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Vázquez AL, Navarro Flores CM, Garcia BH, Barrett TS, Domenech Rodríguez MM. An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic. PLoS One 2024; 19:e0287878. [PMID: 38354165 PMCID: PMC10866513 DOI: 10.1371/journal.pone.0287878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.
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Affiliation(s)
- Alejandro L. Vázquez
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Cynthia M. Navarro Flores
- Department of Psychology, University of Tennessee, Knoxville, Knoxville, Tennessee, United States of America
| | - Byron H. Garcia
- Department of Psychology, Arizona State University, Tempe, Arizona, United States of America
| | - Tyson S. Barrett
- Highmark Health, Pittsburg, Pennsylvania, United States of America
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Duan Z, Kasson E, Ruchelli S, Rajamahanty A, Williams R, Sridharan P, Sapra T, Dopke C, Pannell A, Nakshatri S, Berg CJ, Cavazos-Rehg PA. Assessment of Online Marketing and Sales Practices Among Recreational Cannabis Retailers in Five U.S. Cities. Cannabis Cannabinoid Res 2023. [PMID: 37699251 DOI: 10.1089/can.2022.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Background: With more states legalizing recreational cannabis, examining cannabis retail and marketing is crucial, as it may influence consumers' perceptions and behaviors. Particularly understudied is online cannabis retail. Methods: In Spring 2022, coders collected and analyzed data regarding retailer characteristics, age verification, and marketing strategies (e.g., product availability, health-related content, promotions, website imagery) among 195 cannabis retail websites in five U.S. cities (Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles, California). Descriptive analyses characterized the websites overall and across cities. Results: Overall, 80.5% verified age for website entry, and 92.8% offered online purchases (92.3% of retailers in Seattle, where prohibited). Of these, 82.9% required age verification for purchases, and 30.9% offered delivery. Almost all (>92%) offered flower/bud, concentrates, edibles, vaping devices, topicals, and tinctures. Health warnings were displayed on 38.3% of websites. Although all five states required health warnings regarding use during pregnancy, only 10.3% had these warnings. In addition, 59.0% posted some unsubstantiated health claims, most often indicating physical and mental health benefits (44.6%). Although Colorado, Washington, and Oregon prohibit health claims, 51.2-53.8% of these retailers posted them. Discounts, samples, or promotions were present on 90.8% of websites; 63.6% had subscription/membership programs. Subpopulations represented in website content included the following: 27.2% teens/young adults, 26.2% veterans, 7.2% sexual/gender minorities, and 5.6% racial/ethnic minorities. Imagery also targeted young people (e.g., 29.7% party/cool/popularity, 18.5% celebrity/influencer endorsement). Conclusions: Regulatory efforts are needed to better monitor promotional strategies and regulatory compliance (e.g., health claims, youth-oriented content, underage access) among online cannabis retailers.
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sabrina Ruchelli
- Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, Pennsylvania, USA
| | - Aishwarya Rajamahanty
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Priyanka Sridharan
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Tanvi Sapra
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Campbell Dopke
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Alexandria Pannell
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Sapna Nakshatri
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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3
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Su WC, Lee J, Zhang K, Wong SW, Buu A. Estimation of Health Risks Caused by Metals Contained in E-Cigarette Aerosol through Passive Vaping. TOXICS 2023; 11:684. [PMID: 37624189 PMCID: PMC10459233 DOI: 10.3390/toxics11080684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/29/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023]
Abstract
It is expected that secondary exposure to e-cigarette aerosol (passive vaping) will soon become an issue of public health. Passive vaping inhales e-cigarette aerosol containing similar harmful substances as active vaping. However, parallel studies on passive vaping are minimal. Therefore, there is a need for passive vaping-related health risk studies to assess the impact of vaping on public health. This research conducted a series of experiments in a room using a puffing machine and the Mobile Aerosol Lung Deposition Apparatus (MALDA) to study e-cigarette aerosol respiratory deposition through passive vaping. The experimental data acquired were applied to estimate the deposited mass and health risks caused by toxic metals contained in e-cigarette aerosol. Five popular e-cigarette products were used in this study to generate e-cigarette aerosol for deposition experiments. In addition, size-segregated e-cigarette aerosol samples were collected, and metal compositions in the e-cigarette aerosol were analyzed. Results obtained showed that estimated non-cancer risks were all acceptable, with hazard quotient and hazard index all less than 1.0. The calculated cancer risks were also found acceptable, with lifetime excess cancer risk generally less than 1E-6. Therefore, the e-cigarettes tested and the passive vaping exposure scenarios studied do not seem to induce any potential for metal-related respiratory health effects.
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Affiliation(s)
- Wei-Chung Su
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Jinho Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Su-Wei Wong
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Anne Buu
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Song A, Zhang Z, Liu Z. Psychoactive Comfort Products or Snacks: How Chinese Young Adults Perceive the Potentially Addictive Nature of E-Cigarettes. Healthcare (Basel) 2023; 11:healthcare11101440. [PMID: 37239726 DOI: 10.3390/healthcare11101440] [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: 02/22/2023] [Revised: 04/12/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
The potential health value and pitfalls of e-cigarettes are currently under dispute in the scientific community. Exploring young adult e-cigarette users' perceptions would assist in adding a public dimension of understanding to the literature and in scientific public health decision making. Therefore, in this study, we collected and analyzed data from interviews with young adult (n = 14) e-cigarette users and found that many referred to e-cigarettes as "snacks," indicating that they considered that both their frequency of use and addiction were manageable and that they could stop using e-cigarettes at any time. To further understand the behavior of Chinese young adults in relation to their perception of e-cigarettes as a "snack", the study developed a social context framework (crossroads model) and psychological judgment model to explain how youth e-cigarette users' perception of "controlled addiction and ready cessation" arises. These models can be used to assess the effectiveness of e-cigarette policy.
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Affiliation(s)
- Apei Song
- School of Law, Society, and Criminology, Faculty of Law and Justice, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Zihan Zhang
- School of Sociology and Anthropology, Xiamen University, Xiamen 610225, China
| | - Zixi Liu
- School of Sociology and Anthropology, Xiamen University, Xiamen 610225, China
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5
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Thoonen KAHJ, Jongenelis MI. Perceptions of e-cigarettes among Australian adolescents, young adults, and adults. Addict Behav 2023; 144:107741. [PMID: 37121085 DOI: 10.1016/j.addbeh.2023.107741] [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: 01/15/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
Increases in e-cigarette use are of concern to public health authorities given the harms associated with vaping. Understanding people's perceptions of the risks and benefits of e-cigarette use has the potential to assist with prevention efforts. However, research assessing the perceptions of Australian adolescents and any differences in perceptions between adolescents, young adults, and adults is limited. Additionally, research exploring perceptions of various types of e-cigarettes is lacking. To inform the development of prevention and intervention programs and policies, this study aimed to explore Australians' perceptions of the risks and benefits associated with e-cigarette use and whether perceptions differ by age and user status. A sample of 4,617 Australians aged 12 + years completed an online survey that assessed (i) smoking and e-cigarette user status, (ii) e-cigarette risk perceptions, (iii) beliefs about e-cigarettes as a smoking cessation tool, and (iv) positive e-cigarette outcome expectancies. Across all age groups, respondents perceived non-nicotine and flavoured e-cigarettes as less harmful than nicotine e-cigarettes. Significantly more adolescents and young adults than adults held positive outcome expectancies, and a substantial minority of non-users and never users in all age groups believed that using e-cigarettes confers social and mental health benefits. Given the potential benefits they perceived to be associated with e-cigarette use, a substantial proportion of adolescent and young adult never users may be vulnerable to initiation. These findings highlight the importance of (i) adequately communicating the risks associated with non-nicotine e-cigarette use and (ii) addressing misperceptions about use, especially among youth.
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Affiliation(s)
- Karlijn A H J Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia.
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Kelly BC, Pawson M, Vuolo M. Social Network Ties and Responses to COVID-19 Among E-Cigarette Users. JOURNAL OF DRUG ISSUES 2023; 53:145-158. [PMID: 36606120 PMCID: PMC9684061 DOI: 10.1177/00220426221107555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Social networks can enhance behavioral changes or entrench existing patterns of behavior. We aimed to identify how network ties to other e-cigarette users shaped responses to the pandemic and e-cigarette considerations. A national U.S. survey of 562 e-cigarette users was conducted during April 2020. Participants self-reported network ties to other e-cigarette users and pandemic outcomes: receiving expressions of concern about vaping, risk for a bad COVID outcome, changes in e-cigarette risk perceptions, and considerations of quitting. Each additional e-cigarette user tie was associated with a 0.014 unit increase in expressions of concern (p < 0.001), a 0.034 unit increase in perceived risk of a bad outcome (p < 0.05), and 3.9% higher odds of quit considerations (OR = 1.039; p < 0.01). Family ties to e-cigarette users were particularly important. Additional e-cigarette users within a network shaped risk perceptions in response to COVID-19. Network ties to other e-cigarette users have implications for cessation or reduction of e-cigarette use.
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Affiliation(s)
- Brian C. Kelly
- Department of Sociology, Purdue University, West Lafayette, IN, USA,Brian C. Kelly, Department of Sociology,
Purdue University, 700 W State St, West Lafayette, IN 47907, USA.
| | - Mark Pawson
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Mike Vuolo
- Department of Sociology, The Ohio State
University, Columbus, OH, USA
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Abadi MH, Shamblen SR, Thompson K, Lipperman-Kreda S, Grube J, Richard BO, Aramburu C. Socio-temporal contextual and community factors associated with daily exclusive ENDS use and dual use with tobacco cigarettes among adolescent vapers: an ecological momentary assessment study. BMC Public Health 2022; 22:2289. [PMID: 36474234 PMCID: PMC9728002 DOI: 10.1186/s12889-022-14787-1] [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: 05/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescents who dual use ENDS with tobacco cigarettes are more likely to have an increased risk of developing dependence. Yet, little is understood about the factors driving dual use among adolescents. The current study sought to reveal the day-to-day socio-temporal contextual and community factors associated with adolescents' use of electronic nicotine delivery systems (ENDS), and how these factors predict dual use with tobacco cigarettes. METHODS We collected ecological momentary assessments (EMA) from a sample of 50 adolescent past two-week vapers (ages 14-17 years old) over 14 days. Daily EMA data were collected on ENDS and tobacco cigarette use, as well as a range of contextual (i.e., motivations to vape, location of vaping, who with when vaping) and community factors (i.e., exposure to peers vaping, to adults vaping, to ENDS advertising, to ENDS warning messages). Our primary analyses were multilevel regressions, accounting for daily observations nested within individuals (N = 700 observations). RESULTS Participants used ENDS exclusively on 44% of days and dual used ENDS and tobacco cigarettes on 8% of the days. Dual use days (versus exclusive ENDS use days) were associated with "vaping because tobacco use was prohibited" (OR = 34.65, p < .05). Also, dual use days (versus no use days) were associated with greater exposure to adults vaping (OR = 5.59, p < .05), peers vaping (OR = 7.48, p < .05), and (c) ENDS advertisements or promotions (OR = 2.12, p < .01), whereas exclusive use days (versus no use days) were only associated with greater exposure to peers vaping (OR = 2.58, p < .01). CONCLUSIONS Results showed that exposure to peers and adults vaping and exposure to ENDS marketing were associated with same day dual use behaviors. And, that adolescents who dual used were motivated to use ENDS because they were easy to conceal. Findings support stricter regulation of ENDS marketing and for smoke-free air laws that include ENDS. In addition, these findings support prioritizing family- and school-based prevention programming that effectively communicates risk associated with ENDS use, including heightened risk of dual use and dependence. Such efforts can reduce the number of adolescents who use ENDS as well as the number who transition to tobacco cigarette use.
