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Fedorova EV, Mitchel A, Finkelstein M, Ataiants J, Wong CF, Conn BM, Lankenau SE. Pre-Post Cannabis Legalization for Adult Use: A Trend Study of Two Cohorts of Young Adult Cannabis Users in Los Angeles. J Psychoactive Drugs 2025; 57:99-109. [PMID: 37997888 PMCID: PMC11116271 DOI: 10.1080/02791072.2023.2282515] [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: 03/03/2023] [Revised: 08/07/2023] [Accepted: 10/11/2023] [Indexed: 11/25/2023]
Abstract
Cannabis was legalized for adult use in California in 2016 for individuals 21 and older. Among 18-20-years-olds, who can possess cannabis legally as medical cannabis patients (MCP) but not as non-patient cannabis users (NPU), the impact of adult use legalization (AUL) on cannabis and other substance use is unknown. Two cohorts of 18-20-year-old cannabis users (MCP and NPU) were surveyed, one in 2014-15 (n = 172 "pre-AUL") and another in 2019-20 (n = 139 "post-AUL"), using similar data collection methods in Los Angeles, California. Logistic and negative binomial regressions estimated cohort and MCP differences for cannabis and other drug use outcomes based on past 90-day use. In both pre- and post-AUL cohorts, MCP were more likely to self-report medical cannabis use (p < .001) while the post-AUL cohort reported greater use of edibles (p < .01), but fewer mean days of alcohol (p < .05) and cigarette (p < .01) use in multivariate models. Notably, frequency of cannabis use (days or hits per day) did not significantly differ between the pre- and post-AUL cohorts, except for greater use of edibles, despite potentially greater access to cannabis.
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Affiliation(s)
- Ekaterina V. Fedorova
- Drexel University, Dornsife School of Public Health, Department of Communisty Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, United States
| | - Allison Mitchel
- Drexel University, Dornsife School of Public Health, Department of Communisty Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, United States
| | - Maddy Finkelstein
- Drexel University, Dornsife School of Public Health, Department of Communisty Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, United States
| | - Janna Ataiants
- Drexel University, Dornsife School of Public Health, Department of Communisty Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, United States
| | - Carolyn F. Wong
- University of Southern California, Keck School of Medicine, Department of Pediatrics, 4650 Sunset Blvd., Los Angeles, CA 90027, United States
- Children’s Hospital Los Angeles, Division of Adolescent Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, United States
- Children’s Hospital Los Angeles, Division of Research on Children, Youth, & Families, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, United States
| | - Bridgid M. Conn
- University of Southern California, Keck School of Medicine, Department of Pediatrics, 4650 Sunset Blvd., Los Angeles, CA 90027, United States
- Children’s Hospital Los Angeles, Division of Adolescent Medicine, 4650 Sunset Blvd., MS #2, Los Angeles, CA 90027, United States
| | - Stephen E. Lankenau
- Drexel University, Dornsife School of Public Health, Department of Communisty Health and Prevention, 3215 Market Street, Philadelphia, PA 19104, United States
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Cascio CN, Selkie E, Moreno MA. Effect of Technology and Digital Media Use on Adolescent Health and Development: Protocol for a Multimethod Longitudinal Study. JMIR Res Protoc 2023; 12:e50984. [PMID: 37703071 PMCID: PMC10534290 DOI: 10.2196/50984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Technology and digital media (TDM) use is integral to modern adolescence; adolescents have been labeled as "digital natives," since they have had exposure to digital technology for their entire lives. Previous evidence has illustrated TDM's connections with adolescent risk behaviors such as increased alcohol use and social media exposure, as well as relationships with adolescent well-being such as improved socioemotional health and social media connections with peers. Although several recent review articles have described both the benefits and risks of technology use, most individual studies adopt a singular risk-centered approach. In addition, reviews suggest that little evidence exists on the potential mediating and moderating factors between TDM use and well-being and health outcomes, which limits our understanding of what influences the outcomes of interest. Therefore, there is an urgent need to fill these gaps. OBJECTIVE This protocol addresses the need to understand how TDM exposure and use affect multiple developmental domains and health outcomes. We address the fragmented nature of previous research, the common focus on single behaviors or conditions, and the typical narrow lens on risks. Our approach further aligns with reviews that called for studies identifying and investigating the factors that moderate the relationships between social media and health behaviors and outcomes. METHODS We will address our objective by longitudinally examining over a 2-year period a common set of adolescent participants (N=400, aged 13-15 years) across 3 studies that adopt a multimethodological approach. Study 1 will use TDM to understand the mechanisms behind adolescent health and risk behaviors. Study 2 will use functional magnetic resonance imaging to understand how positive and negative TDM experiences relate to mental and behavioral health in a subsample of 150 adolescents. Study 3 will use a mixed methods design to evaluate self- and other-generated TDM content as the predictors of socioemotional well-being in sexual and gender minority and non-sexual and gender minority adolescents. RESULTS Recruitment is ongoing, and the initial results from the first wave of recruitment are expected in 2024. CONCLUSIONS This integrated approach to longitudinal data collection from a shared adolescent participant pool will lead to novel analyses and findings, allowing for the examination of the health and well-being risks and benefits associated with TDM use and factors that moderate these relationships. The findings from this study will advance conceptual models and inform new interventions to improve adolescent health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50984.
