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Duan Z, Kasson E, Ruchelli S, Rajamahanty A, Williams R, Sridharan P, Sapra T, Dopke C, Pannell A, Nakshatri S, Berg CJ, Cavazos-Rehg PA. Assessment of Online Marketing and Sales Practices Among Recreational Cannabis Retailers in Five U.S. Cities. Cannabis Cannabinoid Res 2024; 9:e1075-e1090. [PMID: 37699251 PMCID: PMC11386994 DOI: 10.1089/can.2022.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Background: With more states legalizing recreational cannabis, examining cannabis retail and marketing is crucial, as it may influence consumers' perceptions and behaviors. Particularly understudied is online cannabis retail. Methods: In Spring 2022, coders collected and analyzed data regarding retailer characteristics, age verification, and marketing strategies (e.g., product availability, health-related content, promotions, website imagery) among 195 cannabis retail websites in five U.S. cities (Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles, California). Descriptive analyses characterized the websites overall and across cities. Results: Overall, 80.5% verified age for website entry, and 92.8% offered online purchases (92.3% of retailers in Seattle, where prohibited). Of these, 82.9% required age verification for purchases, and 30.9% offered delivery. Almost all (>92%) offered flower/bud, concentrates, edibles, vaping devices, topicals, and tinctures. Health warnings were displayed on 38.3% of websites. Although all five states required health warnings regarding use during pregnancy, only 10.3% had these warnings. In addition, 59.0% posted some unsubstantiated health claims, most often indicating physical and mental health benefits (44.6%). Although Colorado, Washington, and Oregon prohibit health claims, 51.2-53.8% of these retailers posted them. Discounts, samples, or promotions were present on 90.8% of websites; 63.6% had subscription/membership programs. Subpopulations represented in website content included the following: 27.2% teens/young adults, 26.2% veterans, 7.2% sexual/gender minorities, and 5.6% racial/ethnic minorities. Imagery also targeted young people (e.g., 29.7% party/cool/popularity, 18.5% celebrity/influencer endorsement). Conclusions: Regulatory efforts are needed to better monitor promotional strategies and regulatory compliance (e.g., health claims, youth-oriented content, underage access) among online cannabis retailers.
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sabrina Ruchelli
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, Pennsylvania, USA
| | - Aishwarya Rajamahanty
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Priyanka Sridharan
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Tanvi Sapra
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Campbell Dopke
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Alexandria Pannell
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Sapna Nakshatri
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Sridharan P, Romm KF, Berg CJ. Use of Cannabis for Medical or Recreational Purposes Among US Young Adults: Correlates and Implications for Problematic Use and Interest in Quitting. CANNABIS (ALBUQUERQUE, N.M.) 2024; 7:51-64. [PMID: 38975600 PMCID: PMC11225981 DOI: 10.26828/cannabis/2024/000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Objective Recreational and medical cannabis use has increased, particularly among young adults, but little is known regarding who uses for these purposes or how purpose of use is associated with problematic use. Methods We analyzed Fall 2019 survey data among 1,083 US young adults (ages 18-34) reporting past 6-month cannabis use. Multivariable regression analyses examined: 1) characteristics of those using for only/primarily medical purposes, primarily recreationally, and only recreationally vs. equally for medical and recreational purposes (referent; multinomial logistic); and 2) reasons for use in relation to cannabis use disorder symptoms (linear) and driving under the influence of cannabis (DUIC; binary logistic). Results 37.1% used only recreationally, 23.5% primarily recreationally, 21.5% equally for both, and 17.8% medically. Compared to those using equally for medical and recreational purposes, those using only/primarily medically had fewer friends who used cannabis; those using primarily recreationally were younger, more educated, less likely used tobacco, and reported fewer ACEs. Those using only recreationally were younger, more likely male, less likely to report an ADHD diagnosis or past-month alcohol or tobacco use, and reported fewer friends who used cannabis, ACEs, and depressive symptoms. Using equally for medical and recreational purposes (vs. all other cannabis use subgroups) correlated with greater use disorder symptoms and DUIC. Conclusions Using cannabis equally for medical and recreational purposes may pose particularly high-risk, given the association with greater mental health concerns and problematic use. Understanding use profiles and how young adults interpret and distinguish medical and recreational use is critical.
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Affiliation(s)
- Priyanka Sridharan
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University
- George Washington Cancer Center, George Washington University
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Cuomo RE, Purushothaman VL, Mackey TK, Yang JW. Rates of adverse events and related risk factors following e-cigarette use. J Public Health (Oxf) 2024; 46:e230-e239. [PMID: 38282109 DOI: 10.1093/pubmed/fdad281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND E-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample. METHODS A cross-sectional survey was conducted with a sample of 4695 current and former e-cigarette users with a median age of 34 years. The survey collected data on e-cigarette use, adverse events experienced, product characteristics, related behaviors, sociodemographic factors and presence of medical comorbidities. Statistical analyses were conducted using Pearson's chi-squared tests and logistic regression. RESULTS A total of 78.9% of respondents reported experiencing an adverse event within 6 h of using a vaping device, with the most common events being headache, anxiety and coughing. Product characteristics and related behaviors significantly influenced the risk of adverse events. There were also sociodemographic disparities, with Hispanic respondents and those with at least college-level education reporting higher rates of adverse events. CONCLUSIONS Our study found a high rate of adverse events among e-cigarette users. We identified that certain e-cigarette product characteristics, behaviors and medical comorbidities significantly increased the risk of these events.
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Affiliation(s)
- Raphael E Cuomo
- School of Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | | | - Tim K Mackey
- San Diego Supercomputer Center, San Diego, CA 92093, USA
| | - Joshua W Yang
- Department of Public Health, California State University, Fullerton, CA 92831, USA
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Phetphum C, Prajongjeep A, Phuengnam K. Relationship between electronic cigarette use, dual smoking habits, and psychological distress among youth in Northern Thailand: A cross-sectional study. Tob Induc Dis 2024; 22:TID-22-82. [PMID: 38765695 PMCID: PMC11100307 DOI: 10.18332/tid/186860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/08/2024] [Accepted: 04/05/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Amidst the escalating trend of electronic cigarette (e-cigarette) use and dual smoking habits among youth, understanding their potential impact on psychological well-being is imperative. Limited research has explored this relationship, particularly among youth in settings where e-cigarettes are banned. This study investigates the relationship between current e-cigarette and traditional cigarette use patterns and the presence of depression and anxiety symptoms among youth in Thailand. METHODS Using a cross-sectional survey encompassing 3424 individuals aged 15-24 years in Northern Thailand from December 2021 to September 2022, we accessed cigarette and e-cigarette usage over the past 30 days alongside depression and anxiety symptoms over the past two weeks. Multivariable logistic regression was employed to analyze the association of these variables, adjusting for sociodemographic factors. RESULTS Among the surveyed youths, 10.8% reported cigarette use, 6.2% utilized e-cigarettes, and 3.3% were dual users within the past 30 days. Regarding mental health, 33.96% exhibited moderate-severe to severe depression, while 52.54% experienced anxiety at similar levels. After adjusting for covariates, both current e-cigarette users and dual users exhibited heightened depression symptoms (AOR=1.80; 95% CI: 1.30-2.51, and AOR=2.30; 95% CI: 1.49-3.55, respectively) and only e-cigarette use had increased odds of increased anxiety levels (AOR=1.70; 95% CI: 1.24-2.32) compared to non-users. Notably, current cigarette smokers demonstrated no association with depression but had decreased odds of higher levels of anxiety compared to non-users (AOR=0.73; 95% CI: 0.55-0.96). CONCLUSIONS A substantial number of Thai youths are using e-cigarettes and experiencing psychological distress. E-cigarette use is associated with heightened levels of depression and anxiety, whereas cigarette smoking is not associated with depression but is likely to be associated with an increased reporting of anxiety. These contradictory findings highlight the need for comprehensive investigations, especially when e-cigarettes are prohibited.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Tobacco Control Research Unit, Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health Phitsanulok, Phitsanulok, Thailand
| | - Kornkan Phuengnam
- Institute of Nursing, Suranaree University of Technology, Nakhon Ratchasima, Thailand
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Goeckner R, Lewis CS, Simon AL, Pacheco J, Hale J, Choi WS, Daley CM. Understanding American Indian tribal college student knowledge, attitudes, beliefs, and behaviors surrounding alternative tobacco products. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38683876 DOI: 10.1080/07448481.2024.2338416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To examine knowledge, attitudes, beliefs, and behaviors about alternative tobacco products among American Indian tribal college students. PARTICIPANTS One hundred and five tribal college students. METHODS Focus groups, one interview, and demographic surveys. RESULTS Tobacco use varied across the sample with 35.2% of the participants being users of ENDS products and 29.5% were cigarette smokers. Overall, participants viewed electronic nicotine delivery systems and chewing tobacco as primary examples of alternative tobacco products and described a generational divide between alternative and conventional tobacco product use. Alternative tobacco products were not considered suitable for use in traditional contexts. CONCLUSIONS Previously successful cessation programs in this population have relied on cultural tailoring related to traditional tobacco use in American Indian communities. Our findings suggest that this strategy may be less effective for addressing alternative tobacco use. Reliance on the importance of family relationships may prove more impactful in future programming.
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Affiliation(s)
- Ryan Goeckner
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Anthropology, The Ohio State University, Columbus, Ohio, USA
| | - Charley S Lewis
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Health Policy and Management, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Ashlee L Simon
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of English, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Joe Pacheco
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Jason Hale
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Won S Choi
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Christine Makosky Daley
- Institute for Indigenous Studies, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
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Record RA, Groznik M, Sussman M. Communicative Processes Underlying DIY eJuice Mixing Among Young Adult International ENDS Users. HEALTH COMMUNICATION 2024; 39:666-674. [PMID: 36809903 DOI: 10.1080/10410236.2023.2179718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The use of electronic nicotine delivery systems (ENDS) is increasing around the world, with contemporary trends outpacing scientific understanding of the health implications. Such trends include do-it-yourself eJuice mixing (DIY eJuice), which involves the unregulated homemade mixing of fogging agents, nicotine salts, and flavorants to create personalized liquid for ENDS products. The purpose of this study was to employ a grounded theory approach to gather formative data on the communicative processes surrounding the behavior of DIY eJuice mixing among international, young adult ENDS users. Participants were recruited locally for mini focus group discussions via SONA (n = 4) and internationally for an open-ended survey via Prolific (n = 138). Questions explored experiences with the online DIY eJuice community, motivations for mixing, information seeking strategies, flavor preferences, and perceived benefits of mixing. Thematic analysis and flow sketching revealed the underlying processes of social cognitive theory to explain the communicative processes of DIY eJuice mixing behaviors. Specifically, environmental determinants emerged in the form of online and social influences; personal determinants in the form of curiosity and control; and behavioral determinants following a benefits/barriers analysis, particularly regarding cost. These findings provide theoretical implications for the role of health communication constructs in understanding contemporary trends in ENDS use and practical implications for tobacco prevention messaging and tobacco control regulations.
