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Adjei A, Wilkinson AV, Chen B, Mantey DS, Harrell MB. Does the time to nicotine dependence vary by internalizing symptoms for young people who use e-cigarettes? An analysis of the Population Assessment of Tobacco and Health (PATH) study, (Waves 1-5; 2013-2019). Addict Behav 2024; 156:108075. [PMID: 38810488 DOI: 10.1016/j.addbeh.2024.108075] [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: 12/22/2023] [Revised: 05/03/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE To determine the relationship between past-year internalizing symptoms and the time to first report of signs of nicotine dependence among young people. METHODS Secondary analysis using data from the Population Assessment of Tobacco and Health (PATH) (Waves 1-5; 2013-2019). The study included 2,102 (N = 5,031,691) young people (age 12-23 years) who reported past-30-day (P30D) e-cigarette use in one or more waves. Kaplan Meier curves, stratified by past year internalizing symptoms were used to estimate the time to the first report of three nicotine dependence symptoms (i.e., use within 30 min of waking, cravings, and really needing to use) following the first P30D e-cigarette use. Cox proportional hazard models were used to estimate crude and adjusted hazard ratios (AHR), comparing any past year internalizing symptoms to no past year internalizing symptoms. RESULTS We found no significant differences between past year internalizing symptoms and the time to the first report of cravings (AHR = 1.30, 95 % CI = 92-1.85), really needing to use (AHR = 1.31; 95 % CI = 0.92-1.89) and use within 30 min of waking for follow-up times 0-156 weeks (AHR = 0.84; 95 % CI = 0.55-1.30) and > 156 weeks (AHR = 0.41; 95 % CI = 0.04-4.67) respectively. CONCLUSION Past year internalizing symptoms did not modify the time to the first report of nicotine dependence among youth with P30D e-cigarette use. Further research is needed to understand how changing internalizing symptoms and e-cigarette use frequency influence nicotine dependence over time and, how this relationship impacts cessation behavior.
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Affiliation(s)
- Abigail Adjei
- University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Austin, TX, United States.
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Austin, TX, United States.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Austin, TX, United States.
| | - Dale S Mantey
- University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Austin, TX, United States.
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth Houston), School of Public Health, Austin, TX, United States.
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2
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Han DH, Harlow AF, Bae D, Cho J, Eckel SP, McConnell R, Barrington-Trimis JL, Audrain-McGovern JE, Leventhal AM. Association between cannabis use and nicotine use persistence among adolescents. Addict Behav 2024; 158:108106. [PMID: 39032200 DOI: 10.1016/j.addbeh.2024.108106] [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: 02/01/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/22/2024]
Abstract
INTRODUCTION Prospective associations of adolescent cannabis use with nicotine use persistence are not well characterized but are important for informing prevention and policy. This study examined the association of 4 types of cannabis product use with subsequent persistent nicotine product use among adolescents. METHODS We used prospective data from an adolescent cohort (14-17 years) from Southern California surveyed at baseline and at approximately 6-month follow-up (2022-2023). We incorporated three mutually non-exclusive analytic samples comprised of individuals with baseline past 6-month use of: (1) any nicotine product (N=308 [mean[SD] age = 16.3[0.6] years]), (2) e-cigarettes (n = 276), and (3) any combustible tobacco product (n = 137). Baseline past 6-month cannabis smoking, vaping, edible use, cannabidiol [CBD] or hemp product use, and any cannabis product use (yes/no) were separately modeled as predictors of past 6-month persistent use of any nicotine products, e-cigarettes, and combustible tobacco at follow-up. RESULTS Baseline use of any cannabis product was associated with increased odds of persistent use of e-cigarettes or any nicotine product (adjusted odds ratio[OR] range: 1.96-2.66). Cannabis smoking was positively associated with persistent any nicotine product use (adjusted OR=2.19, 95 % CI=1.20-4.02). Cannabis smoking, vaping, and edible use predicted persistent use of e-cigarettes (adjusted OR range: 2.22-2.79). Cannabis product use did not predict combustible tobacco use persistence. Associations of CBD/hemp product use with nicotine use persistence outcomes were all non-significant. CONCLUSIONS Adolescents who use cannabis may be at elevated risk for persistent nicotine use.
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Affiliation(s)
- Dae-Hee Han
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Dayoung Bae
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | | | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA; Department of Psychology, University of Southern California, Los Angeles, CA, USA
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3
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Bong AR, Cho YG, Park HA, Kim KW. Unhealthy Weight Control Behaviors according to the Status of Combustible Cigarette and Noncombustible Nicotine or Tobacco Product Use among Korean Adolescents with Experience Attempting to Reduce or Maintain Their Body Weight: The 15th Korea Youth Risk Behavior Survey, 2019. Korean J Fam Med 2024; 45:223-230. [PMID: 38720235 PMCID: PMC11273165 DOI: 10.4082/kjfm.21.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/16/2024] [Accepted: 03/07/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents. METHODS This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users. RESULTS Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users. CONCLUSION This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.
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Affiliation(s)
- A Ra Bong
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Young Gyu Cho
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Hyun Ah Park
- Department of Family Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Kyo Woon Kim
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
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4
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Cuomo RE, Purushothaman VL, Mackey TK, Yang JW. Rates of adverse events and related risk factors following e-cigarette use. J Public Health (Oxf) 2024; 46:e230-e239. [PMID: 38282109 DOI: 10.1093/pubmed/fdad281] [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: 10/02/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND E-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample. METHODS A cross-sectional survey was conducted with a sample of 4695 current and former e-cigarette users with a median age of 34 years. The survey collected data on e-cigarette use, adverse events experienced, product characteristics, related behaviors, sociodemographic factors and presence of medical comorbidities. Statistical analyses were conducted using Pearson's chi-squared tests and logistic regression. RESULTS A total of 78.9% of respondents reported experiencing an adverse event within 6 h of using a vaping device, with the most common events being headache, anxiety and coughing. Product characteristics and related behaviors significantly influenced the risk of adverse events. There were also sociodemographic disparities, with Hispanic respondents and those with at least college-level education reporting higher rates of adverse events. CONCLUSIONS Our study found a high rate of adverse events among e-cigarette users. We identified that certain e-cigarette product characteristics, behaviors and medical comorbidities significantly increased the risk of these events.
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Affiliation(s)
- Raphael E Cuomo
- School of Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | | | - Tim K Mackey
- San Diego Supercomputer Center, San Diego, CA 92093, USA
| | - Joshua W Yang
- Department of Public Health, California State University, Fullerton, CA 92831, USA
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5
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Glantz S, Lempert LK. Vuse Solo e-cigarettes do not provide net benefits to public health: a scientific analysis of FDA's marketing authorisation. Tob Control 2024; 33:e108-e115. [PMID: 36764683 PMCID: PMC10409877 DOI: 10.1136/tc-2022-057296] [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: 01/24/2022] [Accepted: 11/04/2022] [Indexed: 02/12/2023]
Abstract
In October 2021, the US Food and Drug Administration (FDA) authorised marketing of RJ Reynolds Vapor Company's (RJR) Vuse Solo e-cigarette through FDA's Premarket Tobacco Product Application (PMTA) pathway. FDA concluded that RJR demonstrated Vuse products met the statutory standard of providing a net benefit to public health. A review of FDA's scientific justification reveals deficiencies: (1) not adequately considering Vuse's popularity with youth and evidence that e-cigarettes expanded the nicotine market and stimulate cigarette smoking; (2) trading youth addiction for unproven adult benefit without quantifying these risks and benefits; (3) not considering design factors that appeal to youth; (4) not addressing evidence that e-cigarettes used as consumer products do not help smokers quit and promote relapse in former smokers; (5) not discussing evidence that dual use is more dangerous than smoking; (6) narrowly focusing on the fact that e-cigarettes deliver lower levels of some toxicants without addressing direct evidence on adverse health effects; (7) downplaying significant evidence of other substantial harms; (8) not acting on FDA's own study showing no all-cause mortality benefit of reducing (but not stopping) cigarette use; and (9) improperly considering e-cigarettes' high abuse liability and potential for high youth addiction and undermining tobacco cessation. Because marketing these products is not appropriate for the protection of the public health, FDA should reconsider its Vuse marketing order as statutorily required and not use it as a template for other e-cigarette PMTAs. Policymakers outside the USA should anticipate that tobacco companies will use FDA's decision to try to weaken tobacco control regulation of e-cigarettes and promote their products.
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Affiliation(s)
| | - Lauren Kass Lempert
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
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6
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Augenstein JA, Smaldone AM, Usseglio J, Bruzzese JM. Electronic Cigarette Use and Academic Performance Among Adolescents and Young Adults: A Scoping Review. Acad Pediatr 2024; 24:228-242. [PMID: 37748535 DOI: 10.1016/j.acap.2023.09.012] [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: 01/22/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND There are documented links between substance use and poor educational outcomes. However, less is known about electronic cigarette (e-cigarette) use in relation to academics. Therefore, this scoping review aimed to synthesize associations between e-cigarette use and academic performance among adolescents and young adults. METHODS Seven electronic databases were searched. Original research articles were included if associations between e-cigarette use and academic performance among adolescents and young adults aged 11 to 25 years were examined. Extracted data included study and participant descriptors, measures of e-cigarette use and academic performance, key findings, and study limitations. Measures of academic performance were grouped as academic achievement, academic behaviors, or cognitive attitudes. RESULTS Thirty-three studies met inclusion criteria. Most were cross-sectional (n = 28). Significant associations to e-cigarette use were identified across all categories: academic achievement (ie, school grades (n = 24)), academic behaviors (ie, school difficulties (n = 1), time spent on homework (n = 1), school suspension (n = 1), and truancy (n = 3)), and cognitive attitudes (ie, school stress (n = 1), school alienation (n = 1), and school engagement (n = 2)). Longitudinal associations were also identified in 5 prospective cohort studies: among adolescents, poor academic grades (n = 4), and truancy (n = 1) predicted future e-cigarette use, and e-cigarette use predicted future lower school grades (n = 1). CONCLUSIONS E-cigarette use during adolescence and young adulthood is associated with poor academic achievement. There is some evidence that academic achievement may predict future e-cigarette use; less evidence supports the opposite direction. Study designs are needed to support a causal connection. Investigators should consider moving from studying associations and instead look for causal evidence.
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Affiliation(s)
- Jacqueline A Augenstein
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,.
| | - Arlene M Smaldone
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,; Columbia University College of Dental Medicine (AM Smaldone), New York, NY
| | - John Usseglio
- Augustus C. Long Health Sciences Library (J Usseglio), Columbia University Irving Medical Center, New York, NY
| | - Jean-Marie Bruzzese
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY
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7
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Vázquez AL, Navarro Flores CM, Garcia BH, Barrett TS, Domenech Rodríguez MM. An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic. PLoS One 2024; 19:e0287878. [PMID: 38354165 PMCID: PMC10866513 DOI: 10.1371/journal.pone.0287878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.
