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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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Zvolensky MJ, Shepherd JM, Clausen BK, Redmond BY, De Dios M, Cano MÁ. Combustible cigarette smokers versus dual combustible and electronic users: Evaluation of differences in anxiety, depression, and transdiagnostic constructs among Latinx adults. J Ethn Subst Abuse 2024:1-18. [PMID: 39145994 DOI: 10.1080/15332640.2024.2391309] [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: 08/16/2024]
Abstract
Research on dual combustible and electronic nicotine use among Latinx persons is needed to better understand patterns of use because this group is an established tobacco disparities population. Negative emotional symptoms and related processes (e.g., reactive transdiagnostic vulnerabilities) have been among the most prominent factors linked to the onset, maintenance, and relapse of smoking. As such, the current study sought to compare levels of mental health symptoms among combustible users compared to dual combustible and electronic users among Latinx persons who smoke. The current sample consisted of 297 adult Latinx daily cigarette smokers (Mage = 35.90 years; SD = 8.87; age range 18-61; 36.4% female), of which 92 reported current dual use of an e-cigarette (Mage = 33.34 years; SD = 7.75; age range 19-60; 28.3% female). Differences in anxiety, depression, anxiety sensitivity, emotion dysregulation, and distress tolerance were examined, and we hypothesized that dual users would showcase higher mental health problems. Results indicated that adult Latinx dual users evidenced greater levels of anxiety, depression, emotional dysregulation, anxiety sensitivity, and lower levels of distress tolerance compared to combustible users. The current study sheds light on the clinical importance of affective differences among dual versus combustible Latinx smokers.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Justin M Shepherd
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Brooke Y Redmond
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Marcel De Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Houston, Texas, USA
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3
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Emre O, Özyazıcı K, Keskinkılıç A, Arslan Z. The role of adolescents' mental health and well-being in predicting their smoking status. Arch Psychiatr Nurs 2024; 51:137-142. [PMID: 39034070 DOI: 10.1016/j.apnu.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/17/2023] [Accepted: 06/06/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVES This study aims to examine the relationship between adolescent's mental health, well-being and their tobacco use. METHODS The study employed a relational survey model. The sample consisted of 691 adolescents aged between 12 and 15. This study deployed "Decisional Balance Scale" to predict and define the adolescents' tobacco use, and the "Me and My Feelings Scale" to evaluate mental health and well-being. Multiple linear regression analysis was used during data analysis. RESULT The results revealed that the emotional difficulties dimension of Me and My Feelings Scale had a statistically significant effect on the Decisional Balance Scale. However, the behavioral difficulties dimension did not have a statistically significant impact on the Decisional Balance Scale. CONCLUSIONS Adolescents' mental health affects their tobacco use at the level of 2.3 %. A significant relationship was noted across the adolescents' mental health and their perceptions towards smoking.
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Affiliation(s)
- Oğuz Emre
- Inonu Unıversıty, Faculty of Health Sciences, Department of Child Development, Turkey.
| | - Kadriye Özyazıcı
- Cumhuriyet Unıversıty, Faculty of Health Sciences, Department of Child Development, Turkey
| | - Ayşegül Keskinkılıç
- Inonu Unıversıty, Faculty of Health Sciences, Department of Child Development, Turkey
| | - Zekeriya Arslan
- Kahramanmaraş Sütçü İmam Unıversıty, Faculty of Health Sciences, Department of Child Development, Turkey
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4
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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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5
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Lee S, Elam K, Lohrmann D, Luo J, Chow A, Seo DC. Prospective longitudinal relations among frequent social media use, nicotine vaping and experiencing internalizing mental health problems. Addiction 2024. [PMID: 38961689 DOI: 10.1111/add.16601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/03/2024] [Indexed: 07/05/2024]
Abstract
AIMS To compare four a priori rival mediated pathways of frequent social media use, electronic nicotine delivery systems (ENDS) use and internalizing mental health (MH) problems across five waves of nationally representative data. DESIGN, SETTING AND PARTICIPANTS This was a longitudinal study using data drawn from waves 2-5 (October 2014-November 2019) of the Population Assessment of Tobacco and Health Study, a nationally representative cohort study spanning approximately 5 years, conducted in the United States. The analytical sample of participants included those who were aged 12-14 years at wave 2 and who provided data in subsequent waves until wave 4.5 (n = 4627, 69.7% were White and 51.4% were male). MEASUREMENTS Frequent social media use (several times a day), ENDS use (past 30-day use) and internalizing MH problems (endorsed symptoms on four items in the past year) were dichotomized for analysis. FINDINGS The weighted proportions of the three key variables increased over time. From wave 2 to wave 5, frequent social media use grew from 56.9 to 77.2%; internalizing MH problems from 18.9 to 29.0%; and ENDS use from 1.4 to 11.4%. In weighted logistic regressions using generalized linear mixed models with random effects, there was a significant within-person association between frequent social media use at time t and greater ENDS use at t + 1 [adjusted odds ratio (aOR) = 1.87; 95% confidence interval (CI) = 1.47, 2.37] and worsened internalizing MH problems at t + 1 (aOR = 1.19; 95% CI = 1.04, 1.37). A model-based causal mediation analysis and marginal structural models were fitted to estimate the average causal mediation effect. Among all four examined mediation pathways throughout the three constructs, partial mediation was observed, and all the pathways were significant for both boys and girls. Sex differences did not emerge in the examined prospective mediated pathways. CONCLUSIONS Among youth in the United States, frequent social media use appears to mediate the prospective association between experiencing internalizing mental health problems and using electronic nicotine delivery systems.
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Affiliation(s)
- Shieun Lee
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Kit Elam
- Department of Applied Health Science, Indiana University School of Public Health-, Bloomington, IN, USA
| | - David Lohrmann
- Department of Applied Health Science, Indiana University School of Public Health-, Bloomington, IN, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-, Bloomington, IN, USA
| | - Angela Chow
- Department of Applied Health Science, Indiana University School of Public Health-, Bloomington, IN, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health-, Bloomington, IN, USA
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6
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Do VV, Ling PM, Chaffee BW, Nguyen N. Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths. JAMA Netw Open 2024; 7:e2419976. [PMID: 38958977 PMCID: PMC11222996 DOI: 10.1001/jamanetworkopen.2024.19976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/01/2024] [Indexed: 07/04/2024] Open
Abstract
Importance Little is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths. Objective To examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths. Design, Setting, and Participants This cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024. Exposure Past 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse. Main Outcomes and Measures Self-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs-Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms). Results A total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone. Conclusions and Relevance In this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.
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Affiliation(s)
- Vuong V. Do
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- School of Dentistry, University of California, San Francisco
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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7
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Zhang L, Ao SH, Zhao X. A four-year longitudinal analysis examining the effects of e-cigarette advertisements and disparities among youth with internalizing problems. Addict Behav 2024; 153:108002. [PMID: 38430643 DOI: 10.1016/j.addbeh.2024.108002] [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: 12/31/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Prior research indicates a direct, short-term effect of e-cigarette advertising on e-cigarette use among youth. This study seeks to investigate the long-term effects of e-cigarette advertisements and disparities in exposure among adolescents with different levels of internalizing problems. METHODS Panel data of the Population Assessment of Tobacco and Health (PATH) Study Waves 3-5 (2015-2019) were analyzed. Youth aged 12-17 who were non-e-cigarette users at the time of Wave 3 were included (n = 4,678). A moderated mediation model was employed to examine the mediating role of perceived harm of e-cigarettes and the moderating effect of internalizing problems. RESULTS Exposure to e-cigarette advertisements in Wave 3 predicted lower harm perception of e-cigarette in Wave 4 (bp = -0.055, p <.01), leading to more e-cigarette use in Wave 5 (bp = -0.042, p <.001). While e-cigarette advertisements exhibited a lasting indirect effect (bp = 0.002, p <.05), there was no long-term direct effect (bp = 0.017, p >.05) on youth e-cigarette use. Furthermore, a moderating effect of internalizing problems was observed (bp = 0.107, p <.05). CONCLUSIONS E-cigarette advertisements can exert a lasting influence indirectly by diminishing harm perception, particularly among those with lower internalizing problems. Adolescents with higher internalizing problems exhibit lower susceptibility to advertisement influence, yet their perceived harm of e-cigarettes is notably lower than their peers with fewer internalizing problems. These disparities underscore the need for tailored prevention strategies: implementing anti-e-cigarette education programs for adolescents with low internalizing problems and providing mental health care for those facing internalizing challenges. Regulatory measures targeting e-cigarette advertising are also crucial.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau.
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Do EK, Aarvig K, Panigrahi G, Hair EC. Past-Year Mental Illness Diagnosis and E-cigarette Use Status Among a College-Aged Sample: Findings From the National College Health Assessment (2017-2019). Am J Health Promot 2024; 38:468-477. [PMID: 38146733 DOI: 10.1177/08901171231224864] [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] [Indexed: 12/27/2023]
Abstract
PURPOSE To examine associations between past-year mental illness (MI) diagnoses and e-cigarette use status. DESIGN Data were obtained from the National College Health Assessment, a nationally recognized cross-sectional survey of university students. SETTING Participants were recruited from 2-year and 4-year public and private universities across the United States from 2017-2019. SUBJECTS The analytic sample included 277 291 university students. MEASURES Self-reported past-year MI diagnosis, binarily coded, served as the primary predictor. The outcome was e-cigarette use status (never, noncurrent, and current user). ANALYSIS Multinomial logistic regression models were used to estimate relative risk ratios (RRR) of e-cigarette use, as predicted by past-year MI diagnoses, age, race/ethnicity, sex and gender, sexual identity, geographic region, and other combustible tobacco, alcohol, and marijuana use. RESULTS Compared to those who had never received any MI diagnosis in the past year, those who did had a 16% higher relative risk (RRR = 1.16, 95% CI: 1.11, 1.20) of being a noncurrent e-cigarette user and a 33% higher relative risk (RRR = 1.33, 95% CI: 1.28, 1.38) of being a current e-cigarette user. Schizophrenia, substance use or addiction, bipolar disorder, and attention deficit and hyperactivity disorder (ADHD) diagnoses demonstrated the strongest associations with noncurrent and current e-cigarette use. CONCLUSION Results suggest the need to screen young adults for e-cigarette use and mental health indicators to facilitate early detection and timely intervention for at-risk university students.
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Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- School of Global Public Health, New York University, New York, NY, USA
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9
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Gimm G, Schulz JA, Rubenstein D, Casseus M. Examining the prevalence of nicotine vaping and association of major depressive episodes among adolescents and young adults by disability type in 2021. Addict Behav 2024; 152:107975. [PMID: 38309240 DOI: 10.1016/j.addbeh.2024.107975] [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: 09/26/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Nicotine vaping is more prevalent among U.S. adults with disabilities compared to those without disabilities. However, less is known about nicotine vaping among adolescents (12-17 years) and young adults (18-25 years) by disability status. METHODS Using data from a sample of 24,722 adolescents and young adults (AYAs) from the 2021 National Survey on Drug Use and Health, we conducted descriptive and multivariable analyses to estimate the national prevalence of nicotine vaping by disability type and examined major depressive episodes (MDEs) as a risk factor for nicotine vaping. RESULTS A greater proportion of AYAs with disabilities engaged in past-month nicotine vaping compared to those without a disability (13.9 % vs 9.6 %, p = 0.0001). Also, when MDE was excluded from the model, AYAs with any disability had higher odds of nicotine vaping (AOR = 1.41; 95 % CI 1.15, 1.74) than those without a disability. However, disability status was no longer significant when MDE was included (AOR = 1.16; 95 % CI 0.91, 1.46) in the model. CONCLUSIONS The higher prevalence of nicotine vaping among AYAs with disabilities suggests that tailored messages may be needed to communicate health risks and adverse outcomes of e-cigarette use. Also, MDE is associated with nicotine vaping among AYA populations. This information can be helpful to school nurses, counselors, and mental health professionals in their screening of major depression as a risk factor for e-cigarette use.
