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Ouellette RR, Morean ME, Lee J, Kong G. Use of ENDS devices and modifications to vape cannabis among adolescents and young adults who also vape nicotine. Addict Behav 2024; 157:108099. [PMID: 39003977 DOI: 10.1016/j.addbeh.2024.108099] [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: 02/01/2024] [Revised: 06/03/2024] [Accepted: 06/29/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS) are the most used tobacco product among adolescents and young adults (AYAs) and are increasingly used to vape cannabis. It is unclear what vaping devices and ENDS modifications are used most frequently by AYAs who vape both nicotine and cannabis. METHODS AYAs (aged 14-29) reporting ENDS use in the past 30 days were recruited via Qualtrics (N = 1,011). We conducted three multivariable logistic regression models examining differences in likelihood of: 1) vaping cannabis in the past 30 days; 2) mixing cannabis and nicotine liquids; and 3) using nicotine devices to vape cannabis; based on type of vaping device used most often, controlling for age, socio-economic status, gender, race, frequency of ENDS use, and other cannabis use. RESULTS 40 % (n = 405) of AYAs reported vaping both nicotine and cannabis in the past 30 days. AYAs who used vape pens most often were more likely to have vaped cannabis concentrates in the past 30 days compared to individuals using disposable vapes (aOR = 2.72, 95 %CI = 1.75-4.21, p < 0.001). AYAs who used open systems most often (i.e., vape pens, mods, or e-hookah) were more likely than individuals using closed systems (i.e., disposable vapes, rechargeable pods or cigalikes) to combine nicotine and cannabis e-liquids (aOR = 2.03, 95 %CI = 1.43-2.89, p < 0.001) or use a nicotine device to vape cannabis (aOR = 1.66, 95 %CI = 1.17-2.34, p = 0.005). IMPLICATIONS Co-use of cannabis and nicotine via similar devices, particularly vape pens and other open-systems, warrants collaborative regulatory efforts to mitigate co-use of both substances, with a particular need for increased regulation of cannabis vaping products.
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Affiliation(s)
- Rachel R Ouellette
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
| | - Meghan E Morean
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Juhan Lee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
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Kong G, Lee J, Ouellette RR, Morean ME. Modification of Electronic Nicotine Delivery Systems Among Adolescents and Young Adults. Pediatrics 2024; 154:e2023063984. [PMID: 38881359 PMCID: PMC11211691 DOI: 10.1542/peds.2023-063984] [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: 08/16/2023] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVES We assessed awareness and perceptions of, information sources about, and engagement in modifying electronic nicotine delivery systems (ENDS) among adolescents and young adults (AYAs). METHODS AYAs (N = 1018) endorsing past-month ENDS use completed a survey on awareness and use of the following modifications: (1) refilling rechargeable cartridges/pods or (2) disposable pods, (3) rewicking or (4) recharging disposable pods, (5) modifying nicotine e-liquids (eg, changing propylene glycol/vegetable glycerin, nicotine), (6) combining nicotine and cannabis for simultaneous vaping, and (7) putting cannabis in ENDS designed for nicotine vaping. Logistic regression assessed how sources of information (eg, friends, social media, nonsocial media Web sites, vape shops) about and perceptions of ENDS modifications associated with ENDS modifications. RESULTS Refilling (69.0% heard, 40.1% tried) and recharging the battery (66.4% heard, 35.8% tried) of disposable pods were most common. Friends (64.4%) and social media (46.7%) were the most common sources of information. Notable significant associations between information sources and modifications were: 1. nonsocial media Web sites and vape shops with rewicking and recharging disposable devices and modifying nicotine e-liquid; 2. nonsocial media Web sites with refilling rechargeable cartridges/pods and disposable pods; and 3. social media with recharging disposable devices and mixing nicotine and cannabis liquids. Perceptions of reduced harm and "coolness" were associated with various modifications. DISCUSSION AYAs are aware of and modify ENDS for purposes unintended by manufacturers. ENDS policies should consider unintended ENDS use to safeguard public health. Prevention efforts should communicate about the potential harms of ENDS modifications.
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Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Juhan Lee
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | | | - Meghan E. Morean
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Vogel EA, Ranker LR, Harrell PT, Hart JL, Kong G, McIntosh S, Meissner HI, Ozga JE, Romer D, Stanton CA. Characteristics of Adolescents' and Young Adults' Exposure to and Engagement with Nicotine and Tobacco Product Content on Social Media. JOURNAL OF HEALTH COMMUNICATION 2024; 29:383-393. [PMID: 38775659 PMCID: PMC11229177 DOI: 10.1080/10810730.2024.2355291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
To inform policy and messaging, this study examined characteristics of adolescents' and young adults' (AYAs') exposure to and engagement with nicotine and tobacco product (NTP) social media (SM) content. In this cross-sectional survey study, AYAs aged 13-26 (N=1,163) reported current NTP use, SM use frequency, and exposure to and engagement with SM content promoting and opposing NTP use (i.e. frequency, source[s], format[s], platform[s]). Participants who used NTPs (vs. did not use) were more likely to report having seen NTP content (p-values<.001). Prevalent sources were companies/brands (46.6%) and influencers (44.4%); prevalent formats were video (65.4%) and image (50.7%). Exposure to content promoting NTP use was prevalent on several popular platforms (e.g. TikTok, Instagram, Snapchat); exposure to content opposing NTP use was most prevalent on YouTube (75.8%). Among those reporting content engagement (i.e. liking, commenting on, or sharing NTP content; 34.6%), 57.2% engaged with influencer content. Participants reported engaging with content promoting and opposing NTP use on popular platforms (e.g. TikTok, Instagram, YouTube). Participants with (versus without) current NTP use were significantly more likely to use most SM platforms and to report NTP content exposure and engagement (p-values<.05). Results suggest that NTP education messaging and enforcement of platforms' content restrictions are needed.