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Affiliation(s)
| | | | - Mark Sussman
- Department of Biology, San Diego State University
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Hatz LE, Courtney KE, Wade NE, Thompson C, Baca R, Andrade G, Doran N, Jacobus J. First Used Nicotine/Cannabis Product and Associated Outcomes in Late Adolescents. Subst Use Misuse 2024; 59:699-706. [PMID: 38170177 PMCID: PMC10923017 DOI: 10.1080/10826084.2023.2294975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND Nicotine and tobacco product (NTP) and cannabis use are common in adolescence/young adulthood and increase risk for negative psychosocial outcomes. This study investigated associations among adolescent/young adults' initial experiences with NTPs, lifetime frequency of substance use, substance-related problems, and mental health symptoms. METHOD Adolescents and young adults enrolled in a study on NTP and cannabis use were asked at what age they initiated the use of NTPs and were assigned to groups based on which product or substance(s) they reported using at the earliest age. Participants who reported use of NTPs (in isolation, without cannabis) first (N = 78, "NTP-only"), simultaneous use of NTPs and cannabis first (e.g., blunt or bowl; N = 25, "Simult-only"), use of both NTPs in isolation and simultaneous use at the same age (N = 48, "NTP + Simult"), and no NTP use (N = 53, "NTP-naïve") were compared on substance use, substance-related problems, and mental health symptoms. RESULTS Groups differed on lifetime frequency of NTP, simultaneous, and cannabis use, with NTP users reporting more substance use episodes and substance-related problems than the NTP-naïve group. The lifetime frequency of cannabis use did not differ across NTP use groups. NTP use was associated with increased anxiety and depression, with no significant differences between groups. CONCLUSIONS Adolescents and young adults who use nicotine may be at increased risk for greater nicotine use and mental health consequences, but initiating NTP use simultaneously with cannabis may not increase the risk of negative outcomes above and beyond nicotine initiation. Prospective longitudinal research is needed to establish temporal associations between first-used NTP/cannabis products and relevant outcomes.
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Affiliation(s)
- Laura E. Hatz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Kelly E. Courtney
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Natasha E. Wade
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Courtney Thompson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Gianna Andrade
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Neal Doran
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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Nabil AK, Barry AE, Kum HC, Ohsfeldt RL. Actual and perceived E-cigarettes behaviors among a national sample of U.S. college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:109-117. [PMID: 35025725 DOI: 10.1080/07448481.2021.2024209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 10/21/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Objective: Electronic cigarette use represents an important college health concern. This investigation assessed demographic and behavioral correlates associated with actual and perceived e-cigarette use among a national sample of American college students. Methods: Respondents (n = 19,861) comprised college students from over 40 distinct American higher education institutions. Multivariable logistic regression assessed whether (1) alcohol, tobacco or marijuana use were associated with e-cigarette use; (2) perceived peer use of alcohol, tobacco or marijuana were associated with perceived e-cigarette use. Results: Approximately 5% of survey respondents self-reported using e-cigarettes within the past month. More than 7 out of every 10 respondents, however, thought the 'typical student' was an e-cigarette user. As perceptions of typical student substance use increased, respondents were far more likely to contend the typical student used e-cigarettes. Discussion: In addition to adopting smoke-free campus policies, university officials should disseminate accurate information regarding e-cigarette behaviors of students.
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Affiliation(s)
- Anas Khurshid Nabil
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Hye-Chung Kum
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Robert L Ohsfeldt
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
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Kreitzberg DS, Pasch KE, Loukas A. Longitudinal patterns of cannabis and tobacco co-administration and concurrent use among young adult college students. Addict Behav 2024; 148:107871. [PMID: 37778233 PMCID: PMC11247418 DOI: 10.1016/j.addbeh.2023.107871] [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: 04/29/2023] [Revised: 09/19/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Co-use, including concurrent use or co-administration, of cannabis and tobacco is most prevalent in young adulthood and associated with worse health outcomes than use of either substance alone. This study examined latent classes of tobacco and cannabis concurrent use and co-administration, and transitions between classes from 2016 to 2019, among a sample of young adult college students in Texas. METHODS Participants included 4,448 young adults (64.2% female, 64.7% non-white, mean age = 20.5) in a longitudinal cohort study. Measures included past 30-day use of cigarettes. hookah, cigars, ENDS, cannabis, and cannabis and tobacco co-administration. Latent Markov models were used to estimate latent class membership and transitions between classes from 2016 to 2017 and 2017 to 2019. RESULTS Four latent classes emerged: non-use (58% of students) characterized by low/no probability of any use; general use (19%) characterized by some level of use of all behaviors; blunt and cannabis use class (13%) characterized by high probabilities of cannabis use and co-administration with blunts; and concurrent and co-administration use (10%) with high probabilities of cigarette, cannabis, blunt, and spliff use. Most students remained in the same latent class from 2016 to 2019. CONCLUSIONS While most students reported low/no tobacco and cannabis co-use, those who used cannabis and/or tobacco remained in their use classes over the course of the study (2016 to 2019). Public health advocates on college campuses should consider prevention and cessation programs that incorporate the constellation of behaviors related to cannabis and tobacco co-use and educate students about the health consequences of co-use.
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Affiliation(s)
- Daniel S Kreitzberg
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA.
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd, Austin, TX 78712, USA
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David JC, Fonte D, Sutter-Dallay AL, Auriacombe M, Serre F, Rascle N, Loyal D. The stigma of smoking among women: A systematic review. Soc Sci Med 2024; 340:116491. [PMID: 38096599 DOI: 10.1016/j.socscimed.2023.116491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/04/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Smoking stigma has been well documented, but little is known regarding its specific features and effects on women. Notably, women face unique social, cultural, and economic challenges that may interact with smoking stigma and impact health outcomes. This review investigates the extent to which smoking women encounter and internalise stigma, while examining the various coping mechanisms they employ to manage these negative experiences. METHODS In November 2022, major databases were systematically searched with no time restrictions. After applying inclusion and exclusion criteria, 23 studies (three quantitative and 20 qualitative) met our criteria. We conducted a quality assessment and summarised the findings pertaining to public stigma, self-stigma, and coping strategies. RESULTS The stigma about smoking emerges from a variety of sources, such as family, healthcare providers, or internet forums. Women smokers are universally aware of the negative image they have in society. Yet, their experiences and management of the stigma of smoking are shaped by other variables such as cultural background, social class, or motherhood status. Smoking stigma produces ambivalent effects, such as concealment, reduced usage of support services, and to a lesser extent, smoking cessation motivation. CONCLUSIONS These results indicate that smoking stigma is an important social justice and public health issue and that further research is needed to better prevent its effects on women's well-being and health behaviours.
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Affiliation(s)
| | | | - Anne-Laure Sutter-Dallay
- Inserm U1219 Bordeaux Population Health, Bordeaux, France; Hôpital Charles Perrens, Bordeaux, France
| | - Marc Auriacombe
- Hôpital Charles Perrens, Bordeaux, France; CNRS UMR 6033, SANPSY, Bordeaux, France
| | | | - Nicole Rascle
- Inserm U1219 Bordeaux Population Health, Bordeaux, France
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Fagan MJ, Vanderloo LM, Banerjee A, Ferguson LJ, Lee EY, O'Reilly N, Rhodes RE, Spence JC, Tremblay MS, Faulkner G. Re-assessing the social climate of physical (in)activity in Canada. BMC Public Health 2023; 23:2548. [PMID: 38124062 PMCID: PMC10734048 DOI: 10.1186/s12889-023-17436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Social-ecological models suggest that a strategy for increasing population physical activity participation is to reconstruct the "social climate" through changing social norms and beliefs about physical activity (PA). In this study, we assessed whether the PA social climate in Canada has changed over a five-year period after controlling for sociodemographic factors and PA levels. Replicating a survey administered in 2018, a sample of adults in Canada (n = 2,507) completed an online survey assessing social climate dimensions, including but not limited to descriptive and injunctive norms. Descriptive statistics were calculated, and binary logistic regressions were conducted to assess the associations of sociodemographic factors and year of the survey with social climate dimensions. Results suggest some social climate constructs are trending in a positive direction between 2018 and 2023. Physical inactivity was considered a serious public health concern by 49% of respondents, second to unhealthy diets (52%). Compared to those who participated in the 2018 survey, participants in 2023 were less likely to see others walking or wheeling in their neighbourhood (OR = 1.58, 95% CI: 1.41, 1.78), but more likely to see people exercising (OR = 0.82, 95% CI: 0.73, 0.92) and kids playing in their neighbourhood (OR = 0.75, 95% CI: 0.66, 0.85). No changes were reported between 2018 and 2023 in individuals' perceptions of whether physical inactivity is due to individual versus external factors (OR = 0.99, 95% CI: 0.87, 1.13). The findings of this work indicate a modest positive shift in some measured components of the social climate surrounding PA although attributing causes for these changes remain speculative.
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Affiliation(s)
- Matthew James Fagan
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Leigh M Vanderloo
- , ParticipACTION, 77 Bloor Street West, Suite 1205, Toronto, ON, Canada
- School of Occupational Therapy, Western University, London, ON, Canada
| | - Ananya Banerjee
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada
| | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Norman O'Reilly
- Graduate School of Business, University of Maine, Orono, ME, USA
| | - Ryan E Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 1-153 Van Vliet Complex, Edmonton, AB, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, ON, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
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Vargees C, Stroup AM, Niznik T, Dunn D, Wyatt R, Hoetger C, Taleb ZB, Cohn AM, Cobb CO, Fetterman JL. Patterns of use, perceptions, and cardiopulmonary health risks of cigar products: a systematic review. BMC Public Health 2023; 23:2357. [PMID: 38017396 PMCID: PMC10685631 DOI: 10.1186/s12889-023-17216-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE A systematic review was conducted to evaluate the use patterns, health perceptions, and cardiopulmonary health effects of cigars. DATA SOURCES PubMed and Google Scholar were searched for peer-reviewed articles published between June 2014 and February 2021. Search keywords included cigars, cigarillos, little cigars, and cardiopulmonary health outcomes. STUDY SELECTION Of 782 papers identified, we excluded non-English articles, review articles, commentaries, and those without empirical data on cigars. Three coders independently reviewed all articles and compared codes to resolve discrepancies. 93 articles met the inclusion criteria and were included. DATA SYNTHESIS Cigars have evolved from premium cigars to encompass little cigars and cigarillos (LCCs). LCCs are available in an array of flavors and at a price advantage, and as a result, are used by different groups compared to premium cigars. LCCs are more frequently used by youth, young adults, and those who identify as Black/African American. LCCs are often used in combination with other tobacco products, alcohol, and cannabis. Despite limited regulation, cigars generate smoke of a similar composition as cigarettes. Among the studies identified, evidence suggests that cigar use is associated with cardiovascular and pulmonary toxicity. Higher all-cause and cancer-related mortalities are associated with cigar use, particularly with more frequent and deeper inhalation, compared to non-tobacco users. CONCLUSIONS LCCs are used more frequently by at-risk groups compared to premium cigars. Recent studies evaluating cigar cardiopulmonary health effects are limited but suggest cigars have similar health risks as conferred by cigarette smoking. With the use of LCCs and targeted marketing on the rise among high-risk groups, there is a critical need for continued research in this area.
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Affiliation(s)
- Comreen Vargees
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, 600 Albany Street, Boston, MA, USA
| | | | - Taylor Niznik
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Delaney Dunn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Riley Wyatt
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St, Richmond, VA, 23284, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St, Richmond, VA, 23220, USA
- Institute for Integrative Health Care and Health Promotion (IGVF), Witten/Herdecke University, Alfred-Herrhausen-Straße 50, Witten, 58455, Germany
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St, Richmond, VA, 23284, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St, Richmond, VA, 23220, USA
| | - Jessica L Fetterman
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, 600 Albany Street, Boston, MA, USA.