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Affiliation(s)
- Christopher N Cascio
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, WI, United States
| | - Ellen Selkie
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Megan A Moreno
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Clobes TA, Gagnon M. Demographic factors that impact attitudes toward medical cannabis. PEC INNOVATION 2022; 1:100085. [PMID: 37213732 PMCID: PMC10194315 DOI: 10.1016/j.pecinn.2022.100085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 05/23/2023]
Abstract
Objective This study aims to identify pertinent demographic characteristics that influence attitudes toward medical cannabis. Methods Survey respondents were recruited through social media posts, partnering with community organizations, and snowball sampling. Attitudes were measured with a modified version of the medical component of the Recreational and Medical Cannabis Attitudes Scale (MMCAS). Data were analyzed using a one-way ANOVA or one-way Welch ANOVA to determine differences within demographic characteristics. A Tukey-Kramer, or Games-Howell, post-hoc analysis was conducted to determine specific groups within the independent variables that significantly impacted medical cannabis attitudes. Results A total of 645 participants completed the survey. Significant variation in MMCAS was noted between groups based on race, political party affiliation, political view, religion, state legal status, and past/current cannabis use. There were no significant variations noted in MMCAS for apolitical factors. Conclusion Political, religious, and legal demographic factors impact attitudes toward medical cannabis. Innovation The use of health education targeted at the groups of people who continue to harbor antiquated attitudes toward medical cannabis will help to improve patient access and, thus, patient outcomes. Cannabis advocates can innovatively apply health education efforts to groups of people who are aligned with the demographic factors identified in this current work.
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Affiliation(s)
- Thomas A. Clobes
- California State University Channel Islands, One University Dr., Camarillo, CA 93012, USA
| | - Matin Gagnon
- California State University Channel Islands, One University Dr., Camarillo, CA 93012, USA
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Gupta H, Gupta S, Rozatkar AR. Magnitude of Substance Use and Its Associated Factors Among the Medical Students in India and Implications for Medical Education: A Narrative Review. Indian J Psychol Med 2022; 44:218-226. [PMID: 35656413 PMCID: PMC9125464 DOI: 10.1177/02537176211032366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Medical students are at an increased risk of developing substance use and related problems (SURP) because of the inherent stress associated with the professional medical course apart from the developmental risk factors. However, this is under-researched. Moreover, a comprehensive review on the prevalence of SURP among the medical undergraduates (UGs) and associated factors is lacking from India. To fill this gap, the current research work is aimed to review the existing literature on the magnitude of the SURP among UGs of India and its determinants. METHODS PubMed, Medline, and Google Scholar databases were searched for the original articles studying the prevalence of SURP among medical UGs of India, published from inception till date. Non-original articles, studies on behavioral addictions, and those not directly assessing the prevalence of SURP among the medical UGs were excluded. RESULTS A total of 39 studies were found eligible for the review. Alcohol (current use: 3.2%-43.8%), followed by tobacco (3.7%-28.8%) and cannabis (1.6%-15%), were the common substances used by the medical students. Among the females, an increasing trend of substance use, particularly of nonprescription sedatives (even higher than males), alcohol, and smoking, was seen. Family history, peer pressure, transition from school to college life, and progression in the medical course were important associated factors. CONCLUSION Sensitizing medical students and college authorities, increasing the duration of training on SURP in medical curricula, and providing psychological support for the students with SURP could address this issue.