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Affiliation(s)
- Erin A Vogel
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lynsie R Ranker
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Joy L Hart
- Department of Communication, College of Arts and Sciences; Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Scott McIntosh
- Division of Social & Behavioral Sciences, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Helen I Meissner
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
| | - Jenny E Ozga
- Behavioral Health & Health Policy, Westat, Rockville, Maryland, USA
| | - Dan Romer
- University of Pennsylvania Annenberg School for Communication, Philadelphia, Pennsylvania, USA
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Ouellette RR, Selino S, Kong G. Electronic Nicotine Delivery Systems and E-Liquid Modifications to Vape Cannabis Depicted in Online Videos. JAMA Netw Open 2023; 6:e2341075. [PMID: 37917060 PMCID: PMC10623192 DOI: 10.1001/jamanetworkopen.2023.41075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/21/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Electronic nicotine delivery systems (ENDS) were created to vape nicotine e-liquids; however, social media demonstrates increased ENDS modifications to vape cannabis. Analysis of social media content helps with understanding ENDS modifications for cannabis use, overlapping markets for ENDS and cannabis, and the need for additional regulation. Objective To analyze online videos for use, modification, and marketing of ENDS to vape cannabis. Design, Setting, and Participants In this qualitative study, 10 searches were performed on YouTube on July 14, 2022, using different combinations of relevant search terms to identify videos depicting modifications to ENDS and e-liquids to vape cannabis. The first 40 videos from each search (400 videos total, 152 without duplicates) were extracted, of which 59 included depiction or discussion of cannabis vaping content. Content analysis of videos included iterative development of codes, consensus building across team members, and reliability checks. Main Outcomes and Measures Metadata (ie, video length, number of likes, comments, and views) were extracted for included videos. Coding was performed for uploader type, modifications to ENDS and e-liquids, devices used, cannabis products vaped, age restriction, purchasing links, health claims, and discussion of warning messages and cannabis regulations. Results Of the 59 videos analyzed, 34 (58%) included tetrahydrocannabinol; 33 (56%), cannabidiol; and 8 (14%), both. A total of 21 videos (36%) were age-restricted, while 25 (42%) included purchasing links for cannabis products, 20 (34%) for ENDS, and 7 (12%) for nicotine e-liquids. Twenty-six videos (44%) made claims about health benefits of vaping cannabis. Forty-one videos (69%) demonstrated vaping manufacturer-made cannabis products (eg, cannabis concentrates) with no modifications needed. Eighteen videos (31%) depicted modifications to e-liquids or ENDS for cannabis use. The most frequent modification was mixing e-liquids with cannabis products to be compatible with ENDS. The most frequently reported reason for modifications was to vape cannabis in public by using the same devices used for nicotine. Conclusions and Relevance This qualitative study of online videos found high frequencies of statements about health benefits from vaping cannabis, frequent purchasing links, and inadequate age restrictions. Exposure to such content on social media platforms may increase risk of cannabis vaping among youth. Use of the same devices for multiple substances may also enable dual use and complicate the US Food and Drug Administration's regulation of ENDS.
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Affiliation(s)
| | - Sophia Selino
- The Consultation Center, Yale School of Medicine, New Haven, Connecticut
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Donaldson SI, Dormanesh A, Perez C, Zaffer MO, Majmundar A, Unger JB, Allem JP. Monitoring the Official YouTube Channels of E-Cigarette Companies: A Thematic Analysis. HEALTH EDUCATION & BEHAVIOR 2023; 50:677-682. [PMID: 36680338 DOI: 10.1177/10901981221148964] [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] [Indexed: 01/22/2023]
Abstract
BACKGROUND E-cigarette companies use YouTube to foster brand awareness, market their products, and interact with current and future tobacco users. However, research on the official YouTube channels of e-cigarette companies is limited. This study determined the themes of, and degree of user engagement with, videos posted to the official channels of e-cigarette companies on YouTube. METHODS Data were collected from the official YouTube channels of seven e-cigarette companies by scraping (i.e., electronically copying) the videos. The earliest video was posted on October 10, 2013, and the most recent video was posted on April 22, 2021 (n = 260). An inductive approach was used to identify themes in the data. User engagement with posts including number of likes, dislikes, and comments were also collected. RESULTS Prevalent themes included branding (n = 250 of 260 videos, 96%), youth use (n = 222, 85%), and tobacco use (n = 210, 81%), while less common themes included misleading health statements (n = 4, 2%), personal choice (n = 4, 2%), and antitobacco (n = 2, 1%). Videos that contained the themes testimonial, product design features, and instructional received the highest mean number of likes. Videos that contained the themes antitobacco, cessation, and testimonial received the highest mean number of dislikes. The 260 videos in this study were collectively viewed 6,619,700 times as of May 5, 2021. CONCLUSIONS Videos from the official YouTube channels of seven e-cigarette companies often focused on branding and user experience but rarely mentioned cessation. While videos about cessation were rare, they received the second highest mean number of dislikes. Future research should assess the impact of exposure to e-cigarette-related content on YouTube and e-cigarette-related attitudes and behaviors.
