer approval of smoking (AOR 1.95, 95% CI: 1.11-3.41), and unaware of e-cigarettes' risk (AOR 5.25, 95% CI: 2.67-10.34). were significantly associated with current use of e-cigarettes. Male sex, poor academic achievement, and poor life assets (power of wisdom) were only significantly associated with ever e-cigarette use. CONCLUSION Prevalence of current e-cigarette use among Thai middle school students did not change significantly since the government banned importation and sales of e-cigarettes in 2015, suggesting that the Thai ban has been a success. Factors associated with e-cigarette use among Thai youth were consistent with other countries. Ever e-cigarette use, increased, but less than in countries without a ban. To strengthen efforts to prevent youth from e-cigarette use and addiction, the government should improve law enforcement, especially against online marketing and strengthen school-based anti-smoking programs to include e-cigarette lessons, educating parents and the public about the harm of e-cigarettes, including secondhand effects on non-users. .
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Affiliation(s)
- Roengrudee Patanavanich
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education (retired), University of California San Francisco, San Francisco, US.
| | - Rasmon Kalayasiri
- Department of Psychiatry, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand.
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Mshigeni SK, Rittenhouse A, Gwanzura T, Arroyo R, Vaughn C. Understanding Demographics Characteristics of E-Cigarette Users in California and the Need for Tailored Interventions. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1930610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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E-cigarettes use prior to smoking combustible cigarettes among dual users: The roles of social anxiety and E-cigarette outcome expectancies. Addict Behav 2021; 117:106854. [PMID: 33601094 DOI: 10.1016/j.addbeh.2021.106854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023]
Abstract
E-cigarette use is prevalent, and rates of use continue to increase. Although e-cigarettes are often used to help combustible users quit or reduce smoking, some use e-cigarettes in the absence of combustible cigarettes, increasing risk for smoking combustible cigarettes. Yet, little research has examined individual vulnerability factors implicated in transitioning from exclusive e-cigarettes use to dual use of combustible cigarettes. Social anxiety may be one such factor given it is related to a variety of negative smoking-related outcomes. Thus, the current study tested whether social anxiety was related to using e-cigarettes before smoking combustibles among 226 current undergraduate dual users (use both e-cigarettes and combustible cigarettes). Most dual users reported initiating with e-cigarettes (67%). Those who initiated with e-cigarettes reported statistically significantly greater negative reinforcement (d = 0.59) and weight control expectancies (d = 0.37) and greater social anxiety (d = 0.37) than those who initiated with combustibles. Social anxiety was indirectly related to e-cigarette initiation via negative and weight control expectancies. Findings add to a growing literature that dual users initiated with e-cigarettes and extend understanding of this phenomenon by identifying that socially anxious persons may be especially vulnerable to doing so, at least partially due to expectations regarding e-cigarette's ability to manage negative affect and/or weight.
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Kreslake JM, Simard BJ, O'Connor KM, Patel M, Vallone DM, Hair EC. E-Cigarette Use Among Youths and Young Adults During the COVID-19 Pandemic: United States, 2020. Am J Public Health 2021; 111:1132-1140. [PMID: 33856888 DOI: 10.2105/ajph.2021.306210] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To determine whether the COVID-19 pandemic affected e-cigarette use among young people in the United States.Methods. Data came from a weekly cross-sectional online survey of youths and young adults (aged 15-24 years). Logistic regression analyses measured odds of past-30-day e-cigarette use (n = 5752) following widespread stay-at-home directives (March 14-June 29, 2020), compared with the pre‒COVID-19 period (January 1-March 13, 2020). Logistic regression among a subsample of current e-cigarette users (n = 779) examined factors associated with reduced use following stay-at-home orders.Results. Odds of current e-cigarette use were significantly lower during the COVID-19 pandemic compared with the pre‒COVID-19 period among youths aged 15 to 17 years (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.54, 0.96) and young adults aged 18 to 20 years (OR = 0.65; 95% CI = 0.52, 0.81). E-cigarette users with reduced access to retail environments had higher odds of reporting reduced e-cigarette use (OR = 1.51; 95% CI = 1.07, 2.14).Conclusions. COVID-19 stay-at-home directives present barriers to e-cigarette access and are associated with a decline in e-cigarette use among young people.Public Health Implications. Findings support the urgent implementation of interventions that reduce underage access to e-cigarettes to accelerate a downward trajectory of youth and young adult e-cigarette use.