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Affiliation(s)
- Himank Gupta
- All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
| | - Snehil Gupta
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
| | - Abhijit R Rozatkar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
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Burdzovic Andreas J, Sivertsen B, Lønning KJ, Skogen JC. Cannabis use among Norwegian university students: Gender differences, legalization support and use intentions, risk perceptions, and use disorder. Addict Behav Rep 2021; 13:100339. [PMID: 33604449 PMCID: PMC7873627 DOI: 10.1016/j.abrep.2021.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/16/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022] Open
Abstract
Past year cannabis use was fairly common in a sample of Norwegian college students. About 6% of users possibly met criteria for use disorder, function of use frequency. Legalization attitudes and risk perceptions were associated with cannabis use risk. Intentions to use cannabis if legal were evident even among some current non-users. Many non-users expressed uncertainty in legalization attitudes and risk perceptions.
Aims We explored past-year cannabis use and associated characteristics, focusing on legalization attitudes, use intentions, risk perceptions, and possible dependence among Norwegian university/college students. Methods We examined a nation-wide sample of Norwegian university/college students (N = 49,688; 67% female) who participated in the Students’ Health and Wellbeing Study (SHoT-study) in 2018. Participants reported past-year substance use, support for cannabis legalization, intent to use cannabis if legal, and perceived risks of weekly use. Past-year cannabis use (including use frequency) was examined in relation to these indicators. Legalization support, use intentions, and risk perceptions were examined in relation to use and gender. Potential cannabis use disorder was assessed with the Cannabis Abuse Screening Test (CAST) and examined in relation to use frequency and gender. Findings Past-year use was reported by 15.3% (11.8% women; 22.9% men). Majority of current users (roughly 90%) used no more than 50 times past year, and 6% (3.8% women; 8.5% men) met CAST use disorder criteria. Legalization support, use intentions, and no/low risk perceptions were significantly associated with greater odds of use, and greater use frequency among current users in both crude and adjusted models. Legalization support (23.0%), use intentions (14.0%), and perceptions of no/low risk (29.2%) were also relatively common even among current non-users, especially men. Male gender and more frequent use were associated with greater CAST scores and greater odds of use disorder. Conclusions Cannabis use was relatively common in this student sample. In addition to targeting frequent use, interventions may focus on cannabis-related attitudes and risk perceptions among uncertain/uninformed students.
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Affiliation(s)
- Jasmina Burdzovic Andreas
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Jussie Lønning
- The Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Barker AK, Moreno MA. Effects of Recreational Marijuana Legalization on College Students: A Longitudinal Study of Attitudes, Intentions, and Use Behaviors. J Adolesc Health 2021; 68:110-115. [PMID: 32402801 PMCID: PMC7648724 DOI: 10.1016/j.jadohealth.2020.03.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE As legal recreational marijuana use expands rapidly across the U.S., there is growing concern that this will lead to higher rates of use among college-aged young adults. Given the limited research addressing this issue, a longitudinal study was conducted to evaluate the effects of legalizing recreational use on the attitudes, intentions, and marijuana use behaviors of college students in two different legalization contexts, Washington State and Wisconsin. METHODS Survey data assessing marijuana attitudes, intentions, and use behavior were collected from 2011 to 2016 on a longitudinal cohort of 338 students at two large public universities in Washington and Wisconsin. Time series analyses were conducted to evaluate postlegalization changes in ever use, 28-day use, and mean attitude and intention-to-use scores in Washington state, using Wisconsin participants as the control group. RESULTS Ever use, attitude, and intention-to-use scores did not change significantly more in Washington after legalization than in Wisconsin. However, among prior users, the proportion using in the last 28 days rose faster in Washington after legalization that it did in Wisconsin (p < .001). CONCLUSIONS The findings suggest that legalization had the greatest effects on current marijuana users, who are surrounded by a climate that is increasingly supportive of its use.
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Affiliation(s)
- Anna K Barker
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Megan A Moreno
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin.
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Alves R, Precioso J, Becoña E. llicit Drug Use among College Students: The Importance of Knowledge about Drugs, Live at Home and Peer Influence. J Psychoactive Drugs 2020; 53:329-338. [PMID: 33382024 DOI: 10.1080/02791072.2020.1865592] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The problem of consumption of illicit psychoactive substances by students in higher education is not new, since it is in this age group that the highest prevalence of consumption of these substances continues to occur. This study aimed to describe the prevalence of illicit drug use among university students and to analyze the predictive factors and patterns of illicit drug use among university students in Portugal. A cross-sectional design and a stratified random sampling method were used (n = 840). A validated self-administered questionnaire was used, consisting of socio-demographic characteristics, information about the patterns of illicit drugs consumption, and knowledge and attitudes toward illicit drugs use. The prevalence of illicit drugs consumption was 22.2%, while overall students had a low level of knowledge and moderate scores when it came to the attitudes toward drug use. Being male, having changed residence after entering higher education, having friends who use illicit drugs and possessing knowledge on drugs increased the likelihood of consuming illicit drugs. The results of the study could help develop strategies to reduce use of illicit drugs in academic settings, giving special attention to the influence of peers and students who changed their residence after entering higher education.