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Affiliation(s)
- Alejandro L. Vázquez
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Cynthia M. Navarro Flores
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Byron H. Garcia
- Department of Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Tyson S. Barrett
- Highmark Health, Pittsburg, Pennsylvania, United States of America
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8
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Garey L, Smit T, Bizier A, Redmond BY, Ditre JW, Rogers AH, Bakhshaie J, Nizio P, Zvolensky MJ. Pain interference among adult dual combustible and electronic tobacco users in terms of perceived barriers for quitting. Exp Clin Psychopharmacol 2024; 32:45-53. [PMID: 37166909 PMCID: PMC10638470 DOI: 10.1037/pha0000660] [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] [Indexed: 05/12/2023]
Abstract
Electronic cigarette (e-cigarette) use has become increasingly common among combustible cigarette users, and dual use may represent a more severe type of nicotine addiction. Experiencing pain is one prevalent domain that may be important to understand quit processes and behavior among dual users. Although most past research on pain and nicotine/tobacco has focused on combustible cigarette use, initial work on e-cigarette users has found that greater pain severity is associated with higher levels of dependence and negative thinking patterns about e-cigarette use. Yet, there has been no effort to explore the experience of pain among dual users in terms of perceived barriers for quitting combustibles or e-cigarettes. The present study sought to examine pain interference among dual combustible and e-cigarette users in terms of perceived barriers for quitting among 138 (45.9% female; Mage = 35.96 years, SD = 7.16) adult dual users (i.e., users of both combustible cigarette and e-cigarettes). Hierarchical linear regression models indicated that pain interference was significantly associated with both perceived barriers for cessation of combustible cigarettes and perceived barriers for cessation of e-cigarettes. Overall, the present investigation served as an initial evaluation of the role of pain interference in terms of perceived barriers for quitting combustible and e-cigarettes among adult daily dual users. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Boston, MA, USA
- HEALTH Institute, University of Houston, Boston, MA, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Boston, MA, USA
| | - Andre Bizier
- Department of Psychology, University of Houston, Boston, MA, USA
| | | | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Boston, MA, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Boston, MA, USA
| | - Jafar Bakhshaie
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Pamella Nizio
- Department of Psychology, University of Houston, Boston, MA, USA
- HEALTH Institute, University of Houston, Boston, MA, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Boston, MA, USA
- HEALTH Institute, University of Houston, Boston, MA, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
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9
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Adjei A, Chen B, Mantey DS, Wilkinson AV, Harrell MB. Symptoms of nicotine dependence by e-cigarette and cigarette use behavior and brand: A population-based, nationally representative cross-sectional study. Drug Alcohol Depend 2024; 255:111059. [PMID: 38150895 DOI: 10.1016/j.drugalcdep.2023.111059] [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: 09/22/2023] [Revised: 11/18/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Many modern e-cigarette brands contain equivalent or higher nicotine levels than traditional cigarettes. OBJECTIVE To examine differences in four nicotine dependence indicators (i.e., use within 30minutes of waking, cravings, needing to use, and frequent use) among adolescents (aged 12-17 years) with past 30-day (P30D) exclusive use of e-cigarettes, cigarettes, or dual use of both. METHODS Data were from Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health (PATH) study (n=1060; N=2053,659). Multivariable logistic regression was performed to determine differences in indicators by P30D e-cigarette and cigarette use behavior (exclusive vs. dual use) and brand (e-cigarette use: JUUL vs. non-JUUL vs. Unknown). RESULTS The odds of frequent use among adolescents with JUUL (AOR: 2.11; 95% CI=1.02-4.37) and non-JUUL (AOR: 2.12; 95% CI=0.95-4.77) use were similar and paralleled that for dual use (AOR: 3.50; 95% CI=1.46-8.43) but were stronger (JUUL only) than exclusive cigarette use. The odds of using within 30minutes of waking for adolescents with JUUL (AOR: 2.23; 95% CI=0.80-6.25) and non-JUUL (AOR:1.42; 95% CI=0.47-4.32) use were similar and paralleled that for both dual (AOR=3.00; 95% CI=1.01-8.88) and exclusive cigarette use. For adolescents who used unknown brands, the odds of all indicators paralleled exclusive cigarette use but were lower than JUUL, non-JUUL, and dual use. CONCLUSION Compared to exclusive cigarette use, symptoms of nicotine dependence are similar for adolescents with exclusive e-cigarette use, irrespective of brand. Symptoms of nicotine dependence for JUUL and non-JUUL use parallel dual use. Tobacco regulation should consider these findings when assessing the abuse liability of e-cigarettes.
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Affiliation(s)
- Abigail Adjei
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Dale S Mantey
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
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10
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Okamoto SK, Subica AM, An KJ, Okamura KH, Song SD, Saladino PA, Carson AB, Stephens TA, Marshall SM, Chin SK, Wills TA, Kaholokula JK, Pokhrel P. Exploring Native Hawaiian and Pacific Islander Youths' E-Cigarette Resistance Strategies: Implications for Tobacco Product Use Prevention. J Health Care Poor Underserved 2024; 35:692-706. [PMID: 38828589 PMCID: PMC11238740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai'i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were "refuse" (saying no), "explain" (providing reasons for vaping refusal), "avoid" (avoiding people or places where e-cigarettes were used), and "leave" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.
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11
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Silva-Gallardo CP, Maggs JL. Pubertal development at age 14 is associated with male adolescents' combustible cigarette smoking and dual use, but not with e-cigarette use - Findings from the UK Millennium Cohort Study. Drug Alcohol Depend 2023; 253:111031. [PMID: 37995392 DOI: 10.1016/j.drugalcdep.2023.111031] [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: 07/04/2023] [Revised: 10/30/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Adolescent nicotine exposure via electronic cigarettes (e-cigarettes) is a global health concern. Pubertal development earlier than peers increases the risk of tobacco smoking compared to peers experiencing on-time or late maturation, yet relationships of pubertal timing with e-cigarettes are unknown. We examine whether early pubertal timing is associated with risk for e-cigarette use, tobacco cigarettes, or both by age 14. METHODS The Millennium Cohort Study follows a representative cohort of 18,552 9-month-old children born 2000-2002 in the United Kingdom. Our sample includes 11,445 adolescents (5697 boys, 5748 girls) classified at age 14 as early, on-time, or late in pubertal development timing (PDT) relative to same-age, same-sex peers using the Pubertal Development Scale. Outcomes were use of e-cigarettes, tobacco cigarettes, or both by age 14. We included childhood liability confounders and demographics measured from age 7-11. RESULTS For girls, no PDT differences in age 14 e-cigarette or tobacco cigarette use were observed. All relative to on-time PDT boys, early maturing boys' odds of tobacco cigarette use were 59% higher (OR=1.59, 95% confidence interval (CI)=1.08,2.35), and odds of dual-use were 49% higher (OR=1.49, CI=1.11,1.99), both compared to odds of never use. Among late PDT boys, dual-use odds were lower than never use by 35% (OR=0.65, CI=0.47,0.91) and lower than e-cigarette use only by 36% (OR=0.64, CI=0.42,0.97). CONCLUSIONS At age 14, PDT was not associated with e-cigarette use for either sex, yet it was linked with tobacco use and dual use among boys.
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Affiliation(s)
- Constanza P Silva-Gallardo
- Prevention Research Center, Pennsylvania State University, University Park, PA, USA; Society and Health Research Center and Facultad de Ciencias Sociales y Artes, Universidad Mayor, Santiago, Chile; Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Chile.
| | - Jennifer L Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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Harton MR, Seo DC, Evans-Polce RJ, Nguyen I, Parker MA. Cigarette and e-cigarette use trajectories and prospective prescription psychotherapeutic drug misuse among adolescents and young adults. Addict Behav 2023; 147:107818. [PMID: 37540966 PMCID: PMC10528320 DOI: 10.1016/j.addbeh.2023.107818] [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: 03/17/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE This study aimed to determine the potential longitudinal impact of different cigarette and e-cigarette use trajectories among people aged 10-24 on prescription drug misuse of psychotherapeutic drugs. METHODS Data came from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2019; n = 14,454). Group-based trajectory modeling identified groups of adolescents and young adults based on cigarette and e-cigarette use across the five waves. Weighted logistic regression models were fit to examine the association of group membership with two outcomes at all waves: 1) misuse of opioids, sedatives, and/or tranquilizers, and 2) misuse of Ritalin and/or Adderall, adjusting for background characteristics. RESULTS Five trajectory groups emerged: (1) non-use (77.7 %); (2) early-onset cigarette use with reducing use (4.6 %); (3) ever-increasing e-cigarette use (6.1 %); (4) stable dual use of cigarettes and e-cigarettes (3.2 %); and (5) accelerating dual use of cigarettes and e-cigarettes (8.4 %). In comparison to the non-use group, all other groups had significantly higher odds of misuse of opioids, tranquilizers, and/or sedatives and all but the early-onset cigarette use with reducing use group had significantly higher odds of misuse of Ritalin and/or Adderall by the end of wave 5. DISCUSSION Patterns of cigarette and e-cigarette use in adolescent and young adult populations may serve as important indicators for concurrent and prospective prescription psychotherapeutic drug misuse. Findings highlight the need for cigarette and e-cigarette use prevention, harm reduction, and/or cessation efforts among adolescents and young adults.
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Affiliation(s)
- Moriah R Harton
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA
| | - Dong-Chul Seo
- Indiana University Bloomington, School of Public Health, Department of Applied Health Science, 1025 E 7th St, Bloomington, IN 47405, USA
| | - Rebecca J Evans-Polce
- University of Michigan, School of Nursing, Department of Health Behavior and Biological Sciences, 400 North Ingalls Building, Ann Arbor, MI 48109, USA
| | - Ivana Nguyen
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA
| | - Maria A Parker
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA.
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Doumi R, Khaytan S, Alobaidan AS, Alqahtany BM, Aldosari NM, Almutairi AA, Alanazi AA, Fayed A. Knowledge, Attitude, and Practice of E-Cigarettes of Adolescents and Adults in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2998. [PMID: 37998490 PMCID: PMC10671544 DOI: 10.3390/healthcare11222998] [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: 10/15/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
E-cigarettes have gained enormous popularity, and their use has increased drastically worldwide. However, little is known regarding adolescents' and adults' knowledge, attitudes, and practices in Saudi Arabia. We conducted a cross-sectional study using a self-administered online-modified WHO GATS questionnaire on a convenience sample approach. Data were collected between January and March 2021 after the alleviation of COVID-19 lockdown measures in Saudi Arabia. Univariate and multivariate regression models were developed to identify independent factors associated with knowledge, attitude, and practice. Our sample (1335) had a mean age of 26.45 ± 10.5 years; nearly half of the participants had poor knowledge about e-cigarettes. The usage and positive attitude were reported by 18.6% and 19.4%, respectively. Around 43.5% of e-cigarette users reported starting or increased use during the COVID-19 pandemic, while 9.5% of participants would recommend it to others. Logistic regressions showed that older participants were more likely to have poor knowledge (OR = 1.02, 95% C.I. = 1.01-1.03) and positive attitudes (OR = 0.98, 95% C.I. = 0.91-0.96). Male participants and smokers (OR = 3.0, 95% C.I. = 2.3-3.8) were more likely to have a positive attitude. However, younger participants were less likely to go for e-cigarettes (OR = 0.95, 95% C.I. = 0.93-0.97), while males (OR = 2.53, 95% C.I. = 1.65-3.86) and smokers (OR = 4.63, 95% C.I. = 3.47-6.18) were more likely to use them. This study indicated a high level of poor knowledge about e-cigarettes. A considerable proportion of participants reported usage and a positive attitude towards them. Older age, male gender, and being a smoker were the main elicited predictors for e-cigarette use.
