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Yammine L, Tovar M, Yammine NA, Becker C, Weaver MF. E-cigarettes and Youth: The Known, the Unknown, and Implications for Stakeholders. J Addict Med 2024:01271255-990000000-00298. [PMID: 38498621 DOI: 10.1097/adm.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
ABSTRACT Despite the decline in the prevalence of e-cigarette use among youth during the coronavirus disease 2019 pandemic, more than 2.5 million of US high and middle schoolers are still using e-cigarettes. Furthermore, those who use e-cigarettes are starting at a younger age and are using them more intensely, reflecting, at least in part, a high addiction liability of modern e-cigarettes. Beyond addiction, accumulating evidence suggests that, in the short-term, e-cigarettes are associated with cardiovascular and pulmonary effects, whereas the long-term effects of e-cigarette use are yet to be established. The aim of this review is to synthesize current knowledge on e-cigarette use among youth, including established and potential risks and efforts to date to curb youth exposure to e-cigarettes. In addition, we provide recommendations for health care providers, researchers, and other stakeholders to address this significant public health issue.
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Affiliation(s)
- Luba Yammine
- From the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, TX (LY, MFW); University of Texas Health Science Center at Houston, Houston, TX (MT, CB); and University of Texas Health Science Center at San Antonio, San Antonio, TX (NAY)
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2
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Becker TD. A clinical overview of adolescent e-cigarette use (vaping). Minerva Pediatr (Torino) 2024; 76:108-118. [PMID: 37427959 DOI: 10.23736/s2724-5276.23.07131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
E-cigarette use (also known as "vaping") has become increasingly popular among adolescents over the past decade and grown into a significant public health concern in North America, the United Kingdom, and other countries. Concerns about this new trend have generated numerous new research studies. This aim of this study was to summarize recent scientific findings, with a focus on their relevance to clinicians working with adolescents. The first half covers epidemiology, risk factors for e-cigarette use, characteristics of e-cigarette use, youth perceptions of e-cigarettes, physical health risks of e-cigarettes, evidence for "gateway effects" of e-cigarette exposure on subsequent substance use, and the relationship between e-cigarette use and mental health. The review concludes with a clinical focus on assessment of youth who vape, psychoeducation for youth and families, clinical management of vaping, and regulatory considerations.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, New York-Presbyterian Hospital, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Weill Cornell Medicine, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA -
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Zawertailo L, Kouzoukas E, Fougere C, Dragonetti R, Veldhuizen S, Selby P. Clinical guidance for e-cigarette (vaping) cessation: Results from a modified Delphi panel approach. Prev Med Rep 2023; 35:102372. [PMID: 37654515 PMCID: PMC10466900 DOI: 10.1016/j.pmedr.2023.102372] [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: 05/01/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
Individuals seek help to stop their use of e-cigarettes from their healthcare practitioners. However, there is a paucity of published work addressing e-cigarette cessation methods empirically, and what evidence that is available is weak. Therefore, we developed an expert informed clinical resource to guide practitioners helping their clients quit using e-cigarettes. We conducted a modified Delphi process between September and December 2021 to reach consensus on clinical recommendations for e-cigarette cessation. Expert and Peer Panel members (n = 28) voted and provided feedback on the recommendations through three rounds of structured surveys, a discussion board, and one intermediate survey. The penultimate knowledge products underwent usability testing and were finalized based on user feedback. The Expert Panel maintained a 100% response rate for rounds 1 and 2 and 96% for round 3; the Peer Panel achieved a 100% response rate for all three rounds of the modified Delphi process. Consensus was reach on 24 recommendations and 2 statements spanning eight domains: severity and dependence; general approaches; treatment approaches; dual use; pharmacotherapy strategies; behavioural therapy strategies; harm reduction; and relapse prevention. Two additional 'no agreement' statements that did not reach consensus are included in the guidance resource. The recommendations were also contextualized for the following groups: adults; youth; people who are pregnant, breastfeeding and/or chestfeeding; and people with mental illness and/or substance use issues. The recommendations listed in the resource provide general clinical guidance on e-cigarette cessation to assist healthcare practitioners in the treatment planning process.
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Affiliation(s)
- Laurie Zawertailo
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Erika Kouzoukas
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Chantal Fougere
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott Veldhuizen
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Huerne K, Eisenberg MJ. Vaping-Cessation Interventions in Former Smokers. Can J Cardiol 2023; 39:1263-1267. [PMID: 37119945 DOI: 10.1016/j.cjca.2023.04.020] [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: 03/10/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023] Open
Abstract
This review provides an overview of potential vaping-cessation interventions in adult former smokers. The interventions reviewed include varenicline, bupropion, nicotine-replacement therapies (NRTs), and behavioural therapy. Evidence for intervention effectiveness is provided when available, such as for varenicline, whereas recommendations for bupropion and NRT are extrapolated from case studies or smoking-cessation guidelines. The limitations of these interventions, a general lack of prospective studies, and a discussion of challenges to vaping safety from a public health perspective are also discussed. Although these interventions show promise, further research is needed to establish precise protocols and dosages in the context of vaping cessation, rather than adapting existing recommendations from smoking cessation.
