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Rutherford BN, Lim CCW, Cheng B, Sun T, Vu GT, Johnson B, Daniel Paul Ashley, Chung J, Huang S, Leung J, Stjepanović D, Connor JP, Chan GCK. Viral Vaping: A systematic review and meta analysis of e-cigarette and Tobacco-Related social media content and its influence on youth behaviours and attitudes. Addict Behav 2023; 147:107828. [PMID: 37591107 DOI: 10.1016/j.addbeh.2023.107828] [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: 06/08/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
AIMS E-cigarette and tobacco-related content on social media continues to rise from lax restrictions on both personal and promotional posts. This content has been linked to various mechanisms of increased e-cigarette and tobacco use (i.e., lower risk perceptions and increased susceptibility). This study aimed to synthesis the association between exposure to e-cigarette and tobacco-related content and youth behaviours and attitudes. METHODS A comprehensive search was conducted on PubMed, Scopus, PsycINFO and Web of Science. Studies published post-2004 reporting effect estimates for exposure or engagement with e-cigarette or tobacco content on social media and behaviour or attitude outcomes were included. RESULTS Thirty-two studies (N = 274,283, aged 9 to 25 years) were included for synthesis. Meta-analyses revealed significant associations between engagement with tobacco content and use (OR 2.21; 95% CI = 1.27-3.82, p =.005; I2 = 96.4%), exposure to tobacco content and never users' lower risk perceptions (OR 0.68; 95% CI = 0.49-0.91; p =.011; I2 = 78.2%), and exposure to e-cigarette content and use (OR 1.37; 95% CI = 0.99-1.88; p = 0.058; I2 = 64.4%). There was no observed relationship between exposure to tobacco content and ever users' risk perceptions (OR 0.83; 95% CI = 0.61-1.13; p =.231; I2 = 83.5%). Qualitative synthesis found significant associations between tobacco exposure and increased current use and pro-tobacco attitudes; e-cigarette exposure and increased susceptibility and lower risk perceptions; tobacco engagement and increased susceptibility; e-cigarette engagement and increased use; dual exposure and increased susceptibility; and dual engagement and increased dual use. Mixed findings were identified for the influence of e-cigarette exposure on attitudes, tobacco exposure on susceptibility, dual exposure on dual use behaviours, and dual engagement on dual susceptibility. CONCLUSIONS Findings suggest an association between exposure and engagement to e-cigarette or tobacco products on social media and use or pro-use attitudes among youth. Further substantive research in the area of youth-specific use and attitudes following exposure and engagement with e-cigarette and tobacco content is needed to quantify this association.
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Affiliation(s)
- Brienna N Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia.
| | - Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Brandon Cheng
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Giang T Vu
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Benjamin Johnson
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | | | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia
| | - Sandy Huang
- School of Medicine, The University of Queensland, Herston, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
| | - Jason P Connor
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia; School of Psychology, The University of Queensland, St Lucia, Australia; School of Medicine, The University of Queensland, Herston, Australia
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
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Jelagat J, Budambula NLM, Ngari M, Budambula V. Polydrug Use among Students in a Public University in a Lower Middle-Income Country. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8085588. [PMID: 37560202 PMCID: PMC10409583 DOI: 10.1155/2023/8085588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023]
Abstract
Recreational drug use among students in tertiary institutions remains a public health concern. Despite documentation of drug use in Kenyan universities, most of the studies are based on self-reported history which is prone to social desirability bias. It is in this context that we sought to establish lifetime and current drug use among university students. The study investigated self-reported and confirmed drug use. Using proportionate to size and snowball sampling methods, 380 respondents were enrolled from three university campuses. Actual drug use was confirmed qualitatively using a 6 panel plus alcohol saliva test kit. The study participants' median (IQR) age was 22 (20-23) years, and 262 (69%) were male; 328 (86%) were degree-level students, while 127 (33%) were in their fourth year and above. A total of 221 (58%) students reported a lifetime ever use of drugs, while 193 (51%) tested positive for at least one drug. Alcohol, tobacco products (cotinine), marijuana, and amphetamine or khat were the most preferred drugs. The usage was either solely, concurrently, or simultaneously. Having multiple sexual partners compared to students with no sexual partner (adjusted risk ratio (aRR) of 2.33 (95% CI 1.45, 3.76)) and residing in Mishomoroni and Kisauni (aRR 1.50 (95% CI 1.08, 2.09)) were associated with risk of testing positive for any drug. Having one (aRR of 1.54 (95% CI 1.05, 2.26)) and multiple sexual partners (aRR 2.03 (95% CI 1.27, 3.25) and residing in Mishomoroni and Kisauni (aRR 1.48 (95% CI 1.05, 2.08)) were associated with self-reported drug use. One out of two students was currently using drugs. Irrespective of the method used to record data, alcohol, tobacco products, marijuana, and amphetamine or khat were the most preferred drugs. The usage was solely, concurrently, or simultaneously. Future interventions should focus on continuing students, students' residences, and those who are sexually active.