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Affiliation(s)
- Regina Alves
- CIEC - Research Centre Child Studies, Institute of Education - University of Minho, Braga, Portugal
| | - José Precioso
- CIEC - Research Centre Child Studies, Institute of Education - University of Minho, Braga, Portugal
| | - Elisardo Becoña
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Patten CA, Wang XQ, Little MA, Ebbert JO, Talcott GW, Hryshko-Mullen AS, Klesges R. Influence of gender on initiation of tobacco and nicotine containing product use among U.S. Air Force trainees. Prev Med Rep 2020; 19:101104. [PMID: 32435579 PMCID: PMC7229489 DOI: 10.1016/j.pmedr.2020.101104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/02/2022] Open
Abstract
Military personnel are a subgroup of young adults at risk for tobacco and nicotine containing product (TNCP) use. This study of US Air Force (USAF) trainees who were never users of TNCPs examined gender, peer tobacco use, and tobacco use intentions as predictors of TNCP initiation after Basic Military Training (BMT). We used a longitudinal cohort assessment study design with baseline and 1-year surveys completed (2011-2016) among 2393 USAF trainees: 73% men, 95% aged 18-25 years, 36% racial minorities. Overall, initiation of any TNCP use at 1-year was 23% (20% women, 24% men). From a multivariable multinomial logistic regression model predicting TNCP use at 1-year follow-up, significant 2-way interactions were detected between gender and number of close friends using tobacco before BMT (p = 0.015), and between gender and tobacco use intentions (p < 0.0001). Women reporting almost all or many close friends used tobacco were more likely to report TNCP use compared to women with none (Odds ratio [OR] = 5.8, 95% CI 2.5-13.5, Bonferroni corrected p < 0.0001). Having close friends using tobacco had little influence on TNCP use among men. Men with tobacco use intentions were more likely to report TNCP use compared to men having no intentions (OR = 8.0, 95% CI: 4.7-13.6, Bonferroni corrected p < 0.001), but tobacco use intentions had little influence among women. In this sample of USAF trainees, the study provides novel prospective findings on TNCP initiation, and how men and women are influenced differently by peer tobacco use and tobacco use intentions. Gender-specific prevention efforts focused on uptake of TNCPs appear warranted.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Xin-Qun Wang
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Melissa A. Little
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Jon O. Ebbert
- Department of Internal Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Gerald W. Talcott
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
| | - Ann S. Hryshko-Mullen
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, TX 78236, USA
| | - Robert Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, PO Box 800717, Charlottesville, VA 22908, USA
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Patten C, Wang XQ, Ebbert JO, Little MA, Talcott GW, Hryshko-Mullen AS, Klesges RC. Influence of gender and peer tobacco use on tobacco use intentions after a period of involuntary tobacco abstinence among U.S. Air Force trainees. Prev Med Rep 2019; 13:270-276. [PMID: 30723662 PMCID: PMC6351393 DOI: 10.1016/j.pmedr.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 11/21/2022] Open
Abstract
This study examined gender, prior tobacco use, and social-environmental factors as predictors of intentions to use tobacco (cigarette smoking and/or smokeless tobacco [ST]) after a forced period of abstinence among U.S. Air Force (USAF) trainees. Trainees completed 8½ weeks of basic military training (BMT), then 4 weeks of Technical Training; both required abstinence from tobacco. A cross-sectional survey of 13,514 USAF trainees (73% male, 90% age 18–24, 43% prior tobacco use) was conducted at the beginning of the 4-week Technical Training period. Overall, 17% of the sample reported future tobacco use intentions. Intentions for future tobacco use were less prevalent among non-tobacco users before BMT (1%) than those reporting any tobacco use (37%). From a multivariable logistic regression model predicting intentions to use any tobacco after Technical Training, significant two-way interaction effects were detected between gender, and tobacco use prior to BMT (p = 0.0001), and number of close friends who smoked cigarettes (p = 0.018), and number of close friends who used ST (p = 0.029). Among non-tobacco users before BMT, females were more than twice as likely as males to report tobacco intentions (Odds Ratio = 2.2, Bonferroni corrected 95% CI: 1.14.4, p = 0.011); no gender differences were detected among tobacco users. For females, but not males, having more friends who smoked was associated with greater likelihood of tobacco intentions (Bonferroni corrected p ≤ 0.05). In contrast, for males, but not females, having more friends using ST was associated with greater likelihood of tobacco intentions (Bonferroni corrected p < 0.05). In this sample of USAF trainees, the study provides novel findings on how males and females are influenced differently by their prior tobacco use and peers' tobacco use in predicting tobacco intentions. Prevention efforts focused on uptake and resumption of tobacco use, along with gender-specific strategies, may be warranted. Prior tobacco use predicts tobacco use intentions among U.S. Air Force trainees. Male and female trainees are influenced differently by their peers' tobacco use. Gender-specific strategies targeting social norms about tobacco may be warranted.