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Affiliation(s)
- Katherine Huerne
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Mark J Eisenberg
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Departments of Medicine and of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada; Division of Cardiology, Jewish General Hospital, McGill University, Montréal, Québec, Canada.
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Solimini R, Ruokolainen O, Cselko Z, Koprivnikar H, Spizzichino L, Papachristou S, González-Marrón A, Nunes E, Carnicer-Pont D, Fernandez E, López AM, Demosthenous E, Kilibarda B, Gallus S, Gómez-Chacón C, Keć I, Valentic M, Ollila H. Good Practice Statements for the treatment of nicotine dependence. Tob Prev Cessat 2023; 9:24. [PMID: 37448706 PMCID: PMC10336859 DOI: 10.18332/tpc/167964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/05/2023] [Accepted: 06/10/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Renata Solimini
- Istituto Superiore di Sanita, National Centre on Addiction and Doping, Rome, Italy
| | | | - Zsuzsa Cselko
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | | | | | | | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
| | - Emilia Nunes
- National Programme for Smoking Prevention and Tobacco Control, General-Directorate of Health, Portugal
| | - Dolors Carnicer-Pont
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Esteve Fernandez
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Mar López
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Elena Demosthenous
- Policy Department of the Cyprus National Addictions Authority, Nicosia, Cyprus
| | - Biljana Kilibarda
- Institute of Public Health of Serbia "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Ivona Keć
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Maja Valentic
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Hanna Ollila
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Al-Hamdani M, Davidson M, Bird D, Hopkins DB, Smith S. Learning from their experiences: Strategies used by youth and young adult ex-vapers. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 149:209038. [PMID: 37061190 DOI: 10.1016/j.josat.2023.209038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/07/2022] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION The prevalence of vaping among youth and young adults (YYAs; 16-18 and 19-24 years old, respectively) is moderate worldwide. Existing vaping cessation evidence lacks input from ex-vapers with a history of regular use and substantial maintenance periods. This study noted cessation strategies, relapse triggers, and recommendations for quitting identified by ex-vapers and assessed differences in outcomes across age and gender groups. METHODS We recruited ex-vapers (N = 290; mean use = 6.5 days/week, SD = 1.05) with a minimum maintenance period of 30 days and a history of three months of consecutive use of nicotine-based devices from Nova Scotia, Canada. The ex-vapers responded to open-ended questions regarding vaping cessation strategies, triggers, and recommendations for quit strategies in an online survey. We coded responses to each topic (e.g., triggers) and grouped them into categories (e.g., social influences). We used chi-square tests and Bonferroni correction tests to determine group differences by topic and within each category. RESULTS YYA ex-vapers identified cold turkey (28.9 %), self-restriction (27.5 %), and alternative coping mechanisms (19.0 %) as the most common cessation strategies; social influences (35.5 %,), mental state (18.3 %), and substance use (15.7 %) as the top triggers; and support systems (29.5 %), apps (17.3 %), and education (11.8 %) as the most useful recommendations for others. A higher proportion of female youth (51.3 %) identified social influences as a relapse trigger than male YAs (21.2 %) and female YAs (30.3 %). Further, male YAs (36.5 %) reported higher proportions of substance use as a relapse trigger than male youth (3.0 %) and female youth (2.6 %). Female youth (23.7 %) and YAs (22.6 %) recommended apps as a useful cessation strategy more often than male YAs (3.8 %). CONCLUSIONS Input from ex-vapers can help to inform cessation practices, and gender and age differences shed light onto the need to tailor treatments, such as using social-centric behavioral therapy, for female youth and adopting a polysubstance substance use treatment approach for YAs.