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Affiliation(s)
- Rasha Doumi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (S.K.); (A.S.A.); (B.M.A.); (N.M.A.); (A.A.A.); (A.A.A.); (A.F.)
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Henn SL, Martinasek MP, Lange M. Vaping Behavior in Young Adults During the COVID-19 Pandemic. Respir Care 2023; 68:1493-1501. [PMID: 37024281 PMCID: PMC10589117 DOI: 10.4187/respcare.10629] [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: 10/07/2022] [Accepted: 04/05/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS) continue to be popular among young adults. These devices are often advertised as a healthy alternative to quitting tobacco cigarettes. However, young adults represent a population who view it as a novel behavior that provides a sense of popularity, social acceptance, and desired physiologic properties. The objective of this study was to examine characteristics of vaping behavior among college students and explore possible associations between groups of vaping behavior (stopped, initiated, increased, decreased, stayed the same). METHODS In a multi-center cross-sectional study, 656 students from University of Tampa in the United States and University of Applied Sciences in Germany (IST) were recruited to answer a 31-item online questionnaire. A chi-square test was used to evaluate associations between the groups. RESULTS Prevalence rates indicated approximately 31% of all students were currently using ENDS. Even though more negative than positive experiences with ENDS were reported, most students stated their vaping increased during COVID-19 lockdowns. Addiction and stress relief emerged to be predictors (P < .001) of an increase in vaping, whereas social motives were not statistically significant. Living situation (P = .63) and depression (P = .10) were not significantly associated with vaping behavior. CONCLUSIONS ENDS products continue to yield very high levels of nicotine creating addiction in young adults. Addiction counseling and evidenced-based practices should be employed at every level (individual, community, and school). Additionally, mental health counseling for students in pandemic and high-stress environments may help to combat stress in a more proactive manner than self-medicating.
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Affiliation(s)
- Stella L Henn
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany
| | - Mary P Martinasek
- Department of Health Science and Human Performance, The University of Tampa, Tampa, Florida
| | - Martin Lange
- Department of Fitness and Health, IST University of Applied Sciences, Düsseldorf, Germany.
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Cook S, Ortiz Chavez S, Zavala-Arciniega L, Hirschtick JL, Fleischer NL. Trends of Single, Dual, and Polytobacco Use Among School-Based Students in the United States: An Analysis of the National Youth Tobacco Survey. Am J Health Promot 2023; 37:1078-1090. [PMID: 37495509 DOI: 10.1177/08901171231191557] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
PURPOSE To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race/ethnicity. DESIGN A secondary analysis of the National Youth Tobacco Survey (NYTS). SUBJECTS A total of 122 566 students. MEASURES Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual/polyuse without e-cigarettes. ANALYSIS Multivariable modified Poisson regression. RESULTS Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), 'other' combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, 'other' combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial/ethnic groups, and dual e-cigarette/cigarette use trended upward more for middle school students than high school students. CONCLUSIONS Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.
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Affiliation(s)
- Steven Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Stephany Ortiz Chavez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Luis Zavala-Arciniega
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jana L Hirschtick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Romm KF, Dopke C, Price OA, Pannell A, Williams R, Berg CJ. Parental influences on tobacco use and likelihood of future use among sexual minority young adult men and women in the United States. Am J Addict 2023; 32:450-459. [PMID: 36960484 PMCID: PMC10674051 DOI: 10.1111/ajad.13418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/24/2023] [Accepted: 03/22/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Limited research has examined mechanisms, including parenting behaviors, contributing to tobacco use disparities among sexual minority young adults (SMYAs). METHODS Participants were 644 young adult (ages 18-29; 36.5% racial/ethnic minority) women (N = 416; 44.7% bisexual, 7.2% lesbian, 48.1% heterosexual) and men (N = 288; 11.0% bisexual, 13.2% gay, 75.9% heterosexual). Bivariate analyses examined differences among sex-by-sexual identity subgroups in perceived parenting (psychological control, behavioral control, knowledge, autonomy support, warmth, communication), past 30-day cigarette, e-cigarette, and cigar use, and likelihood of future use. Multivariable regression examined associations of sexual identity subgroup and parenting behaviors to tobacco use outcomes among women and men. RESULTS Bisexual (vs. heterosexual) women reported greater parental psychological control and less autonomy support, warmth, and communication. Bisexual (vs. heterosexual) women had greater odds of past 30-day cigarette and cigar use and greater likelihood of future cigarette and e-cigarette use, and parenting behaviors were associated with past 30-day cigarette (knowledge, warmth), e-cigarette (psychological control, autonomy support, warmth), and cigar use (behavioral control, warmth) and likelihood of future cigarette (psychological control, warmth) and e-cigarette use (autonomy support, communication). Gay (vs. heterosexual) men reported greater parental behavioral control, less knowledge, autonomy support, warmth, and communication. Sexual identity and parenting behaviors were largely not associated with tobacco use among men. DISCUSSION AND CONCLUSIONS Findings highlight the role of parenting behaviors as potential mechanisms contributing to tobacco use disparities among SMYA women. SCIENTIFIC SIGNIFICANCE Tobacco prevention/cessation programs should be tailored toward specific SMYA subgroups, combinations of parenting behaviors, and patterns of tobacco use.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Campbell Dopke
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Olga A Price
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Alexandria Pannell
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
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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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Manglallan KS, Johnson DL, Rosario MH, An KJ, Carson AB, Phillips KT, Pokhrel P, Okamoto SK. A Systematic Literature Review of Asian American, Native Hawaiian, and Pacific Islander Youth Electronic Nicotine Delivery Systems (ENDS) Use. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:151-157. [PMID: 37465472 PMCID: PMC10351245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Rates of electronic nicotine delivery systems (ENDS) use are exponentially increasing in youth and young adults within the United States, including Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth in Hawai'i. Disproportionately high ENDS use rates for AANHPI youth point to the need to understand the empirical literature in this area. A systematic literature review is a prerequisite for programs effectively curbing AANHPI youths' elevated use of ENDS. This systematic literature review examines empirical studies published between 2010-2020 on ENDS and their use as it applies to AANHPI youth. A total of 11 articles were identified using specific inclusionary and exclusionary criteria in a literature search. Studies described individual and interpersonal correlates to ENDS use. Notably, there were no published ENDS intervention studies detailed to AANHPI youth. Implications of these studies for prevention and social welfare interventions are discussed.
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Affiliation(s)
| | - Dixie L. Johnson
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
| | | | - Katlyn J. An
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Adabelle B. Carson
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Kristina T. Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai‘i, Honolulu, HI (KTP)
| | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
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19
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Liu PI, Lin MN, Ho PS, Tsai JH, Yang YH, Wu KF, Chuang HY. Prediction and potential risk factors for electronic cigarette use behaviors among adolescents: a pilot study in Chiayi, Taiwan. Front Public Health 2023; 11:1140615. [PMID: 37397731 PMCID: PMC10311257 DOI: 10.3389/fpubh.2023.1140615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Electronic cigarette (e-cigarette) use among adolescents has become increasingly common; therefore, effectively reducing adolescent e-cigarette use is an urgent issue. We aimed to predict and identify potential factors related to adolescent e-cigarette use behaviors. Methods This cross-sectional study was conducted using anonymous questionnaires given to Taiwanese high school students in 2020. Approximately 1,289 adolescent students completed questions on e-cigarette use, personal characteristics, family environment, and substances used. We performed multivariate logistic regression analyses to assess the model's predictive performance in terms of the area under the receiver operating characteristic curve. Results We found that 9.3% of adolescent students used e-cigarettes. Tobacco smoking, close friends' reactions to e-cigarette use, and the use of other substances were independent risk factors for adolescent e-cigarette use. Furthermore, relative to tobacco nonuse, tobacco use and tobacco smoking dependence had odds ratios of 76.49 and 113.81, respectively. The predictive accuracy of adolescent e-cigarette use from personal characteristics, family environment, and substance use status was 73.13, 75.91, and 93.80%, respectively. Conclusion The present study highlights the need for early prevention of e-cigarette use among adolescents, particularly those with a history of using tobacco and other substances and those who have close friends with positive attitudes towards e-cigarette use.
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Affiliation(s)
- Ping-I Liu
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- Department of Geriatric Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ming-Nan Lin
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pei-Shan Ho
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ya-Hui Yang
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Ke-Fei Wu
- Department of Business Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Williams RJ, Wills TA, Choi K, Pagano I. Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents. Addict Behav 2023; 145:107777. [PMID: 37336095 DOI: 10.1016/j.addbeh.2023.107777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/12/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023]
Abstract
Knowledge about the respiratory health consequences of adolescents' use of tobacco products with cannabis remains limited. We studied whether e-cigarettes, combustible cigarettes, and cannabis were independently associated with asthma in a population-based sample of 150,634 public high school students (10th and 12th graders), drawn in a two-stage design to be representative of the state of California in 2019-2020. Measures were obtained for use of e-cigarettes, combustible cigarettes, and cannabis; motives for use (three substances); method of use (for cannabis); ever being diagnosed with asthma; and having an asthma attack in past 12 months. Cross-classification indicated Nonuse for 64% of the sample; 15% Dual E-cigarette/Cannabis Use; 10% Exclusive Cannabis Use; 5% Exclusive E-cigarette Use; and 5% Triple Use. Multinomial logistic regression with a three-level criterion variable, controlling for age, sex, parental education, race/ethnicity, and three types of household use showed that compared with Nonuse, odds of Lifetime Asthma (vs. Never Had) was elevated for Triple Use (AOR = 1.14, CI 1.06-1.24), Dual E-cigarette/Cannabis Use (1.17, 1.12-1.23), Exclusive Cannabis Use (1.17, 1.11-1.23), and Exclusive E-cigarette Use (1.10, 1.02-1.18). Similar results were noted for Recent Asthma. Among persons who had used cannabis, 88% of the Triple group and 74% of the Dual E-cigarette/Cannabis group reported both smoking and vaping cannabis. Thus, co-occurrence of e-cigarette and cannabis use was a common pattern among adolescents in this study, and subgroups of cannabis and e-cigarette use showed similar associations with asthma. Preventive approaches should highlight the health implications of exclusive or combined e-cigarette and cannabis use.
