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Singer JM, Tackett AP, Klein EG, Lu B, Wagner DD, Wold LE, Roberts ME. Demographic and Behavioral Differences Between Adolescents and Young Adults Who Use E-Cigarettes at Low and High Frequency. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:232-239. [PMID: 38258811 DOI: 10.1177/29767342231214115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Among adolescents and young adults (AYAs), "current use" of electronic cigarettes (e-cigarettes) is commonly defined as any use in the past 30 days. However, few studies have examined differences among those within this broad category. This study examined characteristics of AYAs who used e-cigarettes at a low frequency (within the last 3 months but <6 days out of the past 30 days) and those who used e-cigarettes at a high frequency (6+ days out of the past 30 days). METHODS We conducted cross-sectional analyses among 551 Ohio AYAs (15- to 24-year-olds) who reported using an e-cigarette to vape nicotine in the past 3 months. We used descriptive statistics and logistic regression to characterize those using e-cigarettes at a low frequency and a high frequency. RESULTS Among our sample of AYAs who reported past 3-month e-cigarette use, about half (50.8%) reported using an e-cigarette 6 or more days out of the past 30 days (ie, high frequency). In the multivariable analysis, reported nicotine dependence (Odds Ratio [OR]: 7.0, 95% CI: 4.8, 10.3) and current other tobacco product use (OR: 1.8, 95% CI: 1.1, 2.9) were associated with high-frequency e-cigarette use. CONCLUSION Our results suggest that frequency of use is an important characteristic in understanding AYA e-cigarette use. Any use in the past 30 days may not be sensitive enough to understand dependence and tobacco-use behaviors. Further characterizing "current" e-cigarette use by frequency of use may provide meaningful information for public health professionals to better target intervention and cessation efforts to AYAs.
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Affiliation(s)
- Jill M Singer
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Alayna P Tackett
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Elizabeth G Klein
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Bo Lu
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Dylan D Wagner
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Loren E Wold
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Tashakkori NA, Park-Lee E, Roh EJ, Christensen CH. Multiple Tobacco Product Use Among Youth E-Cigarette Users: National Youth Tobacco Survey, 2020. J Adolesc Health 2023; 73:769-775. [PMID: 37410002 DOI: 10.1016/j.jadohealth.2023.05.025] [Citation(s) in RCA: 1] [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: 11/23/2022] [Revised: 04/24/2023] [Accepted: 05/24/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Limited information exists on multiple tobacco product use, particularly among youth. This study assessed the prevalence of current youth use of e-cigarettes with other tobacco products and their associated characteristics using 2020 National Youth Tobacco Survey data. METHODS Prevalence estimates were calculated for current e-cigarette users, by multiple tobacco product use status and product combination. Demographic characteristics, e-cigarette use behaviors, age at first combustible tobacco use, and tobacco dependence symptoms were compared between current users of both e-cigarettes and combustible tobacco (dual users) and current exclusive e-cigarette users. RESULTS In 2020, 61.1% of all current e-cigarette users reported exclusive e-cigarette use, and 38.9% used e-cigarettes with other tobacco products. Among those who used e-cigarettes with other tobacco products, 85.0% used combustible tobacco, with cigarettes being the most commonly used other tobacco product. Compared with current exclusive e-cigarette users, higher proportions of dual users reported the following: frequent e-cigarette use; obtaining e-cigarettes from gas stations, persons other than a family member/friend, vape shops, or the internet; and having any tobacco dependence symptoms. Among dual users, 31.2% reported first combustible product use after e-cigarette initiation, and 34.3% reported first combustible product use prior to e-cigarette initiation. DISCUSSION Approximately four in 10 youth current e-cigarette users reported using multiple tobacco products, with a majority using combustible tobacco. Frequent e-cigarette use and tobacco dependence symptoms were more prevalent among dual users of e-cigarettes and combustible tobacco.
