251
|
Lam CN, Goldenson NI, Burner E, Unger JB. Cultural buffering as a protective factor against electronic cigarette use among Hispanic emergency department patients. Addict Behav 2016; 63:155-60. [PMID: 27513593 DOI: 10.1016/j.addbeh.2016.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/21/2016] [Accepted: 07/30/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hispanics in the U.S. historically use tobacco at lower rates than other racial and ethnic groups. Cultural buffering, the process by which aspects of traditional Hispanic culture delay the adoption of unhealthy behaviors, is believed to be a protective factor against tobacco use. Electronic cigarettes (e-cigarettes) are a new tobacco product that have not been extensively studied, and it is unknown if cultural factors that protect against tobacco use will buffer against e-cigarette use among the Hispanic population. METHODS This cross-sectional study was conducted at the emergency department (ED) in a safety-net hospital in 2014. Patients visiting the ED participated in a survey assessing demographics and substance use. Cultural buffering was operationalized as participants' primary language spoken at home. Multivariate logistic regression and generalized estimating equations examined the association between Hispanic cultural buffering and e-cigarette ever-use. RESULTS Of the 1476 Hispanic ED patients (age: 46.6M±14.5SD, 49.3% male), 7.6% reported e-cigarette ever-use and 11.1% reported current combustible cigarette use. In adjusted models, Spanish speakers were half as likely to report e-cigarette ever-use (O.R.: 0.54, 95% C.I.: 0.34-0.84, p=0.007), compared with English speakers. Combustible cigarette use remained the most significant factor associated with e-cigarette ever-use (O.R.: 9.28, 95% C.I.:7.44-11.56, p<0.001). In higher-income neighborhoods, English speakers reported e-cigarette ever-use at higher rates than Spanish speakers (28.2% vs. 5.9%, p<0.001). CONCLUSIONS Cultural buffering was protective against e-cigarette ever-use, especially in higher-income neighborhoods. These results support research on culturally-sensitive prevention programs for new and emerging tobacco products in Hispanic communities.
Collapse
|
252
|
Allem JP, Unger JB. Emerging adulthood themes and hookah use among college students in Southern California. Addict Behav 2016; 61:16-9. [PMID: 27208879 DOI: 10.1016/j.addbeh.2016.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/22/2016] [Accepted: 05/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hookah (or waterpipe) use is increasing worldwide with implications for public health. Emerging adults (ages 18 to 25) have a higher risk for hookah use relative to younger and older groups. While research on the correlates of hookah use among emerging adults begins to accumulate, it may be useful to examine how transition-to-adulthood themes, or specific thoughts and feelings regarding emerging adulthood, are associated with hookah use. This study determined which transition-to-adulthood themes were associated with hookah use to understand the risk and protective factors for this tobacco-related behavior. METHODS Participants (n=555; 79% female; mean age 22) completed surveys on demographic characteristics, transition-to-adulthood themes, hookah, and cigarette use. RESULTS Past-month hookah use was more common than past-month cigarette use (16% versus 12%). In logistic regression analyses, participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report hookah use. However, transition-to-adulthood themes were not statistically significantly related to cigarette use. CONCLUSIONS The profile for hookah use may differ from that of cigarettes among emerging adults. Themes of experimentation/possibility should be addressed in prevention programs on college campuses and popular recreational spots where emerging adults congregate. These findings can inform future studies of risk and protective factors for hookah use among emerging adults.
Collapse
|
253
|
Chu KH, Allem JP, Cruz TB, Unger JB. Vaping on Instagram: cloud chasing, hand checks and product placement. Tob Control 2016; 26:575-578. [PMID: 27660111 DOI: 10.1136/tobaccocontrol-2016-053052] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/30/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION This study documented images posted on Instagram of electronic cigarettes (e-cigarette) and vaping (activity associated with e-cigarette use). Although e-cigarettes have been studied on Twitter, few studies have focused on Instagram, despite having 500 million users. Instagram's emphasis on images warranted investigation of e-cigarettes, as past tobacco industry strategies demonstrated that images could be used to mislead in advertisements, or normalise tobacco-related behaviours. Findings should prove informative to tobacco control policies in the future. METHODS 3 months of publicly available data were collected from Instagram, including images and associated metadata (n=2208). Themes of images were classified as (1) activity, for example, a person blowing vapour; (2) product, for example, a personal photo of an e-cigarette device; (3) advertisement; (4) text, for example, 'meme' or image containing mostly text and (5) other. User endorsement (likes) of each type of image was recorded. Caption text was analysed to explore different trends in vaping and e-cigarette-related text. RESULTS Analyses found that advertisement-themed images were most common (29%), followed by product (28%), and activity (18%). Likes were more likely to accompany activity and product-themed images compared with advertisement or text-themed images (p<0.01). Vaping-related text greatly outnumbered e-cigarette-related text in the image captions. CONCLUSIONS Instagram affords its users the ability to post images of e-cigarette-related behaviours and gives advertisers the opportunity to display their product. Future research should incorporate novel data streams to improve public health surveillance, survey development and educational campaigns.
Collapse
|
254
|
Samet JM, Pentz MA, Unger JB. Flavoured tobacco products and the public's health: lessons from the TPSAC menthol report. Tob Control 2016; 25:ii103-ii105. [PMID: 27633765 DOI: 10.1136/tobaccocontrol-2016-053208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 11/04/2022]
Abstract
The menthol report developed by the Tobacco Products Scientific Advisory Committee (TPSAC) of the Center for Tobacco Products elaborated a methodology for considering the public health impact of menthol in cigarettes that has relevance to flavourings generally. The TPSAC report was based on a conceptual framework on how menthol in cigarettes has public health impact results of evidence from related systematic reviews, and an evidence-based statistical model. In extending this approach to flavourings generally, consideration will need to be given to the existence of multiple flavourings, a very dynamic market place and regulatory interventions and industry activities. Now is the time to begin to develop the research strategies and models needed to extend the TPSAC approach to flavoured tobacco products generally.
Collapse
|
255
|
Schwartz SJ, Unger JB, Baezconde-Garbanati L, Zamboanga BL, Córdova D, Lorenzo-Blanco EI, Huang S, Des Rosiers SE, Soto DW, Lizzi KM, Villamar JA, Pattarroyo M, Szapocznik J. Testing the Parent-Adolescent Acculturation Discrepancy Hypothesis: A Five-Wave Longitudinal Study. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2016; 26:567-586. [PMID: 27616871 PMCID: PMC5014429 DOI: 10.1111/jora.12214] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This 2½-year, 5-wave longitudinal study tests the hypothesis that acculturation discrepancies between Hispanic immigrant parents and adolescents would lead to compromised family functioning, which would then lead to problematic adolescent outcomes. Recent-immigrant Hispanic parent-adolescent dyads (N = 302) completed measures of acculturation and family functioning. Adolescents completed measures of positive youth development, depressive symptoms, problem behavior, and substance use. Results indicated that Time 1 discrepancies in Hispanic-culture retention, and linear trajectories in some of these discrepancies, negatively predicted adolescent positive youth development, and positively predicted adolescent depressive symptoms and binge drinking, indirectly through adolescent-reported family functioning. The vast majority of effects were mediated rather than direct, supporting the acculturation discrepancy hypothesis. Implications for further research and intervention are discussed.
Collapse
|
256
|
Barrington-Trimis JL, Urman R, Leventhal AM, Gauderman WJ, Cruz TB, Gilreath TD, Howland S, Unger JB, Berhane K, Samet JM, McConnell R. E-cigarettes, Cigarettes, and the Prevalence of Adolescent Tobacco Use. Pediatrics 2016; 138:peds.2015-3983. [PMID: 27401102 PMCID: PMC4960723 DOI: 10.1542/peds.2015-3983] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Adolescent e-cigarette use has increased rapidly in recent years, but it is unclear whether e-cigarettes are merely substituting for cigarettes or whether e-cigarettes are being used by those who would not otherwise have smoked. To understand the role of e-cigarettes in overall tobacco product use, we examine prevalence rates from Southern California adolescents over 2 decades. METHODS The Children's Health Study is a longitudinal study of cohorts reaching 12th grade in 1995, 1998, 2001, 2004, and 2014. Cohorts were enrolled from entire classrooms in schools in selected communities and followed prospectively through completion of secondary school. Analyses used data from grades 11 and 12 of each cohort (N = 5490). RESULTS Among 12th-grade students, the combined adjusted prevalence of current cigarette or e-cigarette use in 2014 was 13.7%. This was substantially greater than the 9.0% adjusted prevalence of current cigarette use in 2004, before e-cigarettes were available (P = .003) and only slightly less than the 14.7% adjusted prevalence of smoking in 2001 (P = .54). Similar patterns were observed for prevalence rates in 11th grade, for rates of ever use, and among both male and female adolescents and both Hispanic and Non-Hispanic White adolescents. CONCLUSIONS Smoking prevalence among Southern California adolescents has declined over 2 decades, but the high prevalence of combined e-cigarette or cigarette use in 2014, compared with historical Southern California smoking prevalence, suggests that e-cigarettes are not merely substituting for cigarettes and indicates that e-cigarette use is occurring in adolescents who would not otherwise have used tobacco products.