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Affiliation(s)
- Joan Jelagat
- Department of Environment and Health Sciences, Technical University of Mombasa, Kenya
| | | | - Moses Ngari
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kenya
| | - Valentine Budambula
- Department of Environment and Health Sciences, Technical University of Mombasa, Kenya
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Gorukanti AL, Kimminau KS, Tindle HA, Klein JD, Gorzkowski J, Kaseeska K, Ali R, Singh L, David SP, Halpern-Felsher B. Cross-sectional online survey of clinicians' knowledge, attitudes and challenges to screening and counselling adolescents and young adults for substance use. BMJ Open 2022; 12:e059019. [PMID: 36414284 PMCID: PMC9685226 DOI: 10.1136/bmjopen-2021-059019] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine adolescent healthcare clinicians' self-reported screening practices as well as their knowledge, attitudes, comfort level and challenges with screening and counselling adolescents and young adults (AYA) for cigarette, e-cigarette, alcohol, marijuana, hookah and blunt use. DESIGN A 2016 cross-sectional survey. SETTING Academic departments and community-based internal medicine, family medicine and paediatrics practices. PARTICIPANTS Adolescent healthcare clinicians (N=771) from 12 US medical schools and respondents to national surveys. Of the participants, 36% indicated male, 64% female, mean age was 44 years (SD=12.3); 12.3% of participants identified as Asian, 73.7% as white, 4.8% as black, 4.2% as Hispanic and 3.8% as other. PRIMARY AND SECONDARY OUTCOME MEASURES Survey items queried clinicians about knowledge, attitudes, comfort level, self-efficacy and challenges with screening and counselling AYA patients about marijuana, blunts, cigarettes, e-cigarettes, hookah and alcohol. RESULTS Participants were asked what percentage of their 10-17 years old patients they screened for substance use. The median number of physicians reported screening 100% of their patients for cigarette (1st, 3rd quartiles; 80, 100) and alcohol use (75, 100) and 99.5% for marijuana use (50,100); for e-cigarettes, participants reported screening half of their patients and 0.0% (0, 50), (0, 75)) reported screening for hookah and blunts, respectively. On average (median), clinicians estimated that 15.0% of all 10-17 years old patients smoked cigarettes, 10.0% used e-cigarettes, 20.0% used marijuana, 25.0% drank alcohol and 5.0% used hookah or blunts, respectively; yet they estimated lower than national rates of use of each product for their own patients. Clinicians reported greater comfort discussing cigarettes and alcohol with patients and less comfort discussing e-cigarettes, hookah, marijuana and blunts. CONCLUSIONS This study identified low rates of screening and counselling AYA patients for use of e-cigarettes, hookahs and blunts by adolescent healthcare clinicians and points to potential missed opportunities to improve prevention efforts.
