1
|
Audrain-McGovern J, Klapec O, Koita F, Manikandan D, Stone MD. The interacting effects of depression symptoms and sweet flavoring on the rewarding and reinforcing value of cigarillo use among young adults. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100234. [PMID: 38646014 PMCID: PMC11033167 DOI: 10.1016/j.dadr.2024.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024]
Abstract
Background Young adults 18-24 years old have the highest prevalence of cigarillo use, exposing young adults to comparable or higher nicotine levels and many of the same toxicants as combustible cigarettes. Identifying individual and product characteristics that increase the potential for persistent use is warranted. We sought to examine the interacting effects of depression symptoms and sweet flavoring on the rewarding and reinforcing value of cigarillo use. Methods 86 young adults (18-24 years old, 73.3 % male, 38.4 % White, 33.7 % Black, and 27.9 % Other) completed three laboratory visits assessing the subjective rewarding value (exposure paradigm), relative reinforcing value (computerized choice task), and absolute reinforcing value (ad libitum cigarillo smoking session) of sweet-flavored versus non-flavored cigarillos. Depression symptoms were measured with the 20-item Center for Epidemiologic Studies of Depression Scale and treated as a continuous variable. Results General linear models with the appropriate family link tested differences in depressive symptomology for each outcome. Irrespective of flavor, greater cigarillo subjective reward was reported across increasing depressive symptomology (B=.0.03 [95%CI=0.00, 0.05], p=.017). Across symptom levels, no significant differences were observed in the subjective reward and relative and absolute reinforcing values of sweet-flavored versus non-flavored cigarillos (p's >.05). Conclusions Young adults with elevated depression find cigarillos more rewarding but not more reinforcing. They are not more vulnerable than young adults with lower symptom levels to sweet cigarillo flavoring. Public health prevention campaigns and tobacco product regulations aimed at preventing the initiation and escalation of young adult cigarillo use may impact young adults broadly.
Collapse
Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Olivia Klapec
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fodie Koita
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Divya Manikandan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew D. Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA
| |
Collapse
|
2
|
Vaz M, Cascais P, Lourenço O. Use of and Beliefs toward Novel Tobacco and Nicotine Products among Portuguese University Students: A Pandemic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:478. [PMID: 38673389 PMCID: PMC11050595 DOI: 10.3390/ijerph21040478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Over the last decade, novel tobacco and nicotine product experimentation and use have dramatically increased among the youth, even in countries with strong tobacco control and anti-smoking social norms. We performed an online questionnaire-based cross-sectional study in March-June 2021, targeting students from the University of Beira Interior, Portugal. The aim was to assess the experimentation and use of tobacco and nicotine products and students' beliefs towards these products. Of the 452 participants, 67.0% were female; the mean age was 21.9 ± 3 years. Most students (60.4%) reported experimenting with tobacco/nicotine products; 31.2% were current users; polyconsumption was common. Of the current users, all used cigarettes, 41.1% used heated tobacco, 20.6% e-cigarettes, and 14.9% used water pipes. Our multivariate analysis showed that being male, being in the third year of study, and cohabiting or socializing with smokers were strongly associated with tobacco/nicotine use. While most students agree that heated tobacco and e-cigarettes are addictive, that they are not less harmful than cigarettes, and that second-hand exposure may cause health problems, few tobacco/nicotine users are ready to quit, and few students support a smoke-free university campus. These findings indicate high experimentation and the regular dual use of novel tobacco and nicotine products and suggest a pro-smoking social norm among university students.
Collapse
Affiliation(s)
- Marina Vaz
- FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; (M.V.); (P.C.)
| | - Pedro Cascais
- FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; (M.V.); (P.C.)
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal
| | - Olga Lourenço
- FCS-UBI, Faculty of Health Sciences, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal; (M.V.); (P.C.)
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal
| |
Collapse
|
3
|
Audrain-McGovern J, Manikandan D, Koita F, Klapec O, Pickworth WB, Stone MD. Effect of sweet flavouring on the rewarding and reinforcing value of cigarillo use among young adults. Tob Control 2023:tc-2023-058307. [PMID: 38050181 PMCID: PMC11116272 DOI: 10.1136/tc-2023-058307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Cigarillos dominate the US cigar market, and young adults largely drive use. While young adults prefer flavoured to non-flavoured cigarillos, especially those flavoured to taste like fruit or other sweets, the factors that underlie this preference have received little attention. We sought to determine if key indicators of abuse liability, the rewarding and reinforcing effects, are greater for sweet versus non-flavoured cigarillos. METHODS Young adults (18-24 years old) completed three laboratory visits assessing the subjective rewarding value (exposure paradigm), relative reinforcing value (computerised choice task) and absolute reinforcing value (ad libitum cigarillo smoking session) of sweet-flavoured versus non-flavoured cigarillos. General linear regression models were fit with the appropriate family link for each outcome measure. RESULTS Young adults rated sweet-flavoured cigarillos as more rewarding (estimated marginal mean (EMM) =4.52, 95% CI 4.00 to 5.03) than the non-flavoured cigarillo (EMM=3.31, 95% CI 2.80 to 3.83; B=1.20, 95% CI 0.80 to 1.60, p<0.001). The reinforcing value of sweet-flavoured cigarillos, measured by break point, was higher relative to non-flavoured cigarillos (6.34 out of 10), especially among young adults with a preference for flavoured cigarillos (B=1.94, 95% CI 0.71 to 3.18, p=0.003). Young adults took 1.9 times the number of puffs (35.75 vs 19.95) from sweet-flavoured cigarillos compared with non-flavoured cigarillos (Rate Ratio =1.94, 95% CI 1.30 to 2.90, p<0.001). CONCLUSIONS Sweet flavouring increases the abuse liability of cigarillos among young adults as reflected in greater liking, motivation to use and actual use. Banning sweet flavouring in cigarillos may diminish their use in young adults.Trial registration number CT.gov (NCT05092919).
Collapse
Affiliation(s)
| | - Divya Manikandan
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Fodie Koita
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Olivia Klapec
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Matthew D Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
4
|
Ickes M, Hester JW, Wiggins AT, Rayens MK. Juul use among emerging adults transitioning from high school to college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:53-60. [PMID: 33577416 DOI: 10.1080/07448481.2021.1873790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
Objective: Assess the prevalence, perceptions, sociodemographic/personal factors that influence Juul use among incoming freshmen.Participants: Incoming undergraduate students (N = 1,706) attending a public university in the southeastern U.S.Methods: Cross-sectional survey administered August 2018. Bivariate relationships assessed using chi-square test of association. Multinomial logistic regression to determine factors associated with Juul use status.Results: 41% had ever used Juul, 24% had used within the past month. Among current users, one-third had used 20-30 days. Risk factors for current use: heterosexual orientation (relative to other sexual orientation) AOR = 2.16, 95% CI: 1.20-3.91), those who planned to join sorority/fraternity (relative to those who did not plan to; AOR = 2.15, 95% CI: 1.59-2.90), current smokers (relative to nonsmokers; AOR = 24.39, 95% CI: 7.52-76.92), current marijuana users (compared with nonusers of marijuana; AOR = 6.45, 95% CI: 3.92-10.64) and alcohol users (compared with nondrinkers; AOR = 7.81, 95% CI: 5.75-10.54).Conclusion: Prevention and treatment efforts are needed for emerging adults transitioning to college.