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Affiliation(s)
| | | | - Cindy Perez
- University of Southern California, Los Angeles, CA, USA
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6
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Churchill V, Fairman RT, Brown D, Massey ZB, Ashley DL, Popova L. "I Get the Flavors and It Makes Me Love Vaping More": How and Why Youth Users Modify Electronic Nicotine Delivery Systems. Nicotine Tob Res 2023; 25:1791-1797. [PMID: 37358211 PMCID: PMC10475604 DOI: 10.1093/ntr/ntad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Youth in the United States are using electronic nicotine delivery systems (ENDS) at a high rate. Modifications to ENDS by youth can introduce additional health hazards which have not been previously considered. To better understand these risks, we need more information on what these modifications are, the motivations behind them, and the sources of information on modifications. AIMS AND METHODS Utilizing a trained moderator, in 2020-2021, we conducted one-on-one interviews with 19 youth ENDS users aged 16-17 living in the United States and analyzed their responses using a qualitative description approach. RESULTS The most prominent modification was to the e-liquid; youth indicated they mixed e-juices to create new flavors and added substances not intended for vaping, including illicit drugs such as cannabis and cocaine. Few youths from our sample were interested in achieving a specific nicotine level to vape, and modifications to the battery, coil and wick were less frequently mentioned. Some of these modifications were motivated by a desire to achieve specific experiences with their device. At other times, modifications were made due to necessity because of limited access to ENDS devices and supplies. YouTube and peers were the main sources of information about modifying. CONCLUSIONS Youth are making modifications that are both intended and unintended by the manufacturer. Adding illicit drugs and other substances not made for vaping is of particular concern. Understanding how youth modify ENDS and how that changes their use is important to guide regulatory policy intended to reduce harm to youth from ENDS use. IMPLICATIONS Youth from our study indicated that they make modifications to the ENDS devices, specifically to the e-liquid. These modifications are both intended by the manufacturer, such as changing the e-liquid and replacing coils, and unintended, such as adding substances not meant for vaping. Future policies aimed at reducing youth ENDS use should consider mandating better safeguards against modifications that appeal to youth.
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Affiliation(s)
- Victoria Churchill
- Morehouse School of Medicine, Cancer Health Equity Institute, Atlanta, GA, USA
| | - Robert T Fairman
- Georgia State University School of Public Health, Atlanta, GA, USA
| | - Devon Brown
- JSI Research & Training Institute, Inc., Atlanta, GA, USA
| | | | - David L Ashley
- Georgia State University School of Public Health, Atlanta, GA, USA
| | - Lucy Popova
- Georgia State University School of Public Health, Atlanta, GA, USA
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7
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Lee J, Krishnan-Sarin S, Kong G. Social media use and cannabis vaping initiation among US youth. Drug Alcohol Depend 2023; 249:109949. [PMID: 37290171 PMCID: PMC10330929 DOI: 10.1016/j.drugalcdep.2023.109949] [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: 12/04/2022] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Youth cannabis vaping has increased in recent years, and there is growing evidence of cannabis vaping content on social media. This study investigated if social media use is associated with the initiation of cannabis vaping among US youth, using the youth dataset from Population Assessment of Tobacco and Health (PATH) Study Waves 4 (2016-2018) and 5 (2018-2019). METHODS Using youth respondents who never vaped cannabis at Wave 4 (N=8357), we conducted a multivariable logistic regression analysis on initiation of cannabis vaping at Wave 5 (i.e., ever-vaped cannabis) by frequency of social media use, after controlling for covariates (e.g., sociodemographic, other tobacco and substance use). RESULTS In this analytic sample, 66.5% reported daily social media use, 16.2% reported non-daily and 17.3% reported 'not having a social media account' or 'no social media use' at Wave 4. Further, 14.0% (n=1183) initiated cannabis vaping at Wave 5. In the multivariable logistic regression model, daily social media use (vs. never use; aOR=2.68; 95% CI=2.05, 3.49) and non-daily social media use (vs. never use; aOR=1.54; 95% CI=1.14, 2.09) at Wave 4 were associated with cannabis vaping initiation at Wave 5. CONCLUSIONS Our evidence suggests that social media use by youth is associated with cannabis vaping initiation among youth in subsequent years, even after controlling for other risk factors. Consistent surveillance and regulation of cannabis vaping-related content on social media, as well as prevention efforts, including counter-messaging on social media about the potential harms of cannabis vaping, are critically needed.
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Affiliation(s)
- Juhan Lee
- Department of Psychiatry, Yale University School of Medicine, United States.
| | | | - Grace Kong
- Department of Psychiatry, Yale University School of Medicine, United States
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Rutherford BN, Lim CCW, Johnson B, Cheng B, Chung J, Huang S, Sun T, Leung J, Stjepanović D, Chan GCK. #TurntTrending: a systematic review of substance use portrayals on social media platforms. Addiction 2023; 118:206-217. [PMID: 36075258 PMCID: PMC10087142 DOI: 10.1111/add.16020] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/21/2022] [Indexed: 01/05/2023]
Abstract
AIMS There is a growing body of literature exploring the types of substance-related content and their portrayals on various social media platforms. We aimed to summarize how content related to substances is portrayed on various social media platforms. METHODS This systematic review was pre-registered on PROSPERO (ref: CRD42021291853). A comprehensive search was conducted in the databases of PubMed, Scopus, PsycINFO and Web of Science in April 2021. Original qualitative studies published post-2004 that included thematic and sentiment analyses of social media content on tobacco, alcohol, psychostimulant, e-cigarette, cannabis, opiate, stimulant/amphetamine, inhalant and novel psychoactive substance were included. Social media platforms were defined as online web- or application-based platforms that allowed users to generate content and interact via 'liking', comment or messaging features. Only studies that included summative and/or thematic content analyses of substance-related social media content were included. RESULTS A total of 73 studies, which covered 15 905 182 substance-related posts on Twitter, YouTube, Instagram, Pinterest, TikTok and Weibo, were identified. A total of 76.3% of all substance-related content was positive in its depiction of substance use, with 20.2% of content depicting use negatively. Sentiment regarding opiate use however was commonly negative (55.5%). Most studies identified themes relating to Health, Safety and Harms (65.0%) of substance use. Themes relating to Promotions/Advertisements (63.3%), Informative content (55.0%) and Use behaviours (43.3%) were also frequently identified. CONCLUSIONS Substance-related content that promotes engagement with substance use or actively depicts use appears to be widely available on social media. The large public presence of this content may have concerning influences on attitudes, behaviours and risk perceptions relating to substance use, particularly among the most vulnerable and heaviest users of social media-adolescents and young adults.