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Affiliation(s)
- Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, 4400 University Drive, MS-1-J3, Fairfax, VA 22030, USA.
| | - Jonathan A Schulz
- Department of Psychiatry, University of Vermont, Vermont Center on Behavior and Health, Burlington, VT, USA
| | - Dana Rubenstein
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Myriam Casseus
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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10
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Patanavanich R, Worawattanakul M, Glantz S. Longitudinal bidirectional association between youth electronic cigarette use and tobacco cigarette smoking initiation in Thailand. Tob Control 2024; 33:310-316. [PMID: 36104174 DOI: 10.1136/tc-2022-057491] [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: 04/25/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION This study quantifies the longitudinal association between e-cigarette use and subsequent conventional cigarette initiation and vice versa among Thai youths. METHODS Data from a longitudinal survey of 6045 Thai seventh grade students with baseline in 2019 and the 12-month follow-up in 2020 were analysed using complex survey multivariate logistic regressions to assess whether e-cigarette use was associated with subsequent cigarette smoking (ever, current and dual product users at follow-up) among baseline never smokers. RESULTS Consistent with prior findings from other countries, among those who had never smoked cigarettes at baseline, ever e-cigarette users were more likely to try cigarette smoking (adjusted OR 4.44; 95% CI 2.23 to 8.86; p<0.001), or become dual users (adjusted OR 5.31; 95% CI 2.63 to 10.74; p<0.001) 1 year later. Baseline current e-cigarette users were more likely to become ever smokers (adjusted OR 5.37; 95% CI 1.82 to 15.90; p=0.005), current smokers (OR 3.92; 95% CI 1.69 to 9.14; p=0.003) and dual product users (adjusted OR 6.96; 95% CI 1.54 to 31.38; p=0.015) at the 12-month follow-up than non-e-cigarette users. Similarly, among never e-cigarette users at baseline, ever cigarette smoking were more likely to try e-cigarettes (adjusted OR 3.38; 95% CI 1.66 to 6.88; p=0.002), currently use e-cigarettes (adjusted OR 2.75; 95% CI 1.47 to 5.13; p=0.003) and currently use both e-cigarettes and cigarettes (adjusted OR 4.87; 95% CI 2.92 to 8.13; p<0.001) at the follow-up than never smokers. Among never e-cigarette users at baseline, current-cigarette smoking were more likely to try e-cigarettes (adjusted OR 6.21; 95% CI 2.58 to 14.95; p<0.001), currently use e-cigarettes (adjusted OR 2.80; 95% CI 1.27 to 6.14; p=0.014) and currently use both e-cigarettes and cigarettes (adjusted OR 7.70; 95% CI 3.45 to 17.19; p<0.001) at the follow-up than never smokers. CONCLUSIONS This longitudinal study in Asian low-income and middle-income countries supports the prospective association of youth e-cigarette use with subsequent smoking initiation and youth cigarette use with subsequent e-cigarette initiation that is similar to that observed in high-income Western countries.
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Affiliation(s)
- Roengrudee Patanavanich
- Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Methavee Worawattanakul
- Department of Community Medicine, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
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Cai J, Bidulescu A. E-cigarette use or dual use of E-cigarette and combustible cigarette and mental health and cognitive impairment: Findings from the National Health Interview Survey, 2020-2021. J Affect Disord 2024; 351:878-887. [PMID: 38211743 DOI: 10.1016/j.jad.2024.01.056] [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: 02/15/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Studies on the association between e-cigarette use and mental health are mostly among adolescents and young adults, leaving limited evidence of this association among general US adults. Besides, few studies have examined how e-cigarette use or dual use of e-cigarette and combustible cigarette is related to cognitive function. METHODS Cross-sectional data of 56,734 adults from the 2020-2021 National Health Interview Survey were analyzed. Weighted multivariable logistic regression models were applied to examine the independent association between e-cigarette use or dual use and anxiety symptoms, depression symptoms, serious psychological distress (SPD), and cognitive impairment. RESULTS Compared with never e-cigarette users, current e-cigarette users had 2.10-fold (95 % CI: 1.84, 2.39), 2.53-fold (95 % CI: 2.13, 3.00), 2.02-fold (95 % CI: 1.47, 2.76), and 2.00-fold (95 % CI: 1.47, 2.72) higher odds of reporting anxiety symptoms, depression symptoms, SPD, and cognitive impairment, respectively. Former e-cigarette use was also associated with all three mental conditions and cognitive impairment (AOR ranged from 1.38 to 2.53, all P < 0.01). Dual users were more likely to report all three mental conditions and cognitive impairment than those who never used combustible cigarette and e-cigarette (AOR ranged from 1.89 to 2.83, all P < 0.01). Dual users also had a greater likelihood of having anxiety or depression symptoms than exclusive combustible cigarette users (AOR ranged from 1.46 to 1.47, all P < 0.01). CONCLUSIONS E-cigarette use or dual use is associated with poor mental health and cognitive impairment among US adults. Regulations on e-cigarette use are needed to prevent mental illness and improve cognitive function.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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Aljohani FA, Alzubaidi BY, Al-Rafdan RH, Alblawi HM, Alrehayan RH, Alsenan GA, Almohaya HS, Taha MM. E-cigarette use, psychological distress, and daily activity participation among adults in Riyadh. Front Psychiatry 2024; 15:1362233. [PMID: 38680785 PMCID: PMC11045981 DOI: 10.3389/fpsyt.2024.1362233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/22/2024] [Indexed: 05/01/2024] Open
Abstract
Objectives The prevalence of e-cigarettes is significantly increasing among adults as an alternative method to tobacco smoking. However, the chemical products of e-cigarettes have an influence on human general health. Therefore, this study aims to investigate the association between e-cigarette use and psychological distress as well as participation in daily activities among adults in Riyadh, Saudi Arabia. It also evaluates the demographic profile and usage patterns of e-cigarette users. Methods This cross-sectional study involved 396 e-cigarette smokers in Riyadh city. An online survey was administered, including questions about smoking patterns and the perceived effects of e-cigarettes on activities of daily living. Additionally, mental health were assessed using the Kessler 6 scale. Results Most of the participants were educated young males (61.4%). About 29.5% of the participants reported using e-cigarettes primarily to quit tobacco cigarettes. In addition, e-cigarette usage was significantly associated with lower participation in activities of daily living and higher psychological distress. Conclusion This study found that many e-cigarette users are well-educated young individuals who use e-cigarettes as a substitute for traditional cigarettes. However, the study also revealed that using e-cigarettes is associated with negative effects on smokers' daily activities and mental health.
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Affiliation(s)
- Fenoon Abdullah Aljohani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Bakriah Yahyaa Alzubaidi
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Reem Hamdan Al-Rafdan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hanan Mutiq Alblawi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rama Hani Alrehayan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ghada Abdulrahman Alsenan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hadeil Salman Almohaya
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mona Mohamed Taha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Evans WD, Bingenheimer J, Cantrell J, Kreslake J, Tulsiani S, Ichimiya M, D'Esterre AP, Gerard R, Martin M, Hair EC. Effects of a Social Media Intervention on Vaping Intentions: Randomized Dose-Response Experiment. J Med Internet Res 2024; 26:e50741. [PMID: 38470468 DOI: 10.2196/50741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/12/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND e-Cigarette use, especially by young adults, is at unacceptably high levels and represents a public health risk factor. Digital media are increasingly being used to deliver antivaping campaigns, but little is known about their effectiveness or the dose-response effects of content delivery. OBJECTIVE The objectives of this study were to evaluate (1) the effectiveness of a 60-day antivaping social media intervention in changing vaping use intentions and beliefs related to the stimulus content and (2) the dose-response effects of varying levels of exposure to the intervention on vaping outcomes, including anti-industry beliefs, vaping intentions, and other attitudes and beliefs related to vaping. METHODS Participants were adults aged 18 to 24 years in the United States. They were recruited into the study through Facebook (Meta Platforms) and Instagram (Meta Platforms), completed a baseline survey, and then randomized to 1 of the 5 conditions: 0 (control), 4, 8, 16, and 32 exposures over a 15-day period between each survey wave. Follow-up data were collected 30 and 60 days after randomization. We conducted stratified analyses of the full sample and in subsamples defined by the baseline vaping status (never, former, and current). Stimulus was delivered through Facebook and Instagram in four 15-second social media videos focused on anti-industry beliefs about vaping. The main outcome measures reported in this study were self-reported exposure to social media intervention content, attitudes and beliefs about vaping, and vaping intentions. We estimated a series of multivariate linear regressions in Stata 17 (StataCorp). To capture the dose-response effect, we assigned each study arm a numerical value corresponding to the number of advertisements (exposures) delivered to participants in each arm and used this number as our focal independent variable. In each model, the predictor was the treatment arm to which each participant was assigned. RESULTS The baseline sample consisted of 1491 participants, and the final analysis sample consisted of 57.28% (854/1491) of the participants retained at the 60-day follow-up. We compared the retained participants with those lost to follow-up and found no statistically significant differences across demographic variables. We found a significant effect of the social media treatment on vaping intentions (β=-0.138, 95% CI -0.266 to -0.010; P=.04) and anti-industry beliefs (β=-0.122, 95% CI 0.008-0.237; P=.04) targeted by the intervention content among current vapers but not among the full sample or other strata. We found no significant effects of self-reported exposure to the stimulus. CONCLUSIONS Social media interventions are a promising approach to preventing vaping among young adults. More research is needed on how to optimize the dosage of such interventions and the extent to which long-term exposure may affect vaping use over time. TRIAL REGISTRATION ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668.
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Affiliation(s)
- William Douglas Evans
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Jeffrey Bingenheimer
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Jennifer Cantrell
- New York University School of Global Public Health, New York, NY, United States
| | | | | | - Megumi Ichimiya
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | | - Raquel Gerard
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Madeline Martin
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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Zheng X, Yang M, Li W, Lin HC. The mediating roles of mental health problems and racial differences in the linkage between social media use and E-cigarette use among American youth. Prev Med 2024; 179:107842. [PMID: 38169240 DOI: 10.1016/j.ypmed.2023.107842] [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: 09/17/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Social media use is shown to be linked to youth's e-cigarette use. However, less is known about the underlying mechanisms. This study examined the mediating roles of internalizing and externalizing problems in the association between youth's social media use and e-cigarette use, and the racial differences in the mediation association. METHODS The study sample included 4913 U.S. youth from the Population Assessment of Tobacco and Health Study Waves 3-5 (2015-2019). Two weighted generalized structural equation models were conducted to examine the mediation pathways between youth's social media use (Wave 3) and past-30-day e-cigarette use (Wave 5) through internalizing and externalizing problems (Wave 4), respectively. Invariance tests were conducted to examine racial group differences. RESULTS Youth with high social media use frequency were more likely to use e-cigarettes (total effect: OR = 1.20, p < 0.001 in both internalizing and externalizing models). Internalizing and externalizing problems mediated the aforementioned associations (mediation proportions: 5.05% and 5.66%, respectively). The invariance tests indicated a significant difference between White and non-White groups (both ps < 0.001), where a larger proportion of mediation was found in the non-White group (12.22% for internalizing and 11.99% for externalizing) compared to their White counterparts (2.46% for internalizing and 3.17% for externalizing). CONCLUSIONS Mental health problems following social media use served as a risk factor for e-cigarette use among youth. Interventions aiming to improve youth's mental health could in turn temper e-cigarette use among youth social media users, and implementing tailored interventions in response to racial differences is warranted.