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Cui Y, LoParco CR, Bar-Zeev Y, Duan Z, Levine H, Abroms LC, Wang Y, Khayat A, Berg CJ. Theory-based correlates of cannabis use and intentions among US and Israeli adults: a mixed methods study. Subst Abuse Treat Prev Policy 2023; 18:54. [PMID: 37674246 PMCID: PMC10483868 DOI: 10.1186/s13011-023-00562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND In the US and Israel, non-medical ('recreational') cannabis use is illegal at the national level; however, use rates are high and decriminalization and legalization is spreading. Thus, theory-based intervention efforts, especially for youth prevention, are crucial. METHODS This mixed-methods study of adults in the US (n = 1,128) and Israel (n = 1,094) analyzed: 1) cross-sectional survey data (Fall 2021) to identify theory-based correlates (risk perceptions, social norms) of past-month cannabis use, next-year use intentions, and intentions to use in the home or among children if non-medical cannabis was legal, using multivariable regression; and 2) qualitative interviews regarding perceptions of cannabis policies and use (US n = 40, Israel n = 44). RESULTS 16.7% reported past-month use; 70.5%, 56.3%, and 82.6% indicated "not at all likely" regarding next-year use and use in the home and among children if legal. Lower perceived risk and greater social norms were associated with past-month use, greater use intentions, and greater intentions to use in the home or among children. Past-month use was more prevalent among US (vs. Israeli) participants (22.0% vs. 11.2%); however, in multivariable regression controlling for past-month use, being from Israel was associated with greater use intentions (next-year; in the home/among children). Qualitative themes indicated: concerns about use (e.g., increasing use, health risks, driving-related risks) and legalization (e.g., impact on society/economy, marketing), and perceived benefits of use (e.g., medical) and legalization (e.g., access/safety, economic, individual rights). CONCLUSIONS Despite differences in cannabis perceptions and use across countries, perceived risk and social norms are relevant intervention targets regardless of sociopolitical context.
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Affiliation(s)
- Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Zongshuan Duan
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
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14
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Nguyen N, Holmes LM, Pravosud V, Cohen BE, Ling PM. Changes in perceived harms of tobacco and cannabis and their correlations with use: A panel study of young adults 2014-2020. Addict Behav 2023; 144:107758. [PMID: 37263178 PMCID: PMC10330743 DOI: 10.1016/j.addbeh.2023.107758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/24/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE Perceived harm is associated with substance use. Changes in product and policy landscapes may impact perceived harms of tobacco and cannabis. This study aimed to examine changes in young adults' perceived harms of tobacco and cannabis and their associations with use behavior during a period including both before and after legalization of cannabis. METHODS We conducted a panel survey of California Bay Area young adults (mean age = 23.5 years old, 64.4% female) in 2014 and 2019-2020. Participants (N = 306) reported past 30-day use and perceived harms of tobacco and cannabis at both waves. Perceived harms to health of cannabis and tobacco (cigarettes, e-cigarettes, hookah, smokeless tobacco, and secondhand tobacco smoke) were measured from 1-"Not at all harmful" to 7-"Extremely harmful." Mixed-effects logistic regressions examined associations between perceived harms and use of tobacco and cannabis, controlling for demographics. RESULTS Participants perceived lower harm for cannabis than for tobacco products. Perceived harms of e-cigarettes, hookah, and smokeless tobacco significantly increased over time; while perceived harms of cigarettes, secondhand tobacco smoke, and cannabis did not change. Increased perceived harm of e-cigarettes was associated with lower odds of any tobacco use (OR = 0.72, 95%CI = 0.56, 0.92), and increased perceived harm of cannabis was associated with lower odds of any cannabis use (OR = 0.51, 95%CI = 0.42, 0.62). CONCLUSIONS Findings suggest that perceived harms of e-cigarettes and cannabis play important roles in driving young adult use behaviors. Risk communication efforts that increase perceptions of health harms related to e-cigarettes and cannabis may decrease use of tobacco and cannabis among young people.
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Affiliation(s)
- Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Louisa M Holmes
- Departments of Geography and Demography and the Consortium on Substance Use and Addiction, The Pennsylvania State University, PA, USA
| | - Vira Pravosud
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Beth E Cohen
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Department of Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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15
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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16
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Romm KF, Cohn AM, Wang Y, Berg CJ. Psychosocial predictors of trajectories of dual cigarette and e-cigarette use among young adults in the US. Addict Behav 2023; 141:107658. [PMID: 36812780 PMCID: PMC10154740 DOI: 10.1016/j.addbeh.2023.107658] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Young adults have the highest prevalence of cigarette and e-cigarette use, warranting research to identify psychosocial correlates of their use trajectories. METHODS Repeated measures latent profile analyses (RMLPAs) examined past 6-month cigarette and e-cigarette trajectories across 5 waves of data (2018-2020) among 3,006 young adults (Mage = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 60.2% racial/ethnic minority). Multinomial logistic regression models examined associations among psychosocial factors (i.e., depressive symptoms, adverse childhood experiences [ACEs], personality traits) and trajectories of cigarette and e-cigarette use, controlling for sociodemographics and past 6-month alcohol and cannabis use. RESULTS RMLPAs yielded a 6-profile solution, which were uniquely associated with predictors: stable low-level or nonusers of cigarettes and e-cigarettes (66.3%; referent group), stable low-level cigarette and high-level e-cigarette use (12.3%; greater depressive symptoms, ACEs, openness; male, White, cannabis use), stable mid-level cigarette and low-level e-cigarette use (6.2%; greater depressive symptoms, ACEs, extraversion; less openness, conscientiousness; older age, male, Black or Hispanic, cannabis use), stable low-level cigarette and decreasing e-cigarette use (6.0%; greater depressive symptoms, ACEs, openness; younger age, cannabis use), stable high-level cigarette and low-level e-cigarette use (4.7%; greater depressive symptoms, ACEs, extraversion; older age, cannabis use), and decreasing high-level cigarette and stable high-level e-cigarette use (4.5%; greater depressive symptoms, ACEs, extraversion, less conscientiousness; older age, cannabis use). CONCLUSIONS Cigarette and e-cigarette prevention and cessation efforts should be targeted both toward specific trajectories of use and their unique psychosocial correlates.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA
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17
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Kim M, Neilands TB, Gregorich SE, Jordan JW, Ling PM. Young Adult Responses to Peer Crowd-Based Targeting in E-cigarette Advertisements: An Experimental Study. Nicotine Tob Res 2023; 25:1125-1134. [PMID: 37101413 PMCID: PMC10202626 DOI: 10.1093/ntr/ntac292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/16/2022] [Accepted: 12/21/2022] [Indexed: 04/28/2023]
Abstract
AIMS To examine the effects of psychographically targeted e-cigarette advertisements on young adults. METHODS A total of 2100 young adults (18-29 years old) representing five peer crowds (groups with shared values, interests, and lifestyle: Mainstream, Young Professional, Hip Hop, Hipster, and Partier) were recruited from a nationwide opt-in online panel. Participants were randomly assigned to view e-cigarette advertisements featuring characters that either did or did not match their own peer crowd affiliation and evaluated advertising effectiveness using Likert-type and semantic differential scales. Participants also reported their attitudes toward using e-cigarettes. RESULTS No significant overall effect of peer crowd matching was observed. However, significant two-way interaction effects emerged where matching advertisements yielded higher evaluations than mismatching advertisements among those who currently do not use tobacco and nicotine products and among Mainstream participants. Advertisements featuring Mainstream characters were in general rated more highly than other advertisements. Additional analyses found significant effects of peer crowd matching among those who viewed advertisements featuring non-Mainstream characters. CONCLUSIONS Peer crowd-based targeting can increase the effectiveness of e-cigarette advertisements which may impact initiation among current nonusers, requiring stricter marketing regulations. More research is needed to determine if anti-tobacco messaging tailored by peer crowds may effectively counteract targeted e-cigarette marketing. IMPLICATIONS E-cigarette advertisements often use psychographic targeting strategies, using lifestyles, attitudes, and values. Low-risk young adults (eg, those who currently do not use tobacco and nicotine products) are susceptible to psychographically targeted e-cigarette advertisements. This may result in the initiation of e-cigarette use among young adults who would otherwise be less likely to use tobacco and nicotine products. Stricter marketing regulations for emerging tobacco and nicotine products are required to reduce marketing exposure.
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Affiliation(s)
- Minji Kim
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Torsten B Neilands
- Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Pamela M Ling
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
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Fairman BJ, Kimmel HL, Blanco C, Compton WM. Blunt and non-blunt cannabis use associated with cigarette, e-cigarette, and cigar initiation: Findings from the population assessment of tobacco and health (PATH) study. Drug Alcohol Depend 2023; 246:109837. [PMID: 36931132 PMCID: PMC10161973 DOI: 10.1016/j.drugalcdep.2023.109837] [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: 10/19/2022] [Revised: 02/14/2023] [Accepted: 03/05/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Smoking cannabis using a tobacco-derived cigar shell or wrap, called blunt smoking, exposes individuals to non-trivial amounts of nicotine. The extent smoking blunts impact the risk of initiating other tobacco products is not well understood. We investigated if past-year blunt smoking is related to the risk of initiating cigarettes, e-cigarettes, and cigars. METHODS We obtained data on a nationally representative, non-institutionalized, civilian cohort of US residents aged 12 years and older who had never used cigarettes, e-cigarettes, or any cigar at baseline and surveyed annually for three years from the Population Assessment of Tobacco and Health Study. We estimated the proportional hazard (odds) of initiating these tobacco products associated with past-year blunt smoking, non-blunt cannabis use, or neither using discrete-time survival analyses. RESULTS Smoking blunts increased the risk of starting cigarettes (OR = 4.5), e-cigarettes (OR = 3.7), and cigars (OR = 6.7) compared to using neither blunts nor cannabis. Non-blunt cannabis use also increased the risk of starting cigarettes (OR = 4.0) but moderately for e-cigarettes (OR = 2.8) and any cigar (OR = 2.2). Blunt use was strongly related to starting combustible tobacco (cigarettes or cigars; OR = 9.0) and any three tobacco products (OR = 10.9). Exploratory findings showed that cigarillos drove cigar results and effect modification by age, race/ethnicity, and sex. CONCLUSIONS People who smoke blunts risk starting cigarettes, e-cigarettes, and cigars more than those who abstain from cannabis. Blunts may contribute to tobacco initiation above cannabis alone.
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Affiliation(s)
- Brian J Fairman
- Department of Epidemiology, University of Arkansas for Medical Sciences, United States.
| | - Heather L Kimmel
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, United States
| | - Wilson M Compton
- Office of the Director, National Institute on Drug Abuse, National Institutes of Health, United States
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Streck JM, Regan S, Werner M, Glynn A, Villanti AC, Park ER, Wakeman SE, Evins AE, Rigotti NA. Preliminary feasibility of integrating tobacco treatment into SUD peer recovery coaching: a mixed-methods study of peer recovery coaches. Addict Sci Clin Pract 2023; 18:25. [PMID: 37122035 PMCID: PMC10148997 DOI: 10.1186/s13722-023-00380-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Individuals with substance use disorder (SUD) have high prevalence of cigarette smoking and difficulty quitting. Peer recovery coaches (PRCs; individuals with lived SUD experience) facilitate SUD behavior change in recoverees but it is unknown if/how they address tobacco treatment in SUD recovery coaching. We assessed PRC's tobacco-related practices and attitudes about tobacco treatment in SUD recovery. METHODS The Tobacco use In Peer-recovery Study (TIPS) was a cross-sectional mixed-methods pilot survey (January-March 2022) of the 26 PRCs employed by a Massachusetts-based healthcare system's 12 SUD treatment clinics/programs. PRCs completed a quantitative survey (n = 23/26; 88%) and a telephone-based qualitative interview (n = 20/26; 77%). RESULTS One-third of PRCs reported current smoking, 50% reported former smoking, and 18% never smoked. Among PRCs, 61% reported accompanying recoverees outdoors to smoke, 26% smoked with recoverees, 17% had provided cigarettes to recoverees, 32% used smoking to help build peer-relationships, and 74% rated smoking as socially acceptable in SUD treatment. PRCs reported regularly talking to recoverees about tobacco treatment (65%), believed they should have a role in helping recoverees quit smoking (52%), and were interested in tobacco treatment training (65%). A majority of both nonsmoking and current smoking PRCs (73% vs. 57%) regularly talked to recoverees about quitting smoking. CONCLUSION PRCs' attitudes about integrating tobacco treatment into SUD recovery coaching were generally positive and PRCs reported they could have a role in helping recoverees with tobacco treatment. Barriers to integrating tobacco treatment into SUD recovery include use of cigarettes as a peer-recovery tool and high prevalence and social acceptability of smoking in SUD recovery.