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Affiliation(s)
- Christi Patten
- Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
- Corresponding author at: Mayo Clinic, BioBusiness 5, 200 1st Street SW, Rochester, MN 55905, USA.
| | - Xin-Qun Wang
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Jon O. Ebbert
- Department of Internal Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Melissa A. Little
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Gerald W. Talcott
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717, Charlottesville, VA 22908, USA
| | - Ann S. Hryshko-Mullen
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, TX 78236, USA
| | - Robert C. Klesges
- Department of Public Health Sciences, University of Virginia School of Medicine, P.O. Box 800717, Charlottesville, VA 22908, USA
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Champion KE, Newton NC, Stapinski L, Teesson M. Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation. BMJ Open 2018; 8:e020433. [PMID: 30478103 PMCID: PMC6254404 DOI: 10.1136/bmjopen-2017-020433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 08/20/2018] [Accepted: 10/10/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To evaluate the effectiveness of the online Climate Schools: Ecstasy and Emerging Drugs module over 2 years, and examine the impact of intervention dose on outcomes. DESIGN Cluster randomised controlled trial. SETTING Secondary schools in Australia. PARTICIPANTS 1126 students (aged 14.9 years) from 11 schools. INTERVENTION Five schools were randomly allocated to the four-lesson internet-based Climate Schools: Ecstasy and Emerging Drugs module. This universal intervention uses cartoon storylines to deliver harm-minimisation information about ecstasy and new psychoactive substances (NPS). It was delivered during health education classes over 4 weeks. Six schools were randomised to the control group (health education as usual). Participants were not blinded to intervention allocation. OUTCOMES MEASURES Students completed self-report surveys at baseline, post-test, 6, 12 and 24 months post-baseline. Intentions to use ecstasy and NPS (including synthetic cannabis and synthetic stimulants), knowledge about ecstasy and NPS and lifetime use of ecstasy and NPS were assessed. This paper reports the results at 24 months post-baseline. ANALYSIS Mixed effects regressions were conducted to analyse intervention effects from baseline to 24 months. Post hoc analyses using Inverse Probability of Treatment Weighting compared controls with students who: i) completed all four lessons ('full dose') and ii) partially completed the intervention (≤three lessons, 'incomplete dose'). RESULTS Primary analyses found that controls were significantly more likely to intend on using synthetic cannabis compared with intervention group students (OR=3.56, p=0.01). Results from the weighted analyses indicated that controls reported significantly lower knowledge about ecstasy (p=0.001) and NPS (p=0.04) compared with the full-dose group. No significant differences were observed between the incomplete dose and control groups. CONCLUSIONS The online intervention was effective in modifying students' intentions to use synthetic cannabis up to 24 months; however, this study highlights the importance of delivering prevention programmes in full to maximise student outcomes. TRIAL REGISTRATION NUMBER ACTRN12613000708752.
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Affiliation(s)
- Katrina E Champion
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Nicola Clare Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lexine Stapinski
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
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Population-level predictions from cannabis risk perceptions to active cannabis use prevalence in the United States, 1991-2014. Addict Behav 2018; 82:101-104. [PMID: 29505985 DOI: 10.1016/j.addbeh.2018.02.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/24/2018] [Accepted: 02/25/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION A mosaic of evidence links risk perceptions with drug use in adolescence, including population summaries to guide public health campaigns, as well as subject-specific estimates on preventing an adolescent's drug use by manipulating that individual's prior risk perceptions. We re-visit these issues with a public health perspective, asking whether population-level cannabis risk perceptions of school-attending adolescents at one grade level might predict cannabis use prevalence two and four grade levels later. METHODS From 1991 to 2014, each year's United States "Monitoring the Future" (MTF) study population included 8th-, 10th-, & 12th-graders. Two and four years later, statistically independent school samples of the same cohorts were drawn and assessed (n ~ 16,000/year). Population-level modeling estimated cannabis use prevalence at time "t" (12th-grade) regressed on that same cohort's cannabis risk perceptions as had been measured at time "t-4" (8th-grade) and time "t-2" (10th-grade). RESULTS Higher cannabis risk perception levels for 10th-graders predict lower cannabis use prevalence when 10th-graders have become 12th-graders (β̂=-0.12), and higher cannabis risk perception levels of 8th-graders predict lower cannabis prevalence when 8th-graders have become 10th-graders (β̂=-0.27); p-values < 0.05. Across four-year spans, the prediction is null (p-value = 0.619). CONCLUSIONS This within-cohort across-grade population-level prediction prompts questions for drug prevention specialists, including "Would a relatively small upward shift in a local area population's appraisal of risk perceptions be followed, two years later, by reduced population prevalence of cannabis use?" Future randomized trial designs, health education, or prevention efforts focused on altering early adolescent cannabis risk perceptions might provide the most convincing and definitive evidence.