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Affiliation(s)
- Melissa H. Abadi
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Stephen R. Shamblen
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Kirsten Thompson
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Sharon Lipperman-Kreda
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA
| | - Joel Grube
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA ,grid.47840.3f0000 0001 2181 7878School of Public Health, University of California, Berkeley, USA
| | - Bonnie O. Richard
- grid.280247.b0000 0000 9994 4271Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, Louisville, KY 40202 USA
| | - Camila Aramburu
- grid.47840.3f0000 0001 2181 7878Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, Berkeley, CA 94704-2642 USA
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Adzrago D, Sulley S, Mamudu L, Ormiston CK, Williams F. The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms. Behav Sci (Basel) 2022; 12:453. [PMID: 36421749 PMCID: PMC9687156 DOI: 10.3390/bs12110453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although several studies examined the association between e-cigarettes, substance use, and mental health conditions, there is limited research on whether COVID-19-related stress and health outcomes, mental health symptoms, and substance use differ by the frequency of e-cigarette use during the COVID-19 pandemic. We assessed the association of past 30-day frequent use of e-cigarettes with alcohol, cannabis, anxiety/depression, and COVID-19 impact. METHODS We conducted a national online cross-sectional survey among a random sample of US adults aged 18 years or older (N = 5065) between 13 May 2021, and 9 January 2022. A multinomial logistic regression analysis was performed to assess the study aims. RESULTS Of the participants, 7.17% reported once to several times per month (OSTPM), 6.95% reported once to several times per week (OSTPW), and 6.57% reported every day to several times per day (ESTPD) use of e-cigarettes in the past month. Alcohol and cannabis use ESTPD and once to several times per week/month (OSTPW/M) were associated with a higher likelihood of e-cigarette use ESTPD and OSTPW/M, respectively. Anxiety/depression was associated with e-cigarette use ESTPD and OSTPW. Individuals who considered social distancing to be stressful were more likely to use e-cigarettes ESTPD and OSTPW/M compared to those that considered social distancing as not stressful. CONCLUSION Individuals who engaged in the frequent use of alcohol or cannabis, had depression/anxiety, and considered social distancing to be stressful were more likely to engage in frequent e-cigarette use. Improving efforts geared toward reducing the use of substances may help decrease the health risks associated with e-cigarette use.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Saanie Sulley
- National Healthy Start Association, 1325 G Street, Washington, DC 20005, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, 800 N. State College Boulevard, Fullerton, CA 92831, USA
| | - Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
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Giovacchini CX, Crotty Alexander LE, Que LG. Electronic Cigarettes: A Pro-Con Review of the Current Literature. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2843-2851. [PMID: 35872217 DOI: 10.1016/j.jaip.2022.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 05/11/2023]
Abstract
Electronic cigarettes (e-cigarettes, e-cigs, or electronic nicotine delivery systems) are battery-operated devices typically containing glycerol and/or propylene glycol-based solutions with varying nicotine content, known as e-liquids. Although e-cigarettes were originally developed as a potentially less harmful alternative to traditional combustible tobacco cigarette smokers, several factors have driven their popularity among smokers and nonsmokers alike, including their sleek product designs, innumerable appealing flavors, lack of combustible smoke and odor, and high potential nicotine concentrations. Furthermore, many advocates have promoted the idea that e-cigarettes are safe to use, or at least safer than conventional tobacco, despite limited longitudinal data to support these claims. Here, we examine what is known about the impacts of e-cigarette use on traditional cigarette smoking cessation, lung health, and youth and young adult tobacco product exposure. Upon review of the currently available literature, the negative effects of e-cigarette use seem to outweigh any potential benefit, because the available evidence does not confirm the use of e-cigarettes as an effective strategy for supporting traditional combustible tobacco cigarette smoking cessation, particularly given the emerging adverse effects on lung health and the potential future public health effects of e-cigarette adoption among a burgeoning new generation of tobacco product users.
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Affiliation(s)
- Coral X Giovacchini
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC
| | - Laura E Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, San Diego, Calif; Division of Pulmonary, Critical Care, Sleep, and Physiology, University of California San Diego, San Diego, Calif.
| | - Loretta G Que
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC.
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10
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Gaddy MY, Vasquez D, Brown LD. Predictors of e-cigarette initiation and use among middle school youth in a low-income predominantly Hispanic community. Front Public Health 2022; 10:883362. [PMID: 36238238 PMCID: PMC9551350 DOI: 10.3389/fpubh.2022.883362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction E-cigarette use among middle and high school youth increased from 2. 5 million in 2014 to 9.2 million in 2019, becoming the most common tobacco product used among youth. Hispanic youth, the largest ethnic minority in the United States, have higher rates of tobacco use, including e-cigarettes, than non-Hispanics. Identifying factors that put youth at risk for future e-cigarette use is vital to focusing prevention efforts. Informed by social cognitive theory, this study identifies predictors of e-cigarette uptake among e-cigarette naïve youth in a predominantly low-income Hispanic community. Methods 1,249 students (6-8th grades) from two middle schools in El Paso, Texas consented to participate in this longitudinal survey during the 2016-2017 school year. The study sample for analysis was restricted to e-cigarette naïve students (n = 862). Outcome measures were e-cigarette initiation and current use at follow-up. Logistic regression models tested six hypotheses about predictors of e-cigarette initiation and current use: (1) intention, (2) outcome expectations, (3) knowledge, (4) friendship network exposure, (5) normative beliefs, and (6) social acceptability. Results Among e-cigarette naïve students at baseline, 8% (n = 71) reported initiation at follow-up; of these, 3% (n = 23) reported current use. Significant predictors of initiation were intention (AOR = 2.46; 95% CI 1.69-3.59; p < 0.001), outcome expectations (AOR = 1.73; 95% CI 1.14-2.61; p = 0.009), friendship network exposure (AOR = 1.53; 95% CI 1.11-2.11; p =0.01), normative beliefs (AOR = 2.12; 95% CI 1.47-3.08; p < 0.001), and social acceptability (AOR = 1.91; 95% CI 1.28-2.85; p = 0.002). Significant predictors of current use were intention (AOR = 1.98; 95% CI 1.07-3.69; p = 0.03) and friendship network exposure (AOR = 1.69; 95% CI 1.06-2.70; p = 0.03). Conclusions With the increasing popularity of e-cigarettes, age appropriate and culturally sensitive prevention strategies tailored at altering these predictive factors are essential in preventing future e-cigarette use.
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Affiliation(s)
- M. Yvonne Gaddy
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, El Paso, TX, United States
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11
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Nicksic NE, Bono RS, Rudy AK, Cobb CO, Barnes AJ. Smoking status and racial/ethnic disparities in youth exposure to tobacco advertising. J Ethn Subst Abuse 2022; 21:959-974. [PMID: 32915098 PMCID: PMC9299970 DOI: 10.1080/15332640.2020.1815113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tobacco advertising exposure increases tobacco use among youth. Data were from a largely racial and ethnic minority sample (60% non-Hispanic (NH) Black/African American) of youth (13-18 years) who were nonsmokers susceptible to future tobacco use (n = 686) or current cigarette smokers (n = 674). Regression models tested associations between tobacco advertisement exposure and smoking status, and determined demographic correlates. Nearly all youth recalled seeing a tobacco advertisement (98%), which was associated with smoking (OR = 1.12; 95% CI = 1.08-1.15). Racial minority youth had higher exposure to tobacco advertising. Policies restricting advertisements for all tobacco products are essential for prevention efforts and may help decrease tobacco-related health disparities.
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Affiliation(s)
- Nicole E Nicksic
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA
| | - Rose S Bono
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA
| | - Alyssa K Rudy
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St, Richmond, VA 23284, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin St, Richmond, VA 23284, USA
| | - Andrew J Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA
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12
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Fitzpatrick CL, Kim HS, Sears CR, McGrath DS. Attentional Bias in Non-Smoking Electronic Cigarette Users: An Eye-Tracking Study. Nicotine Tob Res 2022; 24:1439-1447. [PMID: 35443034 DOI: 10.1093/ntr/ntac112] [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: 08/08/2021] [Revised: 02/09/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examined attentional bias (AB) to e-cigarette cues among a sample of non-smoking daily e-cigarette users (n = 27), non-smoking occasional e-cigarette users (n = 32), and control participants (n = 61) who did not smoke or use e-cigarettes. The possibility that e-cigarette users develop a transference of cues to traditional cigarettes was also examined. METHODS AB was assessed using a free-viewing eye-gaze tracking methodology, in which participants viewed 180 pairs of images for 4 seconds (e-cigarette and neutral image, e-cigarette and smoking image, smoking and neutral image). RESULTS Daily and occasional e-cigarette users attended to pairs of e-cigarette and neutral images equally, whereas non-users attended to neutral images significantly more than e-cigarette images. All three groups attended to e-cigarette images significantly more than smoking images, with significantly larger biases for e-cigarette users. There were no between-group differences in attention to pairs of smoking and neutral images. A moderation analysis indicated that for occasional users but not daily users, years of vaping reduced the bias toward neutral images over smoking images. CONCLUSIONS Taken together, the results indicate that e-cigarette users exhibit heighted attention to e-cigarettes relative to non-users, which may have implications as to how they react to e-cigarette cues in real-world settings. AB for e-cigarettes did not transfer to traditional cigarette cues, which indicates that further research is required to identify the mechanisms involved in the migration of e-cigarettes to traditional cigarettes. IMPLICATIONS This study is the first attempt to examine attentional biases for e-cigarette cues among non-smoking current e-cigarette users using eye-gaze tracking. The results contribute to the growing literature on the correlates of problematic e-cigarette use and indicate that daily and occasional e-cigarette use is associated with attentional biases for e-cigarettes. The existence of attentional biases in e-cigarette users may help to explain the high rate of failure to quit e-cigarettes and provides support for the utility of attentional bias modification in the treatment of problematic e-cigarette use.
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Affiliation(s)
| | - Hyoun S Kim
- Ryerson University, Toronto, Ontario, Canada
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13
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Dai L, He Y, Tan Y, Yu Z, Zhu J. Online E-Cigarette Information Exposure and Its Association with E-Cigarette Use among Adolescents in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063329. [PMID: 35329027 PMCID: PMC8949377 DOI: 10.3390/ijerph19063329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Abstract
E-cigarettes are widely advertised, while the potential risks of e-cigarette use have been reported among adolescents. This study assessed online e-cigarette information exposure and its association with adolescents’ e-cigarette use in Shanghai, China. A total of 12,470 students aged 13–18 years participated. A questionnaire collected information on students’ sociodemographic factors, e-cigarette information exposure, cigarette use, e-cigarette use, and e-cigarette use intention. A multivariate logistic regression was performed to assess correlates of exposure to e-cigarette information and the association between e-cigarette information exposure and e-cigarette use. Overall, 73.9% of students knew about e-cigarettes and the primary sources of information were the internet (42.4%), movies/TV (36.4%), bulletin boards in retail stores or supermarkets (34.9%), advertising flyers (33.9%), and friends (13.8%). Students who had friends using e-cigarettes were curious about e-cigarettes and showed a greater monthly allowance; smokers and females were at a higher risk of social media and website exposure. Moreover, online information exposure (social media exposure, website exposure, and total internet exposure) was significantly associated with the intention to use e-cigarettes. The enforcement of regulations on online e-cigarette content should be implemented. Moreover, efforts to prevent young people from using e-cigarettes may benefit from targeting students at a higher risk of online e-cigarette information exposure.
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Affiliation(s)
- Luojia Dai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (L.D.); (Y.H.); (Y.T.)
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (L.D.); (Y.H.); (Y.T.)
| | - Yinliang Tan
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (L.D.); (Y.H.); (Y.T.)
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL 32224-2649, USA;
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (L.D.); (Y.H.); (Y.T.)