Collapse
Affiliation(s)
- Melinda Ickes
- Tobacco Policy, BREATHE, Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Jakob W Hester
- University of Kentucky Health and Wellness, Lexington, KY, USA
| | - Amanda T Wiggins
- Data Management & Outcomes, BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
5
|
Petkeviciene J, Kriaucioniene V, Raskiliene A. Academic Achievements, Satisfaction with Studies and Risky Behaviours among First-Year Students of Kaunas (Lithuania) Universities, 2000-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137616. [PMID: 35805274 PMCID: PMC9266131 DOI: 10.3390/ijerph19137616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022]
Abstract
Risky behaviours are prevalent among university students and may affect academic achievements. This study aimed to evaluate the associations between academic achievements, satisfaction with studies and risky behaviours among first-year students of Kaunas (Lithuania) universities. Three cross-sectional surveys were conducted in 2000, 2010, and 2017. The self-administered questionnaires were filled in during lectures and assessed frequency and amount of alcohol consumption, drinking problems (CAGE test), smoking and drug use frequency, and academic achievements. The associations between risky behaviours and academic achievements were analysed using multivariable logistic regression analysis. Altogether 3325 students (1341 men and 1984 women) aged 20.0 (1.5) years participated in the survey. The proportion of students who consumed alcohol at least once a week and drank 11 or more standard alcoholic units (SAU) a week decreased. Every fifth student reported a drinking problem. Daily smoking prevalence declined, and drug use increased among male students. Multivariable logistic regression analysis revealed that frequent alcohol consumption and problem drinking were associated with low importance of good grades. Students who rated their academic performance below average and were dissatisfied with studies were more likely to consume ≥11 SAU a week. Daily smoking was more common among students who reported low importance of good grades and academic performance below average. A higher prevalence of drug use was found only in male students who declared low importance of good grades. Health promoting interventions at the individual and student community level are required to reduce the prevalence of substance use and improve the academic achievements of students.
Collapse
Affiliation(s)
- Janina Petkeviciene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania; (V.K.); (A.R.)
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-620-61556
| | - Vilma Kriaucioniene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania; (V.K.); (A.R.)
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania
| | - Asta Raskiliene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, LT47181 Kaunas, Lithuania; (V.K.); (A.R.)
| |
Collapse
|
6
|
Blank MD, Ozga JE, Romm KF, Douglas A, Alexander L, Doogan NJ, Wilson M, Dino G. Geographic isolation predicts tobacco product use among youth: A latent class analysis. J Rural Health 2022; 38:373-381. [PMID: 33978979 PMCID: PMC8586053 DOI: 10.1111/jrh.12583] [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] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the current study was to evaluate associations between geographic rurality and tobacco use patterns among adolescents. METHODS High school students (N = 566) from north-central Appalachia reported on their lifetime and/or current use of cigarettes, electronic cigarettes (ECIGs), cigars, and smokeless tobacco. Geographic rurality was measured via the Isolation scale, whereby residential ZIP Codes determined the degree to which respondents have access to health-related resources. Latent class analysis (LCA) was used to identify discrete classes of adolescent tobacco users based on their use of tobacco products. Then, associations between participants' geographic rurality and class membership were evaluated using a series of multinomial logistic regressions. FINDINGS LCA classified participants as Nonusers, Current ECIG Users, Cigarette/ECIG Experimenters, and Polytobacco Users. Individuals with higher Isolation scores were more likely to be Polytobacco Users and Cigarette/ECIG Experimenters than Nonusers, and were more likely to be Polytobacco Users than Current ECIG Users. CONCLUSIONS The continuous Isolation scale used in the present study predicted polytobacco use patterns among adolescents in a manner that is consistent with, while simultaneously expanding upon, prior work. Tobacco control practices and policies should be viewed through a lens that considers the unique needs of geographically isolated areas.
Collapse
Affiliation(s)
- Melissa D. Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Jenny E. Ozga
- Department of Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, West Virginia, USA
| | - Katelyn F. Romm
- Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health, Washington, DC, USA
| | - Ashley Douglas
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Linda Alexander
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Nathan J. Doogan
- Government Resources Center, Ohio State University, Columbus, Ohio, USA
| | - Michael Wilson
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, West Virginia, USA
- Department of Social & Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| |
Collapse
|
7
|
Support for 100% Tobacco-Free Policy on a College Campus in New Jersey: Differences between students and faculty/staff. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
8
|
Herrera AL, Pasch KE, Marti CN, Loukas A, Perry C. Exposure to tobacco marketing in bars predicts subsequent use of multiple tobacco products among non-tobacco-using college students. Tob Control 2020; 29:631-637. [PMID: 31822526 PMCID: PMC10388690 DOI: 10.1136/tobaccocontrol-2019-055195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Due to other marketing restrictions, one venue where tobacco companies concentrate their marketing efforts to reach young adults is bars/nightclubs. OBJECTIVE This study examined the relationship between exposure to tobacco marketing in bars/nightclubs and number of alternative tobacco/nicotine products used 6 months later among college students. METHODS Participants were 1,406 students aged 18-29 years old who reported going to bars or nightclubs at least rarely (M age=21.95; 67% female; 46% non-Hispanic white). Students completed an online survey in fall 2014/spring 2015 (wave 1) and again 6 months later (wave 2). Multilevel Poisson regression models were used to assess the relationship between exposure to three types of marketing at bars/nightclubs at wave 1 (tobacco/nicotine product advertisements; free samples; industry representatives) and number of tobacco products used (range=0-5) at wave 2, controlling for school type (2 year vs 4 year), age, sex, race/ethnicity and frequency of bar visits. An interaction between the number of wave 1 products and each marketing variable was tested. RESULTS Greater exposure to free samples and tobacco industry representatives at bars/nightclubs predicted a greater number of products used 6 months later, but only among wave 1 non-tobacco users and not among tobacco users. Exposure to advertisements at bars/nightclubs did not predict the number of products used 6 months later. CONCLUSION Tobacco companies claim that marketing is targeted to those who already use the product, not to non-users. However, the current study indicates tobacco marketing in bars and nightclubs may encourage use among non-users and has no influence on current users.
Collapse
Affiliation(s)
- Ana Laura Herrera
- Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA
| | - Keryn E Pasch
- Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA
| | - C Nathan Marti
- Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Loukas
- Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA
| | - Cheryl Perry
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, Texas, USA
| |
Collapse
|
9
|
Ickes MJ, Wiggins AT, Rayens MK, Hahn EJ. Student Tobacco Use Behaviors on College Campuses by Strength of Tobacco Campus Policies. Am J Health Promot 2020; 34:747-753. [PMID: 32048855 PMCID: PMC8101058 DOI: 10.1177/0890117120904015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To examine the association between strength of policy and self-reported tobacco use behavior, controlling for demographic characteristics, polytobacco use, knowledge of campus tobacco policy, and perceived policy compliance by others. DESIGN Cross-sectional, online survey. SETTING Ten participating State University of New York (SUNY) campuses; 5 with designated smoking/tobacco use areas and 5 with 100% tobacco-free policies. SUBJECTS Convenience sample of students from SUNY campuses: only tobacco users (N = 576 students) included for analysis. MEASURES Items assessing tobacco use behaviors on campus, policy knowledge, and observation of others using tobacco on campus. ANALYSIS T tests and chi-square tests of association used to compare responses between tobacco users across campuses. Generalized estimating equations modeling used to evaluate predictors of tobacco use on campus; model estimated with students nested within campus. RESULTS Those on campuses without a comprehensive policy were more likely to report (in the past week) having seen others smoke on campus (98% vs 69%, P < .001), having personally smoked on campus (65% vs 36%, P < .001), and seeing others use tobacco products on campus (88% vs 67%, P < .001), compared to those on tobacco-free campuses. CONCLUSION Tobacco-free campus policies provide numerous protective factors for tobacco users and nonusers. However, compliance strategies are imperative for intended policy success.