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Foster DW, Ye F, Chung T, Hipwell AE, Sartor CE. Longitudinal associations between marijuana-related cognitions and marijuana use in African-American and European-American girls from early to late adolescence. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 32:104-114. [PMID: 29094955 DOI: 10.1037/adb0000323] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined marijuana-related cognitions and marijuana use in African-American (AA) and European-American (EA) girls, with the aim of characterizing their interrelationships from early to late adolescence. Identifying differences by race in these relationships would have implications for tailoring interventions to specific subgroups. Data were drawn from the Pittsburgh Girls Study, an urban community sample (56.8% AA, 43.2% EA; n = 2,172) recruited at ages 5-8 years and assessed each year. Cross-lagged panel models were conducted separately by race to identify patterns of association between marijuana use and related cognitions (i.e., intentions to use, positive attitude toward use, positive and negative expectancies) assessed at ages 12-17 years. Results indicated that AA girls consistently reported higher negative expectancies than EA girls and greater intention to use marijuana, but they did not differ from EA girls on positive expectancies. In cross-lagged models, bidirectional effects between negative expectancies and marijuana use were observed in AA and EA girls across all ages, and at most ages for intentions to use, but were largely absent in both groups for positive attitude. Bidirectional effects of marijuana use with positive expectancies were observed only in AA girls at certain ages. Overall, results demonstrate more similarities than differences between AA and EA girls in the longitudinal associations between marijuana-related cognitions and marijuana use. Results highlight the role of negative expectancies as shaping and being shaped by marijuana use. Interventions that target negative expectancies to reduce marijuana use may be useful for AA and EA adolescent girls. (PsycINFO Database Record
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Affiliation(s)
- Dawn W Foster
- Department of Psychiatry, Yale University School of Medicine
| | - Feifei Ye
- Department of Psychology and Education, University of Pittsburgh
| | - Tammy Chung
- Department of Psychiatry, University of Pittsburgh
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Kerr DCR, Bae H, Phibbs S, Kern AC. Changes in undergraduates' marijuana, heavy alcohol and cigarette use following legalization of recreational marijuana use in Oregon. Addiction 2017; 112:1992-2001. [PMID: 28613454 DOI: 10.1111/add.13906] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/23/2017] [Accepted: 06/02/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Recreational marijuana legalization (RML) went into effect in Oregon in July 2015. RML is expected to influence marijuana use by adolescents and young adults in particular, and by those with a propensity for substance use. We sought to quantify changes in rates of marijuana use among college students in Oregon from pre- to post-RML relative to college students in other states across the same time period. DESIGN Repeated cross-sectional survey data from the 2012-16 administrations of the Healthy Minds Study. SETTING Seven 4-year universities in the United States. PARTICIPANTS There were 10 924 undergraduate participants. One large public Oregon university participated in 2014 and 2016 (n = 588 and 1115, respectively); six universities in US states where recreational marijuana use was illegal participated both in 2016 and at least once between 2012 and 2015. MEASUREMENTS Self-reported marijuana use in the past 30 days (yes/no) was regressed on time (pre/post 2015), exposure to RML (i.e. Oregon students in 2016) and covariates using mixed-effects logistic regression. Moderation of RML effects by recent heavy alcohol use was examined. FINDINGS Rates of marijuana use increased from pre- to post-2015 at six of the seven universities, a trend that was significant overall. Increases in rates of marijuana use were significantly greater in Oregon than in comparison institutions, but only among students reporting recent heavy alcohol use. CONCLUSIONS Rates of Oregon college students' marijuana use increased (relative to that of students in other states) following recreational marijuana legislation in 2015, but only for those who reported recent heavy use of alcohol. Such alcohol misuse may be a proxy for vulnerabilities to substance use or lack of prohibitions (e.g. cultural) against it.