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Affiliation(s)
- Mohammed Al-Hamdani
- Department of Public Health, College of Health Science, QU Health, Qatar University, Doha 2713, Qatar; Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada.
| | - Myles Davidson
- Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada
| | - Danielle Bird
- Department of Psychology, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - D Brett Hopkins
- Department of Community Health and Epidemiology, Halifax, NS B3H4H8, Canada
| | - Steven Smith
- Department of Psychology, Saint Mary's University, Halifax, NS B3H 3C3, Canada
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Kundu A, Kouzoukas E, Zawertailo L, Fougere C, Dragonetti R, Selby P, Schwartz R. Scoping review of guidance on cessation interventions for electronic cigarettes and dual electronic and combustible cigarettes use. CMAJ Open 2023; 11:E336-E344. [PMID: 37072138 PMCID: PMC10118292 DOI: 10.9778/cmajo.20210325] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Although evidence-based smoking cessation guidelines are available, the applicability of these guidelines for the cessation of electronic cigarette and dual e-cigarette and combustible cigarette use is not yet established. In this review, we aimed to identify current evidence or recommendations for cessation interventions for e-cigarette users and dual users tailored to adolescents, youth and adults, and to provide direction for future research. METHODS We systematically searched MEDLINE, Embase, PsycINFO and grey literature for publications that provided evidence or recommendations on vaping cessation for e-cigarette users and complete cessation of cigarette and e-cigarette use for dual users. We excluded publications focused on smoking cessation, harm reduction by e-cigarettes, cannabis vaping, and management of lung injury associated with e-cigarette or vaping use. Data were extracted on general characteristics and recommendations made in the publications, and different critical appraisal tools were used for quality assessment. RESULTS A total of 13 publications on vaping cessation interventions were included. Most articles were youth-focused, and behavioural counselling and nicotine replacement therapy were the most recommended interventions. Whereas 10 publications were appraised as "high quality" evidence, 5 articles adapted evidence from evaluation of smoking cessation. No study was found on complete cessation of cigarettes and e-cigarettes for dual users. INTERPRETATION There is little evidence in support of effective vaping cessation interventions and no evidence for dual use cessation interventions. For an evidence-based cessation guideline, clinical trials should be rigorously designed to evaluate the effectiveness of behavioural interventions and medications for e-cigarette and dual use cessation among different subpopulations.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont.
| | - Erika Kouzoukas
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Laurie Zawertailo
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Chantal Fougere
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Rosa Dragonetti
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Peter Selby
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
| | - Robert Schwartz
- Institute of Medical Science (Kundu), University of Toronto; Centre for Addiction and Mental Health (Kouzoukas, Zawertailo, Fougere, Dragonetti, Selby, Schwartz); Departments of Pharmacology and Toxicology (Zawertailo), and Family and Community Medicine (Dragonetti, Selby), and Dalla Lana School of Public Health (Schwartz), University of Toronto, Toronto, Ont
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Ahuja N, Kedia SK, Jiang Y, Xie L, Ward KD, Pichon LC, Dillon PJ, Yu X. Factors Associated With E-Cigarette Quitting Behavior Among Adolescents in the United States: A Prospective Observational Study. J Adolesc Health 2022; 71:729-736. [PMID: 36088234 DOI: 10.1016/j.jadohealth.2022.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE This prospective observational study examined the association of socioecological factors with quitting behavior among US adolescents who exclusively use electronic cigarettes (e-cigarettes). METHODS We used data from past 30-day adolescent exclusive e-cigarette users (n = 243) participating in Wave 3 of the Population Assessment of Tobacco and Health study, who were then followed-up with approximately 12 months later for Wave 4. Weighted unadjusted and adjusted multivariate logistic regression models and structural equation modeling were performed to analyze the data. RESULTS Adolescents were significantly less likely to quit e-cigarettes if they perceived that nicotine in e-cigarettes was "slightly/somewhat harmful" to health (adjusted odds ratio [aOR] = 0.38; 95% confidence interval [CI]: 0.16-0.90, p = .02). Similarly, adolescents who reported that someone else in their home owned an e-cigarette (aOR = 0.43 [95% CI: 0.19-0.94], p = .03) or important people in their life used e-cigarettes (aOR = 0.45 [95% CI: 0.21-0.95], p = .03) were significantly less likely to quit e-cigarettes. The structural equation modeling showed a direct significant relationship of individual-level (b = 0.206, p = .02) and interpersonal-level factors (b = 0.170, p = .04) with e-cigarette quitting behavior. DISCUSSION Our findings suggest that individual-level (harm perception) and interpersonal-level (e-cigarette use at home and by important people) factors may play a significant role in e-cigarette quitting behavior among US adolescents.