Collapse
Affiliation(s)
- Melinda J. Ickes
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Amanda T. Wiggins
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J. Hahn
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
10
|
Ashford K, McCubbin A, Rayens MK, Wiggins A, Dougherty K, Sturgill J, Ickes M. ENDS use among college students: Salivary biomarkers and persistent cough. Addict Behav 2020; 108:106462. [PMID: 32442871 DOI: 10.1016/j.addbeh.2020.106462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
Though e-cigarette aerosol has been associated with altered lung cell function, few studies have examined the effects of use on immune response and respiratory symptoms. The purpose of this study was to examine if recent persistent cough or cytokine levels are related to Electronic Nicotine Delivery Systems (ENDS) use in college students. In April 2019, 61 undergraduate students at the University of Kentucky completed surveys and provided a salivary sample to evaluate cytokine levels (Interleukin (IL-) 2, 4, 6, 8, 10, 12, 13 and TNFα, INFγ), using quota sampling to obtain comparable numbers of ENDS users and non-ENDS users. Data analysis included chi-square tests and multivariable logistic and linear regression. All ENDS users reported JUUL as their primary product. ENDS users were more likely to be younger, use cigarettes and marijuana, and report a persistent cough. Controlling for cigarette and marijuana use, there was a trend toward greater likelihood of persistent cough among ENDS users. Compared with nonusers, salivary IL-2 and INFγ were elevated and IL-4 was decreased, controlling for cigarette and marijuana use. There was a trend toward lower IL-12p70 values among ENDS users with these covariates. Findings reveal dysregulation of salivary immune profiles toward a TH1 phenotype in emerging adult ENDS users and short-term immune function may be dysregulated in young adult e-cigarette users.
Collapse
|
11
|
Dugas EN, Sylvestre MP, Wellman RJ, O'Loughlin J. Does use of other tobacco products change when cigarette smoking status changes: A descriptive study of young adults. Addict Behav 2020; 107:106404. [PMID: 32222562 DOI: 10.1016/j.addbeh.2020.106404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/06/2020] [Accepted: 03/18/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Whether polytobacco use or nicotine dependence (ND) change when cigarette smoking status changes in young adults is an understudied issue. Our objective was to describe use of other tobacco products (OTPs) and ND according to change in cigarette smoking status over four years in young adults. METHODS We drew data from a longitudinal study of 1294 adolescents age 12-13 at inception in 1999-2000 and followed into young adulthood. Among 790 participants with data at age 20 and 24, 22% had never smoked cigarettes; 37% were "sustained smokers"; 9% were "relapsers"; 10% had quit 1-3 years ago; and 22% had quit ≥4 years ago. We described past-year OTP (i.e., cigars/cigarillos, waterpipe, sundry tobacco products (i.e., pipe, bidis, chewing tobacco, snuff)) use and ND over 4 years in these groups. RESULTS At age 20, sustained smokers reported using a mean(SD) of 1.1(0.9) OTP in the past-year; relapsers reported 0.5(0.6); shorter-term quitters reported 0.9(0.7); longer-term quitters reported 0.3(0.6); and never smokers reported 0.2(0.4). There was no change in OTP use or ND in never smokers and longer-term quitters. Shorter-term quitters reduced the number of OTPs by -0.5(95% confidence interval: -0.7,-0.3) on average over 4 years; sustained smokers decreased by -0.2(-0.3,-0.1). Relapsers increased by 0.6(0.4,0.7) on average. CONCLUSIONS OTP use and ND were stable in early adulthood among never smokers, sustained smokers and longer-term quitters, but fluctuated in parallel with stopping and starting to smoke. Research is needed to ascertain the underpinnings of these fluctuations and whether they help or hinder cessation.
Collapse
Affiliation(s)
- Erika N Dugas
- Centre de recherche du centre hospitalier de l Université de Montréal (CRCHUM), Montreal, QC, Canada.
| | - Marie-Pierre Sylvestre
- Centre de recherche du centre hospitalier de l Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
| | - Robert J Wellman
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Jennifer O'Loughlin
- Centre de recherche du centre hospitalier de l Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.
| |
Collapse
|
12
|
Ickes M, Hester JW, Wiggins AT, Rayens MK, Hahn EJ, Kavuluru R. Prevalence and reasons for Juul use among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:455-459. [PMID: 30913003 PMCID: PMC6763357 DOI: 10.1080/07448481.2019.1577867] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/17/2018] [Accepted: 01/29/2019] [Indexed: 06/01/2023]
Abstract
Objective: Examine Juul use patterns, sociodemographic and personal factors associated with Juul use, and reasons for Juul initiation and current use, among college students. Participants: Convenience sample of 371 undergraduates at a large university in the southeast; recruited April 2018. Methods: Cross-sectional design using an online survey. Logistic regression identified the personal risk factors for current use. Results: Over 80% of participants recognized Juul; 36% reported ever use and 21% past 30-day use. Significant risk factors for current Juul use were: male, White/non-Hispanic, lower undergraduate, and current cigarette smoker. Current Juul users chose ease of use and lack of a bad smell as reasons for use. Ever Juul users most commonly endorsed curiosity and use by friends as reasons for trying Juul. Conclusions: Given the propensity for nicotine addiction among youth and young adults, rates of Juul use are alarming and warrant immediate intervention.
Collapse
Affiliation(s)
- Melinda Ickes
- Kinesiology and Health Promotion, Tobacco Policy, BREATHE, University of Kentucky, Lexington, KY, USA
| | - Jakob W. Hester
- Health Promotion, College of Education, University of Kentucky, Lexington, KY, USA
| | - Amanda T. Wiggins
- Data Management & Outcomes, BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J. Hahn
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ramakanth Kavuluru
- Division of Biomedical Informatics, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
13
|
Ickes MJ, Wiggins AT, Rayens MK, Hahn EJ. Readiness for Tobacco-Free Policy in a Statewide University System. Health Promot Pract 2020; 22:873-879. [PMID: 32546058 DOI: 10.1177/1524839920934799] [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] [Indexed: 11/17/2022]
Abstract
Background. Almost 2,000 campuses have adopted tobacco-free (TF) policies across the United States. However, there is not a systematic process to help campuses implement successful policies. Readiness assessments can help provide assistance as campuses work to implement successful policies. Purpose. We assessed readiness for TF policies among campuses of a statewide university system and determined factors associated with readiness. Participants. Stakeholders from 23 campuses without 100% TF policies were invited to participate in an online survey. Method. System administrators provided contacts for five to eight stakeholders per campus. Included in the analysis were 10 of 23 campuses (43.5%) with at least three stakeholders completing the survey. Results. Of the 10 campuses, one was in Preplanning, five were in Preparation, and four were in the Initiation stage of readiness. Political Climate was the highest scored dimension on seven campuses (0.74-1.0); Resources was the lowest on eight campuses (0.0-0.67). Campus size and county rurality were each associated with one dimension score. Conclusions. Despite being part of a statewide university system, campuses are in varying stages of readiness for TF policies. Stage-based strategies to advance TF campus policies must be implemented to set campuses up for successful policies.