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Affiliation(s)
| | - Harold Bae
- Oregon State University, Corvallis, OR, USA
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Arria AM, Caldeira KM, Allen HK, Bugbee BA, Vincent KB, O'Grady KE. Prevalence and incidence of drug use among college students: an 8-year longitudinal analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:711-718. [PMID: 28402711 DOI: 10.1080/00952990.2017.1310219] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Drug use among college students is associated with adverse academic and health outcomes and risks to personal safety. OBJECTIVES This study utilized data from a longitudinal study to estimate annual prevalence, cumulative lifetime prevalence, and incidence of ten types of drug use during the eight years after college entry and the average age of onset of each drug used. METHODS Participants (N = 1,253; 52% female) were young adults who were originally enrolled as first-time, first-year students at a university in the mid-Atlantic US. Annual personal interviews gathered data about the use of seven illicit drugs and three prescription drugs used nonmedically. Annual follow-up rates ranged from 76 to 91%. RESULTS Marijuana was the most commonly used drug in every year of the study, with the highest annual prevalence estimates in Year 3 (47%wt). In Year 8, when the modal age of participants was 25, 29%wt used marijuana during the past year. Nonmedical use of prescription drugs was more prevalent during college than in the later years of the study. Although the prevalence of cocaine and ecstasy use was low (cumulative prevalence estimates of 17%wt and 13%wt, respectively), incidence for these drugs was particularly high in the later years of the study. CONCLUSION Drug use is prevalent among college students, and drug use persists among young adults, even after many have graduated college. More attention should be directed at identifying and intervening with students at risk for drug use to mitigate possible academic, health, and safety consequences.
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Affiliation(s)
- Amelia M Arria
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kimberly M Caldeira
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Hannah K Allen
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Brittany A Bugbee
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kathryn B Vincent
- a Department of Behavioral and Community Health, Center on Young Adult Health and Development , University of Maryland School of Public Health , College Park , MD , USA
| | - Kevin E O'Grady
- b Department of Psychology , University of Maryland , College Park , MD , USA
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Moreno MA, Arseniev-Koehler A, Selkie E. Development and Testing of a 3-Item Screening Tool for Problematic Internet Use. J Pediatr 2016; 176:167-172.e1. [PMID: 27395768 PMCID: PMC5636184 DOI: 10.1016/j.jpeds.2016.05.067] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/09/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To develop and validate the Problematic and Risky Internet Use Screening Scale (PRIUSS)-3 screening scale, a short scale to screen for Problematic Internet Use. STUDY DESIGN This scale development study applied standard processes using separate samples for training and testing datasets. We recruited participants from schools and colleges in 6 states and 2 countries. We selected 3 initial versions of a PRIUSS-3 using correlation to the PRIUSS-18 score. We evaluated these 3 potential screening scales for conceptual coherence, factor loading, sensitivity, and specificity. We selected a 3-item screening tool and evaluated it in 2 separate testing sets using receiver operating curves. RESULTS Our study sample included 1079 adolescents and young adults. The PRIUSS-3 included items addressing anxiety when away from the Internet, loss of motivation when on the Internet, and feelings of withdrawal when away from the Internet. This screening scale had a sensitivity of 100% and specificity of 69%. A score of ≥3 on the PRIUSS-3 was the threshold to follow up with the PRIUSS-18. DISCUSSION Similar to other clinical screening tools, the PRIUSS-3 can be administered quickly in a clinical or research setting. Positive screens should be followed by administering the full PRIUSS-18. Given the pervasive presence of the Internet in youth's lives, screening and counseling for Problematic Internet Use can be facilitated by use of this validated screening tool.