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Affiliation(s)
- Rebecca J Williams
- California Department of Public Health, California Tobacco Control Program, Sacramento, CA, United States.
| | - Thomas A Wills
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, United States
| | - Ian Pagano
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, United States
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Wilhelm AK, Hammett P, Fu SS, Eisenberg ME, Pratt RJ, Allen ML. Asian American adolescent e-cigarette use and associated protective factors: Heterogeneity in a statewide sample. Addict Behav 2023; 145:107761. [PMID: 37295385 DOI: 10.1016/j.addbeh.2023.107761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study characterized variation in e-cigarette use patterns and related protective factors by ethnicity among Asian American adolescents. METHODS Multivariable logistic regressions modelled associations between ethnic group, 6 protective factors (college aspirations, internal developmental assets, positive teacher engagement, family caring, and peer and parent anti-smoking norms), and past 30-day e-cigarette use, adjusting for covariates among 10,482 8th, 9th, and 11th grade Asian American respondents to the 2019 Minnesota Student Survey. Interaction terms (protective factor × ethnic group) were used in 6 subsequent regression models to examine whether the association between each protective factor and e-cigarette use differed as a function of ethnic group. RESULTS Respondents included 9.0% Indian, 0.3% Burmese, 7.9% Chinese, 2.5% Filipino, 25.0% Hmong, 3.2% Karen, 4.6% Korean, 2.7% Laotian, 8.2% Vietnamese, 7.5% other, 7.5% multi-ethnic, and 21.6% multi-racial adolescents. E-cigarettes were the predominant form of tobacco use. Laotian and multi-racial groups reported the highest e-cigarette use (16.6% and 16.3%), whereas Chinese and Asian Indians reported the lowest (4.7% and 5.0%). Strong peer anti-smoking norms, higher internal developmental assets scores, and positive teacher engagement were associated with lower odds of e-cigarette use across groups, with significant interactions for internal developmental assets by ethnicity. CONCLUSIONS E-cigarettes are the most prevalent tobacco product used by Asian adolescents in Minnesota, with notable heterogeneity by ethnicity. While most established protective factors appeared to function similarly for Asian adolescents, others differed, underscoring the importance of disaggregating data by ethnicity to inform the tailoring of prevention and control strategies for these ethnic groups.
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Affiliation(s)
- April K Wilhelm
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, United States.
| | - Patrick Hammett
- Department of Medicine, University of Minnesota, 401 East River Parkway, VCRC 1(st) Floor, Suite 131, Minneapolis, MN 55455, United States
| | - Steven S Fu
- Department of Medicine, University of Minnesota, 401 East River Parkway, VCRC 1(st) Floor, Suite 131, Minneapolis, MN 55455, United States; Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Mail code: 152, Building 9, One Veterans Drive, Minneapolis, MN 55417, United States
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Suite 353, Minneapolis, MN 55414, United States
| | - Rebekah J Pratt
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, United States
| | - Michele L Allen
- Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, United States
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Martinelli T, Candel MJJM, de Vries H, Talhout R, Knapen V, van Schayck CP, Nagelhout GE. Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders. Tob Control 2023; 32:170-178. [PMID: 34226262 PMCID: PMC9985733 DOI: 10.1136/tobaccocontrol-2021-056528] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/10/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect. However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigarette use and subsequent tobacco use; and tobacco and subsequent e-cigarette use in the Netherlands and Flanders. DESIGN The longitudinal design included baseline (n=2839) and 6-month (n=1276) and 12-month (n=1025) follow-up surveys among a school-based cohort (mean age: 13.62). Ten high schools were recruited as a convenience sample. The analyses involved (1) associations of baseline e-cigarette use and subsequent tobacco smoking among never smokers; (2) associations of e-cigarette use frequency at baseline and tobacco smoking frequency at follow-up; and (3) the association of baseline tobacco smoking and subsequent e-cigarette use among non-users of e-cigarettes. FINDINGS Consistent with prior findings, baseline e-cigarette use was associated with higher odds of tobacco smoking at 6-month (OR=1.89; 95% CI 1.05 to 3.37) and 12-month (OR=5.63; 95% CI 3.04 to 10.42) follow-ups. More frequent use of e-cigarettes at baseline was associated with more frequent smoking at follow-ups. Baseline tobacco smoking was associated with subsequent e-cigarette use (OR=3.10; 95% CI 1.58 to 6.06 at both follow-ups). CONCLUSION Our study replicated the positive relation between e-cigarette use and tobacco smoking in both directions for adolescents. This may mean that the gateway works in two directions, that e-cigarette and tobacco use share common risk factors, or that both mechanisms apply.
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Affiliation(s)
- Thomas Martinelli
- IVO, The Hague, The Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Reinskje Talhout
- Laboratory for Health Protection Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Vera Knapen
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | | | - Gera E Nagelhout
- IVO, The Hague, The Netherlands
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
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Sun R, Méndez D, Warner KE. Association of Electronic Cigarette Use by US Adolescents With Subsequent Persistent Cigarette Smoking. JAMA Netw Open 2023; 6:e234885. [PMID: 36972048 PMCID: PMC10043747 DOI: 10.1001/jamanetworkopen.2023.4885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Importance Many studies have reported a positive association of youth electronic cigarette (e-cigarette) use with subsequent cigarette smoking initiation, but it remains unclear whether e-cigarette use is associated with continued cigarette smoking after initiation. Objective To assess the association of youth baseline e-cigarette use with their continued cigarette smoking 2 years after initiation. Design, Setting, and Participants The Population Assessment of Tobacco and Health (PATH) Study is a national longitudinal cohort study. This sample consisted of youth who participated in waves 3, 4, and 5 of the study (wave 3 was from October 2015 to October 2016, wave 4 was from December 2016 to January 2018, and wave 5 was from December 2018 to November 2019) and had never used cigarettes (cigarette-naive) by wave 3. The current analysis used multivariable logistic regressions in August 2022 to assess the association between e-cigarette use among cigarette-naive adolescents aged 12 to 17 years in 2015 and 2016 and subsequent continued cigarette smoking. PATH uses audio computer-assisted self-interviewing and computer-assisted personal interviewing to collect data. Exposures Ever and current (past 30-day) use of e-cigarettes in wave 3. Main Outcomes and Measures Continued cigarette smoking in wave 5 after initiating smoking in wave 4. Results The current sample included 8671 adolescents who were cigarette naive in wave 3 and also participated in waves 4 and 5; 4823 of the participants (55.4%) were aged 12 to 14 years, 4454 (51.1%) were male, and 3763 (51.0%) were non-Hispanic White. Overall, regardless of e-cigarette use, few adolescents (362 adolescents [4.1%]) initiated cigarette smoking at wave 4, and even fewer (218 participants [2.5%]) continued smoking at wave 5. Controlling for multiple covariates, the adjusted odds ratio of baseline ever e-cigarette use, compared with never e-cigarette use, was 1.81 (95% CI, 1.03 to 3.18) for continued smoking measured as past 30-day smoking at wave 5. However, the adjusted risk difference (aRD) was small and not significant. The aRD was 0.88 percentage point (95% CI, -0.13 to 1.89 percentage points) for continued smoking, with the absolute risk being 1.19% (95% CI, 0.79% to 1.59%) for never e-cigarette users and 2.07% (95% CI, 1.01% to 3.13%) for ever e-cigarette users. Similar results were found using an alternative measure of continued smoking (lifetime ≥100 cigarettes and current smoking at wave 5) and using baseline current e-cigarette use as the exposure measure. Conclusions and Relevance In this cohort study, absolute and relative measures of risks yielded findings suggesting very different interpretations of the association. Although there were statistically significant odds ratios of continued smoking comparing baseline e-cigarette users with nonusers, the minor risk differences between them, along with the small absolute risks, suggest that few adolescents are likely to continue smoking after initiation regardless of baseline e-cigarette use.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham
| | - David Méndez
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor
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25
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Pane J, Murray J, Nugent R, Yang S, Nugent K. Electronic cigarette use by and perceptions of middle and high school students in the United States. J Investig Med 2023; 71:212-222. [PMID: 36772925 DOI: 10.1177/10815589221140588] [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: 02/12/2023]
Abstract
Electronic cigarettes (e-cigarettes) provide a novel source of nicotine and may lead to experimentation by adolescents and eventually to their use of conventional cigarettes. The National Youth Tobacco Survey collected information from a nationally representative sample of students in 2016 to determine their experiences with conventional cigarettes and e-cigarettes, their intentions to use these products in the future, and their perceptions of harm and addiction associated with these products. We analyzed these data with ordered probit regression models to determine possible associations with the intention to try e-cigarettes and conventional cigarettes. This survey included 20,520 respondents, 50.6% were male, 5.9% had used conventional cigarettes, and 9.0% had used e-cigarettes. Approximately 10% thought e-cigarettes caused no harm, 3.7% thought that conventional cigarettes caused no harm, and 52.5% thought that e-cigarettes were less harmful than conventional cigarettes. Less than 1% of the students responded "Definitely yes" to the question, "Do you think you will try an e-cig?" The odds ratios for an intention to try e-cigarettes increased as the perception of harm decreased; these ratios increased from 1.0 for "A lot of harm" to 5.85 (95% CI: 3.51, 9.75) for "No harm." In 2016, the majority of students thought that e-cigarettes could cause some harm. This survey indicates that most students have not tried e-cigarettes or conventional cigarettes. The minority of students who think that e-cigarettes pose no harm and students in the ages 14 and 16 are more likely to try them.
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Affiliation(s)
- Joseph Pane
- Data Science, Thermo Fisher Scientific, Pittsburg, PA, USA
| | - Jared Murray
- McCombs School of Business University of Texas, Austin, TX, USA
| | - Rebecca Nugent
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Shengping Yang
- Department of Biostatistics, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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26
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Jane Ling MY, Abdul Halim AFN, Ahmad D, Ahmad N, Safian N, Mohammed Nawi A. Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3883. [PMID: 36900893 PMCID: PMC10001692 DOI: 10.3390/ijerph20053883] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 06/15/2023]
Abstract
The use of e-cigarettes in adolescents remains a major public health concern. Like other tobacco products, e-cigarettes pose health risks to adolescents. Understanding the magnitude of this problem and identification of its associated factors will serve as a guide for development of preventive interventions. This systematic review aims to identify and discuss current epidemiological data on the prevalence and associated factors of e-cigarette use among adolescents in Southeast Asia. The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original English-language articles published between 2012 and 2021. A total of 10 studies were included in this review. The prevalence of current e-cigarette uses ranges from 3.3% to 11.8%. Several associated factors of e-cigarette use were identified, including sociodemographic factors, traumatic childhood experience, peer and parental influence, knowledge and perception, substance use, and accessibility of e-cigarettes. These factors should be addressed though multifaceted interventions which simultaneously target multiple factors. Laws, policies, programs, and interventions must be strengthened and tailored to the needs of adolescents at risk of using e-cigarettes.
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27
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Silva CP, Maggs JL, Kelly BC, Vuolo M, Staff J. Associations Between E-cigarettes and Subsequent Cocaine Use in Adolescence: An Analysis of the UK Millennium Cohort Study. Nicotine Tob Res 2023; 25:514-523. [PMID: 36125041 DOI: 10.1093/ntr/ntac219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nicotine exposure via early combustible cigarette smoking can prime the adolescent brain for subsequent cocaine use. However, there is limited evidence whether e-cigarette use, a nicotine delivery system that is increasingly popular among youth, is associated with later cocaine use. We examine the association between e-cigarette use by the age of 14 years and cocaine use by the age of 17 years. AIMS AND METHODS The Millennium Cohort Study is a nationally representative sample of 18 552 9-month-old children born between September 2000 and January 2002 in the United Kingdom. Follow-up interviews and surveys were collected from children and their caregivers at modal ages 3, 5, 7, 9, 11, 14, and 17 years. Our analytic sample included 340 youth who had used e-cigarettes by age 14 years (exposure variable), matched using coarsened exact matching, to 4867 nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11. The outcome was cocaine use by the modal age of 17 years. RESULTS Of the 5207 successfully matched youth, 7.6% of adolescent e-cigarette users by age 14 years used cocaine by age 17 years versus 3.1% of non-e-cigarette users. Multivariable logistic regression in the matched sample indicated that e-cigarette use by age 14 years was associated with 2.7 times higher odds of cocaine use by age 17 years (95% CI, 1.75 to 4.28). CONCLUSIONS These findings in a UK sample showed that e-cigarette use in early adolescence is associated with higher odds of cocaine use later in adolescence, similar to risks posed by tobacco cigarette smoking. IMPLICATIONS In this large-scale prospective cohort study (n = 5207), youth who had used e-cigarettes by the age of 14 years were matched to nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11 years (e.g. school engagement, risk-taking propensity, delinquency, peer and parental smoking, parental educational attainment). After matching, 7.6% of age 14 years e-cigarette users had subsequently used cocaine by the age of 17 years versus 3.1% of non-e-cigarette users. Although e-cigarettes are promoted as a strategy for nicotine-dependent users to reduce the harms of combustible cigarettes, the evidence here suggests that for nicotine naïve youth, they may increase the risk of subsequent cocaine use.