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Affiliation(s)
- Xia Zheng
- School of Communication and Journalism, Stony Brook University, NY, United States of America
| | - Meng Yang
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America
| | - Wenbo Li
- School of Communication and Journalism, Stony Brook University, NY, United States of America
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States of America.
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Kurt ZK, Demir Hacıosmanoğlu G, Yıldırım M, Özaslan A. Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample. J Ethn Subst Abuse 2024:1-19. [PMID: 38165398 DOI: 10.1080/15332640.2023.2299873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.
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Affiliation(s)
- Zeynep Kübra Kurt
- Child and Adolescent Psychiatry Department, Gazi University Medical Faculty, Ankara, Turkey
| | | | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Ağrı, Turkey
- Lebanese American University, Beirut, Lebanon
| | - Ahmet Özaslan
- Child and Adolescent Psychiatry Department, Gazi University Medical Faculty, Ankara, Turkey
- Child Protection Research and Application Center, Gazi University, Ankara, Turkey
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16
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Azagba S, Ebling T, Korkmaz A. Social media and e-cigarette use: The mediating role of mental health conditions. J Affect Disord 2024; 344:528-534. [PMID: 37852589 DOI: 10.1016/j.jad.2023.10.053] [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: 06/02/2023] [Revised: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND In recent years, youth social media use, youth e-cigarette use, and youth mental health conditions have become major public health concerns. We examined the role of mental health condition indicators in the link between youth social media use and e-cigarette use. METHODS We used data from the 2022 National Youth Tobacco Survey (N = 23,445) to measure social media use by time spent, anxiety and depression symptoms by the Patient Health Questionnaire-4, and past-30-day e-cigarette use. We applied the potential outcomes framework to examine the relationship between social media use and e-cigarette use mediated by mental health condition indicators. RESULTS Mental health condition indicators mediated the relationship between social media use and e-cigarette use in a dose-response manner, with higher levels of social media use associated with higher odds of e-cigarette use. With mental health condition indicators as a mediator, those who used social media for 4+ hours/day or 3-4 h/day had significantly higher odds of e-cigarette use than those who used social media sometimes or never. In the sex-stratified analysis, we found that very often social media use was associated with higher odds of e-cigarette use for both males and females, compared to sometimes users (OR = 1.53, 95 % CI [1.18,1.96] for males; OR = 2.27, 95 % CI [1.76,2.92] for females). LIMITATIONS Anxiety and depression symptoms were self-reported. CONCLUSIONS This study shows that anxiety and depression symptoms mediate the relationship between social media and e-cigarette use among youth and support the growing concern that frequent social media use may negatively affect youth health.
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Affiliation(s)
- Sunday Azagba
- College of Nursing, The Pennsylvania State University, University Park, PA, United States of America.
| | - Todd Ebling
- College of Nursing, The Pennsylvania State University, University Park, PA, United States of America
| | - Alperen Korkmaz
- College of Nursing, The Pennsylvania State University, University Park, PA, United States of America
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17
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Han DH, Shin E. Parenting practices, mental health, and electronic cigarette use among U.S. young adolescents: A longitudinal panel analysis, 2013-2018. Prev Med 2024; 178:107795. [PMID: 38065337 DOI: 10.1016/j.ypmed.2023.107795] [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: 10/01/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE This study examined prospective association of parenting practices related to tobacco use with adolescent e-cigarette use and the moderating role of mental health among U.S. young adolescents. METHODS We study used multi-wave longitudinal data (2013-2018) drawn from the Population Assessment of Tobacco and Health Study. A total of 5114 young adolescents (12-14 years) who were not lost to follow-ups across four waves (Wave 1-4) comprised the study sample. Weighted logistic regression models along with generalized linear mixed modeling assessed the within-subject associations of parenting practices related to tobacco use (tobacco availability at parent/guardian's home, past-year parent talk about tobacco use, and rules about non-combustible tobacco use at home) with adolescent current e-cigarette use. RESULTS Prevalence of having home rules about non-combustible tobacco use increased (74.5%-80.2%) and that of parent talk about tobacco use decreased (52.0%-33.9%) over time while tobacco availability at home did not show a specific trend. Tobacco availability at home was associated with increased odds of adolescent e-cigarette use (adjusted odd ratio[OR] = 2.25, 95% confidence interval[CI] = 1.72-2.95), and having home rules about non-combustible tobacco use was linked to decreased likelihood of e-cigarette use (adjusted OR = 0.72, 95% CI = 0.55-0.92). The magnitude of negative association between having rules about non-combustible tobacco and adolescent e-cigarette use was stronger among adolescents with internalizing problems but weaker among those with externalizing problems. CONCLUSIONS Our findings highlight the important role of home-based interventions in discouraging young adolescents from e-cigarette use. Parents/guardians should consider adolescents' mental health to provide more efficient home- and/or clinical-based e-cigarette use prevention.
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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, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
| | - Eunkyung Shin
- Department of Psychology, Pennsylvania State University, University Park PA, USA
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18
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Zvolensky MJ, Shepherd JM, Clausen BK, Ditre JW, Smit T, Redmond B. Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain. Behav Med 2023:1-11. [PMID: 38112190 PMCID: PMC11218863 DOI: 10.1080/08964289.2023.2290480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | | | - Bryce K. Clausen
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Brooke Redmond
- Department of Psychology, University of Houston, Houston, TX, USA
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Harlow AF, Han DH, Eckel SP, McConnell R, Leventhal AM, Barrington-Trimis JL. The interaction of e-cigarette use and mental health symptoms on risk of cigarette smoking initiation among young adults in the United States. Addiction 2023; 118:2317-2326. [PMID: 37620973 PMCID: PMC10783200 DOI: 10.1111/add.16319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 07/04/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND AND AIMS It is unknown whether young adults who vape nicotine and have poor mental health have greater risk of smoking initiation than expected based on individual risks of vaping and mental health alone. This study aimed to estimate the joint association of vaping and mental health symptoms with smoking initiation among young adults, and test for additive interaction between vaping and mental health in smoking initiation risk. DESIGN Using five waves of the Population Assessment of Tobacco and Health (wave 1, 2013-2014; wave 2, 2014-2015; wave 3, 2015-2016; wave 4, 2016-2018; wave 5, 2018-2019), we estimated risk differences (RD) for the association of time-varying and time-lagged vaping and internalizing (e.g., anxiety, depressive) and externalizing (e.g., inattention/hyperactivity) mental health symptoms with cigarette smoking initiation at follow-up, over four 1-year intervals. We calculated interaction contrasts (IC) to estimate the excess risk of smoking initiation attributable to the interaction of vaping and mental health symptoms. SETTING United States. PARTICIPANTS A total of 6908 cigarette-naïve individuals aged 18-24 years. MEASUREMENTS Exposures included current (past-30 day) vaping and internalizing and externalizing mental health symptoms (high vs moderate/low symptoms). The outcome was smoking initiation (ever cigarette use) after 1 year. FINDINGS The per-interval risk of smoking initiation was 7.6% (1039 cases/13 712 person-intervals). Compared with noncurrent vaping and moderate/low mental health symptoms, adjusted RDs for current vaping and high mental health symptoms were 17.2% (95% confidence interval [CI]: 7.2% to 27.3%) for internalizing and 18.7% (95%CI: 8.1% to 29.2%) for externalizing symptoms. The excess risk attributed to interaction of current vaping and high externalizing symptoms was IC = 11.3% (95%CI: 1.3% to 21.2%; P = 0.018), with inconclusive findings for internalizing symptoms (IC = 7.7% [95%CI: -2.2% to 17.7%; P = 0.097]). CONCLUSIONS There is possible, but inconclusive, superadditivity between vaping and mental health in risk of smoking initiation among young adults in the United States.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Dae-Hee Han
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Sandrah P. Eckel
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Rob McConnell
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Adam M. Leventhal
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
| | - Jessica L. Barrington-Trimis
- University of Southern California, Department of Population and Public Health Sciences, Institute for Addiction Science, Los Angeles, CA, USA
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Bataineh BS, Wilkinson AV, Sumbe A, Clendennen SL, Chen B, Messiah SE, Harrell MB. Depressive symptoms and the age of initiation of tobacco and marijuana use among adolescents and young adults. Drug Alcohol Depend 2023; 252:110971. [PMID: 37757647 DOI: 10.1016/j.drugalcdep.2023.110971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Studies have demonstrated important associations between depressive symptoms and tobacco and marijuana use. However, to date, it is unknown if depressive symptoms predispose youth to tobacco and marijuana use at earlier ages over time. METHODS Data from the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) for the years 2019-2021 (Waves 9-14) were used. Eligible samples include individuals who had never used cigarette (n=1776), e-cigarette (n=1353), or marijuana (n=1505) at basline and had complete data on covariates. Interval-censoring survival analysis was used to examine the differences in the estimated age of first use of cigarettes, e-cigarettes, and marijuana by depressive symptoms. RESULTS 10th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.45; 95% CI=1.02-2.04)], e-cigarette [AHR=1.65(1.27-2.15)], and marijuana [AHR=1.56(1.20-2.01)]. 12th-grade cohort participants with depressive symptoms had increased risk of earlier age of first use of cigarette [AHR=1.41(1.11-1.82), e-cigarette [AHR=1.35(1.10-1.87)] and marijuana [AHR=1.25(1.01-1.55)]. However, among the two-year post-high school cohort, depressive symptoms predicted the age of first use of marijuana only [AHR=1.34(1.13-1.60)]. Between ages 18-to-20 years, the estimated cumulative incidence of initiation almost doubled for all three products among depressive participants in 10th and 12th-grade cohorts. CONCLUSIONS Among 10th-grade, 12th-grade, and 2-year post-HS students, those with depressive symptoms initiate tobacco and marijuana use at earlier ages than peers without depressive symptoms. Early screening and management of depressive symptoms among adolescents and young adults may be a promising target for preventing or delaying the age of first use of substance use.
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Affiliation(s)
- Bara S Bataineh
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA.