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Affiliation(s)
- Joanna M Streck
- Department of Psychiatry, Massachusetts General Hospital (MGH), 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA.
- Harvard Medical School, Harvard University, Boston, MA, USA.
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA.
| | - Susan Regan
- Harvard Medical School, Harvard University, Boston, MA, USA
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
| | - Michael Werner
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
| | - Alexia Glynn
- Department of Psychiatry, Massachusetts General Hospital (MGH), 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
| | - Andrea C Villanti
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital (MGH), 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
| | - Sarah E Wakeman
- Harvard Medical School, Harvard University, Boston, MA, USA
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
| | - A Eden Evins
- Department of Psychiatry, Massachusetts General Hospital (MGH), 100 Cambridge Street, 16th Floor, Boston, MA, 02114, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Nancy A Rigotti
- Harvard Medical School, Harvard University, Boston, MA, USA
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, MGH, Boston, MA, USA
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20
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Fuss C, Romm KF, Crawford ND, Harrington KRV, Wang Y, Ma Y, Taggart T, Ruiz MS, Berg CJ. Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas. Subst Use Misuse 2023; 58:981-988. [PMID: 37082785 PMCID: PMC10645480 DOI: 10.1080/10826084.2023.2201839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Examining opioid use profiles over time and related factors among young adults is crucial to informing prevention efforts. Objectives: This study analyzed baseline data (Fall 2018) and one-year follow-up data from a cohort of 2,975 US young adults (Mage=24.55, 42.1% male; 71.7% White; 11.4% Hispanic). Multinomial logistic regression was used to examine: 1) psychosocial correlates (i.e. adverse childhood experiences [ACEs], depressive symptoms, parental substance use) of lifetime opioid use (i.e. prescription use vs. nonuse, nonmedical prescription [NMPO] use, and heroin use, respectively); and 2) psychosocial correlates and baseline lifetime use in relation to past 6-month use at one-year follow-up (i.e. prescription use vs. nonuse and NMPO/heroin use, respectively). Results: At baseline, lifetime use prevalence was: 30.2% prescription, 9.7% NMPO, and 3.1% heroin; past 6-month use prevalence was: 7.6% prescription, 2.5% NMPO, and 0.9% heroin. Compared to prescription users, nonusers reported fewer ACEs and having parents more likely to use tobacco, but less likely alcohol; NMPO users did not differ; and heroin users reported more ACEs and having parents more likely to use cannabis but less likely alcohol. At one-year follow-up, past 6-month use prevalence was: 4.3% prescription, 1.3% NMPO, and 1.4% heroin; relative to prescription users, nonusers were less likely to report baseline lifetime opioid use and reported fewer ACEs, and NMPO/heroin users were less likely to report baseline prescription opioid use but more likely heroin use. Conclusions: Psychosocial factors differentially correlate with young adult opioid use profiles, and thus may inform targeted interventions addressing different use patterns and psychosocial risk factors.
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Affiliation(s)
- Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Department of Pediatrics, College of Medicine,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Natalie D Crawford
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin R V Harrington
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tamara Taggart
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Monica S Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
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21
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Feliciano JR, Li D, Xie Z. Public Perceptions of Flavored Waterpipe Smoking on Twitter. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5264. [PMID: 37047880 PMCID: PMC10094574 DOI: 10.3390/ijerph20075264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
Waterpipe tobacco smoking has become increasingly popular in recent years, especially among youth. We aimed to understand longitudinal trends in the prevalence and user perception of waterpipes and their flavors on Twitter. We extracted waterpipe-related tweets from March 2021 to May 2022 using the Twitter Streaming API and classified them into promotional tweets and non-promotional tweets. We examined the longitudinal trends regarding the waterpipe flavors mentioned on Twitter and conducted sentiment analysis on each waterpipe flavor-related non-promotional tweet. Among over 1.3 million waterpipe-related tweets, 1,158,884 tweets were classified as non-promotional and 235,132 were classified as promotional. The most frequently mentioned waterpipe flavor groups were fruit (34%), sweets (17%), and beverages (15%) among all flavor-containing non-promotional tweets (17,746 tweets). The least mentioned flavor groups were tobacco (unflavored, 4%) and spices (2%). Sentiment analysis showed that among non-promotional waterpipe-related tweets, 39% were neutral, 36% were positive, and 23% were negative. The most preferred waterpipe flavors were fruit, mixed, and alcohol flavors. The least preferred flavor groups were tobacco and spice flavors. Our study provided valuable information on the prevalence of waterpipe flavors that can be used to support the future regulation of flavored waterpipe tobacco products given the nature of the current regulations on other flavored tobacco products.
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Affiliation(s)
- Juan Ramon Feliciano
- Department of Computer Science, University of Rochester, Rochester, NY 14620, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
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22
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Gresnigt F, van den Brink LC, Hunault C, Franssen E, de Lange D, Riezebos R. Incidence of cardiovascular symptoms and adverse events following self-reported acute cannabis intoxication at the emergency department: a retrospective study. Emerg Med J 2023; 40:357-358. [PMID: 36941035 DOI: 10.1136/emermed-2022-212784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 03/22/2023]
Affiliation(s)
- Femke Gresnigt
- Emergency Department, OLVG, Amsterdam, The Netherlands
- Dutch Poisons Information Center (DPIC), UMC Utrecht, Utrecht, The Netherlands
| | | | - Claudine Hunault
- Dutch Poisons Information Center (DPIC), UMC Utrecht, Utrecht, The Netherlands
| | | | - Dylan de Lange
- Dutch Poisons Information Center (DPIC), UMC Utrecht, Utrecht, The Netherlands
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23
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Sheer VC. The State of Norm-Based Antismoking Research: Conceptual Frameworks, Research Designs, and Implications for Interventions. HEALTH COMMUNICATION 2023; 38:310-325. [PMID: 34256674 DOI: 10.1080/10410236.2021.1950296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This synthesis review examined 189 qualified studies on norms and smoking in terms of conceptual frameworks, types of social norms, research designs, dependent variables, independent variables and covariates, and findings related to norms. Results show that 7.9% were experimental, and the remaining were cross-sectional. By far, the reasoned action approach (RAA) was the most-cited theory, but RAA was not used to guide experimental designs. The social norms approach, norm focus theory, social cognitive theory guided the intervention experiments. Harmful norms were more frequently examined than healthful norms. Pro-smoking norms positively predicted smoking intentions and behaviors, whereas antismoking norms positively predicted antismoking intentions and behaviors. The over-application of RAA in cross-sectional antismoking research has yielded repetitive findings. Norm-based experiments can adopt other theoretical perspectives to offer insights into antismoking interventions. The RAA constructs are still applicable and can be integrated into intervention designs.
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Affiliation(s)
- Vivian C Sheer
- Department of Communication Studies, Hong Kong Baptist University
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24
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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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25
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West JC, Burt KB, Klemperer EM, Chen HL, Villanti AC. Latent Classes of Perceived Addictiveness Predict Marijuana, Alcohol, and Tobacco Use in Youth and Young Adults. Subst Use Misuse 2023; 58:454-464. [PMID: 36692093 PMCID: PMC10227722 DOI: 10.1080/10826084.2023.2167497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Mass media substance use prevention efforts target addiction perceptions in young people. This study examined youth and young adults' (YAs) perceived addictiveness across several substances and the associations between addiction perceptions and substance use. Methods: Data were collected in 2019 in an online cohort study of Vermonters aged 12-25. Latent class analyses grouped participants by perceived addictiveness of nicotine, caffeine, alcohol, marijuana, cigarettes, electronic vapor products (EVPs), and opioids. Bivariate multinomial logistic and modified Poisson regression estimated associations between sociodemographics, substance use correlates, and subsequent use across latent classes. Results: Four latent classes captured addiction perceptions: high perceived addictiveness of EVPs, cigarettes, marijuana, and alcohol (Class 1: n = 317; 31.3%), low perceived addictiveness of marijuana, alcohol, and caffeine (Class 2: n = 151; 14.3%), low perceived addictiveness of marijuana (Class 3: n = 581; 46.5%), and low perceived addictiveness of nicotine, cigarettes, and EVPs (Class 4: n = 83; 7.9%). For each year increase in age, there was a 36% increased likelihood of being in Class 2 (vs. Class 1) and a 148% increased likelihood of belonging to Class 3 (vs. Class 1). Low perceived addictiveness classes were associated with ever and past 30-day marijuana and alcohol use and predicted past 30-day alcohol use at three-month follow-up. Membership in Classes 2 and 3 also predicted past 30-day marijuana use at Wave 3. Discussion: The strong association between age and latent classes defined by low perceived addictiveness suggests age group differences in addiction perceptions. Findings suggest that YAs may benefit from prevention messaging on addictiveness.
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Affiliation(s)
- Julia C West
- Vermont Center on Behavior and Health, Department of Psychiatry, The University of Vermont Larner College of Medicine, Burlington, Vermont, USA
- Department of Psychological Science, The University of Vermont, Burlington, Vermont, USA
| | - Keith B Burt
- Department of Psychological Science, The University of Vermont, Burlington, Vermont, USA
| | - Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, The University of Vermont Larner College of Medicine, Burlington, Vermont, USA
- Department of Psychological Science, The University of Vermont, Burlington, Vermont, USA
| | - Harry L Chen
- Department of Family Medicine, The University of Vermont Larner College of Medicine, Burlington, Vermont, USA
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, The University of Vermont Larner College of Medicine, Burlington, Vermont, USA
- Department of Psychological Science, The University of Vermont, Burlington, Vermont, USA
- Rutgers Center for Tobacco Studies; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, New Brunswick, New Jersey, USA
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26
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Phetphum C, Prajongjeep A, Youngiam W, Thawatchaijareonying K. Susceptibility to smoking and determinants among never-smoking high school students in Thailand. Tob Induc Dis 2023; 21:02. [PMID: 36694667 PMCID: PMC9832328 DOI: 10.18332/tid/156456] [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: 08/16/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION To prevent youth from becoming smokers, it is essential to understand factors contributing to them becoming susceptible to smoking. The aim of this study was thus to estimate the prevalence of smoking susceptibility among neversmoking youth in Thailand and to identify determinants associated with such behavior. METHODS Cross-sectional data for 4572 eighth-grade students (aged 13-15 years) from 120 secondary schools were obtained from a classroom-based survey using a self-administered questionnaire. Using data from never-smoking students (n=3180), simple and multiple logistic regression analyses were performed to identify factors associated with smoking susceptibility. Frequencies and proportions for descriptive statistics are reported along with adjusted odds ratios and 95% confidence intervals for logistic regression models. RESULTS A total of 16.4% of Thai never-smoking youth were susceptible to smoking. Several variables of interest were identified in multivariable analysis as significantly associated with increased susceptibility to smoking: being male (AOR=3.16; 95% CI: 25.4-3.92), having a positive attitude toward smoking - agreeing that smoking displays maturity (AOR=1.49; 95% CI: 1.07-2.09), the perception that smoking helps relieve stress (AOR=1.57; 95% CI: 1.14-2.15), the presence of current smoking peers (AOR=2.04; 95% CI: 1.57-2.66), exposure to secondhand smoking in public (AOR=1.51; 95% CI: 1.17-1.94), exposure to online cigarette and smoking-related advertising occasionally (AOR=1.98; 95% CI: 1.49-2.65), attendance at schools where there are sometimes anti-smoking education activities (AOR=1.57; 95% CI: 1.18-2.07); as well as exposure to anti-tobacco messages rarely (AOR=1.40; 95% CI: 1.05-1.87), occasionally (AOR=1.48; 95% CI: 1.12-1.96) and infrequently (AOR=1.41; 95% CI : 1.07-1.87). CONCLUSIONS Approximately one in six Thai never-smoking youth was found to be susceptible to smoking. Findings suggest it should be useful to supplement relevant tobacco prevention and control efforts by considering such interpersonal and socio-environmental determinants, among vulnerable people to smoke.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Tobacco Control Research Unit, Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health Phitsanulok, Phitsanulok, Thailand
| | - Waraporn Youngiam
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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27
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Rapoport E, Zhu M, Pham D, Keim SA, Adesman A. Sports Team Participation and Vaping Among High School Students: 2015-2019. Pediatrics 2023; 151:190261. [PMID: 36504398 DOI: 10.1542/peds.2021-055565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Electronic vapor products (EVPs) have gained popularity among adolescents despite the health risks. This study aimed to evaluate whether sports team participation, a well-established protective factor against cigarette use, is similarly associated with decreased EVP use. METHODS This cross-sectional study analyzed the 2015-2019 Youth Risk Behavior Survey cohorts. Survey-weighted logistic regressions investigated associations between sports team participation and past 30-day exclusive cigarette use, exclusive EVP use, and dual cigarette/EVP use among US high school students, adjusting for sex, grade, and survey year. RESULTS The analytic cohort included 16 790 sports team participants (1.7% exclusive cigarette users, 18.3% exclusive EVP users, 5.5% dual users) and 13 972 nonparticipants (3.1% exclusive cigarette users, 13.4% exclusive EVP users, 7.6% dual users). Sports team participation was associated with lower odds of cigarette use (adjusted odds ratio [aOR], 0.58; 95% confidence interval [CI], 0.48-0.71) and dual use (aOR, 0.74; 95% CI, 0.63-0.88) and higher odds of EVP use (aOR, 1.39; 95% CI, 1.25-1.54). Among exclusive cigarette users and exclusive EVP users, sports team participation was associated with lower odds of frequent (≥20 days in the past month) than intermittent (1-19 days in the past month) cigarette use (aOR, 0.30; 95% CI, 0.19-0.49) and EVP use (aOR, 0.74; 95% CI, 0.61-0.91), respectively. CONCLUSIONS Our findings suggest that risk profiles for cigarette and EVP use differ with respect to sports team participation. Given the health risks associated with EVP use, aggressive efforts must be taken to educate student athletes about the health risks of EVP use.