- Correspondence: ; Tel.: +86-2163846590
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14
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Wall N, Rocklein Kemplin K. Methods and Statistical Analyses in Studies of Motivation for E-Cigarette Use Among University Students: An Integrative Review. Subst Use Misuse 2022; 57:67-75. [PMID: 34678110 DOI: 10.1080/10826084.2021.1990332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Understanding the motivations for e-cigarette use among college and university students is essential for developing and implementing effective interventions. Evaluating existing literature is necessary to identify methodological gaps and limitations and improve the quality of future research. We aimed to evaluate the quality of the methods and statistical analyses and integrate evidence addressing motivations for e-cigarette use among college and university students. An integrative literature review was conducted by two researchers to identify and evaluate peer-reviewed, quantitative, and mixed methods research exploring motivations for e-cigarette use among college and university students. A systematic analytic method of data reduction was used to identify alignment and divergence of the data, gaps in the literature, and methodological limitations. Fifteen quantitative studies and three mixed methods studies published between 2015-2020 were included. Most studies were cross-sectional, used convenience sampling, and lacked psychometric and assumptions testing. Half performed regression analyses, however, very few adhered to research and statistical reporting standards. Current literature provides a foundation for developing and implementing interventions aimed to prevent e-cigarette use and encourage cessation. Future research should incorporate stronger sampling methods and research designs, as well as the use of rigorous statistical analyses in conjunction with thorough reporting. Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1990332.
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Affiliation(s)
- Nicole Wall
- Department of Nursing, University of Windsor, Windsor, Ontario, Canada
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15
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Lu J, Lee EWJ. Examining Twitter Discourse on Electronic Cigarette and Tobacco Consumption During National Cancer Prevention Month in 2018: Topic Modeling and Geospatial Analysis. J Med Internet Res 2021; 23:e28042. [PMID: 34964716 PMCID: PMC8756341 DOI: 10.2196/28042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/08/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between electronic cigarettes (e-cigarettes) and lung cancer. In addition, it is unclear how members of the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer. Objective In this study, we aimed to analyze e-cigarette and smoking tweets in the context of lung cancer during National Cancer Prevention Month in 2018 and examine how e-cigarette and traditional tobacco product discussions relate to implementation of tobacco control policies across different states in the United States. Methods We mined tweets that contained the term “lung cancer” on Twitter from February to March 2018. The data set contained 13,946 publicly available tweets that occurred during National Cancer Prevention Month (February 2018), and 10,153 tweets that occurred during March 2018. E-cigarette–related and smoking-related tweets were retrieved, using topic modeling and geospatial analysis. Results Debates on harmfulness (454/915, 49.7%), personal experiences (316/915, 34.5%), and e-cigarette risks (145/915, 15.8%) were the major themes of e-cigarette tweets related to lung cancer. Policy discussions (2251/3870, 58.1%), smoking risks (843/3870, 21.8%), and personal experiences (776/3870, 20.1%) were the major themes of smoking tweets related to lung cancer. Geospatial analysis showed that discussion on e-cigarette risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. In particular, the number of indoor and on campus smoke-free policies was related to the number of tweets on e-cigarette risks (smoke-free indoor, r49=0.33, P=.02; smoke-free campus, r49=0.32, P=.02). The total number of e-cigarette policies was also positively related to the number of tweets on e-cigarette risks (r49=0.32, P=.02). In contrast, the number of smoking policies was not significantly associated with any of the smoking themes in the lung cancer discourse (P>.13). Conclusions Though people recognized the importance of traditional tobacco control policies in reducing lung cancer incidences, their views on e-cigarette risks were divided, and discussions on the importance of e-cigarette policy control were missing from public discourse. Findings suggest the need for health organizations to continuously engage the public in discussions on the potential health risks of e-cigarettes and raise awareness of the insidious lobbying efforts from the tobacco industry.
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Affiliation(s)
- Jiahui Lu
- School of New Media and Communication, Tianjin University, Tianjin, China
| | - Edmund W J Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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16
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Irvine DS, McGarity-Shipley E, Lee EY, Janssen I, Leatherdale ST. Longitudinal associations between e-cigarette use, cigarette smoking, physical activity and recreational screen time in Canadian adolescents. Nicotine Tob Res 2021; 24:978-985. [PMID: 34850182 DOI: 10.1093/ntr/ntab248] [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: 05/19/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study examined longitudinal associations between e-cigarette use, cigarette smoking, physical activity, and recreational screen time (ST) in a cohort of Canadian adolescents (ages 14-17 years; grades 9-12). METHODS Data from 5,951 adolescents who participated in COMPASS Year 4 (2015-16; baseline) and Year 6 (2017-18; follow-up) were used. Exposures included e-cigarette use and cigarette smoking. Outcomes included cut-points for moderate- to vigorous- physical activity (MVPA; ≥ 60 min/d), muscular strengthening exercises (MSE; ≥ 3 time/wk), participation in sport (SP; intramural or competitive), and recreational screen time (ST; ≤ 430 min/day). Generalized linear mixed models were performed. RESULTS E-cigarette use (16.6% vs 39.2%), cigarette smoking (0.9% vs 4.7%) and dual use (0.8% vs 4.1%) increased from baseline to follow-up. SP (70.8% vs 61.3%) and the prevalence of meeting MVPA (49.8% vs 42.1%) and MSE cut-points (54.0% vs 45.3%) decreased from baseline to follow-up. Recreational ST remained similar from baseline to follow-up. New e-cigarette use at follow-up was associated with maintenance of SP and meeting MVPA and MSE cut-points, but also with increased ST. New cigarette smoking at follow-up was associated with maintaining high ST and low SP. Cigarette smoking at baseline and follow-up was associated with maintaining high ST, low MSE, and low SP. Cigarette smoking cessation at follow-up was associated with increasing MVPA and MSE, decreasing ST, and maintaining low SP. CONCLUSION Given the clustering and co-occurring unhealthy behavioral patterns, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously. IMPLICATIONS This investigation highlighted that, unhealthy behaviors, particularly e-cigarette use, cigarette smoking, and excessive use of screens, tend to co-occur among Canadian adolescents. Therefore, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously particularly in school and community settings. As an exception, new and stable e-cigarette use appears to co-occur with achieving sufficient levels of physical activity. Increasing awareness about the risk of e-cigarette use may target population groups that are physically and socially active (e.g., athletes, sport teams).
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Affiliation(s)
- Dylan S Irvine
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, United States of America
| | | | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Gender Studies, Queen's University, Kingston, ON, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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17
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Adermark L, Galanti MR, Ryk C, Gilljam H, Hedman L. Prospective association between use of electronic cigarettes and use of conventional cigarettes: a systematic review and meta-analysis. ERJ Open Res 2021; 7:00976-2020. [PMID: 34262971 PMCID: PMC8273394 DOI: 10.1183/23120541.00976-2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/05/2021] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking. Data sources A systematic literature search was finalised on 11 November 2019 using PubMed (including MEDLINE), EMBASE, Cochrane Library, Scopus, PubMed Health, NICE Evidence Search, PROSPERO, CRD and PsycInfo. Study selection Studies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and nonusers of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE. Data synthesis 30 longitudinal studies from 22 different cohorts assessing e-cigarette use among nonsmokers or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline nonsmoker e-cigarette users compared with nonusers of 4.68 (CI 3.64–6.02), while the adjusted OR was 3.37 (CI 2.68–4.24). These results were consistent irrespective of whether the outcome was measured as ever-smoking or as past 30-day smoking. The evidence was graded as moderate. Conclusions Use of e-cigarettes may predict the initiation or recurrence of cigarette smoking. This meta-analysis shows that e-cigarette use increases the risk of future initiation or recurrence of cigarette smoking, even after adjusting for potential confounders, suggesting that e-cigarette use could be considered a predictor of subsequent smokinghttps://bit.ly/3buMccm
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Affiliation(s)
- Louise Adermark
- Dept of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Dept of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Rosaria Galanti
- Dept of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre of Epidemiology and Community Medicine, Stockholm, Sweden
| | - Charlotta Ryk
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Hans Gilljam
- Dept of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Hedman
- Dept of Public Health and Clinical Medicine, Division Sustainable health, The OLIN Unit, Umeå University, Umeå, Sweden.,Dept of Health Sciences, Division of Nursing, Luleå University of Technology, Luleå, Sweden
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18
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Hughes J, Sykes G, Hughes K, O'Reilly M, Goodwin J, Sutton C, Karim K. From gateways to multilinear connections: A qualitative longitudinal investigation of the relationships between vaping and smoking among adolescent users. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 97:103341. [PMID: 34229192 DOI: 10.1016/j.drugpo.2021.103341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/03/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The international growth of e-cigarette use has been accompanied by a corresponding concern that e-cigarettes will act as a 'gateway' to smoking and the use of other drugs. Taking these concerns as our point of departure, we explore the relationships between vaping and smoking among a cohort of young people. METHODS Qualitative longitudinal methods with a diverse sample of 36 14-18-year olds from the UK city of Leicester. A total of 66 depth interviews conducted across two phases separated by 6-12 months. The interviews were recorded, transcribed verbatim and thematically analysed. FINDINGS We highlight a complex 'tangle' of connections between substances/risk behaviours recounted to us by our adolescent study participants, including multiple and multilinear relationships between vaping and smoking. These findings problematise some of the core axioms of the notion of gateways as an explanatory model of causality and sequential connection between smoking and vaping. They also throw into question gateway logics more fundamentally. While many of our study participants themselves consciously invoked ideas of 'gateway effects', the accounts they produced repeatedly disrupted the logics of connection (between e-cigarettes and smoking; one set of behaviours and another) presupposed in gateway theory and our own early lines of questioning. Accordingly, we explore how cultural understandings of gateway effects are invoked by users in accounting for their vaping and smoking behaviours, noting the potential influence of these ideas upon the very processes they are understood to apprehend. CONCLUSION Our findings suggest there is a case to be made to reinforce the distinctiveness of tobacco and e-cigarettes in the life-worlds of young people to avoid naturalising a 'gateway' logic of connection that might ultimately inform the associative logic of young users themselves, and potentially the development of their usage careers.
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Affiliation(s)
- Jason Hughes
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7RH, UK.
| | - Grace Sykes
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7RH, UK
| | - Kahryn Hughes
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
| | - Michelle O'Reilly
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7RH, UK
| | - John Goodwin
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7RH, UK
| | - Charlie Sutton
- Social and Policy Studies, Loughborough University, Loughborough, LE11 3TU, UK
| | - Khalid Karim
- College of Life Sciences, University of Leicester, Leicester, LE1 7RH, UK
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19
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Vogel EA, Ramo DE, Rubinstein ML, Delucchi KL, Darrow SM, Costello C, Prochaska JJ. Effects of Social Media on Adolescents' Willingness and Intention to Use E-Cigarettes: An Experimental Investigation. Nicotine Tob Res 2021; 23:694-701. [PMID: 31912147 DOI: 10.1093/ntr/ntaa003] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/06/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This study examined the effects of experimentally manipulated social media exposure on adolescents' willingness and intention to use e-cigarettes. AIMS AND METHODS Participants were 135 adolescents of age 13-18 (52.6% female, mean age = 15.3) in California. Participants viewed six social media posts online in a 2 (post source: peer or advertisement) × 2 (e-cigarette content exposure: heavy or light) between-subjects design. Analyses were weighted to population benchmarks. We examined adolescents' beliefs, willingness, and intention to use e-cigarettes in association with social media use intensity in daily life and with experimentally manipulated exposure to social media posts that varied by source (peer or advertisement) and content (e-cigarette heavy or light). RESULTS Greater social media use in daily life was associated with greater willingness and intention to use e-cigarettes and more positive attitudes, greater perceived norms, and lower perceived danger of e-cigarette use (all p-values <.01). In tests of the experimental exposures, heavy (vs. light) e-cigarette content resulted in greater intention (p = .049) to use e-cigarettes and more positive attitudes (p = .019). Viewing advertisements (vs. peer-generated posts) resulted in greater willingness and intention (p-values <.01) to use e-cigarettes, more positive attitudes (p = .003), and greater norm perceptions (p = .009). The interaction effect of post source by post content was not significant for any of the outcomes (all p-values >.529). CONCLUSIONS Greater social media use and heavier exposure to advertisements and e-cigarette content in social media posts are associated with a greater risk for e-cigarette use among adolescents. Regulatory action is needed to prohibit sponsored e-cigarette content on social media platforms used by youth. IMPLICATIONS Adolescents who use social media intensely may be at higher risk for e-cigarette use. Even brief exposure to e-cigarette content on social media was associated with greater intention to use and more positive attitudes toward e-cigarettes. Regulatory action should be taken to prohibit sponsored e-cigarette content on social media used by young people, including posts by influencers who appeal to young people.