Collapse
|
257
|
Allem JP, Sussman S, Unger JB. The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) and Substance Use Among College Students. Eval Health Prof 2016; 40:401-408. [PMID: 27468859 DOI: 10.1177/0163278716660742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transition-to-adulthood themes, or thoughts and feelings about emerging adulthood, have been measured by the Inventory of the Dimensions of Emerging Adulthood (IDEA) and found to be associated with substance use among emerging adults. It has been suggested, however, that the IDEA is lengthy and may not include the most unique and theoretically relevant constructs of emerging adulthood. The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) was developed as an alternative instrument, but research has yet to determine the relationship between the IDEA-R and substance use among emerging adults (ages 18-25 years). College students completed surveys indicating their identification with transition-to-adulthood themes and substance use. Logistic regression models examined the associations between transition-to-adulthood themes and marijuana use and binge drinking, respectively. Participants who felt emerging adulthood was a time of identity exploration were less likely to report marijuana use, while feelings of experimentation/possibility were positively associated with marijuana use and binge drinking. The IDEA-R may be useful for identifying correlates of substance use among emerging adults. Future research should evaluate the IDEA-R among representative samples of emerging adults to confirm the findings of this study. Health professionals working in substance use prevention may consider targeting the themes of identity exploration and experimentation/possibility in programs intended for emerging adults.
Collapse
|
258
|
Unger JB, Kipke MD, Simon TR, Johnson CJ, Montgomery SB, Iverson E. Stress, Coping, and Social Support among Homeless Youth. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743554898132003] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Evaluated in this study was the extent to which stress, coping strategies, and social support were associated with depressive symptoms, poor physical health, and substance use in homeless youth. Data were obtained from a stratified random sample of 432 homeless youth recruited.from service sites and street sites in Los Angeles, California. Stres,sful life events were associated positively with symptoms of depression, poor physical health, and substance use. Use of emotion-focused coping strategies increased the risk of symptoms of depression, poor health, and substance-use disorders, whereas use of problem-focused coping strategies decreased the risk of alcohol use disorder and poorhealth. Social support decreased the risk of symptoms of depression and poor health but was not related to the risk of substance use. Results indicate that effective coping skills and social support may counteract the negative efficts of stressful life events on physical and psychological health in homeless youth.
Collapse
|
259
|
Unger JB, Molina GB. The Ucla Multidimensional Condom Attitudes Scale: Validity in a Sample of Low-Acculturated Hispanic Women. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2016. [DOI: 10.1177/0739986399212006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Condom use can prevent unintended pregnancy, HIV infection, and other sexually transmitted diseases. Unfortunately, scales assessing attitudes toward condom use have not been validated in Hispanic samples. Low-acculturated Hispanic women (N = 291) completed the University of California, Los Angeles (UCLA) Multidimensional Condom Attitudes Scale (MCAS). The MCAS contains five subscales: Reliability and Effectiveness, Pleasure, Identity Stigma, Embarrassment About Negotiation and Use, and Embarrassment About Purchase. Confirmatory factor analysis was used to evaluate the factor loadings of the questionnaire items on the five factors. The model fit and factor structure were similar to results originally obtained with a college student sample. Higher education was associated with higher scores on Pleasure and lower scores on Identity Stigma, whereas financial strain was associated with higher scores on Embarrassment About Negotiation and Use and Embarrassment About Purchase. Results suggest that the MCAS can be used to assess condom attitudes among low-acculturated Hispanic women.
Collapse
|
260
|
Abstract
This study examined posttraumatic growth (PTG), the construing of benefits from a traumatic event, in a sample of 435 mostly Hispanic adolescentswho experienced a major life event within the previous 3 years. Levels of PTG did not differ between experienced negative life events. The relationship between PTG and sociodemographics, substance use, religiosity, and depression was explored. Age and religiosity were positively associated with PTG, whereas substance use was inversely associated with PTG. Only age and substance use remained associated with PTG after adjusting for all other variables in a multiple regression analysis. These results demonstrate the existence of PTG among an adolescent population and suggest that PTG can be related to important health behaviors such as substance use.
Collapse
|
261
|
Zheng Y, Rijsdijk F, Pingault JB, McMahon RJ, Unger JB. Developmental changes in genetic and environmental influences on Chinese child and adolescent anxiety and depression. Psychol Med 2016; 46:1829-1838. [PMID: 27019009 DOI: 10.1017/s0033291716000313] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Twin and family studies using Western samples have established that child and adolescent anxiety and depression are under substantial genetic, modest shared environmental, and substantial non-shared environmental influences. Generalizability of these findings to non-Western societies remains largely unknown, particularly regarding the changes of genetic and environmental influences with age. The current study examined changes in genetic and environmental influences on self-reported anxiety and depression from late childhood to mid-adolescence among a Chinese twin sample. Sex differences were also examined. METHOD Self-reported anxiety and depression were collected from 712 10- to 12-year-old Chinese twins (mean = 10.88 years, 49% males) and again 3 years later. Quantitative genetic modeling was used to examine developmental changes in genetic and environmental influences on anxiety and depression, and sex differences. RESULTS Heritability of anxiety and depression in late childhood (23 and 20%) decreased to negligible in mid-adolescence, while shared environmental influences increased (20 and 27% to 57 and 60%). Shared environmental factors explained most of the continuity of anxiety and depression (75 and 77%). Non-shared environmental factors were largely time-specific. No sex differences were observed. CONCLUSIONS Shared environmental influences might be more pronounced during the transition period of adolescence in non-Western societies such as China. Future research should examine similarities and differences in the genetic and environmental etiologies of child and adolescent internalizing and other psychopathology in development between Western and non-Western societies.
Collapse
|
262
|
Barrington-Trimis JL, Berhane K, Unger JB, Cruz TB, Urman R, Chou CP, Howland S, Wang K, Pentz MA, Gilreath TD, Huh J, Leventhal AM, Samet JM, McConnell R. The E-cigarette Social Environment, E-cigarette Use, and Susceptibility to Cigarette Smoking. J Adolesc Health 2016; 59:75-80. [PMID: 27161417 PMCID: PMC4920702 DOI: 10.1016/j.jadohealth.2016.03.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE One concern regarding the recent increase in adolescent e-cigarette use is the possibility that electronic (e-) cigarettes may be used by those who might not otherwise have used cigarettes, and that dual use, or transition to cigarette use alone, may follow. METHODS Questionnaire data were obtained in 2014 from 11th/12th grade students attending schools in 12 communities included in the Southern California Children's Health Study. We evaluated the cross-sectional association between e-cigarette use, the social environment (family and friends' use and approval of e-cigarettes and cigarettes), and susceptibility to future cigarette use among never cigarette smokers (N = 1,694), using previously validated measures based on reported absence of a definitive commitment not to smoke. RESULTS Among adolescents who had never used cigarettes, 31.8% of past e-cigarette users and 34.6% of current (past 30-day) e-cigarette users indicated susceptibility to cigarette use, compared with 21.0% of never e-cigarette users. The odds of indicating susceptibility to cigarette use were two times higher for current e-cigarette users compared with never users (odds ratio = 1.97; 95% confidence interval: 1.21-3.22). A social environment favorable to e-cigarettes (friends' use of and positive attitudes toward the use of e-cigarettes) was also associated with greater likelihood of susceptibility to cigarette use, independent of an individual's e-cigarette use. CONCLUSIONS E-cigarette use in adolescence, and a pro-e-cigarette social environment, may put adolescents at risk for future use of cigarettes. E-cigarettes may contribute to subsequent cigarette use via nicotine addiction or social normalization of smoking behaviors.
Collapse
|
263
|
Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, Samet JM, Leventhal AM, McConnell R. E-Cigarettes and Future Cigarette Use. Pediatrics 2016; 138:peds.2016-0379. [PMID: 27296866 PMCID: PMC4925085 DOI: 10.1542/peds.2016-0379] [Citation(s) in RCA: 316] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal. METHODS The Children's Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade. RESULTS Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30-11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37-10.4), including hookah, cigars, or pipes. CONCLUSIONS E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use.
