1
|
Hochgraf AK, Fosco GM, Lanza ST. Comorbidity between body dissatisfaction and nicotine vaping among young adults in college: a daily diary study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38713866 DOI: 10.1080/07448481.2024.2346354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/09/2024] [Indexed: 05/09/2024]
Abstract
Objective: The purpose of this study was to elucidate comorbidity between body dissatisfaction and nicotine vaping. Participants: Participants were 121 college students (M age = 20.51 years; 75.0% female; 75.2% White) who participated in a 14-day daily diary study. Methods: Logistic regression was used to test links between baseline trait body dissatisfaction and vaping frequency across 14 days. Multilevel logistic regression was used to test within-person, daily links between body dissatisfaction and nicotine vaping. Results: Each additional unit of trait body dissatisfaction increased the odds of frequent vaping by 33% (95% CI [1.00, 1.77]) and daily vaping by 54% (95% CI [1.10, 2.15]). Within-person, daily associations between body dissatisfaction and vaping were nonsignificant. Conclusions: Body dissatisfaction may increase college students' risk for engaging in frequent nicotine vaping. However, daily changes in body dissatisfaction may not predict same- or next-day vaping. College students with body dissatisfaction may benefit from nicotine interventions.
Collapse
Affiliation(s)
- Anna K Hochgraf
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- Division of Epidemiology and Community Health, School of Public Health, The University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory M Fosco
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Stephanie T Lanza
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| |
Collapse
|
2
|
Krishnan N, Berg CJ, Elmi AF, Klemperer EM, Sherman SE, Abroms LC. Trajectories of ENDS and cigarette use among dual users: analysis of waves 1 to 5 of the PATH Study. Tob Control 2024; 33:e62-e68. [PMID: 36601793 DOI: 10.1136/tc-2022-057405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Concurrent electronic nicotine delivery system (ENDS) and cigarette (dual) use is harmful. Identifying longitudinal trajectories of ENDS and cigarette use among dual users can help to determine the public health impact of ENDS and inform tobacco control policies and interventions. OBJECTIVES (1) To identify independent and joint trajectories of ENDS and cigarette use among wave (W) 1 adult dual users across W1 to W5 of the Population Assessment of Tobacco and Health (PATH) Study; and (2) identify W1 predictors of ENDS and cigarette joint trajectory group membership. METHODS We used group-based trajectory modelling to estimate independent and joint trajectories of ENDS and cigarette use from wave 1 (W1; 2013-2014) to wave 5 (W5; 2018-2019) among W1 adult established dual users of ENDS and cigarettes (n=545) from the PATH Study. We used multinomial logistic regression to identify W1 predictors of joint trajectories. RESULTS Two ENDS (early quitters=66.0%, stable users=34.0%) and three cigarette (stable users=55.2%, gradual quitters=27.3%, early quitters=17.5%) trajectories of W1 were identified. In joint trajectory analysis, 41.6% of participants were early ENDS quitters and stable cigarette users; 14.8% early ENDS quitters and gradual cigarette quitters; 14.6% stable ENDS users and stable cigarette users; 11.2% stable ENDS users and gradual cigarette quitters; 10.3% early ENDS quitters and early cigarette quitters; and 7.4% stable ENDS users and early cigarette quitters. Cigarette and ENDS use frequency, nicotine dependence, cannabis use and other non-combusted tobacco product use predicted trajectory group membership (p values <0.05). CONCLUSIONS Most dual users maintained long-term cigarette smoking or dual use, highlighting the need to address cessation of both products. Continued monitoring of trajectories and their predictors is needed, given ongoing changes to the ENDS marketplace.
Collapse
Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Angelo F Elmi
- Department of Biostatistics and Bioinformatics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Elias M Klemperer
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
- Vermont Center on Behavior and Health, Burlington, Vermont, USA
| | - Scott E Sherman
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| |
Collapse
|
3
|
Liu J, Winickoff JP, Hanby E, Rees V, Emmons KM, Tan AS. Prevalence and correlates of past 30-day dual-vaping of nicotine and cannabis among adolescents in five New England states. Drug Alcohol Depend 2024; 254:111055. [PMID: 38071894 PMCID: PMC10872281 DOI: 10.1016/j.drugalcdep.2023.111055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/22/2023]
Abstract
SIGNIFICANCE Adolescent vaping behavior includes vaping of multiple substances, including both nicotine and cannabis (dual-vaping). This study describes the prevalence and the sociodemographic correlates of past 30-day dual-vaping. METHODS We recruited adolescents ages 13-17 from five New England states (Massachusetts, Connecticut, Rhode Island, Vermont, New Hampshire) through the Prodege online survey panel from April 2021 to August 2022. Dual-vaping was defined as vaping both nicotine and cannabis (THC and/or CBD) in the past 30-days. We analyzed the prevalence of sole-nicotine, sole-cannabis, and dual-vaping of nicotine and cannabis and used multinomial logistic regression to examine associations between sociodemographic factors and sole- and dual-vaping of nicotine and cannabis. RESULTS The analytic sample included 2013 observations from 1858 participants (mean age 15.1 years, 46.2% female, 74.1% White, 82.2% heterosexual). Among these observations, 5.6% reported past 30-day sole-nicotine vaping, 5.5% reported sole-cannabis vaping, and 7.3% had dual-vaped. Correlates for higher odds of past 30-day dual-vaping included total social media sites used and household tobacco use, in contrast with sole-cannabis vaping, which included older age and self-reported depression (all p's <0.05). DISCUSSION Adolescent past 30-day dual-vaping of nicotine and cannabis was more prevalent than past 30-day sole-vaping of either nicotine or cannabis alone. Future studies should continue to collect detailed data on the type of substances, besides nicotine, that adolescents are vaping.
