Misconceptions of Vaping Among Young Adults

Prevalence of vaping, vaping-associated short-term symptoms of respiratory and cardiovascular morbidities, and factors associated with the initiation of vaping among young adults in Kuwait

INTRODUCTION

E-cigarette use or vaping is a public health concern, especially among young adults worldwide. This cross-sectional study aimed to: 1) assess the prevalence of vaping among young adults; 2) assess the prevalence of short-term vaping-associated respiratory and cardiovascular symptoms; and 3) identify factors associated with vaping status among a student population in Kuwait.

METHODS

In October 2024, a cross-sectional study enrolled students, aged ≥18 years, from various colleges of Kuwait University. Data were collected using a structured e-questionnaire administered through in-person invitations and online platforms. The prevalence (%) of vaping was computed. A multivariable log-binomial regression model was used to estimate adjusted prevalence ratios (APRs) and corresponding 95% confidence intervals (CI) for the factors significantly associated with vaping status. All the statistical tests were two-tailed.

RESULTS

Of 1144 participants, most were females (78.5%), Kuwaiti (85.5%), and aged 18-21 years (70.6%). The prevalence of vaping in our sample was 15.5% (177/1144). After adjusting for the effects of age and monthly family income (in KWD), the factors that were significantly (p<0.05) and independently associated with vaping status were male gender (APR=4.52; 95% CI: 3.28-6.22), being a student at a literary college (APR=1.50; 95% CI: 1.12-2.02), a positive belief that 'vaping is less harmful than cigarette smoking' (APR=1.46; 95% CI: 1.06-2.01), and a 'disbelief that vaping leads to cigarette smoking' (APR=1.80; 95% CI: 1.32-2.45), and 'perception about easy accessibility of vaping products' (APR=3.27; 95% CI: 1.04-10.32).

CONCLUSIONS

A moderately high prevalence (15.5%) of vaping in the study sample was recorded. Male gender and some misplaced beliefs and perceptions were significantly associated with vaping status in the study sample. The high prevalences of respiratory symptoms among the participants call for targeted interventions. If instituted, future studies may evaluate the impact of such efforts.

The Normalization of Vaping on TikTok Using Computer Vision, Natural Language Processing, and Qualitative Thematic Analysis: Mixed Methods Study

BACKGROUND

Social media posts that portray vaping in positive social contexts shape people's perceptions and serve to normalize vaping. Despite restrictions on depicting or promoting controlled substances, vape-related content is easily accessible on TikTok. There is a need to understand strategies used in promoting vaping on TikTok, especially among susceptible youth audiences.

OBJECTIVE

This study seeks to comprehensively describe direct (ie, explicit promotional efforts) and indirect (ie, subtler strategies) themes promoting vaping on TikTok using a mixture of computational and qualitative thematic analyses of social media posts. In addition, we aim to describe how these themes might play a role in normalizing vaping behavior on TikTok for youth audiences, thereby informing public health communication and regulatory policies regarding vaping endorsements on TikTok.

METHODS

We collected 14,002 unique TikTok posts using 50 vape-related hashtags (eg, #vapetok and #boxmod). Using the k-means unsupervised machine learning algorithm, we identified clusters and then categorized posts qualitatively based on themes. Next, we organized all videos from the posts thematically and extracted the visual features of each theme using 3 machine learning-based model architectures: residual network (ResNet) with 50 layers (ResNet50), Visual Geometry Group model with 16 layers, and vision transformer. We chose the best-performing model, ResNet50, to thoroughly analyze the image clustering output. To assess clustering accuracy, we examined 4.01% (441/10,990) of the samples from each video cluster. Finally, we randomly selected 50 videos (5% of the total videos) from each theme, which were qualitatively coded and compared with the machine-derived classification for validation.

RESULTS

We successfully identified 5 major themes from the TikTok posts. Vape product marketing (1160/10,990, 8.28%) reflected direct marketing, while the other 4 themes reflected indirect marketing: TikTok influencer (3775/14,002, 26.96%), general vape (2741/14,002, 19.58%), vape brands (2042/14,002, 14.58%), and vaping cessation (1272/14,002, 9.08%). The ResNet50 model successfully classified clusters based on image features, achieving an average F1-score of 0.97, the highest among the 3 models. Qualitative content analyses indicated that vaping was depicted as a normal, routine part of daily life, with TikTok influencers subtly incorporating vaping into popular culture (eg, gaming, skateboarding, and tattooing) and social practices (eg, shopping sprees, driving, and grocery shopping).