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Affiliation(s)
- Constanza P Silva
- Criminal Justice Research Center, Pennsylvania State University, University Park, PA, USA.,Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
| | - Jennifer L Maggs
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Mike Vuolo
- Department of Sociology, Ohio State University, Columbus, OH, USA
| | - Jeremy Staff
- Criminal Justice Research Center, Pennsylvania State University, University Park, PA, USA.,Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA
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28
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Mus S, Monzon J, Islam F, Thrasher JF, Barnoya J. First tobacco product tried and current use of cigarettes and electronic cigarettes among adolescents from Guatemala City. SALUD PUBLICA DE MEXICO 2023; 65:46-53. [PMID: 36750072 PMCID: PMC11091932 DOI: 10.21149/13972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/13/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To assess how first experimenting with ciga-rettes or e-cigarettes is associated with current use in Gua-temala, a middle-income country with weak tobacco control and no e-cigarette regulations. MATERIALS AND METHODS We surveyed students from private schools in Guatemala City, limiting analyses to ever users (n=1 026). Multinomial logistic models regressed current product use on first product used, adjusting for sociodemographics and friends and family use. RESULTS The most common first product used was e-cigarettes (56%), followed by flavored cigarettes (24%) and regular cigarettes (20%). At the time of the survey, 4% were exclusive smokers, 37% were exclusive e-cigarette users, 18% dual users, and 40% had ever tried either but were not current users. Compared to those who first tried cigarettes, students who first tried e-cigarettes were less likely to be current smokers (RR=0.19 [CI: 0.11,0.31]) or dual users (RR=0.26 [CI: 0.14,0.49]) and students who first tried flavored cigarettes were more likely to be current smokers (RR=1.66 [CI=1.13,2.42]). CONCLUSIONS In our sample, Guatemalan adolescents from private schools more frequently experiment and continue to use e-cigarettes than cigarettes. There is urgent need to implement e-cigarette restrictions in addition to tobacco control policy implementation.
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Affiliation(s)
- Sophia Mus
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala. Guatemala City, Guatemala.
| | - Jose Monzon
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala. Guatemala City, Guatemala.
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina. Columbia, South Carolina, USA.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, South Carolina, USA/Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico.
| | - Joaquin Barnoya
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala/Integra Cancer Institute. Guatemala City, Guatemala.
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Abadi MH, Shamblen SR, Thompson K, Lipperman-Kreda S, Grube J, Richard BO, Aramburu C. Socio-temporal contextual and community factors associated with daily exclusive ENDS use and dual use with tobacco cigarettes among adolescent vapers: an ecological momentary assessment study. BMC Public Health 2022; 22:2289. [PMID: 36474234 PMCID: PMC9728002 DOI: 10.1186/s12889-022-14787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescents who dual use ENDS with tobacco cigarettes are more likely to have an increased risk of developing dependence. Yet, little is understood about the factors driving dual use among adolescents. The current study sought to reveal the day-to-day socio-temporal contextual and community factors associated with adolescents' use of electronic nicotine delivery systems (ENDS), and how these factors predict dual use with tobacco cigarettes. METHODS We collected ecological momentary assessments (EMA) from a sample of 50 adolescent past two-week vapers (ages 14-17 years old) over 14 days. Daily EMA data were collected on ENDS and tobacco cigarette use, as well as a range of contextual (i.e., motivations to vape, location of vaping, who with when vaping) and community factors (i.e., exposure to peers vaping, to adults vaping, to ENDS advertising, to ENDS warning messages). Our primary analyses were multilevel regressions, accounting for daily observations nested within individuals (N = 700 observations). RESULTS Participants used ENDS exclusively on 44% of days and dual used ENDS and tobacco cigarettes on 8% of the days. Dual use days (versus exclusive ENDS use days) were associated with "vaping because tobacco use was prohibited" (OR = 34.65, p < .05). Also, dual use days (versus no use days) were associated with greater exposure to adults vaping (OR = 5.59, p < .05), peers vaping (OR = 7.48, p < .05), and (c) ENDS advertisements or promotions (OR = 2.12, p < .01), whereas exclusive use days (versus no use days) were only associated with greater exposure to peers vaping (OR = 2.58, p < .01). CONCLUSIONS Results showed that exposure to peers and adults vaping and exposure to ENDS marketing were associated with same day dual use behaviors. And, that adolescents who dual used were motivated to use ENDS because they were easy to conceal. Findings support stricter regulation of ENDS marketing and for smoke-free air laws that include ENDS. In addition, these findings support prioritizing family- and school-based prevention programming that effectively communicates risk associated with ENDS use, including heightened risk of dual use and dependence. Such efforts can reduce the number of adolescents who use ENDS as well as the number who transition to tobacco cigarette use.
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Affiliation(s)
- Melissa H. Abadi
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Stephen R. Shamblen
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Kirsten Thompson
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Sharon Lipperman-Kreda
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA
| | - Joel Grube
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA ,grid.47840.3f0000 0001 2181 7878School of Public Health, University of California, Berkeley, USA
| | - Bonnie O. Richard
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Camila Aramburu
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA
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30
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Romano I, Butler A, Williams G, Aleyan S, Patte KA, Leatherdale ST. Risky cannabis use is associated with varying modes of cannabis consumption: Gender differences among Canadian high school students. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100101. [PMID: 36844170 PMCID: PMC9948853 DOI: 10.1016/j.dadr.2022.100101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Our objective was to explore associations between indicators of more risky cannabis use (i.e., solitary use, frequent use, and younger age of initiation) and different modes of cannabis use (i.e., smoking, vaping and/or edibles). METHODS Data were gathered from a large sample of Canadian youth in Alberta, British Columbia, Ontario, and Quebec who participated in Year 8 (2019-20) of the COMPASS study, and who reported using cannabis in the past year (n = 4,763). Generalized estimating equations were used to examine associations between risky cannabis use and modes of cannabis use, stratified by gender. RESULTS Overall, 38% of students reported using multiple modes of cannabis use. Consistent among both males and females, students who used cannabis alone (35%) and at a higher frequency (55%) were more likely to use multiple modes than smoking only. Among females, those who used cannabis alone were more likely to report using edibles only compared to smoking only (aOR=2.27, 95%CI=1.29-3.98). Earlier cannabis use initiation was associated with lower likelihood of vaping cannabis only among males (aOR=0.25; 95%CI = 0.12-0.51), and lower likelihood of using edibles only among females (aOR=0.35; 95%CI = 0.13-0.95), than by smoking only. CONCLUSIONS Our findings suggest that multiple modes of use may be an important indicator or risky cannabis use among youth, given associations with frequency, solitary use, and age of onset.
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Affiliation(s)
- Isabella Romano
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Alexandra Butler
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Gillian Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sarah Aleyan
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Karen A. Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
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Muacevic A, Adler JR, Algethmi AM, Alamri NS, Natto YS, Hashim ST, Altammar A, Alzubaidi AS, Alzahrani IB, Alghamdi AA. E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation? Cureus 2022; 14:e32435. [PMID: 36644067 PMCID: PMC9833272 DOI: 10.7759/cureus.32435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
The prevalence of using e-cigarettes (vaping) has risen rapidly since its introduction in 2007, mostly among male youth. Although research on the health risks of e-cigarettes is still limited, there is growing evidence of debilitating pulmonary conditions and general immune weakness from e-cigarettes, leading to various infections. Moreover, there are concerns that vaping could be used as a new model of cannabis consumption, increasing cannabis addiction among adolescents. With well-known health risks from traditional smoking, e-cigarettes are viewed as a safe way of smoking, appealing more to youth. Additionally, extensive e-cigarette marketing boosted by the internet and fame has resulted in worries that e-cigarettes can lead to a renormalization of cigarette smoking and can be used as a new method to consume vaporized drugs. Although the concern that e-cigarettes are as harmful as traditional smoking has been raised, youth and most healthcare providers remain relatively unaware. Therefore, this review explored the association between e-cigarettes and traditional smoking. With the introduction of e-cigarettes in the last two decades, the topic is still new and less studied. Therefore, this review will help us understand the topic to better care for e-cigarette smokers and reduce the increasing public health burden from vaping.
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32
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Cooper M, Day HR, Ren C, Oniyide O, Corey CG, Ambrose BK, Michael Cummings K, Sargent J, Niaura R, Pierce JP, Kaufman A, Choi K, Goniewicz ML, Stanton CA, Villanti A, Kasza K, Bansal-Travers M, Silveira ML, Kimmel HL, Hull LC, Koblitz A, Poonai K, Paredes A, Taylor K, Borek N, Hyland AJ. Correlates of tobacco product initiation among youth and young adults between waves 1-4 of the population assessment of tobacco and Health (PATH) study (2013-2018). Addict Behav 2022; 134:107396. [PMID: 35749867 PMCID: PMC9726988 DOI: 10.1016/j.addbeh.2022.107396] [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: 12/15/2021] [Revised: 05/13/2022] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION While risk factors for cigarette smoking among youth and young adults are well-documented, less is known about the correlates of initiation of other tobacco products. This study aims to provide estimates and correlates of initiation among U.S. youth and young adults. METHODS Data on youth aged 12-17 (n = 10,072) and young adults aged 18-24 (N = 5,727) who provided information on cigarettes, electronic nicotine delivery systems (ENDS), cigars, pipe, hookah and smokeless tobacco use in Wave 1 (W1: 2013-2014)-Wave 4 (W4: 2016-2018) of the nationally-representative PATH Study were used to calculate ever use initiation and correlates of initiation by W4. RESULTS Nearly 6 million youth and 2.5 million young adults used tobacco for the first time between W1-W4. Approximately one quarter of youth and young adult ENDS never users initiated ENDS between W1-W4 of the PATH Study. Among youth, use of other tobacco products, ever substance use, and high externalizing problems were associated with initiation of most products. Among young adults, use of other tobacco products and ever substance use were associated with initiation of most products. In both youth and young adults, Hispanics were more likely to initiate hookah use than their non-Hispanic White counterparts. While male sex was a risk factor for most tobacco product initiation across both age groups, it was not associated with hookah initiation. CONCLUSIONS Cigarette and non-cigarette products shared many correlates of initiation, although there are noteworthy demographic differences. Findings can help tailor product specific interventions to reach populations at risk during preliminary stages of use.
