Bullying Victimization and e-Cigarette Use among Middle and High School Students

Adolescent E-cigarette use and associated socio-contextual variables, psychological variables, and problem behaviors

PURPOSE

E-cigarette use by adolescents has reached epidemic proportions. This study's purpose was to explore adolescent e-cigarette use and dual use of e-cigarettes with other tobacco products and the relationships between socio-contextual variables (in-school/electronic bullying, threats with a weapon), psychological variables (sadness, suicide attempts) and problem behaviors (alcohol/marijuana use, sexual risk behavior, weapon carrying).

DESIGN AND METHODS

Cross-sectional descriptive study using secondary data from the 2019 Youth Risk Behavior Survey. Multiple logistic regression was used to examine the relationship between socio-contextual variables, psychological variables, problem behaviors and current adolescent e-cigarette use or dual use. E-cigarette users and dual users were examined in separate regression equations.

RESULTS

Most adolescent e-cigarette users (59 %) and dual users (63 %) were white with e-cigarette only users being majority female (55 %) and dual users majority male (57 %). E-cigarette use was significantly correlated with experiencing electronic bullying, sadness, threats with a weapon, alcohol use, marijuana use, and sexual risk behaviors. Dual use was significantly correlated with experiencing electronic bullying, sadness, alcohol use, marijuana use, sexual risk behaviors, and weapon carrying.

IMPLICATIONS TO PRACTICE

Problem behaviors, psychological variables, and socio-contextual variables are associated with e-cigarette use. It is imperative that adolescents are screened for use in addition to other behaviors.

CONCLUSIONS

E-cigarette use and dual use of e-cigarettes and other tobacco products is linked to other problem behaviors and feelings of sadness, with dual users being at significantly higher risk. Adolescents should be screened for e-cigarette use and dual use at every health care visit.

Young Women's Perspectives About Vaping: A Cross Sectional Study from Jordan

Vaping has become very popular among young generations in Jordan. However, less is known about women's awareness and intention to vape. The aim of this study is to assess women's knowledge and beliefs about vaping, with a focus on vaping women's attitudes and practices. This is an observational cross-sectional study. Data were collected from January through March 2024, by using a self-administrated survey inspired from the WHO GATS questionnaire. Among the 923 participating women, 12.4% were vaping. We observed significant variations in knowledge and beliefs among women. Vaping women have a substantially younger age than non-vaping. 57% of vaping women think that vape is safer to use than cigarettes compared to 14% of non-vaping. 61% of vaping women believed that vaping helps to quit cigarette smoking compared to 24% of non-vaping. Vaping women tended to underestimate the health risks associated with it compared to non-vaping women. They are also supporting legislations that allow vaping indoors and in public places. Women vape primarily for enjoyment, to cope with stress, to pass free time, and to hang out with friends. Luckily, many of them believed that smoking increases the risk of cardiovascular and respiratory ailments and limited life expectancy, which supports their future quitting plans. This study revealed misconceptions and knowledge gaps around vaping among women. Emotional demands and social interactions influenced women's vaping use in Jordan, highlighting the need for targeted public health education and legislative measures to promote women's health.

Sex Differences in E-Cigarette Use and Related Health Effects

BACKGROUND

Electronic cigarettes (e-cigarettes) comprise a variety of products designed to deliver nicotine, flavorings, and other substances. To date, multiple epidemiological and experimental studies have reported a variety of health issues associated with their use, including respiratory toxicity, exacerbation of respiratory conditions, and behavioral and physiological effects. While some of these effects appear to be sex- and/or gender-related, only a portion of the research has been conducted considering these variables. In this review, we sought to summarize the available literature on sex-specific effects and sex and gender differences, including predictors and risk factors, effects on organ systems, and behavioral effects.

METHODS

We searched and selected articles from 2018-2023 that included sex as a variable or reported sex differences on e-cigarette-associated effects.