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Affiliation(s)
- Erin A Vogel
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA.,Hopelab, San Francisco, CA
| | - Mark L Rubinstein
- Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, CA
| | - Kevin L Delucchi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Sabrina M Darrow
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Caitlin Costello
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
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20
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Sharma A, McCausland K, Jancey J. Adolescent's Health Perceptions of E-Cigarettes: A Systematic Review. Am J Prev Med 2021; 60:716-725. [PMID: 33775514 DOI: 10.1016/j.amepre.2020.12.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
CONTEXT E-cigarette use is increasing among adolescents, particularly in high-income countries. This review examines the health perceptions of E-cigarettes among adolescents (aged 12-17 years) residing in the U.S., United Kingdom, Canada, Australia, and New Zealand and their sources of E-cigarette information. EVIDENCE ACQUISITION Peer-reviewed literature published in January 2009-April 2019 in MEDLINE, Embase, and ProQuest were systematically reviewed using identified keywords. The search identified 654 references. Studies (n=99) that met the inclusion criteria were subjected to full-text screening. A total of 27 articles were subjected to quality appraisal using the Joanna Briggs Institute's critical appraisal checklists. EVIDENCE SYNTHESIS A total of 7 qualitative and 18 quantitative studies were included in the review, and the study characteristics, results, and limitations were extracted. A total of 4 main themes emerged from the study findings: (1) perceived relative harm of E-cigarettes versus that of cigarettes, (2) perceived health effects of E-cigarettes, (3) perceived benefits and safety of E-cigarettes, and (4) sources of E-cigarette information and exposure. Most adolescents perceived E-cigarettes to be less harmful than cigarettes; however, often, their health perceptions of E-cigarettes were conflicting. Sources of exposure to E-cigarette information included friends, family, retail point of sale, TV and online advertising, national agencies, healthcare providers, and from direct experience. CONCLUSIONS Findings indicate that adolescents, particularly E-cigarette users, have more favorable perceptions of E-cigarettes than of cigarettes; however, these perceptions are conflicting. Advertising, marketing, and peer and family networks appear to influence adolescents' perceptions. More research is required, particularly in Australia and New Zealand, to better understand adolescents' health perceptions of E-cigarettes and where they source information from so that misperceptions can be addressed through appropriate channels with suitable messaging.
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Affiliation(s)
- Anupriya Sharma
- School of Population Health, Curtin University, Bentley, Australia.
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, Australia
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21
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Xie Z, Rahman I, Goniewicz ML, Li D. Perspectives on Epigenetics Alterations Associated with Smoking and Vaping. FUNCTION (OXFORD, ENGLAND) 2021; 2:zqab022. [PMID: 35330676 PMCID: PMC8788872 DOI: 10.1093/function/zqab022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/03/2021] [Accepted: 04/21/2021] [Indexed: 01/11/2023]
Abstract
Epigenetic alterations, including DNA methylation, microRNA, and long noncoding RNA, play important roles in the pathogenesis of numerous respiratory health conditions and diseases. Exposure to tobacco smoking has been found to be associated with epigenetic changes in the respiratory tract. Marketed as a less harmful alternative to combustible cigarettes, electronic cigarette (e-cigarette) has rapidly gained popularity in recent years, especially among youth and young adults. Accumulative evidence from both animal and human studies has shown that e-cigarette use (vaping) is also linked to similar respiratory health conditions as observed with cigarette smoking, including wheezing, asthma, and COPD. This review aims to provide an overview of current studies on associations of smoking and vaping with epigenetic alterations in respiratory cells and provide future research directions in epigenetic studies related to vaping.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, USA
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, USA,Address correspondence to D.L. (e-mail: )
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22
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García BH, Vázquez AL, Moses JO, Cromer KD, Morrow AS, Villodas MT. Risk for substance use among adolescents at-risk for childhood victimization: The moderating role of ADHD. CHILD ABUSE & NEGLECT 2021; 114:104977. [PMID: 33578244 DOI: 10.1016/j.chiabu.2021.104977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/08/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Youth who are victimized by violence are at heightened risk for substance use (SU) during adolescence, a period characterized by elevated impulsivity and risk-taking behavior. This risk may be magnified by attention-deficit/hyperactivity disorder (ADHD). OBJECTIVE To examine risk/protective factors for adolescent SU among adolescents at-risk for victimization and whether ADHD moderates these associations. PARTICIPANTS AND SETTING Participants were 1058 caregiver-adolescent dyads in the U.S. who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHOD Binary logistic regression analyses were conducted for each SU type. First-order effects of all variables were tested first and for each SU outcome, followed by tests of two-way interactions between ADHD group and each predictor, after controlling for first-order effects. RESULTS More externalizing behavior (odds ratio [OR] = 1.38; 95 % confidence interval [CI]:1.12, 1.71) and less parental knowledge (OR = .75; 95 %CI: .60, .95) were associated with greater risk for subsequent tobacco use. Less positive peer affiliation was associated with greater risk for subsequent illicit SU (OR = .59; 95 %CI: .36, .96). More deviant peer affiliation were associated with greater risk for all forms of SU. ADHD moderated the association between deviant peer affiliation and marijuana use [b = .9, p < .05, 95 %CI: .03, 1.77), such that deviant peer affiliation was a significantly stronger predictor of marijuana use among adolescents with ADHD than those without. CONCLUSIONS Findings suggest risk and protective factors for SU are largely consistent for adolescents at-risk for victimization with and without ADHD, but at-risk adolescents with ADHD may be more susceptible to deviant peer influences.
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Affiliation(s)
- Byron H García
- Utah State University, 2810 Old Main Hill, Logan, UT, 84322-2810, United States.
| | - Alejandro L Vázquez
- Utah State University, 2810 Old Main Hill, Logan, UT, 84322-2810, United States
| | - Jacqueline O Moses
- Florida International University, 11200 S.W. 8th Street, DM 256, Miami, FL, 33199, United States
| | - Kelly D Cromer
- Florida International University, 11200 S.W. 8th Street, DM 256, Miami, FL, 33199, United States
| | - Anne S Morrow
- Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL, 33314, United States
| | - Miguel T Villodas
- San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, United States; Child and Adolescent Services Research Center, 3665 Kearny Villa Road, Suite 200N, San Diego, CA, 92123, United States
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D'Angelo H, Patel M, Rose SW. Convenience Store Access and E-cigarette Advertising Exposure Is Associated With Future E-cigarette Initiation Among Tobacco-Naïve Youth in the PATH Study (2013-2016). J Adolesc Health 2021; 68:794-800. [PMID: 33039271 PMCID: PMC8317228 DOI: 10.1016/j.jadohealth.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/04/2020] [Accepted: 08/28/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE The association between e-cigarette marketing exposure and youth e-cigarette initiation is not well understood. This study examines whether convenience store access, exposure to retail e-cigarette marketing, and having a favorite e-cigarette ad before e-cigarette use is associated with susceptibility to use and future e-cigarette initiation in a national longitudinal study of youth. METHODS A nationally representative longitudinal cohort of youth in the Population Assessment of Tobacco and Health study (12-17 years) was followed up over three waves of annual data collection (2013-2016). Tobacco-naïve (wave 1) and e-cigarette-naïve (wave 2) youth (n = 6,470) were included. Marketing exposure at wave 2 was examined in association with e-cigarette susceptibility (wave 2) and e-cigarette initiation (wave 3) using adjusted logistic regression models. Analysis occurred in 2019. RESULTS Youth visiting convenience stores at least weekly (vs. never) had 1.51 times the odds of e-cigarette susceptibility (95% confidence interval [CI]: 1.25, 1.81) and 1.79 times the odds of e-cigarette initiation (95% CI: 1.29, 2.48). Noticing a retail e-cigarette ad (vs. not noticing) was associated with e-cigarette susceptibility (adjusted odds ratio [AOR] 1.36, 95% CI: 1.18, 1.57), but not initiation. Youth reporting a favorite branded e-cigarette ad had greater odds of both susceptibility (AOR 1.31, 95% CI, 1.10, 1.56) and e-cigarette initiation (AOR 1.60, 95% CI: 1.18, 2.17) compared to youth without a favorite ad. CONCLUSIONS Tobacco-naïve youth with frequent convenience store access and exposure to e-cigarette marketing were at greater risk of e-cigarette susceptibility and progression to e-cigarette initiation over a 2-year period. Policies to restrict retailer locations and e-cigarette marketing could enhance youth e-cigarette use prevention efforts.
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Affiliation(s)
- Heather D'Angelo
- School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin. heather.d'
| | - Minal Patel
- Truth Initiative Schroeder Institute, Washington, District of Columbia
| | - Shyanika W Rose
- College of Medicine, Department of Behavioral Science, and Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, Lexington, Kentucky
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24
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Su WC, Wong SW, Buu A. Deposition of E-cigarette aerosol in human airways through passive vaping. INDOOR AIR 2021; 31:348-356. [PMID: 33020934 PMCID: PMC7904647 DOI: 10.1111/ina.12754] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 05/06/2023]
Abstract
Secondary exposure to e-cigarette aerosol (passive vaping) will soon become a pressing public health issue in the world. Yet, the current knowledge about respiratory depositions of e-cigarette aerosol through passive vaping in human airways is limited due to critical weaknesses of traditional experimental methods. To fill in this important knowledge gap, this study proposed a special approach involving an upgraded Mobile Aerosol Lung Deposition Apparatus (MALDA) that consists of a set of human airway replicas including a head airway, tracheobronchial airways down to the 11th lung generation, and a representative alveolar section. In addition to the comprehensive coverage of human airways, the MALDA is easily transportable for providing efficient estimations of aerosol respiratory deposition. In this study, the MALDA was first evaluated in the laboratory and then applied to estimate the respiratory deposition associated with passive vaping in an indoor real-life setting. The results showed that the respiratory deposition data aligned closely with the conventional respiratory deposition curves not only in the head-to-TB region but also in the alveolar region. The strengths of MALDA demonstrate great promise for a wide variety of applications in real-life settings that could provide crucial information for future public health and indoor air quality studies.
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Affiliation(s)
- Wei-Chung Su
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Su-Wei Wong
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Anne Buu
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
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25
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Young-Wolff KC, Adams SR, Sterling SA, Tan ASL, Salloum RG, Torre K, Carter-Harris L, Prochaska JJ. Nicotine and cannabis vaping among adolescents in treatment for substance use disorders. J Subst Abuse Treat 2021; 125:108304. [PMID: 34016296 DOI: 10.1016/j.jsat.2021.108304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/07/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022]
Abstract
This study examined nicotine and cannabis vaping among adolescents in treatment for substance use disorders. Participants were 363 adolescents aged 12-17 (66% male, mean age = 15.5 [SD = 1.3], 46% non-Hispanic white) seen for a specialty addiction intake evaluation between 2017 and 2019 at one of six medical offices of a large, integrated health care system in Northern California. Multivariable logistic regression models tested for associations of sociodemographics, cigarette smoking, and substance use disorders with vaping behaviors. A majority of adolescents reported ever (68%) or current vaping (60%) of nicotine and/or cannabis; current vaping was similar for nicotine (50%) and cannabis (51%); 40% reported current vaping of both. Current smokers (6% of the sample) had higher odds of ever vaping (aOR = 3.95, 95%CI: 1.04-14.95). Black (versus non-Hispanic white) adolescents had lower odds of current nicotine vaping (aOR = 0.08, 95%CI: 0.02-0.37) and current vaping of both nicotine and cannabis (aOR = 0.12, 95%CI: 0.03-0.60). Having an alcohol use disorder was associated with current vaping (aOR = 2.14, 95%CI: 1.06-4.33). Those who endorsed that most friends get drunk/high (aOR = 1.87, 95%CI: 1.02-3.42) or that cannabis was their substance of choice (aOR = 2.36, 95%CI: 1.16-4.81) had higher odds of current cannabis vaping. Higher neighborhood household income ($80,000-$120,000 and >$120,000 vs. <$80,000, aORs = 2.05-9.48), never versus ever blunt use (aORs = 2.47-8.68), and intakes in 2018 and 2019 versus 2017 (aORs = 2.18-5.38) were associated with higher odds of all vaping outcomes. Vaping was common among adolescents in addiction treatment and varied with sociodemographics and substance-related factors. Research should assess how vaping impacts the development of substance use disorders and whether it interferes with addiction treatment.
