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Greene KM, Parks MJ, Patrick ME. Day-level correlates of nicotine and cannabis vaping among young adults in the United States. Addict Behav 2024; 158:108119. [PMID: 39067417 PMCID: PMC11407289 DOI: 10.1016/j.addbeh.2024.108119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 07/10/2024] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
Over the past two decades, vaping has increased in popularity among young adults. Yet, little is known about the daily activities or contexts associated with vaping behavior. The current study examined whether nicotine vaping, cannabis vaping, and dual-substance vaping (i.e., vaping both nicotine and cannabis) fluctuated in tandem with alcohol use and activities on a given day. Data came from the Monitoring the Future Vaping Supplement, a national sample of U.S. young adults. A subsample of people who vaped (N = 330 people) completed up to 14 daily surveys (N = 3686 days). Multilevel logistic regressions separated within- and between-person characteristics and controlled for combustible nicotine and cannabis use, day of the week, and demographic characteristics. Weights accounted for the complex survey design and attrition. Results demonstrated that nicotine vaping was more common on days when participants drank moderately or binge drank (compared to not drinking), used cigarettes, and spent more time at bars and parties than usual. Cannabis vaping on a given day was more likely on days when young adults drank moderately and spent more time at bars/parties. Likewise, moderate drinking, spending more time at bars/parties than usual, and spending less time on schoolwork than usual was associated with a higher likelihood of dual-substance vaping on a given day. Our findings highlight when young adults vape nicotine and cannabis, while also identifying proximal correlates of these behaviors to inform intervention and cessation efforts.
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Affiliation(s)
- Kaylin M Greene
- Department of Sociology and Anthropology, Montana State University, USA.
| | - Michael J Parks
- Center for Applied Research and Educational Improvement, University of Minnesota, USA; Butler Center for Research, Hazelden Betty Ford Foundation, USA
| | - Megan E Patrick
- Survey Research Center, Institute for Social Research, University of Michigan, USA
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Yang JJ, Ou TS, Lin HC, Kyung Nam J, Piper ME, Buu A. Retrospective and Real-time Measures of the Quantity of E-cigarette Use: An Ecological Momentary Assessment Study. Nicotine Tob Res 2023; 25:1667-1675. [PMID: 37327251 PMCID: PMC10445250 DOI: 10.1093/ntr/ntad094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Quantifying e-cigarette use is challenging because of the wide variety of products and the lack of a clear, objective demarcation of a use event. This study aimed to characterize the difference between retrospective and real-time measures of the quantity of e-cigarette use and identify the covariates that may account for discrepancies between the two types of measures. METHODS This study analyzed data from 401 college student e-cigarette users in Indiana and Texas who responded to a web survey (retrospective) and 7-day ecological momentary assessments (EMA) (real-time) on their e-cigarette use behavior, dependence symptomatology, e-cigarette product characteristics, and use contexts from Fall 2019 to Fall 2021. Generalized linear mixed models were used to model the real-time measures of quantity offset by the retrospective average quantity. RESULTS Although the number of times using e-cigarettes per day seems to be applicable to both retrospective and real-time measures, the number reported via EMA was 8.5 times the retrospective report. E-cigarette users with higher e-cigarette primary dependence motives tended to report more daily nicotine consumption via EMA than their retrospective reports (ie, perceived average consumption). Other covariates that were associated with discrepancies between real-time and retrospective reports included gender, nicotine concentration, using a menthol- or fruit-flavored product, co-use with alcohol, and being with others when vaping. CONCLUSIONS The study found extreme under-reporting of e-cigarette consumption on retrospective surveys. Important covariates identified to be associated with higher than average consumption may be considered as potential targets for future vaping interventions. IMPLICATIONS This is the first study that characterizes the direction and magnitude of the difference between retrospective and real-time measures of the quantity of e-cigarette use among young adults-the population most likely to use e-cigarettes. An average retrospective account of vaping events per day may significantly underestimate e-cigarette use frequency among young adults. The lack of insight into the degree of consumption among users with heavy primary dependence motives illustrates the importance of incorporating self-monitoring into cessation interventions.
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Affiliation(s)
- James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, Houston, TX, USA
| | - Tzung-Shiang Ou
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
| | - Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
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LoParco CR, Walker A, Livingston MD, Khoshhal B, Gonzalez-Pons KM, Soule E, Treffers R, Rossheim ME. A national assessment of on-premise drinking establishments near public universities: Drink prices, drink specials, indoor tobacco use, and state-level alcohol laws. Alcohol Clin Exp Res 2022; 46:2068-2076. [PMID: 36098371 PMCID: PMC9743012 DOI: 10.1111/acer.14937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Inexpensive drinks and price promotions increase alcohol consumption and have been observed at on-premise drinking establishments near large colleges. Some bars may sell tobacco products and allow indoor tobacco use to encourage patrons to stay and drink more. This study examined drink prices/specials and associated practices of on-premise drinking establishments including tobacco sales and policies regarding tobacco use. METHODS In 2018, telephone calls about prices/practices were made to 403 randomly selected bars/nightclubs within 2 miles of large residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol laws. Multivariable linear and logistic regression models examined associations between alcohol prices/specials, state laws, and establishment practices. RESULTS The average price for the least expensive draft beer and a vodka shot at each location were $3.62 (SD = $1.15) and $4.77 (SD = $1.16), respectively. Most establishments (65%) had happy hour specials, 6% had 2-for-1 specials, 91% sold food, 9% sold cigarettes, 8% allowed smoking indoors, and 18% permitted electronic cigarette (e-cigarette) use indoors. Allowing e-cigarette use indoors (b = -0.54) and selling cigarettes (b = -0.79) were associated with lower vodka prices; allowing cigarette smoking indoors (b = -0.46) was associated with lower beer prices. Lower beer prices (OR = 1.38), selling food (OR = 2.97), and no state law banning happy hour specials altogether (OR = 4.24) or with full-day price reduction exemptions (OR = 12.74) were associated with higher odds of having happy hour specials. Allowing e-cigarette use indoors was associated with having 2-for-1 specials (OR = 6.38). CONCLUSION In bars near large public universities, beers and shots were often available for less than $5 and drink specials were prevalent. Further, some establishments allowed tobacco use indoors and/or sold cigarettes. Laws that increase alcohol taxes, set minimum drink prices, and ban the sale and indoor use of tobacco products at on-premise drinking locations are important harm reduction tools.