Collapse
Affiliation(s)
- Jessica Liu
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Kresge Building, Boston, MA, USA; REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
| | - Jonathan P Winickoff
- Massachusetts General for Children, Division of General Academic Pediatrics, Boston, MA, USA; MGH Tobacco Research and Treatment Center, Boston, MA, USA; American Academy of Pediatrics Julius B. Richmond Center, Itasca, IL, USA
| | - Elaine Hanby
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA
| | - Vaughan Rees
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Kresge Building, Boston, MA, USA
| | - Karen M Emmons
- Harvard University, T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Kresge Building, Boston, MA, USA
| | - Andy Sl Tan
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA; University of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PA, USA; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, PA, USA
| |
Collapse
|
4
|
Nathan Marti C, Arora S, Loukas A. Depressive symptoms predict trajectories of electronic delivery nicotine systems, cigarette, and cannabis use across 4.5 years among college students. Addict Behav 2023; 146:107809. [PMID: 37515895 DOI: 10.1016/j.addbeh.2023.107809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/07/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND This study examined the role of depressive symptoms on trajectories of electronic nicotine delivery systems (ENDS), cigarette, and cannabis use across 4.5 years in a sample of college students aged 18-19 at the initial study wave. METHODS Participants were 2,264 students enrolled in one of 24 Texas colleges that participated in a multi-wave study between 2014 and 2019. Latent growth mixture models were fit to identify longitudinal trajectories for past 30-day ENDS, cigarette, and cannabis use over a 4.5-year period. Class membership was regressed on baseline depressive symptoms in multinomial regression models. RESULTS Four trajectory classes were identified for each product: abstainer/minimal, decreasing, increasing, and high. Depressive symptoms were associated with a greater likelihood of belonging to the decreasing, increasing, and high trajectory classes relative to the abstainer/minimal class for all products, with the exception of the increasing ENDS class and the decreasing cannabis class. DISCUSSION The findings demonstrate that there is considerable similarity across trajectories of ENDS, cigarette, and cannabis use during traditional collegiate years. Furthermore, depressive symptoms increased the likelihood of belonging to substance using trajectory classes for all products.
Collapse
Affiliation(s)
- C Nathan Marti
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA.
| | - Srishty Arora
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA
| | - Alexandra Loukas
- Department of Kinesiology & Health Education, University of Texas at Austin, 2700 San Jacinto Blvd. D3700, Austin, TX 78712, USA
| |
Collapse
|
5
|
Romm KF, Cohn AM, Wang Y, Williams R, Berg CJ. Disparities in trajectories of cigarette and E-cigarette use across sexual orientation groups of young adult men and women in the US. Addict Behav 2023; 145:107763. [PMID: 37295384 PMCID: PMC10674053 DOI: 10.1016/j.addbeh.2023.107763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/12/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Limited research has examined differences in cigarette/e-cigarette use trajectories among specific subgroups of sexual minority (SM) young adult (SMYA) men and women. METHODS Repeated measures latent profile analyses (RMLPAs) examined past 6-month cigarette and e-cigarette use trajectories across 5 waves of data (2018-2020) among men (n = 1235; Mage = 25.56, SD = 4.85; 8.0% bisexual, 12.7% gay; 36.4% racial/ethnic minority) and women (n = 1574; Mage = 24.64, SD = 4.72; 23.8% bisexual, 5.9% lesbian; 35.3% racial/ethnic minority) residing in 6 US metropolitan statistical areas. Multinomial logistic regressions examined associations among sexual orientation (bisexual, gay/lesbian, heterosexual) and tobacco use trajectories among men and women, separately. RESULTS RMLPAs yielded a 6-profile solution: stable low-level cigarette and e-cigarette use (66.6%), stable low-level cigarette and high-level e-cigarette use (12.2%), stable low-level cigarette and decreasing e-cigarette use (6.2%), stable mid-level cigarette and low-level e-cigarette use (6.2%), stable high-level cigarette and low-level e-cigarette use (4.5%), and stable high-level cigarette and e-cigarette use (4.2%). Gay (vs. heterosexual) men were less likely to display stable low-level cigarette and stable high-level e-cigarette use. Bisexual (vs. heterosexual) women were more likely to display stable low-level cigarette and stable high-level e-cigarette use, stable low-level cigarette and decreasing high-level e-cigarette use, and stable high-level cigarette and stable low-level e-cigarette use. CONCLUSIONS Bisexual women were at greatest risk for displaying several problematic cigarette and e-cigarette use trajectories, whereas few differences emerged for men. Tailored interventions and campaigns are needed to curtail ongoing tobacco use disparities among SMYA men and women, particularly bisexual women.
