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Kava CM, Watkins SL, Gilbert PA, Villhauer TJ, Welter TL, Afifi RA. E-cigarettes in college: Associations between mental health and e-cigarette use with other substances. Tob Prev Cessat 2024; 10:TPC-10-24. [PMID: 38828438 PMCID: PMC11141061 DOI: 10.18332/tpc/188712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION College students are a priority population for substance use prevention, and other studies have reported associations between mental health and e-cigarette use. This study described the association of mental health to e-cigarette and other substance use (ECIG+ use) among US college students. METHODS We used Fall 2018 and Spring 2019 National College Health Assessment data among undergraduate students aged 18-24 years (n=55654) at 138 institutions. We characterized substance use patterns and used multinomial regression to model adjusted odds of past 30-day ECIG use type [no substance use (reference); sole e-cigarette use; e-cigarette use and other substance use (ECIG+ use); no e-cigarette use but other substance use] by mental health characteristics, past 12-month diagnosis/treatment and psychological distress, individual characteristics, and college characteristics. RESULTS Alcohol was the most prevalent substance (58%) used, followed by cannabis (23%) and e-cigarettes (15%). Nearly all (95%) students who used e-cigarettes reported using another substance. Adjusted odds of ECIG+ use (vs no substance use) were higher among students with past 12-month mental health diagnosis/treatment (AOR=1.5; 95% CI: 1.4-1.6) and higher psychological distress (AOR=1.1; 95% CI: 1.1-1.2). Other characteristics significantly associated with ECIG+ use included gender identity, sexual orientation, race and ethnicity, self-rated health, year in school, cumulative grade average, fraternity/sorority membership, and current residence. CONCLUSIONS Most students who used e-cigarettes also reported other substance use, and this pattern of use was associated with poorer mental health outcomes than no substance use. Clarifying the relationship between mental health and ECIG+ use may enhance health interventions for college students.
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Affiliation(s)
- Christine M. Kava
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, United States
| | - Shannon L. Watkins
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, United States
| | - Paul A. Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, United States
| | - Tanya J. Villhauer
- The Office of the Dean of Students, University of Iowa, Iowa Memorial Union, Iowa City, United States
| | | | - Rima A. Afifi
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, United States
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Roh T, Fields S, Sahu R, Trisha NF, Carrillo G. Vaping Behavior and Intention to Quit among Undergraduate Students in a Hispanic-Serving University. J Community Health 2024:10.1007/s10900-024-01364-3. [PMID: 38762685 DOI: 10.1007/s10900-024-01364-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 05/20/2024]
Abstract
The surge in electronic nicotine delivery systems (ENDS) usage, particularly among young adults, poses significant public health concerns. This study aimed to identify predictors of e-cigarette use, quit attempts, and frequency among undergraduate students in a Hispanic-serving university in Texas. A cross-sectional study was conducted between August 1 and October 26, 2023, recruiting undergraduate students through the Sona system, an online experiment management platform. Participants completed an online survey that covered demographics, educational status, vaping status, initiation age, reasons for first and current e-cigarette use, frequency of past usage, intentions to quit, and quit attempt frequency. Statistical analysis included descriptive statistics, multinomial logistic regression, and multivariable linear regression. Among 316 participants, 33.9% reported current e-cigarette use. Junior and senior students, as well as prior tobacco users, were more likely to be current vapers. Prior vaping experience was more prevalent among Hispanic individuals and those with a history of tobacco use. Notably, 74.3% of current users attempted to quit in the past year, with a higher frequency of quit attempts among females, Hispanic students, and those with vaping acquaintances. However, the vaping behavior and quit attempt patterns were similar across other categories. This study highlights how various factors influence e-cigarette use among college students. It suggests that prevention and quitting programs should consider the specific needs of different groups. Future studies will continue to look at different student groups to find the most effective ways to help them quit vaping.
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Affiliation(s)
- Taehyun Roh
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA.
| | - Sherecce Fields
- Department of Psychological and Brain Sciences, College of Arts and Science, Texas A&M University, College Station, TX, 77843, USA
| | - Ruchi Sahu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
| | - Nusrat Fahmida Trisha
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
| | - Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
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Stanley AK, Frederickson K, Pokhrel P. Electronic Cigarette Use and Anxiety Among College Students: "Trapped in That Cycle". J Addict Nurs 2024; 35:59-66. [PMID: 38829995 DOI: 10.1097/jan.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Electronic cigarette use is the most prevalent form of tobacco among young college adults between 18 and 25 years old. In addition, during the young adult years, mental health issues surface, such as anxiety. As a result of these factors, it is imperative to describe the experience of electronic cigarettes among college students to better understand the cycle of addiction among electronic cigarette users. OBJECTIVE This study aims to explore and describe the experience of electronic cigarette use among college students who report feelings of anxiety. METHODS A qualitative descriptive study design with the Roy Adaptation Model as the theoretical framework was used to describe the experience. The setting was at one medium-sized private university on the east coast of the United States. Twenty participants met the study inclusion criteria of traditional undergraduate students aged 18-25 years. Data were collected using a demographic questionnaire, a smoking status questionnaire, a self-report feelings of anxiety questionnaire, and a semistructured interview guide. RESULTS Data analysis synthesized three themes: the perfect storm, the power of ripping the nic, and trapped in that cycle. It was found through interviews that feelings of anxiety and the vape culture, along with the college experience, led to the powerful draw to electronic cigarette use among this population. CONCLUSION This study reflects findings that the college life experience, the vape culture, and the feelings of anxiety contribute to electronic cigarette use and, finally, lead to intense addiction.