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Affiliation(s)
- Maria Cooper
- US Food and Drug Administration, Center for Tobacco Products, United States.
| | - Hannah R Day
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Chunfeng Ren
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Olusola Oniyide
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Catherine G Corey
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Bridget K Ambrose
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - K Michael Cummings
- Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, United States
| | - James Sargent
- Dartmouth Medical School, Data Sciences Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center, United States
| | - Ray Niaura
- New York University, College of Global Public Health, United States
| | - John P Pierce
- University of California, San Diego, Herbert Wertheim School of Public Health, United States
| | - Annette Kaufman
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, United States
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, United States
| | | | | | | | - Karin Kasza
- Roswell Park Comprehensive Cancer Center, United States
| | | | - Marushka L Silveira
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States; Kelly Government Solutions, United States
| | - Heather L Kimmel
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States
| | - Lynn C Hull
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Amber Koblitz
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Karl Poonai
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Antonio Paredes
- US Food and Drug Administration, Center for Tobacco Products, United States
| | - Kristie Taylor
- Westat, Behavioral Health and Health Policy, United States
| | - Nicolette Borek
- US Food and Drug Administration, Center for Tobacco Products, United States
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Davis DR, Bold KW, Morean ME, Kong G, Jackson A, Simon P, Rajesh-Kumar L, Krishnan-Sarin S. Association of youth impulsivity and use of e-cigarette devices, flavors, and frequency of use. Addict Behav 2022; 134:107386. [PMID: 35809413 PMCID: PMC10243516 DOI: 10.1016/j.addbeh.2022.107386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/05/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Given high youth e-cigarette use, it is important to investigate how traits, like impulsivity, may be associated with youth e-cigarette use behaviors. The study aim is to determine if impulsivity is associated with trying more e-cigarette flavors and device types, and greater frequency of e-cigarette use. METHOD Cross sectional survey data from CT high schoolers (n = 4875, 6 schools) were collected in 2019. Lifetime (ever) e-cigarette users (n = 2313) completed the Brief Barrett Impulsivity Scale, which contains two subscales; behavioral impulsivity and impaired self-control. Among lifetime users, associations between impulsivity subscales and number of e-cigarette flavors tried, e-cigarette devices tried, and past 30-day frequency of e-cigarette use were examined using regression models. Additionally, associations of impulsivity and use frequency were examined among only current e-cigarette users (≥1 day of use in past 30; n = 1327). School, age, race/ethnicity, vaping initiation age, other tobacco product use, and sex were included as covariates in models. RESULTS Higher behavioral impulsivity was associated with greater number of e-cigarette flavors tried (AOR: 1.06, 95% CI: 1.02, 1.11, p <.008) and higher frequency of past 30-day use both among ever and current e-cigarette users (AOR: 1.26, 95%CI:1.10,1.44, p <.001; AOR: 1.12, 95%CI:1.02,1.22, p <.02), but not number of e-cigarette devices tried. Impaired self-control was not associated with any outcomes. CONCLUSION Youth with higher behavioral impulsivity may be more at risk for using more e-cigarette flavors and using e-cigarettes more frequently. Regulations aimed at reducing flavor availability among youth and interventions targeting impulsive behavior may be important for this population.
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Affiliation(s)
- Danielle R Davis
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America.
| | - Krysten W Bold
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Meghan E Morean
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Asti Jackson
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Lavanya Rajesh-Kumar
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale School of Medicine, 34 Park Street, New Haven, CT, United States of America
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Kim J, Lee S, Chun J. An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11570. [PMID: 36141845 PMCID: PMC9517489 DOI: 10.3390/ijerph191811570] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 06/06/2023]
Abstract
While the prevalence of young people's conventional cigarette use has decreased in many countries, the use of e-cigarettes has risen. To effectively counteract the growing popularity of e-cigarettes among young people internationally, researchers should know the exact prevalence as well as the protective and risk factors associated with vaping. Based on five eligibility criteria, 53 articles were chosen and analyzed by general characteristics, prevalence, sample characteristics, gender difference, protective factors, and risk factors. In this study, the international pooled prevalence of young people's lifetime e-cigarette use was 15.3%, the current use was 7.7%, and dual use was 4.0%. While the highest lifetime, current, and dual prevalence were found in Sweden, Canada, and the United Kingdom, respectively, the lowest prevalence was found in Germany, followed by South Korea and Sweden. Some protective and risk factors include perceived cost and danger of vaping, parental monitoring, internal developmental assets, cigarette use, family and peer smoking, exposure to online advertisements, and the presence of nearby retail stores. Based on this review, researchers and practitioners can develop different intervention programs and strategies for young smokers.
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Affiliation(s)
| | | | - JongSerl Chun
- Department of Social Welfare, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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Wężyk-Caba I, Znyk M, Zajdel R, Balwicki Ł, Tyrańska-Fobke A, Juszczyk G, Zajdel K, Świątkowska B, Kaleta D. Determinants of E-Cigarette and Cigarette Use among Youth and Young Adults in Poland-PolNicoYouth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11512. [PMID: 36141783 PMCID: PMC9517296 DOI: 10.3390/ijerph191811512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Teen use of tobacco-related products is a significant public health concern. This study evaluated the predictors of e-cigarette use among secondary school students who were never cigarette smokers and ever cigarette smokers in Poland. METHODS This study examined a sample of Polish youths aged 13-19 (n = 19,241) attending 200 schools, 12 on average in each county. The study was a part of the National Health Program in Poland for 2016-2020. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. RESULTS Of all participants, 32.5% were ever cigarette users. Among the never cigarette users, 13.6% were deemed susceptible to e-cigarette use. Among the ever cigarette users, 60.6% were deemed susceptible to e-cigarette use. Of those susceptible to e-cigarette use, 68.2% were among the 32.5% ever cigarette users. The profile of e-cigarette use among never e-cigarette users also included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16-17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04), and living in big cities >500,000 inhabitants (OR = 1.4; p = 0.04). E-cigarette users among ever cigarette users were similar to never cigarette users in their opinion that e-cigarette use is less harmful than traditional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). CONCLUSIONS The major determinant of e-cigarette use in this population was prior smoking. Additionally, the results revealed that fairly obvious predictors such as parental smoking and a belief in the less harmfulness of e-cigarette use are important determinants for smoking among never or ever e-cigarette users.
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Affiliation(s)
- Ilona Wężyk-Caba
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Radosław Zajdel
- Department of Business and Informatics, University of Łódź, POW 3/5 Street, 90-255 Łódź, Poland
| | - Łukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland
| | - Anna Tyrańska-Fobke
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 5 Jana Nielubowicza St., 02-097 Warsaw, Poland
| | - Karolina Zajdel
- Department of Medical Informatics and Statistics, Medical University of Lodz, 1 Hallera Sq., 90-645 Łódź, Poland
| | - Beata Świątkowska
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
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Vaping. JAAPA 2022; 35:25-30. [DOI: 10.1097/01.jaa.0000854544.26702.2e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Torregrossa H, Dautzenberg B, Birkui P, Rieu N, Dautzenberg MD, Melchior M, Mary-Krause M. What differentiates youths who use e-cigarettes from those who smoke traditional tobacco products? BMC Public Health 2022; 22:1357. [PMID: 35841088 PMCID: PMC9288082 DOI: 10.1186/s12889-022-13673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Electronic cigarette (e-cigarette) use has spread among adolescents in many countries, however users’ characteristics are not well known. We aimed to compare characteristics of exclusive e-cigarette users to those of exclusive tobacco users and dual users. Methods Data come from a representative sample of 11–19 years old students in Paris, surveyed each year between 2013 and 2017. Current e-cigarette and tobacco use were ascertained in the preceding 30 days. Data were analyzed using random intercept multinomial logistic regression models, exclusive tobacco smokers being the reference group. Results Among the 17,435 students included, 2.3% reported exclusive e-cigarette use, 7.9% exclusive tobacco use and 3.2% dual e-cigarette and tobacco use. Compared to exclusive tobacco smokers, e-cigarette users were: a) less likely to use cannabis (adjusted Odds-Ratio (aOR) = 0.15, 95% confidence interval (95% CI) = 0.09–0.25); b) more likely to initiate smoking with an e-cigarette or a hookah rather than traditional cigarettes (aOR = 2.91, 95% CI = 1.74–4.87 and aOR = 15.99, 95% CI = 8.62–29.67, respectively). Additionally, exclusive e-cigarette users are younger with an aOR = 0.29 (95% CI = 0.17–0.49) among 13–15 years and aOR = 0.11 (95% CI = 0.06–0.21) among > 17 years as compared to 11–13 years. The probability of being an exclusive e-cigarette user is lower among participants whose best friend smokes tobacco (aOR = 0.30, 95% CI = 0.20–0.44). Exclusive tobacco users and dual users have similar profiles. Conclusions Adolescents who only used e-cigarettes had intermediate levels of risk compared to nonusers and those who used tobacco and/or e-cigarettes, suggesting that e-cigarettes use extends to young people at low-risk of using tobacco products. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13673-0.
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Affiliation(s)
- Hugo Torregrossa
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France
| | - Bertrand Dautzenberg
- Service de Pharmacologie, Hôpital Pitié-Salpêtrière, AP-HP, 75013, Paris, France.,Consultation de Tabacologie, Institut Arthur Vernes, 75006, Paris, France.,Paris Sans Tabac (PST), 75007, Paris, France
| | | | - Nicole Rieu
- Rectorat de L'Académie de Paris, 75019, Paris, France
| | | | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie Et de Santé Publique (IPLESP), ERES, 75012, Paris, France.
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Moustafa AF, Rodriguez D, Pianin SH, Testa SM, Audrain-McGovern JE. Dual Use of Nicotine and Cannabis Through Vaping Among Adolescents. Am J Prev Med 2022; 63:60-67. [PMID: 35365396 PMCID: PMC9232951 DOI: 10.1016/j.amepre.2021.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study seeks to identify adolescent nicotine and cannabis vaping patterns and the characteristics of those adolescents who comprised each pattern. METHODS This prospective longitudinal survey study measured the relationship between nicotine and cannabis vaping among 1,835 adolescents from 4 public high schools outside of Philadelphia, Pennsylvania. Adolescents completed in-classroom surveys, including questions of lifetime and past 30-day nicotine and cannabis vaping, at Wave 1 (fall 2016, ninth grade) and 6-month intervals for the following 36 months (fall 2019, 12th grade). Data were analyzed in 2021. RESULTS A sequential processes growth mixture model revealed 4 latent conjoint classes of nicotine and cannabis vaping: early, declining dual use (Class 1: n=259); rapidly increasing dual use (Class 2: n=128); later, slower dual use (Class 3: n=313); and no use (Class 4: n=1,136). Increased odds of belonging to Class 1 and Class 2 versus belonging to Class 4 were significantly associated with cigarette smoking (OR=3.71, OR=2.21), alcohol use (OR=2.55, OR=4.39), peer vaping (OR=1.24, OR=1.20), sensation seeking (OR=1.03, OR=1.11), positive E-cigarette expectations (OR=1.21, OR=1.17), and cigar smoking (OR=2.39 Class 2 only). Increased odds of belonging to Class 3 versus Class 4 were significantly associated with alcohol use (OR=1.66), perceived benefits of E-cigarette use (OR=1.03), positive E-cigarette expectations (OR=1.08), depressive symptoms (OR=1.02), and sensation seeking (OR=1.03). CONCLUSIONS From middle to late adolescence, vaping of nicotine and cannabis develop in close parallel. Regulatory policy and prevention interventions should consider the interplay between these 2 substances during this period of adolescence.
