Reasons for Polytobacco Use among Young Adults: Scale Development and Validation

Multiple tobacco product use among cigarette smokers: a longitudinal examination of menthol and non-menthol smokers during young adulthood

BACKGROUND

Multiple tobacco product (MTP) use is common among young adults. Most MTP users are combustible cigarette smokers that use one or more other tobacco products. This study aims to explore menthol as a risk factor for MTP use among a cohort of young adult cigarette smokers.

METHODS

Participants were 18-29 years cigarette smokers at 24 Texas colleges in a 6-wave study. Participants (n=4700 observations) were classified as: single product users (ie, exclusive cigarette smoking); dual product users and poly product users. A multilevel, ordered logistic regression model was used to examine the association between menthol cigarette smoking and MTP use. Two longitudinal, multilevel, multinomial logistic regressions were used to examine the relationship between menthol cigarette smoking and number of tobacco products used.

RESULTS

Overall, 40.7% of the sample were single product users, 33.7% were dual product users and 25.6% were poly product users. Menthol was associated with 1.28 greater odds of MTP use. Further, menthol was associated with 1.19 greater risk of dual and 1.40 greater risk of poly product use, relative to single product use. Lastly, menthol cigarette smoking was associated with 1.18 greater risk of poly product use, relative to dual product use.

CONCLUSIONS

There was a gradient relationship between menthol cigarette smoking and number of tobacco products used among young adult cigarette smokers. Findings provide for greater regulatory and programmatic efforts to reduce the use of menthol cigarettes.

A synthesis of the literature to inform vaping cessation interventions for young adults

There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.

Differences in Tobacco Product Use by Sexual Orientation and Violence Factors Among United States Youth

OBJECTIVE

To assess differences in the relationship between violence factor exposure and tobacco product pattern use (exclusive and poly), we hypothesized that compared with heterosexuals, sexual minority youth would be more likely to report exclusive-tobacco and poly-tobacco use patterns, and controlling for violence factors would attenuate these associations.

STUDY DESIGN

Data from 27 513 US high-school youth were analyzed from the Centers for Disease Control and Prevention's Youth Risk Factor Surveillance System from 2015 and 2017. We fit sex-stratified, weighted, adjusted log-Poisson models to compare past 30-day exclusive combustible, exclusive e-cigarette, and poly-tobacco use in across sexual orientation. Then, models were adjusted for past-year experiences of physical fighting, bullying, attempting suicide, and physical and sexual dating violence.

RESULTS

Compared with heterosexual girls with other-sex partners, sexual minority girls were more likely to use exclusive combustible, exclusive e-cigarette, or poly-tobacco products. When adjusting for violence factors, most tobacco use associations were partially attenuated for all sexual minority girls, and completely attenuated for exclusive e-cigarette use among all sexual minority girls.

CONCLUSIONS

Sexual minority girls have greater exclusive- and poly-tobacco use compared with heterosexual girls. Tobacco interventions for sexual minority youth should address the risks of poly-tobacco use as well as violence-based risk factors.

A Combined Alcohol and Smoking Cue-Reactivity Paradigm in People Who Drink Heavily and Smoke Cigarettes: Preliminary Findings

AIMS

Previous studies have shown that there may be an underlying mechanism that is common for co-use of alcohol and tobacco and it has been shown that treatment for alcohol use disorder can increase rates of smoking cessation. The primary aim of this study was to assess a novel methodological approach to test a simultaneous behavioral alcohol-smoking cue reactivity (CR) paradigm in people who drink alcohol and smoke cigarettes.

METHODS

This was a human laboratory study that utilized a novel laboratory procedure with individuals who drink heavily (≥15 drinks/week for men; ≥8 drinks/week for women) and smoke (>5 cigarettes/day). Participants completed a CR in a bar laboratory and an eye-tracking (ET) session using their preferred alcohol beverage, cigarettes brand and water.

RESULTS

In both the CR and ET session, there was a difference in time spent interacting with alcohol and cigarettes as compared to water (P's < 0.001), but no difference in time spent interacting between alcohol and cigarettes (P > 0.05). In the CR sessions, craving for cigarettes was significantly greater than craving for alcohol (P < 0.001), however, only time spent with alcohol, but not with cigarettes, was correlated with craving for both alcohol and cigarettes (P < 0.05).

CONCLUSION

This study showed that it is feasible to use simultaneous cues during a CR procedure in a bar laboratory paradigm. The attention bias measured in the integrated alcohol-cigarettes ET procedure predicted participants' decision making in the CR. This novel methodological approach revealed that in people who drink heavily and smoke, alcohol cues may affect craving for both alcohol and cigarettes.

E-cigarette Use, Tobacco Product Polyuse, and Motivations for Use among Baltimore Young Adults

OBJECTIVE

We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting.

METHODS

Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessation interest, and beliefs and risk perceptions about tobacco use were explored.