CONCLUSIONS

The results from both computational and qualitative analyses of text and visual data reveal that vaping is normalized on TikTok. Our identified themes underscore how everyday conversations, promotional content, and the influence of popular figures collectively contribute to depicting vaping as a normal and accepted aspect of daily life on TikTok. Our study provides valuable insights for regulatory policies and public health initiatives aimed at tackling the normalization of vaping on social media platforms.

Knowledge, Attitudes, and Practices of University Students Regarding the Impact of Smokeless Tobacco, Areca Nut, E-cigarette Use on Oral Health

BACKGROUND

 The prevalence of smokeless tobacco, areca nut, and e-cigarette use among university students has raised concerns regarding their potential impact on oral health. Assessing students' knowledge, attitudes, and practices toward these substances is necessary. Understanding these factors can inform targeted interventions and policies promoting oral health among this population. This study aims to investigate the awareness levels, attitudes, and behaviors of university students regarding smokeless tobacco, areca nut, and e-cigarette use and their potential effects on oral health. Identifying gaps in knowledge and misconceptions will help guide educational initiatives and public health interventions tailored to the needs of university students.

METHODOLOGY

 The study employed a designed questionnaire, comprising 20 closed-ended queries, administered via the Google Forms platform. This survey was disseminated among college students in Chennai to gather insights for the study.

RESULTS

Of the 500 college students included in the study, almost 85.5% (427) were aware of the harmful effects of smokeless tobacco on oral health. Additionally, 74.6% (373) recognized that chewing areca nut contributes to poor oral health, while 59.8% (299) acknowledged the negative impact of e-cigarette use.

CONCLUSIONS

The present study concluded that 11.1% (6) used smokeless tobacco, 18.9% (94) chewed areca nut, and 1.9% (10) used areca nut along with tobacco. Regarding e-cigarettes, 3.9% (19) indulged in vaping as a substitute for smoking regular cigarettes and 12.1% (61) used it along with tobacco cigarettes. It was also noted that 27.8% (139) were trying to quit and 12.6% (63) have tried but could not succeed. Therefore, although there was awareness of the ill effects of these deleterious habits on oral health and the increased risk of oral cancer, there remains a need to educate individuals and provide support for quitting these habits. Our study will provide insights into the present scenario of the awareness of the association between oral health and tobacco/areca nut consumption among college students in Chennai city.

[Tabacco harm reduction: the need for a paradigm shift in German tobacco control policy]

The consumption of tobacco continues to be the greatest preventable health risk in Germany. Every year, more than 127,000 people die prematurely as a result of using tobacco - one in five new cases of cancer is a consequence of smoking. Germany's current tobacco control policy, consisting of advertising bans, the promotion of smoke-free environments, and an abstinence-only paradigm, are only able to initiate slow change. Other countries have shown how the number of smokers can be reduced and deaths prevented by integrating harm reduction as a complementary measure and providing a much more active support for people who want to quit. This article first presents the current situation and current measures in Germany. Then recommendations for changes to the current tobacco control policy in Germany are derived from a look at the United Kingdom, which is considered a pioneer throughout Europe with its tobacco control policy, as well as a summary of the current state of research.

Prevalence of Electronic Cigarette Use Among Female Residents of Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study

Background Electronic cigarettes (e-cigarettes) have gained considerable popularity on a global scale, with an increasing prevalence among younger adults. The objective of this study was to investigate the prevalence, patterns, and determinants of e-cigarette use among women in Al-Ahsa, Saudi Arabia. Methodology A cross-sectional study was conducted between October 2023 and July 2024 involving 491 adult female participants. The data were collected using a structured questionnaire and subsequently analyzed using SPSS Version 26.0 (IBM Corp., Armonk, NY, USA). Descriptive and inferential statistics, including chi-square tests, were employed to assess relationships between e-cigarette use and various independent variables. Results The prevalence of e-cigarette use among participants was 17.5%. Significant factors associated with e-cigarette use included age (highest among women aged 21 to 30 years, p = 0.038), unemployment (p = 0.011), perceived poor health (p = 0.002), and having friends or family members who use e-cigarettes (p = 0.001). The primary reasons for using e-cigarettes were influence from friends (70.9%) and family members (54.7%), curiosity (33.7%), and appealing flavors (30.2%). A considerable proportion of users reported experiencing dependence and difficulty quitting. Conclusions The prevalence of e-cigarette use among female residents of Al-Ahsa is influenced by a complex interplay of social, demographic, and perceptual factors. The findings underscore the necessity for comprehensive interventions targeting social environments and educational initiatives and addressing misconceptions about the potential risks of e-cigarettes.