Collapse
Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA
| |
Collapse
|
6
|
Rabinowitz JA, Reboussin BA, Sosnowski DW, Kuo SIC, Strickland JC, García-Marín LM, Rentería ME, Gillespie N, Maher B, Ialongo NS, Thorpe RJ, Uhl G. Associations of polygenic risk scores for smoking heaviness and lifetime cannabis use with tobacco and cannabis co-use trajectories among African Americans. Drug Alcohol Depend 2023; 250:110895. [PMID: 37517263 PMCID: PMC10495192 DOI: 10.1016/j.drugalcdep.2023.110895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND We aimed to identify distinct trajectories of tobacco, cannabis, and their co-use among African Americans, and to investigate whether these patterns were associated with polygenic risk scores (PRS) for tobacco and cannabis use. METHOD Participants (N=428 participants; 50.9% male) were initially recruited for an elementary school-based prevention in a Mid-Atlantic city when they were in first grade. From ages 14-26, participants reported on their frequency of tobacco and cannabis use in the past year during annual assessments. DNA was collected from participants at age 21. PRS for smoking heaviness (i.e., cigarettes per day) and lifetime cannabis use were created based on genome-wide association study results derived from Liu et al. (2019) and Pasman et al. (2018), respectively. RESULTS We identified five distinct trajectories of tobacco and cannabis co-use, including (1) Low Tobacco and Cannabis Use, (2) Adolescent Limited Tobacco and Cannabis Use, (3) Experimental Cannabis, Young Adult Increasing Tobacco, (4) Experimental Tobacco, Young Adult Increasing Cannabis, and (5) High, Chronic Tobacco and Cannabis Use. Compared to the Low Tobacco and Cannabis Use subgroup, individuals in the High, Chronic Tobacco and Cannabis Use subgroup had greater PRS for smoking heaviness, and individuals in the Experimental Cannabis, Young Adult Increasing Tobacco subgroup had higher PRS for lifetime cannabis use. CONCLUSIONS Polygenic risk for lifetime cannabis use and smoking heaviness is associated with the developmental progression of tobacco and cannabis co-use among African Americans, furthering knowledge on the etiology of co-use in this population.
Collapse
Affiliation(s)
- Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David W Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Services, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Luis M García-Marín
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland4006, Australia; School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland4012, Australia
| | - Miguel E Rentería
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland4006, Australia; School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland4012, Australia
| | - Nathan Gillespie
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, USA
| | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- Department of Psychiatry and Behavioral Services, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - George Uhl
- New Mexico VA Health Care SystemAlbuquerque, NMUSA
| |
Collapse
|
7
|
Bessenyei K, Yakovenko I. Predictors of polysubstance vaping in emerging adults. Addict Behav 2023; 142:107675. [PMID: 36857931 DOI: 10.1016/j.addbeh.2023.107675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Polysubstance use, which increases the risk for negative consequences of substance use, is common among emerging adults who regularly consume substances by vaping. Examining predictors of polysubstance vaping is crucial for understanding whether this novel form of substance consumption lends itself equally efficaciously to established forms of intervention for smoked substances. OBJECTIVE The current study aimed to examine whether modifiable cognitive risk factors for increased vaping in the form of attitudes, expectancies and norms can predict co-use of nicotine and cannabis among vapers over and above the effect of demographics, personality risk factors and anxiety, depression symptoms. METHODS Regular nicotine and cannabis vapers between 18 and 30 years were recruited online in Canada via a Qualtrics panel. Hierarchical binary logistic regression was used to predict membership in a polysubstance or a single substance vaping group. Demographics, personality risk factors, depression and anxiety symptoms were included as predictors in block 1; attitudes, expectancies and perceived norms of vaping were added in block 2. RESULTS Attitudes, expectancies and norms predicted polysubstance use over and above the effect of demographics, personality risk factors and anxiety, depression symptoms. Positive expectancies played a uniquely significant role in the prediction of polysubstance vaping. CONCLUSIONS Cognitive interventions targeting attitudes, expectancies and norms may be effective in prevention of polysubstance vaping, although positive expectancies appear to be the main unique factor that has an influence above and beyond all other cognitive factors related to vaping. Treatment and prevention programs should put special focus on lowering positive expectancies.
Collapse
Affiliation(s)
- Kitti Bessenyei
- Departments of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Igor Yakovenko
- Departments of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| |
Collapse
|
8
|
Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
Collapse
Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
| |
Collapse
|
9
|
Romm KF, Cohn AM, Wang Y, Berg CJ. Psychosocial predictors of trajectories of dual cigarette and e-cigarette use among young adults in the US. Addict Behav 2023; 141:107658. [PMID: 36812780 PMCID: PMC10154740 DOI: 10.1016/j.addbeh.2023.107658] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION Young adults have the highest prevalence of cigarette and e-cigarette use, warranting research to identify psychosocial correlates of their use trajectories. METHODS Repeated measures latent profile analyses (RMLPAs) examined past 6-month cigarette and e-cigarette trajectories across 5 waves of data (2018-2020) among 3,006 young adults (Mage = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 60.2% racial/ethnic minority). Multinomial logistic regression models examined associations among psychosocial factors (i.e., depressive symptoms, adverse childhood experiences [ACEs], personality traits) and trajectories of cigarette and e-cigarette use, controlling for sociodemographics and past 6-month alcohol and cannabis use. RESULTS RMLPAs yielded a 6-profile solution, which were uniquely associated with predictors: stable low-level or nonusers of cigarettes and e-cigarettes (66.3%; referent group), stable low-level cigarette and high-level e-cigarette use (12.3%; greater depressive symptoms, ACEs, openness; male, White, cannabis use), stable mid-level cigarette and low-level e-cigarette use (6.2%; greater depressive symptoms, ACEs, extraversion; less openness, conscientiousness; older age, male, Black or Hispanic, cannabis use), stable low-level cigarette and decreasing e-cigarette use (6.0%; greater depressive symptoms, ACEs, openness; younger age, cannabis use), stable high-level cigarette and low-level e-cigarette use (4.7%; greater depressive symptoms, ACEs, extraversion; older age, cannabis use), and decreasing high-level cigarette and stable high-level e-cigarette use (4.5%; greater depressive symptoms, ACEs, extraversion, less conscientiousness; older age, cannabis use). CONCLUSIONS Cigarette and e-cigarette prevention and cessation efforts should be targeted both toward specific trajectories of use and their unique psychosocial correlates.