RESULTS

We found 115 relevant studies published since 2018 that reported sex differences in a variety of outcomes. The main differences reported were related to reasons for initiation, including smoking history, types of devices and flavoring, polysubstance use, physiological responses to nicotine and toxicants in e-liquids, exacerbation of lung disease, and behavioral factors such as anxiety, depression, sexuality, and bullying.

CONCLUSIONS

The available literature supports the notion that both sex and gender influence the susceptibility to the negative effects of e-cigarette use. Future research needs to consider sex and gender variables when addressing e-cigarette toxicity and other health-related consequences.

Psychosocial stressors and current e-cigarette use in the youth risk behavior survey

BACKGROUND

This study explores the association between psychosocial stressors and current e-cigarette use among adolescents in the United States.

METHODS

We used data from 12,767 participants in the 2019 National Youth Risk Behavioral Survey to examine the association between psychosocial stressors (bullying, sexual assault, safety-related absence from school, depressive symptoms, suicidal ideation, physical altercation, and weapon threats) and past-30-day e-cigarette use using multivariable-adjusted logistic regression models. We examined the association for each stressor and then as a burden score (0-7). To compare the strength of the association between stressors and current e-cigarette use to current combustible cigarette use, we additionally examined the association between each stressor and current combustible cigarette use.

RESULTS

Approximately 32.7% reported current e-cigarette use. The weighted prevalence of current e-cigarette use was higher among individuals who experienced stressors than those who did not. For example, bullying (43.9% vs. 29.0%). Similar prevalence patterns were seen among other stressors. Individuals who experienced stressors had significantly higher adjusted odds of current e-cigarette use than those who did not (OR [Odds Ratio] range: 1.47-1.75). Similarly, individuals with higher burden scores had a higher prevalence (zero [20.5%], one [32.8%], two [41.4%], three [49.6%], four to seven [60.9%]) and higher odds of current e-cigarette use (OR range: 1.43-2.73) than those with a score of zero. The strength of the association between the stressors and e-cigarette use was similar to that between the stressors and combustible cigarette use.

CONCLUSION

The study demonstrates a significant association between psychosocial stressors and adolescent e-cigarette use, highlighting the potential importance of interventions, such as targeted school-based programs that address stressors and promote stress management, as possible means of reducing adolescent e-cigarette use. Future research directions include exploring underlying mechanisms linking stressors to e-cigarette use and evaluating the effectiveness of interventions addressing stressors in reducing adolescent e-cigarette use.

Mental health condition indicators and e-cigarette use among sexual minority youth

BACKGROUND

Sexual minorities face mental health disparities compared to heterosexual people. There is limited research on the possible connections between mental health and e-cigarette use among sexual minority youth. This study examines anxiety, depression, and e-cigarette use for sexual minority youth only and between sexual minorities versus straight youth.

METHODS

Study data were drawn from the 2021 National Youth Tobacco Survey (n = 16,065). Prevalence of self-reported anxiety and depression by sexual minority status was calculated, and the univariate analysis was assessed using Rao-Scott Chi-Square tests. Multivariable logistic regression models were used to evaluate the association of current e-cigarette use with self-reported anxiety and depression among sexual minority youth. The study also examined current e-cigarette use between sexual minorities versus straight students for those with or without anxiety and depression, and stratified analyses were performed by sex.

RESULTS

Analysis showed a substantially higher prevalence of all self-reported mental health problems among sexual minorities than straight students. Sexual minority males with anxiety (aOR 1.91, 95 % CI, 1.22-3.00), depression (aOR 2.08, 95 % CI, 1.27-3.40), moderate depression and anxiety (aOR 1.85, 95 % CI, 1.16-2.97), and severe depression and anxiety (aOR 2.03, 95 % CI, 1.16-3.56) were more likely to be current e-cigarette users than their straight peers with similar mental health conditions.

LIMITATIONS

Self-reported measures and the analysis design precludes making causal inferences.