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Affiliation(s)
- Nicole A Tashakkori
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Eunice Park-Lee
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Esther J Roh
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Carol H Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
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Sánchez-Franco S, Montgomery SC, Torres-Narvaez ES, Ramírez AM, Murray JM, Tate C, Llorente B, Bauld L, Hunter RF, Kee F, Sarmiento OL. How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia. Int J Behav Med 2023:10.1007/s12529-023-10211-z. [PMID: 37697141 DOI: 10.1007/s12529-023-10211-z] [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] [Accepted: 07/31/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. METHOD A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data. RESULTS We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. CONCLUSION These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.
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Affiliation(s)
- Sharon Sánchez-Franco
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | | | - Erika S Torres-Narvaez
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | - Ana M Ramírez
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia
| | - Jennifer M Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Christopher Tate
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | | | - Linda Bauld
- College of Medicine and Veterinary Medicine, Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Olga L Sarmiento
- School of Medicine, Universidad de los Andes, Carrera 1 # 18A-10 Block Q, 111711018, Bogotá, Colombia.
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Blank MD, Romm KF, Childers MG, Douglas AE, Dino G, Bray BC. Longitudinal transitions in adolescent polytobacco use across waves 1-4 of the Population Assessment of Tobacco and Health study. Addiction 2023; 118:727-738. [PMID: 36401561 PMCID: PMC9992106 DOI: 10.1111/add.16095] [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: 04/14/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
AIMS This study aims to identify adolescent patterns of polytobacco use and measure transitions between patterns over time. DESIGN Longitudinal analysis using data derived from waves 1-4 (2013-18) of the Population Assessment of Tobacco and Health (PATH) study. Transitions in tobacco use patterns were examined via latent transition analysis, and then, socio-demographic characteristics were used to predict transitions via logistic regression. SETTING United States. PARTICIPANTS Participants included 975 adolescents who used at least one tobacco product at any wave (W1 mean age = 13.29, standard deviation = 0.86; W4 54.2% male; 54.5% white, 25.9% Hispanic). MEASUREMENTS Measurements included past 30-day use of cigarettes, electronic cigarettes (e-cigs), traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco (SLT) or hookah. FINDINGS Six latent classes were identified. Cigarette users (43.5-58.8%) and SLT users (50.8-79.6%) tended to persist in their use over time. E-cig users began to probably transition to non-users (80.0%), but became more likely to persist in this use over time (31.1%). Non-users at a given wave were most likely to transition to e-cig users (8.5-43.7%) or cigarette users (6.7-28.6%). Cigarillo/poly-users and hookah/poly-users displayed more variable transition patterns. Adolescents were more likely to transition to non-use (versus become/remain e-cig users) if they were older (cigarette users, SLT users), younger (e-cig users), other race (SLT users), male (SLT users) or had less-educated parents (SLT users) compared with their counterparts. Hispanic (versus white) cigarette users were more likely to transition to non-users than to persist in this use. CONCLUSIONS Among adolescents in the United States, patterns of tobacco use characterized by the use, mainly, of single, specific products appear to be stable, particularly by late adolescence. In contrast, patterns characterized by polytobacco use appear to be more variable and may represent experimentation without specialization.