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Affiliation(s)
- Anu L Gorukanti
- Department of Pediatrics, Stanford University, Stanford, California, USA
| | - Kim S Kimminau
- Department of Family and Community Medicine, University of Missouri Columbia, Columbia, Missouri, USA
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Jonathan D Klein
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Julie Gorzkowski
- Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Kristen Kaseeska
- Department of Healthy Resilient Children Youth and Families, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Raabiah Ali
- Healthcare Settings Program, Chicago Department of Public Health, Chicago, Illinois, USA
| | - Lavisha Singh
- Department of Biostatistics, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Sean P David
- Department of Family Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA
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Donaldson SI, Dormanesh A, Perez C, Majmundar A, Allem JP. Association Between Exposure to Tobacco Content on Social Media and Tobacco Use: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:878-885. [PMID: 35816331 PMCID: PMC9274450 DOI: 10.1001/jamapediatrics.2022.2223] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/23/2022] [Indexed: 11/14/2022]
Abstract
Importance Exposure to tobacco-related content on social media may foster positive attitudes toward tobacco products and brands, and influence the likelihood of initiating or continuing use of tobacco, especially among adolescents and young adults. Objective To perform the first systematic review and meta-analysis, to our knowledge, on studies that examined the association between exposure to tobacco content on social media and lifetime tobacco use, past 30-day tobacco use, and susceptibility to use tobacco among never users. Data Sources Tobacco, social media, and marketing search terms were entered into online databases, including MEDLINE, ISI Web of Science, Scopus, and PsychINFO. Study characteristics, including research design and methods, sampling strategy, and demographics, were assessed for each study. Study Selection Studies reporting odds ratios (ORs) for self-reported exposure to, or experimentally manipulated, tobacco content on social media and lifetime tobacco use, past 30-day tobacco, and susceptibility to use tobacco among never users. The systematic search produced 897 independent articles, of which 29 studies met inclusion criteria. Data Extraction and Synthesis A 3-level random-effects meta-analysis was used to estimate ORs, 95% CIs, and heterogeneity (I2) for each tobacco use outcome. Study quality and publication bias were assessed. Main Outcomes and Measures Lifetime tobacco use, past 30-day tobacco use, and susceptibility to use tobacco among never users. Tobacco use included e-cigarettes, cigarettes, and other (cigar, hookah, smokeless tobacco). Results The total sample size across the 24 included datasets was 139 624, including 100 666 adolescents (72%), 20 710 young adults (15%), and 18 248 adults (13%). Participants who were exposed to tobacco content on social media, compared with those who were not exposed, had greater odds of reporting lifetime tobacco use (OR, 2.18; 95% CI, 1.54-3.08; I2 = 94%), past 30-day tobacco use (OR, 2.19; 95% CI, 1.79-2.67; I2 = 84%), and susceptibility to use tobacco among never users (OR, 2.08; 95% CI, 1.65-2.63; I2 = 73%). Subgroup analyses showed similar associations for tobacco promotions, active engagement, passive engagement, lifetime exposure to tobacco content, exposure to tobacco content on more than 2 platforms, and exposure to tobacco content among adolescents and young adults. Conclusions and Relevance Findings suggest that a comprehensive strategy to reduce the amount of tobacco content on social media should be developed by federal regulators. Such actions may have downstream effects on adolescent and young adult exposure to protobacco content, and ultimately tobacco use behaviors.
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Affiliation(s)
- Scott I. Donaldson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Allison Dormanesh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Cindy Perez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Anuja Majmundar
- Tobacco Control Research, Surveillance and Health Equity Science, American Cancer Society, Inc, Kennesaw, Georgia
| | - Jon-Patrick Allem
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
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Pérez A, Kuk AE, Bluestein MA, Harrell MB, Perry CL, Chen B. Prospective estimation of the age of initiation of hookah use among youth: Findings from the Population Assessment of Tobacco and Health (PATH) study waves 1-4 (2013-2017). Addict Behav 2021; 117:106838. [PMID: 33545623 PMCID: PMC7956064 DOI: 10.1016/j.addbeh.2021.106838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/06/2021] [Accepted: 01/17/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study reports the prospectively estimated age of initiation of susceptibility to, ever, past 30-day, and fairly regular hookah use. DESIGN Secondary data analyses of the first four waves (2013-2017) of the PATH study, a nationally representative longitudinal cohort study of US youth (ages 12-17). METHODS Youth who were never hookah users at their first wave of participation were identified (n = 16,678; N = 31,136,834). Four outcomes were analyzed, age of first report of: (i) susceptibility to use, (ii) ever use, (iii) past 30-day use, and (iv) fairly regular hookah use. The age of hookah initiation of each outcome was estimated. Weighted interval censoring survival analyses and Cox regression models were conducted to estimate the age of initiation of each hookah use outcome, and to estimate differences in age of initiation by sex and by race, respectively. RESULTS Around 11% of youth were classified as susceptible to hookah use by 13 years of age, 8% reported initiating ever hookah use by age 17, almost 10% reported initiating past 30-day hookah use by age 19, and 3% reported initiating fairly regular hookah use by age 20. Females and Hispanics were at higher risk of becoming susceptible to and ever hookah use at earlier ages compared to males and Non-Hispanic White youth. CONCLUSION Education, communication campaigns, and proven culturally targeted tobacco interventions that reach youth at ages before they first become susceptible or start using hookah use are needed to prevent the onset of hookah use among vulnerable youth.
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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 78701, USA; 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 78701, USA.
| | - 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 78701, USA.
| | - 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 78701, USA.
| | - 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 78701, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health Austin Campus, Austin, TX 78701, USA.
| | - Cheryl L Perry
- Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth), School of Public Health Austin Campus, Austin, TX 78701, USA.
| | - 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 78701, USA; 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 78701, USA.