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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
| | - 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
| | - 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
| | - 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, 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
| | - 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
| | - Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
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Hinds JT, Marti CN, Pasch KE, Loukas A. Longitudinal trajectories of marijuana use in tobacco products among young adult Texas college students from 2015 to 2019. Addiction 2023; 118:372-377. [PMID: 35971289 PMCID: PMC11232895 DOI: 10.1111/add.16027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/03/2022] [Indexed: 01/05/2023]
Abstract
AIMS To measure longitudinal trajectories of marijuana use in four tobacco/nicotine products (hand-rolled cigarettes/spliffs, cigars/blunts, hookah, and e-cigarettes) among young adult Texas college students from 2015 to 2019. DESIGN This study used six consecutive waves of data from the marketing and promotions across colleges in Texas project (Project M-PACT), a longitudinal study of the tobacco behaviors of young adult college students. The first four waves were collected every 6 months (fall 2015-spring 2017), and the final two waves were conducted yearly (spring 2018 and 2019). Growth curve models measured trajectories of marijuana use in tobacco products across the 3.5-year period. SETTING AND PARTICIPANTS A total of 4857 young adults from 24 colleges in the largest metropolitan areas of Texas, United States (Austin, Dallas, Houston, and San Antonio): mean age = 21.0, SD = 2.3; 64.2% assigned female; 36.1% non-Hispanic white, 31.0% Hispanic, and 33.0% other or combination race/ethnicity. MEASUREMENTS Participants completed online surveys assessing their past 6-month use of marijuana in four tobacco products of interest (spliffs, blunts, hookah, and e-cigarettes) and socio-demographic variables (sex, race/ethnicity, age, 2-year/4-year college attendance, and sexual and gender minority identity). FINDINGS Observed vaping marijuana in e-cigarettes approximately doubled between the spring of 2015 and the spring of 2019, from 11.8% to 23.9% following a quadratic time trend (linear OR = 0.84, 95% CI = 0.73-0.97, quadratic OR = 1.18, CI = 1.13-1.22). This same time period saw a quadratic decline in using marijuana in hookah (P < 0.001) and no changes in using hand-rolled cigarettes/spliffs or cigars/blunts for marijuana delivery. CONCLUSIONS The popularity of nicotine e-cigarettes appears to be expanding the avenues for marijuana delivery among young adults in Texas, United States.
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Affiliation(s)
- Josephine T Hinds
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - C Nathan Marti
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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10
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Murthy D, Lee J, Dashtian H, Kong G. Influence of User Profile Attributes on e-Cigarette-Related Searches on YouTube: Machine Learning Clustering and Classification. JMIR INFODEMIOLOGY 2023; 3:e42218. [PMID: 37124246 PMCID: PMC10139687 DOI: 10.2196/42218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/30/2022] [Accepted: 02/06/2023] [Indexed: 05/02/2023]
Abstract
Background The proliferation of e-cigarette content on YouTube is concerning because of its possible effect on youth use behaviors. YouTube has a personalized search and recommendation algorithm that derives attributes from a user's profile, such as age and sex. However, little is known about whether e-cigarette content is shown differently based on user characteristics. Objective The aim of this study was to understand the influence of age and sex attributes of user profiles on e-cigarette-related YouTube search results. Methods We created 16 fictitious YouTube profiles with ages of 16 and 24 years, sex (female and male), and ethnicity/race to search for 18 e-cigarette-related search terms. We used unsupervised (k-means clustering and classification) and supervised (graph convolutional network) machine learning and network analysis to characterize the variation in the search results of each profile. We further examined whether user attributes may play a role in e-cigarette-related content exposure by using networks and degree centrality. Results We analyzed 4201 nonduplicate videos. Our k-means clustering suggested that the videos could be clustered into 3 categories. The graph convolutional network achieved high accuracy (0.72). Videos were classified based on content into 4 categories: product review (49.3%), health information (15.1%), instruction (26.9%), and other (8.5%). Underage users were exposed mostly to instructional videos (37.5%), with some indication that more female 16-year-old profiles were exposed to this content, while young adult age groups (24 years) were exposed mostly to product review videos (39.2%). Conclusions Our results indicate that demographic attributes factor into YouTube's algorithmic systems in the context of e-cigarette-related queries on YouTube. Specifically, differences in the age and sex attributes of user profiles do result in variance in both the videos presented in YouTube search results as well as in the types of these videos. We find that underage profiles were exposed to e-cigarette content despite YouTube's age-restriction policy that ostensibly prohibits certain e-cigarette content. Greater enforcement of policies to restrict youth access to e-cigarette content is needed.