RESULTS

All participants had a history of polyuse, and 85% were current polyusers. Stress was the primary reason reported for tobacco use. Compared to single-product users, current polyusers also were more likely to mention environment and cheap cost as reasons for use. Most participants perceived cigarettes to be as addictive as cocaine or heroin, although this perception was less common among e-cigarette users than non-users. Among study participants, 59% reported wanting to stop using tobacco completely. Among current polyusers, those that used e-cigarettes were more likely to report cessation attempts during the past year and express interest in enrolling in a quit smoking text messaging program.

CONCLUSION

In our sample there was a high prevalence of polytobacco product use and complex tobacco use patterns among young adults, both in and out of college, from an urban community.

Ecological momentary assessment of various tobacco product use among young adults

INTRODUCTION

Young adults are at high risk for using traditional and novel tobacco products. However, little is known about daily/weekly use patterns or psychosocial triggers for using various tobacco products.

METHODS

This ecological momentary assessment (EMA) study examined timing, tobacco cravings, affect, social context, and other substance use (alcohol, marijuana) in relation to use of cigarettes, electronic nicotine delivery systems (ENDS), and any tobacco product (i.e., cigarettes, ENDS, cigars, hookah), respectively. We also examined interactions between these predictors, sex, and race/ethnicity. From a longitudinal study of 3418 18-25 year-olds from seven Georgia colleges/universities, we recruited 72 reporting current tobacco use to participate in the 21-day EMA study; 43 participated, of which 31 completed ≥66% assessments and were analyzed. Cravings, affect, social context, and substance use were assessed daily across four four-hour windows.

RESULTS

Of the 31 participants, average age was 21.10 years (SD = 1.95), 45.2% were female, and 71.0% non-Hispanic White; 71.0% used cigarettes, 58.1% ENDS, 38.7% cigars, and 25.8% hookah (25.6% used one product, 46.5% two, 27.9% ≥ three). Predictors of cigarette use included higher anxiety, greater odds of marijuana and alcohol use, and higher boredom levels among women. Predictors of ENDS use included being non-White and greater odds of marijuana use, as well as higher tobacco cravings among women and higher boredom among men. Predictors of any tobacco product use included being non-White, higher boredom levels, and greater odds of marijuana and alcohol use.

CONCLUSIONS

Distinct interventions may be needed to address use of differing tobacco products among young adults.

Nye bruksmønstre i et tobakksmarked i endring – kombinert bruk av sigaretter, snus og e-sigaretter blant ungdom

Objectives:

There is limited research on combined use of cigarettes, snus and e-cigarettes in the Nordic countries. This study will investigate whether this pattern of use occurs among adolescents in Norway. In addition, we will investigate the association between combined use of several tobacco products, e-cigarettes and socio-demographic and psychosocial factors (SPF).

Method:

A school-based cross-sectional survey of adolescents in the 8th to the 12th grade (N = 875) in 2014. Information on the use of cigarettes, snus, e-cigarettes and SPF was collected using an electronic questionnaire.

Results:

Of the adolescents, 31% reported having tried or used one or more tobacco product and/or e-cigarette. Of these, over half reported having tried or used one product, 1/3 two products and 1/10 three products. There were more boys among poly-users (63%) than among single-users (44%). Compared to single-users, poly-users also reported weaker school performance (30% and 11%, respectively), more often reported drinking alcohol to intoxication (91% and 75%, respectively), and having tried cannabis (28% and 9%, respectively). Poly-users also scored higher on impulsivity, sensation-seeking and depression.

Conclusion:

The study shows that combined use of tobacco products and e-cigarettes occurs among young people in Norway. Such use was associated with psychosocial and socio-demographic risk factors. There is a need to investigate this phenomenon in more details in representative samples.

Psychosocial and cessation-related differences between tobacco-marijuana co-users and single product users in a college student population

Limited research has examined psychosocial factors that differ among cigarette users, marijuana users, and co-users and influence their cessation efforts. We examined: 1) sociodemographic, mental health, and other substance use in relation to user category; and 2) associations among these factors in relation to recent quit attempts and readiness to quit among single product versus co-users. We used a cross-sectional design to study college students aged 18-25 from seven Georgia campuses, focusing on the 721 reporting cigarette and/or marijuana use in the past 4months (238 cigarette-only; 331 marijuana-only; 152 co-users). Multinomial logistic regression showed that correlates (p's<0.05) of cigarette-only versus co-use included attending public or technical colleges (vs. private) and not using little cigars/cigarillos (LCCs), e-cigarettes, and alcohol. Correlates of marijuana-only versus co-use included being Black or Hispanic (vs. White), not attending technical school, and not using LCCs and e-cigarettes. Importance was rated higher for quitting cigarettes versus marijuana, but confidence was rated lower for quitting cigarettes versus marijuana (p's<0.001). Co-users were more likely to report readiness to quit and quit attempts of cigarettes versus marijuana (p's<0.001). While 23.26% of marijuana-only and 15.13% of cigarette-only users reported readiness to quit, 41.18% of cigarette-only and 21.75% of marijuana-only users reported recent quit attempts (p's<0.001). Binary logistic regressions indicated distinct correlates of readiness to quit and quit attempts of cigarettes and marijuana. Cessation efforts of the respective products must attend to co-use with the other product to better understand relative perceptions of importance and confidence in quitting and actual cessation efforts.