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Affiliation(s)
- Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Ashley E Douglas
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Geri Dino
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Bethany C Bray
- Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, IL, USA
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Wu J, Origgi JM, Ranker LR, Bhatnagar A, Robertson RM, Xuan Z, Wijaya D, Hong T, Fetterman JL. Compliance With the US Food and Drug Administration's Guidelines for Health Warning Labels and Engagement in Little Cigar and Cigarillo Content: Computer Vision Analysis of Instagram Posts. JMIR INFODEMIOLOGY 2023; 3:e41969. [PMID: 37113379 PMCID: PMC10132024 DOI: 10.2196/41969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023]
Abstract
Background Health warnings in tobacco advertisements provide health information while also increasing the perceived risks of tobacco use. However, existing federal laws requiring warnings on advertisements for tobacco products do not specify whether the rules apply to social media promotions. Objective This study aims to examine the current state of influencer promotions of little cigars and cigarillos (LCCs) on Instagram and the use of health warnings in influencer promotions. Methods Instagram influencers were identified as those who were tagged by any of the 3 leading LCC brand Instagram pages between 2018 and 2021. Posts from identified influencers, which mentioned one of the three brands were considered LCC influencer promotions. A novel Warning Label Multi-Layer Image Identification computer vision algorithm was developed to measure the presence and properties of health warnings in a sample of 889 influencer posts. Negative binomial regressions were performed to examine the associations of health warning properties with post engagement (number of likes and comments). Results The Warning Label Multi-Layer Image Identification algorithm was 99.3% accurate in detecting the presence of health warnings. Only 8.2% (n=73) of LCC influencer posts included a health warning. Influencer posts that contained health warnings received fewer likes (incidence rate ratio 0.59, P<.001, 95% CI 0.48-0.71) and fewer comments (incidence rate ratio 0.46, P<.001, 95% CI 0.31-0.67). Conclusions Health warnings are rarely used by influencers tagged by LCC brands' Instagram accounts. Very few influencer posts met the US Food and Drug Administration's health warning requirement of size and placement for tobacco advertising. The presence of a health warning was associated with lower social media engagement. Our study provides support for the implementation of comparable health warning requirements to social media tobacco promotions. Using an innovative computer vision approach to detect health warning labels in influencer promotions on social media is a novel strategy for monitoring health warning compliance in social media tobacco promotions.
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Affiliation(s)
- Jiaxi Wu
- College of Communication Boston University Boston, MA United States
| | - Juan Manuel Origgi
- Department of Computer Science Boston University Boston, MA United States
| | - Lynsie R Ranker
- Department of Community Health Sciences School of Public Health Boston University Boston, MA United States
| | - Aruni Bhatnagar
- Department of Medicine University of Louisville Louisville, KY United States
- American Heart Association Tobacco Regulation and Addiction Center Dallas, TX United States
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center Dallas, TX United States
- Department of Medicine School of Medicine, Vanderbilt University Nashville, TN United States
| | - Ziming Xuan
- Department of Community Health Sciences School of Public Health Boston University Boston, MA United States
| | - Derry Wijaya
- Department of Computer Science Boston University Boston, MA United States
| | - Traci Hong
- College of Communication Boston University Boston, MA United States
| | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute Boston University Chobanian & Avedisian School of Medicine Boston, MA United States
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Almutairi RM, Al-Dubai SAR, Almutairi MM, Alharbi HH, Alshlahi HM, Albadrani MS. The degree of nicotine dependence among users of different tobacco and nicotine products in Madinah City, Saudi Arabia. J Family Community Med 2023; 30:30-36. [PMID: 36843868 PMCID: PMC9954428 DOI: 10.4103/jfcm.jfcm_181_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND Nicotine addiction has many consequences. The World Health Organization has classified nicotine dependence as a disorder of substance use. This study aimed to assess the dependence in users of different tobacco and/or nicotine-containing products (TNPs). MATERIALS AND METHODS This analytical, cross-sectional study involved 211 TNP users in Madinah, Saudi Arabia. The data was collected using a self-administered questionnaire that consisted of two main sections. The first section included sociodemographic domain, TNP status domain, and the Stages of Change model domain. The second section of the instrument included the ABOUT dependence construct comprising 12 items. Independent t-test, analysis of variance, and correlation analysis were used to assess the relationship between the study variables. RESULTS Most users of TNPs exclusively used tobacco cigarettes (53.1%). Total dependence score was significantly associated with gender, marital status, age group, monthly income, nicotine concentration in electronic cigarettes (e-cigarettes) liquid, and the number of cigarettes smoked per day (P < 0.05). Total dependence score was correlated with the duration of TNP usage (r = 0.24, P < 0.001), Switching attempts to another TNP (r = 0.16, P = 0.020), attempts of quitting TNPs (r = 0.25, P < 0.001), and willingness to quit (r = -0.37, P < 0.001). CONCLUSION Dependence was associated with gender, marital status, age group, monthly income, nicotine concentration in e-cigarette liquid, and the number of cigarettes smoked per day. It was also associated with duration of TNP usage, Switching attempts to another TNP, attempts of quitting TNPs and the willingness to quit.