Collapse
|
264
|
Pokhrel P, Fagan P, Herzog TA, Chen Q, Muranaka N, Kehl L, Unger JB. E-cigarette advertising exposure and implicit attitudes among young adult non-smokers. Drug Alcohol Depend 2016; 163:134-40. [PMID: 27125661 PMCID: PMC5155506 DOI: 10.1016/j.drugalcdep.2016.04.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study tested whether exposure to e-cigarette advertising affects the subliminal-spontaneous or automatic-attitudes towards e-cigarettes as a more pleasant or safer alternative to cigarettes among non-smoking young adults. METHODS 187 young adult (mean age=21.9; SD=4.1) current non-smokers who had never used an e-cigarette were randomly assigned to one of the 3 conditions that involved viewing magazine advertisements. Two of the 3 conditions were experimental conditions where thematically different [harm-reduction ("Health") vs. social enhancement ("Social") focused] e-cigarette ads were interspersed among ads of everyday objects. The third condition was the control condition in which participants viewed ads of everyday objects only. Participants provided data on explicit (e.g., harm perceptions) and implicit [e.g., Implicit Association Test (IAT), Affect Misattribution Procedure (AMP)] measures after viewing the ads. RESULTS Relative to the Control condition, participants in the Social condition showed 2.8 times higher odds of being open to using an e-cigarette in the future. Participants in the Health condition showed significantly higher implicit attitudes towards e-cigarettes as a safer alternative to cigarettes than participants in the Control condition. E-cigarette stimuli elicited more positive spontaneous affective reactions among participants in the Social condition than participants in the Health condition. CONCLUSIONS E-cigarette ads may implicitly promote e-cigarettes as a reduced-harm cigarette alternative. Marketing of e-cigarette use as a way to enhance social life or self-image may encourage non-smoking young adults to try e-cigarettes. Findings may inform regulations on e-cigarette marketing.
Collapse
|
265
|
Unger JB, Soto DW, Leventhal A. E-cigarette use and subsequent cigarette and marijuana use among Hispanic young adults. Drug Alcohol Depend 2016; 163:261-4. [PMID: 27141841 PMCID: PMC7453602 DOI: 10.1016/j.drugalcdep.2016.04.027] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/04/2016] [Accepted: 04/19/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Electronic cigarettes (e-cigarettes) could have a multifaceted effect on public health by changing the likelihood that: (a) non-smokers and non-users of marijuana subsequently transition to cigarette and marijuana use, respectively, and/or: (b) cigarette smokers subsequently quit smoking. We analyzed data from a longitudinal study of Hispanic young adults in Los Angeles, California to determine whether e-cigarette use is associated with subsequent cigarette or marijuana use over a one-year period. METHODS Survey data were collected from 1332 Hispanic young adults (59% female, mean age=22.7 years, SD=0.39 years) in 2014 and 2015. Logistic regression analyses examined the association between e-cigarette use in 2014 and cigarette/marijuana use in 2015, controlling for age, sex, and other substance use. RESULTS In 2014, prevalence of past-month use was 9% for e-cigarettes, 21% for cigarettes, and 23% for marijuana. Among past-month cigarette nonsmokers in 2014, those who were past-month e-cigarette users in 2014 were over 3 times more likely to be past-month cigarette smokers in 2015, compared with those who did not report past-month e-cigarette use in 2014 (26% vs. 7%; OR=3.32, 95% CI=1.55, 7.10). Among past-month marijuana non-users in 2014, those who were past-month e-cigarette users in 2014 were nearly 2 times more likely to be past-month marijuana users in 2015 (24% vs. 12%;OR=1.97, 95% CI=1.01, 3.86). Among past-month cigarette and marijuana users in 2014, e-cigarette use in 2014 was not associated with a change cigarette and marijuana use, respectively, in 2015. CONCLUSIONS Among Hispanic young adults, e-cigarettes could increase the likelihood of transitioning from non-user to user of cigarettes or marijuana and was not associated with smoking cessation.
Collapse
|
266
|
Sussman S, Allem JP, Garcia J, Unger JB, Cruz TB, Garcia R, Baezconde-Garbanati L. Who walks into vape shops in Southern California?: a naturalistic observation of customers. Tob Induc Dis 2016; 14:18. [PMID: 27231480 PMCID: PMC4880826 DOI: 10.1186/s12971-016-0082-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 05/18/2016] [Indexed: 11/26/2022] Open
Abstract
Background The rising popularity of electronic cigarettes (e-cigarettes) has been accompanied by the proliferation of vape shops in the United States. Vape shops are devoted to the sale of e-cigarettes and e-juices. This study aimed to describe the age, gender, and ethnicity of customers who frequent these shops, determine whether conversations transpire between retailers and customers, as well as identify the types of activities taking place while customers are inside the store. Methods A naturalistic observation study of 186 customers in 59 vape shops in Southern California was completed in locations that were relatively high in Korean, Non-Hispanic white, Hispanic, or African American ethnicity. Results Across all shops, the average estimated age of customers was 30.29 years old (SD = 9.70), 53 % were estimated to be non-Hispanic white, and 79 % were males; few minors entered the shops. Conversations about vaping related topics were prevalent (e.g., sampling e-juices, receiving help on hardware, and talking about vaping). Purchases were commonly observed as well as customers lounging in the shop. Conclusion Vape shops provide consumers a place to purchase and discuss e-cigarettes and offer an environment that serves as a place of recreation with customers lounging once inside. Findings should inform local tobacco control efforts and regulatory policies in the future.
Collapse
|
267
|
Córdova D, Schwartz SJ, Unger JB, Baezconde-Garbanati L, Villamar JA, Soto DW, Des Rosiers SE, Lee TK, Meca A, Cano MÁ, Lorenzo-Blanco EI, Oshri A, Salas-Wright CP, Piña-Watson B, Romero AJ. A Longitudinal Test of the Parent-Adolescent Family Functioning Discrepancy Hypothesis: A Trend toward Increased HIV Risk Behaviors Among Immigrant Hispanic Adolescents. J Youth Adolesc 2016; 45:2164-77. [PMID: 27216199 DOI: 10.1007/s10964-016-0500-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Abstract
Parent-adolescent discrepancies in family functioning play an important role in HIV risk behaviors among adolescents, yet longitudinal research with recent immigrant Hispanic families remains limited. This study tested the effects of trajectories of parent-adolescent family functioning discrepancies on HIV risk behaviors among recent-immigrant Hispanic adolescents. Additionally, we examined whether and to what extent trajectories of parent-adolescent family functioning discrepancies vary as a function of gender. We assessed family functioning of 302 Hispanic adolescents (47 % female) and their parent (70 % female) at six time points over a three-year period and computed latent discrepancy scores between parent and adolescent reports at each timepoint. Additionally, adolescents completed measures of sexual risk behaviors and alcohol use. We conducted a confirmatory factor analysis to determine the feasibility of collapsing parent and adolescent reported family functioning indicators onto a single latent discrepancy variable, tested model invariance over time, and conducted growth mixture modeling (GMM). GMM yielded a three-class solution for discrepancies: High-Increasing, High-Stable, and Low-Stable. Relative to the Low-Stable class, parent-adolescent dyads in the High-Increasing and High-Stable classes were at greater risk for adolescents reporting sexual debut at time 6. Additionally, the High-Stable class was at greater risk, relative to the Low-Stable class, in terms of adolescent lifetime alcohol use at 30 months post-baseline. Multiple group GMM indicated that trajectories of parent-adolescent family functioning trajectories did not vary by gender. Implications for future research and practice are discussed.
Collapse
|
268
|
Unger JB, Barker D, Baezconde-Garbanati L, Soto DW, Sussman S. Support for electronic cigarette regulations among California voters. Tob Control 2016; 26:334-337. [PMID: 27207853 DOI: 10.1136/tobaccocontrol-2016-052918] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/28/2016] [Indexed: 11/04/2022]
Abstract
Policies regulating the sale and use of electronic cigarettes (e-cigarettes) vary widely within the USA and worldwide. We assessed support for four proposed policies among a representative sample of California voters (N=1002) and identified latent classes of voters who were likely to support or oppose various policies. Findings showed support for prohibiting e-cigarette use where smoking is banned (70%), taxing e-cigarettes (74%), licensing e-cigarette retailers (74%), and restricting flavourings (57%). Correlates of policy support included smoking status, political orientation, age group and California region. The latent class analysis revealed three classes of voters: Policy Supporters (predominantly college-educated, higher-income, liberal non-smokers), Policy Opposers (predominantly low-educated, low-income, conservative smokers), and Swing Voters (intermediate levels of education, income, and smoking, conservative). Findings provide information to inform segmented state-based communication campaigns regarding regulation of e-cigarettes. If policymakers want to enact prohibitive state-level policies, Opposers and Swing Voters may be important constituents to target.