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Affiliation(s)
- Dhiraj Murthy
- Computational Media Lab, School of Journalism and Media Moody College of Communication The University of Texas at Austin Austin, TX United States
| | - Juhan Lee
- Department of Psychiatry Yale School of Medicine New Haven, CT United States
| | - Hassan Dashtian
- Computational Media Lab, School of Journalism and Media Moody College of Communication The University of Texas at Austin Austin, TX United States
| | - Grace Kong
- Department of Psychiatry Yale School of Medicine New Haven, CT United States
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11
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Austin-Datta RJ, Chaudhari PV, Cheng TYD, Klarenberg G, Striley CW, Cottler LB. Electronic Nicotine Delivery Systems (ENDS) use Among Members of a Community Engagement Program. J Community Health 2022; 48:338-346. [PMID: 36436165 PMCID: PMC9702843 DOI: 10.1007/s10900-022-01169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/28/2022]
Abstract
Electronic nicotine delivery systems (ENDS) are relatively new and ENDS use data from community engagement programs may help us understand usage patterns and facilitate targeted longitudinal studies. Community members in Florida, USA, were asked about ENDS use, tobacco use, and health history/concerns by Community Health Workers. Among 7253 members recruited during 2014 to 2021 into our HealthStreet program, 1177 had ever used ENDS; the proportion increased from 12 to 27% from 2014 to 2021 (adjusted odds ratio (aOR) 2.5; 95% CI 1.7-3.5; Ever versus never used ENDS). Ever tobacco use was strongly associated with ENDS use; 69% of ever users were current tobacco users. Demographic determinants (sex, age, race) and food insecurity were strongest predictors of ENDS use. Most who had ever used ENDS were aged 18-25 (aOR 5.9; 95% CI 4.6-7.6; vs. aged 60 + years), White (aOR 3.7; 95% CI 3.2-4.3; vs. Black/African American), male (aOR 1.5; 95% CI 1.3-1.7; vs. female), and recently food insecure (aOR 1.8; 95% CI 1.5-2.0; vs. not recently food insecure). Those with respiratory issues were more likely to have used ENDS compared to those without (aOR 2.0; 95% CI 1.6-2.6; aOR 1.3; 95% CI 1.1-1.5). Members concerned about hypertension were less likely to have used ENDS (aOR 0.7; 95% CI 0.5-0.9). In this relatively rural, micropolitan sample, tobacco use, socio-economic determinants, and certain health history/concerns were strongly associated with ENDS use. Community outreach approaches are needed to further understand these factors and implement interventions.
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Affiliation(s)
- Rebecca J Austin-Datta
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA.
| | - Piyush Vilas Chaudhari
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
| | - Ting-Yuan David Cheng
- Division of Cancer Prevention and Control, Department of Internal Medicine, The Ohio State University, Columbus, OH, 43201, USA
| | - Geraldine Klarenberg
- UF/IFAS School of Forest, Fisheries, and Geomatics Sciences, Gainesville, FL, 32611, USA
| | - Catherine Woodstock Striley
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
| | - Linda B Cottler
- Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA
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12
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Li Y, Ashley DL, Popova L. Users’ Modifications to Electronic Nicotine Delivery Systems: Content Analysis of YouTube Video Comments. JMIR INFODEMIOLOGY 2022; 2. [PMID: 35992739 PMCID: PMC9387347 DOI: 10.2196/38268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: User modifications can alter the toxicity and addictiveness of electronic nicotine delivery systems (ENDSs). YouTube has been a major platform where ENDS users obtain and share information about ENDS modifications. Past research has examined the content and characteristics of ENDS modification videos. Objective: This study aims to analyze the video comments to understand the viewers’ reactions to these videos. Methods: We identified 168 YouTube videos depicting ENDS modifications. Each video’s top 20 most liked comments were retrieved. The final sample included 2859 comments. A content analysis identified major themes of the comment content. Results: Most comments were directed to creators and interacted with others: 952/2859 (33.30%) expressed appreciation, 135/2859 (4.72%) requested more videos, 462/2859 (16.16%) asked for clarification, and 67/2859 (2.34%) inquired about product purchases. In addition, comments mentioned viewers’ experiences of ENDS modifications (430/2859, 15.04%) and tobacco use (167/2859, 5.84%); about 198/2859 (6.93%) also indicated intentions to modify ENDSs and 34/2859 (1.19%) mentioned that they were “newbies.” Moreover, comments included modification knowledge: 346/2859 (12.10%) provided additional information, 227/2859 (7.94%) mentioned newly learned knowledge, and 162/2859 (5.67%) criticized the videos. Furthermore, few comments mentioned the dangers of ENDS modifications (136/2859, 4.76%) and tobacco use (7/2859, 0.24%). Lastly, among the 15 comments explicitly mentioning regulations, 13/2859 (0.45%) were against and 2/2859 (0.07%) were supportive of regulations. Conclusions: The results indicated acceptance and popularity of ENDS modifications and suggested that the videos might motivate current and new users to alter their devices. Few comments mentioned the risks and regulations. Regulatory research and agencies should be aware of online ENDS modification information and understand its impacts on users.