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Affiliation(s)
- Rami M. Almutairi
- Department of Preventive Medicine, Joint Program of Saudi Board of Preventive Medicine, Al-Madinah Almunawara, Saudi Arabia
| | - Sami A. R. Al-Dubai
- Department of Preventive Medicine, Joint Program of Saudi Board of Preventive Medicine, Al-Madinah Almunawara, Saudi Arabia
| | - Mai M. Almutairi
- Medical Student, College of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Hani H. Alharbi
- Department of Preventive Medicine, Joint Program of Saudi Board of Preventive Medicine, Al-Madinah Almunawara, Saudi Arabia
| | - Hatim M. Alshlahi
- Department of Family Medicine, Joint Program of Family Medicine Postgraduate Studies, Al-Madinah Almunawara, Saudi Arabia
| | - Muayad S. Albadrani
- Department of Family and Community Medicine, Taibah University, Madinah, Saudi Arabia
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The Impact of Influencers on Cigar Promotions: A Content Analysis of Large Cigar and Swisher Sweets Videos on TikTok. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127064. [PMID: 35742315 PMCID: PMC9222503 DOI: 10.3390/ijerph19127064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Little is known about the content, promotions, and individuals in cigar-related videos on TikTok. TikTok videos with large cigar and Swisher Sweets-related hashtags between July 2016 and September 2020 were analyzed. Follower count was used to identify influencers. We compared content characteristics and demographics of featured individuals between cigar types, and by influencer status. We also examined the association between content characteristics and video engagement. Compared to large cigar videos, Swisher Sweets videos were more likely to feature arts and crafts with cigar packages, cannabis use, and flavored products. In addition, Swisher Sweets videos were also more likely to feature females, Black individuals, and younger individuals. Both Swisher Sweets and large cigar influencers posted more videos of cigar purchasing behaviors than non-influencers, which was associated with more video views. None of the videos disclosed sponsorship with #ad or #sponsored. Videos containing the use of cigar packages for arts and crafts, and flavored products highlight the importance of colorful packaging and flavors in the appeal of Swisher Sweets cigars, lending support for plain packaging requirements and the prohibition of flavors in cigar products to decrease the appeal of cigars. The presence and broad reach of cigar promotions on TikTok requires stricter enforcement of anti-tobacco promotion policies.
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Sharma AD, Garg S, Singh MM, Deshmukh CP, Sharma P, Borle AL. Prevalence and Social Contextual Factors of Smokeless Tobacco Use: Insights from Schools of Delhi, India. Asian Pac J Cancer Prev 2021; 22:2351-2355. [PMID: 34452545 PMCID: PMC8629448 DOI: 10.31557/apjcp.2021.22.8.2351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background: It was observed that adult users start tobacco use in childhood or adolescence. The influence of digital and print media, social acceptance among peers, and in order to mimic role models from films attracts youth towards tobacco. Hence this study was conducted to assess the prevalence of smokeless tobacco (SLT) use among school-going adolescents with the assessment of the influencing factors such as exposure at school, home, and public places along with the role of various media in SLT use by adolescents. Methods: Cross sectional study was conducted with 860 students of class 9th -12th enrolled in schools. Purposive sampling of three schools was done from the study area to reach desired sample size. All the students of class 9th - 12th within selected schools were given chance to participate in the study. Data collection was done using pretested modified Global Youth Tobacco Survey (GYTS) questionnaire. Results: Consumption of smokeless tobacco (SLT) was observed in 79 (11%) of 714 subjects. Significantly higher proportion (18.4%) of study subjects consumed SLT who were exposed to tobacco at school premises and 19.1% of study subjects who were exposed to teacher using SLT in schools compared to non-exposed group. (p=0.016). It was observed that 8.1% of subjects without any exposure to tobacco at home and 9.8% of subjects without exposure to tobacco at outdoor public space consumed SLT. Consumption of SLT use was highest (16.7%) among subjects exposed to tobacco advertisement or promotion through social media (p=0.04). Conclusion: High prevalence of SLT was detected among adolescents in school. Factors such as exposure to tobacco at home, public places, school and school teacher using SLT, exposure of tobacco advertisement and promotion via different modes of media was found to be significantly associated with the use of SLT in the adolescents of school.