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Dadipoor S, Mirzaei-Alavijeh M, Aghamolaei T, Heyrani A, Ghaffari M, Ghanbarnejad A. Predictors of hookah smoking frequency among women in the South of Iran: A cross-sectional study. J Ethn Subst Abuse 2020; 21:1-19. [PMID: 33135955 DOI: 10.1080/15332640.2020.1836703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country. This study aimed to determine the behavioral and socio-demographic predictors of the hookah smoking frequency among women in southern Iran. This research was conducted on 400 women hookah smokers selected through multi-stage sampling method. Data were collected from October 2018 to September 2019 using a questionnaire guided by literature. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic predictors involved in the frequency of hookah smoking. Variables with a P-value of less than 0.05 in the final fitting model were associated with the outcome variable (frequency of hookah smoking per day1 = once a day, 2 = twice a day, 3 = three times a day, 4 = more than three times a day). We found that the longer duration of hookah smoking, family usage of hookah smoking, beginning to smoke hookah with peers, absence of either parent in family (single-parent families and a lack of prior intention to cease smoking), ever-married women and low socio-economic status (SES) predicted the frequency of hookah smoking. To prevent the behavior and make effective interventions to reduce hookah smoking, policy-makers should stay focused on factors other than internal motivations. Focus on the companies surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one's intention to smoke hookah can help reduce such unhealthy behaviors.
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Affiliation(s)
- Sakineh Dadipoor
- Student Research Committee, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ali Heyrani
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohtasham Ghaffari
- Environmental and Occupational Hazards Control Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Ghanbarnejad
- Tobacco and Health Research center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Gueorguieva R, Buta E, Simon P, Krishnan-Sarin S, O'Malley SS. Data Visualization Tools of Tobacco Product Use Patterns, Transitions and Sex Differences in the PATH Youth Data. Nicotine Tob Res 2020; 22:1901-1908. [PMID: 32219313 DOI: 10.1093/ntr/ntaa056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 03/24/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Evaluations of multiple tobacco product use and temporal changes in patterns of use are complicated by a large number of combinations and transitions. Visualization tools could easily identify most common patterns and transitions. METHODS Set intersection bar plots describe ever use of five tobacco products among 12-17 years old youth in wave 1 of the Population Assessment of Tobacco and Health (PATH) study (N = 11 497). Heat maps visualize unweighted frequencies of transitions from ever use at wave 1 (2013-2014) to past 12-month use at wave 2 (2014-2015). Weighted calibrated heat maps assess differences in relative frequencies of transitions by pattern at wave 1 and identify differences in transitions by sex. RESULTS The most common tobacco product ever use patterns in wave 1 were of cigarettes only, e-cigarettes only or hookah only, followed by ever use of both cigarettes and e-cigarettes. Initiation of use between waves was uncommon. The most frequent transition among those who reported use at wave 2 but not at wave 1 (N = 971) was to e-cigarette use (N = 301). However, among e-cigarette-only ever users at wave 1 (N = 260), about half did not report any product use at wave 2. Use of three or more products remained stable. Adolescent girls compared to boys appeared more likely to report hookah use at both waves. CONCLUSION Set intersection bar plots and heat maps are useful for visualizing tobacco product use patterns and transitions, especially for multiple products. Both techniques could identify common problematic tobacco use patterns across and within populations. IMPLICATIONS Given the growing complexity of the youth tobacco use landscape, approaches to efficiently communicate patterns of multiple tobacco product use should be used more often. This study introduces set intersection bar plots and modified versions of heat maps to the tobacco product literature and illustrates their use in the PATH youth sample. These techniques are useful for visualizing absolute and relative frequencies of multiple possible patterns and transitions. They also suggest targets for subsequent statistical inference such as sex differences in hookah use. The methods can be applied more generally for data visualization wherever large number of combinations occurs.
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Affiliation(s)
- Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Eugenia Buta
- Department of Biostatistics, Yale School of Public Health, New Haven, CT.,Yale Center for Analytical Sciences, New Haven, CT
| | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Fauzi R, Areesantichai C. Determinants of waterpipe smoking among high school students in Jakarta, Indonesia. Int J Adolesc Med Health 2020; 34:269-274. [PMID: 32862148 DOI: 10.1515/ijamh-2020-0084] [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: 04/23/2020] [Accepted: 07/12/2020] [Indexed: 11/15/2022]
Abstract
Objectives The study aimed to examine factors associated with past 30 days waterpipe use among high school students in Jakarta, Indonesia. Methods We surveyed a multistage cluster random sample of 1,318 students of grade 10th and 11th from 14 schools in Jakarta. Multiple logistic regressions were employed to examine the association between past 30 days waterpipe use with sociodemographic characteristics, cigarettes smoking status, parental and peer use, availability and affordability. Results Of 1,318 participants, 3.3% of female and 8.4% of male currently smoked waterpipe. Multivariate analysis revealed that current waterpipe use was significantly associated with family use (AOR: 4.844, 95% CI: 1.225-19.151), friend use (AOR: 2.554, 95% CI: 1.424-4.582), and availability (AOR: 2.143, 95% CI: 1.127-4.076). Being current smokers were six times more likely (AOR: 6.055, 95% CI: 3.123-11.739) to use waterpipe in the past 30 days. Conclusions The finding suggests that smoking by a family member, friends, use of conventional cigarettes, and availability are significantly associated with increased probability of current waterpipe used among adolescents.