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA
| | - Aslesha Sumbe
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA
| | - Stephanie L Clendennen
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA
| | - Baojiang Chen
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA; Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA; Department of Pediatrics, McGovern Medical School, Houston, TX USA
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston, School of Public Health, Austin, TX, USA
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21
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Zhang L, Ao SH, Zhao X. Longitudinal relationship between social media and e-cigarette use among adolescents: the roles of internalizing problems and academic performance. BMC Public Health 2023; 23:2133. [PMID: 37907896 PMCID: PMC10617229 DOI: 10.1186/s12889-023-17059-8] [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: 07/20/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Prior research has investigated the influence of social media on e-cigarette use among adolescents, predominantly through the display of e-cigarette content and advertisements. However, the psychological mechanism underlying this relationship remains underexplored. This study aims to address the mediating effect of youths internalizing problems and elucidate the moderating effect of academic performance from a longitudinal perspective. METHODS Panel data from the Public Assessment of Tobacco and Health (PATH) Study Waves 3-5 (2015-2019) were utilized in this study. The sample consisted of 3,975 youths between the ages of 12 and 17 years old. A moderated mediation model was utilized for analyses. RESULTS Adolescents using social media more frequently in Wave 3 reported higher odds of internalizing problems in Wave 4 (bp = 0.061, p < .01), which led to more e-cigarette use in Wave 5 (bp = 0.029, p < .01). A negative moderating effect of academic performance was found in the association between internalizing problems and e-cigarette use (bp=-0.088, p < .05). CONCLUSIONS Frequent social media use among young individuals leads to an increase in e-cigarette use through enhanced internalizing problems. However, adolescents who perform well academically exhibit higher resistance to e-cigarette use. Based on our findings, we recommend that tailored anti-e-cigarette campaigns and mental health interventions be used to target frequent social media users and academically struggling adolescents to prevent adverse health outcomes.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China.
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22
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Bautista M, Mogul AS, Fowler CD. Beyond the label: current evidence and future directions for the interrelationship between electronic cigarettes and mental health. Front Psychiatry 2023; 14:1134079. [PMID: 37645635 PMCID: PMC10460914 DOI: 10.3389/fpsyt.2023.1134079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Electronic cigarette use has dramatically increased over the last decade. With this recent technological development and wide range of constituents in various products, putative adverse effects on the brain and body have been largely unexplored. Here, we review current evidence linking electronic nicotine cigarette use with potential health consequences and provide evidence supporting an association between drug use and depression in humans. We also examine the biological effects of individual constituents in electronic cigarette aerosols, which include labeled ingredients, such as propylene glycol, vegetable glycerin, nicotine, and flavorants, as well as unlabeled ingredients found in the aerosols, such as carbonyls and heavy metals. Lastly, we examine the effects of electronic cigarette use on endogenous metabolism via changes in cytochrome P450 enzymes, which can thereby impact therapeutic outcomes. While the current evidence offers insight into the potential effects of electronic cigarette use on biological processes, further studies are necessary to determine the long-term clinical relevance of aerosol inhalation.
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Affiliation(s)
| | | | - Christie D. Fowler
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
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23
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Lee B, Levy D, Seo DC. Underlying patterns of the co-occurrence of tobacco use and mental health among youth. J Behav Med 2023; 46:668-679. [PMID: 36637734 DOI: 10.1007/s10865-022-00386-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/12/2022] [Indexed: 01/14/2023]
Abstract
We aimed to examine how bidirectional relationships between mental health problems and tobacco use are formed over time by types of tobacco use in recent samples of U.S. youth. Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (N = 10,082) and analyzed using cross-lagged panel models. A high level of internalizing problems at Wave 1 predicted conventional cigarette smoking (adjusted odds ratio [AOR] = 1.19, 95% CI = 1.06-1.34) and e-cigarette use (AOR = 1.25, 95% CI = 1.09-1.43) at Wave 2, but not vice versa. Both cigarette smoking and e-cigarette use at Wave 2 tended to persist into Wave 3, which, in turn, increased the risk of subsequent internalizing problems in late adolescence or young adulthood (Wave 4). The bidirectional relationship between tobacco use and internalizing problems seems to begin as a procession from internalizing problems to tobacco use, and then from persistent tobacco use to exacerbated internalizing problems over time.
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Affiliation(s)
- Boram Lee
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Douglas Levy
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Suite 116, 1025 E. 7th Street, Bloomington, IN, 47405-7109, USA.
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24
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Evans-Polce RJ, Schuler MS, Kcomt L, McCabe VV, McCabe SE. Sexual Identity Differences in Tobacco (Re)Uptake: Testing Mediation by Internalizing and Externalizing Symptoms. Am J Prev Med 2023; 64:824-833. [PMID: 36774307 PMCID: PMC10583217 DOI: 10.1016/j.amepre.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Tobacco use among gay, lesbian, and bisexual individuals is disproportionately higher than among heterosexual individuals. Identifying the mechanisms behind these differences can inform prevention and cessation efforts aimed at advancing health equity. Internalizing and externalizing symptoms as mediators of tobacco (re)uptake among sexual minority individuals was examined. METHODS Waves 4 and 5 of the Population Assessment of Tobacco and Health (2016-2019) study were analyzed in 2022. Adolescents aged ≥14 and adults years not using tobacco at Wave 4 (n=21,676) were included. Wave 4 sexual identity was categorized as heterosexual, gay/lesbian, bisexual, or something else. Associations of sexual identity with (re)uptake of cigarette use, E-cigarette use, and polytobacco use at Wave 5 were assessed, along with possible mediation of these associations by Wave 4‒internalizing and ‒externalizing symptoms. RESULTS Internalizing and externalizing symptoms predicted tobacco (re)uptake regardless of sexual identity, particularly for female individuals. Gay/lesbian females (AOR=2.26; 95% CI=1.14, 4.48) and bisexual females (AOR=1.36; 95% CI=1.06, 1.74) had greater odds of E-cigarette (re)uptake than heterosexual females. High internalizing and externalizing symptoms accounted for over one third of the difference in E-cigarette (re)uptake among bisexual compared with that among heterosexual females. Males who reported sexual identity as something-else had lower odds of cigarette (re)uptake than heterosexual males (AOR=0.19; 95% CI=0.06, 0.66); this association was not mediated by internalizing and externalizing symptoms. CONCLUSIONS Internalizing and externalizing symptoms uniquely contribute to E-cigarette (re)uptake among bisexual females. Strategies that reduce sexual minority stressors and resulting psychological distress may help to reduce tobacco use disparities.
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Affiliation(s)
- Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI
| | | | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI
- School of Social Work, Wayne State University, Detroit, MI
| | - Vita V. McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Injury Prevention Center University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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25
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Atuegwu NC, Mortensen EM, Krishnan-Sarin S, Laubenbacher RC, Litt MD. Prospective predictors of electronic nicotine delivery system initiation in tobacco naive young adults: A machine learning approach. Prev Med Rep 2023; 32:102148. [PMID: 36865398 PMCID: PMC9971268 DOI: 10.1016/j.pmedr.2023.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/11/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
The use of electronic nicotine delivery systems (ENDS) is increasing among young adults. However, there are few studies regarding predictors of ENDS initiation in tobacco-naive young adults. Identifying the risk and protective factors of ENDS initiation that are specific to tobacco-naive young adults will enable the creation of targeted policies and prevention programs. This study used machine learning (ML) to create predictive models, identify risk and protective factors for ENDS initiation for tobacco-naive young adults, and the relationship between these predictors and the prediction of ENDS initiation. We used nationally representative data of tobacco-naive young adults in the U.S drawn from the Population Assessment of Tobacco and Health (PATH) longitudinal cohort survey. Respondents were young adults (18-24 years) who had never used any tobacco products in Wave 4 and who completed Waves 4 and 5 interviews. ML techniques were used to create models and determine predictors at 1-year follow-up from Wave 4 data. Among the 2,746 tobacco-naive young adults at baseline, 309 initiated ENDS use at 1-year follow-up. The top five prospective predictors of ENDS initiation were susceptibility to ENDS, increased days of physical exercise specifically designed to strengthen muscles, frequency of social media use, marijuana use and susceptibility to cigarettes. This study identified previously unreported and emerging predictors of ENDS initiation that warrant further investigation and provided comprehensive information on the predictors of ENDS initiation. Furthermore, this study showed that ML is a promising technique that can aid ENDS monitoring and prevention programs.
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Affiliation(s)
- Nkiruka C. Atuegwu
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Corresponding author at: University of Connecticut, Department of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Eric M. Mortensen
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA
| | - Reinhard C. Laubenbacher
- Laboratory for Systems Medicine, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Mark D. Litt
- Division of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington, CT 06030, USA
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26
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Han DH, Elam KK, Quinn PD, Huang C, Seo DC. Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults. Addiction 2023; 118:509-519. [PMID: 36367333 PMCID: PMC10098511 DOI: 10.1111/add.16082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
AIMS Most extant evidence has addressed between-person differences, short-term or cross-sectional associations of electronic nicotine delivery systems (ENDS) use with other substance use, the majority focusing on current rather than escalated use. The present study aimed to examine within-person changes in escalated ENDS use and their associations with individual and combined substance use over a 6-year period. DESIGN, SETTING AND PARTICIPANTS This study used a longitudinal cohort design with US young adults. A generalized linear mixed-model approach was employed to fit a series of weighted logistic regression models. Data were drawn from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) study in the United States. Of the 9110 young adults at baseline, aged 18-24 years, a total of 5042 individuals had matched data across all five waves of assessments. MEASUREMENTS Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave w - 1 from that at wave w and coded as 1 = escalated, if the value was greater than zero (otherwise, coded as 0 = not escalated). FINDINGS Escalated ENDS use gradually decreased over time, with the lowest prevalence at wave 4 (4.0%) but sharply increasing at wave 5 (8.4%). Escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use (Ps < 0.05). In addition, sweet/fruit flavor use (versus menthol/mint) was associated with increased likelihood of reporting co-use of cigarettes and marijuana. CONCLUSIONS In the United States, the prevalence of young adults using electronic nicotine delivery systems appears to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years. Escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.
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Affiliation(s)
- Dae-Hee Han
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kit K Elam
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Patrick D Quinn
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Chunfeng Huang
- Department of Statistics, Indiana University, Bloomington, IN, USA
| | - Dong-Chul Seo
- School of Public Health, Indiana University, Bloomington, IN, USA
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27
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Romm KF, Turiano NA, Milstred AR, Bray BC, Dino G, Doogan N, Blank MD. Socioecological Predictors of Change in Adolescent Tobacco Use Across Waves 1-4 of the Population Assessment of Tobacco and Health Study. J Adolesc Health 2023; 72:375-382. [PMID: 36528513 PMCID: PMC10868139 DOI: 10.1016/j.jadohealth.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite decreases in adolescents' cigarette use over the past decade, overall rates of adolescent tobacco use have increased. Research examining adolescents' changes across a range of tobacco products reflective of the current market, as well as multilevel predictors of use trajectories is needed. METHODS Data derive from Waves 1-4 (W1-4; 2013-2018) of the Population Assessment of Tobacco and Health (PATH) study. Participants included 975 adolescents who used ≥1 tobacco product (cigarettes, electronic cigarettes [ECIGs], traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco [SLT], hookah) at any wave (W1 Mage = 13.29 [0.86], 54.2% male; 54.5% White, 25.9% Hispanic). RESULTS Utilizing latent growth curve modeling (separate models per product), adolescents displayed increases in their past 30-day use of all tobacco products from W1-4. Greater W1 use was predicted by identifying as non-Hispanic (cigarettes); lower parent education (SLT); greater externalizing problems (cigarillos); greater motives (all products except cigarillos); greater youth-reported household smoking rules (cigarillos); and greater isolation (ECIGs). More use across time (i.e., higher slope) was predicted by older age (cigarettes); identifying as male (ECIGs, SLT), Black (vs. White; cigarillos), White (vs. Black, Hispanic; ECIGs, SLT); fewer externalizing problems (SLT); fewer motives (ECIGs); fewer youth-reported rules (cigarillos, SLT); and greater geographic isolation (cigarettes, SLT). DISCUSSION Although some individual-level factors (i.e., motives, externalizing problems) predicted greater W1 use (i.e., intercept) only, interpersonal- (parent rules) and community-level (geographic isolation) factors were associated with changes in use over time (i.e., slope). Intervention efforts may address such factors to reduce adolescents' escalations in 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; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Nicholas A Turiano
- Department of Psychology, West Virginia University, Morgantown, West Virginia; West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Andrea R Milstred
- Department of Psychology, West Virginia University, Morgantown, West Virginia
| | - Bethany C Bray
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Geri Dino
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Nathan Doogan
- Ohio State University, Government Resources Center, Columbus, Ohio
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia; West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
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28
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Clendennen SL, Smith J, Sumbe A, Chen B, Wilkinson AV, Harrell MB. Symptoms of Depression and Anxiety and Subsequent Use of Nicotine and THC in Electronic Cigarettes. Subst Use Misuse 2023; 58:591-600. [PMID: 36912516 PMCID: PMC10155290 DOI: 10.1080/10826084.2023.2177110] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes. METHODS Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES. RESULTS Participants were 16-23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later. CONCLUSIONS Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.