Collapse
Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA
| |
Collapse
|
10
|
Croker JA, Werts M, Couch ET, Chaffee BW. Cannabis use among adolescents and emerging adults who use e-cigarettes: Findings from an online, national U.S. Sample. Addict Behav 2023; 140:107620. [PMID: 36724700 PMCID: PMC9984189 DOI: 10.1016/j.addbeh.2023.107620] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/17/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023]
Abstract
Concurrent use of e-cigarettes and cannabis among adolescents and emerging adults is a growing public health concern. More research is needed describing cannabis use among adolescents and emerging adults who vape. The objective of this study was to characterize cannabis use among adolescents and emerging adults (age 14-20) who reported e-cigarette ever-use, particularly their use of blunts and liquid cannabis vape (LCV) products. Using cross-sectional data from a national online survey, we describe their patterns of cannabis use, detail their use of flavored cannabis and tobacco products, and estimate associations of demographic factors and other current substance use behaviors with levels of blunt and LCV use. Of the 2253 respondents in the sample, 1379 (61 %) reported some form of cannabis use in the past 30 days, among whom 80 % used flavored cannabis (including edibles). Significant associations with current cannabis use were observed on several demographic measures, with current cannabis blunt use more frequent among participants not in school, non-Hispanic Blacks, multiracial respondents, and those whose incomes do not meet their expenses. Other than income, demographic characteristics were generally not associated with LCV use frequency. Use of other substances was associated with more frequent use of both blunts and LCV in the past 30 days, and enrollment in college or the military seems somewhat protective for emerging adults. These findings suggest a need for tailored prevention efforts among high-risk adolescents and emerging adults, potential regulation of added flavors in commercialized cannabis products, and stronger enforcement of retail restrictions for individuals under age 21 more broadly.
Collapse
Affiliation(s)
- James A Croker
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Miranda Werts
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
| | - Elizabeth T Couch
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
| | - Benjamin W Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA; Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
11
|
Han DH, Elam KK, Quinn PD, Huang C, Seo DC. Within-person associations of escalated electronic nicotine delivery systems use with cigarette, alcohol, marijuana and drug use behaviors among US young adults. Addiction 2023; 118:509-519. [PMID: 36367333 PMCID: PMC10098511 DOI: 10.1111/add.16082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
AIMS Most extant evidence has addressed between-person differences, short-term or cross-sectional associations of electronic nicotine delivery systems (ENDS) use with other substance use, the majority focusing on current rather than escalated use. The present study aimed to examine within-person changes in escalated ENDS use and their associations with individual and combined substance use over a 6-year period. DESIGN, SETTING AND PARTICIPANTS This study used a longitudinal cohort design with US young adults. A generalized linear mixed-model approach was employed to fit a series of weighted logistic regression models. Data were drawn from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) study in the United States. Of the 9110 young adults at baseline, aged 18-24 years, a total of 5042 individuals had matched data across all five waves of assessments. MEASUREMENTS Escalated ENDS use was computed by subtracting the number of days of ENDS use within the past 30 days at wave w - 1 from that at wave w and coded as 1 = escalated, if the value was greater than zero (otherwise, coded as 0 = not escalated). FINDINGS Escalated ENDS use gradually decreased over time, with the lowest prevalence at wave 4 (4.0%) but sharply increasing at wave 5 (8.4%). Escalated ENDS use was associated with increased odds of using each substance (binge drinking, marijuana use, marijuana vaping, prescription and illicit drugs) and different combinations of polysubstance use between cigarette smoking, binge drinking and marijuana use (Ps < 0.05). In addition, sweet/fruit flavor use (versus menthol/mint) was associated with increased likelihood of reporting co-use of cigarettes and marijuana. CONCLUSIONS In the United States, the prevalence of young adults using electronic nicotine delivery systems appears to have increased steadily between 2013 and 2019, although the rate of increase may have started to accelerate in recent years. Escalated electronic nicotine delivery systems use and time-lagged established electronic nicotine delivery systems use appear to be prospectively associated with individual and combined substance use, particularly between cigarettes, alcohol and marijuana. Among established electronic nicotine delivery systems users, sweet/fruit flavor appears to be associated with increased risk of co-using cigarettes and marijuana.