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Affiliation(s)
- Akash Deep Sharma
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | | | | | - Pragya Sharma
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Amod L Borle
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
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Kwon M, Chung SJ, Lee J. Use of Single, Dual, and Poly Tobacco Products in Korean Adolescents. Asia Pac J Public Health 2021; 33:571-578. [PMID: 34137306 DOI: 10.1177/10105395211022950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to examine the prevalence of single, dual, and poly use of conventional cigarettes, e-cigarettes, and heated tobacco products among Korean adolescent smokers and identify factors related to dual and poly tobacco product use. Data from 4028 current smokers in the 2019 Korea Youth Behavior Web-based Survey were included. Single users accounted for 53.1%, followed by dual users at 24.8% and poly users at 22.1%. The factors influencing dual and poly tobacco product use included male, living in a metropolitan area, risky alcohol drinking, sexual experience, number of cigarettes smoked, secondhand smoke exposure, and easy-to-buy tobacco products. The findings suggest restricting the use of new types of tobacco products in the high-risk group are required to prevent dual and poly use. Furthermore, it is necessary to provide support like education for new tobacco products and smoking cessation, programs for secondhand smoke prevention, or rigorous marketing regulations for adolescents.
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Affiliation(s)
- Min Kwon
- The University of Suwon, Hwaseong, South Korea
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Grobman B, Wu R, Jackson A, Bold KW, Morean ME, Camenga DR, Davis DR, Simon P, Krishnan-Sarin S, Kong G. First tobacco product tried among adolescents based on race/ethnicity and socioeconomic status. Addict Behav 2021; 113:106666. [PMID: 33130462 DOI: 10.1016/j.addbeh.2020.106666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/31/2020] [Accepted: 09/16/2020] [Indexed: 12/27/2022]
Abstract
In recent years, the tobacco use landscape among youth has changed greatly, underscoring a need to understand current tobacco product initiation patterns. This study aimed to examine if adolescents' first tobacco product tried differs by race/ethnicity and socioeconomic status (SES). Cross-sectional survey data were collected from 6 Connecticut high schools in Spring 2019 (N = 4875). The analytic sample comprised ever users of tobacco products who reported on the first tobacco product they tried (N = 2530; 53.6% female). Of ever tobacco product users, 64.6% reported that their first tobacco product tried was an e-cigarette, 24.4% reported blunts, 6.5% reported another tobacco product, and 4.5% reported cigarettes. A multinomial logistic regression model examined race/ethnicity and SES as predictors of the first tobacco product tried with cigarettes as the reference group. Compared to Non-Hispanic (NH) White students, NH Black students (OR = 0.38, 95%CI = 0.17-0.82), Hispanic students (OR = 0.44, 95%CI = 0.27-0.71), and students of other NH races (OR = 0.30, 95%CI = 0.18-0.52) were less likely to report initiating tobacco product use with e-cigarettes. Additionally, compared to NH White students, NH Black students were more likely to report using blunts as their first tobacco product (OR = 3.01, 95%CI = 1.38-6.56). Compared to low SES, middle SES (OR = 1.62, 95%CI = 1.04-2.52) was associated with greater odds of reporting e-cigarettes as the first tobacco product. These findings suggest that youth of different backgrounds initiate tobacco use with different tobacco products and tailored prevention strategies are needed.