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Affiliation(s)
- Stephanie L. Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Jacob Smith
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
- The University of Texas Rio Grande Valley School of Medicine, 1201 West University Dr., Edinburg, Texas 78541, USA
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Baojiang Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Anna V. Wilkinson
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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29
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Luca AC, Curpăn AȘ, Iordache AC, Mîndru DE, Țarcă E, Luca FA, Pădureț IA. Cardiotoxicity of Electronic Cigarettes and Heat-Not-Burn Tobacco Products-A Problem for the Modern Pediatric Cardiologist. Healthcare (Basel) 2023; 11:healthcare11040491. [PMID: 36833024 PMCID: PMC9957306 DOI: 10.3390/healthcare11040491] [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: 12/15/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
Electronic nicotine delivery systems (ENDS) have become increasingly popular among adolescents, either as an alternative to conventional cigarettes (CCs) or as a newly acquired recreational habit. Although considered by most users as a safer option for nicotine intake, these devices pose significant health risks, resulting in multisystem damage. Heat-not-burn products, which, unlike ENDS, contain tobacco, are also alternatives to CCs that consumers use based on the idea that their safety profile is superior to that of cigarettes. Recent studies in the USA and EU show that adolescents are particularly prone to using these devices. Pediatric cardiologists, as well as other healthcare professionals, should be aware of the complications that may arise from acute and chronic consumption of these substances, considering the cardiovascular damage they elicit. This article summarized the known data about the impact of ENDS on the cardiovascular system, with emphasis on the pathophysiological and molecular changes that herald the onset of systemic lesions alongside the clinical cardiovascular manifestations in this scenario.
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Affiliation(s)
- Alina-Costina Luca
- Sfânta Maria’ Emergency Children’s Hospital, 700309 Iași, Romania
- Department of Pediatric Cardiology, Faculty of Medicine, Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Alexandrina-Ștefania Curpăn
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University of Iași, Bd. Carol I, 20A, 700505 Iași, Romania
- Correspondence: (A.-Ș.C.); (E.Ț.)
| | - Alin-Constantin Iordache
- Department of Mother and Child Medicine–Pediatric Cardiology, “Grigore T. Popa”, University of Medicine and Pharmacy of Iasi, 16 Universitatii Str., 700115 Iași, Romania
| | - Dana Elena Mîndru
- Department of Pediatric Cardiology, Faculty of Medicine, Gr. T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Elena Țarcă
- Sfânta Maria’ Emergency Children’s Hospital, 700309 Iași, Romania
- Department of Surgery II—Pediatric Surgery, Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence: (A.-Ș.C.); (E.Ț.)
| | - Florin-Alexandru Luca
- Department BMTM, “Gheorghe Asachi” Technical University of Iasi, 700050 Iaşi, Romania
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Harlow AF, Stokes AC, Brooks DR, Benjamin EJ, Leventhal AM, McConnell RS, Barrington‐Trimis JL, Ross CS. Prospective association between e-cigarette use frequency patterns and cigarette smoking abstinence among adult cigarette smokers in the United States. Addiction 2022; 117:3129-3139. [PMID: 35913015 PMCID: PMC9804676 DOI: 10.1111/add.16009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
AIMS To estimate the association of longitudinal patterns of e-cigarette use with cigarette smoking abstinence, after accounting for time-dependent confounding and selection bias. DESIGN Secondary analysis of longitudinal national cohort data. Using marginal structural models and four waves of the population assessment of tobacco and health (wave 1, 2013-14; wave 2, 2014-15; wave 3, 2015-16; wave 4, 2016-18), we estimated the association of vaping frequency across waves 2 and 3 with 12-month sustained cigarette smoking abstinence at wave 4, adjusting for time-dependent confounders at waves 1 and 2 and selection bias due to drop-out with inverse probability of treatment and censoring weights. SETTING United States. PARTICIPANTS/CASES A total of 5699 adults (18+ years) who smoked cigarettes and did not vape at wave 1. MEASUREMENTS The exposure was vaping frequency at waves 2 and 3 (non-use, non-daily use, daily use), representing nine possible combinations of vaping frequency across two waves. Non-use at both waves was the exposure reference group. The primary outcome was sustained 12-month cigarette smoking abstinence at wave 4. FINDINGS Among 5699 adults who smoked cigarettes at wave 1, a total of 560 (9.8%) reported smoking abstinence at wave 4. Compared with nonuse at both waves, daily vaping at both waves [risk ratio (RR) = 3.82, 95% confidence interval (CI) = 2.59-5.64] and non-use at wave 2 followed by daily vaping at wave 3 (RR = 2.50, 95% CI = 1.66-3.77) were positively associated with smoking abstinence; non-daily vaping at both waves was inversely associated with smoking abstinence (RR = 0.28, 95% CI = 0.11-0.75). Results persisted after accounting for misclassification of e-cigarette use and cigarette smoking abstinence and after restricting to participants with plans to quit smoking. CONCLUSIONS In a US cohort of adult smokers, longitudinal patterns of vaping frequency appear to predict smoking abstinence, even after accounting for several sources of systematic error. Consistent daily vaping is associated with increased chances of cigarette smoking abstinence, while consistent non-daily vaping is associated with decreased chances of smoking abstinence.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA,Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Andrew C. Stokes
- Department of Global HealthBoston University School of Public HealthBostonMAUSA
| | - Daniel R. Brooks
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
| | - Emelia J. Benjamin
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA,Department of MedicineBoston University School of Medicine and Boston Medical CenterBostonMAUSA
| | - Adam M. Leventhal
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Rob S. McConnell
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Jessica L. Barrington‐Trimis
- University of Southern California, Department of Population and Public Health SciencesInstitute for Addiction ScienceLos AngelesCAUSA
| | - Craig S. Ross
- Department of EpidemiologyBoston University School of Public HealthBostonMAUSA
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31
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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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E-cigarette use among high school students in the United States prior to the COVID-19 pandemic: Trends, correlates, and sources of acquisition. Prev Med Rep 2022; 29:101925. [PMID: 35911577 PMCID: PMC9326337 DOI: 10.1016/j.pmedr.2022.101925] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022] Open
Abstract
Frequent e-cigarette use, a pattern depicting greater nicotine dependence, has increased among youth. An increasing proportion of youth tobacco users are making quit attempts. The sources of e-cigarettes among youth are changing; hence continued surveillance is needed.
Detailed description of the prevalence and sources of e-cigarettes among youth is needed to inform effective regulatory policies. We used the Youth Risk Behavior Surveillance System data (2015–2019) to assess trends in current (past-30-day-use) and frequent (≥10 days in past-30-days) e-cigarette use among United States high schoolers before the COVID-19 pandemic. First, we assessed trends overall and then stratified by participants’ sociodemographic characteristics, use of other tobacco products, and experiences of psychosocial stress. We also evaluated past year quit attempts and the changing sources of e-cigarettes. Our sample size was 41,021 (15,356–2015; 12,873–2017; 12,792–2019). The prevalence of current e-cigarette use increased from 24.0% (95%CI:21.9%–26.3%) in 2015 to 32.7% (30.4%–35.1%) in 2019. The proportion of current users who reported frequent use also increased significantly from 22.6% (20.4%–24.8%) to 45.4% (42.7%–48.2%). Thus, an increasing proportion of US high school students who use e-cigarettes reported frequent use, indicating greater nicotine dependence. The increase in current and frequent e-cigarette use was more pronounced in youth who reported other substance use and psychosocial stressors such as bullying. Between 2017 and 2019, there was a decline in the proportion of youth who bought e-cigarettes online (6.9% to 3.2%) or from convenience stores (22.0% to 16.6%). Conversely, there was an increase in the proportion who borrowed (34.5% to 40.1%) or purchased e-cigarettes through other people (10.7% to 18.0%), indicating that most youth are evading age-related restrictions by obtaining e-cigarettes from other people. Finally, a considerable proportion of youth tobacco users are making quit attempts; 47.6% (45.1%–50.1%) in 2019.
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Nguyen HV, Mital S. Effects of e-cigarette use on mental health among youths: quasi-experimental evidence from Canada. Addiction 2022; 117:2673-2682. [PMID: 35545859 DOI: 10.1111/add.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/19/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Existing research on mental health comorbidities of youth e-cigarette use is subject to confounding bias and reverse causality. This study aimed to measure the effects of e-cigarette use on youth mental health, using e-cigarette minimum legal age (MLA) law in Canada as a natural experiment. DESIGN We used difference-in-differences (DD), difference-in-differences-in-differences (DDD) and two-sample instrumental variables (TSIV) methods. SETTING Data were from nationally representative Canadian Community Health Surveys 2008-2019 and Canadian Student Tobacco Alcohol and Drugs Surveys 2008-2019. PARTICIPANTS The study sample comprised of respondents aged 15 to 18 (in DD analysis; n = 33 858) and aged 15 to 24 (in DDD analysis; n = 78 689). MEASUREMENTS Primary outcomes were self-reported mood disorders and anxiety disorders. Secondary outcomes were cannabis use, illicit drug use, cigarette use and strength of peer relationships at schools. FINDINGS After the e-cigarette MLA laws, risks of mood disorders declined by 1.9 percentage points (95% CI, 0.0-3.8; P = 0.05) in the DD analysis and by 2.6 percentage points (95% CI, 0.2-5.0; P = 0.03) in the DDD analysis. For anxiety disorders, while the DD estimate was negative but imprecisely estimated, the MLA law reduced risks of anxiety disorder by 3.6 percentage points (95% CI, 0.9-6.2; P = 0.01) in the DDD analysis. Youths in provinces with MLA laws were also less likely to report cannabis use and illicit drug use and more likely to feel being part of schools. TSIV analysis indicates that youth e-cigarette use increased the likelihood of mood and anxiety disorders by 44% and 37%, respectively. CONCLUSION AND RELEVANCE In Canada, the e-cigarette minimum legal age law appears to have reduced risks of mood and anxiety disorders, lowered substance use and improved peer relationships at schools. Combined with previous evidence of lower e-cigarette use following the minimum legal age law, our findings indicate that youth e-cigarette use increases risks of mood and anxiety disorders.