Collapse
Affiliation(s)
- Dae-Hee Han
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kit K Elam
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Patrick D Quinn
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Chunfeng Huang
- Department of Statistics, Indiana University, Bloomington, IN, USA
| | - Dong-Chul Seo
- School of Public Health, Indiana University, Bloomington, IN, USA
| |
Collapse
|
12
|
Romm KF, Turiano NA, Milstred AR, Bray BC, Dino G, Doogan N, Blank MD. Socioecological Predictors of Change in Adolescent Tobacco Use Across Waves 1-4 of the Population Assessment of Tobacco and Health Study. J Adolesc Health 2023; 72:375-382. [PMID: 36528513 PMCID: PMC10868139 DOI: 10.1016/j.jadohealth.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite decreases in adolescents' cigarette use over the past decade, overall rates of adolescent tobacco use have increased. Research examining adolescents' changes across a range of tobacco products reflective of the current market, as well as multilevel predictors of use trajectories is needed. METHODS Data derive from Waves 1-4 (W1-4; 2013-2018) of the Population Assessment of Tobacco and Health (PATH) study. Participants included 975 adolescents who used ≥1 tobacco product (cigarettes, electronic cigarettes [ECIGs], traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco [SLT], hookah) at any wave (W1 Mage = 13.29 [0.86], 54.2% male; 54.5% White, 25.9% Hispanic). RESULTS Utilizing latent growth curve modeling (separate models per product), adolescents displayed increases in their past 30-day use of all tobacco products from W1-4. Greater W1 use was predicted by identifying as non-Hispanic (cigarettes); lower parent education (SLT); greater externalizing problems (cigarillos); greater motives (all products except cigarillos); greater youth-reported household smoking rules (cigarillos); and greater isolation (ECIGs). More use across time (i.e., higher slope) was predicted by older age (cigarettes); identifying as male (ECIGs, SLT), Black (vs. White; cigarillos), White (vs. Black, Hispanic; ECIGs, SLT); fewer externalizing problems (SLT); fewer motives (ECIGs); fewer youth-reported rules (cigarillos, SLT); and greater geographic isolation (cigarettes, SLT). DISCUSSION Although some individual-level factors (i.e., motives, externalizing problems) predicted greater W1 use (i.e., intercept) only, interpersonal- (parent rules) and community-level (geographic isolation) factors were associated with changes in use over time (i.e., slope). Intervention efforts may address such factors to reduce adolescents' escalations in use.
Collapse
Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Nicholas A Turiano
- Department of Psychology, West Virginia University, Morgantown, West Virginia; West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Andrea R Milstred
- Department of Psychology, West Virginia University, Morgantown, West Virginia
| | - Bethany C Bray
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Geri Dino
- West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Nathan Doogan
- Ohio State University, Government Resources Center, Columbus, Ohio
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia; West Virginia Prevention Research Center, Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| |
Collapse
|
13
|
Identifying changes in e-cigarette use among a longitudinal sample of Canadian youth e-cigarette users in the COMPASS cohort study, 2017/18-2018/19. Addict Behav Rep 2022; 16:100458. [PMID: 36164667 PMCID: PMC9508506 DOI: 10.1016/j.abrep.2022.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/11/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022] Open
Abstract
Those who use e-cigarettes may increase, decrease, or keep the same frequency of use. Half of current youth e-cigarette users increased their frequency of use. One third of current youth e-cigarette users decreased their frequency of use. E-cigarette use patterns differed by gender and ethnicity.
Objectives There are few studies describing longitudinal changes in vaping patterns among current youth e-cigarette users. The objective of this study was to identify-one-year changes in e-cigarette use patterns among a longitudinal sample of Canadian youth e-cigarette users between 2017/18 and 2018/19. Methods The longitudinal sample included n = 4,071 current (past 30-day) e-cigarette users in grades 9–11 attending schools in four Canadian provinces. Students reported the number of days they used e-cigarettes in the past 30 days in 2017/18 and 2018/19. Based on responses, students could have escalated, reduced, stopped, or maintained their level of vaping. The prevalence of each e-cigarette use pattern was identified across demographic characteristics and regression models identified significant predictors of each use pattern. Results Over one year, 49.2% of current youth e-cigarette users escalated, 12.8% reduced, 20.2% stopped, and 17.8% maintained their frequency of e-cigarette use. Baseline e-cigarette use frequencies varied according to use pattern. Current youth e-cigarette users with higher baseline vaping frequencies had lower odds of escalating and stopping e-cigarette use and higher odds of reducing e-cigarette use relative to maintaining the same frequency of use. Conclusions While about half of current youth e-cigarette users increased their frequency of e-cigarette use over a 1-year period, a significant number also decreased or stopped vaping at a time when the prevalence of youth e-cigarette use increased rapidly in Canada. There is a need for longitudinal data to monitor and evaluate changes to e-cigarette use patterns that may be in response to changing public health policies.
Collapse
|
14
|
Moustafa AF, Rodriguez D, Pianin SH, Testa SM, Audrain-McGovern JE. Dual Use of Nicotine and Cannabis Through Vaping Among Adolescents. Am J Prev Med 2022; 63:60-67. [PMID: 35365396 PMCID: PMC9232951 DOI: 10.1016/j.amepre.2021.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study seeks to identify adolescent nicotine and cannabis vaping patterns and the characteristics of those adolescents who comprised each pattern. METHODS This prospective longitudinal survey study measured the relationship between nicotine and cannabis vaping among 1,835 adolescents from 4 public high schools outside of Philadelphia, Pennsylvania. Adolescents completed in-classroom surveys, including questions of lifetime and past 30-day nicotine and cannabis vaping, at Wave 1 (fall 2016, ninth grade) and 6-month intervals for the following 36 months (fall 2019, 12th grade). Data were analyzed in 2021. RESULTS A sequential processes growth mixture model revealed 4 latent conjoint classes of nicotine and cannabis vaping: early, declining dual use (Class 1: n=259); rapidly increasing dual use (Class 2: n=128); later, slower dual use (Class 3: n=313); and no use (Class 4: n=1,136). Increased odds of belonging to Class 1 and Class 2 versus belonging to Class 4 were significantly associated with cigarette smoking (OR=3.71, OR=2.21), alcohol use (OR=2.55, OR=4.39), peer vaping (OR=1.24, OR=1.20), sensation seeking (OR=1.03, OR=1.11), positive E-cigarette expectations (OR=1.21, OR=1.17), and cigar smoking (OR=2.39 Class 2 only). Increased odds of belonging to Class 3 versus Class 4 were significantly associated with alcohol use (OR=1.66), perceived benefits of E-cigarette use (OR=1.03), positive E-cigarette expectations (OR=1.08), depressive symptoms (OR=1.02), and sensation seeking (OR=1.03). CONCLUSIONS From middle to late adolescence, vaping of nicotine and cannabis develop in close parallel. Regulatory policy and prevention interventions should consider the interplay between these 2 substances during this period of adolescence.