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Affiliation(s)
- Yachao Li
- Department of Communication Studies, The College of New Jersey, Ewing, NJ, United States
- Department of Public Health, The College of New Jersey, Ewing, NJ, United States
| | - David L Ashley
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, GA, United States
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13
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Electronic Nicotine Delivery System (ENDS) Device Types and Flavors Used by Youth in the PATH Study, 2016-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095236. [PMID: 35564630 PMCID: PMC9101111 DOI: 10.3390/ijerph19095236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 02/06/2023]
Abstract
The evolving electronic nicotine delivery system (ENDS) marketplace and recent regulatory actions may influence youth ENDS device preferences. Using data from Waves (W) 4, 4.5, and 5 (2016–2019) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study, this study estimated the prevalence of open and closed system primary ENDS use by youth (12–17 years) current (past 30-day) ENDS users, and compared demographics, tobacco use characteristics, and patterns of ENDS use, including flavors, by device type. Among current ENDS users, closed system use was significantly higher than open system use in W4.5 (68.3% vs. 31.7%) and W5 (60.5% vs. 39.5%). In W5, closed system users were more likely to have a regular ENDS brand, believe their ENDS had nicotine, and use tobacco and mint or menthol flavors in the past 30 days compared to open system users. In W5, users of closed systems were less likely to use fruit, non-alcoholic drink, and candy, desserts, or other sweets flavors in the past 30 days than users of open systems. Youth were more likely to use closed over open system ENDS in 2017–2019. Differences were observed between device types, particularly with flavor use, reflecting recent changes in flavored product availability.
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14
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Douglas AE, Childers MG, Romm KF, Felicione NJ, Ozga JE, Blank MD. Device features and user behaviors as predictors of dependence among never-smoking electronic cigarette users: PATH Wave 4. Addict Behav 2022; 125:107161. [PMID: 34710840 PMCID: PMC8629948 DOI: 10.1016/j.addbeh.2021.107161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Electronic cigarettes (ECIGs) vary greatly in their ability to deliver nicotine, which suggests they may also vary in their ability to produce dependence. This study examined individual and combined ECIG device features, and also user behaviors, as predictors of dependence in never-smoking ECIG users. Methods Data were collected from 711 current ECIG users who had smoked <100 cigarettes in their lifetime at Wave 4 of the Population Assessment of Tobacco and Health (PATH) Study. Multivariable linear regressions examined individual (e.g., contains nicotine, uses a tank, flavor preference) and combined (e.g., refillable tanks, refillable mods) device features, and user behaviors (e.g., uses/day) as predictors of dependence, withdrawal, and craving after accounting for demographic variables. Results Results for ECIG dependence and craving showed a similar pattern; higher levels were observed for older age, more frequent past 30-day use, using an ECIG containing nicotine (vs no nicotine), and using a non-refillable cartridge or refillable tank style (vs disposables). Higher withdrawal levels were observed for higher education levels and individual device features of tank (vs no tank), cartridge (vs no cartridge), refillable (vs non-refillable), and "other" flavor preference (vs tobacco flavor). Lower withdrawal levels were associated with a preference for sweet/fruit flavor(s) (vs tobacco flavor). Conclusions Few use behaviors and device features, whether examined alone or in combination, predicted dependence-related outcomes. Findings underscore the challenge with regulating ECIG products in the current marketplace, which is inundated with a myriad of device types.
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Affiliation(s)
- Ashley E. Douglas
- Department of Psychology, 53 Campus Drive, 2214 Life Sciences Building, West Virginia University, Morgantown WV 26506 USA
| | - Margaret G. Childers
- Department of Psychology, 53 Campus Drive, 2214 Life Sciences Building, West Virginia University, Morgantown WV 26506 USA
| | - Katelyn F. Romm
- Milken Institute School of Public Health, 800 22 Street NW #7000C, George Washington University, Washington, DC 20052 USA
| | - Nicholas J. Felicione
- Department of Health Behavior, 665 Elm Street, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14216 USA
| | - Jenny E. Ozga
- Department of Behavioral Medicine & Psychiatry, 3602 Collins Ferry Road, West Virginia University, Morgantown, WV 26505 USA
| | - Melissa D. Blank
- Department of Psychology, 53 Campus Drive, 2214 Life Sciences Building, West Virginia University, Morgantown WV 26506 USA
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15
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Dashtian H, Murthy D, Kong G. An Exploration of e-Cigarette-Related Search Items on YouTube: Network Analysis. J Med Internet Res 2022; 24:e30679. [PMID: 35084353 PMCID: PMC8832267 DOI: 10.2196/30679] [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: 05/24/2021] [Revised: 09/27/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background e-Cigarette use among youth is high, which may be due in part to pro–e-cigarette content on social media such as YouTube. YouTube is also a valuable resource for learning about e-cigarette use, trends, marketing, and e-cigarette user perceptions. However, there is a lack of understanding on how similar e-cigarette–related search items result in similar or relatively mutually exclusive search results. This study uses novel methods to evaluate the relationship between e-cigarette–related search items and results. Objective The aim of this study is to apply network modeling and rule-based classification to characterize the relationships between e-cigarette–related search items on YouTube and gauge the level of importance of each search item as part of an e-cigarette information network on YouTube. Methods We used 16 fictitious YouTube profiles to retrieve 4201 distinct videos from 18 keywords related to e-cigarettes. We used network modeling to represent the relationships between the search items. Moreover, we developed a rule-based classification approach to classify videos. We used betweenness centrality (BC) and correlations between nodes (ie, search items) to help us gain knowledge of the underlying structure of the information network. Results By modeling search items and videos as a network, we observed that broad search items such as e-cig had the most connections to other search items, and specific search items such as cigalike had the least connections. Search items with similar words (eg, vape and vaping) and search items with similar meaning (eg, e-liquid and e-juice) yielded a high degree of connectedness. We also found that each node had 18 (SD 34.8) connections (common videos) on average. BC indicated that general search items such as electronic cigarette and vaping had high importance in the network (BC=0.00836). Our rule-based classification sorted videos into four categories: e-cigarette devices (34%-57%), cannabis vaping (16%-28%), e-liquid (14%-37%), and other (8%-22%). Conclusions Our findings indicate that search items on YouTube have unique relationships that vary in strength and importance. Our methods can not only be used to successfully identify the important, overlapping, and unique e-cigarette–related search items but also help determine which search items are more likely to act as a gateway to e-cigarette–related content.