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Affiliation(s)
- Nikhil Ahuja
- Department of Public Health and Social Work, Slippery Rock University of Pennsylvania, Slippery Rock, Pennsylvania.
| | - Satish K Kedia
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Yu Jiang
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Lu Xie
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Latrice C Pichon
- Division of Social and Behavioral Sciences, University of Memphis, School of Public Health, Memphis, Tennessee
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, Ohio
| | - Xinhua Yu
- Division of Epidemiology and Biostatistics, University of Memphis, School of Public Health, Memphis, Tennessee
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Keyes KM, Kreski NT, Ankrum H, Cerdá M, Chen Q, Hasin DS, Martins SS, Olfson M, Miech R. Frequency of adolescent cannabis smoking and vaping in the United States: Trends, disparities and concurrent substance use, 2017-19. Addiction 2022; 117:2316-2324. [PMID: 35588004 PMCID: PMC10037679 DOI: 10.1111/add.15912] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/07/2022] [Indexed: 01/24/2023]
Abstract
AIM To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. DESIGN Observational study. Survey-weighted multinomial logistic regression models assessed trends and disparities in past 30-day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental education and urbanicity. Multinomial logistic regression models also estimated associations of cannabis use (none, use without vaping, use with vaping) with past 2-week binge drinking and past 30-day nicotine/tobacco use. SETTING United States, 2017-19. PARTICIPANTS Participants in the national Monitoring the Future (n = 51 052) survey. MEASUREMENTS Past 30-day frequent cannabis use (six or more times/30 days) and past 30-day occasional use (one to five times/30 days), with and without vaping. FINDINGS Past 30-day frequent cannabis use with vaping and occasional use with vaping rose from 2017 to 2019. Past 30-day frequent and occasional cannabis use without vaping declined. Certain groups, such as Hispanic/Latino or lower socio-economic status adolescents, experienced particularly notable increases in frequent cannabis use with vaping (e.g. prevalence among Hispanic/Latino adolescents). Adolescents who reported smoking and vaping nicotine, and 10+ occasions of binge drinking, were 42.28 [95% confidence interval (CI) = 33.14-53.93] and 10.09 (95% CI = 4.51-22.53) times more likely to report past 30-day cannabis use with vaping, respectively, compared with no use. DISCUSSION Cannabis use without vaping appears to be declining among adolescents in the United States, while cannabis use with vaping is accelerating; frequent cannabis vaping is especially increasing, with consistent increases across almost all adolescent demographic groups. Cannabis use among US adolescents remains highly associated with other substance use.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Noah T. Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hadley Ankrum
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Deborah S. Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Richard Miech
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Metcalf M, Rossie K, Stokes K, Tanner B. Health Care Professionals' Clinical Skills to Address Vaping and e-Cigarette Use by Patients: Needs and Interest Questionnaire Study. JMIR Form Res 2022; 6:e32242. [PMID: 35404264 PMCID: PMC9039806 DOI: 10.2196/32242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Widespread vaping and e-cigarette use is a relatively new phenomenon. Youth vaping peaked in 2019, with over 25% of high school students currently vaping. e-Cigarettes are used where smoking is not permitted or as an alternative smoking cessation treatment instead of Food and Drug Administration-approved options. Vaping and e-cigarette use has the potential to harm health, including causing adverse respiratory effects and nicotine addiction. Health care professionals need skills training to help their patients with this relatively new and evolving health problem. OBJECTIVE The aim of this study is to understand health care professionals' training needs in this subject area to determine the focus for web-based continuing education training. METHODS We reviewed the literature on clinical aspects of vaping and e-cigarette use. Using the results and our experience in substance use continuing education, we created a list of key clinical skills and surveyed health care professionals about their training needs. We also asked about their interest in a list of related topics. We recruited individuals who completed our web-based courses on substance use, members of health care professional-related groups, and experts who had published an article on the subject. Half of the 31 health care professionals who completed the survey were physicians and the remainder were primarily nurses, social workers, and counselors. Participants self-identified as nonexperts (n=25) and experts (n=6) on vaping. RESULTS Participants who were nonexperts on average agreed or strongly agreed that they needed training in each of 8 clinical skills (n=25; range 3.7-4.4 agreement out of 5). The top two skills were recommending treatments for patients (4.4 out of 5, SD 0.49) and evaluating and treating the health effects of vaping and e-cigarette use (4.4 out of 5, SD 0.50). Experts agreed on the importance of training for health care professionals in all skills but rated the need for training higher than nonexperts for each topic. Over half of the participating health care professionals (44%-80%) were interested in nearly all (9/10, 90%) vaping-related topics on a checklist. The topics participants were most interested in were the pros and cons of vaping versus smoking and the health effects of second- and third-hand vaping. Primary care physicians showed more interest in vaping-related topics than nonprimary care physicians (t13=2.17; P=.02). CONCLUSIONS This study confirmed gaps in health care professionals' vaping-related clinical skills identified in the literature by identifying a perceived need for training in related skills and health care professionals' interest in key topics related to vaping prevention and cessation. This study provides specific guidance on which clinical skills training is most needed and which topics are most interesting to health care professionals.