Collapse
Affiliation(s)
- Melinda J Ickes
- College of Education, University of Kentucky, Lexington, KY, USA
| | | | - Mary Kay Rayens
- College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J Hahn
- College of Nursing, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
14
|
Comiford AL, Rhoades DA, Dvorak JD, Ding K, Mehta T, Spicer P, Wagener T, Doescher MP. Use of Potentially Reduced Exposure Tobacco Products Among American Indian Smokeless Tobacco Users: Associations With Cessation Behaviors and Cotinine Levels. Public Health Rep 2020; 135:141-149. [PMID: 31835016 DOI: 10.1177/0033354919893031] [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] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES American Indian/Alaska Native (AI/AN) adults use smokeless tobacco products (eg, chewing and dip tobacco) more often than other racial/ethnic groups do. Although US adults increasingly use potentially reduced exposure tobacco products (PREPs), such as electronic cigarettes and snus, no studies have examined the use of PREPs among AI/AN smokeless tobacco users. We examined associations between current PREPs use and smokeless tobacco-related measures, including cessation attempts and cotinine levels, in a sample of American Indian adults who currently use smokeless tobacco. METHODS We collected survey and tobacco biomarker data from 299 adult American Indian smokeless tobacco users at Cherokee Nation health care facilities and events in 2016 and 2017. We used multivariable analyses to determine associations between current PREPs use and smokeless tobacco-related characteristics. RESULTS Current PREPs users were younger, less likely to be married or living with a partner, less likely to report a chronic medical condition, and more likely to report other tobacco use than PREPs nonusers. Among participants with annual household incomes ≤$30 000, current PREPs users were less likely than PREPs nonusers to report a definite desire to quit smokeless tobacco (P = .02). PREPs use was not associated with planning to quit smokeless tobacco, past 12-month smokeless tobacco quit attempts, amount of smokeless tobacco used per week, cotinine levels, or scores on the Fagerström Test for Nicotine Dependence-Smokeless Tobacco. CONCLUSIONS Our study suggests that American Indian smokeless tobacco users may not be using PREPs as a smokeless tobacco cessation aid. Future studies should take this finding into consideration when evaluating the role of PREPs use in smokeless tobacco cessation and in total tobacco cessation in this population.
Collapse
Affiliation(s)
- Ashley L Comiford
- Department of Community Health Promotions, Cherokee Nation, Tahlequah, OK, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Toral Mehta
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus OH, USA
| | - Paul Spicer
- Department of Anthropology and Center for Applied Social Research, University of Oklahoma, Norman, OK, USA
| | - Theodore Wagener
- Center for Tobacco Research and Division of Medical Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Mark P Doescher
- Center for Tobacco Research, Ohio State University Comprehensive Cancer Center, Columbus OH, USA.,Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
15
|
Audrain-McGovern J, Rodriguez D, Alexander E, Pianin S, Sterling KL. Association Between Adolescent Blunt Use and the Uptake of Cigars. JAMA Netw Open 2019; 2:e1917001. [PMID: 31808925 PMCID: PMC6902767 DOI: 10.1001/jamanetworkopen.2019.17001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Almost two-thirds of adolescents who smoke blunts also report using cigars. Although adolescent co-use of blunts and cigars is prevalent, whether adolescent blunt use is associated with progression to current cigar use (past 30-day use) and increased frequency of use is unknown. OBJECTIVE To determine whether adolescent use of blunts is associated with progression to cigar use (past 30-day use) and increased number of days used (in the past 30 days) across the subsequent 24 months compared with adolescents who have never used blunts. DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study of adolescents from 4 public high schools outside of Philadelphia, Pennsylvania, in-classroom surveys were administered at baseline (fall 2016, beginning of 9th grade) and at 6-month intervals for the following 24 months (fall 2018, beginning of 11th grade). Data analyses were conducted in September and October 2019. EXPOSURES Self-report of lifetime (ever) blunt use at baseline (age 14 years). MAIN OUTCOMES AND MEASURES Progression to current cigar use (use in the past 30 days) and escalation in the frequency of use (number of days used in the past 30 days) across the subsequent 24 months. RESULTS Of 1825 participants, 907 (49.7%) were female, 1330 (72.9%) were white, and 376 (20.6%) were Hispanic; the mean (SD) age at baseline was 14.38 (0.55) years. In all, 257 participants (14.0%) reported ever blunt use. Mixed-effects models revealed that ever blunt use at baseline vs never blunt use was associated with progression to current cigar use (past 30 days use: odds ratio, 22.66; 95% CI, 11.34-45.27) but not escalation in the number of days used across the following 24 months (β = 0.13; 95% CI, -0.17 to 0.43). CONCLUSIONS AND RELEVANCE These findings highlight the risk that blunt use may pose for subsequent cigar use among adolescents. Policies and public health campaigns addressing marijuana as well as cigars will be important to reduce adolescent blunt use and cigar use.
Collapse
Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Daniel Rodriguez
- School of Nursing and Health Sciences, LaSalle University, Philadelphia, Pennsylvania
| | - Emily Alexander
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Stephen Pianin
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | |
Collapse
|
16
|
Elin Smith K. Prevalence and Correlates of Electronic Cigarette Use Among a Clinical Sample of Polysubstance Users in Kentucky: Long Live the Cigarette? Subst Use Misuse 2019; 54:225-235. [PMID: 30409060 DOI: 10.1080/10826084.2018.1512629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND E-cigarette use has increased in the US, yet, in some regions rates of cigarette use remain high. PURPOSE To describe the prevalence and features of lifetime and past-year e-cigarette use among a clinical sample of polysubstance users in Kentucky, and to determine significant associations of past-year e-cigarette use. RESULTS Of the final sample (N = 497), 83.5% reported having ever used e-cigarettes and 97.2% reported having ever used cigarettes. These rates surpass those found among Kentucky's general population. Compared to those who did not report e-cigarette use, e-cigarette users were more likely to be younger ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mover><mml:mrow><mml:mi>x</mml:mi></mml:mrow><mml:mo>¯</mml:mo></mml:mover></mml:math> = 33.4 vs. 43.6, p<.001) and White (88.2.1% vs. 62.5%, p = .001). E-cigarette users showed higher rates for lifetime incarceration (91.1% vs. 72.8%, p = .001) and past-year arrest (75.0% vs. 47.5%, p = .001). This group also presented with more severe substance use history and lower mean age for illicit drug use initiation ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mover><mml:mrow><mml:mi>x</mml:mi></mml:mrow><mml:mo>¯</mml:mo></mml:mover></mml:math> = 13.8 vs. 16.4, p = .001). Approximately 65% of the sample reported past-year e-cigarette use and 96.6% reported past-year cigarette use. Logistic regression indicated that being younger (AOR = .973, p = .030), White (AOR = 1.92, .046), having a past-year arrest (AOR = 1.73, p = .047) and having used cigarettes (AOR = 8.93, p = .001) or kratom (AOR = 3.04, p = .025) within the past year were significantly associated with past-year e-cigarette use. CONCLUSIONS E-cigarette use was related to more severe drug-using patterns. Rates of dual tobacco use among this sample are high, particularly among younger individuals. In ecological contexts where cigarette use remains normative, it is likely that dual use will persist for nicotine-dependent, polysubstance-using individuals.