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Affiliation(s)
- Hai V Nguyen
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada
| | - Shweta Mital
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Canada
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Cambron C. E-Cigarette Use Is Associated with Increased Psychological Distress among Youth: A Pooled Cross-Sectional Analysis of State-Level Data from 2019 and 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811726. [PMID: 36142001 PMCID: PMC9516976 DOI: 10.3390/ijerph191811726] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 05/27/2023]
Abstract
A crisis of worsening youth mental health in recent years across the United States has created alarm among health professionals. As a result, health professionals have sought to improve methods of identifying youth in need of treatment services. Cigarette, cannabis, and alcohol use each consistently serve as behavioral markers of risk for youth mental health problems. Despite the recent growth of electronic cigarette (e-cigarette) use among youth, few studies have examined whether e-cigarettes follow the same associational pattern with mental health problems in the context of other substance use. Additionally, the COVID-19 pandemic may have altered the associations between youth substance use and mental health problems due to both reduced overall use and increased mental health problems after the onset of the pandemic. The current study examined associations between youth substance use and psychological distress before and after the onset of the COVID-19 pandemic using two state-representative samples of youth in grades 8, 10, and 12 from 2019 (N = 58,689) and 2021 (N = 46,823) from Utah. Pooled cross-sectional linear and negative binomial regression models clustered by grade, stratified by school district, and weighted to represent population characteristics estimated associations between recent e-cigarette, combustible cigarette, cannabis, and heavy alcohol use and two measures of psychological distress-depressive symptoms and mental health treatment needs. After controlling for sociodemographic factors and recent uses of other substances, results indicated that psychological distress increased from 2019 to 2021 and that recent e-cigarette, combustible cigarette, cannabis, and heavy alcohol use were each significantly associated with increased levels on both measures of psychological distress. Compared to other substances, e-cigarette use showed the strongest standardized associations. The association of e-cigarette use with depressive symptoms strengthened significantly from 2019 to 2021. Given the youth mental health crisis paired with the widespread adoption of e-cigarettes, health professionals should consider recent e-cigarette use an increasingly important behavioral marker for risks of mental health problems among youth. Results suggest that future research studies examining the temporal ordering of substance use and mental health among youth should include e-cigarettes.
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McBrayer K, Ouyang F, Adams Z, Hulvershorn L, Aalsma MC. Rates of Tobacco Use Disorder, Pharmacologic Treatment, and Associated Mental Health Disorders in a Medicaid Claim Review Among Youth in Indiana, USA. Tob Use Insights 2022; 15:1179173X221119133. [PMID: 36052177 PMCID: PMC9424880 DOI: 10.1177/1179173x221119133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose This study delineates a number of Medicaid youth with tobacco use disorder (TUD), prescribing habits for treatment, and associated externalizing disorders. Methods Youth Medicaid claims from 2007-2017 processed in a large Midwestern city were analyzed for a diagnosis of TUD, related pharmacotherapy, and externalizing mental health and substance use disorders. Results Claims connected 6541 patients with 42 890 visits. Mean age was 16.4 with 40% female. 1232 of the 6541 charts contained a TUD diagnosis equating to 1848 visits. A comorbid diagnosis of ADHD, cannabis use, and conduct disorder were more common in males (3.9% vs 1.3% in females; 3.4% vs .8%; and 2.8% vs .8%; P < .05). 808 scripts were provided to 152 of the 1232 youths, with 4.7% of those scripts a nicotine replacement product. Conclusions Pharmacotherapy is underutilized in this Medicaid claims data set. Certain externalizing factors were associated with males with TUD more than females.
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Affiliation(s)
- Kimberly McBrayer
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fangqian Ouyang
- Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Zachary Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matthew C Aalsma
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Xie Z, Cartujano-Barrera F, Cupertino P, Li D. Cross-Sectional Associations of Self-Reported Social/Emotional Support and Life Satisfaction with Smoking and Vaping Status in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10722. [PMID: 36078438 PMCID: PMC9517882 DOI: 10.3390/ijerph191710722] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to examine the cross-sectional association of self-reported social/emotional support and life satisfaction with smoking/vaping status in US adults. The study included 47,163 adult participants who self-reported social/emotional support, life satisfaction, and smoking/vaping status in the 2016 and 2017 BRFSS national survey data. We used multivariable weighted logistic regression models to measure the cross-sectional association of self-reported social/emotional support and life satisfaction with smoking/vaping status. Compared to never users, dual users and exclusive smokers were more likely to have low life satisfaction, with an adjusted odds ratio (aOR) = 1.770 (95% confidence interval [CI]: 1.135, 2.760) and an aOR = 1.452 (95% CI: 1.121, 1.880) respectively, especially for the age group 18-34. Exclusive cigarette smokers were more likely to have low life satisfaction compared to ex-smokers (aOR = 1.416, 95% CI: 1.095, 1.831). Exclusive cigarette smokers were more likely to have low social/emotional support (aOR = 1.193, 95% CI: 1.030, 1.381) than never users, especially those aged 65 and above. In addition, exclusive cigarette smokers were more likely to have low social/emotional support than ex-smokers, with an aOR = 1.279 (95% CI: 1.097, 1.492), which is more pronounced among the age group 18-34, as well as 65 and above. Our results suggest that life satisfaction and social/emotional support may play important roles in smoking and vaping, which should be incorporated into behavioral interventions to reduce tobacco use.
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Affiliation(s)
- Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences and Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Paula Cupertino
- Department of Public Health Sciences and Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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Pérez A, Bluestein MA, Kuk AE, Chen B, Harrell MB. Internalizing and externalizing problems on the age of e-cigarette initiation in youth: Findings from the Population Assessment of Tobacco and Health (PATH), 2013-2017. Prev Med 2022; 161:107111. [PMID: 35716810 PMCID: PMC10234265 DOI: 10.1016/j.ypmed.2022.107111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/19/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022]
Abstract
Previous research has established an association between internalizing and externalizing problems with e-cigarette use in youth. Secondary analysis of Population Assessment of Tobacco and Health youth waves 1-4(2013-2017). Age of initiation of ever e-cigarette use and age of first report of past 30-day e-cigarette use were prospectively estimated among never e-cigarette users(waves 1-3). Weighted interval-censoring multivariable Cox proportional hazard models were fit to assess differences in each e-cigarette outcome among youth with internalizing and externalizing problems, as well as the interaction between internalizing and externalizing problems, while adjusting for covariates. Weighted interval-censoring survival analyses estimated the age of initiation of ever and age of first report of past 30-day e-cigarette use stratified by internalizing and externalizing problems. Among youth never e-cigarette users, those with high internalizing problems and high externalizing problems had increased risk of initiating ever e-cigarette use at earlier ages compared to youth with none/low internalizing and externalizing problems, respectively. Youth with high internalizing problems and high externalizing problems had increased risk of first reporting past 30-day e-cigarette use at earlier ages compared to youth with none/low internalizing problems, respectively. By age 17, 36.3% of youth with high internalizing problems and 38.5% of youth with high externalizing problems initiated ever e-cigarette use. By age 17, 16.8% of youth with high internalizing and 18.7% of youth with high externalizing problems first reported past 30-day e-cigarette use. Youth with internalizing and externalizing problems should be screened for e-cigarette use and provided with proper resources to prevent onset of e-cigarette use.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States; Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States.
| | - Meagan A Bluestein
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Arnold E Kuk
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Baojiang Chen
- Department of Biostatistics and Data Science, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States; Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Melissa B Harrell
- Michael & Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States; Department of Epidemiology, Human Genetics and Environmental Sciences, the University of Texas Health Science Center at Houston (UTHealth), School of Public Health in Austin Campus, Austin, TX, United States
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Harlow AF, Stokes AC, Brooks DR, Benjamin EJ, Barrington-Trimis JL, Ross CS. e-Cigarette Use and Combustible Cigarette Smoking Initiation Among Youth: Accounting for Time-Varying Exposure and Time-Dependent Confounding. Epidemiology 2022; 33:523-532. [PMID: 35394965 PMCID: PMC9156560 DOI: 10.1097/ede.0000000000001491] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Youth e-cigarette use is associated with the initiation of combustible cigarette smoking, but prior studies have rarely accounted for time-varying measures of e-cigarette exposure or time-dependent confounding of e-cigarette use and smoking initiation. METHODS Using five waves of the Population Assessment of Tobacco and Health (2013-2019), we estimated marginal structural models with inverse probability of treatment and censoring weights to examine the association between time-varying e-cigarette initiation and subsequent cigarette smoking initiation among e-cigarette- and cigarette-naïve youth (12-17 years) at baseline. Time-dependent confounders used as predictors in inverse probability weights included tobacco-related attitudes or beliefs, mental health symptoms, substance use, and tobacco-marketing exposure. RESULTS Among 9,584 youth at baseline, those who initiated e-cigarettes were 2.4 times as likely to subsequently initiate cigarette smoking as youth who did not initiate e-cigarettes (risk ratio = 2.4, 95% confidence interval [CI] = 2.1, 2.7), after accounting for time-dependent confounding and selection bias. Among youth who initiated e-cigarettes, more frequent vaping was associated with greater risk of smoking initiation (risk ratio ≥3 days/month = 1.8, 95% CI = 1.4, 2.2; 1-2 days/month = 1.2; 95% CI = 0.93, 1.6 vs. 0 days/month). Weighted marginal structural model estimates were moderately attenuated compared with unweighted estimates adjusted for baseline-only confounders. At the US population level, we estimated over half a million youth initiated cigarette smoking because of prior e-cigarette use over follow-up. CONCLUSIONS The association between youth vaping and combustible cigarette smoking persisted after accounting for time-dependent confounding. We estimate that e-cigarette use accounts for a considerable share of cigarette initiation among US youth. See video abstract at, http://links.lww.com/EDE/B937.
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Affiliation(s)
- Alyssa F. Harlow
- University of Southern California, Department of Population and Public Health Sciences, Los Angeles, CA
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Andrew C. Stokes
- Boston University School of Public Health, Department of Global Health, Boston, MA
| | - Daniel R. Brooks
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
| | - Emelia J. Benjamin
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
- Boston University School of Medicine, Department of Medicine, Boston, MA
| | | | - Craig S. Ross
- Boston University School of Public Health, Department of Epidemiology, Boston, MA
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Farooqui M, Shoaib S, Afaq H, Quadri S, Zaina F, Baig A, Liaquat A, Sarwar Z, Zafar A, Younus S. Bidirectionality of smoking and depression in adolescents: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210429. [PMID: 35738567 PMCID: PMC10416256 DOI: 10.47626/2237-6089-2021-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. METHODS A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. RESULTS The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. CONCLUSION The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.