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Affiliation(s)
- Mary Metcalf
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Karen Rossie
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Katie Stokes
- Clinical Tools, Inc, Chapel Hill, NC, United States
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Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations. Eur J Pediatr 2022; 181:453-462. [PMID: 34396473 PMCID: PMC8364775 DOI: 10.1007/s00431-021-04220-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/24/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
Worldwide, youth electronic cigarette use (vaping) has risen significantly over the past decade. This public health concern has spurred many high-quality studies characterizing country-specific prevalence, risk factors, physical and behavioral health complications, and optimal methods of assessment and counseling for youth vaping. Clinicians remain underexposed to this recent work, limiting translation of evidence into higher quality patient care. This review aims to provide pediatricians and other clinicians working with youth a clinically focused survey of key research findings and considerations based on recent evidence. This narrative review surveys emerging trends in EC use across different countries, reasons for youth vaping, characteristics of vaping materials that promote youth use, associations with combustible cigarette use, relation with cannabis and other illicit substances, physical and behavioral health risks associated with vaping, and methods of assessment, counseling, and intervention for problematic vaping in youth. Since vaping remains a relatively new phenomenon, long-term health consequences remain unknown.Conclusion: Youth vaping is an increasingly well-studied phenomenon with both physical and behavioral health risks. Pediatricians and other youth-focused clinicians can apply the lessons of recent research in work with youth and their families. What is Known: • Youth vaping is an increasingly prevalent public health concern. • Recent research demonstrates physical and behavioral health risks associated with vaping as well as methods for assessment, counseling, and intervention. What is New: • The current review summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice.
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Walsh BE, Williams CM, Zale EL. Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults. Subst Use Misuse 2022; 57:2101-2109. [PMID: 36331140 DOI: 10.1080/10826084.2022.2136495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Young adults' use of alcohol and e-cigarettes are of public health concern, as they report among the highest prevalence for use of both substances. Many young adults use alcohol and e-cigarettes simultaneously (i.e., at the same time with overlapping effects) despite heightened risk for adverse effects. Objectives: This study assessed simultaneous use expectancies and changes in pleasure from e-cigarettes as a function of alcohol consumption and simultaneous use frequency. Participants (N = 408; Mage = 23.64 years; 52.7% female) recruited through Amazon MTurk completed measures of alcohol and e-cigarette use, and expectancies, pleasure and frequency of simultaneous use. Results: Separate linear regression models revealed that alcohol consumption was positively associated with expectancies for simultaneous use of e-cigarettes/alcohol and pleasure from simultaneous use (ps ≤ .015). As individuals engaged in simultaneous use more frequently, they also reported greater expectancies for, and increased pleasure from, simultaneous use (ps < .001). Conclusions/Importance: Expectancies for simultaneous use may be greatest among young adults who consume more alcohol and engage in simultaneous use more frequently. Increased pleasure from e-cigarettes while drinking suggests that positive reinforcement may be implicated in simultaneous use patterns. Future research should examine the role of pleasure in simultaneous use trajectories.
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Affiliation(s)
- Brendan E Walsh
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Callon M Williams
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
| | - Emily L Zale
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
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13
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Chadi N, Vyver E, Bélanger RE. La protection des enfants et des adolescents contre les risques du vapotage. Paediatr Child Health 2021; 26:358-374. [PMID: 34552677 PMCID: PMC8448502 DOI: 10.1093/pch/pxab038] [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: 09/20/2020] [Accepted: 02/26/2021] [Indexed: 11/14/2022] Open
Abstract
Le vapotage chez les jeunes comporte des risques importants pour la santé et la sécurité des enfants et des adolescents canadiens. Le présent document de principes fournit de l'information générale sur le vapotage et les produits et dispositifs qui y sont liés, traite des méfaits à court et à long terme associés à leur utilisation et propose des stratégies de prévention et d'abandon pour les jeunes vapoteurs ou ceux qui sont à risque de commencer à vapoter. Le vapotage chez les jeunes est associé à un risque accru d'usage de tabac et de substances psychoactives, de troubles de santé mentale, de pneumopathie, de cardiopathie et de blessures accidentelles. Le vapotage ne doit pas servir d'outil d'abandon du tabac chez les jeunes, en raison de son manque d'efficacité et des données probantes sur les méfaits qu'il occasionne. De nombreuses stratégies préventives et thérapeutiques utilisées pour l'abandon du tabac, y compris les stratégies comportementales et pharmacologiques, peuvent être adaptées pour aider les jeunes à arrêter de vapoter. Des recommandations sont formulées pour les intervenants communautaires et les décideurs.