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Affiliation(s)
- Ridhwan Fauzi
- Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia.,College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Perry CL, Creamer MR, Chaffee BW, Unger JB, Sutfin EL, Kong G, Shang C, Clendennen SL, Krishnan-Sarin S, Pentz MA. Research on Youth and Young Adult Tobacco Use, 2013-2018, From the Food and Drug Administration-National Institutes of Health Tobacco Centers of Regulatory Science. Nicotine Tob Res 2020; 22:1063-1076. [PMID: 31127298 PMCID: PMC7457341 DOI: 10.1093/ntr/ntz059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
Abstract
The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior. IMPLICATIONS The Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.
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Affiliation(s)
- Cheryl L Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | - MeLisa R Creamer
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Jennifer B Unger
- Keck School of Medicine,University of Southern California, Los Angeles, CA
| | | | | | - Ce Shang
- Oklahoma Tobacco Research Center, Stephenson Cancer Center
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stephanie L Clendennen
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Mary Ann Pentz
- Keck School of Medicine,University of Southern California, Los Angeles, CA
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Salehi L. Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations. Int J Adolesc Med Health 2020; 33:401-407. [PMID: 32549155 DOI: 10.1515/ijamh-2019-0153] [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: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 11/15/2022]
Abstract
Objectives This study was done to investigate popularity, awareness, perceptions, and motivations regarding water pipe smoking (WPS) among medical sciences students in 2017. Methods This cross sectional study was done among 385 medical sciences student in 2017.The systematic random sampling was used to recruit subjects. Multidimensional questionnaire (demographic characteristics, awareness, perceptions, action, and water pipe motivators) was used. t-test, ANOVA, X2, and logistic regression was used to analyze the data by SPSS. Results The mean ages of participants were 22 ± 2.64 and 89% were male. The majority of the study sample was from health school. Most participants reported having smoked before. Family entertainment was found to be the most common motivator for WPS. The second one was to be fun. WPS use was significantly associated with age (odds ratio [OR], 0.17; 95% Confidence Interval [CI], 0.04-0.61); awareness (OR, 1.55; 95% CI, 1.35-1.78); and perception (OR, 0.71; 95% CI, 0.65-0.78). Conclusions Results show that WPS is very popular among Iranian youth. In designing public health programs, policy makers should consider the motivators for inclination to WPS. Intervention should focus on addressing students' perception and awareness regarding WPS.
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Affiliation(s)
- Leili Salehi
- Research Center for Health, Safety and Environment, Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Islamic Republic of Iran
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11
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Nguyen V, Salama M, Fernandez D, Sperling JD, Regina A, Rivera R, Wang J, Friedman BW, Smith SW. Comparison between carbon monoxide poisoning from hookah smoking versus other sources. Clin Toxicol (Phila) 2020; 58:1320-1325. [DOI: 10.1080/15563650.2020.1745225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Vincent Nguyen
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Maha Salama
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Denise Fernandez
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeremy D. Sperling
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Angela Regina
- Department of Emergency Medicine, Saint Barnabas Hospital Health System, Bronx, NY, USA
| | - Robert Rivera
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jessica Wang
- Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Benjamin W. Friedman
- Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Silas W. Smith
- Ronald O Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA