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Affiliation(s)
- Cassidy R LoParco
- School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | | | | | - Bita Khoshhal
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | | | - Eric Soule
- College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Ryan Treffers
- Pacific Institute for Research and Evaluation, Beltsville, Maryland, USA
| | - Matthew E Rossheim
- School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Yang JJ, Lin HC, Ou TS, Tong Z, Li R, Piper ME, Buu A. The situational contexts and subjective effects of co-use of electronic cigarettes and alcohol among college students: An ecological momentary assessment (EMA) study. Drug Alcohol Depend 2022; 239:109594. [PMID: 35988530 PMCID: PMC10232334 DOI: 10.1016/j.drugalcdep.2022.109594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Understanding the co-use of e-cigarettes and alcohol, including the situational contexts and subjective effects associated with co-use in real-time is necessary for validating this behavior and informing intervention. Yet, the sparse literature has built upon retrospective data. METHODS This study recruited 686 college students who were currently using e-cigarettes from three campuses in the Midwest and South of U.S in Fall 2019-Fall 2021. An on-line survey was conducted to measure e-cigarette use patterns, GPA, e-cigarette and alcohol dependence symptoms, and respiratory symptoms. A 7-day ecological momentary assessment was used to collect real-time data on e-cigarette and alcohol use, situational contexts and subjective effects. RESULTS Frequent drinking e-cigarette users reported more high-risk use behavior including consuming 6 + drinks/occasion and simultaneous use, and reported more e-cigarettes and alcohol related dependence symptoms and respiratory symptoms, compared to infrequent/non-drinker e-cigarette users. Alcohol quantity was positively associated with e-cigarette quantity among the high frequency drinking group. This study identified important use contexts that were associated with higher e-cigarette consumption including use of menthol or fruit flavored e-cigarettes, being in a car, and the presence of others. E-cigarette use and alcohol use both increased the levels of positive affect, physiological sensation, and craving for e-cigarettes, whereas only alcohol use significantly decreased negative affect. No interaction effects between e-cigarette use and alcohol use were found. CONCLUSIONS The findings highlight the addiction and health risks associated with frequent co-use of e-cigarettes and alcohol, and also call for regulations on nontobacco flavorings in e-cigarette products.
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Affiliation(s)
- James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA.
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA.
| | - Tzung-Shiang Ou
- Department of Applied Health Science, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA.
| | - Zhaoxue Tong
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA 16802-2111, USA.
| | - Runze Li
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA 16802-2111, USA.
| | - Megan E Piper
- Center for Tobacco Research & Intervention, Department of Medicine, University of Wisconsin, 1930 Monroe Street, Suite 200, Madison, WI 53711, USA.
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.., Houston, TX 77030, USA.
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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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Ganson KT, Nagata JM. Associations between vaping and eating disorder diagnosis and risk among college students. Eat Behav 2021; 43:101566. [PMID: 34534874 DOI: 10.1016/j.eatbeh.2021.101566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
Vaping is common among college-age young adults. Preliminary research has shown associations between vaping and eating disorder symptoms, however, there remain gaps in this knowledge among college students. The aim of this study was to determine the associations between vaping and a self-reported lifetime eating disorder diagnosis and eating disorder risk among a large sample of college students. Cross-sectional data from the 2018-2019 national (U.S.) Healthy Minds Study (n = 51,231) were analyzed. Multiple logistic regression analyses were conducted to determine the unadjusted and adjusted associations between vaping or e-cigarette use in the past 30 days and a self-reported lifetime eating disorder diagnosis (any diagnosis, anorexia nervosa, bulimia nervosa, binge-eating disorder) and eating disorder risk (SCOFF). Among the sample, 19.0% of participants reported vaping or e-cigarette use in the past 30 days, 3.7% self-reported any lifetime eating disorder diagnosis, and 25.0% were at elevated risk for an eating disorder. Vaping or e-cigarette use was associated with higher odds of all eating disorder measures, including the self-reported lifetime eating disorder diagnosis items (any diagnosis, anorexia nervosa, bulimia nervosa, binge-eating disorder) and elevated eating disorder risk, while adjusting for demographic and confounding variables. Among a large sample of college students, vaping or e-cigarette use was associated with a self-reported lifetime eating disorder diagnosis and elevated eating disorder risk, which may exacerbate the many medical complications associated with eating disorder behaviors. Clinical professionals should screen for eating disorder behaviors among college students who report vaping or e-cigarette use to monitor symptoms and medical complications.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States of America
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