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Affiliation(s)
- Nicholas Chadi
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
| | - Ellie Vyver
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
| | - Richard E Bélanger
- Société canadienne de pédiatrie, comité de la santé de l’adolescent, Ottawa (Ontario)Canada
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14
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Chadi N, Vyver E, Bélanger RE. Protecting children and adolescents against the risks of vaping. Paediatr Child Health 2021; 26:358-374. [PMID: 34552676 DOI: 10.1093/pch/pxab037] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
Youth vaping presents significant risks for the health and safety of Canadian children and adolescents. This statement provides background information about vaping, vaping products, and related devices, discusses the short- and long-term harms known to be associated with their use, and offers prevention and cessation strategies for youth who vape or are at risk for starting. Youth vaping is associated with increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries. Vaping should not be used as a smoking cessation tool for youth, due to lack of effectiveness and evidence of harm. Many preventive and treatment strategies used for tobacco cessation, including behavioural and pharmacological options, can be adapted to help youth quit vaping. Recommendations for community stakeholders and policy makers are included.
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Affiliation(s)
- Nicholas Chadi
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
| | - Ellie Vyver
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
| | - Richard E Bélanger
- Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario, Canada
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Berg CJ, Krishnan N, Graham AL, Abroms LC. A synthesis of the literature to inform vaping cessation interventions for young adults. Addict Behav 2021; 119:106898. [PMID: 33894483 PMCID: PMC8113079 DOI: 10.1016/j.addbeh.2021.106898] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
There is an urgent need to address young adult (YA) vaping. However, there is limited vaping cessation intervention research, particularly studies tested via experimental designs. This manuscript focuses on YA vaping and critical needs for research to advance vaping cessation interventions for YAs. The smoking cessation literature, especially regarding YA smoking, provides evidence and theory from which to draw. However, the extent to which this literature has utility for vaping cessation warrants investigation. Research to inform the development and optimization of effective vaping cessation interventions for YAs requires attention to both potential targets for behavioral intervention (e.g., conceptual framework) and how to best reach YAs (i.e., delivery modality). Regarding the former, such interventions must consider the complexity of YA vaping (e.g., complex social influences, limited negative outcome expectancies, quit intentions). One particularly challenging aspect of YA cessation is co-use of other tobacco products and marijuana and ensuring that those who quit vaping do not continue or increase other product use. With regard to intervention modality, technology-based interventions (e.g., text messaging, apps) may prove promising, and individualized intervention (e.g., one-on-one counseling) may be needed to carefully intervene on the complexity of substance use, particularly cigarette and marijuana use, within this population.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States.
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Amanda L Graham
- Innovations Center, Truth Initiative, Washington, DC, United States; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; George Washington University Cancer Center, George Washington University, Washington, DC, United States
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Berg CJ, Duan X, Romm K, Pulvers K, Le D, Ma Y, Krishnan N, Abroms LC, Getachew B, Henriksen L. Young Adults' Vaping, Readiness to Quit, and Recent Quit Attempts: The Role of Co-use With Cigarettes and Marijuana. Nicotine Tob Res 2021; 23:1019-1029. [PMID: 33331889 PMCID: PMC8628650 DOI: 10.1093/ntr/ntaa265] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/11/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION E-cigarette cessation intervention research is limited. Young adult e-cigarette use and cessation is particularly nuanced, given various user profiles (ie, polytobacco use, co-use with marijuana) warranting different intervention approaches. METHODS The current study is an analysis of baseline survey data (collected September-December 2018) among 1133 young adult (aged 18-34) e-cigarette users in a 2-year longitudinal study. We examined (1) e-cigarette user profiles (ie, e-cigarette only; e-cigarette/other tobacco; e-cigarette/marijuana; e-cigarette/other tobacco/marijuana) and (2) correlates of readiness to quit e-cigarette use in the next 6 months and past-year e-cigarette quit attempts. RESULTS In this sample (Mage = 23.91, 47.3% male, 35.5% sexual minority, 75.2% White, 13.7% Hispanic), e-cigarette user profiles were as follows: 16.8% e-cigarettes-only, 23.4% e-cigarette/other tobacco, 18.0% e-cigarette/marijuana, and 41.8% e-cigarette/other tobacco/marijuana. Multinomial logistic regression (referent: e-cigarette-only use) indicated that all polyuse groups were more likely to use high-nicotine e-liquids (containing ≥9 mg of nicotine). Other predictors included e-cigarettes/other tobacco users being older and male; e-cigarettes/marijuana users using closed systems; and e-cigarettes/other tobacco/marijuana users being sexual minority (p's < .01). Readiness to quit e-cigarettes and past-year quit attempts were reported by 20.8% and 32.3%, respectively. Per multilevel regression, readiness to quit and quit attempts correlated with using fewer days, high-nicotine e-liquids, and closed systems, but not marijuana, as well as being heterosexual and Black (vs White); readiness to quit also correlated with being single; past-year quit attempts correlated with other tobacco use and being Hispanic. CONCLUSIONS Young adult e-cigarette users demonstrate distinct user profiles and cessation-related experiences that should be considered in developing cessation interventions. IMPLICATIONS The vast majority of young adult e-cigarette users use other tobacco products and marijuana. Unfortunately, few reported readiness to quit or attempting quit. Moreover, certain subgroups (eg, sexual/racial/ethnic minorities) are more likely to be ready or attempt to quit, but may not be successful. Vaping cessation interventions must attend to these nuances.