Collapse
Affiliation(s)
- Kirsten Elin Smith
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA.,Kent School of Social Work, University of Louisville, Louisville, KY, USA
| |
Collapse
|
17
|
Auf R, Trepka MJ, Selim M, Ben Taleb Z, De La Rosa M, Bastida E, Cano MÁ. E-cigarette use is associated with other tobacco use among US adolescents. Int J Public Health 2019; 64:125-134. [PMID: 30413840 PMCID: PMC6585986 DOI: 10.1007/s00038-018-1166-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine whether tobacco initiation via e-cigarettes increases the likelihood of subsequent tobacco use among a large representative sample of US adolescents. METHODS This study is a retrospective longitudinal analysis from a representative sample of US middle and high school students (n = 39,718) who completed the 2014 and 2015 National Youth Tobacco Survey. The adjusted odds ratios of lifetime and current use of tobacco use were estimated by logistic regression analysis while controlling for important socio-ecological factors associated with tobacco use. RESULTS E-cigarette initiators were more likely to report current use of cigarettes (AOR 2.7; 1.9-4.0, p < 0.001), cigars (AOR 1.7; 1.2-2.4, p < 0.01), or smokeless tobacco (AOR 3.1; 2.2-5.4, p < 0.001), and lifetime use of the same products as well. Also, lifetime and current use of e-cigarettes significantly increased the likelihood of cigarettes, cigars, and smokeless tobacco use. CONCLUSIONS Initiation of tobacco via e-cigarette, lifetime, and current use of e-cigarettes are associated with higher odds of lifetime and current use of cigarettes, cigars, and smokeless tobacco. Collectively this suggests e-cigarettes may lead to an increased use of tobacco among adolescents.
Collapse
Affiliation(s)
- Rehab Auf
- Department of Health, Human Performance, and Leisure (HHPL), College of Arts and Science (COAS), Howard University, Washington, DC, 20059, USA.
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
| | - Mazen Selim
- Jackson South Community Hospital, Miami, FL, 33176, USA
| | - Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Elena Bastida
- Department of Health Promotion, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, FL, 33199, USA
| |
Collapse
|
18
|
Hookah use as a predictor of other tobacco product use: A longitudinal analysis of Texas college students. Addict Behav 2018; 87:131-137. [PMID: 30016762 DOI: 10.1016/j.addbeh.2018.06.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Hookah use is particularly prevalent among U.S. college students; however, few studies have investigated whether hookah use is a risk factor for the initiation of other tobacco products. This study examined whether hookah use predicted subsequent initiation of other combustible tobacco products (conventional cigarettes and cigar products) and Electronic Nicotine Delivery Systems (ENDS) among Texas college students during a 2.5-year study period. METHODS This study involved a longitudinal analysis of data from Waves 1-6, with 6 months between each wave, of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Two separate multilevel discrete-time survival analyses were used to model the associations between past 30-day hookah use and subsequent initiation of 1) other combustible tobacco products, and 2) ENDS during the 2.5 year study period, after controlling for demographic, other tobacco use, and risk-taking personality characteristics (i.e. sensation seeking and impulsivity). RESULTS After controlling for covariates, past 30-day hookah use was associated with significantly higher odds of subsequent initiation of other combustible tobacco products. Past 30-day hookah use also predicted subsequent initiation of ENDS after controlling for covariates. CONCLUSIONS This study is one of the first to demonstrate that hookah use is a predictor of subsequent initiation of other combustible tobacco products and ENDS among college students. These findings suggest that hookah may prime individuals to use other tobacco products, which has important implications for prevention programs and future research.
Collapse
|
19
|
King JL, Reboussin D, Cornacchione Ross J, Wiseman KD, Wagoner KG, Sutfin EL. Polytobacco Use Among a Nationally Representative Sample of Adolescent and Young Adult E-Cigarette Users. J Adolesc Health 2018; 63:407-412. [PMID: 30115508 PMCID: PMC6388402 DOI: 10.1016/j.jadohealth.2018.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/02/2018] [Accepted: 04/18/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Electronic nicotine delivery systems (ENDS) are adolescents' most commonly used tobacco product and young adults' second most used. Little is known about ENDS use alongside other tobacco products (polytobacco use) and whether exclusive ENDS users differ from polytobacco ENDS users. METHODS In spring 2016, we surveyed a nationally representative sample of 3,517 13-25-year olds (36.9% 13-17-year olds), and examined sociodemographic and relative risk perceptions between two groups of past 30-day ENDS users: exclusive (only ENDS) and polytobacco (ENDS and at least one other tobacco product). RESULTS 4.5% of adolescents and 10% of young adults reported past 30-day ENDS use (n = 281; analytic sample). ENDS users were 38.8% female and 70.6% white. Over half (55.9%) were polytobacco ENDS users. The most common patterns of polytobacco ENDS use were ENDS and cigarettes (11.5%), ENDS and cigars (7.7%), and ENDS, cigars, and waterpipe (5.2%). Those who perceived ENDS to be less harmful than cigarettes were more likely to be exclusive ENDS users than those who perceived ENDS to be as or more harmful than cigarettes (adjusted odds ratio = 2.6, confidence interval = 1.2, 5.7). There were no differences between ENDS groups on age, race, sex, parental education, sexual orientation, or ENDS use frequency. CONCLUSIONS Just over half of ENDS users also used other tobacco products, increasing their risk for nicotine addiction and other health harms. The Food and Drug Administration is responsible for communicating product risk to consumers and should consider common patterns of use and relative risk perceptions in its ENDS public education efforts.
Collapse
Affiliation(s)
- Jessica L King
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - David Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Kimberly G Wagoner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| |
Collapse
|
20
|
Wong EC, Haardörfer R, Windle M, Berg CJ. Distinct Motives for Use Among Polytobacco Versus Cigarette Only Users and Among Single Tobacco Product Users. Nicotine Tob Res 2018; 20:117-123. [PMID: 27798088 DOI: 10.1093/ntr/ntw284] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/24/2016] [Indexed: 12/30/2022]
Abstract
Background Alternative tobacco product (ATP) use as well as co-use of various tobacco products has increased in recent years, particularly among young adults. However, little is known about the differential role of motives for ATP or polytobacco use. Methods We examined (1) motives for tobacco use in relation to polytobacco versus cigarette only use and (2) motives for tobacco use in relation to levels of tobacco use across products. We analyzed data from past 30-day tobacco users at Wave 2 (Spring 2015) of a six-wave longitudinal study of 3418 students aged 18-25 years from seven U.S. colleges/universities. Variables included sociodemographics, tobacco use (cigarettes, little cigars/cigarillos [LCCs], smokeless tobacco [SLT], hookah, and e-cigarettes), and tobacco use motives (social, self-enhancement, boredom relief, and affect regulation). Results Multivariate analyses found that boredom relief motives were associated with polytobacco use versus cigarette only use (p = .007). Higher consumption levels demonstrated the following associations: cigarettes-positively with boredom relief (p = .025) and affect regulation motives (p < .001); LCCs-positively with affect regulation motives (p = .035); SLT-negatively with social (p = .003) and positively with self-enhancement (p = .017) and boredom relief motives (p = .007); and hookah-positively with social (p = .002) and boredom relief motives (p = .033) and negatively with self-enhancement (p = .004) and affect regulation motives (p = .001). Conclusions Distinct motives for use were associated with polytobacco use among smokers. Moreover, higher levels of use among single product users also demonstrated distinct associations across use motives. These data should inform targeted cessation interventions addressing motives for use in ATP and polytobacco users. Implications Interventionists, public health practitioners, and health care providers must address the increasing issue of ATP and polytobacco use and tailor interventions to reduce ATP and polytobacco use in light of the distinct motives for use.