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Affiliation(s)
| | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA
| | - Kira Torre
- Addiction Medicine and Recovery Services, Kaiser Permanente Northern California, USA
| | - Lisa Carter-Harris
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
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Durkin K, Williford DN, Turiano NA, Blank MD, Enlow PT, Murray PJ, Banvard-Fox C, Duncan CL. Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use. J Pediatr Psychol 2021; 46:112-122. [PMID: 33120416 PMCID: PMC8456300 DOI: 10.1093/jpepsy/jsaa097] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Prior research identified peer use as a salient risk factor of adolescent electronic cigarette (e-cigarette) use, but has not expanded on the mechanisms of this association. METHODS Participants were 562 adolescents recruited from rural and suburban public high schools and an adolescent medicine clinic in the mid-Atlantic United States. Participants completed a packet of questionnaires that assessed demographics, substance use, expectations about the consequences of e-cigarette use, and perceptions of their own self-efficacy to resist using e-cigarettes. We estimated a series of mediation models using the MODEL INDIRECT command in MPLUS statistical software. In all models, significance of indirect effects from peer e-cigarette use to self-reported e-cigarette use were tested via two variables: (a) expected costs, (b) benefits of e-cigarette use, and (c) the perceived self-efficacy of the individual to refrain from e-cigarette use. RESULTS Adolescents with more peers using e-cigarettes were more likely to have ever used an e-cigarette and perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 1). Those with more peers using e-cigarettes were more likely to be currently using e-cigarettes themselves because they perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 2). CONCLUSION Peer use, self-efficacy to resist use, and expectations of cost and benefits of e-cigarette use should be considered as possible targets when devising tailored interventions and policies to prevent or reduce negative health consequences of long-term e-cigarette use.
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Affiliation(s)
| | | | - Nicholas A Turiano
- Department of Psychology, West Virginia University
- WV Prevention Research Center, West Virginia University
| | - Melissa D Blank
- Department of Psychology, West Virginia University
- WV Prevention Research Center, West Virginia University
| | - Paul T Enlow
- Center for Healthcare Delivery Science, Nemours/A.I. DuPont Hospital for Children
| | | | | | - Christina L Duncan
- Department of Psychology, West Virginia University
- Department of Pediatrics, West Virginia University
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Hair EC, Barton AA, Perks SN, Kreslake J, Xiao H, Pitzer L, Leventhal AM, Vallone DM. Association between e-cigarette use and future combustible cigarette use: Evidence from a prospective cohort of youth and young adults, 2017-2019. Addict Behav 2021; 112:106593. [PMID: 32927247 DOI: 10.1016/j.addbeh.2020.106593] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION A surge in popularity of e-cigarettes prompts concern given the association between e-cigarettes and future cigarette use. However, much of the evidence for this association comes from early, less efficient, and lower nicotine e-cigarettes than are available and widely used now. The goal of this study was to examine the relationship between e-cigarette use in 2018 and subsequent smoking initiation and continued e-cigarette use. METHODS Participants included members of a national longitudinal panel of youth and young adults aged 15-27 who, in 2017, reported never having used a nicotine containing product (n = 3360). Logistic regression analyses assessed associations between participants' self-reported ever e-cigarette use in 2018 and ever cigarette use, current cigarette use, and current e-cigarette use in 2019, after controlling for demographic and psychosocial variables. RESULTS Compared with those who still had never used an e-cigarette, those who reported ever e-cigarette use in 2018 had significantly higher odds of ever cigarette use (aOR = 7.29, 95% CI [4.10, 12.97]), current cigarette use (aOR = 8.26, 95% CI [3.17, 21.53]), and current e-cigarette use (aOR = 9.70, 95% CI [6.41, 14.69]) one year later in 2019. CONCLUSIONS These findings show that the pod mod style, high nicotine containing e-cigarettes subject young users to the same risks of transitioning to combustible cigarettes as their earlier, less efficient predecessors. Strong regulation of all nicotine products, including e-cigarettes, is needed to prevent the trajectory of e-cigarette to cigarette use among youth and young adults.
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Affiliation(s)
- Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA.
| | - Alexis A Barton
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Siobhan N Perks
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Jennifer Kreslake
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haijun Xiao
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Lindsay Pitzer
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles CA, USA
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA
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Owotomo O, Stritzel H, McCabe SE, Boyd CJ, Maslowsky J. Smoking Intention and Progression From E-Cigarette Use to Cigarette Smoking. Pediatrics 2020; 146:e2020002881. [PMID: 33168672 PMCID: PMC7781200 DOI: 10.1542/peds.2020-002881] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To investigate whether the prospective association between electronic cigarette (e-cigarette) use and cigarette smoking is dependent on smoking intention status. METHODS Waves 2 and 3 data of the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative prospective cohort study of tobacco use. Data were collected in 2014-2015 (wave 2) and 2015-2016 (wave 3) and analyzed in 2019. RESULTS At wave 2, 12.8% of adolescent never-smokers of conventional cigarettes had intention to smoke and 8.5% had ever used an e-cigarette. At wave 3, 3.2% had ever smoked a cigarette. Both smoking intention and ever using e-cigarettes at wave 2 were positively associated with cigarette smoking at wave 3 (adjusted odds ratio [aOR] = 3.03; 95% confidence interval [CI] = 1.97-4.68, P < .001; aOR = 4.62, 95% CI = 2.87-7.42, P < .001, respectively). The interaction between smoking intention and ever using e-cigarettes was significant (aOR = 0.34, 95% CI = 0.18-0.64, P < .01). Among adolescents who had expressed intention to smoke conventional cigarettes at wave 2, the odds of cigarette smoking at wave 3 did not significantly differ for e-cigarette users and never e-cigarette users (aOR = 1.57; 95% CI 0.94-2.63; P = .08). Among adolescents who had no intention to smoke at wave 2, e-cigarette users, compared with never e-cigarette users, had >4 times the odds of cigarette smoking (aOR = 4.62; 95% CI 2.87-7.42; P < .0001). CONCLUSIONS E-cigarette use is associated with increased odds of cigarette smoking among adolescents who had no previous smoking intention. E-cigarette use may create intention to smoke and/or nicotine use disorder that lead to onset of cigarette smoking.
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Affiliation(s)
| | - Haley Stritzel
- Department of Sociology and
- Population Research Center, College of Liberal Arts and
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and
- Department of Health Behavior and Biological Sciences, School of Public Health and
- Institutes for Research on Women and Gender
- Social Research, and
- Healthcare Policy and Innovation and
- Rogel Cancer Center and
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and
- Department of Health Behavior and Biological Sciences, School of Public Health and
- Institutes for Research on Women and Gender
- Addiction Center, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Julie Maslowsky
- Population Research Center, College of Liberal Arts and
- Department of Kinesiology & Health Education, College of Education and
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas; and
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29
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Owotomo O, Stritzel H, McCabe SE, Boyd CJ, Maslowsky J. Smoking Intention and Progression From E-Cigarette Use to Cigarette Smoking. Pediatrics 2020. [PMID: 33168672 DOI: 10.1542/peds.2020‐002881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To investigate whether the prospective association between electronic cigarette (e-cigarette) use and cigarette smoking is dependent on smoking intention status. METHODS Waves 2 and 3 data of the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative prospective cohort study of tobacco use. Data were collected in 2014-2015 (wave 2) and 2015-2016 (wave 3) and analyzed in 2019. RESULTS At wave 2, 12.8% of adolescent never-smokers of conventional cigarettes had intention to smoke and 8.5% had ever used an e-cigarette. At wave 3, 3.2% had ever smoked a cigarette. Both smoking intention and ever using e-cigarettes at wave 2 were positively associated with cigarette smoking at wave 3 (adjusted odds ratio [aOR] = 3.03; 95% confidence interval [CI] = 1.97-4.68, P < .001; aOR = 4.62, 95% CI = 2.87-7.42, P < .001, respectively). The interaction between smoking intention and ever using e-cigarettes was significant (aOR = 0.34, 95% CI = 0.18-0.64, P < .01). Among adolescents who had expressed intention to smoke conventional cigarettes at wave 2, the odds of cigarette smoking at wave 3 did not significantly differ for e-cigarette users and never e-cigarette users (aOR = 1.57; 95% CI 0.94-2.63; P = .08). Among adolescents who had no intention to smoke at wave 2, e-cigarette users, compared with never e-cigarette users, had >4 times the odds of cigarette smoking (aOR = 4.62; 95% CI 2.87-7.42; P < .0001). CONCLUSIONS E-cigarette use is associated with increased odds of cigarette smoking among adolescents who had no previous smoking intention. E-cigarette use may create intention to smoke and/or nicotine use disorder that lead to onset of cigarette smoking.
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Affiliation(s)
| | - Haley Stritzel
- Department of Sociology and
- Population Research Center, College of Liberal Arts and
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and
- Department of Health Behavior and Biological Sciences, School of Public Health and
- Institutes for Research on Women and Gender
- Social Research, and
- Healthcare Policy and Innovation and
- Rogel Cancer Center and
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing and
- Department of Health Behavior and Biological Sciences, School of Public Health and
- Institutes for Research on Women and Gender
- Addiction Center, Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Julie Maslowsky
- Population Research Center, College of Liberal Arts and
- Department of Kinesiology & Health Education, College of Education and
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas; and
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Luzius A, Dobbs PD, Jozkowski KN. College students' reasons for using different e-cigarette products: A mixed methods analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:832-838. [PMID: 31157606 DOI: 10.1080/07448481.2019.1618313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
This study examined if college students used particular e-cigarette devices for different reasons. Participants: College students from a large southern university completed an online, close- and open-ended survey. Data were delimited to those 18-25 years of age who had used e-cigarettes (n = 338). Methods: A convergent mixed-methods design was employed by quantifying qualitative responses via an inducting coding method. Next, χ2 analyses examined relationships between use of different products (i.e., cigalikes, vape pens, eGos, mods) and reasons for using e-cigarettes. Results: Emerging themes representing reasons for trying e-cigarettes included: curiosity, peer pressure, recreation, flavors, better than cigarettes, and to quit/reduce tobacco use. Significant relationships existed between use of cigalikes, (p < . 01), eGos (p < . 05), and mods (p < . 05) and use of e-cigarettes to quitting/reducing tobacco use. Conclusions: Health promotion efforts on college campuses should address curiosity about these products and provide scientifically proven therapy to those seeking to quit tobacco.