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Affiliation(s)
- Hassan Dashtian
- The Computational Media Lab and School of Journalism and Media, The University of Texas at Austin, Austin, TX, United States
| | - Dhiraj Murthy
- The Computational Media Lab and School of Journalism and Media, The University of Texas at Austin, Austin, TX, United States
| | - Grace Kong
- The Department of Psychiatry at Yale School of Medicine, New Haven, CT, United States
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16
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"It's Cool, Modifying and All, but I Don't Want Anything Blowing Up on Me:" A Focus Group Study of Motivations to Modify Electronic Nicotine Delivery Systems (ENDS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211735. [PMID: 34831491 PMCID: PMC8619023 DOI: 10.3390/ijerph182211735] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/03/2022]
Abstract
Introduction: Modifications to electronic nicoti ne delivery systems (ENDS) can pose health risks to users. This study explored users’ motivations for modifying ENDS devices and how perceived risks of modifications influenced modification behaviors as product availability and device characteristics changed over time. Method: We conducted nine focus groups (February–June 2020) with 32 current ENDS users (18+, used ENDS in the past 30 days, and had been using ENDS for more than 2 months). Results: Participants primarily modified ENDS devices to improve their experiences, such as experimenting with flavor, controlling nicotine levels, or using cannabis products with ENDS. Another reason for modifying was routine maintenance to ensure a satisfactory experience, including maintaining coils and keeping batteries charged. The broader availability of ENDS products shifted modification behaviors over time, with newer devices making some modifications (e.g., coil replacement) easier and making more intricate modifications (e.g., building coil from scratch) less common. Participants were aware of modification dangers and cited perceived risk as the reason for avoiding certain modifications, such as battery alterations. Conclusions: Modifications of ENDS are ongoing and evolving among users and should be considered by the Food and Drug Administration (FDA) and other regulatory decision-makers as product authorization reviews are conducted and product standards are developed.
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17
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Lim CCW, Leung J, Chung JYC, Sun T, Gartner C, Connor J, Hall W, Chiu V, Tisdale C, Stjepanović D, Chan G. Content analysis of cannabis vaping videos on YouTube. Addiction 2021; 116:2443-2453. [PMID: 33561317 DOI: 10.1111/add.15424] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/05/2020] [Accepted: 01/13/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS There has been an increase in the potency of cannabis during the last two decades and adoption of a novel method of administration-vaping. YouTube, a social media platform, has become a popular source to access cannabis-related information. This study aimed to identify cannabis vaping YouTube videos from 2016 to 2020 and examine the themes and metrics. DESIGN Cross-sectional sample of 200 YouTube videos. SETTING YouTube, an on-line video sharing platform. MEASUREMENTS Videos related to cannabis vaping were identified using the search terms: 'vaping cannabis', 'vaping weed', 'vaping marijuana' and 'vaping THC' [tetrahydrocannabinol]. Videos were independently coded by two researchers. The number of views, likes, dislikes and comments were also collected. Robust regression was used to analyse the relationship between identified video themes and video metrics. FINDINGS Six themes were identified: 'advertisement', 'product review', 'celebratory', 'reflective', 'how-to' and 'warning'. The 'how-to' and 'celebratory' videos received the highest number of views and likes. The most popular video was viewed more than 4 000 000 times. Many videos portrayed risky behaviour (e.g. vaping a whole THC cartridge in a single setting). Fifty-two percent of these videos had no age access restrictions. The robust regression model also found that engagement metric was positively associated with 'reflective' videos and negatively associated with 'advertisement' videos. CONCLUSIONS A large number of videos on cannabis vaping are available on-line without age-restriction. Videos that portrayed risky behaviour appear to be prevalent.
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Affiliation(s)
- Carmen C W Lim
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Jack Yiu Chak Chung
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Coral Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.,Queensland Alliance for Environmental Health Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Woolloongabba, QLD, Australia
| | - Jason Connor
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Vivian Chiu
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Calvert Tisdale
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
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18
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Massey ZB, Brockenberry LO, Murray TE, Harrell PT. Dripping Technology Use Among Young Adult E-Cigarette Users. Tob Use Insights 2021; 14:1179173X211035448. [PMID: 34377042 PMCID: PMC8327010 DOI: 10.1177/1179173x211035448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Young adults are increasingly using electronic nicotine delivery systems (ENDS). The standard ENDS device involves an electric coil that heats a wick to vaporize an e-liquid solution. "Dripping" is another method that involves applying e-liquid directly to the coil. Dripping increases risk of harmful toxic compounds in vapor aerosols. Despite evidence of high levels of dripping among adolescents, young adult prevalence is unknown. METHODS Young adults aged 18 to 24 completed an online survey assessing vaping and dripping status, type of devices used, tobacco use, and vaping expectancies. Among ever-vapers, univariate and multivariate logistic regression models assessed whether demographics predicted dripping and use of dripping devices. Multivariate Analysis of Variance compared never- and ever-drippers on expectancies for vaping outcomes. RESULTS Over 2 in 5 young adult ever-vapers (43.7%) reported dripping. A multivariate regression model found that male gender (AOR = 1.83), identifying as White (AOR = 2.37), and use of other tobacco products (hookah; AOR = 1.91; cigars; AOR = 2.26; cigarettes; AOR = 2.51) were associated with dripping. E-cigarette users who reported lifetime dripping were more likely to consider vaping stimulating, socially facilitating, and flavorful. They ascribed lower health risks to vaping and felt it could reduce negative affect, weight gain, nicotine cravings, and boredom (all P < .05). CONCLUSION Dripping was a highly prevalent behavior among this sample of young adults, particularly among White males. These findings point to the importance of gaining a greater understanding of the drivers and consequences of vaping and dripping behavior.