Collapse
|
269
|
Sussman S, Chou CP, Pang RD, Kirkpatrick M, Guillot CR, Stone M, Khoddam R, Riggs NR, Unger JB, Leventhal AM. Social Self-Control Is a Statistically Nonredundant Correlate of Adolescent Substance Use. Subst Use Misuse 2016; 51:788-94. [PMID: 27070833 PMCID: PMC4848138 DOI: 10.3109/10826084.2016.1141959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The social self-control scale (SSCS), which taps provocative behavior in social situations, was compared with five potentially overlapping measures (i.e., temperament-related impulsivity, psychomotor agitation-related self-control, perceived social competence, and rash action in response to negative and positive affectively charged states) as correlates of tobacco use and other drug use among a sample of 3,356 ninth-grade youth in Southern California high schools. While there was a lot of shared variance among the measures, the SSCS was incrementally associated with both categories of drug use over and above alternate constructs previously implicated in adolescent drug use. Hence, SSC may relate to adolescent drug use through an etiological pathway unique from other risk constructs. Given that youth who tend to alienate others through provocative social behavior are at risk for multiple drug use, prevention programming to modify low SSC may be warranted.
Collapse
|
270
|
Cano MÁ, Schwartz SJ, Castillo LG, Unger JB, Huang S, Zamboanga BL, Romero AJ, Lorenzo-Blanco EI, Córdova D, Des Rosiers SE, Lizzi KM, Baezconde-Garbanati L, Soto DW, Villamar JA, Pattarroyo M, Szapocznik J. Health risk behaviors and depressive symptoms among Hispanic adolescents: Examining acculturation discrepancies and family functioning. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2016; 30:254-265. [PMID: 26301514 PMCID: PMC4766064 DOI: 10.1037/fam0000142] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement 6 months postbaseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms 1 year postbaseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning; (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS; (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS.
Collapse
|
271
|
Leventhal AM, Strong DR, Sussman S, Kirkpatrick MG, Unger JB, Barrington-Trimis JL, Audrain-McGovern J. Psychiatric comorbidity in adolescent electronic and conventional cigarette use. J Psychiatr Res 2016; 73:71-8. [PMID: 26688438 PMCID: PMC4738156 DOI: 10.1016/j.jpsychires.2015.11.008] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 11/09/2015] [Accepted: 11/16/2015] [Indexed: 12/20/2022]
Abstract
The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use.
Collapse
|
272
|
Gilreath TD, Leventhal A, Barrington-Trimis JL, Unger JB, Cruz TB, Berhane K, Huh J, Urman R, Wang K, Howland S, Pentz MA, Chou CP, McConnell R. Patterns of Alternative Tobacco Product Use: Emergence of Hookah and E-cigarettes as Preferred Products Amongst Youth. J Adolesc Health 2016; 58:181-5. [PMID: 26598059 PMCID: PMC4963235 DOI: 10.1016/j.jadohealth.2015.10.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 10/01/2015] [Accepted: 10/02/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE There is a growing public health concern related to the rapid increase in the use of multiple tobacco products among adolescents. This study examined patterns of adolescent use of cigarettes, e-cigarettes, cigars/cigarillo, hookah/waterpipe, and smokeless/dip/chewing tobacco in a population of southern California adolescents. METHODS Data from 2,097 11th- and 12th-grade participants in the Southern California Children's Health Study were collected via self-report in 2014. Study participants were asked about lifetime and current (past 30 days) use of cigarettes, cigars/cigarillos/little cigars, e-cigarettes, hookah/waterpipe, and smokeless/dip/chewing tobacco. Latent class analysis (LCA) was used to identify patterns of tobacco use. RESULTS Hookah/waterpipe tobacco use had the highest current prevalence (10.7%) followed by e-cigarettes (9.6%). The prevalence of use of smokeless/dip/chewing tobacco was lowest, with 2.2% of adolescents reporting current use. The LCA suggested four distinct classes, comprising nonusers (72.3% of the sample), polytobacco experimenters (13.9%), e-cigarette/hookah users (8.2%), and polytobacco users (5.6%). Multinomial logistic regression based on these four classes found that males had double the odds to be polytobacco users relative to nonusers compared to females (odds ratio, 2.3; 95% confidence interval, 1.26-4.25). CONCLUSIONS By identifying naturally occurring configurations of tobacco product use in teens, these findings may be useful to practitioners and policymakers to identify the need for tobacco control interventions that address specific tobacco products and particular combinations of polytobacco use. LCA can be used to identify segments of the population overrepresented among certain tobacco use classes (e.g., boys) that may benefit most from targeted polyproduct intervention approaches.
Collapse
|
273
|
Grigsby TJ, Forster M, Soto DW, Unger JB. Changes in the strength of peer influence and cultural factors on substance use initiation between late adolescence and emerging adulthood in a Hispanic sample. J Ethn Subst Abuse 2016; 16:137-154. [PMID: 26822557 DOI: 10.1080/15332640.2015.1108255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We examine whether peer substance use and cultural factors differentially influence the initiation of tobacco, alcohol, and marijuana use in adolescence and emerging adulthood (EA) among a community-based sample of Hispanics. Participants provided data in 11th grade (M = 16.8 years old, SD = 0.54) and emerging adulthood (M = 20.3 years old, SD = 0.6). Peer tobacco use had a stronger association with initiation of tobacco use in emerging adulthood (OR = 1.46, 95% CI = 1.13, 1.89) than in adolescence (OR = 1.20, 95% CI = 1.03, 1.40), but this pattern was not observed with initiation of alcohol or marijuana use. Cultural orientation is associated with initiation of tobacco use during EA but not with initiation of alcohol or marijuana use.
Collapse
|
274
|
Arpawong TE, Rohrbach LA, Milam JE, Unger JB, Land H, Sun P, Spruijt-Metz D, Sussman S. Stressful Life Events and Predictors of Post-traumatic Growth among High-Risk Early Emerging Adults. THE JOURNAL OF POSITIVE PSYCHOLOGY 2016; 11:1-14. [PMID: 26640507 PMCID: PMC4666321 DOI: 10.1080/17439760.2014.994223] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
Abstract
Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools (n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.
Collapse
|
275
|
Lorenzo-Blanco EI, Unger JB, Oshri A, Baezconde-Garbanati L, Soto D. Profiles of bullying victimization, discrimination, social support, and school safety: Links with Latino/a youth acculturation, gender, depressive symptoms, and cigarette use. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2016; 86:37-48. [PMID: 26752445 PMCID: PMC5041296 DOI: 10.1037/ort0000113] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Latino/a youth are at risk for symptoms of depression and cigarette smoking but this risk varies by acculturation and gender. To understand why some youth are at greater risk than others, we identified profiles of diverse community experiences (perceived discrimination, bullying victimization, social support, perceived school safety) and examined associations between profiles of community experience and depressive symptoms, cigarette smoking, acculturation, and gender. Data came from Project Red (Reteniendo y Entendiendo Diversidad para Salud), a school-based longitudinal study of acculturation among 1,919 Latino/a adolescents (52% female; 84% 14 years old; 87% U.S. born). Latent profile analysis (LPA) revealed 4 distinct profiles of community experience that varied by gender and acculturation. Boys were overrepresented in profile groups with high perceived discrimination, some bullying, and lack of positive experiences, while girls were overrepresented in groups with high bullying victimization in the absence and presence of other community experiences. Youth low on both U.S. and Latino/a cultural orientation described high perceived discrimination and lacked positive experiences, and were predominantly male. Profiles characterized by high perceived discrimination and /or high bullying victimization in the absence of positive experiences had higher levels of depressive symptoms and higher risk of smoking, relative to the other groups. Findings suggest that acculturation comes with diverse community experiences that vary by gender and relate to smoking and depression risk. Results from this research can inform the development of tailored intervention and prevention strategies to reduce depression and/or smoking for Latino/a youth.