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Affiliation(s)
- Mudassir Farooqui
- Department of NeurologyUniversity of IowaHospitals and ClinicsIowa CityIAUSA Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - Samra Shoaib
- Department of PsychiatryNassau UniversityMedical CenterEast MeadowNYUSA Department of Psychiatry, Nassau University Medical Center, East Meadow, NY, USA.
| | - Humera Afaq
- Department of Public HealthNational UniversitySan DiegoCAUSA Department of Public Health, National University, San Diego, CA, USA.
| | - Syed Quadri
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Fatima Zaina
- Department of PulmonologyZiauddin University and HospitalKarachiPakistan Department of Pulmonology, Ziauddin University and Hospital, Karachi, Pakistan.
| | - Aqsa Baig
- Liaquat National HospitalMedical CollegeKarachiPakistan Liaquat National Hospital & Medical College, Karachi, Pakistan.
| | - Ayesha Liaquat
- Karachi Medical and Dental CollegeKarachiPakistan Karachi Medical and Dental College, Karachi, Pakistan.
| | - Zoona Sarwar
- Department of SurgeryUniversity of OklahomaOklahoma CityOKUSA Department of Surgery, University of Oklahoma, Oklahoma City, OK, USA.
| | - Atif Zafar
- Department of NeurologyUniversity of TorontoTorontoONCanada Department of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Sana Younus
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTXUSA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Farrell KR, Weitzman M, Karey E, Lai TKY, Gordon T, Xu S. Passive exposure to e-cigarette emissions is associated with worsened mental health. BMC Public Health 2022; 22:1138. [PMID: 35672813 PMCID: PMC9172130 DOI: 10.1186/s12889-022-13470-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/12/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Cigarette smoking, secondhand cigarette smoke (SHS) exposure, and e-cigarette use ("vaping") are each associated with increased rates of depressive symptoms and other internalizing mental health disorders. The prevalence of vaping has increased greatly, yet the mental health correlates of secondhand exposure to e-cigarette emissions are as yet to be investigated. This study examined the potential adverse mental health outcomes associated with different tobacco exposures (direct and passive), with a particular focus on the mental health correlates of secondhand exposure to e-cigarette emissions. METHODS The Population Assessment of Tobacco and Health Study data collected from a sample of 16,173 Wave 4 adults were used to test the hypothesis that secondhand e-cigarette emissions exposure is associated with increased odds of internalizing mental health disorders. Individuals were categorized as exclusive cigarette smokers, exclusive e-cigarette users, cigarette and e-cigarette dual users, exclusive noncombustible tobacco users, secondhand smoke exposed non-users, secondhand e-cigarette emissions exposed non-users, and non-users with no current SHS/secondhand e-cigarette aerosol exposure. Adjusted weighted logistic regression analysis was used to investigate the association between exposure type and internalizing problems as assessed by scores on the Global Appraisal of Individual Needs-Short Screener (GAIN-SS), a widely used instrument for assessing mental health problems. RESULTS Cigarette smokers (AOR = 2.53, 95% CI: 2.19-2.92), e-cigarette users (AOR = 3.14, 2.41-4.09), dual users (AOR = 3.37, 2.85-4.00), noncombustible tobacco users (AOR = 1.48, 1.01-2.17), SHS exposed non-users (AOR = 1.63, 1.37-1.94), and secondhand e-cigarette emissions exposed non-users (AOR = 1.43, 1.03-1.99) were each associated with increased odds of moderate to severe internalizing mental health problems as compared to unexposed non-users. Odds of internalizing problems among SHS and secondhand e-cigarette emissions exposed non-users did not differ (p = 0.46). CONCLUSIONS This is the first study, to our knowledge, to identify an association between recent secondhand exposure to e-cigarette emissions and mental health problems, and the risk is comparable to that of SHS. Corroboration of this relationship needs further research to explicate directionality and mechanisms underlying this association.
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Affiliation(s)
- Kayla Rae Farrell
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010 USA
| | - Michael Weitzman
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010 USA
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY 10003 USA
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016 USA
| | - Emma Karey
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010 USA
| | - Teresa K. Y. Lai
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY 10003 USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010 USA
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY 10003 USA
| | - Shu Xu
- Department of Biostatistics, New York University School of Global Public Health, 708 Broadway, 7th floor - Rm 761, New York, NY 10003 USA
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Kaliamurthy S, Camenga DR. Clinical approach to the treatment of e-cigarette use among adolescents. Curr Probl Pediatr Adolesc Health Care 2022; 52:101203. [PMID: 35534404 DOI: 10.1016/j.cppeds.2022.101203] [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: 11/29/2022]
Abstract
E-cigarette use remains a serious public health threat for adolescents in the United States. Pediatric providers can intervene early to prevent the adverse, and sometimes life-long, health consequences of e-cigarette use. This article reviews the clinical management of e-cigarette use among adolescents using the "Ask-Counsel-Treat" model. This model was recently introduced by the American Academy of Pediatrics to help pediatric healthcare providers manage e-cigarette screening, counseling, and treatment. Behavioral treatments for e-cigarette cessation can be delivered via multiple formats, including via text, in-person, or online. Additionally, pediatric healthcare providers may consider the off-label use of nicotine replacement therapy in individuals less than 18 years of age to alleviate some of the symptoms of nicotine withdrawal. Further research is needed to inform the design and implementation of effective e-cigarette cessation strategies for adolescents.
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Affiliation(s)
- Sivabalaji Kaliamurthy
- Children's National Hospital, Washington, DC, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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Gaiha SM, Lin C, Lempert LK, Halpern-Felsher B. Use Patterns, Flavors, Brands, and Ingredients of Nonnicotine e-Cigarettes Among Adolescents, Young Adults, and Adults in the United States. JAMA Netw Open 2022; 5:e2216194. [PMID: 35612852 PMCID: PMC9133942 DOI: 10.1001/jamanetworkopen.2022.16194] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Nonnicotine e-cigarettes contain chemicals, flavorants, and solvents that have known health harms and/or have not been proven safe for inhalation. OBJECTIVE To evaluate nonnicotine e-cigarette use patterns, including common flavors, brands, and ingredients. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included a convenience sample of US residents aged 13 to 40 years who completed an online survey in November and December 2021. Quota sampling was used for an equal proportion of participants aged 13 to 17 years, 18 to 20 years, and 21 to 40 years, balanced for sex, race, and ethnicity per the latest US Census. MAIN OUTCOMES AND MEASURES Nonnicotine e-cigarette use (ever, past 30- and past 7-day, number of times used, time taken to finish); co-use with nicotine e-cigarettes; age at first try; and flavors, brands, and ingredients used. RESULTS Overall, 6131 participants (mean [SD] age, 21.9 [6.8] years; range, 13-40 years; 3454 [56.3%] identifying as female) completed the survey (55.1% completion rate). Among all participants, 1590 (25.9%) had ever used a nonnicotine e-cigarette, 1021 (16.7%) used one in the past 30 days, and 760 (12.4%) used one in the past 7 days. By age group, 227 of 1630 participants aged 13 to 17 years (13.9%), 497 of 2033 participants aged 18 to 20 years (24.4%), 399 of 1041 participants aged 21 to 24 years (38.3%), and 467 of 1427 participants aged 25 to 40 years (32.7%) had ever used nonnicotine e-cigarettes. Among 1590 participants who had ever used a nonnicotine e-cigarette, 549 (34.5%) had used one more than 10 times; 1017 (63.9%) finished 1 nonnicotine e-cigarette in less than 1 week. Co-use of nonnicotine with nicotine e-cigarettes was reported by 1155 participants (18.8%), 1363 (22.2%) exclusively used nicotine e-cigarettes, and 431 (7.0%) exclusively used nonnicotine e-cigarettes. Most-used flavors were sweet, dessert, or candy (578 [36.3%]); fruit (532 [33.4%]); and mint or menthol (321 [20.2%]); similar flavor patterns were observed for the top 2 flavors among those who used nonnicotine e-cigarettes in the past 30 days, followed by combinations of coffee, alcohol, flower, plant, and mint or menthol flavors by age group. Participants most reported using tetrahydrocannabinol (587 [36.9%]), cannabidiol (537 [33.7%]), melatonin (438 [27.5%]), caffeine (428 [26.9%]), and essential oils (364 [22.9%]) in their nonnicotine e-cigarettes. CONCLUSIONS AND RELEVANCE In this study of adolescents, young adults, and adults, a sizeable proportion reported having used nonnicotine e-cigarettes and co-using them with nicotine e-cigarettes. Surveillance studies should further assess nonnicotine e-cigarette use patterns and regulations, and prevention should be developed to address youth appeal, unsubstantiated health claims, and possible health harms.
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Affiliation(s)
- Shivani Mathur Gaiha
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
| | - Crystal Lin
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
| | - Lauren Kass Lempert
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
| | - Bonnie Halpern-Felsher
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
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Duan Z, Wang Y, Weaver SR, Spears CA, Zheng P, Self-Brown SR, Eriksen MP, Huang J. Effect modification of legalizing recreational cannabis use on the association between e-cigarette use and future cannabis use among US adolescents. Drug Alcohol Depend 2022; 233:109260. [PMID: 35152099 PMCID: PMC8957562 DOI: 10.1016/j.drugalcdep.2021.109260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many states have legalized recreational cannabis use for adults. However, no study has examined how this policy may interact with youth vaping to influence cannabis use among US adolescents. This study investigates whether the association between baseline e-cigarette use and subsequent cannabis use differs by state recreational cannabis legalization status. METHODS This study analyzed data from the first four waves (2013-2018) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal survey. The study sample included adolescents (aged 12-17) who reported never used cannabis at baseline. Generalized estimating equations were used to analyze the effect modification of state recreational cannabis law on the association between baseline e-cigarette use and cannabis use at 12-month follow-up, controlling for individual characteristics. RESULTS Among adolescents who have never used cannabis at baseline, baseline past-30-day e-cigarette use was significantly associated with past-30-day cannabis use at 12-month follow-up (aOR=5.92, 95% CI: 3.52-9.95). This association was different by state recreational cannabis legalization status, as indicated by the significant interaction term. Subgroup analysis showed that the aOR was 18.39 (95% CI: 4.25-79.68) for adolescents living in states that legalized adult recreational cannabis use and 5.09 (95% CI: 2.86-9.07) for adolescents living in states without such laws. CONCLUSIONS E-cigarette use is associated with cannabis initiation among youth. This association is stronger among those living in states that legalized adult recreational cannabis use. Further examination of the impact of e-cigarette use on cannabis initiation in relation to state cannabis laws is warranted.
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Affiliation(s)
- Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Claire A. Spears
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Pinpin Zheng
- School of Public Health, Fudan University, Shanghai 200433, China
| | | | - Michael P. Eriksen
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA.
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Han DH, Seo DC. Identifying risk profiles for marijuana vaping among U.S. young adults by recreational marijuana legalization status: A machine learning approach. Drug Alcohol Depend 2022; 232:109330. [PMID: 35123363 DOI: 10.1016/j.drugalcdep.2022.109330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study attempted to identify risk profiles of marijuana vaping by state-level recreational marijuana legalization (RML) status among U.S. young adults (YA). METHODS Data were drawn from the most recent two waves of restricted use files of the Population Assessment of Tobacco and Health Study with state identifiers. We analyzed 6155 young adult (18-24 years) respondents who were naïve to marijuana vaping at Wave 4 and had matched data at Wave 5. We employed a two-stage machine learning approach to predict marijuana vaping initiation at Wave 5 with predictors measured at Wave 4. RESULTS Among YA who had never vaped marijuana at Wave 4, 19% of those who lived in the states with RML and 15% of those who lived in the states without RML reported marijuana vaping at Wave 5. Substance-use-related predictors were rarely found as leading predictors in the states with RML. In the states without RML, substance use behaviors, including electronic nicotine delivery systems and smokeless tobacco use, and the presence of externalizing symptoms emerged as predictors for marijuana vaping. Results also revealed that nonlinear interactions between the predictors of marijuana vaping. CONCLUSIONS Our results highlight the importance of accounting for the RML status in developing risk profiles of marijuana vaping. Externalizing symptoms may be a behavioral endophenotype of marijuana vaping in the states without RML. Machine learning appears to be a promising analytical approach to identify complex interactions between factors in predicting an emerging risk behavior such as marijuana vaping.
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Affiliation(s)
- Dae-Hee Han
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Dong-Chul Seo
- Indiana University School of Public Health, Bloomington, IN, USA.