Collapse
Affiliation(s)
- Eugene C Wong
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| |
Collapse
|
21
|
Trumbo CW. Influence of Risk Perception on Attitudes and Norms Regarding Electronic Cigarettes. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:906-916. [PMID: 29023906 DOI: 10.1111/risa.12918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 08/07/2017] [Accepted: 08/18/2017] [Indexed: 06/07/2023]
Abstract
The use of electronic cigarettes has grown substantially over the last few years. Currently, about 4% of adults use electronic cigarettes, about 16% of high school students report use in the past 30 days, as do approximately 11-25% of college students. A hallmark of the reduction in tobacco use has been the shift in social norms concerning smoking in public. Such norms may also drive views on acceptability of public electronic cigarette use. While normative factors have been given attention, little substantive application of the literature on risk perception has been brought to bear. The overall aim of this study was to place a cognitive-affective measure of risk perception within a model that also includes social cues for e-cigarettes, addictiveness beliefs, and tobacco use to predict perceived social acceptability for public use of e-cigarettes. To do so, a cross-sectional study using an online survey was conducted among a sample of undergraduate students at a Western university (n = 395). A structural equation model showed that the acceptability of public e-cigarette use was influenced by social cues, beliefs about addiction, and cognitive risk perception, even after controlling for nicotine use. What is revealed is that cognitive assessment of e-cigarette risk and perception of addictiveness had a suppressing effect on perceived acceptability of public vaping, while greater exposure to social cues exerted a countervailing effect. This is evidence of the role that risk perception and social norms may play in the increases in electronic cigarette use that have been observed.
Collapse
|
22
|
Wagoner KG, Sutfin EL, Song EY, King JL, Egan KL, Reboussin B, Debinski B, Spangler J, Wolfson M. Trends in point-of-sale tobacco marketing around college campuses: Opportunities for enhanced tobacco control efforts. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:145-154. [PMID: 29020532 PMCID: PMC5922252 DOI: 10.1080/07448481.2017.1389734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North Carolina and Virginia. PARTICIPANTS Between January-March of 2011, 2012 and 2013, 481 tobacco-selling retailers, including convenience stores, pharmacies and supermarkets, located near campuses were assessed. METHODS Trained observers completed annual point-of-sale assessments. RESULTS The percentage of stores selling (81.4% to 58.6%; p < .0001) and advertising snus (80.1% to 53.11%; p < .0001) significantly decreased over time. Convenience stores increased promotions of cigarettes (65.4% to 72.8%; p = 0.04) and SLT (3.1% to 23.3%; p = 0.02). CONCLUSIONS Off-campus environments have abundant tobacco availability and marketing. Colleges should collaborate with state and local tobacco control advocates to address tobacco promotion near campuses to potentially decrease product appeal and access among young adults.
Collapse
Affiliation(s)
- Kimberly G. Wagoner
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Erin L. Sutfin
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Eunyoung Y. Song
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Jessica L. King
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Kathleen L. Egan
- University of Florida, Department of Epidemiology, 2004 Mowry Road, Gainesville, Florida 32610, USA
| | - Beth Reboussin
- Wake Forest School of Medicine, Department of Biostatistical Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Beata Debinski
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, 615 N. Wolfe St # E4527, Baltimore, MD 21205, USA
| | - John Spangler
- Wake Forest School of Medicine, Department of Family Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Mark Wolfson
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC 27157, USA
| |
Collapse
|
23
|
Butler KM, Ickes MJ, Rayens MK, Wiggins AT, Ashford K, Hahn EJ. Intention to quit smoking and polytobacco use among college student smokers. Prev Med Rep 2018; 10:72-75. [PMID: 29560301 PMCID: PMC5856666 DOI: 10.1016/j.pmedr.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 11/28/2022] Open
Abstract
Little is known about polytobacco use in college students. One nationally representative survey indicated 51.3% of tobacco-using college students used more than one product, which may increase risk of tobacco-related disease and premature death. The purpose of this study was to examine the association of intention to quit smoking (ITQS) cigarettes with polytobacco use status, controlling for frequency of tobacco product use and cigarette smoking intensity as measured by cigarettes per day (CPD). Data are from a larger quasi-experimental study conducted at a large state university in the Southeastern United States. Analysis is based on the combined sample of current smokers from two randomly selected cohorts surveyed two months apart. Polytobacco users (n = 52) were as likely as cigarette-only users (n = 81) to intend to quit smoking. Compared to students who used tobacco products 1–9 days per month, students using 10–29 days per month or daily reported higher ITQS. Higher intensity smokers (>10 CPD) were 71% less likely to indicate ITQS, compared to lower intensity smokers (≤10 CPD) (p = .025). College student polytobacco users were as likely as those using only cigarettes to intend to quit smoking. Interventions are needed to target college student polytobacco users as well as cigarette smokers as both groups may intend to quit. Smokers using 10 or fewer CPD and those who use tobacco products daily or 10–29 days per month may be more motivated to quit than college students who smoke with more intensity but who use tobacco products less frequently. 44.4% of the sample reported using at least one form of tobacco in addition to cigarettes. Polytobacco users were as likely as cigarette-only users to intend to quit smoking (ITQS). Significant ITQS predictors were sex, academic status, use frequency, cigarettes per day (CPD). Higher intensity smokers (>10 CPD) were 71% less likely than lower intensity (≤10 CPD) to ITQS. Students using tobacco 10–29 days/month or daily (vs. 1–9 days/month) reported greater ITQS.
Collapse
Affiliation(s)
- Karen M Butler
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Melinda J Ickes
- University of Kentucky Department of Kinesiology and Health Promotion, College of Education, 111 Seaton, Lexington, KY 40506-0219, United States
| | - Mary Kay Rayens
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Amanda T Wiggins
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Kristin Ashford
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Ellen J Hahn
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| |
Collapse
|
24
|
Vu M, Getachew B, Payne JB, Kirchner TR, Berg CJ. Initiation, continuation of use and cessation of alternative tobacco products among young adults: A qualitative study. Tob Prev Cessat 2018; 4. [PMID: 30272039 PMCID: PMC6159942 DOI: 10.18332/tpc/84869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diverse non-cigarette alternative tobacco products are increasingly popular in the United States. This study investigates the reasons why young adults initiate and continue the use of these products, as well as potential motivations and approaches for quitting. Products assessed include cigarettes, little cigars/cigarillos (LCCs), smokeless tobacco, e-cigarettes, and hookahs. METHODS We conducted 60 telephone interviews, of 30-minute duration, with tobacco users enrolled in colleges in Georgia. Qualitative analysis was used to identify themes emerging from the data. RESULTS Reasons for initiation, continued use, and (potential) cessation showed similarities and differences across products. Most commonly cited reasons for initiation included: peer influence (all products), flavors/tastes (all products except cigarettes), and easy environmental access and/or low costs (LCCs, smokeless tobacco, and e-cigarettes). Participants discussed several influences on continued use, such as peer influence (cigarettes, LCCs, and hookahs), stress management (all products except hookahs), and use with other substances (cigarettes, LCCs, and hookahs). Primary motivations for cessation mentioned by participants were family responsibilities (cigarettes, e-cigarettes, and hookahs) and health concerns (all products except e-cigarettes). Frequently used cessation strategies included avoidance of other tobacco users (cigarettes, LCCs, and hookahs) and a reduction of nicotine intake (cigarettes and e-cigarettes). CONCLUSIONS Our findings suggest that researchers should consider the differences in reasons for use and discontinued use of tobacco products in order to develop targeted messaging strategies, particularly noting the differential impact of interpersonal influences and health concerns. We also point to a need for regulatory action that limits diversification and accessibility of different products.