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Cooper M, Pacek LR, Guy MC, Barrington-Trimis JL, Simon P, Stanton C, Kong G. Hookah Use Among US Youth: A Systematic Review of the Literature From 2009 to 2017. Nicotine Tob Res 2019; 21:1590-1599. [PMID: 29961895 PMCID: PMC6861827 DOI: 10.1093/ntr/nty135] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Given the US Food and Drug Administration (FDA)'s authority to regulate hookah, more research is needed to inform regulations intended to prevent youth from using hookah. This systematic review summarizes and assesses the literature related to hookah use among adolescents (11 to ≤18 years of age) in the United States from 2009 to 2017. METHODS Database searches yielded 867 peer-reviewed articles. After duplicates were removed, authors reviewed 461 articles for inclusion. Included articles (n = 55) were coded for study themes, study quality, and their relevance to FDA's research priorities. A qualitative synthesis is presented. RESULTS The following themes were identified: (1) prevalence of hookah use (n = 42), (2) tobacco use transitions (n = 7), (3) sociodemographic correlates (n = 35), (4) psychosocial risk factors (n = 21), (5) concurrent use of other tobacco products (n = 31), (6) concurrent use of other substances (n = 9), and (7) other (n = 15)-which includes low prevalence themes. The qualitative synthesis showed increasing rates of hookah use. Older age, male gender, positive social normative beliefs, higher peer use, as well as lower perceived risk were associated with hookah use. Longitudinal studies of youth hookah use showed bidirectional relationships between use of hookah and other tobacco products. All articles fell within FDA's research priority related to "behavior," and three priorities ("impact analysis," "health effects," and "toxicity") have not been explored for hookah use among US youth since 2009. CONCLUSIONS The prevalence of hookah use among youth in the United States is increasing, thus more research is needed to inform policies targeted to protect this vulnerable population. IMPLICATIONS This study represents a novel contribution to our understanding of hookah use among youth in the United States from 2009-the year that the Family Smoking Prevention and Tobacco Control Act was passed-to 2017. In recent years, hookah has become a more popular tobacco product among US youth; however, to date, no systematic reviews of hookah use among this population exist. Results highlight implications for future US FDA regulatory policy and identify gaps in research to be addressed in future studies.
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Affiliation(s)
- Maria Cooper
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in Austin, Austin, TX
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Mignonne C Guy
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA
| | | | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Cassandra Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Rockville, MD
- The Department of Oncology, Georgetown University Medical Center/Lombardi Comprehensive Cancer Center, Washington, DC
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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El Hajj D, Cook PF, James KA, Battaglia C, Prochazca AV. Newer Forms of Tobacco Products: Characteristics of Poly Users Among Adults Living in Colorado-A Secondary Data Analysis of the Attitudes and Behaviors Survey on Health 2015. Tob Use Insights 2019; 12:1179173X19874811. [PMID: 31523133 PMCID: PMC6734605 DOI: 10.1177/1179173x19874811] [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: 07/10/2019] [Accepted: 08/18/2019] [Indexed: 12/05/2022] Open
Abstract
Aims: Data from The Attitudes and Behaviors Survey (TABS) conducted in 2015 were used to investigate the prevalence of different forms of tobacco use and marijuana use among adults in Colorado. Methods: A secondary analysis of TABS on health data was conducted. A representative sample of 8616 adults 18 years and older participated in the survey, with sample weights used to adjust for oversampling. Results: Lifetime prevalence of cigarette-only use was 25.8%, compared with 10.6% for hookah use, 7.0% for both hookah and cigarettes, 12.6% for anything except cigarettes, and 43.0% for marijuana. The typical hookah user was a single/living alone (15.9%), English-speaking (11.6%), male (16.7%), age < 30 years (24.2%), with some college education (13.0%), and income less than 35 000 per year (14.3%). Hookah users, whether or not they also used cigarettes, were similar to those who used any other noncigarette tobacco products. The typical marijuana user was a single/living alone (50.2%), white (46.0%), English-speaking (46.7%), male (48.5%), age < 30 years (50.1%), with a graduate degree (40.8%) and salary of at least 50 000 per year (43.4%). Implications: In Colorado, in 2015, cigarette use was still highest among all forms of tobacco, but the use of other tobacco products such as vaping and hookah is on the rise, especially among young adults. Marijuana and hookah users were demographically similar to each other, and different from the typical cigarette user. These results indicate the need for further study of alternative tobacco product use, especially among young adults.