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Duan Z, Wang Y, Spears CA, Self-Brown SR, Weaver SR, Zheng P, Eriksen MP, Huang J. Role of Mental Health in the Association Between E-Cigarettes and Cannabis Use. Am J Prev Med 2022; 62:307-316. [PMID: 34949509 PMCID: PMC8863617 DOI: 10.1016/j.amepre.2021.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/31/2021] [Accepted: 09/17/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION E-cigarette use may be associated prospectively with subsequent cannabis use among U.S. adolescents. However, it remains unclear whether this association differs by individual mental health status. This longitudinal study examines effect modifications by mental health status. METHODS The first 4 waves (2013-2017) of the Population Assessment of Tobacco and Health study were analyzed in 2020. Adolescents (aged 12-17 years) who reported never using cannabis at baseline waves were included. Waves 1-3 were each considered as baseline for their 12-month follow-up waves. Generalized estimating equations were used to evaluate the effect modification of internalizing mental health and externalizing mental health problems on the associations between baseline past 30-day e-cigarette use and past 30-day cannabis use at follow-up, controlling for individual characteristics and state recreational cannabis laws. RESULTS Baseline e-cigarette use was significantly associated with cannabis use at follow-up (AOR=4.81, 95% CI=2.93, 7.90). Adolescents with high severity of internalizing mental health/externalizing mental health problems were significantly more likely to initiate cannabis use. However, current e-cigarette users who reported high severity of internalizing mental health symptoms were less likely to initiate cannabis use (AOR=2.51, 95% CI=0.92, 6.83) than those who reported low severity of internalizing mental health problems (AOR=8.84, 95% CI=4.19, 18.65). There were no differences by the severity of externalizing mental health problems. CONCLUSIONS Baseline e-cigarette use and endorsement of severe internalizing mental health/externalizing mental health problems were significantly associated with subsequent cannabis use among U.S. adolescents. Efforts to reduce youth vaping and improve youth mental health could help curb cannabis initiation. Tailored interventions may be warranted for e-cigarette‒using adolescents with internalizing mental health problems.
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Yu Wang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Claire A Spears
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Shannon R Self-Brown
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Scott R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Michael P Eriksen
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Jidong Huang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia.
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Sociodemographic Factors Associated with Adolescents' and Young Adults' Susceptibility, Use, and Intended Future Use of Different E-Cigarette Devices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041941. [PMID: 35206132 PMCID: PMC8872322 DOI: 10.3390/ijerph19041941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 12/10/2022]
Abstract
Numerous studies have identified sociodemographic factors associated with susceptibility, ever-use and past-30-day use of e-cigarettes, including JUUL. However, it remains unknown which sociodemographic factors are associated with adolescents’ and young adults’ (AYA) use of the entire spectrum of different types of e-cigarette devices (e.g., disposables, pod/cartridge-based, and other e-cigarettes, like mods or tanks). The aim of this study was to examine the relationship between sociodemographic factors and use, future use intent and susceptibility to use different e-cigarette device types. We conducted a national online survey using a convenience sample of 13–24-year-olds, 50:50 e-cigarette ever- to never-users and sex and race/ethnicity balanced per the U.S. Census (n = 4351). Sociodemographic factors were not associated with ever use of disposables among AYAs or generally with intent to use e-cigarette devices in the future. However, sociodemographic factors were related to the use of pod/cartridge-based and other e-cigarette devices. LGBTQ+ AYAs were more likely to use pod/cartridge-based devices and to be susceptible to using all device types compared to other AYAs. Young adults, males, and other/multiracial non-Hispanic AYAs were more likely to report past-30-day-use of all devices and AA/Black non-Hispanic AYAs were more likely to report past-30-day use of pod/cartridge-based and other devices compared to former users. AA/Black non-Hispanic AYAs were more likely to be susceptible to using all devices and other/multiracial non-Hispanic AYAs were susceptible to using other devices (compared to White non-Hispanic AYAs). AYAs under 21 who were former users were more likely to intend using other devices in the future compared to AYAs 21 years or above. These findings may inform targeted prevention efforts to curb the growing popularity of different devices among AYAs.
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Adverse childhood experiences and other risk factors associated with adolescent and young adult vaping over time: a longitudinal study. BMC Public Health 2022; 22:95. [PMID: 35027027 PMCID: PMC8759271 DOI: 10.1186/s12889-021-12477-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaping among adolescents and young adults is a significant public health concern worldwide. Understanding which risk factors are associated with vaping is important to help inform evidence-based prevention and intervention strategies. There are several gaps in the current literature examining these associations such as limited longitudinal research. We examined the association between parental smoking/vaping, adolescent sex, mental disorders in adolescence, 13 adverse childhood experiences (ACEs) and a) any vaping and b) course of vaping across two time points among adolescents and young adults. METHODS Data were from Waves 1 and 2 of the longitudinal Well-Being and Experiences Study (The WE Study) in Manitoba, Canada which collected data from a community sample of adolescents (14 to 17 years) and their parent/caregiver in Wave 1 in 2017-18 and the adolescents/young adults only in Wave 2 in 2019. A total of 752 adolescents/young adults (72.4% of the original cohort) completed both waves of the study. Binary and multinomial logistic regressions were conducted to understand the relationship between the 16 risk factors and the two vaping outcomes. RESULTS Vaping prevalence was 45.5% for any vaping, 2.7% for Wave 1 vaping only, 19.7% for new onset Wave 2 vaping, and 21.2% for vaping at both waves. After adjusting for covariates, the majority of risk factors examined were associated with any adolescent or young adult vaping, including: parental smoking or vaping, emotional abuse, emotional neglect, exposure to verbal intimate partner violence, household substance use, household mental illness, parental separation/divorce, parental problems with police, foster care or contact with a child protective organization, an unsafe neighbourhood, and peer victimization. The majority of these risk factors, as well as adolescent mental health and parental gambling, were associated with different courses of vaping across the two time points. CONCLUSIONS The findings emphasize the need for early vaping prevention and identified several ACEs and other factors that were associated with adolescent and young adult vaping and course of vaping. These identified ACEs and risk factors can help inform programs, strategies, and potential groups to target for vaping interventions.
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Hajat C, Stein E, Shantikumar S, Niaura R, Ferrara P, Polosa R. A scoping review of studies on the health impact of electronic nicotine delivery systems. Intern Emerg Med 2022; 17:241-268. [PMID: 34637075 PMCID: PMC8841326 DOI: 10.1007/s11739-021-02835-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/20/2021] [Indexed: 11/05/2022]
Abstract
We conducted a scoping review of studies on health outcomes from electronic nicotine delivery systems (ENDS). The objective was to identify, narratively synthesize, assess the strength and quality of evidence and critically appraise studies that have reported disease end points associated with the use of ENDS. We included published literature on the health impact of ENDS from 01/01/2015 until 01/02/2020 following the PRISMA guidelines using PubMed, Embase, Scopus and Google Scholar. The database search identified 755 studies, and other sources 265; 37 studies met final eligibility criteria. Levels of evidence included 24(65%) cross-sectional, one (2.7%) case-control and six (16%) case studies, four (11%) cohort studies, one (2.7%) randomized controlled trial (RCT) and one (2.7%) meta-analysis; 27(73%) studies reported only on harms, eight (22%) reported on benefits, two (2%) on benefits and harms. Quality ratings were poor in 20 (54%), fair in 9(24%) and good in 8(22%) of studies. In our review, ENDS was not shown to be causative for harmful cardiovascular disease (CVD) outcomes and shown to be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of chronic obstructive pulmonary disease (COPD), with no evidence of long-term deterioration in lung function. Mental Health, cancer and mortality were not adequately studied to form any consensus. Our review has not demonstrated ENDS to be causative of harmful CVD outcomes; furthermore switching from cigarettes to e-cigarettes was associated with improved hypertensive control and reduced exacerbations of COPD, with no evidence of increased asthma risk or long-term respiratory harm. Mental health, cancer and mortality outcomes have not been adequately studied to form a conclusion. Overall, the findings of our review did not provide evidence to counter the consensus held by many that ENDS use is safer than the risks posed from smoking cigarettes.
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Affiliation(s)
- Cother Hajat
- Public Health Institute, UAE University, Al Ain, United Arab Emirates
| | | | | | - Raymond Niaura
- School of Global Public Health, New York University, New York, USA
| | - Pietro Ferrara
- Centre for Public Health Research, University of Milan - Bicocca, Monza, Italy
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Williams GC, Cole AG, de Groh M, Jiang Y, Leatherdale ST. Investigating individual-level correlates of e-cigarette initiation among a large sample of Canadian high school students. Health Promot Chronic Dis Prev Can 2021; 41:292-305. [PMID: 34668684 PMCID: PMC8565859 DOI: 10.24095/hpcdp.41.10.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Having a better understanding of individual factors associated with e-cigarette initiation can help improve prevention efforts. Therefore, this study aimed to (1) identify baseline characteristics associated with e-cigarette initiation, and (2) determine whether changes in these baseline characteristics were associated with e-cigarette initiation. METHODS This study used data from Year 6 (2017/18, baseline) and Year 7 (2018/19, follow-up) of the COMPASS study. The final sample included 12 315 students in Grades 9 to 11 who reported never having tried e-cigarettes at baseline. Students reported demographic information, other substance use, school behaviours, physical activity, sedentary behaviour, sleep, symptoms of anxiety and depression, and emotional regulation and flourishing scores. Hierarchical GEE models, stratified by gender, examined the association between (1) baseline characteristics and e-cigarette initiation at follow-up and (2) changes in baseline characteristics and e-cigarette initiation at follow-up. RESULTS In total, 29% of students who had not yet initiated e-cigarette use reported initiating e-cigarette use at follow-up. Students in Grades 10 and 11 were less likely to initiate e-cigarette use. Other substance use, skipping school and meeting the physical activity guidelines at baseline and one-year changes to these behaviours were associated with e-cigarette initiation among both male and female students. Additionally, some differences were noted between females and males. CONCLUSION Given that other health behaviours were associated with e-cigarette initiation, prevention approaches should target multiple health-risk behaviours to help prevent youth e-cigarette use. Additionally, school-based approaches may benefit by being implemented at the beginning of high school or in junior high school.
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Affiliation(s)
- Gillain C Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Adam G Cole
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | | | - Ying Jiang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Examining potential risk factors for early age of nicotine vaping initiation in a sample of Florida youth. Addict Behav 2021; 120:106962. [PMID: 33964584 DOI: 10.1016/j.addbeh.2021.106962] [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: 01/14/2021] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 11/22/2022]
Abstract
Previous research has examined risk factors for nicotine vaping in young adults and older adolescents. Even so, significantly less research has examined risk factors for initiating nicotine vaping in early adolescence. This paper addresses this gap in the literature by examining risk factors for initiating nicotine vaping in a sample of middle- and high-school students. In order to do so, we analyze data from the 2019 cohort of the Florida Youth Substance Abuse Survey (FYSAS). We employ multinomial logistic regression and logistic regression to examine potential risk factors for early age of nicotine vaping initiation. Our findings reveal that early age of nicotine vaping initiation is associated with cigarette use, alcohol use, having substance using peers, lifetime incidence of arrest, and lifetime incidence of school suspension. In conclusion, our findings reveal that early age of nicotine vaping initiation is associated with other forms of risky behavior in adolescence (i.e., substance use, misbehavior leading to arrest and/or school suspension). We discuss the implications of these findings for future research.
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