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Affiliation(s)
- 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
| | - Xuejing Duan
- Department of Biostatistics and Bioinformatics, Milken Institute School
of Public Health, George Washington University,
Washington, DC, USA
| | - Katelyn Romm
- 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
| | - Kim Pulvers
- Department of Psychology, California State University San
Marcos, San Marcos, CA, USA
| | - Daisy Le
- Community of Policy, Populations and Systems, School of Nursing, George
Washington University, Washington, DC,
USA
| | - Yan Ma
- George Washington Cancer Center, George Washington
University, Washington, DC, USA
- Department of Biostatistics and Bioinformatics, Milken Institute School
of Public Health, George Washington University,
Washington, DC, USA
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School
of Public Health, George Washington University,
Washington, DC, USA
| | - Lorien C Abroms
- 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
| | - Betelihem Getachew
- Department of Behavioral, Social and Health Education Sciences, Rollins
School of Public Health, Emory University, Atlanta,
GA, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford
University School of Medicine, Palo Alto,
CA, USA
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Teriba A, Mbama U, Sharma S, Abraham A, Ndefo UA. Evidence against e-cigarettes for smoking cessation. J Am Pharm Assoc (2003) 2021; 61:e55-e58. [PMID: 34034964 DOI: 10.1016/j.japh.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 11/17/2022]
Abstract
Electronic cigarettes (e-cigarettes) have been touted as a safer alternative to cigarettes and even as a smoking cessation aid. The health risks associated with smoking are well known, and smoking cessation has been studied extensively with options including behavioral therapy and pharmacotherapy (nicotine replacement therapy [NRT], varenicline, and bupropion). Several studies analyzed the effects of e-cigarettes as a smoking cessation aid. When used for smoking cessation, those who successfully abstain from cigarette smoking have a higher rate of continuation on e-cigarettes than NRT or pharmacotherapy. Other risks of e-cigarettes are highlighted including e-cigarette or vaping product use-associated lung injury. There is no approved pharmacotherapy for e-cigarette cessation. Two of the analyzed studies demonstrated the use of varenicline as a potential pharmacotherapy for e-cigarette cessation. The proposed benefits of e-cigarettes as a smoking cessation aid should be weighed against their probable detrimental effects. E-cigarette use should be discouraged as a whole and notably, as a smoking cessation aid.
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19
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Ruppel T, Alexander B, Mayrovitz HN. Assessing Vaping Views, Usage, and Vaping-Related Education Among Medical Students: A Pilot Study. Cureus 2021; 13:e13614. [PMID: 33816013 PMCID: PMC8011463 DOI: 10.7759/cureus.13614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background E-cigarette use, or vaping, is known to be associated with potentially life-threatening lung injury, with the Centers for Disease Control and Prevention reporting 2,807 hospitalizations and 68 deaths in the United States due to e-cigarette or vaping-associated lung injury. Vaping is also a risk factor for and is implicated in the spreading of COVID-19. Despite the consequences of vaping, the views and training of medical students regarding vaping is unclear. This study sought to investigate the knowledge and perception of vaping amongst future health care providers. Methods An anonymous, online survey was administered to 259 first through fourth year medical students at Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine via a secure website link in October 2019 and January 2020. The survey consisted of two sections. All participants answered section one, involving nine questions. This first section addressed sociodemographic characteristics, personal views on vaping, rating and impact of vaping medical education, and whether students had ever tried vaping. If students had ever vaped, they proceeded to section two of the survey including nine additional questions. Students that reported no past vaping use ended the survey and did not proceed to section two. Section two focused on evaluating vaping habits of users by questioning age of first usage, use frequency and nature, reasons for first trying and/or continuing to use, plans for quitting, personal impact of use, and current use. Data was analyzed with frequency and percentage distributions. Results Most respondents were of age 18-25 years (66.8%) and female (60.2%). Almost all students (96.5%) were aware of the negative health consequences of vaping. More than two thirds of students (68.7%) rated their vaping medical education as inadequate and the majority (76.1%) indicated their medical school curriculum did not impact their view on the matter. Most students (71.0%) reported a more negative stance on vaping due to recent news and media. Of the respondents, over two thirds (37.5%) vaped at least once and were labeled “vapers.” The most commonly stated reason for first trying vaping was recreational (60.8%). Half of vapers (50.5%) admitted to vaping in the past year and most vapers (90.6%) did not think their vaping impacted others. Current vaping use was reported in almost one-third of vapers (32.3%) despite knowing its dangers, and several (6.3%) did not consider vaping dangerous. Conclusion The findings from this pilot study conducted at a single medical school indicate possible deficiencies in vaping education, at least as perceived by the respondents and demonstrated by their vaping-related actions. It is unknown if the stated vaping views and practices of these medical students would be positively impacted by better vaping education or if these practices are generalizable to other students. However, the data suggests there is a need to consider more extensive analyses of medical school curriculums with respect to vaping education and training of students in these and related areas. Recommendations to enhance medical school curriculums include vaping-focused respiratory and gastrointestinal lectures, problem-based case studies on vaping, standardized patient encounters, and a community education program taught by medical students.