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Affiliation(s)
- Dana El Hajj
- Rocky Mountain Regional Medical Center, Denver-Seattle Center of Innovation (COIN), Aurora, CO, USA
| | - Paul F Cook
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine A James
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Catherine Battaglia
- Rocky Mountain Regional Medical Center, Denver-Seattle Center of Innovation (COIN), Aurora, CO, USA
| | - Allan V Prochazca
- Rocky Mountain Regional Medical Center, Denver-Seattle Center of Innovation (COIN), Aurora, CO, USA
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Determinants of Intentions toward Smoking Hookah in Iranian Adolescents Based on the Theory of Planned Behavior. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1317-1325. [PMID: 31497554 PMCID: PMC6708534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Smoking hookah is considered a health problem among the adolescents, which currently has a high prevalence. The present study aimed to determine the reasons for tendency toward smoking hookah. METHODS Participants of this qualitative study were 24 adolescents from Tehran selected using purposeful sampling method in 2017. Data gathered through individual semi-structured interviews and two focus groups. Using directed content analysis approach 423 primary codes were categorized into 28 subcategories and 9 categories. RESULTS Most of the participants were 16 to 18 yr old (64%), male (58%) and had high school degree (58%) and 75% of them were student. In Theory of Planned Behavior, attitude toward smoking hookah contained categories of replacement for cigarette, the pleasurableness of hookah, easy access and spending the leisure times. Subjective norms contained the categories of family, friends and society. The construct of behavioral control contained the categories of personal and social factors. CONCLUSION Our Results could be helpful in policy-making and planning toward improving the awareness and changing the attitude and performance of the adolescents toward smoking hookah.
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Pratiti R, Mukherjee D. Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review. Cardiovasc Hematol Agents Med Chem 2019; 17:82-93. [PMID: 31483237 DOI: 10.2174/1871525717666190904151856] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.
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Affiliation(s)
- Rebecca Pratiti
- McLaren HealthCare, G-3245 Beecher Rd, Flint, MA 48532, United States
| | - Debabrata Mukherjee
- Texas Tech University Health Science Center, Department of Internal Medicine, El Paso, TX 79905, United States
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Audrain-McGovern J, Stone MD, Barrington-Trimis J, Unger JB, Leventhal AM. Adolescent E-Cigarette, Hookah, and Conventional Cigarette Use and Subsequent Marijuana Use. Pediatrics 2018; 142:peds.2017-3616. [PMID: 30082450 PMCID: PMC6317758 DOI: 10.1542/peds.2017-3616] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5799875103001PEDS-VA_2017-3616Video Abstract OBJECTIVES: Noncigarette tobacco products may confer a risk of marijuana use similar to combustible cigarettes. We examined whether adolescent electronic cigarette (e-cigarette), hookah, or combustible cigarette use is associated with initiating and currently using marijuana as well as using both tobacco and marijuana concurrently. METHODS Adolescents from 10 public schools in Los Angeles, California, completed in-classroom surveys at baseline (fall 2013, ninth grade) and at a 24-month follow-up (fall 2015, 11th grade). Among adolescents who never used marijuana at baseline (N = 2668), associations of baseline e-cigarette, hookah, or combustible cigarette use with ever marijuana use (initiation), current marijuana use (past 30 days), and current dual use of marijuana and these tobacco products at the 24-month follow-up were examined. RESULTS Baseline ever versus never e-cigarette use was associated with initiation (odds ratio [OR] 3.63; 95% confidence interval [CI] 2.69-4.90) and current (OR 3.67; 95% CI 2.51-5.36) marijuana use 24 months later. Ever versus never hookah use was associated with initiation (OR 3.55; 95% CI 2.49-5.08) and current (OR 4.10; 95% CI 2.69-6.25) marijuana use 24 months later. Similar associations were observed for combustible cigarette smoking and initiation (OR 4.30; 95% CI 2.79-6.63) and current use of marijuana (OR 1.97; 95% CI 1.05-3.68). Current use of any of these tobacco products at baseline was associated with current use of both tobacco and marijuana (OR 2.28; 95% CI 1.47-3.55) 24 months later. CONCLUSIONS The association between tobacco use and subsequent marijuana use across adolescence extends to multiple tobacco products.
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Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Matthew D. Stone
- Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, California
| | - Jessica Barrington-Trimis
- Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, California
| | - Jennifer B. Unger
- Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, California
| | - Adam M. Leventhal
- Departments of Psychology and,Preventive Medicine, Keck School of Medicine,
University of Southern California, Los Angeles, California
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Unger JB, Urman R, Cruz TB, Majmundar A, Barrington-Trimis J, Pentz MA, McConnell R. Talking about tobacco on Twitter is associated with tobacco product use. Prev Med 2018; 114:54-56. [PMID: 29898418 PMCID: PMC6644040 DOI: 10.1016/j.ypmed.2018.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/21/2018] [Accepted: 06/08/2018] [Indexed: 11/17/2022]
Abstract
Tobacco-related content appears on social media in the form of advertising and messages by individuals. However, little is known about associations between posting social media messages and tobacco product use among adolescents and young adults. Self-reports of tobacco product use were obtained from the Children's Health Study of young adults in Southern California. Among the 1486 respondents in the most recent wave of the cohort (2016-2017), 284 provided tobacco product use data and their Twitter user names to access publicly available Twitter account data (mean age = 20.1 yrs. (SD = 0.6), 54% female, 49% Hispanic). We obtained the tweets that those respondents posted on Twitter, searched the tweets for 14 nicotine- and tobacco-related keywords, and coded these statements as positive or negative/neutral. Logistic regression analyses were conducted to determine whether respondents who posted positive tobacco-related tweets were more likely to report tobacco product use, relative to those who did not post any positive tobacco-related tweets. Respondents who posted any positive messages about tobacco had significantly higher odds of reporting past month use of cigarettes (OR = 3.15, 95% CI = 1.36, 7.30) and any tobacco product (OR = 2.41, 95% CI = 1.16, 5.01), relative to respondents who did not post about tobacco. This is the first study to establish an empirical link between adolescents' and young adults' tobacco-related Twitter activity and their tobacco product use. Health communications about the risks of tobacco use could target adolescents who post positive messages about tobacco products on Twitter.