Collapse
Affiliation(s)
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, La Salle University, Philadelphia, Pennsylvania
| | - Stephen H Pianin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Shannon M Testa
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Janet E Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
15
|
Copeland WE, Hill SN, Shanahan L. Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use. J Am Acad Child Adolesc Psychiatry 2022; 61:533-543. [PMID: 34416291 PMCID: PMC8850538 DOI: 10.1016/j.jaac.2021.07.824] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/09/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Research on associations of early cannabis use with adult functioning reports mixed findings. This may be due, in part, to wide variations in the definitions of early cannabis use. This study aims to compare associations of 4 commonly used definitions of early cannabis use-related to timing, dose, duration, and associated symptoms-with adult outcomes. METHOD Analyses were based on a 20+-year longitudinal, community-representative study of 1,420 participants. Between ages 9 and 21 years (8,806 observations), participants were assessed for cannabis use and DSM-5 cannabis use disorder. In early adulthood (ages 24-26 and 30; 2,424 observations of 1,266 subjects), participants were also assessed for psychiatric, substance use, and functional outcomes. RESULTS All definitions of early use were associated with multiple adult outcomes in models that adjusted for sex and race/ethnicity. In models that also adjusted for childhood psychiatric problems and family adversities, only daily use and a persistent developmental subtype (defined as daily/problematic use that began in adolescence and continued into early adulthood) were associated with later substance use/disorders, poorer functional outcomes, and derailments in the transition to adulthood. CONCLUSION Daily, continued-over-time cannabis use beginning on adolescence was most problematic for a range of adult outcomes. Cessation of early use did not fully eliminate later risks; but was associated with fewer negative outcomes, with weaker effect sizes.
Collapse
Affiliation(s)
| | - Sherika N. Hill
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| |
Collapse
|
16
|
Mattingly DT, Patel A, Hirschtick JL, Fleischer NL. Sociodemographic differences in patterns of nicotine and cannabis vaping among US adults. Prev Med Rep 2022; 26:101715. [PMID: 35141121 PMCID: PMC8814645 DOI: 10.1016/j.pmedr.2022.101715] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 11/26/2022] Open
Abstract
About half (54.2%) of adults who used electronic vapor products (EVPs) vaped nicotine only. Only 7.4% of adults who used EVPs vaped cannabis only, while one-fourth (23.8%) vaped nicotine and cannabis. Patterns of nicotine and cannabis vaping differed by age, race/ethnicity, education, and sexual orientation. Vaping nicotine and cannabis and cannabis only was more common among young adults. Vaping cannabis only was more common among Hispanic and non-Hispanic Black adults.
Nicotine and cannabis vaping has increased over the past several years. While patterns of cigarette and cannabis co-use are well-documented, less is known about the intersection between nicotine and cannabis vaping, especially among adults. Thus, we categorized nicotine and cannabis vaping among adults (18+) who currently (past 30-day) used electronic vapor products (EVPs) from Wave 4 of the Population Assessment of Tobacco and Health Study (n = 3795) as: 1) nicotine only, 2) cannabis only, 3) nicotine and cannabis, and 4) non-nicotine/non-cannabis e-liquid. We calculated vaping pattern proportions overall and by sociodemographic characteristics. Adjusted multinomial logistic regression models assessed associations between sociodemographic characteristics and vaping categories relative to nicotine-only vaping. Approximately half (54.2%) of adults who currently used EVPs vaped nicotine only, 7.4% vaped cannabis only, 23.8% vaped nicotine and cannabis, and 14.6% vaped non-nicotine/non-cannabis e-liquid. Young adults (aged 18–24) (vs. adults aged 35+) had at least three-fold greater odds of vaping cannabis only, nicotine and cannabis, and non-nicotine/non-cannabis e-liquid, compared to nicotine only. Hispanic and non-Hispanic Black (vs. non-Hispanic White) adults had 2.5–3 times greater odds of vaping cannabis only and non-nicotine/non-cannabis e-liquid, compared to nicotine only. Sexual minority adults (vs. heterosexual adults) had 1.5 times greater odds of vaping nicotine and cannabis, compared to nicotine only. Nearly half of adults who vaped EVPs consumed something other than nicotine only, and nicotine/cannabis vaping patterns differed by sociodemographic groups. Vaping and nicotine reduction efforts must recognize that adults who currently vape may be vaping cannabis, or neither nicotine nor cannabis.