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Affiliation(s)
- Eli Rapoport
- New York University Grossman School of Medicine, New York, New York
| | - Meng'ou Zhu
- Washington University School of Medicine, Saint Louis, Missouri
| | - Duy Pham
- Cohen Children's Medical Center of New York, Lake Success, New York
| | - Sarah A Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, College of Medicine.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Andrew Adesman
- Cohen Children's Medical Center of New York, Lake Success, New York.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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28
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Al Rajeh AM, Mahmud I, Al Imam MH, Rahman MA, Al Shehri F, Alomayrin S, Alfazae N, Elmosaad YM, Alasqah I. E-Cigarette Use among Male Smokers in Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:143. [PMID: 36612462 PMCID: PMC9819296 DOI: 10.3390/ijerph20010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
E-cigarette use is increasing globally. Recent evidence suggests that e-cigarettes contain harmful substances that could cause adverse health outcomes. This study investigated the prevalence and associated factors of e-cigarette use among male current smokers in Saudi Arabia. We conducted a cross-sectional survey of adult male current smokers in the Al-Ahsa province of Saudi Arabia. Data were collected using a structured questionnaire. We performed logistic regression analyses to investigate the factors associated with e-cigarette use among adult male current smokers. 325 current smokers participated in the study. A third of them (33.5%) were e-cigarette users. Almost all the study participants (97.0%) had heard about e-cigarettes. Participants who were occasional smokers (Odds Ratio (OR): 2.28; 95% Confidence Interval (CI): 1.17-4.41) and had good knowledge perception of e-cigarettes (OR 3.49; 95% CI: 2.07-5.90) had higher odds of using e-cigarettes when compared to regular smokers of conventional cigarettes and current smokers with poor knowledge perception of e-cigarettes, respectively. In contrast, private employees (OR: 0.25, 95% CI: 0.07-0.85), and business owners (OR: 0.09, 95% CI: 0.01-0.63) had lower odds of using e-cigarettes compared to unemployed individuals. Compared with non-e-cigarette users, the rate of conventional cigarette smoking per day was significantly lower among e-cigarette users. Use of e-cigarette (OR: 3.57, 95% CI: 2.14-5.98), believing that e-cigarette quitting is hard (OR: 2.02, 95% CI: 1.17-3.49) and trying to quit e-cigarettes (OR: 2.17, 95% CI: 1.1-4.25) were found to be significant predictors of good knowledge perception of e-cigarettes among the current smokers. The use and knowledge perception of e-cigarettes were higher among occasional conventional male cigarette smokers than regular male smokers in Al-Ahsa province. The use of e-cigarettes as smoking cessation aids should be examined further in the Saudi Arabian setting.
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Affiliation(s)
- Ahmed M. Al Rajeh
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al-Bukairiyah 52741, Saudi Arabia
| | - Mahmudul Hassan Al Imam
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4701, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3350, Australia
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne, VIC 3086, Australia
| | - Fariss Al Shehri
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Salman Alomayrin
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Nawaf Alfazae
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Yousif Mohammed Elmosaad
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Ibrahim Alasqah
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al-Bukairiyah 52741, Saudi Arabia
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29
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Abdelwahab M, Klebanoff MA, Venkatesh KK. Association between Prenatal Marijuana and Tobacco Smoke Exposures and Small for Gestational Age at Birth. Am J Perinatol 2022; 39:1726-1734. [PMID: 36007919 DOI: 10.1055/s-0042-1753489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of this study was to determine the association of prenatal marijuana exposure with and without tobacco smoke exposure and small for gestational age (SGA) at birth. STUDY DESIGN We conducted a secondary analysis of the prospective Lifestyle and Early Achievement in Families (LEAF) cohort enrolled from 2010 to 2015. We included singleton nonanomalous liveborn pregnancies. We assessed marijuana use inclusive of any pregnancy urine specimen with a Δ9-THC-COOH concentration of more than 15 ng/mL by mass spectrometry, self-report on questionnaire, and/or electronic health record; and self-reported maternal tobacco use. Because of the high co-frequency of marijuana with tobacco exposure in pregnancy and the known association between tobacco and fetal growth restriction, we modeled the exposure as: both marijuana and tobacco (hereafter "co-use"), only marijuana, only tobacco, and neither (reference). Incidence of SGA in each group was compared with the neither group. The primary outcome was SGA less than 10th percentile, and secondarily less than 5th percentile, using parity-specific definitions per 2017 US natality reference data. RESULTS Among 325 assessed mothers, 46% had neither exposure, 11% had only prenatal marijuana exposure, 20% only tobacco exposure, and 23% co-use exposure. A third (33%) of infants were SGA less than 10th percentile and 20% SGA less than 5th percentile. Marijuana exposure only was associated with an increased risk of SGA less than 10th percentile (43 vs. 26%; adjusted relative risk [aRR]: 1.66; 95% confidence interval [CI]: 1.02-2.69), and SGA less than5th percentile (30 vs. 13%; aRR: 2.26; 95% CI: 1.15-4.47). Tobacco was not associated with SGA less than 10th percentile, but was with SGA less than 5th percentile (26 vs. 13%; aRR: 2.01; 95% CI: 1.13, 3.56). Co-use was not associated with increased SGA risk in multivariate analysis, but was in sensitivity analysis when tobacco use was defined using a cotinine assay rather than self-report (SGA <10th percentile, aRR: 1.97; 95% CI: 1.24-3.15) and (SGA <5th percentile, aRR: 2.03; 95% CI: 1.09-3.78). CONCLUSION Prenatal marijuana exposure in addition to tobacco may increase the risk of SGA. Given the rising prevalence of marijuana use in pregnancy, further research is warranted to understand how in utero marijuana exposure may impact fetal growth and birth weight with and without tobacco exposure. KEY POINTS · Marijuana and tobacco are commonly used together in pregnancy.. · Prenatal marijuana and tobacco exposure may increase the risk of a small for gestational age infant.. · Further research is warranted to understand how in utero marijuana exposure impacts fetal growth..
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Affiliation(s)
- Mahmoud Abdelwahab
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
| | - Mark A Klebanoff
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Kartik K Venkatesh
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
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30
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Galstyan E, Galimov A, Meza L, Huh J, Berg CJ, Unger JB, Baezconde-Garbanati L, Sussman S. An Assessment of Vape Shop Products in California before and after Implementation of FDA and State Regulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15827. [PMID: 36497899 PMCID: PMC9738621 DOI: 10.3390/ijerph192315827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Vape shops specialize in sales of e-cigarettes and related products. This study examines whether vape shops adapted their products and services in response to changes in federal and state policies that affect the tobacco retail environment between 2014-2022. In this multicohort study, four waves of study data were used to examine the trends in products sold in vape shops in Southern California. Items sold were assessed through systematic store product observations and included categories of e-cigarettes, device modification equipment, and other products (e.g., Cannabidiol (CBD), paraphernalia). Descriptive statistics are reported. The availability of disposable devices increased from 18% at Wave 1 to 98% of shops at Wave 4. Pod mods were first observed in 79% of the shops beginning at Wave 3. Device modification drills later become obsolete, from 60% at Wave 1 to 0 by Wave 4; self-service sampling displays declined from 83% of shops to 9%. Vape shops did not carry CBD products until Wave 3 (2017/2018), when 19.0% of shops carried CBD products and 72.9% at Wave 4. Future research should examine how e-cigarette retailers and manufacturers respond to changing state and federal regulations to better understand the implications of regulatory efforts.
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Affiliation(s)
- Ellen Galstyan
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Artur Galimov
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Leah Meza
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Jimi Huh
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, GW Cancer Center, George Washington University, Science & Engineering Hall, 800 22nd St. NW, #7000C, Washington, DC 20052, USA
| | - Jennifer B. Unger
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Lourdes Baezconde-Garbanati
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
| | - Steve Sussman
- Institute for Health Promotion and Disease Prevention Research, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90007, USA
- School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
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31
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Wężyk-Caba I, Kaleta D, Zajdel R, Balwicki Ł, Świątkowska B. Do Young People Perceive E-Cigarettes and Heated Tobacco as Less Harmful Than Traditional Cigarettes? A Survey from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14632. [PMID: 36429359 PMCID: PMC9690410 DOI: 10.3390/ijerph192214632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
New tobacco and nicotine-containing products are gaining more popularity among young people. The aim of this study is to assess the prevalence in the perception of e-cigarettes and heated tobacco among young people in Poland and to assess the factors that are positively correlated with this perception. A cross-sectional study covering almost 12,000 adolescents aged 13-18 was carried out in January and February 2020. Data were collected through a detailed questionnaire recommended for monitoring tobacco use by adolescents. The results of the study showed that 52.2% and 61.9% of young people perceive e-cigarettes and heated tobacco products as less harmful compared to traditional cigarettes, respectively. The risk of perceiving these products as less harmful than smoking was higher among older adolescents, males, those who used these products, had a family member who used e-cigarettes/heated tobacco products and those who were exposed to tobacco advertising. Our study indicates the need to consider the coexistence of traditional smoking, e-cigarettes and heated tobacco and its impact on the assessment of the harmfulness of these products. More research is needed to better understand how perceptions of the harmfulness of e-cigarettes and heated tobacco affect their subsequent use.