Collapse
Affiliation(s)
- Milkie Vu
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, United States
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, United States
| | - Jackelyn B Payne
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, United States
| | - Thomas R Kirchner
- College of Global Public Health, New York University, New York City, United States
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, United States
| |
Collapse
|
25
|
Webb Hooper M, Kolar SK. Racial/ethnic differences in electronic cigarette knowledge, social norms, and risk perceptions among current and former smokers. Addict Behav 2017; 67:86-91. [PMID: 28063324 DOI: 10.1016/j.addbeh.2016.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/16/2016] [Accepted: 12/23/2016] [Indexed: 01/22/2023]
Abstract
Psychosocial factors that may affect electronic cigarette (e-cigarette) initiation or maintenance among racial/ethnic minorities are not well-understood. This study examined racial/ethnic differences in e-cigarette knowledge, risk perceptions, and social norms among current and former smokers. Individuals with a tobacco smoking history and an awareness of e-cigarettes (N=285) were recruited from the community from June to August 2014. Telephone-administered surveys assessed demographics, smoking status, and e-cigarette knowledge, risk perceptions, and normative beliefs. Analyses of covariance and multinomial logistic regression tested associations by race/ethnicity. Controlling for sociodemographics and smoking status, White participants scored significantly higher on e-cigarette knowledge, compared to both Hispanics and African Americans/Blacks. Knowledge was lower among African Americans/Blacks compared to Hispanics. Compared to both Whites and Hispanics, African American/Black participants held lower perceptions regarding e-cigarette health risks and were less likely to view e-cigarettes as addictive. Normative beliefs did not differ by race/ethnicity. In conclusion, e-cigarette knowledge, health risk perceptions, and perceived addictiveness differed by race/ethnicity. The variation in e-cigarette knowledge and beliefs among smokers and former smokers has implications for use, and potentially, dual use. Understanding these relationships in unrepresented populations can inform future research and practice.
Collapse
|
26
|
Ickes MJ, Rayens MK, Wiggins A, Hahn EJ. Students' Beliefs About and Perceived Effectiveness of a Tobacco-Free Campus Policy. Policy Polit Nurs Pract 2017; 18:17-25. [PMID: 28558518 DOI: 10.1177/1527154417700633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Tobacco-free (TF) college campus policies have potential to be a high-impact tobacco control strategy. The purposes of the study presented here were to (a) determine the demographic and personal characteristics associated with students' beliefs about and perceived effectiveness of a TF campus policy and (b) assess whether tobacco use status and exposure to secondhand smoke (SHS) predicted beliefs and perceived effectiveness. Five thousand randomly selected students from a large southeastern university were invited by e-mail to participate in an online survey in April 2013, three and a half years after policy implementation. Students held positive beliefs about the policy (average rating 84% of the maximum possible score). Sixty-one percent believed that the policy was successful at reducing SHS exposure; and 40% thought the policy encouraged quitting. Males were less likely than females to believe the policy was effective in reducing SHS exposure and encouraging quitting. Lower undergraduates were more likely to perceive the policy as less effective in reducing SHS exposure; international students were more likely than domestic students to perceive the policy as more effective at encouraging quitting. Students most exposed to SHS were less likely to perceive the policy was effective. Compared with nonusers, those who smoked cigarettes were less likely to perceive the policy as effective in encouraging quitting. Tailored messaging regarding policy benefits are necessary. Perceived effectiveness of TF policies may be related to compliance with the policy and should be further investigated. Objective measures of effectiveness and tobacco use behaviors are needed to fully measure the success of TF campus policies.
Collapse
Affiliation(s)
- Melinda J Ickes
- 1 Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA.,2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,3 College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Amanda Wiggins
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,4 College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J Hahn
- 2 BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA.,3 College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
27
|
Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
Collapse
Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
28
|
Prokhorov AV, Machado TC, Calabro KS, Vanderwater EA, Vidrine DJ, Pasch KP, Marani SK, Buchberg M, Wagh A, Russell SC, Czerniak KW, Botello GC, Dobbins MH, Khalil GE, Perry CL. Developing mobile phone text messages for tobacco risk communication among college students: a mixed methods study. BMC Public Health 2017; 17:137. [PMID: 28143432 PMCID: PMC5282879 DOI: 10.1186/s12889-017-4027-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging young adults for the purpose of communicating health risks associated with nicotine and tobacco use can be challenging since they comprise a population heavily targeted with appealing marketing by the evolving tobacco industry. The Food and Drug Administration seeks novel ways to effectively communicate risks to warn about using these products. This paper describes the first step in developing a text messaging program delivered by smartphones that manipulate three messaging characteristics (i.e., depth, framing, and appeal). METHODS Perceptions of community college students were described after previewing text messages designed to inform about risks of using conventional and new tobacco products. Thirty-one tobacco users and nonusers, aged 18-25 participated in five focus discussions held on two community college campuses. Attendees reviewed prototype messages and contributed feedback about text message structure and content. Qualitative data were coded and analyzed using NVivo Version 10. RESULTS Most participants were female and two-thirds were ethnic minorities. A variety of conventional and new tobacco products in the past month were used by a third of participants. Three identified domains were derived from the qualitative data. These included perceived risks of using tobacco products, receptivity to message content, and logistical feedback regarding the future message campaign. CONCLUSION Overall, participants found the messages to be interesting and appropriate. A gap in awareness of the risks of using new tobacco products was revealed. Feedback on the prototype messages was incorporated into message revisions. These findings provided preliminary confirmation that the forthcoming messaging program will be appealing to young adults.