Collapse
|
17
|
Mamudu HM, Shahani D, Jones A, Ahuja M, Adeniran E, Weierbach F, Swindle J, Liu Y, Keener J, Blair CJ, McNabb M, Asare M, Wood DL, Ferketich A. Exploring Patterns of the Use of Electronic Nicotine Delivery Systems among Adolescents in High-Risk Appalachian (U.S.A) Communities. Subst Use Misuse 2022; 57:167-174. [PMID: 34927538 DOI: 10.1080/10826084.2021.1990333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Electronic nicotine delivery systems (ENDS) use among adolescents in the United States (U.S.) has surpassed conventional tobacco products (CTPs), including cigarettes. Increasingly, ENDS are used concurrently with CTPs and substances such as cannabis. However, few studies involve Central Appalachia, a region with historically high rates of tobacco and other substance use. Objective: To examine prevalence of concurrent use of ENDS and cannabis among school-going adolescents in Appalachian Tennessee and delineate associations between ENDS use and substance-related risk behavior (cannabis use), social relations (peer use), and school-related risk behavior (academic performance). Methods: Data were obtained from a survey conducted with youth aged 13-17 years in 2018 in a county in Appalachian Tennessee (n = 280). A multivariable logistic regression model was fit to evaluate associations between ENDS and cannabis use, and other factors. Results: Overall, lifetime ENDS and cannabis prevalence estimates were 31.1% and 18.6%, respectively. Lifetime ENDS users had increased odds of also being lifetime cannabis users [OR = 9.22, 95% confidence interval (CI): 3.44-24.75]. Lifetime ENDS users had increased odds of reporting ENDS use among peers [OR = 12.11; 95% CI: 5.40-27.12] and lower academic performance (OR associated with mostly C or D vs. A grades was 4.28, 95% CI: 1.68-10.90). Conclusion: This study found an association between ENDS and cannabis use among adolescents in Appalachian Tennessee exists. Additionally, peer use and academic performance were associated with ENDS use. The findings have implications for public health intervention planning to address not only ENDS but also substance use among Appalachian youth.
Collapse
Affiliation(s)
- Hadii M Mamudu
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Disha Shahani
- George Washington University, Washington, District of Columbia, USA
| | - Antwan Jones
- George Washington University, Washington, District of Columbia, USA
| | - Manik Ahuja
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Esther Adeniran
- East Tennessee States University, Johnson City, Tennessee, USA
| | | | - Jean Swindle
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Ying Liu
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Janet Keener
- East Tennessee States University, Johnson City, Tennessee, USA
| | - Cynthia J Blair
- East Tennessee States University, Johnson City, Tennessee, USA
| | | | | | - David L Wood
- East Tennessee States University, Johnson City, Tennessee, USA
| | | |
Collapse
|
18
|
Abstract
Purpose of Review The purpose of this review was to describe the state-of-the-literature on research specific to cannabis vaping among youth and young adults. Recent Findings Out of 1801 records identified, a total of 202 articles met eligibility criteria for inclusion in this review. Most of this literature (46.0% of studies) was specific to the health effects of cannabis vaping, particularly EVALI (e-cigarette and vaping associated lung injury). Other research areas identified in the review included the etiology (24.3%) and epidemiology (24.8%) of cannabis vaping, in addition to articles on regulation (8.4%) and marketing (5.5%) of the same. Summary Cannabis vaping is increasingly common among youth and young adults and more prevalent is settings where recreational use for adults has been legalized. The literature documents a number of negative health effects of cannabis vaping for young people, along with risk factors and reasons for the same. Supplementary Information The online version contains supplementary material available at 10.1007/s40429-022-00413-y.
Collapse
|
19
|
Mallela JL, Fedele DA. Commentary: Understanding Complexities of Adolescent E- cigarette Use to Develop Intervention Strategies. J Pediatr Psychol 2021; 47:12-14. [PMID: 34718679 DOI: 10.1093/jpepsy/jsab111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jaya L Mallela
- Department of Clinical & Health Psychology, University of Florida, USA
| | - David A Fedele
- Department of Clinical & Health Psychology, University of Florida, USA
| |
Collapse
|
20
|
Short M, Cole AG. Factors Associated with E-Cigarette Escalation among High School Students: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10067. [PMID: 34639369 PMCID: PMC8507960 DOI: 10.3390/ijerph181910067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND E-cigarette use has been identified as a behaviour of concern among adolescents, and ever and daily use among this population has increased recently. The purpose of this review was to summarize the relevant studies investigating the frequency and intensity of e-cigarette use in adolescents and the factors associated with these patterns of use. METHODS A scoping search of two databases was conducted to identify longitudinal studies examining escalating e-cigarette use among adolescents. Escalating e-cigarette use could refer to an increasing frequency or intensity of use over time. Articles were screened for relevance. Studies that met inclusion criteria were included for synthesis. RESULTS Five articles were included for synthesis. All five articles were longitudinal studies taking place in the United States between 2013 and 2017. Age, gender, cost of e-cigarettes, use of cigarettes, polysubstance use, and e-liquid nicotine concentration were associated with escalation of e-cigarette use. CONCLUSIONS A paucity of information exists regarding the escalation of e-cigarette use among adolescents. Given the changing popularity of devices, additional updated evidence is needed to understand the factors associated with the escalation of e-cigarette use among adolescents, which can be used to inform local and national programs and policies.
Collapse
Affiliation(s)
- Michael Short
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON L1G 0C5, Canada;
| | | |
Collapse
|
21
|
Harrell MB, Chen B, Clendennen SL, Sumbe A, Case KR, Wilkinson AV, Loukas A, Perry CL. Longitudinal trajectories of E-cigarette use among adolescents: A 5-year, multiple cohort study of vaping with and without marijuana. Prev Med 2021; 150:106670. [PMID: 34087321 PMCID: PMC8316299 DOI: 10.1016/j.ypmed.2021.106670] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
E-cigarette use harms adolescent health, yet it continues to escalate rapidly among teens nationwide. This longitudinal study sought to identify and differentiate between developmental trajectories of past 30-day e-cigarette use with and without marijuana (i.e., liquid THC) across adolescence (11-19 years old). Three population-based cohorts of adolescents (n = 3907; N = 461,069) living in major metropolitan areas of Texas (Houston, Dallas-Ft. Worth, San Antonio, Austin) completed up to 9 Waves of an e-cigarette use survey, from 2014 to 2019. Growth curve models (GCMs) were used to identify average trajectories of past 30-day e-cigarette use, by cohort. Growth mixture models (GMMs) were used to investigate developmental patterns in these trajectories, by cohort. Sociodemographic differences in trajectories were also investigated. Stable trajectories of e-cigarette use with and without marijuana were identified, from 11 through 19 years of age. Trajectories varied by age of onset; frequency and escalation in use; and substance used. With one exception, all trajectories of e-cigarette use escalated with age. Moreover, age of onset and progression in use were positively related. The most problematic trajectories, corresponding to more frequent use, were observed among the younger cohorts compared to the oldest. Primary prevention is critical. Interventions to prevent the onset and progression in e-cigarette use among teens must begin early (e.g., in middle school) and be sustained throughout adolescence.