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Affiliation(s)
- Abbie Luzius
- Hope Cancer Resources, Outreach and Development Department, Springdale, USA
| | - Page D Dobbs
- Department of Health and Exercise Science, University of Oklahoma, Norman, USA
| | - Kristen N Jozkowski
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, USA
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31
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Vajdi B, Tuktamyshov R. Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview. World J Cardiol 2020; 12:475-483. [PMID: 33173566 PMCID: PMC7596422 DOI: 10.4330/wjc.v12.i10.475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/12/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to review the most recent literature on the safety of electronic cigarettes (ECs) in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes. The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials. Daily use of ECs has implications in myocardial infarction (MI) with an odds ratio of 1.70 compared to healthy, nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62. Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions. Platelet aggregation, endothelial function, and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure. Though more studies need to be done on the topic of EC use and cardiovascular disease, the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes. ECs are toxic to human beings and their harmful effects cannot be overlooked. There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use. It will take decades to collect data for chronic EC use on long term sequelae, such as lung cancer. Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported. Due to undergoing investigations of possible harm and life threatening complications of EC use, we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies. A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage, frequency of use, and contents of EC liquid are just some of the vast complicating factors that limit the ability to effectively compare data.
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Affiliation(s)
- Borna Vajdi
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, United States
| | - Rasikh Tuktamyshov
- Department of Internal Medicine, Yale University, New Haven, CT 06511, United States
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Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145133. [PMID: 32708622 PMCID: PMC7399914 DOI: 10.3390/ijerph17145133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population.
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Perry CL, Creamer MR, Chaffee BW, Unger JB, Sutfin EL, Kong G, Shang C, Clendennen SL, Krishnan-Sarin S, Pentz MA. Research on Youth and Young Adult Tobacco Use, 2013-2018, From the Food and Drug Administration-National Institutes of Health Tobacco Centers of Regulatory Science. Nicotine Tob Res 2020; 22:1063-1076. [PMID: 31127298 PMCID: PMC7457341 DOI: 10.1093/ntr/ntz059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 12/21/2022]
Abstract
The Tobacco Regulatory Science Program is a collaborative research effort between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). In 2013, the NIH funded 14 Tobacco Centers of Regulatory Science (TCORS), which serve as partners in establishing research, training, and professional development programs to guide FDA. Each of the fourteen TCORS, and two other NIH-funded research programs, the Center for the Evaluation of Nicotine in Cigarettes (CENIC) and the Consortium on Methods Evaluating Tobacco (COMET), pursued specific research themes relevant to FDA's priorities. A key mandate for FDA is to reduce tobacco use among young people. This article is a review of the peer-reviewed research, including published and in-press manuscripts, from the TCORS, CENIC, and COMET, which provides specific data or other findings on youth (ages 10-18 years) and/or young adults (ages 18-34 years), from 2013 to 2018. Citations of all TCORS, CENIC, and COMET articles from September 2013 to December 2017 were collected by the TCORS coordinating center, the Center for Evaluation and Coordination of Training and Research. Additional citations up to April 30, 2018 were requested from the principal investigators. A scoring rubric was developed and implemented to assess study type, primary theme, and FDA priority area addressed by each article. The major subareas and findings from each priority area are presented. There were 766 articles in total, with 258 (34%) focusing on youth and/or young adults. Findings relevant to FDA from this review concern impact analysis, toxicity, health effects, addiction, marketing influences, communications, and behavior. IMPLICATIONS The Tobacco Centers of Regulatory Science, CENIC, and COMET have had a high output of scientific articles since 2013. These Centers are unique in that the FDA supports science specifically to guide future regulatory actions. The 258 articles that have focused on youth and/or young adults are providing data for regulatory actions by the FDA related to the key priority areas such as the addictiveness of non-cigarette products, the effects of exposure to electronic cigarette marketing on initiation and cessation, and the impact of flavored products on youth and young adult tobacco use. Future regulations to reduce tobacco use will be guided by the cumulative evidence. These Centers are one innovative mechanism to promote important outcomes to advance tobacco regulatory science.
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Affiliation(s)
- Cheryl L Perry
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | - MeLisa R Creamer
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Jennifer B Unger
- Keck School of Medicine,University of Southern California, Los Angeles, CA
| | | | | | - Ce Shang
- Oklahoma Tobacco Research Center, Stephenson Cancer Center
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Stephanie L Clendennen
- School of Public Health at Austin, The University of Texas Health Science Center at Houston, Austin, TX
| | | | - Mary Ann Pentz
- Keck School of Medicine,University of Southern California, Los Angeles, CA
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Belisle J, Dixon MR. Behavior and Substance Addictions in Children: A Behavioral Model and Potential Solutions. Pediatr Clin North Am 2020; 67:589-602. [PMID: 32443997 DOI: 10.1016/j.pcl.2020.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Behavior and substance use addictions are increasingly prevalent in children with increased risk for substance abuse and mental health diagnoses in adulthood. This article proposes a comprehensive model of addiction to inform research on the prevention and treatment of childhood addiction, emphasizing skills training, mindfulness training, and broader treatment strategies consistent with acceptance and commitment therapy.
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Affiliation(s)
- Jordan Belisle
- Applied Behavior Analysis, Psychology Department, Missouri State University, 901 S National Avenue, Springfield, MO 65897, USA
| | - Mark R Dixon
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, USA.
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Barrington-Trimis JL, Yang Z, Schiff S, Unger J, Cruz TB, Urman R, Cho J, Samet JM, Leventhal AM, Berhane K, McConnell R. E-cigarette Product Characteristics and Subsequent Frequency of Cigarette Smoking. Pediatrics 2020; 145:peds.2019-1652. [PMID: 32253264 PMCID: PMC7193941 DOI: 10.1542/peds.2019-1652] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a dearth of evidence regarding the association of use of electronic cigarettes (e-cigarettes) with certain product characteristics and adolescent and young adult risk of unhealthy tobacco use patterns (eg, frequency of combustible cigarette smoking), which is needed to inform the regulation of e-cigarettes. METHODS Data were collected via an online survey of participants in the Southern California Children's Health Study from 2015 to 2016 (baseline) and 2016 to 2017 (follow-up) (N = 1312). We evaluated the association of binary categories of 3 nonmutually exclusive characteristics of the e-cigarette used most frequently with the number of cigarettes smoked in the past 30 days at 1-year follow-up. Product characteristics included device (vape pen and/or modifiable electronic cigarette [mod]), use of nicotine in electronic liquid (e-liquid; yes or no), and use for dripping (directly dripping e-liquid onto the device; yes or no). RESULTS Relative to never e-cigarette users, past-30-day e-cigarette use was associated with greater frequency of past-30-day cigarette smoking at follow-up. Among baseline past-30-day e-cigarette users, participants who used mods (versus vape pens) smoked >6 times as many cigarettes at follow-up (mean: 20.8 vs 1.3 cigarettes; rate ratio = 6.33; 95% confidence interval: 1.64-24.5) after adjustment for sociodemographic characteristics, baseline frequency of cigarette smoking, and number of days of e-cigarette use. After adjustment for device, neither nicotine e-liquid nor dripping were associated with frequency of cigarette smoking. CONCLUSIONS Baseline mod users (versus vape pen users) smoked more cigarettes in the past 30 days at follow-up. Regulation of e-cigarette device type warrants consideration as a strategy to reduce cigarette smoking among adolescents and young adults who vape.
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Affiliation(s)
- Jessica L. Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Zhi Yang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Sara Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Jennifer Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Robert Urman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Jonathan M. Samet
- Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | - Adam M. Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Kiros Berhane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
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Narcisse MR, Dobbs P, Long CR, Purvis RS, Kimminau KS, McElfish PA. Electronic cigarette use and psychological distress in the Native Hawaiian and Pacific Islander adults compared with other racial/ethnic groups: Data from the National Health Interview Survey, 2014. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:225-236. [PMID: 31535719 PMCID: PMC9284937 DOI: 10.1002/jcop.22248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/22/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Document the prevalence of electronic cigarette (E-cigarette) use among the native Hawaiian and other Pacific Islander (NHPI) adults compared with other racial/ethnic groups, and examine associations between psychological distress and E-cigarette use. 2014 National Health Interview Survey (NHIS) and 2014 NHPI-NHIS were combined for comparisons. Data were analyzed using descriptive statistics, Rao-Scott χ2 test, and multivariable logistic regression. E-cigarette use among NHPI (5.6%) was significantly higher than among Blacks (2.1%), Hispanics (2.2%), and Asians (1.7%; p < .001). NHPI with Kessler 6 (K6) score of 11-24 had greater odds of using E-cigarettes (odds ratio [OR]: 3.90; 95% confidence intervals [CI]: 1.81-8.42) as compared to those with a K6 score of 0. Associations between having a K6 score of 11-24 and using E-cigarettes were also found for Whites (OR: 3.49; CI: 2.44-4.99), Asians (OR: 5.29; CI: 1.29-21.70), and Hispanics (OR: 6.14; CI: 2.72-13.83). E-cigarette use was higher among NHPI relative to other racial/ethnic groups. NHPI with K6 score of 11-24 had greater odds of using E-cigarettes as compared to those with a K6 score of 0. Policies and strategies to reduce E-cigarette use among NHPI should give careful consideration to the associations between E-cigarette use and psychological distress in the NHPI population.
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Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Page Dobbs
- College of Arts and Sciences, Department of Health and Exercise Science, The University of Oklahoma, 1401 Asp Ave., Room 118 Norman, OK 73019
| | - Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Rachel S. Purvis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Kim S. Kimminau
- Department of Family Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
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Etim N, Pike J, Xie B. Age-varying associations between e-cigarette use and peer use, household use, and exposure to e-cigarette commercials among alternative high school students in Southern California. Tob Induc Dis 2020; 18:7. [PMID: 32047418 PMCID: PMC7008390 DOI: 10.18332/tid/116412] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/05/2019] [Accepted: 01/09/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) have rapidly become the most commonly used tobacco product among youth in the United States. Exposure to advertising, peer use, and household use, increases the risk of current e-cigarette use; however, the influence of these factors may be dynamic across adolescence. The aim of this study is to examine the age-varying associations between e-cigarette use and peer use, household use, and exposure to e-cigarette commercials among alternative high school students in Southern California. METHODS Using data previously collected for a tobacco marketing study, we examine the age-varying associations of current e-cigarette use and three risk factors (peer use, exposure to commercials, and household use) across ages 15 to 20 years using time-varying effect modeling (TVEM). Analyses include three waves of data from alternative high school students (N=1060 students; 2036 observations). RESULTS The probability of e-cigarette use gradually increased over the age of 15 years and then decreased by the age of 17 years for females and after the age of 18 years for males. Significant gender differences were observed between the ages of 17 and 19.5 years. Peer e-cigarette use was associated with higher odds of current e-cigarette use across all ages for females and after the age of 16 years for males. Exposure to e-cigarette commercials increased current use significantly for males between the ages of 16 and 18 years. Household use increased the odds of current use of e-cigarettes between the ages of 17 and 19 years for males and under 16.5 and over 18 years for females. CONCLUSIONS The findings highlight the utility of TVEM in understanding the risk factors of e-cigarette use and suggest that these factors are dynamic across adolescence.
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Affiliation(s)
- Ndifreke Etim
- School of Community and Global Health, Claremont Graduate University, Claremont, United States
| | - James Pike
- School of Community and Global Health, Claremont Graduate University, Claremont, United States
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, United States
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Sidani JE, Colditz JB, Barrett EL, Chu KH, James AE, Primack BA. JUUL on Twitter: Analyzing Tweets About Use of a New Nicotine Delivery System. THE JOURNAL OF SCHOOL HEALTH 2020; 90:135-142. [PMID: 31828791 PMCID: PMC7034811 DOI: 10.1111/josh.12858] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/21/2019] [Accepted: 05/11/2019] [Indexed: 05/14/2023]
Abstract
BACKGROUND Initial reports suggest that JUUL, a popular e-cigarette, is being used in schools and other locations in which cigarette smoking is illegal or discouraged. However, there is little scholarly research documenting this. We aimed to make a systematic analysis of JUUL use themes and sentiment on Twitter. METHODS Data were collected from Twitter's Filtered Streams Application Programming Interface from April 12, 2018 to May 10, 2018. This yielded 67,934 tweets, from which a random sample of 2% was selected for coding. The final dataset included 1209 tweets. Inter-rater reliability ranged κ = 0.64-0.85. RESULTS The majority (71.5%) of tweets expressed positive sentiment toward JUUL. JUUL use in places where cigarette smoking is illegal or discouraged appeared in 111 tweets (9.2%); approximately one-third of these tweets referring to using the device in school. Nearly 20% of tweets mentioned using the device at home and/or directly in front of responsible adults. CONCLUSIONS This study confirms anecdotal reports of JUUL use in places where cigarette smoking is illegal or discouraged. Positive sentiment about use of JUUL suggests that the product is being normalized among young people. It may be valuable for educators to discuss the addictive nature of nicotine delivered through JUUL with younger populations.