Collapse
Affiliation(s)
- Alexander V. Prokhorov
- The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Tamara C. Machado
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Karen S. Calabro
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Elizabeth A. Vanderwater
- Population Research Center, University of Texas at Austin, 305 E. 23rd Street, Austin, TX 78712 USA
| | - Damon J. Vidrine
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73104 USA
| | - Keryn P. Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 1 University Station, D 3700, Austin, TX 78712 USA
| | - Salma K. Marani
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Meredith Buchberg
- Department of Periodontics, The University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249 USA
| | - Aditya Wagh
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Sophia C. Russell
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Katarzyna W. Czerniak
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Gabrielle C. Botello
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Mackenzie H. Dobbins
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Georges E. Khalil
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Str., Unit 1330, Houston, TX 77030 USA
| | - Cheryl L. Perry
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe St, Suite 6.300, Austin, TX 78701 USA
| |
Collapse
|
29
|
Braverman MT, Hoogesteger LA, Johnson JA, Aarø LE. Supportive of a smoke-free campus but opposed to a 100% tobacco-free campus: Identification of predictors among university students, faculty, and staff. Prev Med 2017; 94:20-26. [PMID: 27784635 DOI: 10.1016/j.ypmed.2016.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
Many universities are adopting campus tobacco policies, but little research has explored factors influencing the choice between the policy options of smoke-free versus 100% tobacco-free. Students, faculty, and staff at a U.S. state university participated in a web-based survey in 2013, approximately one year after adoption of a smoke-free policy. Respondents who expressed support for the policy were included in an analysis to examine their opinions regarding a 100% tobacco-free policy. The samples included 4138 students and 1582 faculty/staff. Bivariate analyses and multivariate logistic regression were used to identify predictors of opposition to a tobacco-free campus. Independent variables included strength of support for a smoke-free campus, past-month tobacco use (cigarettes, smokeless tobacco, e-cigarettes, non-cigarette combustible tobacco products), campus exposure to secondhand smoke, perceptions of tobacco-related behaviors and norms, and demographics. Of these supporters of a smoke-free campus, 14.3% of students and 10.2% of faculty/staff were opposed to a tobacco-free campus. In the multivariate analyses, in both samples, smokeless tobacco use predicted opposition while smoke-free policy support and female gender predicted support. In addition, among students, current or former cigarette smoking and non-cigarette combustible tobacco use predicted opposition; international student status and secondhand smoke exposure predicted support. Among faculty/staff, age over 55 predicted support. Future research should examine why current and former smokers might oppose policies restricting non-combustible tobacco products, even when they support smoke-free policies. In policy planning, campus administrators should communicate actual tobacco usage levels. International students who do not use tobacco may be a source of policy support.
Collapse
Affiliation(s)
- Marc T Braverman
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR 97331, USA.
| | - Lisa A Hoogesteger
- Advising Services, Linn-Benton Community College, Albany, OR 97321, USA.
| | - Jessica A Johnson
- Southern Nevada Health District, Office of Chronic Disease Prevention and Health Promotion, 280 S. Decatur Blvd., Las Vegas, NV 89107, USA.
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
| |
Collapse
|
30
|
Bandiera FC, Loukas A, Wilkinson AV, Perry CL. Associations between tobacco and nicotine product use and depressive symptoms among college students in Texas. Addict Behav 2016; 63:19-22. [PMID: 27393934 DOI: 10.1016/j.addbeh.2016.06.024] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 06/16/2016] [Accepted: 06/28/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is a well-established link between cigarette smoking and depression; less is known about the potential association between alternative tobacco products, such as hookah, cigars, smokeless tobacco, and electronic cigarette (e-cigarette use) with depression. The Food and Drug Administration (FDA) is now regulating tobacco products and is interested in tobacco product use among those with mental health problems and other special populations such as college students. METHODS Cross-sectional statewide convenience sample study of 5438 college students in 24 colleges and universities in Texas. Past 30-day use of hookah, cigar, smokeless tobacco, cigarette, and e-cigarette use were measured by self-report. Depressive symptoms were measured by the 10-item short form of the Center for Epidemiologic Studies scale. RESULTS Only e-cigarette use was positively associated with depressive symptoms, even after accounting for all other tobacco products and socio-demographics. There were no significant interactions between race/ethnicity or gender with each of the tobacco products on depressive symptoms. CONCLUSIONS E-cigarette use was positively associated with depressive symptoms among college students in Texas. Further research is needed to determine causality, which may inform FDA regulatory planning.
Collapse
Affiliation(s)
| | - Alexandra Loukas
- University of Texas at Austin, Department of Kinesiology & Health Education, United States.
| | | | - Cheryl L Perry
- University of Texas School of Public Health, United States
| |
Collapse
|
31
|
Loukas A, Chow S, Pasch KE, Li X, Hinds Iii JT, Marti CN, Harrell MB, Creamer MR, Perry CL. College Students' Polytobacco Use, Cigarette Cessation, and Dependence. Am J Health Behav 2016; 40:514-22. [PMID: 27338998 DOI: 10.5993/ajhb.40.4.13] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We examined patterns of tobacco and electronic cigarette (e-cigarette) use among college students. Differences in sociodemographic characteristics between non-users of these products and 4 mutually exclusive groups of tobacco/e-cigarette users were assessed. Differences in cigarette cessation attempts and dependence between exclusive cigarette smokers and users of cigarettes and at least one alternative tobacco product also were examined. METHODS Participants were 5468 18-29 year-old students from 24 colleges in Texas who completed an online survey. RESULTS Multiple-product use was more prevalent than single-product use. All 4 current tobacco/e-cigarette-user groups were more likely than non-users to be men and older. College students who were younger when they smoked their first cigarette, and those reporting ever needing a cigarette, were more likely to be multiple-product users than cigarette-only users. There were no group differences in cigarette cessation attempts or any other variables. CONCLUSIONS Using multiple products is associated with some indicators of dependence, but does not seem to aid or deter college students' smoking cessation attempts. Longitudinal research is needed given that transitions in tobacco/e-cigarette use continue throughout young adulthood.
Collapse
Affiliation(s)
- Alexandra Loukas
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA.
| | - Sherman Chow
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Keryn E Pasch
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Xiaoyin Li
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Josephine T Hinds Iii
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - C Nathan Marti
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Melissa B Harrell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health, University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA
| | - MeLisa R Creamer
- Department of Health Promotion and Behavioral Sciences, UT Health, University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA
| | - Cheryl L Perry
- Department of Health Promotion and Behavioral Sciences, UT Health, University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA
| |
Collapse
|
32
|
Kalkhoran S, Padilla JL, Neilands TB, Ling PM. Multiple tobacco product use among young adult bar patrons in New Mexico. Prev Med 2016; 83:16-21. [PMID: 26666395 PMCID: PMC5433518 DOI: 10.1016/j.ypmed.2015.11.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/26/2015] [Accepted: 11/27/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Use of non-cigarette tobacco products is common, and e-cigarette use is increasing among young adults. We aimed to identify use of other tobacco products among young adult bar patrons in the context of a bar-based intervention to decrease cigarette smoking. METHODS 2291 cross-sectional surveys were collected from young adults in bars in Albuquerque, New Mexico using time-location sampling between 2011 and 2013 (N=1142 in 2011, N=1149 in 2012-2013), 2 and 3years into an intervention to reduce cigarette use, and analyzed in 2014-2015. Participants reported current (i.e. past 30-day) use of cigarettes, snus, dip, cigarillos, hookah, and e-cigarettes, demographics, and tobacco-related attitudes. Multiple imputation was used to account for planned missing data. Logistic regression determined correlates of multiple tobacco product use. RESULTS Cigarette smoking in the population decreased during the intervention from 43% to 37%. Over 60% of current cigarette smokers reported poly-use, most frequently with e-cigarettes (46%) and hookah (44%), followed by cigarillos (24%), dip (15%), and snus (14%) in 2012-2013. Among cigarette smokers, current e-cigarette use increased, while use of other products decreased during the intervention. Odds of poly-use (versus smoking cigarettes only) were greater among males and those reporting past 30-day binge drinking, and lower in those who strongly believed secondhand smoke exposure is harmful. CONCLUSIONS Among young adult bar patrons in Albuquerque, New Mexico, most cigarette smokers reported currently using at least one other tobacco product. Public health interventions should address use of all tobacco products, use of which may rise despite decreased cigarette use.
Collapse
Affiliation(s)
- Sara Kalkhoran
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - James L Padilla
- Tobacco Use Prevention & Control Program, New Mexico Department of Health, Albuquerque, NM, USA
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Pamela M Ling
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|