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Affiliation(s)
- Ilona Wężyk-Caba
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Radosław Zajdel
- Department of Informatics in Business, University of Łódź, POW 3/5 Street, 90-255 Łódź, Poland
| | - Łukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland
| | - Beata Świątkowska
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
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Hicks TA, Zaur AJ, Keeley JW, Amstadter AB. The association between recreational cannabis use and posttraumatic stress disorder: A systematic review and methodological critique of the literature. Drug Alcohol Depend 2022; 240:109623. [PMID: 36162309 PMCID: PMC9665003 DOI: 10.1016/j.drugalcdep.2022.109623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Given recent changes in the legal status of cannabis, the risks and benefits associated with its use have become an important public health topic. A growing body of research has demonstrated that posttraumatic stress disorder (PTSD) and recreational cannabis use (RCU) frequently co-occur, yet findings are inconsistent (e.g., direction of effect) and methodological variability makes comparison across studies difficult. METHODS We conducted a comprehensive systematic review of all studies (N = 45) published before May 2020 regarding etiologic models of co-occurring RCU and PTSD, as well as provided a methodological critique to inform suggestions for future research initiatives. RESULTS Findings indicate that a majority of studies (n = 37) demonstrated a significant association between RCU and PTSD. Findings provide evidence for the self-medication and high-risk models posited to explain co-occurring RCU and PTSD despite variability in assessment of RCU, which includes commonly used non-standardized self-report questions. CONCLUSION The association between RCU and PTSD is likely bidirectional. Results inform clinicians and researchers working in the mental health and cannabis use fields how the variability in findings on the association between RCU and PTSD may be attributable, in part, to methodological issues that permeate the extant literature pertaining to RCU and PTSD.
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Affiliation(s)
- Terrell A Hicks
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA.
| | - Angela J Zaur
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, USA; Department of Psychology, Virginia Commonwealth University, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, USA
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Villanti AC, Wackowski OA, LePine SE, West JC, Stevens EM, Unger JB, Mays D. Effects of Vaping Prevention Messages on Electronic Vapor Product Beliefs, Perceived Harms, and Behavioral Intentions among Young Adults: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14182. [PMID: 36361061 PMCID: PMC9655851 DOI: 10.3390/ijerph192114182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Youth have been the focus of electronic vapor product (EVP) prevention efforts though young adults had similar increases in current EVP use from 2015-2019. This study tested messages to reduce EVP use in young adults. Eight messages on vaping related harms and addictiveness combined with themes on social use and flavors were selected for inclusion in an online randomized controlled trial. Vermont young adults aged 18-24 (n = 569) were randomized to view the eight vaping prevention messages (n = 295) or eight messages on sun safety (n = 274). After completing baseline measures, participants viewed study messages and completed measures on message perceptions and perceived message effectiveness (PME), EVP-related beliefs, and EVP-related harm perceptions. Participants completed EVP-related beliefs and harm perception measures again at 1-month follow-up, as well as measures on tobacco and EVP-related behavioral intentions and behavior (ever and past 30-day use). Intervention participants reported positive impacts on vaping-related message responses. However, findings suggested no effect of vaping prevention messages on EVP-related beliefs, harm perceptions, or behaviors in the full sample. Exploratory analyses in the intervention condition showed that greater PME was associated with lower odds to intent to try cigarettes in the next year at follow-up.
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Affiliation(s)
- Andrea C. Villanti
- Rutgers Center for Tobacco Studies, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA
| | - Olivia A. Wackowski
- Rutgers Center for Tobacco Studies, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - S. Elisha LePine
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
| | - Julia C. West
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA
- Department of Psychological Science, University of Vermont, Burlington, VT 05401, USA
| | - Elise M. Stevens
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Darren Mays
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA
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Sholler DJ, Zamarripa CA, Spindle TR, Martin EL, Kuntz D, Vandrey R, Grabenauer M. Urinary Excretion Profile of Cannabinoid Analytes Following Acute Administration of Oral and Vaporized Cannabis in Infrequent Cannabis Users. J Anal Toxicol 2022; 46:882-890. [PMID: 35770374 PMCID: PMC9995664 DOI: 10.1093/jat/bkac042] [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: 02/21/2022] [Revised: 05/14/2022] [Accepted: 06/28/2022] [Indexed: 11/12/2022] Open
Abstract
Traditionally, smoking has been the predominant method for administering cannabis, but alternative routes of administration have become more prevalent. Additionally, research examining urinary cannabinoid excretion profiles has primarily focused on 11-nor-9-carboxy-∆9-tetrahydrocannabinol (∆9-THC-COOH), a metabolite of ∆9-tetrahydrocannabinol (∆9-THC), as the primary analyte. The aim of the current study was to characterize the urinary excretion profile of ∆9-THC-COOH, ∆9-THC, ∆8-tetrahydrocannabinol (∆8-THC), 11-hydroxy-∆9-tetrahydrocannabinol (11-OH-∆9-THC), ∆9-tetrahydrocannabivarin (THCV), 11-nor-∆9-tetrahydrocannabivarin-9-carboxlic acid (THCV-COOH), cannabidiol (CBD), cannabinol (CBN) and 8,11-dihydroxytetrahydrocannabinol (8,11-diOH-∆9-THC) following controlled administration of both oral and vaporized cannabis. Participants (n = 21, 11 men/10 women) who were infrequent cannabis users ingested cannabis-containing brownies (0, 10 and 25 mg ∆9-THC) and inhaled vaporized cannabis (0, 5 and 20 mg ∆9-THC) across six double-blind outpatient sessions. Urinary concentrations of ∆9-THC analytes were measured at baseline and for 8 h after cannabis administration. Sensitivity, specificity and agreement between the three immunoassays (IAs) for ∆9-THC-COOH (cutoffs of 20, 50 and 100 ng/mL) and liquid chromatography-tandem mass spectrometry (LC-MS-MS) analyses (confirmatory cutoff concentrations of 15 ng/mL) were assessed. Urinary concentrations for ∆9-THC-COOH, ∆9-THC, 11-OH-∆9-THC, THCV, CBN and 8,11-diOH-∆9-THC all peaked at 5-6 h and 4 h following oral and vaporized cannabis administration, respectively. At each active dose, median maximum concentrations (Cmax) for detected analytes were quantitatively higher after oral cannabis administration compared to vaporized. Using current recommended federal workplace drug-testing criteria (screening via IA with a cutoff of ≥50 ng/mL and confirmation via LC-MS-MS at a cutoff of ≥15 ng/mL), urine specimens tested positive for ∆9-THC-COOH in 97.6% of oral sessions and 59.5% of vaporized sessions with active ∆9-THC doses. These data indicate that while ∆9-THC-COOH may serve as the most consistent confirmatory analyte under the current drug-testing guidelines, future work examining 11-OH-∆9-THC under similar parameters could yield an alternative analyte that may be helpful in distinguishing between licit and illicit cannabis products.
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Affiliation(s)
- Dennis J Sholler
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - C Austin Zamarripa
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Tory R Spindle
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Erin L Martin
- Department of Neuroscience, Medical University of South Carolina, 125 Doughty St., Charleston, SC 29403, USA
| | - David Kuntz
- Clinical Reference Laboratory, 8433 Quivira Rd, Lenexa, KS 66214, USA
| | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224, USA
| | - Megan Grabenauer
- Center for Forensic Sciences, RTI International, 3040 East Cornwallis Rd., Research Triangle Park, NC 27709, USA
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Prevalence, Knowledge, Attitude, and Predictors of Waterpipe Smoking among School Adolescents in Saudi Arabia. Glob Health Epidemiol Genom 2022; 2022:1902829. [PMID: 36263374 PMCID: PMC9553653 DOI: 10.1155/2022/1902829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022] Open
Abstract
This cross-sectional study was designed to investigate the prevalence, knowledge, attitude, and predictors of waterpipe (WP) smoking among intermediate and secondary school adolescents in the Kingdom of Saudi Arabia (KSA). A self-administered anonymous questionnaire was used to collect data on demography, WP smoking status and patterns, the Arabic version of the Global Youth Tobacco Survey tool, and instruments to assess knowledge and attitude towards WP smoking. The Patient Health Questionnaire (PHQ-9) was also used. Descriptive and inferential statistical techniques were used. Modeling of WP smoking behavior was conducted using logistic regression. A total of 639 male students participated in this study. The prevalence of current WP and cigarette smokers were 17.7% and 14.6%, respectively. Out of the total population, 47.8% of students have the misconception that WP smoking is less harmful than cigarettes. A significant association (P < 0.05) of some demographic factors (age, school stage, residence, and parents' educational level) on WP smoking status was observed. Pleasure, socializing, and happiness represented the primary motives for initiating WP smoking. The majority of students had misconceptions about WP's health effects. More than 50% believed that smoking WP could ease anxiety, cause less harm, and has less addictive properties compared to cigarettes. Modeling suggested that the most significant predictors of WP smoking were cigarette smoking, depression, and the attitude index. Current findings warrant further research and official health programs to promote educational initiatives regarding WP smoking.
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Duan Z, Le D, Ciceron AC, Dickey-Chasins R, Wysota CN, Bar-Zeev Y, Levine H, Abroms LC, Romm KF, Berg CJ. 'It's like if a vape pen and a cigarette had a baby': a mixed methods study of perceptions and use of IQOS among US young adults. HEALTH EDUCATION RESEARCH 2022; 37:364-377. [PMID: 36036655 PMCID: PMC9502850 DOI: 10.1093/her/cyac019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
Young adults' perceptions and use of heated tobacco products (HTPs) are understudied. This mixed methods study analyzed (i) Fall 2020 survey data from 2470 US young adults (meanage = 24.67; 19.5% and 25.2% past-month cigarette and e-cigarette use; 4.1% ever HTP use) assessing HTP use intentions and perceptions (1 = not at all to 7 = extremely) and (ii) Spring 2021 interview data regarding IQOS (most widely available HTP) in a subset of 40 e-cigarette users. Among survey participants, HTPs versus cigarettes and e-cigarettes showed lower use intentions (mean = 1.27 vs. mean = 1.73, mean = 2.16) but were perceived as less addictive (mean = 5.11 vs. mean = 6.28, mean = 5.82) and harmful (mean = 5.37 vs. mean = 6.65, mean = 5.62). HTPs were perceived more socially acceptable than cigarettes but less than e-cigarettes (mean = 3.39 vs. mean = 3.13, mean = 4.37). Among interviewees, most reported limited HTP knowledge. A few perceived IQOS as a hybrid of traditional cigarettes and e-cigarettes. Most perceived IQOS as harmful but less harmful than cigarettes and were uncertain in relation to e-cigarettes. Over half reported minimal interest in trying IQOS; common reasons included IQOS containing tobacco, limited flavors and use complexity. The varied perceptions of IQOS versus cigarettes and e-cigarettes underscore the need for continued surveillance of perceptions, use and marketing of IQOS to inform regulatory oversight and potential interventions.