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Affiliation(s)
- Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213
| | - Erica L Barrett
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213
| | - Kar-Hai Chu
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213
| | - A Everette James
- Health Policy Institute, University of Pittsburgh School of Public Health, 130 De Soto Street, Pittsburgh, PA, 15261
| | - Brian A Primack
- University of Arkansas College of Education and Health Professions, 1 University of Arkansas, Fayetteville, AR, 72701
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Vena A, Miloslavich K, Cao D, King A. Cue salience of the use of an electronic nicotine delivery system (ENDS) device marketed to women. Addict Behav 2020; 100:106116. [PMID: 31622947 DOI: 10.1016/j.addbeh.2019.106116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/16/2019] [Accepted: 09/02/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Passive exposure to the use of electronic nicotine delivery systems (ENDS or e-cigarettes) has been shown to generalize as a smoking cue. As young adult women in particular are increasingly targeted by ENDS distributors, the present study examined whether passive exposure to the use of a female-marketed ENDS product selectively enhanced smoking urge, cigarette and e-cigarette desire, and smoking behavior among women (vs men) smokers. METHODS Using a mixed design, young adult smokers (n = 64; mean age 28.2 yrs.; ≥5 cigarettes/day) observed a study confederate drink bottled water (control cue) and then vape a female-marketed tank-based ENDS (active cue). Main measures were the Brief Questionnaire of Smoking Urges (BQSU) and visual analog scales (VAS) for cigarette and e-cigarette desire pre- and post-cue exposure, followed by a smoking latency task. RESULTS Compared to the control cue, the female-marketed ENDS cue increased smoking urge and desire for cigarettes and e-cigarettes to a similar extent in women and men. It also affected subsequent smoking behavior similarly between the sexes, with 68% of men and 58% of women opting to smoke (vs. obtaining monetary reinforcers). CONCLUSIONS Both women and men were sensitive to the use of the female-marketed ENDS as a smoking cue. Consistent with prior work by our group, findings demonstrate the cue salience of ENDS, which may be attributable to the aspects of vaping that resemble traditional smoking (e.g. hand-to-mouth and inhalation and exhalation behaviors).
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Affiliation(s)
- Ashley Vena
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, Chicago, IL, USA
| | - Krista Miloslavich
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, Chicago, IL, USA
| | - Dingcai Cao
- University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, IL, USA
| | - Andrea King
- University of Chicago, Department of Psychiatry & Behavioral Neuroscience, Chicago, IL, USA.
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Bigwanto M, Nurmansyah MI, Orlan E, Farradika Y, Purnama TB. Determinants of e-cigarette use among a sample of high school students in Jakarta, Indonesia. Int J Adolesc Med Health 2019; 34:/j/ijamh.ahead-of-print/ijamh-2019-0172/ijamh-2019-0172.xml. [PMID: 31800392 DOI: 10.1515/ijamh-2019-0172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/26/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The aim of this study was to determine the predisposing, enabling and reinforcing factors associated with electronic cigarette (e-cigarette) use among high school students in Jakarta, Indonesia. METHODS This cross-sectional study took place in eight high schools in Jakarta, Indonesia. A total of 767 students were recruited by multistage cluster random sampling. Bivariate and multivariate statistical analyses were employed to determine the associations between socio-demographic, predisposing, reinforcing and enabling factors and e-cigarette use. RESULTS Respondents were 54.1% male and the mean age was 16 years old [standard deviation (SD): 1.02]. In this sample, 32.2% of students (n = 247) had ever used e-cigarettes and 11.8% of students were e-cigarette users (n = 90). Several measured factors were positively associated with e-cigarette use, including: current smoking of conventional cigarettes [odds ratio (OR): 2.06]; perception that e-cigarettes are less addictive than conventional cigarettes (OR: 1.98); perception that e-cigarettes do not cause cancer (OR: 2.38); parental acceptance of e-cigarette use (OR: 3.80); and having enough money to buy e-cigarettes (OR: 3.24). The only variable found that was negatively associated with e-cigarette use was teacher's use of e-cigarettes (OR: 0.34). CONCLUSIONS This study found that student social influences, perceptions about and accessibility to e-cigarettes were significantly positively associated with e-cigarette use among high school students in Jakarta, Indonesia. This study highlights the importance of educating students, their parents and teachers regarding safety and potential health hazards of using e-cigarettes. Efforts to implement and enforce youth access restrictions on e-cigarettes in Indonesia are crucial to preventing further uptake of these products.
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Affiliation(s)
- Mouhamad Bigwanto
- University of Muhammadiyah Prof. Dr. Hamka, Faculty of Health Sciences, South Jakarta, Indonesia
| | - Mochamad Iqbal Nurmansyah
- Universitas Islam Negeri Syarif Hidayatullah Jakarta, Faculty of Health Science, Kertamukti No. 5 South Tangerang, Banten, 15412, Indonesia
| | - Elizabeth Orlan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yoli Farradika
- University of Muhammadiyah Prof. Dr. Hamka, Faculty of Health Sciences, South Jakarta, Indonesia
| | - Tri Bayu Purnama
- Faculty of Public Health, Universitas Islam Negeri Sumatera Utara, Medan, Indonesia
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Lim KH, Ghazali SM, Lim HL, Cheong KC, Teh CH, Lim KK, Heng PP, Cheah YK, Lim JH. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open 2019; 9:e031164. [PMID: 31662384 PMCID: PMC6830643 DOI: 10.1136/bmjopen-2019-031164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DESIGN Cross-sectional study. SETTING Primary and secondary schools in Malaysia. PARTICIPANTS 11 246 non-smoking school-going adolescents. OUTCOME MEASURES The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. RESULTS Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking. CONCLUSION Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.
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Affiliation(s)
- Kuang Hock Lim
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | | | - Hui Li Lim
- Pathology Unit, Hospital Sultan Haji Ahmad Shah, Mentakab, Malaysia
| | - Kee Chee Cheong
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Kuang Kuay Lim
- Occupational Health Center, Institute of Public Health, Setia Alam, Malaysia
| | - Pei Pei Heng
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- School of Pharmacy, Monash University, Malaysia Campus, Bandar Sunway, Malaysia
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Zvolensky MJ, Manning K, Garey L, Mayorga NA, Peraza N. Fatigue severity and electronic cigarette beliefs and use behavior. Addict Behav 2019; 97:1-6. [PMID: 31108412 DOI: 10.1016/j.addbeh.2019.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/04/2019] [Accepted: 05/13/2019] [Indexed: 01/02/2023]
Abstract
Electronic cigarette (e-cigarette) use has risen dramatically in the United States. Clinically significant fatigue may represent one previously unexplored individual difference factor related to e-cigarette use patterns and e-cigarette specific cognitive processes. Fatigue reflects the experience of being tired, lacking energy, and feeling exhausted. Although fatigue is a normal bodily response, severe or chronic fatigue is maladaptive. Thus, the current study sought to evaluate clinically significant fatigue and its relation to perceived barriers for quitting e-cigarettes, perceived risks and perceived benefits of e-cigarette use, and e-cigarette dependence among 625 adult e-cigarette smokers (51.8% female, Mage = 34.91 years, SD = 10.29). Results indicated that severe fatigue was significantly related to greater perceived barriers to quitting (p < .001), perceived risks (p < .001) and perceived benefits (p < .001) of e-cigarette use, and greater e-cigarette dependence (p < .001); effects that were evident after adjusting for a range of other factors (e.g., combustible cigarette use, pain severity). These novel empirical results highlight the severity of fatigue as a potentially important construct in efforts to better understand beliefs related to e-cigarette use and e-cigarette dependence.
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Gassman RA, Dutta T, Agley J, Jayawardene W, Jun M. Social Media Outrage in Response to a School-Based Substance Use Survey: Qualitative Analysis. J Med Internet Res 2019; 21:e15298. [PMID: 31516129 PMCID: PMC6746064 DOI: 10.2196/15298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND School-based alcohol, tobacco, and other drug use (ATOD) surveys are a common epidemiological means of understanding youth risk behaviors. They can be used to monitor national trends and provide data, in aggregate, to schools, communities, and states for the purposes of funding allocation, prevention programming, and other supportive infrastructure. However, such surveys sometimes are targeted by public criticism, and even legal action, often in response to a lack of perceived appropriateness. The ubiquity of social media has added the risk of potential online firestorms, or digital outrage events, to the hazards to be considered when administering such a survey. Little research has investigated the influence of online firestorms on public health survey administration, and no research has analyzed the content of such an occurrence. Analyzing this content will facilitate insights as to how practitioners can minimize the risk of generating outrage when conducting such surveys. OBJECTIVE This study aimed to identify common themes within social media comments comprising an online firestorm that erupted in response to a school-based ATOD survey in order to inform risk-reduction strategies. METHODS Data were collected by archiving all public comments made in response to a news study about a school-based ATOD survey that was featured on a common social networking platform. Using the general inductive approach and elements of thematic analysis, two researchers followed a multi-step protocol to clean, categorize, and consolidate data, generating codes for all 207 responses. RESULTS In total, 133 comments were coded as oppositional to the survey and 74 were coded as supportive. Among the former, comments tended to reflect government-related concerns, conspiratorial or irrational thinking, issues of parental autonomy and privacy, fear of child protective services or police, issues with survey mechanisms, and reasoned disagreement. Among the latter, responses showed that posters perceived the ability to prevent abuse and neglect and support holistic health, surmised that opponents were hiding something, expressed reasoned support, or made factual statements about the survey. Consistent with research on moral outrage and digital firestorms, few comments (<10%) contained factual information about the survey; nearly half of the comments, both supportive and oppositional, were coded in categories that presupposed misinformation. CONCLUSIONS The components of even a small online firestorm targeting a school-based ATOD survey are nuanced and complex. It is likely impossible to be fully insulated against the risk of outrage in response to this type of public health work; however, careful articulation of procedures, anticipating specific concerns, and two-way community-based interaction may reduce risk.