Collapse
Affiliation(s)
- Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Stephanie L Clendennen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Aslesha Sumbe
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Kathleen R Case
- UT Health San Antonio, Center for Research to Advance Community Health, San Antonio, TX, United States of America
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| | - Alexandra Loukas
- Health Behavior and Health Education in the Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, United States of America
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States of America
| |
Collapse
|
22
|
Lee WK, Smith CL, Gao CX, Borg BM, Nilsen K, Brown D, Makar A, McCrabb T, Thompson BR, Abramson MJ. Are e-cigarette use and vaping associated with increased respiratory symptoms and poorer lung function in a population exposed to smoke from a coal mine fire? Respirology 2021; 26:974-981. [PMID: 34227181 DOI: 10.1111/resp.14113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/03/2021] [Accepted: 06/15/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE E-cigarette use has become increasingly prevalent, but there is some evidence demonstrating potential harms with frequent use. We aimed to identify the profiles of e-cigarette users from a regional community in Australia and investigate the associations of e-cigarettes with respiratory symptoms and lung function. METHODS A total of 519 participants completed a cross-sectional study. Exposure to e-cigarettes was collected via a validated questionnaire. Respiratory symptoms were evaluated via a self-reported questionnaire and lung function measured with spirometry and forced oscillation technique (FOT). Linear and logistic regression models were fitted to investigate the associations between e-cigarettes and outcomes, while controlling for confounders such as tobacco smoking. RESULTS Of the 519 participants, 46 (9%) reported e-cigarette use. Users tended to be younger (mean ± SD 45.2 ± 14.5 vs. 55.3 ± 16.0 years in non-users), concurrently using tobacco products (63% vs. 12% in non-users), have a mental health diagnosis (67% vs. 37% in non-users) and have self-reported asthma (63% vs. 42% in non-users). After controlling for known confounders, chest tightness (OR = 2.4, 95% CI 1.2-4.9, p = 0.02) was associated with e-cigarette use. Spirometry was not different after adjustment for confounding. However, FOT showed more negative reactance and a greater area under the reactance curve in e-cigarette users than non-users. CONCLUSION E-cigarette use was associated with increased asthma symptoms and abnormal lung mechanics in our sample, supporting a potential health risk posed by these products. Vulnerable populations such as young adults and those with mental health conditions have higher usage, while there is high concurrent tobacco smoking.
Collapse
Affiliation(s)
- Wai Kit Lee
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Catherine L Smith
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline X Gao
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Centre for Youth Mental Health (Orygen), University of Melbourne, Melbourne, Victoria, Australia
| | - Brigitte M Borg
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Respiratory Medicine, The Alfred, Melbourne, Victoria, Australia
| | - Kristopher Nilsen
- Respiratory Medicine, The Alfred, Melbourne, Victoria, Australia.,School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - David Brown
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Annie Makar
- Respiratory Medicine, The Alfred, Melbourne, Victoria, Australia
| | - Thomas McCrabb
- Respiratory Medicine, The Alfred, Melbourne, Victoria, Australia.,School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Bruce R Thompson
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
23
|
Jacobs W, Idoko E, Montgomery L, Smith ML, Merianos AL. Concurrent E-cigarette and marijuana use and health-risk behaviors among U.S. high school students. Prev Med 2021; 145:106429. [PMID: 33476680 PMCID: PMC8194044 DOI: 10.1016/j.ypmed.2021.106429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/28/2022]
Abstract
The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.
Collapse
Affiliation(s)
- Wura Jacobs
- Department of Kinesiology, California State University, Stanislaus, One University Circle, Turlock, CA 95382, USA.
| | - Ehikowoicho Idoko
- Department of Health and Kinesiology, Texas A&M University, 2929 Research Parkway, College Station, TX 77843, USA.
| | - LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, P.O. Box 670559, Cincinnati, OH 45267, USA.
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, 212 Adriance Lab, College Station, TX 77843, USA; School of Public Health, Texas A&M University, 212 Adriance Lab, College Station, TX 77843, USA.
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati, OH 45221, USA.
| |
Collapse
|
24
|
Cho J, Bello MS, Christie NC, Monterosso JR, Leventhal AM. Adolescent emotional disorder symptoms and transdiagnostic vulnerabilities as predictors of young adult substance use during the COVID-19 pandemic: mediation by substance-related coping behaviors. Cogn Behav Ther 2021; 50:276-294. [PMID: 33706676 DOI: 10.1080/16506073.2021.1882552] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic's social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September-December 2016; M[SD] age = 17.45[0.38]). At follow-up (May-August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (βs = 0.04-0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (βindirect range: 0.028-0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic's social conditions warrant consideration.
Collapse
Affiliation(s)
- Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Nina C Christie
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - John R Monterosso
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|