Collapse
|
276
|
Chu KH, Unger JB, Allem JP, Pattarroyo M, Soto D, Cruz TB, Yang H, Jiang L, Yang CC. Diffusion of Messages from an Electronic Cigarette Brand to Potential Users through Twitter. PLoS One 2015; 10:e0145387. [PMID: 26684746 PMCID: PMC4694088 DOI: 10.1371/journal.pone.0145387] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/03/2015] [Indexed: 11/19/2022] Open
Abstract
Objective This study explores the presence and actions of an electronic cigarette (e-cigarette) brand, Blu, on Twitter to observe how marketing messages are sent and diffused through the retweet (i.e., message forwarding) functionality. Retweet networks enable messages to reach additional Twitter users beyond the sender’s local network. We follow messages from their origin through multiple retweets to identify which messages have more reach, and the different users who are exposed. Methods We collected three months of publicly available data from Twitter. A combination of techniques in social network analysis and content analysis were applied to determine the various networks of users who are exposed to e-cigarette messages and how the retweet network can affect which messages spread. Results The Blu retweet network expanded during the study period. Analysis of user profiles combined with network cluster analysis showed that messages of certain topics were only circulated within a community of e-cigarette supporters, while other topics spread further, reaching more general Twitter users who may not support or use e-cigarettes. Conclusions Retweet networks can serve as proxy filters for marketing messages, as Twitter users decide which messages they will continue to diffuse among their followers. As certain e-cigarette messages extend beyond their point of origin, the audience being exposed expands beyond the e-cigarette community. Potential implications for health education campaigns include utilizing Twitter and targeting important gatekeepers or hubs that would maximize message diffusion.
Collapse
|
277
|
Unger JB. E-Cigarettes: Introducing New Complexities and Controversies to the Field of Nicotine and Tobacco Research. Nicotine Tob Res 2015; 17:1185-6. [PMID: 26400902 DOI: 10.1093/ntr/ntv186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
278
|
Miller KA, Huh J, Unger JB, Richardson JL, Allen MW, Peng DH, Cockburn MG. Patterns of sun protective behaviors among Hispanic children in a skin cancer prevention intervention. Prev Med 2015; 81:303-8. [PMID: 26436682 PMCID: PMC4679689 DOI: 10.1016/j.ypmed.2015.09.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/26/2015] [Accepted: 09/27/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Invasive melanoma is becoming more common in U.S. Hispanics, yet little is known about the sun protection behaviors in this population, particularly children and adolescents who incur high ultraviolet (UV) exposures. METHODS We used latent class analysis to examine patterns of sun protective behaviors in a cross-sectional survey of Hispanic elementary students participating in a sun safety intervention in Los Angeles from 2013- to 2014 (N=972). Five behavior indicators in two environments (school and home) representing multiple methods of sun protection were selected for the model. RESULTS Results suggested a four-class model best fit the data. Classes were labeled in order of increasing risk as multiple protective behaviors (28%), clothing and shade (32%), pants only (15%), and low/inconsistent protective behaviors (25%). Children who reported high parental engagement with sun protection were significantly more likely to be classified in high overall protective categories (odds ratio (OR)=4.77). Girls were more likely than boys to be classified in the highest protecting class (OR=3.46), but were also more likely to be in the "pants only" class (OR=2.65). Sensitivity to sunburn was associated with less likelihood of being in the "clothing and shade" class (OR=0.53). CONCLUSION The differences among these classes and their predictors reveal the heterogeneity and complexity of Hispanic children's sun protective behaviors. These findings have implications for the design and delivery of future sun protection interventions targeting Hispanic children, as strategies tailored to specific subgroups may be more effective in achieving meaningful behavioral changes.
Collapse
|
279
|
Schwartz SJ, Unger JB, Baezconde-Garbanati L, Benet-Martínez V, Meca A, Zamboanga BL, Lorenzo-Blanco EI, Des Rosiers SE, Oshri A, Sabet RF, Soto DW, Pattarroyo M, Huang S, Villamar JA, Lizzi KM, Szapocznik J. Longitudinal trajectories of bicultural identity integration in recently immigrated Hispanic adolescents: Links with mental health and family functioning. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2015; 50:440-50. [PMID: 26212218 PMCID: PMC10906138 DOI: 10.1002/ijop.12196] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 06/02/2015] [Accepted: 06/03/2015] [Indexed: 11/10/2022]
Abstract
This study examined, in a sample of recently immigrated Hispanic adolescents in Miami and Los Angeles, the extent to which bicultural identity integration (BII; involving the ability to synthesise one's heritage and receiving cultural streams and to identify as a member of both cultures) is best understood as a developmental construct that changes over time or as an individual-difference construct that is largely stable over time. We were also interested in the extent to which these trajectories predicted mental health and family functioning. Recent-immigrant 9th graders (N = 302) were assessed 6 times from 9th to 12th grade. Latent class growth analyses using the first 5 timepoints identified 2 trajectory classes-one with lower BII scores over time and another with higher BII scores over time. Higher heritage and US identity at baseline predicted membership in the higher BII class. At the 6th study timepoint, lower BII adolescents reported significantly poorer self-esteem, optimism, prosocial behaviour and family relationships compared with their higher BII counterparts. These findings are discussed in terms of further research on the over-time trajectory of biculturalism, and on the need to develop interventions to promote BII as a way of facilitating well-being and positive family functioning.
Collapse
|
280
|
Davis AN, Carlo G, Schwartz SJ, Unger JB, Zamboanga BL, Lorenzo-Blanco EI, Cano MÁ, Baezconde-Garbanati L, Oshri A, Streit C, Martinez MM, Piña-Watson B, Lizzi K, Soto D. The Longitudinal Associations Between Discrimination, Depressive Symptoms, and Prosocial Behaviors in U.S. Latino/a Recent Immigrant Adolescents. J Youth Adolesc 2015; 45:457-70. [PMID: 26597783 DOI: 10.1007/s10964-015-0394-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/13/2015] [Indexed: 10/22/2022]
Abstract
The links between discrimination and adjustment in U.S. Latino/a immigrant adolescents is an important but understudied phenomenon. We aimed to investigate the longitudinal associations (across 1 year) among discrimination, prosocial behaviors, and depressive symptoms in U.S. Latino immigrant adolescents using two competing models: associations between discrimination and prosocial behaviors via depressive symptoms (mental health strain model), and associations between discrimination and depressive symptoms via prosocial behaviors (prosociality strain model). Participants were 302 Latino/a recent immigrant adolescents (53.3 % boys, M age = 14.51 years at Time 1, SD = .88 years) who completed measures of discrimination, depressive symptoms, and prosocial behaviors at 6-month intervals. The results provided support for both proposed models. The discussion examines the importance of prosocial behaviors in understanding adjustment and effects of discrimination among recently immigrated U.S. Latino adolescents.
Collapse
|
281
|
Allem JP, Unger JB, Garcia R, Baezconde-Garbanati L, Sussman S. Tobacco Attitudes and Behaviors of Vape Shop Retailers in Los Angeles. Am J Health Behav 2015; 39:794-8. [PMID: 26450547 DOI: 10.5993/ajhb.39.6.7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The growing popularity of e-cigarettes has been accompanied by the proliferation of vape shops in the US. Vape shops are devoted to the sale and use of e-cigarettes, allowing customers to sample flavors and learn about different hardware from retailers. Research on vape shop retailers is lagging behind their popularity. This study documented the attitudes and behaviors regarding e-cigarettes and other tobacco products of retailers located in Los Angeles. METHODS Surveys were conducted among retailers at 78 vape shops in 2014. RESULTS The majority of retailers (76%) believed e-cigarettes are safer than combustible cigarettes, with about one-fourth believing e-cigarettes are completely safe. Retailers believed e-cigarettes are, on average, safer than products (eg, nicotine patch, gum, and inhaler) that have been approved for cessation by the FDA. About 14% of retailers reported dual use of cigarettes and e-cigarettes in the past month. CONCLUSION This is the first study to investigate tobacco-related behaviors and attitudes of vape shop retailers located in Los Angeles. Educating vape shop retailers on the benefits and harms of e-cigarettes is important, especially if retailers are to be informed about a product that is only now being considered to receive regulation from the FDA.