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
| | - Daisy Le
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, 1919 Pennsylvania Ave NW, Suite 500, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
| | - Annie C Ciceron
- Department of Policy, Populations, and Systems, School of Nursing, George Washington University, 1919 Pennsylvania Ave NW, Suite 500, Washington, DC 20052, USA
| | - Ruth Dickey-Chasins
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW, 4th Floor, Washington, DC 20052, USA
| | - Christina N Wysota
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Organization, PO Box 12272, Jerusalem 9110202, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Organization, PO Box 12272, Jerusalem 9110202, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University, 800 22nd St NW, #7000, Washington, DC 20052, USA
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Zamarripa CA, Novak MD, Weerts EM, Vandrey R, Spindle TR. The effects of oral and vaporized cannabis alone, and in combination with alcohol, on driving performance using the STISIM driving simulator: A two-part, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory protocol. Front Pharmacol 2022; 13:964749. [PMID: 36147331 PMCID: PMC9486093 DOI: 10.3389/fphar.2022.964749] [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: 06/09/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
The legalization of cannabis for medicinal and non-medicinal purposes, and the corresponding increase in diversity of cannabis products, has resulted an urgent need for cannabis regulatory science. Among the most pressing needs is research related to impairment due to cannabis exposure, especially on driving performance. The present project was designed to evaluate the impact of oral and vaporized cannabis, when administered alone or in combination with alcohol, on simulated driving performance (STISIM driving simulator), cognitive/psychomotor ability, and field sobriety performance. Healthy adults will complete two, double-blind, double-dummy, placebo-controlled, randomized crossover clinical laboratory studies, one with oral cannabis (16 men/16 women) and the second with vaporized cannabis (16 men/16 women). In each study, participants will complete seven experimental sessions during which acute doses of placebo or high Δ9-THC cannabis containing 0, 10, or 25 mg Δ9-THC will be administered both alone and in combination with placebo or alcohol-containing beverages (target breath alcohol concentrations, BAC, of 0.0% or 0.05%). A positive control session (i.e., alcohol at target BAC of 0.08% with placebo cannabis) will also be completed. Simulated driving performance tests (available for download; see Methods), field sobriety assessments, subjective drug effect questionnaires, a mobile device impairment test (DRUID app), and collection of whole blood specimens will be completed repeatedly during each session. Linear mixed models will be used to test for differences across experimental conditions and a priori planned comparisons will be used to determine differences between conditions of interest (e.g., cannabis alone vs cannabis with alcohol). This research is designed to extend prior studies of cannabis and alcohol on driving performance by using oral and vaporized routes of cannabis administration. By increasing understanding of impairment associated with co-use of alcohol and these novel forms of cannabis, this research could inform impairment detection standards for cannabis and alcohol and have important implications for law enforcement, public policy decisions regarding accessibility of these substances, and education of the general population who may use cannabis and/or alcohol. Lastly, this manuscript provides interested researchers with access to the simulated driving scenarios and data extraction tools developed for this study as a means of facilitating future cross-study comparisons, which is important given the heterogeneity in methods used across laboratories in prior research.
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Affiliation(s)
| | | | | | | | - Tory R. Spindle
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Romm KF, Wang Y, Ma Y, Wysota CN, Blank MD, Huebner DM, Roche KM, Berg CJ. The reciprocal relationships of social norms and risk perceptions to cigarette, e-cigarette, and cannabis use: Cross-lagged panel analyses among US young adults in a longitudinal study. Drug Alcohol Depend 2022; 238:109570. [PMID: 35926300 PMCID: PMC11365042 DOI: 10.1016/j.drugalcdep.2022.109570] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/02/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Given the distinct and evolving social norms, research on health implications, and regulations regarding cigarettes, e-cigarettes, and cannabis, it is important to understand the interplay between social norms, risk perceptions, and use of these products. METHODS We analyzed 3 waves of longitudinal data (Fall 2018, 2019, 2020) from 3006 young adults (Mage=24.56, 54.8% female, 31.6% sexual minority, 39.6% racial/ethnic minority) from 6 US metropolitan statistical areas. Cross-lagged panel models (CLPMs) examined reciprocal relationships of (a) perceived social norms (i.e., peer use, social acceptability) and risk perceptions (i.e., harm, addictiveness) to (b) number of days of cigarette, e-cigarette, and cannabis use in the past 30 days, respectively. RESULTS At baseline, lifetime and past 30-day use prevalence was: 61.8% and 26.9% for cigarettes, 57.7% and 37.7% for e-cigarettes, and 70.7% and 39.2% for cannabis. Perceived social norms and use of cigarettes and e-cigarettes decreased over time, and risk perceptions increased (except cigarettes showed stable perceived harm). Regarding cannabis, perceived social norms and use increased, yet perceived harm and addictiveness also increased. CLPM indicated that greater perceived social norms predicted greater cigarette, e-cigarette, and cannabis use over time, and vice versa. While greater perceived risk predicted less e-cigarette and cannabis use and vice versa, this did not hold true for cigarettes: use predicted lower perceived risk, but risk perceptions did not predict later use. CONCLUSIONS Tobacco and cannabis intervention and regulatory efforts should address health risks of use, particularly of e-cigarettes and cannabis, as well as denormalizing use.
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Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Christina N Wysota
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA.
| | - David M Huebner
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Kathleen M Roche
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA.
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Casseus M, Cooney JM, Wackowski OA. Tobacco Use, Dependence, and Age of Initiation among Youths with Cognitive Disability. J Pediatr 2022; 247:102-108.e8. [PMID: 35569523 DOI: 10.1016/j.jpeds.2022.04.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/04/2022] [Accepted: 04/28/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the prevalence of tobacco use by product type among youths with cognitive disability; the prevalence of tobacco dependence among youths with cognitive disability; and the relationship between age of tobacco use initiation and cognitive disability. STUDY DESIGN This cross-sectional study analyzed data from the 2019 National Youth Tobacco Survey (NYTS). Participants were a nationally representative sample of 19 018 students in grades 6-12. Estimates were calculated for ever use, current use, age of tobacco use initiation, and tobacco dependence. Associations between use patterns and cognitive disability status were examined using bivariate analyses and multivariable logistic regression. RESULTS Compared with youths without cognitive disability, youths with cognitive disability had significantly greater odds of ever using any tobacco product (aOR, 1.49; 95% CI, 1.31-1.70), currently using any tobacco product (aOR, 1.41; 95% CI, 1.26-1.58), and currently using electronic cigarettes (e-cigarettes), cigarettes, cigars, hookahs, roll-your-own cigarettes, and heated tobacco products, specifically. They had higher prevalence and odds of reporting younger age of tobacco use initiation (aOR, 1.25; 95% CI, 1.10-1.43). Higher prevalence and odds of tobacco dependence were also observed among youths with cognitive disability compared with youths without cognitive disability (P < .001). CONCLUSIONS These findings reinforce the importance of developing early primary prevention efforts to reduce or delay tobacco use among adolescents with cognitive disability. They also suggest the need to address co-occurring disorders during tobacco cessation programs with this high-risk group.
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Affiliation(s)
- Myriam Casseus
- Department of Pediatrics, Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - James M Cooney
- Rutgers School of Management and Labor Relations, New Brunswick, NJ
| | - Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Rutgers University, New Brunswick, NJ
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Abar CC, Thomson BR, Miley A, Jones V, Ruffino R. Letter to the Editor: Parental Behaviors and Cannabis-Related Harm Reduction in College. Cannabis Cannabinoid Res 2022; 7:557-558. [PMID: 35167357 PMCID: PMC9418360 DOI: 10.1089/can.2021.0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Caitlin C. Abar
- Department of Psychology, The College at Brockport, Brockport, New York, USA
| | - Bonnie Rose Thomson
- Department of Psychology, The College at Brockport, Brockport, New York, USA
| | - Allison Miley
- Department of Psychology, The College at Brockport, Brockport, New York, USA
| | - Vanity Jones
- Department of Psychology, The College at Brockport, Brockport, New York, USA
| | - Rebecca Ruffino
- Department of Psychology, The College at Brockport, Brockport, New York, USA
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Factors that Impact the Pharmacokinetic and Pharmacodynamic Effects of Cannabis: a Review of Human Laboratory Studies. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00429-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cabral Barata P, Ferreira F, Oliveira C. Non-medical cannabis use: international policies and outcomes overview. An outline for Portugal. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 44:e20210239. [PMID: 34898143 PMCID: PMC9490937 DOI: 10.47626/2237-6089-2021-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/20/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Cannabis is probably the most commonly used illicit drug. It is often regarded as a relatively nonharmful experience, even though evidence indicates otherwise. Legalization of non-medical cannabis, which has already taken place in several countries, is currently a controversial issue. OBJECTIVE To provide an up-to-date overview of current models and policies and their outcomes that can inform future political decisions regarding non-medical cannabis use. METHODS PubMed/MEDLINE and Google Scholar scientific databases were searched for articles written in English, Spanish, and Portuguese published between 1990 and December 2020. The reference lists of these articles were similarly used as bibliography sources. Gray literature was also included. RESULTS While non-medical cannabis has been decriminalized in many countries, it has only been legalized in Uruguay, Canada, and some U.S. states. Several benefits of legalization were identified: decreases in cannabis-related crimes, law-enforcement and judicial costs; reduction in synthetic cannabis supply; decline in black economies and possible diminution of other illegal drug buying; and tax revenue increases. Reported legalization problems included: increases in cannabis use; cannabis-related disorders; and cannabis-related accidents and hospitalizations. Harm-reduction strategies are available in the scientific literature. CONCLUSION Growing, although incomplete, evidence exists to guide policy makers, minimize cannabis-related harm, and positively contribute to public health, if the legalization path is to be followed. Dialogue between legislators and science should be encouraged. There are more than a few legalization pathways, with diverse economic, social and health wellbeing effects. Public health-driven, instead of profit-driven models, seem to offer the most benefits regarding non-medical cannabis legalization. Most of the true public health effects of cannabis legalization are still unknown, for we are still in the early stages of these policies and their implications. Future studies should address the medium-to-long-term social, economic, and health consequences of legalization policies.
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Affiliation(s)
- Pedro Cabral Barata
- Regionspsykiatrien VestHerningDenmarkRegionspsykiatrien Vest, Herning, Denmark.
| | - Filipa Ferreira
- Departamento de Psiquiatria e Saúde MentalHospital Prof. Dr. Fernando FonsecaAmadoraPortugalDepartamento de Psiquiatria e Saúde Mental, Hospital Prof. Dr. Fernando Fonseca, Amadora, Portugal.
| | - Catarina Oliveira
- Departamento de Psiquiatria e Saúde MentalUnidade Local de Saúde de Castelo BrancoCastelo BrancoPortugalDepartamento de Psiquiatria e Saúde Mental, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal.
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Sun DL, Schleicher NC, Recinos A, Henriksen L. Spatial Clustering of Hookah Lounges, Vape Shops, and All Tobacco Retailers Near Colleges. Nicotine Tob Res 2022; 24:834-839. [PMID: 35022769 PMCID: PMC9048933 DOI: 10.1093/ntr/ntac007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/06/2021] [Accepted: 01/06/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION US college students smoke hookah and vape nicotine at higher rates than other young adults. Density and/or proximity of hookah lounges and vape shops near colleges has been described, but this study is the first to test whether tobacco retailers spatially cluster near college campuses. AIMS AND METHODS We created and linked spatial shapefiles for community colleges and 4-year colleges in California with lists of hookah lounges, vape shops, and licensed tobacco retailers. We simulated 100 datasets, placing hookah lounges, vape shops, and tobacco retailers randomly in census tracts in proportion to population density. A modified version of Ripley's K-function was computed using the radius (r) from each retailer within retail category. RESULTS In 2018-2019, 50.5% of hookah lounges (n = 479), 42.5% of vape shops (n = 2467), and 42.0% of all tobacco retailers (n = 31 100) were located within 3 miles of a community college. Spatial clustering was significant (p < .05) from at least 0.4 miles for hookah lounges, 0.1 mile for vape shops, and 0.3 miles for all tobacco retailers. For 4-year colleges, approximately 46.8% of hookah lounges, 31.3% of vape shops, and 31.6% of all tobacco retailers were located within 3 miles. Clustering was significant from 0.2 miles for hookah lounges and 1.3 miles for all tobacco retailers but was not significant for vape shops. CONCLUSIONS Evidence that some types of tobacco retailers cluster near community colleges and 4-year colleges implies greater accessibility and exposure to advertising for students. It is also concerning because a higher probability of underage tobacco sales presumably exists near colleges. IMPLICATIONS Prior studies infer that hookah lounges and vape shops cluster near colleges from the density and closer proximity to campuses. This study modified a traditional test of spatial clustering and considered community colleges separately from 4-year universities. Spatial clustering of hookah lounges and all licensed tobacco retailers was evident near both types of campuses, but vape shops clustered only near community colleges. Place-based strategies to limit tobacco retail density could expand state and local laws that prohibit tobacco sales near schools to include retailers near college campuses. In addition, college environments should be a target for reducing hookah smoking and nicotine vaping.