CONCLUSIONS

Sexual minority males with mental health conditions may be particularly vulnerable to e-cigarette use and may require special efforts toward prevention and cessation.

Bullying victimization and nicotine and marijuana vaping among Florida adolescents

PURPOSE

Previous research links bullying victimization with the use of illicit substances in adolescence. In addition, recent research has linked bullying victimization with vaping. Very limited research, however, has explored how different forms of bullying may be linked with nicotine and marijuana vaping specifically.

PROCEDURES

This study addresses this gap in the literature by utilizing logistic regression to examine the relationships between verbal, physical, and cyber bullying victimization and nicotine and marijuana vaping in a sample of Florida adolescents.

FINDINGS

Our findings reveal that all three forms of bullying victimization are linked with recent nicotine vaping, and these associations differ somewhat by youth gender. In addition, our findings indicate that cyber bullying victimization is linked with marijuana vaping.

CONCLUSIONS

In conclusion, our findings suggest that bullying victimization is linked with greater odds of vaping activity in adolescents. The implications of these findings for future research and policy are discussed.

Subtypes of Bullying and Types of Substance Use among Urban African American Adolescents: Who Is Likely to Use What?

The present study examined the types of drugs likely to be used by bullies, victims, and bully/victims. Participants comprise African American adolescents from three high schools, one youth church group, two community youth programs, and four public venues in low-income communities in Chicago's Southside. A series of logistic regression analyses and latent class analyses were employed. Victims are likely to use alcohol, marijuana, and lean/krokodil. Bullies were likely to use alcohol and marijuana. Bully/victims were not at risk of any of the substances. Our LCA findings revealed a lower occurrence of substance use among victims although 30% used alcohol and marijuana; more than half of bullies showed high levels of alcohol, marijuana, and lean/krokodil use; a diverse pattern of drug use was shown among bully/victims although their lean/krokodil and crack/cocaine use was higher than other subgroups of bullying. The drugs of choice for African American bullies, victims, or bully/victims are variable.

Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex

Although studies have investigated the association between conventional tobacco smoking and mental health outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) and mental health among adolescents. This study aimed to investigate the cross-sectional association between EVPs use, symptoms of depression, and suicidal behaviors among adolescents. Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 14,285 adolescents (50.3% female) was analyzed using binary logistic regression. The outcome variables investigated were symptoms of depression, suicidal ideation, suicide plan, and suicide attempts, and the main explanatory variable was EVPs use. Of the 14,285 adolescents, 22.2%, 19.2%, and 58.8% were current, former and never users of EVPs, respectively. Controlling for other factors, current users of EVPs were significantly more likely to report having symptoms of depression (AOR = 1.82, 95% CI = 1.58-2.09), having suicidal ideation (AOR = 1.55, 95% CI = 1.30-1.86), making a suicide plan (AOR = 1.62, 95% CI = 1.34-1.97), or attempting suicide (AOR = 1.75, 95% CI = 1.41-2.18) when compared to never users of EVPs. Gender moderated the association between EVPs use, symptoms of depression, suicidal ideation, and suicide plan. Racial minority identity, sexual minority identity, sexual violence victimization, victim of school and cyberbullying, alcohol use, and cigarette smoking were all significantly associated with depression and suicidal behaviors. Study findings support the association between EVPs use and adolescent mental health. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying this association.

Association Between Bully Victimization and Vaping Among Texas High School Students

INTRODUCTION

Bullying and vaping among adolescents in Texas is a major public health concern. Bully victimization has been associated with substance use in adolescents; however, research examining the association between bully victimization and vaping in adolescents is sparse. This study aims to examine the independent association between bully victimization and vaping among Texas high school students.

METHODS

Pooled data from the 2017 and 2019 Texas Youth Risk Behavior Survey (N=3,486) were analyzed in July 2020. Past-year bully victimization was categorized into 4 mutually exclusive groups: no bully victimization, school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization. Current vape use was measured as a binary variable. Multivariable logistic regression was used to examine the association.