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Affiliation(s)
- Jennifer M Kreslake
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
| | - Bethany J Simard
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
| | - Katie M O'Connor
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
| | - Minal Patel
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
| | - Donna M Vallone
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
| | - Elizabeth C Hair
- All authors are with the Schroeder Institute at Truth Initiative, Washington, DC
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Mantey DS, Omega-Njemnobi O, Ruiz FA, Vaughn TL, Kelder SH, Springer AE. Association between observing peers vaping on campus and E-cigarette use and susceptibility in middle and high school students. Drug Alcohol Depend 2021; 219:108476. [PMID: 33360854 PMCID: PMC7975070 DOI: 10.1016/j.drugalcdep.2020.108476] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND This study examines the association between exposure to e-cigarette use on school campus and e-cigarette use behaviors among adolescents in the United States. METHODS Data were obtained from the 2019 National Youth Tobacco Survey. First, two multivariate logistic regression models examined the association between in-school exposure to e-cigarette use and ever and past 30-day (i.e., current) e-cigarette use. Next, a multivariate logistic regression model to examine the relationship between in-school exposure to e-cigarette use and susceptibility to use was conducted among a subsample (n = 11,958) of never e-cigarette users. Covariates included grade, race/ethnicity, marketing exposure, and ever use of other tobacco products. RESULTS Approximately 64.3 % of adolescents reported seeing someone use an e-cigarette on school campus; the most common locations being in the bathroom/locker room (34.4 %) and parking lot (34.0 %). In-school exposure to e-cigarette use was associated with greater odds of ever (Adj OR: 2.06; 95 % CI: 1.82-2.33) and current (Adj OR: 1.70; 95 % CI: 1.46-1.98) e-cigarette use among adolescents as well as greater odds of susceptibility to use (Adj OR: 2.00; 95 % CI: 1.82-2.20) among never e-cigarette users. CONCLUSIONS Observing e-cigarette use on school campus was associated with greater odds of e-cigarette use and susceptibility. It is plausible that observing e-cigarette use on campus reinforces the social acceptability of adolescent e-cigarette use. Findings inform on the prevalence of e-cigarettes use on-campus as well as how this phenomenon may influence e-cigarette use/susceptibility among youth. The observed relationship highlights the role of schools in the efforts to reduce adolescent e-cigarette use.
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Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Felisa A Ruiz
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Tara L Vaughn
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Andrew E Springer
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Dai H. Youth Observation of E-Cigarette Use in or Around School, 2019. Am J Prev Med 2021; 60:241-249. [PMID: 33353794 PMCID: PMC10074326 DOI: 10.1016/j.amepre.2020.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION E-cigarette use increased dramatically among U.S. students during 2017-2019, and school plays an important role in preventing and reducing youth substance use. This study examines the prevalence and correlates of self-reported youth observation of e-cigarette use on school grounds. METHODS Data from the 2019 National Youth Tobacco Survey (N=19,018) were analyzed to examine the prevalence and factors associated with youth observation of e-cigarette use in or around the school. Multivariable logistic regressions were performed to assess the associations between youth observation of e-cigarette use and the susceptibility to initiate cigarettes or e-cigarettes. Analyses were conducted in 2020. RESULTS In 2019, about 63.9% of students (16.8 million) reported noticing youth use of e-cigarettes in or around the school, with bathroom or locker room as the most common location (33.2%). Female (versus male) students; high-school (versus middle-school) students; non-Hispanic Whites (versus other groups); former and past 30-day e-cigarette users (versus never users); students with exposure to tobacco marketing (versus none); and students living with a household member using e-cigarettes (versus not) had higher odds of reporting the observation of vaping in schools. Among never tobacco users (n=11,518), observation of vaping in schools was associated with higher odds of being susceptible to smoking cigarettes (AOR=1.2, 95% CI=1.0, 1.3) and using e-cigarettes (AOR=1.7, 95% CI=1.6, 1.9), especially among middle-school students. CONCLUSIONS E-cigarette use is common on school grounds, and youth observation of vaping in schools may increase the risk of initiating tobacco use in the future. School vaping policy and education programs are needed to curb youth e-cigarette use.