E-cigarette use among university students in Palestine: Prevalence, knowledge, and determinant factors

BACKGROUND

Recent reports indicated accelerated rates of e-cigarette use, especially among youth in various Middle Eastern countries, including Palestine. Nevertheless, little is known about knowledge, attitudes, and perceptions regarding this topic in Palestine. This study aimed to assess the prevalence of e-cigarette use among Palestinian university students, along with their knowledge, attitudes, and perceptions about e-cigarette use.

METHODS

An observational cross-sectional study, utilizing an online self-administered questionnaire, was conducted on Palestinian students from five universities between 17/04/2023 and 04/11/2023.

RESULTS

A total of 1002 Palestinian university students completed the questionnaire. The prevalence of e-cigarette use among students was 18.1%. The mean knowledge score about e-cigarettes was significantly lower among the users of e-cigarettes compared to non-users. E-cigarette use was significantly associated with the participants' smoking status. Among e-cigarette users, 43.6% were also current traditional cigarette users, and 66.9% were current waterpipe users. E-cigarette use was significantly associated with having a friend who is a smoker and/ or a smoking mother. Binary logistic regression revealed a significant positive effect between the participant's smoking status, the mother's smoking status, knowledge about e-cigarettes, and the use of e-cigarettes (p-value < 0.05). Among e-cigarette users, 18.8% used them in indoor places at the university, and 25% reported using them daily in the past month. Affordability of e-cigarettes was the most reported reason for their use (47.5%).

CONCLUSION

This study concluded that e-cigarette use is prevalent and rapidly rising among university students in Palestine. This is worrisome as it is significantly associated with insufficient knowledge about the adverse health effects of E-cigarette use, and its addictive nature. These findings focus on the importance of improving the students' knowledge about e-cigarette use by implementing educational campaigns and considering age regulations on e-cigarette availability and use.

Immigration status-related exclusive e-cigarette use and cannabis use and their dual use disparities associated with mental health disorder symptoms

INTRODUCTION

E-cigarette and cannabis use has been linked to various health risks, including respiratory and cardiovascular conditions. Yet, extant knowledge about the risk factors for exclusive and dual use of e-cigarettes and cannabis is limited, especially among immigrants. We examined exclusive e-cigarette and cannabis use and their dual use associated with mental health disorders among immigrants and U.S.-born.

METHODS

We analyzed national cross-sectional data collected between May 13, 2021, and January 9, 2022, among adults aged >18 years (n= 4766) living in U.S. Multinomial logistic regression analyses were conducted to model the associations of exclusivity and dual-use (reference group= non-use) with anxiety/depression.

RESULTS

The dual-use prevalence was higher than exclusive e-cigarette and cannabis use, especially among U.S.-born (dual use= 14.79% vs. cannabis use= 13.53% vs. e-cigarette use= 7.11%) compared to immigrants (dual use= 8.23% vs. cannabis use= 5.03% vs. e-cigarette use= 6.31%). Immigrants had lower risks of exclusive cannabis and dual use compared to U.S.-born. Anxiety/depression was associated with higher risks of exclusive cannabis use and dual use across immigration status, but was associated with exclusive e-cigarette use among only immigrants. While effect sizes of dual-use associated with anxiety/depression were higher among U.S.-born, the effect sizes of exclusive e-cigarette and cannabis use associated with anxiety/depression were higher among immigrants.

CONCLUSIONS

The findings revealed significant mental health risks for e-cigarette, cannabis, and their dual use among immigrants and U.S.-born, especially among U.S.-born. These findings highlight the need for public health research and interventions to consider immigration status-related disparities in substance use.