Collapse
|
282
|
Soto C, Baezconde-Garbanati L, Schwartz SJ, Unger JB. Stressful life events, ethnic identity, historical trauma, and participation in cultural activities: Associations with smoking behaviors among American Indian adolescents in California. Addict Behav 2015; 50:64-9. [PMID: 26103424 PMCID: PMC4515401 DOI: 10.1016/j.addbeh.2015.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 05/15/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION American Indian (AI) adolescents have the highest prevalence of commercial tobacco use of any ethnic group in the United States. This study examines ethnic identity (EI), participation in cultural activities, and stressful life events (SLEs) as correlates of smoking and examines historical trauma (HT) as a mediator of these associations. METHODS California AI youth (N = 969, ages 13-19, recruited from 49 tribal youth organizations and cultural activities in urban and reservation areas in California) completed a tobacco survey. Structural equation modeling was used to test a model examining HT as a potential mediator of the associations of EI, participation in cultural activities, and SLEs with cigarette smoking. RESULTS Model fit was adequate. EI, participation in cultural activities, and SLEs predicted HT. HT mediated the associations of participation in cultural activities and SLEs with past-month smoking. Stronger EI predicted greater past-month smoking and this effect was mediated by greater HT. The direct effects from HT to both smoking outcomes were positive and the direct effect from EI to past-month smoking was negative. CONCLUSIONS HT is a risk factor for cigarette smoking both directly and in mediating the links of EI, cultural activities, and SLEs. More efforts are needed to help AI youth to process these thoughts and empower themselves to contribute to their own lives and those of their families and communities without resorting to unhealthy addictive behaviors such as commercial tobacco use.
Collapse
|
283
|
Allem JP, Forster M, Neiberger A, Unger JB. Characteristics of emerging adulthood and e-cigarette use: Findings from a pilot study. Addict Behav 2015; 50:40-4. [PMID: 26093505 DOI: 10.1016/j.addbeh.2015.06.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/02/2015] [Accepted: 06/05/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Emerging adults (ages 18 to 25) are more likely to use e-cigarettes compared to other age groups, but little is known about their risk and protective factors. A next step to understanding e-cigarette use among emerging adults may involve examining how transition-to-adulthood themes are associated with e-cigarette use. It may also be important to know which specific transitions, and how the accumulated number of role transitions experienced in emerging adulthood, are associated with e-cigarette use. METHODS Emerging adults completed surveys indicating their identification with transition-to-adulthood themes, role transitions in the past year, and e-cigarette use. Logistic regression models examined the associations between transition-to-adulthood themes and e-cigarette use. Separate logistic regression models explored the association between individual role transitions, as well as the accumulated number of role transitions experienced, and e-cigarette use, controlling for age, gender, and ethnicity. RESULTS Among the participants (n = 555), 21% were male, the average age was 22, 45% reported lifetime, and 12% reported past-month, e-cigarette use. Participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report e-cigarette use. Several role transitions were found to be associated with e-cigarette use such as loss of a job, dating someone new, and experiencing a breakup. The relationship between the accumulated number of role transitions and e-cigarette use was curvilinear. CONCLUSION Findings from this pilot study can be a point of departure for future studies looking to understand the risk and protective factors of e-cigarettes among emerging adults.
Collapse
|
284
|
Allem JP, Soto DW, Baezconde-Garbanati L, Unger JB. Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California. Addict Behav 2015; 50:199-204. [PMID: 26160522 PMCID: PMC4515389 DOI: 10.1016/j.addbeh.2015.06.038] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/03/2015] [Accepted: 06/16/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Emerging adults who experienced stressful childhoods may engage in substance use as a maladaptive coping strategy. Given the collectivistic values Hispanics encounter growing up, adverse childhood experiences may play a prominent role in substance use decisions as these events violate the assumptions of group oriented cultural paradigms. Alternatively, adverse childhood events might not increase the risk of substance use because strong family ties could mitigate the potential maladaptive behaviors associated with these adverse experiences. This study examined whether adverse childhood experiences were associated with substance use among Hispanic emerging adults. METHOD Participants (n = 1420, mean age = 22, 41% male) completed surveys indicating whether they experienced any of 8 specific adverse experiences within their first 18 years of life, and past-month cigarette use, marijuana use, hard drug use, and binge drinking. Logistic regression models examined the associations between adverse childhood experiences and each category of substance use, controlling for age, gender, and depressive symptoms. RESULTS The number of adverse childhood experiences was significantly associated with each category of substance use. A difference in the number of adverse childhood experiences, from 0 to 8, was associated with a 22% higher probability of cigarette smoking, a 24% higher probability of binge drinking, a 31% higher probability of marijuana use, and a 12% higher probability of hard drug use respectively. CONCLUSIONS These findings should be integrated into prevention/intervention programs in hopes of quelling the duration and severity of substance use behaviors among Hispanic emerging adults.
Collapse
|
285
|
Ameringer KJ, Chou CP, Sussman S, Unger JB, Leventhal AM. Identifying Shared Latent Dimensions of Psychological Symptoms: Implications for the Psychological Correlates of Smoking. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 37:454-468. [PMID: 26478654 PMCID: PMC4606875 DOI: 10.1007/s10862-014-9467-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Shared latent dimensions may account for the co-occurrence of multiple forms of psychological dysfunction. However, this conceptualization has rarely been integrated into the smoking literature, despite high levels of psychological symptoms in smokers. In this study, we used confirmatory factor analysis to compare three models (1-factor, 2-factor [internalizing-externalizing], and 3-factor [low positive affect-negative affect-disinhibition]) of relations among nine measures of affective and behavioral symptoms implicated in smoking spanning depression, anxiety, happiness, anhedonia, ADHD, aggression, and alcohol use disorder symptoms. We then examined associations of scores from each of the manifest scales and the latent factors from the best-fitting model to several smoking characteristics (i.e., experimentation, lifetime established smoking [≥100 cigarettes lifetime], age of smoking onset, cigarettes/day, nicotine dependence, and past nicotine withdrawal). We used two samples: (1) College Students (N =288; mean age =20; 75 % female) and (2) Adult Daily Smokers (N=338; mean age=44; 32 % female). In both samples, the 3-factor model separating latent dimensions of deficient positive affect, negative affect, and disinhibition fit best. In the college students, the disinhibition factor and its respective indicators significantly associated with lifetime smoking. In the daily smokers, low positive and high negative affect factors and their respective indicators positively associated with cigarettes/day and nicotine withdrawal symptom severity. These findings suggest that shared features of psychological symptoms may be parsimonious explanations of how multiple manifestations of psychological dysfunction play a role in smoking. Implications for research and treatment of co-occurring psychological symptoms and smoking are discussed.
Collapse
|
286
|
Lorenzo-Blanco EI, Unger JB. Ethnic Discrimination, Acculturative Stress, and Family Conflict as Predictors of Depressive Symptoms and Cigarette Smoking Among Latina/o Youth: The Mediating Role of Perceived Stress. J Youth Adolesc 2015; 44:1984-97. [PMID: 26294041 DOI: 10.1007/s10964-015-0339-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
Abstract
Latino youth can experience a range of cultural (i.e., ethnic discrimination and acculturative stress) and familial (i.e. family conflict) risk factors that can contribute to their perceived stress, thereby increasing their risk for depressive symptoms and cigarette smoking. To understand the mechanisms by which ethnic discrimination, acculturative stress and family conflict influence the risk for depressive symptoms and cigarette smoking of youth, the current study investigated the mediating role of perceived stress in these associations. The data came from a longitudinal study of acculturation and substance use with 1919 Latino adolescents (52% female; 84% 14 year-olds; 87% U.S. born). Structural equation modeling indicated that discrimination and family conflict (Time 1) related with higher perceived stress (Time 2), which, in turn, related with more depressive symptoms and smoking (Time 3). The results suggest that perceived stress might be one mechanism by which ethnic discrimination and family conflict contribute to Latino youth symptoms of depression and cigarette smoking. The findings highlight the need for prevention and intervention strategies that help youth manage their general perceived stress and/or focus on stress reduction techniques.