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Affiliation(s)
| | - Laurel O Brockenberry
- Division of Community Health &
Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk,
USA
- Department of Psychiatry &
Behavioral Sciences, Eastern Virginia Medical School, Norfolk, USA
| | - Tori E Murray
- Division of Community Health &
Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk,
USA
- Department of Psychiatry &
Behavioral Sciences, Eastern Virginia Medical School, Norfolk, USA
| | - Paul T Harrell
- Division of Community Health &
Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk,
USA
- Department of Psychiatry &
Behavioral Sciences, Eastern Virginia Medical School, Norfolk, USA
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19
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Li Y, Guan M, Hammond P, Berrey LE. Communicating COVID-19 information on TikTok: a content analysis of TikTok videos from official accounts featured in the COVID-19 information hub. HEALTH EDUCATION RESEARCH 2021; 36:261-271. [PMID: 33667311 PMCID: PMC7989330 DOI: 10.1093/her/cyab010] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/02/2021] [Indexed: 05/12/2023]
Abstract
Amid the COVID-19 pandemic, TikTok, an emerging social media platform, has created an information hub to provide users with engaging and authoritative COVID-19 information. This study investigates the video format, type and content of the COVID-19 TikTok videos, and how those video attributes are related to quantitative indicators of user engagement, including numbers of views, likes, comments and shares. A content analysis examined 331 videos from official accounts featured in the COVID-19 information hub. As of 5 May 2020, the videos received 907 930 000 views, 29 640 000 likes, 168 880 comments and 781 862 shares. About one in three videos had subtitles, which were positively related to the number of shares. Almost every video included a hashtag, and a higher number of hashtags was related to more likes. Video types included acting, animated infographic, documentary, news, oral speech, pictorial slideshow and TikTok dance. Dance videos had the most shares. Video themes included anti-stigma/anti-rumor, disease knowledge, encouragement, personal precautions, recognition, societal crisis management and work report. Videos conveying alarm/concern emotions, COVID-19 susceptibility and severity, precaution response efficacy had higher user engagement. Public health agencies should be aware of the opportunity of TikTok in health communication and create audience-centered risk communication to engage and inform community members.
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Affiliation(s)
- Yachao Li
- Department of Communication Studies and Department of Public Health, The College of New Jersey, 2000 Pennington Rd, Ewing, NJ 08618, USA
- Correspondence to: Y. Li. E-mail:
| | - Mengfei Guan
- Department of Communication, University of Arkansas, 417 Kimpel Hall, Fayetteville, AR 72701, USA
| | - Paige Hammond
- Department of Communication Studies and Department of Public Health, The College of New Jersey, 2000 Pennington Rd, Ewing, NJ 08618, USA
| | - Lane E Berrey
- Department of Communication, University of Arkansas, 417 Kimpel Hall, Fayetteville, AR 72701, USA
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20
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Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, Finn SP. Vaping and lung cancer - A review of current data and recommendations. Lung Cancer 2021; 153:11-20. [PMID: 33429159 DOI: 10.1016/j.lungcan.2020.12.030] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lung cancer is the most common cause of cancer mortality worldwide and, while tobacco smoke remains the primary cause, there is increasing concern that vaping and E-cigarette use may also increase lung cancer risk. This review concentrates on the current data, scholarship and active foci of research regarding potential cancer risk and oncogenic mechanisms of vaping and lung cancer. MATERIALS AND METHODS We performed a literature review of current and historical publications on lung cancer oncogenesis, vaping device/e-liquid contents and daughter products, molecular oncogenic mechanisms and the fundamental, potentially oncogenic, effects of electronic cigarette smoke/e-liquid products. RESULTS E-cigarette devices and vaping fluids demonstrably contain a series of both definite and probable oncogens including nicotine derivatives (e.g. nitrosnornicotine, nitrosamine ketone), polycyclic aromatic hydrocarbons, heavy metals (including organometal compounds) and aldehydes/other complex organic compounds. These arise both as constituents of the e-liquid (with many aldehydes and other complex organics used as flavourings) and as a result of pyrolysis/complex organic reactions in the electronic cigarette device (including unequivocal carcinogens such as formaldehyde - formed from pyrolysis of glycerol). Various studies demonstrate in vitro transforming and cytotoxic activity of these derivatives. E-cigarette device use has been significantly increasing - particularly amongst the younger cohort and non-smokers; thus, this is an area of significant concern for the future. CONCLUSION Although research remains somewhat equivocal, there is clear reason for concern regarding the potential oncogenicity of E-Cigarettes/E-Liquids with a strong basic and molecular science basis. Given lag times (extrapolating from tobacco smoke data) of perhaps 20 years, this may have significant future public health implications. Thus, the authors feel further study in this field is strongly warranted and consideration should be made for tighter control and regulation of these products.
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Affiliation(s)
| | - Dhruv Kapoor
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Anne Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Paul James Buchanan
- DCU Cancer Research, Faculty of Science and Health, Dublin City University, Dublin, Ireland; National Institute of Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Kathy Gately
- Department of Clinical Medicine, Trinity College School of Medicine and St James's Hospital, Dublin, Ireland
| | - Sinead Cuffe
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Stephen P Finn
- Department of Pathology, St James' Hospital and Trinity College School of Medicine, Dublin, Ireland
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