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Affiliation(s)
- Tyler Ruppel
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
| | - Brooke Alexander
- Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
| | - Harvey N Mayrovitz
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
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Hopkins DB, Al-Hamdani M. Young Canadian e-Cigarette Users and the COVID-19 Pandemic: Examining Vaping Behaviors by Pandemic Onset and Gender. Front Public Health 2021; 8:620748. [PMID: 33585389 PMCID: PMC7874134 DOI: 10.3389/fpubh.2020.620748] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/30/2020] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to test how youth and young adult e-cigarette users responded to the COVID-19 pandemic. The 2020 Youth and Young Adult Vaping Survey (N = 1,308) included 540 (44.7%) participants that reported differences in their vaping behaviors since the onset of the pandemic. Gender was the only relevant covariate that yielded a significant effect and/or interaction through a multivariate test. A two-way multivariate analysis of variance was used to test the effect of pandemic onset (pre- vs. during-pandemic), gender (males vs. females), and their interaction on vaping behaviors (days of vaping per week, episodes of vaping per day, and puffs per vaping episode). Respondents reported fewer days of vaping per week, episodes of vaping per day, and puffs per vaping episode during-pandemic than pre-pandemic [F(3,533) = 52.81, p < 0.001, ηp2 = 0.229]. The multivariate effect of gender on the three vaping outcomes was not statistically significant [F(3, 533) = 2.14, p = 0.095, ηp2 = 0.012], though the interaction between pandemic onset and gender was [F(3, 533) = 2.86, p = 0.036, ηp2 = 0.016]. Males reported fewer episodes of vaping per day [t(262) = 7.40, p < 0.001, 95% CI: 5.19–8.97] and puffs per vaping episode [t(263) = 3.23, p = 0.001, 95% CI:0.292–1.20] during-pandemic than pre-pandemic. Females reported fewer vaping episodes per day during-pandemic than pre-pandemic [t(273) = 5.14, p < 0.001, 95% CI: 2.76–6.18]. Further, females reported more frequent puffs per vaping episode in comparison to males during-pandemic [t(538) = −2.38, p = 0.017, 95% CI: −2.09–0.200]. The COVID-19 pandemic presents an opportunity to reduce vaping through health promotion messaging. Since females take more puffs per vaping episode overall, they may benefit the most from greater vaping cessation supports.
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Affiliation(s)
- D Brett Hopkins
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.,The Lung Association of Nova Scotia, Halifax, NS, Canada
| | - Mohammed Al-Hamdani
- The Lung Association of Nova Scotia, Halifax, NS, Canada.,Department of Psychology, Saint Mary's University, Halifax, NS, Canada
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Fedt A, Bhattarai S, Oelstrom MJ. Vaping-Associated Lung Injury: A New Cause of Acute Respiratory Failure. J Adolesc Health 2020; 66:754-757. [PMID: 32473722 DOI: 10.1016/j.jadohealth.2020.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/05/2020] [Accepted: 03/08/2020] [Indexed: 11/24/2022]
Abstract
E-cigarette-and vaping-associated lung injury (EVALI) is a new diagnosis with at least 2,807 hospitalizations and 68 deaths since 2019. This clinical observation describes one of the first cases of EVALI in a teenager who presented with nic-sick symptoms and developed acute respiratory distress syndrome and pneumomediastinum. The manuscript also reviews the presentation, work-up, recommended management, and proposed etiology of the condition and summarizes recent national vaping regulations enacted to address the EVALI epidemic.
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Affiliation(s)
- Aleesa Fedt
- Department of Pediatrics, Marshfield Children's Hospital, Marshfield, Wisconsin.
| | - Samhita Bhattarai
- Department of Pediatrics, Marshfield Children's Hospital, Marshfield, Wisconsin
| | - Matthew J Oelstrom
- Pediatric Intensive Care Unit, Marshfield Children's Hospital, Marshfield, Wisconsin
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