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Affiliation(s)
- Hongying Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.
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Kelder SH, Mantey DS, Van Dusen D, Vaughn T, Bianco M, Springer AE. Dissemination of CATCH My Breath, a middle school E-Cigarette prevention program. Addict Behav 2021; 113:106698. [PMID: 33130463 DOI: 10.1016/j.addbeh.2020.106698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In 2016, the US Surgeon General issued a Call to Action to address adolescent e-cigarette use and school-based prevention interventions are an effective component of comprehensive tobacco control. This study describes the development and dissemination of CATCH My Breath, an e-cigarette prevention program for middle and high school students. METHODS Starting in 2014, a university and nonprofit collaboration designed, formatively evaluated, pilot tested, and disseminated the CATCH My Breath Program (CMB). The team used Social Cognitive Theory to develop the program and Diffusion of Innovations Theory to disseminate the program. Dissemination strategies were applied beginning in 2016. This paper describes the application of both theories and the resulting reach of CMB. RESULTS Since dissemination began, CMB has been rapidly adopted, following the typical diffusion normal curve. As of June 2020, approximately 4,000 schools in the United States have adopted the program, 70,000 teachers have taught the program, and 1,400,000 students have been exposed to program materials. CONCLUSION The application of Social Cognitive Theory and Diffusion of Innovation Theory resulted in effective prevention results and rapid, widespread adoption of the CMB. This level of adoption and implementation represents 25% of the school marketplace. CMB should be considered as the school component of the recommended combustible and e-cigarette prevention and control toolkit, alongside mass media, marketing restrictions, retail access, taxation, flavor ban, and FDA premarket approval. Other public health interventions seeking rapid adoption should consider applying principles of Diffusion of Innovation as a guide for development and dissemination.
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Obinwa U, Clendennen SL, Rangwalam S, Sumbe A, Case KR, Harrell MB. Comparing Risk Factors for Past 30-day E-cigarette and Combustible Tobacco Use: A Longitudinal Analysis of the Texas Adolescent Tobacco and Marketing Surveillance Study (2014-2017). TEXAS PUBLIC HEALTH JOURNAL 2021; 73:25-32. [PMID: 35759323 PMCID: PMC9232195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Youth use of e-cigarettes is reaching 'epidemic proportions,' even as combustible tobacco use is declining. Comparison of risk factors that are uniquely associated with e-cigarette and combustible tobacco use among adolescents is warranted. METHODS Six waves of data from the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) study (n=3907; N=461,069; 2014-2017) were used in this analysis. A random intercept logistic regression model was used to compare intrapersonal, interpersonal, and environmental risk factors for use of both products based on the Social Ecological Model. RESULTS Risk factors that were significantly associated with both past 30-day use of e-cigarette and combustible tobacco products over time included past 30-day use of marijuana and alcohol, social acceptability of product use, having friends and family members who used the products, and male gender. Increasing age, worse academic performance, higher sensation seeking score, higher recall of social media promotion in the past 30 days, and lower positive affect score were associated with past 30-day use of combustible tobacco only. White race was associated with past-30 day use of e-cigarettes only. CONCLUSION Involving peers and parents in preventive interventions designed to reduce uptake of these products is paramount, as is the need to address other substance use, like alcohol and marijuana. Efforts should also be made to create a social climate that makes tobacco use (e-cigarettes and combustible products) less acceptable and desirable.
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Affiliation(s)
- Udoka Obinwa
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Stephanie L. Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Shazia Rangwalam
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
| | - Kathleen R. Case
- The University of Texas Health Science Center at Houston (UT Health), School of Public Health in San Antonio
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
- Tobacco Center of Regulatory Science on Youth and Young Adults (TCORS), The University of Texas Health Science Center at Houston (UT Health), School of Public Health in Austin, Austin, Texas
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