Collapse
|
287
|
Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, Stone MD, Khoddam R, Samet JM, Audrain-McGovern J. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA 2015; 314:700-7. [PMID: 26284721 PMCID: PMC4771179 DOI: 10.1001/jama.2015.8950] [Citation(s) in RCA: 677] [Impact Index Per Article: 75.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Exposure to nicotine in electronic cigarettes (e-cigarettes) is becoming increasingly common among adolescents who report never having smoked combustible tobacco. OBJECTIVE To evaluate whether e-cigarette use among 14-year-old adolescents who have never tried combustible tobacco is associated with risk of initiating use of 3 combustible tobacco products (ie, cigarettes, cigars, and hookah). DESIGN, SETTING, AND PARTICIPANTS Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, mean age = 14.1 years) and at a 6-month follow-up (spring 2014, 9th grade) and a 12-month follow-up (fall 2014, 10th grade). Ten public high schools in Los Angeles, California, were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and completed follow-up assessments at 6 or 12 months (N = 2530). At each time point, students completed self-report surveys during in-classroom data collections. EXPOSURE Student self-report of whether he or she ever used e-cigarettes (yes or no) at baseline. MAIN OUTCOMES AND MEASURES Six- and 12-month follow-up reports on use of any of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes or no); (2) combustible cigarettes (yes or no), (3) cigars (yes or no); (4) hookah (yes or no); and (5) number of combustible tobacco products (range: 0-3). RESULTS Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever users (n = 222) than never users (n = 2308) at the 6-month follow-up (30.7% vs 8.1%, respectively; difference between groups in prevalence rates, 22.7% [95% CI, 16.4%-28.9%]) and at the 12-month follow-up (25.2% vs 9.3%, respectively; difference between groups, 15.9% [95% CI, 10.0%-21.8%]). Baseline e-cigarette use was associated with greater likelihood of use of any combustible tobacco product averaged across the 2 follow-up periods in the unadjusted analyses (odds ratio [OR], 4.27 [95% CI, 3.19-5.71]) and in the analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR, 2.73 [95% CI, 2.00-3.73]). Product-specific analyses showed that baseline e-cigarette use was positively associated with combustible cigarette (OR, 2.65 [95% CI, 1.73-4.05]), cigar (OR, 4.85 [95% CI, 3.38-6.96]), and hookah (OR, 3.25 [95% CI, 2.29-4.62]) use and with the number of different combustible products used (OR, 4.26 [95% CI, 3.16-5.74]) averaged across the 2 follow-up periods. CONCLUSIONS AND RELEVANCE Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal.
Collapse
|
288
|
Barrington-Trimis JL, Berhane K, Unger JB, Cruz TB, Huh J, Leventhal AM, Urman R, Wang K, Howland S, Gilreath TD, Chou CP, Pentz MA, McConnell R. Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use. Pediatrics 2015; 136. [PMID: 26216326 PMCID: PMC4516947 DOI: 10.1542/peds.2015-0639] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence. METHODS Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children's Health Study during the spring of 2014. RESULTS Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends' use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use. CONCLUSIONS Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.
Collapse
|
289
|
Lorenzo-Blanco EI, Schwartz SJ, Unger JB, Zamboanga BL, Des Rosiers SE, Huang S, Villamar JA, Soto DW, Pattarroyo M, Baezconde-Garbanati L. Latino/a Youth Intentions to Smoke Cigarettes: Exploring the Roles of Culture and Gender. JOURNAL OF LATINX PSYCHOLOGY 2015; 3:129-142. [PMID: 28042523 PMCID: PMC5201205 DOI: 10.1037/lat0000034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Latino/a youth are at risk for cigarette smoking. This risk seems to increase as youth navigate the U.S. cultural context, especially for girls. To investigate how acculturation may influence Latino/a youths' intentions to use cigarettes, this study combines a bidimensional/multidomain model of acculturation and the Theory of Reasoned Action. Our sample consisted of 303 recent Latino/a immigrant youth who had resided in the United States for five years or less at baseline (141 girls, 160 boys; 153 from Miami, 150 from Los Angeles) who completed surveys at 3 time-points. Youth completed measures of acculturation (Latino/a practices, Latino/a identity, collectivistic values; U.S. cultural practices, U.S. identity, individualistic values), smoking related health risk attitudes, perceived subjective norms regarding smoking, and intentions to use cigarettes. Structural equation modeling indicated that collectivistic values were associated with more perceived disapproval of smoking, which in turn was negatively associated with intentions to smoke. Collectivistic values may help protect Latino/a immigrant youth from intending to smoke. Thus, educational smoking prevention efforts could promote collectivistic values and disseminate messages about the negative consequences of smoking on interpersonal relationships.
Collapse
|
290
|
Fagerstrom K, Etter JF, Unger JB. E-cigarettes: a disruptive technology that revolutionizes our field? Nicotine Tob Res 2015; 17:125-6. [PMID: 25609846 DOI: 10.1093/ntr/ntu240] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
291
|
Forster M, Grigsby T, Soto DW, Schwartz SJ, Unger JB. The role of bicultural stress and perceived context of reception in the expression of aggression and rule breaking behaviors among recent-immigrant Hispanic youth. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:1807-27. [PMID: 25210028 PMCID: PMC4501481 DOI: 10.1177/0886260514549052] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Adolescent aggression and delinquency impede healthy adjustment in early adulthood and may have particularly serious long-term consequences for minority youth. Therefore, prevention research should examine these behaviors within a sociocultural framework among newer immigrant samples to determine whether, and how, adaptation to life in the US affects these behaviors. This study investigated the role of two sociocultural variables-bicultural stress and negative context of reception-on changes in aggression and rule breaking behaviors over two time points among recently immigrated Hispanic adolescents residing in Los Angeles (N = 136) and Miami-Dade (N = 142) counties. Linear stepwise regression models were used to assess the associations between predictors and behavioral outcomes. Bicultural stress and negative context of reception both had independent associations, above and beyond parental involvement and delinquent peer associations, with changes in aggressive and rule-breaking behavior during the first year of high school. These findings suggest that social, cultural, and interpersonal processes all influence deviant behaviors in recent-immigrant Hispanic populations. We discuss the implications of these finding for prevention and intervention research and practice. We also recommend that future research continue to examine the role of these factors over the course of adolescence and consider sociocultural influences when designing behavioral interventions for Hispanic immigrant populations.
Collapse
|
292
|
Cano MÁ, Schwartz SJ, Castillo LG, Romero AJ, Huang S, Lorenzo-Blanco EI, Unger JB, Zamboanga BL, Des Rosiers SE, Baezconde-Garbanati L, Lizzi KM, Soto DW, Oshri A, Villamar JA, Pattarroyo M, Szapocznik J. Depressive symptoms and externalizing behaviors among Hispanic immigrant adolescents: Examining longitudinal effects of cultural stress. J Adolesc 2015; 42:31-9. [PMID: 25899132 PMCID: PMC4464969 DOI: 10.1016/j.adolescence.2015.03.017] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 03/20/2015] [Accepted: 03/29/2015] [Indexed: 11/29/2022]
Abstract
This study examined longitudinal effects of cultural stress (a latent factor comprised of bicultural stress, ethnic discrimination, and negative context of reception) on depressive symptoms and a range of externalizing behaviors among recently (≤5 years in the U.S. at baseline) immigrated Hispanic adolescents. A sample of 302 adolescents (53% boys; mean age 14.51 years) completed baseline measures of perceived ethnic discrimination, bicultural stress, and perceived negative context of reception; and outcome measures of depressive symptoms, cigarette smoking, alcohol use, aggressive behavior, and rule-breaking behavior six months post-baseline. A path analysis indicated that higher cultural stress scores predicted higher levels of all outcomes. These effects were consistent across genders, but varied by study site. Specifically, higher cultural stress scores increased depressive symptoms among participants in Miami, but not in Los Angeles. Findings suggest that cultural stress is a clinically relevant predictor of depressive symptoms and externalizing behaviors among Hispanic immigrant adolescents.
Collapse
|
293
|
Sussman S, Baezconde-Garbanati L, Garcia R, Barker DC, Samet JM, Leventhal A, Unger JB. Commentary: Forces That Drive the Vape Shop Industry and Implications for the Health Professions. Eval Health Prof 2015; 39:379-88. [PMID: 25967071 DOI: 10.1177/0163278715586295] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
At least three factors may be driving the evolution of the vape shop industry, a rapidly growing market sector that specializes in the sales of electronic cigarettes: (1) the tobacco industry, (2) the public health sector and its diverse stakeholders, and (3) consumer demand. These influences and the responses of the vape shop sector have resulted in a rapidly changing landscape. This commentary briefly discusses these three factors and the implications for the health professions, as they address the vape shop industry and its consequences for public health.
Collapse
|
294
|
Leventhal AM, Unger JB, Audrain-McGovern J, Sussman S, Volk HE, Strong DR. Measuring Anhedonia in Adolescents: A Psychometric Analysis. J Pers Assess 2015; 97:506-14. [PMID: 25893676 DOI: 10.1080/00223891.2015.1029072] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Anhedonia-the reduced capacity to experience pleasure-is a trait implicated in mental and physical health. Yet, psychometric data on anhedonia measures in adolescents are absent. We conducted an in-depth psychometric analysis of the Snaith-Hamilton Pleasure Scale (SHAPS; Snaith et al., 1995 )-a self-report measure of anticipated pleasure response to 14 pleasant experiences-in adolescents. Adolescents (N = 585, M age = 14.5) completed the SHAPS and other paper-and-pencil surveys. Item response theory models were used to evaluate the psychometric performance of each SHAPS item. Correlations of the SHAPS with other personality and psychopathology measures were calculated to evaluate construct validity. Results showed that (a) certain items (e.g., reported pleasure from basic experiences like "seeing smiling faces" or "smelling flowers") provided more information about latent anhedonia than others; and (b) SHAPS scales exhibited construct-consistent convergent and discriminant validity (i.e., stronger correlations with low positive affect constructs, weaker correlations with negative affect). Reporting diminished pleasure from basic pleasant experiences accurately indicates adolescent anhedonia, which is important for future scale development and understanding the phenomenology of anhedonia in teens. These data support using the SHAPS for assessing anhedonia in epidemiological research and school-based universal prevention programming in general adolescent populations.