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Affiliation(s)
- Jennifer B Unger
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America.
| | - Robert Urman
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
| | - Tess Boley Cruz
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
| | - Anuja Majmundar
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
| | - Jessica Barrington-Trimis
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
| | - Mary Ann Pentz
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
| | - Rob McConnell
- Tobacco Center of Regulatory Science, University of Southern California Keck School of Medicine, United States of America
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Bashirian S, Barati M, Abasi H, Sharma M, Karami M. The role of sociodemographic factors associated with waterpipe smoking among male adolescents in western Iran: A cross-sectional study. Tob Induc Dis 2018; 16:29. [PMID: 31516429 PMCID: PMC6659475 DOI: 10.18332/tid/91601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/12/2018] [Accepted: 05/24/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Waterpipe smoking (WPS) is an increasingly popular leisure activity among young people in Iran. The purpose of this study was to identify the role of sociodemographic factors associated with WPS among male adolescents in Iran. METHODS The study used a cross-sectional design. It included 730 high school male students (Grades 10–12) recruited through multistage random sampling conducted in 2017 in Hamadan city, western Iran. The self-administered questionnaires included information on demographic variables and behavioral risk factors related to WPS. Descriptive statistics and multinomial logistic regression modeling were conducted using SPSS. RESULTS The student mean age, and standard deviation (SD), and age at WPS initiation were 16.41 (0.84) and 13.31 (2.43) years, respectively. The percentages of never, former and current WPS were 37.3%, 36.4% and 26.3%, respectively. We found that ever cigarette smoking (OR=5.14, 95% CI: 2.56–10.32) and WPS family (OR=2.55, 95% CI: 1.40–4.64) were significantly associated with former WPS. Furthermore, being 18 years, studying in technical fields, reporting ever and current smoking of cigarettes and family usage of WP were significantly associated with current WPS. Friends with WPS (OR= 0.50, 95% CI: 0.34–0.72) however played a protective role on former WPS. CONCLUSIONS The results indicate that the prevalence of former and current WPS was high in Hamadan city. Thus, designing and implementing interventions for increasing students’, friends’ and family’s awareness regarding the harms of WPS and cigarette smoking are necessary to facilitate behavior change.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Abasi
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoj Sharma
- Behavioral & Environmental Health School of Public Health, Jackson State University, Jackson, United States
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Abstract
Objectives To inform targeted prevention efforts, it is important to understand which tobacco products are used first and associations by demographic characteristics. Methods We conducted a nationally-representative random digit-dial telephone survey of 1125 adolescents ages 13-17. Adolescents reported the first tobacco product they tried, and we analyzed associations with demographic variables. Results Two-hundred nineteen (18.6%) adolescents reported ever using a tobacco product. The most common first product tried was cigarettes (35.4%), followed by electronic nicotine delivery systems (24.3%), smokeless tobacco (17.7%), cigars (11.4%), and waterpipe (11.2%). Weighted multivariable logistic regression analyses showed girls were 2.7 times more likely than boys to report cigarettes as their first product, Hispanic/Latinos were 5.0 times more likely than non-Hispanic/Latinos to report cigarettes, and those whose mothers had at least a 4-year college degree were 6.1 times more likely to report waterpipe compared to those whose mothers had less than a 4-year college degree. Conclusions Nearly one in 5 adolescents had tried a tobacco product. Although cigarettes were the most frequently reported product, most youth initiated with a non-cigarette tobacco product, and demographic differences were found. These findings point towards potential regulatory policies, including targeted campaigns, which might deter adolescents from initiating tobacco use.
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