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Affiliation(s)
- Dennis L Sun
- Department of Statistics, Cal Poly San Luis Obispo, San Luis Obispo, CA, USA
| | - Nina C Schleicher
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Duan Z, Wang Y, Weaver SR, Spears CA, Zheng P, Self-Brown SR, Eriksen MP, Huang J. Effect modification of legalizing recreational cannabis use on the association between e-cigarette use and future cannabis use among US adolescents. Drug Alcohol Depend 2022; 233:109260. [PMID: 35152099 PMCID: PMC8957562 DOI: 10.1016/j.drugalcdep.2021.109260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many states have legalized recreational cannabis use for adults. However, no study has examined how this policy may interact with youth vaping to influence cannabis use among US adolescents. This study investigates whether the association between baseline e-cigarette use and subsequent cannabis use differs by state recreational cannabis legalization status. METHODS This study analyzed data from the first four waves (2013-2018) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal survey. The study sample included adolescents (aged 12-17) who reported never used cannabis at baseline. Generalized estimating equations were used to analyze the effect modification of state recreational cannabis law on the association between baseline e-cigarette use and cannabis use at 12-month follow-up, controlling for individual characteristics. RESULTS Among adolescents who have never used cannabis at baseline, baseline past-30-day e-cigarette use was significantly associated with past-30-day cannabis use at 12-month follow-up (aOR=5.92, 95% CI: 3.52-9.95). This association was different by state recreational cannabis legalization status, as indicated by the significant interaction term. Subgroup analysis showed that the aOR was 18.39 (95% CI: 4.25-79.68) for adolescents living in states that legalized adult recreational cannabis use and 5.09 (95% CI: 2.86-9.07) for adolescents living in states without such laws. CONCLUSIONS E-cigarette use is associated with cannabis initiation among youth. This association is stronger among those living in states that legalized adult recreational cannabis use. Further examination of the impact of e-cigarette use on cannabis initiation in relation to state cannabis laws is warranted.
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Affiliation(s)
- Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Scott R. Weaver
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Claire A. Spears
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Pinpin Zheng
- School of Public Health, Fudan University, Shanghai 200433, China
| | | | - Michael P. Eriksen
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA.
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45
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Kondracki AJ, Li W, Kalan ME, Ben Taleb Z, Ibrahimou B, Bursac Z. Changes in the National Prevalence of Current E-Cigarette, Cannabis, and Dual Use among Reproductive Age Women (18-44 Years Old) in the United States, 2013-2016. Subst Use Misuse 2022; 57:833-840. [PMID: 35258396 DOI: 10.1080/10826084.2022.2046092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Electronic cigarette (e-cigarette) and cannabis (marijuana) use is rapidly increasing. Objectives: To report percentage prevalence and changes over time in current (past 30 days) e-cigarette, cannabis, and dual (concurrent) use in the population of reproductive age women (18-44 years old) in the United States. Methods: Our cross-sectional analysis involved data of 11, 004 women from Waves 1 to 3 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2016). We estimated weighted percentage prevalence and 95% confidence intervals (CIs) and changes between 2013 and 2016 in current e-cigarette, cannabis, and dual use at each wave overall and across race/ethnicity, age, education, cigarette smoking status, alcohol use, and perceived mental health. Changes were reported as p for trend. Results: Between 2013 and 2016, e-cigarette use increased 13.6% (p for trend <.001) [15.2% (95% CI:14.2, 16.2) in 2013-2014; 22.2% (95% CI: 20.2, 24.3) in 2014-2015; and 28.8% (95% CI: 26.3, 31.3) in 2015-2016]; cannabis use increased 6.2% (p for trend <.001) [23.6% (95% CI: 22.1, 25.1) in 2013-2014; 28.5% (95% CI: 26.0, 31.0) in 2014-2015; and 29.8% (95% CI: 27.9, 31.1) in 2015-2016]; and dual use declined 0.3% (p for trend <.001) [5.8% (95% CI: 5.2, 6.3) in 2013-2014; 4.8% (95% CI: 3.7, 5.8) in 2014-2015; and 5.5% (95% CI: 4.2, 6.7) in 2015-2016]. Increases and declines in prevalence varied across sociodemographic characteristics, cigarette smoking status, alcohol use, and perceived mental health. Conclusions: Continued monitoring can capture further changes in prevalence and patterns to inform targeted public health intervention programs.
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Affiliation(s)
- Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Savannah, Georgia, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mohammad E Kalan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ziyad Ben Taleb
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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Wong CY, Ong HX, Traini D. The application of in vitro cellular assays for analysis of electronic cigarettes impact on the airway. Life Sci 2022; 298:120487. [DOI: 10.1016/j.lfs.2022.120487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
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Support for 100% Tobacco-Free Policy on a College Campus in New Jersey: Differences between students and faculty/staff. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Benson R, Hu M, Chen AT, Zhu SH, Conway M. Examining Cannabis, Tobacco, and Vaping Discourse on Reddit: An Exploratory Approach Using Natural Language Processing. Front Public Health 2022; 9:738513. [PMID: 35071153 PMCID: PMC8766503 DOI: 10.3389/fpubh.2021.738513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/26/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Perceptions of tobacco, cannabis, and electronic nicotine delivery systems (ENDS) are continually evolving in the United States. Exploring these characteristics through user generated text sources may provide novel insights into product use behavior that are challenging to identify using survey-based methods. The objective of this study was to compare the topics frequently discussed among Reddit members in cannabis, tobacco, and ENDS-specific subreddits. Methods: We collected 643,070 posts on the social media site Reddit between January 2013 and December 2018. We developed and validated an annotation scheme, achieving a high level of agreement among annotators. We then manually coded a subset of 2,630 posts for their content with relation to experiences and use of the three products of interest, and further developed word cloud representations of the words contained in these posts. Finally, we applied Latent Dirichlet Allocation (LDA) topic modeling to the 643,070 posts to identify emerging themes related to cannabis, tobacco, and ENDS products being discussed on Reddit. Results: Our manual annotation process yielded 2,148 (81.6%) posts that contained a mention(s) of either cannabis, tobacco, or ENDS with 1,537 (71.5%) of these posts mentioning cannabis, 421 (19.5%) mentioning ENDS, and 264 (12.2%) mentioning tobacco. In cannabis-specific subreddits, personal experiences with cannabis, cannabis legislation, health effects of cannabis use, methods and forms of cannabis, and the cultivation of cannabis were commonly discussed topics. The discussion in tobacco-specific subreddits often focused on the discussion of brands and types of combustible tobacco, as well as smoking cessation experiences and advice. In ENDS-specific subreddits, topics often included ENDS accessories and parts, flavors and nicotine solutions, procurement of ENDS, and the use of ENDS for smoking cessation. Conclusion: Our findings highlight the posting and participation patterns of Reddit members in cannabis, tobacco, and ENDS-specific subreddits and provide novel insights into aspects of personal use regarding these products. These findings complement epidemiologic study designs and highlight the potential of using specific subreddits to explore personal experiences with cannabis, ENDS, and tobacco products.
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Affiliation(s)
- Ryzen Benson
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Mengke Hu
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Annie T. Chen
- Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle, WA, United States
| | - Shu-Hong Zhu
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | - Mike Conway
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
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Berg CJ, Windle M, Dodge T, Cavazos-Rehg P, Yang YT, Ma Y, Haardörfer R. Marijuana Use and Increases in Use over Time among Young Adult College Students in the State of Georgia: Analyses of Sociocontexual Predictors. Subst Use Misuse 2022; 57:350-359. [PMID: 34913832 DOI: 10.1080/10826084.2021.2012691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND While research has assessed correlates of marijuana use, there has been less focus on predictors of differing levels of changes in use during young adulthood, a critical period for use/escalation. OBJECTIVES We examined changes in marijuana use and related sociocontextual predictors (e.g., earlier-onset substance use, parental use, college type). METHODS Using data from Georgia college students (ages 18-25 years) in a 2-year, 6-wave longitudinal study (64.6% female, 63.4% White), 2-part random-effects modeling examined use at any assessment and number of days used. RESULTS Predictors of use status at any assessment included being male (OR = 1.87, 95%CI = [1.28-2.73]), Black (OR = 1.91, 95%CI = [1.15-3.19]), earlier-onset marijuana (OR = 2.63, 95%CI = [1.70-4.06]), cigarette (OR = 2.04, 95%CI = [1.19-3.48]), and alcohol users (OR = 1.49, 95%CI = 1.00-2.22]), parental tobacco (OR = 2.14, 95%CI = [1.18-3.86]) and/or alcohol use (OR = 1.55, 95%CI = [1.09-2.20]), and attending private (vs. public) institutions (OR = 1.68, 95%CI = [1.10-2.59]). Predictors of lower likelihood of use over time included being male (OR = 0.87, 95%CI = [0.77-0.98]), earlier-onset cigarette use (OR = 0.82, 95%CI = [0.68-0.98]), parental alcohol use (OR = 0.86, 95%CI = [0.77-0.97]), and private institution students (OR = 1.17, 95%CI = [1.02-1.34]). Predictors of more days used at baseline included being male (OR = 1.77, 95%CI = [1.40-2.23]), Black (OR = 1.42, 95%CI = [1.04-1.93]), earlier-onset marijuana (OR = 2.32, 95%CI = [1.78-3.01]) and alcohol users (OR = 1.29, 95%CI = [1.01-1.66]), and parental tobacco use (OR = 1.90, 95%CI = [1.32-2.73]). Predictors of fewer days used over time included being older (OR = 0.98, 95%CI = [0.97-1.00]), parental tobacco use (OR = 0.86, 95%CI = [0.78-0.95]), and attending private institutions (OR = 0.89, 95%CI = [0.83-0.93]). CONCLUSIONS Intervention efforts can be informed by current findings that correlates of baseline use (e.g., being male, attending private institutions) also predicted less use over time, and one's earlier use and parents' use of various substances impacted young adult use.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Michael Windle
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Y Tony Yang
- Center for Health Policy and Media Engagement, School of Nursing, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Okpalauwaekwe U, Nwoke CN, Messier J. Youth Demographic Characteristics and Risk Perception of Using Alternative Tobacco Products: An Analysis of the 2014-2015 Canadian Student Tobacco, Alcohol, and Drugs Survey (CSTADS). Tob Use Insights 2021; 14:1179173X211058150. [PMID: 34866954 PMCID: PMC8637779 DOI: 10.1177/1179173x211058150] [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: 06/21/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is a growing attraction by youth to alternative tobacco products (ATPs) such as e-cigarettes and hookahs. This study investigated risk perceptions and demographic characteristics associated with ATP use in grade 8-10 students. Methods Data were drawn from the 2014/15 cycle of the CSTADS. The analytic sample included 1819 students from a total pool of 42 094 students who completed the survey. Logistic regression models were used to examine factors (demographic characteristics and risk perception) associated with ATP use in the past 30 days. Results 12% of students in grade 8-10 self-identified as having used ATPs in the past 30-days, with a majority of students in grade 10 (56%). Male students had higher odds of reporting ATP use when compared to females. Although a lesser proportion of Indigenous students reported ATP use in comparison to White students (31% vs 61%), Indigenous students were 2.42 (1.49, 3.93) times as likely to use ATPs as White students. Students who perceived smoking hookah once in a while as "no to slight risk" were 1.58 (1.09, 2.28) times more likely to report ATP use than students who perceived "moderate to great risk." Also, students who perceived using e-cigarettes on a regular basis as "no to slight risk" were 2.21 (1.53, 3.21) times more likely to report ATP use as students who perceived "moderate-great risk." Conclusion A significant number of grade 8-10 students use ATPs, especially e-cigarettes, with the misconception of minimal health risks. There remains the need to do more to counteract the rise in social and epidemiological alternative tobacco use trends among the youth.
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Affiliation(s)
- Udoka Okpalauwaekwe
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Jacinthe Messier
- Independent Researcher in Indigenous Studies, Project Coordinator, Siksika First Nation Project, Calgary, AB, Canada
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