Collapse
|
295
|
Schwartz SJ, Unger JB, Baezconde-Garbanati L, Zamboanga BL, Lorenzo-Blanco EI, Des Rosiers SE, Romero AJ, Cano MÁ, Gonzales-Backen MA, Córdova D, Piña-Watson BM, Huang S, Villamar JA, Soto DW, Pattarroyo M, Szapocznik J. Trajectories of cultural stressors and effects on mental health and substance use among Hispanic immigrant adolescents. J Adolesc Health 2015; 56:433-9. [PMID: 25650112 PMCID: PMC4399639 DOI: 10.1016/j.jadohealth.2014.12.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE We sought to determine the extent to which initial levels and over-time trajectories of cultural stressors (discrimination, negative context of reception, and bicultural stress) predicted well-being, internalizing symptoms, conduct problems, and health risk behaviors among recently immigrated Hispanic adolescents. Addressing this research objective involved creating a latent factor for cultural stressors, establishing invariance for this factor over time, estimating a growth curve for this factor over time, and examining the effects of initial levels (intercepts) and trajectories (slopes) of cultural stressors on adolescent outcomes. METHODS A sample of 302 recently immigrated Hispanic adolescents in Miami (median of 1 year in the United States at baseline) and Los Angeles (median of 3 years in the United States at baseline) was recruited from public schools and assessed six times over a 3-year period. RESULTS Perceived discrimination, context of reception, and bicultural stress loaded onto a latent factor at each of the first five timepoints. A growth curve conducted on this factor over the first five timepoints significantly predicted lower self-esteem and optimism, more depressive symptoms, greater aggressive behavior and rule breaking, and increased likelihood of drunkenness and marijuana use. CONCLUSIONS The present results may be important in designing interventions for Hispanic immigrant children and adolescents, including those within the present wave of unaccompanied child migrants. Results indicate targeting cultural stressors in interventions may have potential to improve well-being and decrease externalizing behaviors and substance use within this population.
Collapse
|
296
|
Basáñez T, Warren MT, Crano WD, Unger JB. Perceptions of intragroup rejection and coping strategies: malleable factors affecting Hispanic adolescents’ emotional and academic outcomes. J Youth Adolesc 2015; 43:1266-80. [PMID: 24234042 DOI: 10.1007/s10964-013-0062-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 11/06/2013] [Indexed: 11/28/2022]
Abstract
Understanding psychosocial factors that affect the academic achievement of Hispanic adolescents remains a nationwide priority in the United States. Extending previous studies of the stressful effects of perceived discrimination, this year-long longitudinal study examined the correlates of perceived ethnic in-group rejection, coping strategies and fatalistic beliefs, on depressive symptoms, grades, and college aspirations of 2,214 Hispanic adolescents (54% female) in Southern California. Based on the transactional model of stress and coping and on self-perception theory, structural equation models revealed that high perceived intragroup rejection (10th grade) and low levels of active coping (11th grade) were associated with depressive symptoms in 11th grade. Also, depressive symptoms partially mediated the link between intragroup rejection and both academic outcomes. Avoidant coping strategies (e.g., watching TV) also predicted depressive symptoms and were positively related to fatalism. In addition, fatalism was negatively related to grades and aspiration to attend college. The findings suggest the need to help adolescents find adequate outlets for communication and to create awareness about the potential effects of intragroup rejection.
Collapse
|
297
|
Pentz MA, Shin H, Riggs N, Unger JB, Collison KL, Chou CP. Parent, peer, and executive function relationships to early adolescent e-cigarette use: a substance use pathway? Addict Behav 2015; 42:73-8. [PMID: 25462657 DOI: 10.1016/j.addbeh.2014.10.040] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/15/2014] [Accepted: 10/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Little is known about influences on e-cigarette use among early adolescents. This study examined influences that have been previously found to be associated with gateway drug use in adolescents: demographic (age, gender, ethnicity, free lunch), social contextual influences of parents and peers, and executive function deficits (EF). METHODS A cross-sectional survey was administered to 410 7th grade students from two diverse school districts in Southern California (M age;=12.4years, 48.3% female, 34.9% on free lunch (low socioeconomic status), 45.1% White, 25.4% Hispanic/Latino, 14.9% Mixed/bi-racial.) Logistic regression analyses examined influences of demographic, parent e-cigarette ownership and peer use, and EF on lifetime e-cigarette, and gateway drug use (cigarette and/or alcohol use). RESULTS Lifetime use prevalence was 11.0% for e-cigarettes, 6.8% for cigarettes, and 38.1% for alcohol. Free lunch and age were marginally related to e-cigarette use (p<.10). Parent e-cigarette ownership was associated with use of all substances, while peer use was associated with gateway drug use (p's<.05-.001). EF deficits were associated with use of all substances five times more likely than others to use e-cigarettes and over twice as likely to use gateway drugs. CONCLUSIONS E-cigarette and gateway drug use may have common underlying risk factors in early adolescence, including parent and peer modeling of substance use, as well as EF deficits. Future research is needed to examine longitudinal relationships of demographics, parent and peer modeling, and EF deficits to e-cigarette use in larger samples, trajectories of e-cigarette use compared to use of other substances, and the potential of EF skills training programs to prevent e-cigarette use.
Collapse
|
298
|
Cabassa LJ, Oh H, Humensky JL, Unger JB, Molina GB, Baron M. Comparing the impact on Latinos of a depression brochure and an entertainment-education depression fotonovela. Psychiatr Serv 2015; 66:313-6. [PMID: 25727121 PMCID: PMC4424796 DOI: 10.1176/appi.ps.201400146] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose was to evaluate the impact of a depression fotonovela in increasing knowledge of depression symptoms and treatments and reducing stigma among Latinos. METHODS Data were from a randomized controlled trial in which Latinos from adult schools (N=132) were assigned to receive the fotonovela or a depression brochure and were assessed on knowledge and stigma measures before and after reading the material and one month later. Random-effects linear and logistic regression models assessed changes within and between groups. RESULTS No significant differences were found between groups in symptom knowledge, social distance, and perceptions of dangerousness. Gains in depression treatment knowledge were significantly greater for the fotonovela than for the depression brochure group. CONCLUSIONS Findings suggest that a depression fotonovela informed by an entertainment-education approach is a useful tool for improving depression treatment knowledge among Latinos but is limited in improving symptom knowledge and reducing stigma related to social distance and perceptions of dangerousness.
Collapse
|
299
|
Forster M, Allem JP, Mendez N, Qazi Y, Unger JB. Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California. ETHNICITY & HEALTH 2015; 21:58-70. [PMID: 25650806 PMCID: PMC5508717 DOI: 10.1080/13557858.2015.1007119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. DESIGN 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). RESULTS Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. CONCLUSION Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.
Collapse
|
300
|
Schwartz SJ, Unger JB, Zamboanga BL, Córdova D, Mason CA, Huang S, Baezconde-Garbanati L, Lorenzo-Blanco EI, Des Rosiers SE, Soto DW, Villamar JA, Pattarroyo M, Lizzi KM, Szapocznik J. Developmental trajectories of acculturation: links with family functioning and mental health in recent-immigrant Hispanic adolescents. Child Dev 2015; 86:726-48. [PMID: 25644262 DOI: 10.1111/cdev.12341] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study was designed to examine acculturative changes, and their effects on mental health and family functioning, in recent-immigrant Hispanic adolescents. A sample of 302 Hispanic adolescents was assessed five times over a 2½-year period. Participants completed measures of Hispanic and U.S. practices, collectivist and individualist values, and ethnic and U.S. identity at each time point. Baseline and Time 5 levels of mental health and family functioning were also assessed. Latent class growth analyses produced two-class solutions for practices, values, and identifications. Adolescents who increased over time in practices and values reported the most adaptive mental health and family functioning. Adolescents who did not change in any acculturation domain reported the least favorable mental health and family functioning.
Collapse
|