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Affiliation(s)
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Stephen H Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shannon M Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Janet E Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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Xu L, Yang Y, Simien JM, Kang C, Li G, Xu X, Haglund E, Sun R, Zuo YY. Menthol in Electronic Cigarettes Causes Biophysical Inhibition of Pulmonary Surfactant. Am J Physiol Lung Cell Mol Physiol 2022; 323:L165-L177. [PMID: 35762601 DOI: 10.1152/ajplung.00015.2022] [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: 11/22/2022] Open
Abstract
With an increasing prevalence of electronic cigarette (e-cigarette) use, especially among youth, there is an urgent need to better understand the biological risks and pathophysiology of health conditions related to e-cigarettes. A majority of e-cigarette aerosols are in the submicron size and would deposit in the alveolar region of the lung, where they must first interact with the endogenous pulmonary surfactant. To date, little is known whether e-cigarette aerosols have an adverse impact on the pulmonary surfactant. We have systematically studied the effect of individual e-cigarette ingredients on an animal-derived clinical surfactant preparation, bovine lipid extract surfactant, using a combination of biophysical and analytical techniques, including in vitro biophysical simulations using constrained drop surfactometry, molecular imaging with atomic force microscopy, chemical assays using carbon nuclear magnetic resonance and circular dichroism, and in silico molecular dynamics simulations. All data collectively suggest that flavorings used in e-cigarettes, especially menthol, play a predominant role in inhibiting the biophysical function of the surfactant. The mechanism of biophysical inhibition appears to involve menthol interactions with both phospholipids and hydrophobic proteins of the natural surfactant. These results provide novel insights into the understanding of the health impact of e-cigarettes and may contribute to a better regulation of e-cigarette products.
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Affiliation(s)
- Lu Xu
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Yi Yang
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | | | - Christopher Kang
- Department of Chemistry, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Guangle Li
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Xiaojie Xu
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Ellinor Haglund
- Department of Chemistry, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Rui Sun
- Department of Chemistry, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Yi Y Zuo
- Department of Mechanical Engineering, University of Hawaii at Manoa, Honolulu, Hawaii, United States.,Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States
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Copp SR, Wilson MN, Asbridge M. Smoking Susceptibility in Canadian Adolescent Electronic-Cigarette Users. Subst Use Misuse 2022; 57:1022-1034. [PMID: 35403553 DOI: 10.1080/10826084.2022.2058702] [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: 10/18/2022]
Abstract
Background: E-cigarette use is increasing among Canadian youth, with experimentation especially prevalent among never-smoking youth. Among this group, there is concern e-cigarette use contributes to future initiation of smoking through a gateway effect. However, e-cigarette use and smoking share many common risk factors; a postulated mechanism to explain the apparent causal pathway from e-cigarette use to smoking initiation in previously smoking-naïve youth. A better understanding of the relationships between smoking susceptibility and e-cigarette use among never-smoking youth is needed. Purpose/objectives: The primary aim of this study was to gain a deeper understanding of the risk factors associated with smoking susceptibility in youth who have recently used e-cigarettes. Methods: This study used data (n = 40,363) from the 2018/2019 Canadian Student Tobacco Alcohol and Drug Use Survey (CSTADS) to compare the risk factor profiles of susceptible and non-susceptible never-smoking e-cigarette users, as well as susceptible and non-susceptible never-smoking youth who have never used an e-cigarette. Results: E-cigarette use, independent of susceptibility status, was associated with a sociodemographic and behavioral risk factor profile likely to confer a higher risk of initiating smoking. Among e-cigarette users, smoking susceptibility was associated with more smoking risk factors. Conclusions/importance: Study findings support a common risk-factor model, rather than e-cigarette use itself, to explain differences in the likelihood of smoking initiation among e-cigarette users. E-cigarette use and smoking initiation may be interchangeable outcomes amongst those with smoking risk factors. The risks of e-cigarette use, and their regulatory status, need to be balanced with their potential as harm reduction tools.
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Affiliation(s)
- Sebastian R Copp
- Department of Post-Graduate Medicine, Dalhousie University Faculty of Medicine, Medicine, Halifax, Nova Scotia, Canada
| | - Maria N Wilson
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Siembida J, Mohammed S, Chishty M, Leontieva L. Diagnostic Difficulties and Treatment Challenges of a Young Patient With Severe Acute Psychosis and Complete Recovery. Cureus 2022; 14:e23744. [PMID: 35509728 PMCID: PMC9057638 DOI: 10.7759/cureus.23744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
First break psychosis in young adults is sometimes presented as a dichotomous model of organic or substance-induced etiology or a primary psychiatric disorder on the schizophrenia spectrum and related disorders. In this case of a young adult with a typical age of onset for psychotic symptoms also presenting with cannabis use, excessive vaping, history of COVID-19 illness, pineal cyst, and extreme elevation of blood pressure, the diagnostic certainty decreases. Increased risk of progression to schizophrenia in individuals with cannabis use disorder and genetic loading has been extensively reported in the literature. Clinicians may face significant diagnostic and treatment challenges when managing a patient with severe psychotic symptoms. For the clinicians acutely managing such patients facing these exact questions of unknown certainty in progression to full-blown schizophrenia, we highlight a case of severe acute psychosis and complete recovery on a first-generation antipsychotic and mood stabilizer.
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Sun R, Mendez D, Warner KE. Is Adolescent E-Cigarette Use Associated With Subsequent Smoking? A New Look. Nicotine Tob Res 2022; 24:710-718. [PMID: 34897507 PMCID: PMC8962683 DOI: 10.1093/ntr/ntab243] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/29/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Prospective studies have consistently reported a strong association between e-cigarette use and subsequent cigarette smoking, but many failed to adjust for important risk factors. METHODS Using longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, we employed multivariable logistic regressions to assess the adolescent vaping-to-smoking relationship, with four regressions (Models 1-4) sequentially adding more risk factors.Our sample included all waves (waves 1-5) of the PATH Study. RESULTS The association between ever e-cigarette use and subsequent cigarette smoking decreased substantially in magnitude when adding more control variables, including respondents' sociodemographic characteristics, exposure to tobacco users, cigarette susceptibility, and behavioral risk factors. Using the most recent data (waves 4-4.5 and waves 4.5-5), this association was not significant in the most complete model (Model 4). Using wave 4.5-5 data, the adjusted odds ratio (aOR) for ever e-cigarette use at initial wave and subsequent past 12-month smoking declined from 4.07 (95% confidence interval [CI, 2.86-5.81) in Model 1, adjusting only for sociodemographic characteristics, to 1.35 (95% CI, 0.84-2.16) in Model 4, adjusting for all potential risk factors. Similarly, the aOR of ever e-cigarette use and past 30-day smoking at wave 5 decreased from 3.26 (95% CI, 1.81-5.86) in Model 1 to 1.21 (95% CI, 0.59-2.48) with all covariates (Model 4). CONCLUSIONS Among adolescent never cigarette smokers, those who had ever used e-cigarettes at baseline, compared with never e-cigarette users, exhibited modest or non-significant increases in subsequent past 12-month or past 30-day smoking when adjusting for behavioral risk factors.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Mendez
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Usidame B, Hirschtick JL, Mattingly DT, Patel A, Patrick ME, Fleischer NL. Sociodemographic Patterns of Exclusive and Dual Combustible Tobacco and E-Cigarette Use among US Adolescents-A Nationally Representative Study (2017-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2965. [PMID: 35270656 PMCID: PMC8910207 DOI: 10.3390/ijerph19052965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022]
Abstract
This study assessed the sociodemographic predictors of exclusive and dual use of the most frequently used nicotine/tobacco products, e-cigarettes, and combustible tobacco among adolescents. Cross-sectional data was from the 2017-2020 Monitoring the Future nationally representative study of eighth, tenth, and twelfth-grade students. We coded past 30 day nicotine/tobacco use into four mutually exclusive categories: no use, e-cigarette use only, combustible use (cigarette or cigar) only, and dual use (e-cigarette and combustible). We pooled the 2017-2020 data to examine the relationship between sex, race/ethnicity, parental education, and each product-use category using multinomial logistic regression, stratified by grade level. Among eighth (N = 11,189), tenth (N = 12,882), and twelfth graders (N = 11,385), exclusive e-cigarette use was the most prevalent pattern (6.4%, 13.2%, 13.8%, respectively), followed by dual use (2.7%, 4.5%, 8.9%), and exclusive combustible use (1.5%, 2.5%, 5.3%). eighth and tenth-grade adolescents whose highest parental education was a 4-year college degree or more had lower odds of exclusive combustible and dual use when compared to adolescents whose highest parental education was less than a high school degree. Research should continue to monitor the differential use of combustible tobacco products and e-cigarettes among adolescents from low socioeconomic status backgrounds or racial/ethnic minority households to inform ongoing and future interventions or policies.
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Affiliation(s)
- Bukola Usidame
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.L.H.); (D.T.M.); (A.P.); (N.L.F.)
| | - Jana L. Hirschtick
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.L.H.); (D.T.M.); (A.P.); (N.L.F.)
| | - Delvon T. Mattingly
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.L.H.); (D.T.M.); (A.P.); (N.L.F.)
| | - Akash Patel
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.L.H.); (D.T.M.); (A.P.); (N.L.F.)
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, USA;
| | - Nancy L. Fleischer
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.L.H.); (D.T.M.); (A.P.); (N.L.F.)
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Hogan TH, Quisenberry A, Breitborde N, Moe A, Ferketich A. An evaluation of the feasibility of implementing a novel tobacco dependence treatment program for high-risk individuals into clinical practice within a community mental health center. Int J Ment Health Syst 2022; 16:15. [PMID: 35184758 PMCID: PMC8858522 DOI: 10.1186/s13033-022-00517-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background Individuals with serious mental illnesses experience deaths related to smoking at a higher prevalence than individuals without a psychotic-spectrum disorders. Traditional smoking cessation programs are often not effective among individuals with chronic mental disorders. Little is known about how to implement a tobacco cessation treatment program for this at-risk population within a community health center. The current study used qualitative methods to examine the factors that may enhance or impede the delivery of a novel tobacco cessation treatment for smokers with a psychotic-spectrum disorder diagnosis in an integrated care community health center. Methods Using a case study design, we conducted 22 semi-structured interviews with primary care providers, mental health providers, addiction counselors, case managers, intake specialists, schedulers, pharmacists, and administrative staff employed at the organization. Interviews were transcribed and themes were identified through a rich coding process. Results We identified environmental factors, organizational factors, provider factors and patient factors which describe the potential factors that may enhance or impede the implementation of a smoking cessation program at the integrated care community health center. Most notably, we identified that community mental health centers looking to implement a smoking cessation program for individuals with chronic mental health disorders should ensure the incentives for providers to participate align with the program’s objectives. Additionally, organizations should invest in educating providers to address stigma related to smoking cessation and nicotine use. Conclusions The findings of our study provide valuable insight for administrators to consider when implementing a smoking cessation program in an integrated care community health center. Our findings provide public health practitioners with potential considerations that should be discussed when designing and implementing a smoking cessation program for individuals with chronic mental disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00517-y.