RESULTS

In the total sample, the past-year prevalence of school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization was 8.3%, 4.6%, and 7.7%, respectively. Approximately 1 in 7 students (14.5%) reported vaping during the past 30 days. Female students who experienced both school bullying and cyberbullying had 68% greater odds of vaping than female students who did not experience bullying (AOR=1.68, 95% CI=1.02, 3.41). Bully victimization was not significantly associated with vaping in male students.

CONCLUSIONS

Female Texas high school students who are victims of both school bullying and cyberbullying have a greater likelihood of vaping. Healthcare providers, school counselors, and educators should be aware of the association and sex differences that exist while developing intervention programs to address bullying and vaping in high school students.

Disparities in the frequency of tobacco products use by sexual identity status

BACKGROUND

Largely absent from the literature are studies examining differences in tobacco use frequency among sexual minority populations versus heterosexuals. The current study examined the frequency of tobacco product use (i.e., cigarette, e-cigarettes and cigars, smokeless tobacco, hookah, and heated tobacco products) among sexual minority students versus heterosexuals (straight).

METHODS

Data from the 2020 National Youth Tobacco Survey (n = 14,531) were analyzed to examine the association between sexual identity (lesbian or gay, bisexual, not sure, and heterosexual or straight) and tobacco use frequency. Negative binomial regression and zero-inflated negative binomial models were used to assess the association between sexual identity and each tobacco use frequency among current and ever users.

RESULTS

Current e-cigarettes users who identified as gay or lesbian used e-cigarette more frequently than heterosexual students. Multivariable count regression analysis showed that the e-cigarette use frequency in the past 30 days was significantly higher for gays or lesbians (IRR 1.45, 95% CI, 1.19-1.76) compared to heterosexuals. Similarly, gay or lesbian students who were current hookah users on average reported 81% more days of hookah use (IRR, 1.81, 95% CI, 1.08-3.03). The frequency of cigarette smoking was also significantly higher among bisexual cigarette smokers. No significant differences were found in other tobacco product use frequencies between sexual minority and heterosexual youths.

CONCLUSION

Sexual identity was associated with tobacco use frequency, especially for e-cigarettes and hookah. Elevated tobacco use among sexual minority groups deserves special consideration among a population group that is highly vulnerable to marketing and advertisement targeting.

Who are the young users of tobacco products? Prevalence and characteristics of Danish adolescents who have either smoked cigarettes, used alternative tobacco products, or used both

Aims:

We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied.

Methods:

We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported.

Results:

A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families’ and friends’ smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns.

Conclusion:

ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.

Association between bullying victimization and e-cigarette use among German students

This study examined the association between bullying victimization and e-cigarette use. Data from a 2019-2020 German student survey were used (N = 16,476). The target population consisted of students enrolled in grades 5-10, with a mean age of 13.1 years (SD = 1.8), and equal gender distribution (49.5% female). Mixed-effect multivariable logistic regression models were used to examine the association between bullying victimization (attacked physically, assaulted verbally, experienced relational bullying, sexual harassment, cyberbullying) and current e-cigarette use. The multivariable analysis controlled for age, sex, sensation-seeking, socioeconomic status, school performance, type of school attended, and substance use (current cigarette smoking, hookah smoking, and alcohol drinking). Overall 510 (3.7%) students reported current use of e-cigarettes. The odds for using e-cigarettes increased each step of being bullied from "never," "rarely," "sometimes," "once a week," to "several times a week" by 2.03 (95% confidence interval [CI]: 1.81, 2.29) in the unadjusted model, and by 1.46 (95% CI: 1.24, 1.71) in the covariate-adjusted model. Data indicate an empirical association between victimization and e-cigarette use among German students. Design limitations prevent the conclusion of a causal relationship, calling for well-designed longitudinal studies to investigate the temporal sequence between victimization and e-cigarette use.