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Giberson J, Nardone N, Addo N, Khan S, Jacob P, Benowitz N, St.Helen G. Nicotine Intake in Adult Pod E-cigarette Users: Impact of User and Device Characteristics. Nicotine Tob Res 2023; 25:1489-1495. [PMID: 37061820 PMCID: PMC10347964 DOI: 10.1093/ntr/ntad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/13/2023] [Accepted: 04/14/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION This study examined user behavior, e-cigarette dependence, and device characteristics on nicotine intake among users of pod-mod e-cigarettes. AIMS AND METHODS In 2019-2020, people who use pod-mods in the San Francisco Bay Area completed questionnaires and provided a urine sample for analysis of total nicotine equivalents (TNE). The relationship between TNE and e-cigarette use, e-cigarette brands, e-liquid nicotine strength, e-cigarette dependence, and urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), as a measure of combustible cigarette exposure, were examined. RESULTS Of 100 participants (64% male, 71% in the 18-34 age group, 45% white), 53 used JUUL primarily, 12 used Puff Bar primarily, and 35 used other brands, including Suorin; 48 participants reported current cigarette smoking. Participants most often reported use of e-liquid with 4.5%-6.0% nicotine (68%), fruit (35%), tobacco (28%), and menthol or mint flavors (26%), used e-cigarettes on 25.5 (SD = 6.3) days a month, 10.2 (SD = 14.2) times a day, and 40% used 1-2 pods/cartridges per week. In bivariate analysis, urinary TNE was higher with greater frequency (days used) and intensity (number of pods used) of e-cigarette use, e-cigarette dependence, and combustible cigarette use. In multivariable analysis, days of e-cigarette use in the last 30 days, number of pods used per week, and NNAL levels were significantly associated with TNE. There was no significant impact of e-liquid nicotine strength on TNE. CONCLUSIONS Nicotine intake among people who used pod-mod e-cigarettes increased with e-cigarette consumption and e-cigarette dependence, but not with e-liquid nicotine strength. Our findings may inform whether FDA adopts a nicotine standard for e-cigarettes. IMPLICATIONS The study examined how device and user characteristics influence nicotine intake among pod-mod e-cigarette users. Nicotine intake increased with frequency (days of e-cigarette use in past 30 days) intensity of use (number of pods used per day) and e-cigarette dependence but not with the flavor or nicotine concentration of the e-liquids. Regulation of nicotine concentration of e-liquids is unlikely to influence nicotine exposure among adult experienced pod-mod users.
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Affiliation(s)
- Jeremy Giberson
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Natalie Nardone
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Newton Addo
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Peyton Jacob
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
| | - Neal Benowitz
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
| | - Gideon St.Helen
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
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Palmer AM, Price SN, Foster MG, Sanford BT, Fucito LM, Toll BA. Urgent Need for Novel Investigations of Treatments to Quit E-cigarettes: Findings from a Systematic Review. Cancer Prev Res (Phila) 2022; 15:569-580. [PMID: 35816038 PMCID: PMC9444997 DOI: 10.1158/1940-6207.capr-22-0172] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022]
Abstract
E-cigarette use has been increasing globally over the past decade. Many use e-cigarettes as an alternative or method to quit cigarette smoking, whereas others use these products recreationally. As technology has advanced, many individuals have reported symptoms of dependence on these products and continue to use them beyond achieving abstinence from smoking. Despite individuals reporting interest in quitting, little is known about e-cigarette cessation. This systematic review sought to identify and evaluate all human subjects literature published on the outcome of e-cigarette cessation through September 2021. Of the 79 articles identified, 56 were cross-sectional, 6 were qualitative, 5 were cohort studies, 3 were experimental, 2 were mixed methods, and 7 reported intervention or case studies of e-cigarette cessation. Results showed youth generally had high intent to quit e-cigarettes, whereas results were mixed with adult samples. Youth were motivated to quit e-cigarettes by health concerns, whereas adults were motivated to quit e-cigarettes by cost, lack of satisfaction, and psychologic factors. Adults were more likely to report past e-cigarette quit attempts, most commonly "cold turkey." Few interventions tested strategies for e-cigarette cessation, with a majority targeted for youth. Given the lack of information on e-cigarette cessation, recommendations for future studies are outlined.
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah N. Price
- Department of Psychology, University of Arizona, Tucson, AZ, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Madeline G. Foster
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon T. Sanford
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Family Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA,Yale Cancer Center, New Haven, CT USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
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