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Hillyer GC, Nazareth M, Lima S, Schmitt KM, Reyes A, Fleck E, Schwartz GK, Terry MB. E-cigarette Use Among Young Adult Patients: The Opportunity to Intervene on Risky Lifestyle Behaviors to Reduce Cancer Risk. J Community Health 2022; 47:94-100. [PMID: 34453225 PMCID: PMC10034475 DOI: 10.1007/s10900-021-01027-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
Use of e-cigarettes and other electronic nicotine delivery systems (ENDS) is on the rise. We administered a health needs survey via email to 804 adult primary care and oncology patients at a large urban academic medical center in 2019. We examined differences in e-cigarette use by smoking status, personal history of cancer, alcohol use, and second-hand tobacco smoke exposure. Of the 804 participants, 90 (11.2%) reported ever using e-cigarettes. E-cigarette use was more prevalent in young adults (risk ratio [RR] for 18-24 years: 4.58, 95% confidence interval [95% CI] 2.05, 10.26), current smoking (RR 4.64, 95% CI 1.94, 11.07), very often/often binge drinking (RR 3.04, 96% CI 1.38, 6.73), and ≥ 1 smokers in the home (RR 3.90, 95% CI 2.10, 7.23). Binge alcohol consumption and tobacco smoking are associated with increased risk cancer. Inquiries about e-cigarette use among adults 25-40 years present providers the opportunity to also counsel young adult about reducing cancer risk.
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Affiliation(s)
- Grace C Hillyer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 1611, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA.
| | - Meaghan Nazareth
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
| | - Sarah Lima
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 1611, New York, NY, 10032, USA
| | - Karen M Schmitt
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
- Division of Community and Population Health, New York Presbyterian Hospital, New York, NY, 10032, USA
| | - Andria Reyes
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
| | - Elaine Fleck
- Division of Community and Population Health, New York Presbyterian Hospital, New York, NY, 10032, USA
| | - Gary K Schwartz
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
- Department of Hematology and Oncology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, Room 1611, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA
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Tarasenko Y, Ciobanu A, Fayokun R, Lebedeva E, Commar A, Mauer-Stender K. Electronic cigarette use among adolescents in 17 European study sites: findings from the Global Youth Tobacco Survey. Eur J Public Health 2022; 32:126-132. [PMID: 34694383 PMCID: PMC8807119 DOI: 10.1093/eurpub/ckab180] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND As new findings on public health implications of electronic cigarette (e-cigarette) use emerge, its surveillance remains of utmost importance. This study examined the latest state of e-cigarette use in youth in 17 European study sites (i.e. 16 countries and the Federation of Bosnia and Herzegovina) using the Global Youth Tobacco Survey (GYTS). METHODS This was an observational study. Cross-sectional data on students aged 11-17 years from the latest available GYTS round completed in 17 study sites were used to estimate crude and adjusted prevalence of e-cigarette use by sex and pocket money. Panel GYTS data from five countries were used for the trend analyses. All analyses were weighted to account for the survey design and non-response. RESULTS Compared to 2014, the age-adjusted prevalence of e-cigarette use more than doubled in Georgia and Italy, and nearly doubled in Latvia. Significantly more male than female students aged 11-17 years reported use of e-cigarettes, with little to no confounding by age, grade and pocket money across countries. Youth with medium or higher amount of pocket money was 20-200% more likely to use e-cigarettes than those with fewer to no pocket money in 14 study sites. DISCUSSION As e-cigarette use is becoming widespread throughout the world, there is variation in use among and between countries. Expanded and consistent surveillance of e-cigarette use by all World Health Organization member states is essential to generate data on the extent and correlates of youth e-cigarette use for evidence-based planning and evaluation of the electronic nicotine delivery systems and electronic non-nicotine delivery systems national and global control programmes.
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Affiliation(s)
- Yelena Tarasenko
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Angela Ciobanu
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ranti Fayokun
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Elizaveta Lebedeva
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Alison Commar
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Kristina Mauer-Stender
- Division of Country Support and Emergencies, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
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Benson R, Hu M, Chen AT, Zhu SH, Conway M. Examining Cannabis, Tobacco, and Vaping Discourse on Reddit: An Exploratory Approach Using Natural Language Processing. Front Public Health 2022; 9:738513. [PMID: 35071153 PMCID: PMC8766503 DOI: 10.3389/fpubh.2021.738513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/26/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Perceptions of tobacco, cannabis, and electronic nicotine delivery systems (ENDS) are continually evolving in the United States. Exploring these characteristics through user generated text sources may provide novel insights into product use behavior that are challenging to identify using survey-based methods. The objective of this study was to compare the topics frequently discussed among Reddit members in cannabis, tobacco, and ENDS-specific subreddits. Methods: We collected 643,070 posts on the social media site Reddit between January 2013 and December 2018. We developed and validated an annotation scheme, achieving a high level of agreement among annotators. We then manually coded a subset of 2,630 posts for their content with relation to experiences and use of the three products of interest, and further developed word cloud representations of the words contained in these posts. Finally, we applied Latent Dirichlet Allocation (LDA) topic modeling to the 643,070 posts to identify emerging themes related to cannabis, tobacco, and ENDS products being discussed on Reddit. Results: Our manual annotation process yielded 2,148 (81.6%) posts that contained a mention(s) of either cannabis, tobacco, or ENDS with 1,537 (71.5%) of these posts mentioning cannabis, 421 (19.5%) mentioning ENDS, and 264 (12.2%) mentioning tobacco. In cannabis-specific subreddits, personal experiences with cannabis, cannabis legislation, health effects of cannabis use, methods and forms of cannabis, and the cultivation of cannabis were commonly discussed topics. The discussion in tobacco-specific subreddits often focused on the discussion of brands and types of combustible tobacco, as well as smoking cessation experiences and advice. In ENDS-specific subreddits, topics often included ENDS accessories and parts, flavors and nicotine solutions, procurement of ENDS, and the use of ENDS for smoking cessation. Conclusion: Our findings highlight the posting and participation patterns of Reddit members in cannabis, tobacco, and ENDS-specific subreddits and provide novel insights into aspects of personal use regarding these products. These findings complement epidemiologic study designs and highlight the potential of using specific subreddits to explore personal experiences with cannabis, ENDS, and tobacco products.
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Affiliation(s)
- Ryzen Benson
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Mengke Hu
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Annie T. Chen
- Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle, WA, United States
| | - Shu-Hong Zhu
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | - Mike Conway
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
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Sangster-Carrasco L, Blitchtein-Winicki D. Association of lifetime e-cigarette and/or tobacco use and last year cannabis use among university students: A cross-sectional secondary analysis of a national survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000452. [PMID: 36962355 PMCID: PMC10022225 DOI: 10.1371/journal.pgph.0000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The accelerated increase in the use of e-cigarette by university students in recent years has incremented nicotine use in addition to tobacco, but it is not known whether the use of cannabis is related to these alternatives. This study analyzes the association between the use of electronic cigarettes and/or tobacco and the use of cannabis in the last 12 months. An analytical cross-sectional study conducted based on the III Andean epidemiological study on drug consumption among university students in 2016. A multivariate analysis performed using a generalized linear family model and the log Poisson link option. The results were shown as Prevalence Ratios (PR) in raw (PRc) and adjusted (PRa) models, and the analysis also employed 95% confidence intervals (95% CI) for the percentages. SETTING Ten Peruvian universities. PARTICIPANTS University students' lifetime. EXPOSURE Participants' e-cigarette and/or tobacco consumption, based on questions about consumption of tobacco and e-cigarettes. Participants were categorized into those consuming: only e-cigarettes, only tobacco, both, or neither. OUTCOME The use of cannabis by participants in the last 12 months. Among the university students who met the inclusion criteria (n = 3981), the prevalence of using both e-cigarettes and tobacco (dual) throughout life was 11.6% (95% CI: 10.1 to 13.3), and only e-cigarettes was 1.2% (95% CI: 0.7 to 1.8). The use of cannabis in the last 12 months was 5.2% (95% CI: 4.1 to 6.5). Results of this study found a sequential probability gradient of cannabis use, where those with dual use had 58.5 times more probability of having used cannabis in the last 12 months (PRa 58.5, 95% CI: 20.9 to 163.7, p <0.001) compared to those who used none; whereas those who used only tobacco were 33.3 times more likely to have used cannabis in the last 12 months (PRa 33.3, 95% CI: 11.9 to 93.2, p <0.001), those who reported using only e-cigarette had 9.8 times more probability of having used cannabis in the last 12 months (PRa 9.8, 95% CI: 1.6 to 60.4, p = 0.014). We found an increase in the probability of having used cannabis in the last 12 months among university students who reported tobacco and/or e-cigarettes use. A sequential probability gradient was found and it showed that, in comparison to students who informed being nonusers of tobacco and/or e-cigarette, university students who were lifetime dual users were most likely to having used cannabis in the last 12 months, followed by those reporting an exclusive lifetime use of tobacco, as well as those students who reported an exclusive lifetime use of e-cigarettes. It is necessary to raise awareness of the association of tobacco and e-cigarette use with an increased possibility of using cannabis. Studies are needed in different cultural contexts to investigate the progression of electronic cigarette and/or tobacco use, as well as their dosage, intensity of use, concurrent use, and neurological and behavioral mechanisms that are related to the use of cannabis and other illegal drugs that may increase dependence and mental health problems.
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Roh EJ, Chen-Sankey JC, Wang MQ. Electronic nicotine delivery system (ENDS) use patterns and its associations with cigarette smoking and nicotine addiction among Asian Americans: Findings from the national adult tobacco survey (NATS) 2013-2014. J Ethn Subst Abuse 2022; 21:253-271. [PMID: 32459579 PMCID: PMC7704701 DOI: 10.1080/15332640.2020.1747039] [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] [Indexed: 01/03/2023]
Abstract
This study examined the ENDS use and their associations with conventional cigarette smoking and nicotine addiction among Asian Americans (AAs). The study sample was restricted to Non-Hispanic AAs (n = 1,956) using the National Adult Tobacco Survey (NATS) 2013-2014. Chi-square tests and logistic regressions were employed. AAs who ever used ENDS reported they were more likely to smoke conventional cigarettes, smoke ≤100 cigarettes in a lifetime, and felt more difficulty concentrating without using tobacco than those who never used END. Study findings indicate that ENDS use may be associated with conventional cigarette smoking and may lead to nicotine addiction among AAs.
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Affiliation(s)
- Esther J Roh
- University of Maryland, College Park, Maryland, USA
| | - Julia C Chen-Sankey
- National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Min Q Wang
- University of Maryland, College Park, Maryland, USA
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Pascoe M, Nagia S, Atal N, Gadway H, Huizenga K, Bailey B. Have e-cigarettes created a new crop of young adult substance users? Overlap between e-cigarette, traditional cigarette, and alcohol use. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michael Pascoe
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Sally Nagia
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Nanaki Atal
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Hannah Gadway
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Kamren Huizenga
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Beth Bailey
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
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