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Affiliation(s)
- Ruth Ann Gassman
- Prevention Insights, Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Tapati Dutta
- Rural Center for AIDS/STD Prevention, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Jon Agley
- Prevention Insights, Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Wasantha Jayawardene
- Prevention Insights, Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Mikyoung Jun
- Prevention Insights, Institute for Research on Addictive Behavior, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
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Azagba S, Kah K, Latham K. Frequency of E-cigarette use and cigarette smoking among Canadian students. Prev Med 2019; 126:105769. [PMID: 31310786 DOI: 10.1016/j.ypmed.2019.105769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/24/2019] [Accepted: 07/12/2019] [Indexed: 11/24/2022]
Abstract
The emergence of electronic nicotine delivery systems (commonly referred to as e-cigarettes) has created an ongoing public health debate and concerns, especially in regards to adolescents. The present study examined associations between the frequency of e-cigarette use and cigarette smoking among school students. Data on students (grades 7-12) was obtained from the 2016-2017 Canadian Student Tobacco, Alcohol and Drugs Survey (n = 51,661). Multivariable logistic regression analyses were conducted to examine associations between the frequency of e-cigarette use and smoking. Subgroup analyses were performed for male and female students. Among those who reported any cigarette smoking in the past 30 days, 55% reported e-cigarette use at least once in the last 30 days. Additionally, 17% reported e-cigarette use for 21-30 days among those who smoked cigarettes for at least 21 days. Multivariable logistic regression analysis showed e-cigarette use was associated with higher odds of cigarette smoking, especially among more frequent e-cigarette users. Those who used an e-cigarette 21-30 days had higher odds of cigarette smoking (smoked cigarette at least once AOR = 4.83, CI = 3.33-7.01; at least 11 days AOR = 3.73, CI = 2.40-5.80; at least 21 days AOR = 3.39, CI = 2.16-5.34). Findings suggest that those who smoked cigarettes at least once in the past 30 days had a higher frequency of e-cigarette use.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America.
| | - Kebba Kah
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
| | - Keely Latham
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
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Beliefs, Attitudes, and Confidence to Deliver Electronic Cigarette Counseling among 1023 Chinese Physicians in 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173175. [PMID: 31480401 PMCID: PMC6747414 DOI: 10.3390/ijerph16173175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/09/2019] [Accepted: 08/27/2019] [Indexed: 01/11/2023]
Abstract
Background: The use of electronic cigarettes (e-cigarettes) is gaining popularity, so it is important to evaluate physicians’ understanding of e-cigarettes. This study assessed the beliefs, attitudes, and confidence in e-cigarette counseling among Chinese physicians and explored the factors related to asking patients about e-cigarette use. Methods: Physicians from across China were invited to participate in a questionnaire survey using the platform provided by DXY (www.dxy.cn) in 2018. In total, 1023 physicians completed the online survey. Descriptive analyses were used to characterize the participants, and multivariate logistic regression analyses were applied to identify predictors of physicians’ asking about patients’ e-cigarette use. Results: Only 46.3% of respondents agreed that e-cigarettes had adverse health effects, and 66.8% indicated that e-cigarettes can be regarded as a type of smoking cessation treatment. We found that 61.3% thought it was important to discuss e-cigarettes with patients, and 71.7% reported feeling confident about their ability in counseling about e-cigarettes. Respondents who had used e-cigarettes (OR = 2.05; 95% CI: 1.16–2.63), had received training about e-cigarettes (OR = 3.13; 95% CI: 2.17–4.52), or were confident about their ability to answer patients’ question about e-cigarettes (OR = 2.45; 95% CI: 1.65–3.65) were more likely to ask patients about e-cigarette use. Physicians who showed a supportive attitude toward using e-cigarettes to quit smoking (OR = 0.79; 95% CI: 0.63–0.99) were less likely to ask about patients’ e-cigarettes use frequently. Conclusions: Chinese physicians appeared to ignore the adverse health effects of e-cigarettes, and considered e-cigarettes as a smoking cessation treatment. Comprehensive training and regulations are needed to help physicians incorporate the screening of e-cigarette use into routine practice and provide patients truthful information as new data emerge.
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Canzan F, Finocchio E, Moretti F, Vincenzi S, Tchepnou-Kouaya A, Marognolli O, Poli A, Verlato G. Knowledge and use of e-cigarettes among nursing students: results from a cross-sectional survey in north-eastern Italy. BMC Public Health 2019; 19:976. [PMID: 31331316 PMCID: PMC6647064 DOI: 10.1186/s12889-019-7250-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 06/28/2019] [Indexed: 12/24/2022] Open
Abstract
Background Data on electronic cigarette (e-cigarette) use among health professional students, who can play a central role in promoting healthy habits and smoking cessation, are sparse. Moreover, the association between e-cigarettes and smoking habits is still debated. The present study aimed to investigate the diffusion of e-cigarette use among nursing students in north-eastern Italy and explore its association with tobacco smoking. Methods In 2015, a questionnaire focused on e-cigarette use and tobacco smoking habits was anonymously administered to 2020 students attending nursing courses held by Verona University in 5 different centres. Of these students, 1463 (72.4%) answered the questionnaire. The influence of e-cigarette ever use on both tobacco smoking initiation in all subjects and smoking cessation among ever smokers was investigated by multivariable logistic models. Results Most responders were female (77.1%), and the mean (SD) age was 23.2 (4.2) years. Nearly all students (94.7%) had heard about e-cigarettes. Approximately one-third (30.3, 95% CI 27.9–32.7%) had ever used e-cigarettes, but only 2.1% (1.5–3.0%) had used e-cigarettes in the last month. Very few (2.1%) of those responders who had never used e-cigarettes were willing to try them. Prevalence values were much higher for tobacco smoking: 40.9% of responders reported being current tobacco smokers, and 10.1% reported being past smokers. Ever use and current use of e-cigarettes were reported by 57.2 and 4.4% of current tobacco smokers and by 12.0 and 0.6% of never or past smokers, respectively (p < 0.001). In multivariable analysis, students who ever used e-cigarettes had 13 times greater odds of being an ever tobacco smoker than never users, whereas they had three times lower odds of being a former smoker. Only 26 students were currently using both electronic and tobacco cigarettes, and most declared that they used e-cigarettes to stop or reduce tobacco smoking. Of note, only three students reported that they had completely stopped smoking thanks to e-cigarette use. Conclusion Use of e-cigarettes seemed to be rather rare among Italian nursing students and was mainly restricted to current smokers. E-cigarette use was not associated with smoking cessation in nursing students. Electronic supplementary material The online version of this article (10.1186/s12889-019-7250-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Eliana Finocchio
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Moretti
- Unit of Hygiene, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | | | | | - Albino Poli
- Unit of Hygiene, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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Thomson G, Nee‐Nee J, Sutherland K, Holland R, Wilson M, Wilson N. Observed vaping and smoking in outdoor public places: piloting objective data collection for policies on outdoor vaping. Aust N Z J Public Health 2019; 43:401-402. [DOI: 10.1111/1753-6405.12907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- George Thomson
- Department of Public HealthUniversity of Otago Wellington New Zealand
| | - Johanna Nee‐Nee
- Department of Public HealthUniversity of Otago Wellington New Zealand
| | - Kirsty Sutherland
- Department of Public HealthUniversity of Otago Wellington New Zealand
| | - Rebecca Holland
- Department of Public HealthUniversity of Otago Wellington New Zealand
| | - Miriam Wilson
- Department of Public HealthUniversity of Otago Wellington New Zealand
| | - Nick Wilson
- Department of Public HealthUniversity of Otago Wellington New Zealand
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Carey FR, Rogers SM, Cohn EA, Harrell MB, Wilkinson AV, Perry CL. Understanding susceptibility to e-cigarettes: A comprehensive model of risk factors that influence the transition from non-susceptible to susceptible among e-cigarette naïve adolescents. Addict Behav 2019; 91:68-74. [PMID: 30241775 DOI: 10.1016/j.addbeh.2018.09.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
The primary objective of this study was to identify risk factors associated with becoming susceptible to e-cigarette use over the course of a year among e-cigarette-naive adolescents considering a comprehensive model of risk factors (risk perceptions, social influences and norms, affective risk factors, and other behavioral risk factors). Data came from the Texas Adolescent Tobacco and Marketing Surveillance system (TATAMS), a longitudinal cohort study of students who were in the 6th, 8th, and 10th grades (n = 3907) during the 2014-2015 academic year. Weighted generalized linear mixed models assessed multiple predictors' associated with the transition to susceptibility to e-cigarettes at 12 months. Among 6th graders, family influence, use of other substances, and positive affect were important. Adolescents transitioning from 8th grade to high school presented the greatest number of risk factors (e.g., social and normative influences). Only sensation seeking increased the risk of susceptibility to e-cigarettes among 10th graders. Overall, by grade level, incidence of susceptibility to e-cigarettes at 12 months did not vary, but risk factor profiles varied substantially.
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Lozano P, Arillo-Santillán E, Barrientos-Gutíerrez I, Shigematsu LMR, Thrasher JF. E-Cigarette Social Norms and Risk Perceptions Among Susceptible Adolescents in a Country That Bans E-Cigarettes. HEALTH EDUCATION & BEHAVIOR 2019; 46:275-285. [PMID: 30606077 PMCID: PMC6438717 DOI: 10.1177/1090198118818239] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study examined how risk perceptions and social norms around e-cigarettes are associated with susceptibility (i.e., openness to using the product in the next 12 months) of e-cigarettes and smoking among adolescents. METHODS We analyzed data from a 2016 representative survey of 8,718 middle school students in Mexico. The study sample was restricted to students who had tried neither e-cigarettes nor cigarettes, ( N = 4471). Students reported on the risks of e-cigarettes compared with those of cigarettes, and product-specific norms were measured by assessing current use by family members, at least one close friend, and, for e-cigarettes, by perceived societal acceptability of use (i.e., acceptability among people in general). Adjusted prevalence ratios (APR) were estimated using generalized estimating equation models that regressed e-cigarette societal acceptability on study variables. Adjusted generalized estimating equation models also regressed susceptibility for each product on study variables. RESULTS Susceptibility to both e-cigarettes and smoking was higher among students who reported that their family and friends used only cigarettes or both products when compared with students whose family and friends did not use either of these products. Friend use of e-cigarettes was associated with e-cigarette susceptibility (APR = 1.33) but not smoking susceptibility. Students who perceived that e-cigarettes were less risky than smoking were more susceptible to e-cigarette use (APR = 1.45). The association between e-cigarette susceptibility and friend or family use was not mediated by societal acceptability. CONCLUSIONS E-cigarette use among family and peers appears associated with susceptibility to use e-cigarettes in a way that is similar to the patterns found for cigarettes. However, the influences appear somewhat specific to the type of product that network members use.
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Affiliation(s)
- Paula Lozano
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Edna Arillo-Santillán
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, México
| | - Inti Barrientos-Gutíerrez
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, México
| | - Luz Myriam Reynales Shigematsu
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, México
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, México
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Chien YN, Gao W, Sanna M, Chen PL, Chen YH, Glantz S, Chiou HY. Electronic Cigarette Use and Smoking Initiation in Taiwan: Evidence from the First Prospective Study in Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071145. [PMID: 30935027 PMCID: PMC6480595 DOI: 10.3390/ijerph16071145] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022]
Abstract
A growing literature indicates that electronic cigarette use increases the risk of subsequent initiation of conventional smoking among cigarette-naïve adolescents in several Western countries. This research assesses the same relationship in an Asian country, Taiwan. The Taiwan Adolescent to Adult Longitudinal Study is a school-based survey that was carried out in two waves in 2014 (baseline) and in 2016 (follow-up). It employs probability sampling to create nationally representative samples of students in junior high school (mean age 13, 7th grade at baseline) and in senior high school (mean age 16, 10th grade at baseline). Data from this survey were analyzed via logistic regression to estimate the association between ever use of e-cigarettes at baseline and smoking initiation at follow-up, accounting for susceptibility to smoking, socio-demographic profile, depression status, and peer support. Among the 12,954 cigarette-naïve students surveyed, those with e-cigarette experience at baseline exhibited higher odds of smoking initiation at follow-up (Odds Ratio = 2.14, 95% CI (1.66, 2.75), p < 0.001). For the first time, we confirmed, through a longitudinal survey, a prospective association between ever use of e-cigarettes and smoking initiation in an Asian adolescent population. The restrictive policy on e-cigarettes currently in force in Taiwan is justified to prevent both e-cigarette and cigarette use among adolescents.
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Affiliation(s)
- Yu-Ning Chien
- Chung-Hua Institution for Economic Research, Taipei 106, Taiwan.
- College of Public Health, Taipei Medical University, Taipei 110, Taiwan.
| | - Wayne Gao
- Master's Program in Global Health and Development, Taipei Medical University, Taipei 110, Taiwan.
| | - Mattia Sanna
- Master's Program in Global Health and Development, Taipei Medical University, Taipei 110, Taiwan.
| | - Ping-Ling Chen
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan.
| | - Yi-Hua Chen
- College of Public Health, Taipei Medical University, Taipei 110, Taiwan.
| | - Stanton Glantz
- Department of Medicine, Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA 94117, USA.
| | - Hung-Yi Chiou
- College of Public Health, Taipei Medical University, Taipei 110, Taiwan.
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