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Klosterhalfen S, Kotz D, Kuntz B, Zeiher J, Starker A. Waterpipe Use among Adolescents in Germany: Prevalence, Associated Consumer Characteristics, and Trends (German Health Interview and Examination Survey for Children and Adolescents, KiGGS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7740. [PMID: 33105905 PMCID: PMC7660200 DOI: 10.3390/ijerph17217740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/16/2022]
Abstract
Waterpipe (WP) use is popular among youth worldwide, but epidemiological data from Germany are scarce. We aimed to describe prevalence rates of WP use (current, last 12 months, ever) and analysed correlates and trends among 11- to 17-year-olds in Germany. Analyses were based on data from the "German Health Interview and Examination Survey for Children and Adolescents" study during 2014-2017 (n = 6599). Changes in WP use prevalence compared with 2009-2012 were used to describe trends. Associations with sociodemographic characteristics and cigarette smoking were assessed with multivariable logistic regression models. Prevalence of current WP use among adolescents was 8.5% (95% confidence interval (CI) = 7.5-9.6), use in the last 12 months was 19.7% (95% CI = 18.3-21.2), and ever use was 25.8% (95% CI = 24.2-27.5). High prevalence rates were particularly found among 16-17-year-olds. During 2009-2012, these prevalence rates were 9.0%, 18.5%, and 26.1%, respectively. WP use was associated with older age, male sex, migration background, lower educational level, and current smoking status. Among current WP users, 66.2% (95% CI = 60.0-71.9) identified themselves as non-smokers, and 38.1% (95% CI = 32.5-44.0) had used WP ≥ three times in the last month. WP consumption is popular among German youth, and prevalence rates have not changed over time. Specific prevention strategies to reduce harmful WP consumption among youth should be implemented.
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Affiliation(s)
- Stephanie Klosterhalfen
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany; (S.K.); (D.K.)
| | - Daniel Kotz
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany; (S.K.); (D.K.)
| | - Benjamin Kuntz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101 Berlin, Germany; (B.K.); (J.Z.)
| | - Johannes Zeiher
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101 Berlin, Germany; (B.K.); (J.Z.)
| | - Anne Starker
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101 Berlin, Germany; (B.K.); (J.Z.)
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"Look at Me, I Plan to Quit Smoking": Bayesian Hierarchical Analysis of Adolescent Smokers' Intention to Quit Smoking. Healthcare (Basel) 2020; 8:healthcare8020076. [PMID: 32230923 PMCID: PMC7349091 DOI: 10.3390/healthcare8020076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/23/2022] Open
Abstract
The tobacco epidemic is one of the most prominent public health threats the world has ever faced. Public health policy that seeks to limit the problem may have to target not only the price of tobacco but also the initiation stage in a smoker’s life—the adolescent stage. Most research on teen smoking focuses on initiation and other stories. Moreover, what determines the desire to quit smoking among teens is not well understood, even though planning to quit smoking is an important stage toward successful cessation. This research contributes to healthcare literature by using Bayesian hierarchical techniques, estimated using Hamiltonian Monte Carlo (HMC) and its extension, the No-U-Turn Sampler (NUTS), to empirically identify what drives the intention to quit smoking among teen smokers in Zambia. Results suggest that, among the junior secondary school-going adolescent smokers in Zambia, about 63% have plans to quit smoking. We find socio-demographic characteristics and several tobacco-smoking-related factors as salient drivers of adolescent smokers’ plans to quit smoking. For policymaking, we recommend that school-going teen smokers should have access to smoking cessation aids to help them quit smoking. Most importantly, increased awareness of dangers of smoking, advice by health professionals, stringent public policies on smoking, as well as parental guidance could be useful to help adolescent smokers realize their quitting plans.
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