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Affiliation(s)
- Megan A. Moreno
- Seattle Children's Research Institute; Center for Child Health, Behavior and Development, PO Box 5371, Seattle, WA 98145-5005, (206) 884-1424
| | | | - Ellen Selkie
- University of Michigan, Department of Pediatrics, (734) 232-9962
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Villanti AC, Bover Manderski MT, Gundersen DA, Steinberg MB, Delnevo CD. Reasons to quit and barriers to quitting smoking in US young adults. Fam Pract 2016; 33:133-9. [PMID: 26733658 PMCID: PMC5006105 DOI: 10.1093/fampra/cmv103] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Young adulthood provides an enormous opportunity to alter trajectories of smoking behaviour for a large public health impact. OBJECTIVE The purpose of this study was to examine correlates of perceived barriers to quitting smoking and reasons to quit in a sample of young adult current and former smokers. METHODS This study used data from the 2011 National Young Adult Health Survey, a random-digit-dial cellphone survey. Participants were US young adult current smokers aged 18-34 (n = 699) and young adults who were either current smokers who had made a quit attempt in the past-year (n = 402) or former smokers (n = 289). Correlates of barriers to quitting smoking and reasons for quitting smoking were assessed using bivariate and multivariable analyses. RESULTS More than half of current smokers identified 'loss of a way to handle stress' (59%) and 'cravings or withdrawal' (52%) as barriers to quitting. Female gender, daily smoking and intention to quit remained significantly associated with endorsing 'loss of a way to handle stress' as a barrier to quitting in multivariable analyses. The two most popular reasons for quitting smoking were physical fitness (64%) and the cost of tobacco (64%). CONCLUSION These findings highlight barriers to cessation and the reasons that young smokers give for quitting. This information may be helpful to physicians as they counsel their young adult patients to quit smoking.
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Affiliation(s)
- Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Daniel A Gundersen
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and
| | - Michael B Steinberg
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and
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Moreno MA, Whitehill JM, Quach V, Midamba N, Manskopf I. Marijuana experiences, voting behaviors, and early perspectives regarding marijuana legalization among college students from 2 states. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:9-18. [PMID: 26182234 PMCID: PMC5001493 DOI: 10.1080/07448481.2015.1062769] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The purpose of this mixed-methods study was to understand college students' (1) views and experiences regarding marijuana, (2) voting behaviors, and (3) early perceptions of the impact of legislation. PARTICIPANTS College students from Washington and Wisconsin were interviewed between May and September 2013. METHODS Participants completed phone interviews assessing marijuana attitudes, intentions, behaviors, voting behaviors or intentions, and perceptions of the impact of legislation. RESULTS A total of 283 participants completed the interview (83.7% retention rate): 56.8% were female, 57.2% were from Wisconsin, and 74.6% were Caucasian. Almost half of Washington participants (46.3%) indicated that they voted for marijuana legalization. Participants most commonly responded that the legislation did not change their attitudes towards marijuana, although some participants discussed perceived safety of the product because legislation passed. CONCLUSIONS Findings indicate similarities in views and experiences among college students from states affected and unaffected by legalization; legalization may increase perceptions of safety.
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Affiliation(s)
- Megan A Moreno
- a Seattle Children's Research Institute , Seattle , Washington , USA
- b Department of Pediatrics , University of Washington , Seattle , Washington , USA
- c Division of Adolescent Medicine, Seattle Children's Hospital , Seattle Washington , USA
| | - Jennifer M Whitehill
- d Department of Public Health , University of Massachusetts , Amherst , Massachusetts , USA
| | - Vincent Quach
- a Seattle Children's Research Institute , Seattle , Washington , USA
| | - Nikita Midamba
- a Seattle Children's Research Institute , Seattle , Washington , USA
| | - Inga Manskopf
- c Division of Adolescent Medicine, Seattle Children's Hospital , Seattle Washington , USA
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Hampson SE, Andrews JA, Severson HH, Barckley M. Prospective Predictors of Novel Tobacco and Nicotine Product Use in Emerging Adulthood. J Adolesc Health 2015; 57:186-91. [PMID: 26206439 PMCID: PMC4514910 DOI: 10.1016/j.jadohealth.2015.04.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether risk factors for cigarette smoking assessed in adolescence predict the use of novel tobacco and nicotine products (hookah, little cigars, and e-cigarettes) in early emerging adulthood. METHODS In a longitudinal study (N = 862), risk factors were measured in middle and high school, and novel product use was measured in emerging adulthood (mean age 22.4 years). Structural equation modeling was used to test a model predicting lifetime use of any of hookah, little cigars, and e-cigarettes in early emerging adulthood from distal predictors (gender, maternal smoking through Grade 8; already tried alcohol, cigarettes, or marijuana by Grade 8; and sensation seeking at Grade 8) and potential mediators (intentions to smoke cigarettes, drink alcohol or smoke marijuana at Grade 9, and smoking trajectory across high school). RESULTS The most prevalent novel tobacco product was hookah (21.7%), followed by little cigars (16.8%) and e-cigarettes (6.6%). Maternal smoking, having already tried substances, and sensation seeking each predicted the use of at least one of these products via an indirect path through intentions to use substances and membership in a high-school smoking trajectory. CONCLUSIONS Risk factors for cigarette smoking were found to predict novel tobacco use, suggesting that interventions to prevent cigarette smoking could be extended to include common novel tobacco products.
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